Update

11/10/2015

For those new to this blog site, at present there are 5 posts on the blog and each has its own set of comments. To read the comments you have to hit the word "Comments" at the beginning or end of the post. Somewhat confusing is that when you bring up the comments for a specific post it eliminates the other posts from the screen. To bring the other posts back up simply go back to the top of the page and click on Blog. Finally, to understand the development of the blog it is best to read it from the bottom post (Dr. Paul Kearney Case) up.

Okay folks, just another talking point that has relevance to the Dr. Paul Kearney case. The State of Kentucky Attorney General Jack Conway has ruled that, because the Kentucky Medical Services Foundation (KMSF: a nonprofit entity that pays all UK doctors) was created by UK and remains under its control, it is by definition a public agency and is subject to the state's Open Records Act. You may ask, “What relevance does this have to the Paul Kearney case?” To begin with, many believe that it was Dr. Kearney’s audacious request of an audit of KMSF at a College of Medicine Faculty Council meeting that initiated the cascade of punitive measures taken by the hospital administration against Dr. Kearney. During that meeting Dr. Michael Karpf, the executive VP for health affairs, threatened Dr. Kearney after this request. Secondly, the Dan Ross case cited below suspiciously points to illegal use of KMSF administered hospital revenue to fund state research initiatives, and lastly, these issues would have never made it to the state attorney general’s office if it wasn’t for the simple fact that KMSF and the lawyers at UK were resistant to either releasing these public records or highly selective to both whom they release the public records to as well as which records they are willing to release. The UK lawyers have yet to decide whether they will appeal this decision, and my guess is that they will put it off for as long as possible or at least until the new Attorney General, Andy Beshear, takes office in January.

I hate to beat a dead horse, but does it not seem strange that the University’s hospital administration and the attorneys for this public taxpayer financed institution should be so resistant to (one might say scared of) an audit of their financial practices? As I pointed out in my letter to President Capilouto, “If you want to silence some of those critics and "ill-informed rants" have a public audit performed on hospital and KMSF finances for the past 10 years.” I know as a taxpayer of this state that I would like to know that my taxes are supporting a public institution with integrity.

Feel free to comment with your thoughts on the matter. The URLs for 3 documents relevant to this situation are below.
http://www.kentucky.com/2015/11/09/4130017/attorney-general-medical-foundation.html

http://ag.ky.gov/civil/orom/2015/15ORD205.doc

https://cases.justia.com/kentucky/court-of-appeals/2011-ca-000433-mr.pdf?ts=1388761332

16 Comments

Shirley Satan

11/11/2015 12:26:38 pm

Hey Dan, I can’t fathom why you would think they would have something to hide. I mean they are always so open and forthright about all that they do, and you have to know that these lawyers at UK wouldn’t try to cover up any illegal activities or pay off any potential threats. After all those years you spent working for these kind and gentle people, you should be ashamed to even propose the possibility that something outside the law could have occurred with respect to the management of the hospital revenue. I mean the paltry salaries and bonuses these administrators are making surely suggest they would never endorse anything dishonest. As I look up on all of the joyous and happy faces working in the medical center I can’t for the life of me understand your concern. I truly believe there is a special place for these kind administrator folks when they are gone, and I look forward to shaking the hands of each and everyone of them.

More importantly, Happy Veterans Day Dan and thanks for serving.

Dan Noonan

11/12/2015 12:50:07 pm

Hi Shirley, Thanks for the comment. You may be right, I may have been too harsh on them. I hope I did not hurt any of their feelings, especially those nice and considerate lawyers. I was only thinking, gee isn’t this university part of the United States of America ….. that country I went to war for? You know, free speech, innocent till proven guilty, trial by jury and all that. My bad, I failed to recognize that these freedoms do not apply at the empire of UK. They seem to make their own laws and at least in the Hospital and College of Medicine it is simply shut your mouth or trial by administration. I will try to be a little more compassionate in my next post.

iRobot

11/14/2015 10:56:07 am

You have to be wrong about these generous hospital administrators Dan. Just this week they showered us with gifts in appreciation for all that we do. We were given beautiful T-shirts and they even bought breakfast for those able to find the time to go get it. Morale is skyrocketing, and I will be back shortly with more good things to say as soon as they update my program and give me the A-Okay.

11/16/2015 06:53:46 pm

Thanks for the comment iRobot. It really sounded a little too ….. programed to me, but what do I know. At any rate, I feel certain Mike and the boys would endorse it and I think your job is safe. Keep up the good work and continue to monitor the blog.

