Worried patients who received one of the tainted steroid injections linked to the deadly fungal meningitis outbreak continue to trickle into area hospitals for examinations.

While the numbers have slowed considerably, both Carilion Clinic and LewisGale Regional Health System report a small, but steady stream of emergency room visits related to the outbreak that has killed 28 and sickened 377 in 19 states.

So far this week, five patients have arrived at one of four LewisGale emergency rooms, said spokeswoman Joy Sutton. One person was admitted for treatment after a spinal tap tested positive for meningitis, she said.

At Carilion, about two patients a day arrive to be evaluated and most recently, they have not been testing positive for meningitis, spokesman Eric Earnhart.

As of today, public health officials have confirmed 46 cases and two deaths in Virginia linked to the outbreak. The official count, which has continued to grow, has lagged behind the numbers seen at area hospitals as health department officials verify that the cases are tied to the outbreak. Read more »

Medicare made a mistake.

In calculating the fines hospitals must pay for having too many patients readmitted within 30 days of being discharged, the government used some old data, according to NPR and Kaiser Health News.

It means that hospitals run by LewisGale Regional Health System and Carilion Clinic, are subject to slightly higher penalties, than what I previously shared on this blog.

“The changes were tiny, averaging two-hundreds of a percent of a hospital’s regular Medicare reimbursements,” Kaiser reported.

See a list of penalties by hospital all of the penalties here.

Starting today, Medicare is fining hospitals that have too many patients readmitted within 30 days of being discharged.

The penalties are relatively small, with the Associated Press reporting the average amounts to about $125,000 per facility. But the broader implication is part of a national push to reduce hospital spending and improve the quality of health care by eliminating what have been labeled as unnecessary hospital readmissions.

The penalties are part of President Barack Obama’s Affordable Care Act.

This year, the penalty is capped at 1 percent of a hospital’s Medicare reimbursements. Most hospitals will pay less. In coming years, the maximum penalties will increase to 2 percent and then 3 percent.

“The smallest penalties are one hundredth of a percent, which 50 hospitals will receive,” reported  Kaiser Health News, an arm of the Henry J. Kaiser Family Foundation.

In Southwest Virginia, the penalties range from hospitals that are being not penalized to LewisGale Hospital Pulaski, which received the maximum 1 percent penalty, according to the data collected by Kaiser.

According to Kaiser, the Carilion Clinic and LewisGale Regional Health System hospitals being penalized are:

• Carilion New River Valley Medical Center, 0.7 percent
• Carilion Roanoke Memorial Hospital, 0.06 percent
• Carilion Tazewell Community Hospital, 0.49 percent
• LewisGale Hospital Alleghany, 0.25 percent
• LewisGale Hospital Montgomery, 0.34 percent
• LewisGale Hospital Pulaski, 1 percent
• LewisGale Medical Center, 0.61 percent

Carilion needed money.

The health care giant was on the verge of announcing its plans to convert to a clinic, and its flagship hospital in Roanoke was in the midst of a $105 million expansion. More cash was necessary to pay outstanding debt and buy expensive new medical equipment.

The nonprofit decided to borrow money, even with a multimillion-dollar surplus at its disposal.

Just how Carilion raised that money turned out to be a costly mistake.

Seven years later, Carilion is still tallying how much it lost in a series of complex financial transactions related to the $308 million in tax-exempt bonds it issued on Dec. 14, 2005. But in court papers, the losses were pegged at “many millions of dollars.”

Read the rest of the story and share your comments or ask questions below.

Carilion Clinic will open two new operating rooms in Roanoke to meet outpatient surgical needs, and specifically to target dental surgeries.

State Health Commissioner Karen Remley approved the two new operating rooms at Carilion Roanoke Community Hospital, specifying that they must be able to “provide ready access to dental procedures for Medicaid-reimbursed pediatric patients.”

Read more about the $4 million project here.

