Medical copter hits hospital; 2 hurt


A medical helicopter practicing approaches crashed on the roof of a hospital Thursday, catching fire moments after the two people on board escaped with minor injuries, a fire official said.

The pilot and passenger were in stable condition, said Richard Breon, president and CEO of Spectrum Health.

No patients were aboard the chopper, which crashed about 11 a.m. on a helipad atop Spectrum Health Butterworth Hospital. The helicopter landed on its side, and the two people got out before it caught fire, Fire Chief John VanSolkema said.

“There’s not a whole lot left, but you can tell it was a helicopter,” VanSolkema said.

Elizabeth Isham Cory, a spokeswoman for the Federal Aviation Administration in Chicago, said the helicopter was practicing approaches at the time of the crash.

Proposed EMTALA Regulation Changes to Affect On-Call Programs

The CMS EMTALA Technical Advisory Group (TAG) has recommended that hospitals establish a formal “community call arrangement.” A community call plan would help to ensure compliance with EMTALA obligations, and eliminate problems with the current system wherein there is a shortage of physicians of various specialties, or where a continuous on-call obligation is often placed on a single physician.   

The regulation change will result in a reorganization of all patient services from the hospital level to the street level. For example, regional groups of hospitals will have to collaboratively determine the best sources for specific types of patient care. Likewise, EMS authorities and services will have to revise and update their protocols to include a process to acquire and update information for their crews as to the best destinations for patients.   

According to the recommendations, a specific hospital in a region would “be designated as the on-call facility for a specific time period or for a specific service, or both.”  

Transfer of unstable patients requiring care by the on-call specialists would occur in accordance with the community call plan; EMTALA would continue to apply to the patient until stabilization at the second hospital occurs. 

For additional information about the proposed regulation change, please read Dr. Chase’s full article on the subject:

Consumers Union’s New Hospital Comparison Service

From the Wall Street Journal:

The nonprofit Consumers Union is launching a new hospital-ratings service, adding to the growing competition to provide online consumer information about health care.

The Consumer Reports online hospital service will include around 3,000 facilities. Consumers will be able to see a graph showing how intensely each hospital tends to treat patients, on a scale from zero for the most conservative to 100 for the most aggressive. Intensity of care is based on time spent in the hospital and the number of doctor visits. The index reflects the hospital’s handling of nine serious conditions, including cancer and heart failure, when it treats patients in the last two years of life.

Child Health

From US Today:

(Point of Pride: Iowa is #1!)

Only 46% of kids visit the doctor and dentist at least once a year in Idaho, but 75% of Massachusetts children do. Infant mortality rates are 2.5 times higher in the District of Columbia than in Maine. And South Carolina kids are 5.7 times as likely to wind up in the hospital for asthma as those in Vermont.

These measures of children’s health are part of a report out today by The Commonwealth Fund, a private foundation that studies health issues and supports efforts to cover more people. The report found that top-performing states tend to have lower rates of uninsured children than those ranked at the bottom but also have higher health costs.

Ill. bill to limit charging of uninsured moves ahead

From Modern Healthcare (requires free subscription)

The Illinois General Assembly is poised to pass a bill that would limit what hospitals could charge and collect from eligible uninsured patients. A bill carrying an amendment dubbed the Hospital Uninsured Patient Discount Act was passed unanimously by the House and is expected to clear the Senate.

Specifically, hospitals could charge no more than 135% of costs for medically necessary care. To be eligible, the patient would have to be an Illinois resident and make no more than six times the federal poverty level, or half that amount in rural and critical-access areas. The hospital would be barred from collecting more than 25% of a patient’s income each year unless the patient has assets that exceed the income levels described in the eligibility guidelines, not counting a primary residence or retirement funds.

New Proposed EMTALA Regulations Issued By CMS


New proposals for EMTALA rules issued April 30.

Just days after new site review guidelines went into effect in April, CMS issued proposed new regulations that would implement some recommendations of the EMTALA Technical Advisory Group (TAG) that were issued before the committee went out of existence last year. 

Among the proposals:

  1. Move the on-call requirements of the regulations from the regulations section pertaining to emergency responsibilities of hospitals to the section pertaining to terms of the Medicare Provider Agreement.  Contrary to the procedural intent of the industry advocates supporting the move, CMS’s proposed regulation would retain on-call violations as an EMTALA violation.  The industry goal had been to move on-call violations into the general conditions of participation process and out of the EMTALA enforcement process.
  2. Clarify that even though a patient has been admitted, hospitals with higher levels of care are required to accept the transfer of a patient with an emergency medical condition that remains unstabilized, even though the admission ends the sending hospital responsibilities under EMTALA.  CMS is also asking for comments on whether the rule should also apply to any in-patient, such as one that suffers a deterioration in condition while in the hospital for an elective procedure.
  3. Allow hospitals to meet their on-call obligation by participating in a formal community-wide on-call system, but a patient presenting to the “wrong” hospital would still be subject to EMTALA requirements and could not be moved to the “on-call hospital” without full EMTALA compliance.


From Edwin Leap:

Our emergency department electronic charting system is now going to start listing as separate categories allergies and intolerances.  It makes sense, really.  How many times are we told ‘he’s allergic to Lortab…it makes him act all crazy!’  (Never mind that he might have been a wee bit crazy to begin with.)  ‘She can’t take Motrin, it makes her stomach hurt.’  ‘I can’t take steroids…I’m allergic to them and get swollen, hungry and irritable.’


From the Wall Street Journal Health Blog:

They call the overnight doctors “nocturnists,” though as far as we can tell they’re basically hospitalists who work at night. As of last year, about 1,200 hospitals had either a nocturnist or hospitalist sharing night coverage, compared with 700 hospitals in 2003, according to the Society of Hospital Medicine.

After Taser Shot, Fugitive’s Irregular Heartbeat Becomes Normal

From the Wall Street Journal Health Blog:

A 28-year-old man with a history of mental problems fled from the cops and spent 40 minutes hiding in a lake before they collared him and hauled him to the ER.

His body temperature had fallen to a chilly 89 degrees. Docs found speed and cocaine in his blood, and an ECG showed an irregular heartbeat.

Then things turned ugly. The guy got agitated, ripped off his electrodes and tried to pull out his IV. A cop stepped in and gave him a jolt to the chest with a Taser, and the suspect’s heart soon went back into a normal rhythm.

“We Need Free Trade in Health Care”

A Wall Street Journal Opinion Piece

Comprehensive coverage of the over 45 million uninsured today will require that they can access doctors and related medical personnel. An IOU that cannot be cashed in is worthless.

Massachusetts ran into this problem: Few doctors wanted (or were able, given widespread shortages in many specialties) to treat many of the patients qualifying under the program. The solution lies in allowing imports of medical personnel tied into tending to the newly insured.

This is what the Great Society program did in the 1960s, with imports of doctors whose visas tied them, for specific periods, to serving remote, rural areas. U.S.-trained physicians practicing for a specified period in an “underserved” area were not required to return home.