Nooney_Tunes

11/19/2015 11:28:51 am

Yeah..lets go back to the good old days when David Watt and Joe Claypool were running the hospital. Karpf out!

11/19/2015 12:36:58 pm

Thanks for the comment Mr. or Ms Tunes. Personally I would prefer to move up to the good new days and get someone in there with integrity, is less arrogant, less threatening, less manipulative and recognizes that this is a state funded academic institution and not a research institute or private hospital.

looney nooney tunes

11/26/2015 01:48:02 pm

Do you actually think UK is a "state funded" institution? Or maybe you think that the 8% of the operating budget that comes from the state was somehow being used to support the "faculty salary lines" that you like to believe existed when you were working there?

In contrast, the state provided its flagship university a mere 8 percent of UK's total budget, the lowest percentage ever. State funding to UK has been cut $55 million since 2008 and now stands at $280 million a year.

Read more here: http://www.kentucky.com/news/local/education/article44604042.html#storylink=cpy

11/27/2015 12:40:42 pm

Thanks for your blog post Looney. To begin with I have read this Herald Leader article and the most relevant statement made in this article with respect to this blog is its 2nd paragraph.

“With its labyrinth of new buildings for patients, UK HealthCare has grown to a $1.3 billion enterprise, an increase of more than $200 million over last year. The health care division now accounts for 41 percent of the university's budget.”

We appear to have a hospital administration intent on bankrupting the university. Sound familiar UCLA?

This brings to mind a hospital/College of Medicine budget meeting I attended a couple years ago. While discussing the burgeoning financial problems we were experiencing, Darrell Griffith, the head of KMSF, presented evidence to support the observation that greater than 50% of the billable hospital charges were never getting billed. Of course like any experienced overpaid administrator, Mr. Griffith found a way to blame the physicians for this oversight. Hmmmm, I believe I still have the slides for this meeting. If I can find the pdf file I will add it to the post. The bottom line being we could more than double the income from patient care by simply having competent leadership in the hospital.

Finally, I would just like to add that if you feel $280 million taxpayer dollars is trivial I can only guess we will shortly see your name in the presidential race. These taxpayer dollars are primarily provided to pay salaries and utilities, not to build buildings.

11/28/2015 07:11:41 am

So as I understand it you think that UK Healthcare is badly run and has to somehow drain money from the university in order to fund construction. And presumably this is the malfeasance that will be "revealed" by the much awaited KMSF audit. Where does this "university" money actually come from? State support? Tuition? Athletics? Extramural research support? How much money do you think UK Healthcare has taken exactly? Would this be more than the funds that UK Healthcare contributes to the operating costs of the COM?

The problem with the UK COM vs UK Healthcare situation is that the research and academic side is so weak that its been powerless to stand up to Dr Karpf when he favors investment in the Healthcare enterprise of research and academic programs. The reason he left UCLA was that this wasn't the case at a top public academic medical center and there was considerable coordinated push-back against him which made his position untenable when accomplished people who could leave the institution if they wanted went around him and over his head to get things they wanted.

At UK, the best we can manage is this silly blog and irrelevant people like Paul Kearney and Davy Jones stirring up trouble.

Bottom line- UK and Karpf deserve each other.

On a more constructive note, can you help me identify an academic medical center/public or private, where the academic mission and healthcare enterprise function in harmony? Or do you somehow think you can have a college of medicine and an academic medical center without a hospital. How would that work exactly?

11/28/2015 09:08:49 am

Thank you Mr./Ms Tunes for once again presenting the administration’s perspectives of the situation in the hospital and College of Medicine. I feel that this is important and needs to be included in the blog. Furthermore, I think your statement:

“At UK, the best we can manage is this silly blog and irrelevant people like Paul Kearney and Davy Jones stirring up trouble”

clearly illustrates the concern I and others have with respect to the current administration. This view that everyone working at the College and hospital (of course with the exception of the administrators themselves), and especially anyone with the audacity to challenge the status quo are viewed as “irrelevant people” says it all.

I suppose we could all be good sheep and simply let the administration do whatever it wants whenever it wants to, but luckily for everyone living in it, this country has a tradition of challenging the status quo when it needs to be challenged.