If my email inbox is any indication, a lot happened during my week off. While I sort through the tips and press releases, I thought I would point out a few stories as a way to begin catching up:

• The Virginia Department of Health confirmed, as of  Tuesday, five cases of West Nile Virus in the Commonwealth. Meanwhile, the state public health officials have joined the national plea for people to avoid mosquito bites as a way to prevent the disease. Among the health department’s hints are to use insect repellent, wear long sleeves and pants at dusk and dawn, and eliminate  standing water to deter mosquito breeding areas from forming in your yard.
• The Edward Via College of Osteopathic Medicine announced plans to open a second branch campus. The latest addition to the private Blacksburg-based school will be in Alabama and is expected to open by 2015. The  college’s first branch campus welcomed its second class in South Carolina earlier this summer.
• A community health survey released last week by Carilion Clinic revealed some local residents need better access to medical care, more nutritious food, increased health education and opportunities to build their physical fitness. The findings didn’t surprise those who conducted the survey, my colleague Neil Harvey reported. Read the entire executive summary.
• Finally, if you missed it, I posted an entry earlier today on Anthem Blue Cross Blue Shield of Virginia’s plans to open four four medical offices as a way to begin providing health care directly to Medicare recipients.

Carilion Clinic’s MyChart, an online personalized health management tool for patients, is now available as a mobile app.

MyChart launched in 2008 as a secure online program for Carilion’s patients to see test results, email doctors, view upcoming appointments and check immunization and medication records.

Since the number of patients using the system has grown to about 20,000 people, said Carilion spokeswoman Allie Buth. Read more »

Carilion Roanoke Memorial Hospital is full today forcing the flagship hospital for Carilion Clinic to not accept adult patient transfers from other hospitals.

Transfer patients are being sent to other hospitals, said Carilion spokesman Eric Earnhart.

The hospital’s emergency department, however, was operating as normal and continued to accept EMS traffic, Earnhart said.

Additionally the hospital, which is the region’s largest and the only Level 1 trauma center in Southwest Virginia, has continued to accept trauma patients, children and mothers in labor, Earnhart said.

Carilion previously reported it was full and needed to divert patients in September 2011 and attributed that situation to an overall increase in patients.

“It’s been busy here lately,” said CEO Nancy Agee last year. “We’ve gained some market share and there has just been a lot of activity.”

Earnhart said the situation was similar today with hospital officials not identifying a specific illness or medical reason for the full hospital. He said the hospital’s decision to divert transfer patients will be re-evaluated later today.

In the aftermath of the derecho, several hospitals and nursing homes relied on generators as Appalachian Power Co. worked to restore power.

It took hours in some cases and days for others.

In all nine hospitals in Southwest Virginia lost power including, according to the Virginia Department of Health:

• LewisGale Hospital Alleghany
• Carilion Giles Community Hospital
• Carilion Franklin Memorial Hospital
• Memorial Hospital of Martinsville & Henry County
• Catawba Hospital
• Lynchburg General Hospital
• Virginia Baptist Hospital
• LewisGale Hospital Pulaski
• Bath Community Hospital

All the hospitals had power restored by Monday. Giles hospital was on generator power until Monday, said Carilion Clinic spokesman Eric Earnhart. The hospital in Pulaski, however, didn’t lose power during Friday’s storm but in the subsequent storm that hit just after midnight Monday, LewisGale spokeswoman Joy Sutton said.

Throughout the region that stretches from Roanoke west to the New River Valley and east to Lynchburg, 18 long-term care facilities went dark or had to rely on generators for power. At one point, Roanoke officials discussed the possibility of evacuating Friendship Retirement Community’s nursing home.

These major health care providers will be adding up the costs of the storm over the next couple of weeks.

LewisGale Regional Health System provided me with an early indicator of the cost at the two hospitals that lost power by looking at the fuel costs. In Pulaski it cost $667 to run on generator power for 11 hours and 30 minutes. In Alleghany the cost of running the generator for 9 hours and 30 minutes was $1,515.

Hospitals in the Roanoke and New River Valley experienced an influx of patients coming to emergency rooms in the aftermath of Saturday’s storms.

LewisGale Medical Center saw 345 patients in its ER from Saturday to Sunday, compared to a typical volume of 250 patients, said LewisGale spokeswoman Nancy May. That’s a 38 percent increase.

The Salem-based hospital attributed most of the ER visits to the storm, she said.

Carilion Clinic also saw demand for its hospitals’ emergency services increase between 4 percent and 8 percent across the region, said spokesman Eric Earnhart.

At Carilion Roanoke Memorial Hospital, the region’s busiest hospital, slightly more than 500 patients visited the ER from Saturday to Sunday, he said.

“I can’t say how many were storm related, but a lot of the traffic was related to the storm, including patients received or diverted from other facilities,” he said.