I can fully appreciate the complexities of trying to manage the financial problems associated with meeting the needs of the university, its hospital and its academic goals, but there is a right way and a wrong way of doing this. Who knows, we may be wrong about KMSF and our concerns with money mismanagement issues being discussed here, but concentrated efforts to either pay off or silence anyone investigating these issues only fans the flames. Furthermore, because this is the University of the state of Kentucky, a “public institution”, and we are taxpayers that provide some of the $280 million dollars to support it, we have that right (and some believe the obligation) to challenge this status quo at times when we feel it is being either unethically or illegally managed. Again, the easiest solution to this problem is a 10-year audit of the hospital and College finances.

I owe nothing to Dr. Kearney and would have personally never gotten involved in this if the administration had used a reasonable approach to their concerns with Dr. Kearney’s behavior. I would hope that even you might have viewed the approach used to be extreme and prejudicial. Defamation of character, trial without a jury and banishment from the university clearly reeks of some ulterior motive, and for nothing other than these it needs to be challenged.

Finally, I must state that I disagree with your “Bottom line”. I feel UK deserves much better than Dr. Karpf. I feel the best gift Michael Karpf could give this University, hospital and College would be his retirement.

Nooney Tunes (Mrs)

12/8/2015 03:16:12 pm

The reason Mike Karpf left UCLA was not that he bankrupted the place, it was that he did what he has done at UK which is to prioritize spending on their Healthcare enterprise over investment in research and academic pursuits. The stories about his mismanagement of the UCLA hospital are just the product of the same sort of busy bodying and rumor mongering that you and your cronies are doing here. The difference is that UCLA is apparently the #5 public institution in the country and the #3 public academic medical center so when people started complaining and threatening to leave because they didn't like Mike Karpf the administration listened. I am sure part of the attraction of UK to Mike was that the "academic" side of things is so weak that nobody would take any pushback seriously. And to make things even easier to manage UK has operated with a series of puppet Deans to create the illusion that someone else is managing the research and academic programs.

And so here we are.

Do you really think I'm wrong about this?

Geo

11/23/2015 12:45:48 pm

11/24/2015 02:31:41 am

Hi Geo, Was there something you wanted to say?

11/26/2015 09:49:12 am

Hi again Dan. Happy Thanksgiving. My question is: Why do you think it is that when you go to the UKy Human Resources page and look at jobs available at UKy Medical Center one observes over 100 registered nurse position openings and over 100 other assorted job openings in the Medical Center? There are even something like 5 positions open in the EVPHA's office. Thanks for starting this blog.

11/27/2015 03:59:23 am

Hi Geo, Thanks for the post. I am not certain I have an answer for you but I would be happy to speculate. I suspect if you asked the administration you would be told it was because of all of the expanding they have been doing, and to a limited extent I suspect it is. But there are a couple things that tend to make me think it is more than this. The first is a brief conversation I had with a human resources person from Central Baptist. This person asked “what’s going on over at UK? We are getting a lot of applications from UK hospital people and we can’t come close to matching their benefits package.” The other is the morale situation being discussed above.

I personally believe it all reflects back on the priorities of the current administration in both the hospital and university. As mentioned previously, these administrators clearly feel that the buildings at UK are much more important than the people working in them. Before I retired last year it became clear to myself and many others that the current administration at both the hospital and College of Medicine were attempting to create a puppet government and were using intimidation tactics to silence detractors. It began with the internal appointment of Fred deBeer as COM Dean and he in turn has internally appointed perhaps up to 15 new Chairs. Price Waterhouse Cooper was paid close to a millions dollars to sanction a reorganization that prioritized reducing salary load as one of the primary ways to generate the 500 million dollars needed to finish off Michael Karpf’s legacy, the new hospital. Interestingly, the salary load that was targeted was not at the upper administration level (that has actually increased) but rather at the staff level. What resulted from this investment was the formation of Integrated Business Units (IBUs) or I B Useless as many of the employees are now calling them. The real gist of these units was the opportunity to legitimize reorganization and more specifically “downsizing”. The bottom line is that there are a lot of scared people working at the hospital and College. This unfortunately appears to be what they want, because as we all know, scared people work harder and keep their mouth shut. The one thing they don't seem take into consideration or care about is that scared people also leave.

So I leave it up to you Geo to cogitate on these and any other explanations folks may wish to offer for your observations/questions. Thanks for adding to the blog and I hope you and your family had a peaceful and joyous Thanksgiving.

Mrs LT

1/14/2016 02:02:16 pm

https://www.uky.edu/EVPFA/Controller/Docs/2014SignedKMSFFinancialStatements.pdf

Presumably whatever financial information you want to see about KMSF is not contained in these published financial statements. Can someone explain to me exactly what you think is missing?

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