HOSPITAL DIVERTS JOBS FOR NURSING ST. ANTHONY'S CUTS 25 AND TRANSFERS OTHERS TO ADDRESS CARE SHORTAGE.(Business) - Rocky Mountain News (Denver, CO)

Byline: Michael Perrault News Staff Writer

St. Anthony Central Hospital is cutting administrative and support jobs and shifting other positions to funnel more money to bedside nurses and other patient-care jobs.

But the 500-bed Denver hospital, founded in 1892 to care for Colorado's gold rush settlers, has job openings for some 85 nurses, 52 technical specialists and 19 patient-support jobs - the most difficult positions to fill for hospitals across the metro area.

``We're still hiring,'' said hospital spokeswoman Bev Lilly, who declined to say how many non-patient-care jobs are being trimmed.

Like other hospitals in the Centura Health system, St. Anthony Central's costs for salaries and benefits have spiraled, in part because of high-cost temporary staffing resulting from the Denver area's chronic nursing shortage.

``Looking to the future and to stay proactive in the current health-care climate, we have made moderate reductions in staff,'' Lilly said.

``Because of the size of our (Centura Health's) health-care system, we have successfully transferred many of those staff members to other positions or other facilities, so this has resulted in affecting less than 25 staff members at St. Anthony Hospital.''

Centura, Colorado's largest health-care system with 10 hospitals and numerous senior and home-care hospices along the Front Range, saw its salary and benefits expenses jump more than 13 percent in fiscal 2001, with temporary staffing costs for nurses taking a significant toll.

In addition to 85 nurse vacancies at St. Anthony Central, Centura needs 100 nurses at Porter Adventist Hospital, 38 at St. Anthony North in Westminster, 34 at Littleton Adventist, and 126 at Penrose-St. Francis in Colorado Springs, according to job postings listed Friday on Centura's Web site.

Centura's St. Anthony hospitals also were hit with a 73 percent increase in charity care for the poor and uninsured during fiscal 2001 compared with a year earlier. System wide, Centura's hospitals tallied $113 million in unreimbursed care during the fiscal year, said Joseph Swedish, president and chief executive officer of Centura Health.

This year, Centura expects its pharmaceutical costs to increase an average of 16 percent and supply costs to increase about 5 percent, despite ``aggressive cost-control measures,'' Centura officials said.

In fiscal 2001, Centura posted nearly $1.1 billion in revenue, earning $141 million in net income and solidifying a financial turnaround from several years ago. But Centura remains aggressive about controlling operating costs, even as it invests $190 million to expand Littleton, Avista, St. Anthony North and St. Thomas More hospitals and to build a new hospital in Douglas County.

``We are facing sizable challenges in the future that will require a fiscally stable organization,'' Swedish said.

Executives from Colorado's hospitals, educators and government officials have come together in recent months to seek solutions to the growing nursing shortage. Initiatives such as the Colorado Center for Nursing Excellence aim to address a shortage for registered nurses that could reach 35,000 in Colorado by 2006, according to the Colorado Department of Labor.

Resolving the shortage will take more than merely pumping dollars into recruiting, said Robert Espinosa, a spokesman for the Service Employees Union in Colorado, which represents several thousand health-care workers.

``It's as much a retention issue,'' Espinosa said.

Colorado's Largest Hospital System Balks on Discounting Services to Uninsured. - The Denver Post (Denver, CO)

Byline: Marsha Austin

Dec. 16--Colorado's largest hospital system has backed out of a plan to discount services to the uninsured, patient advocates said Monday.

Last spring, Centura Health told two nonprofits that it would offer uninsured patients the same discounts health plans get, which would result in potentially thousands of dollars in savings for individuals.

But after months of negotiations with Los Angeles-based civil rights group Consejo de Latinos Unidos and the Colorado Consumer Health Initiative, Centura has decided not to commit to the price breaks.

'We recognize the problem, but we want to address it in a thoughtful way,' said Pam Nicholson, Centura vice president of advocacy.

Giving the uninsured discounts may violate several federal laws, including one that bars hospitals from using financial incentives to draw customers and another that prohibits them from charging different prices for the same care, Centura's attorney Chris Ordelheide said.

K.B. Forbes, Consejo's executive director, called the hospital's decision 'blatantly wrong for the No. 1 hospital chain in Colorado, one that calls itself faith-based, to say, 'We are going to continue our discriminatory practices of price gouging,' ' Forbes said.

All Centura had to do to alleviate legal concerns was follow in the footsteps of hospital giant Tenet Healthcare Corp. and say its pact with the uninsured would be enacted pending government approval, Colorado Consumer Health Initiative advocate Lorez Meinhold said.

Patient advocates simply want Centura to commit to charging uninsured patients 'a fair and reasonable rate,' she said.

Centura is considering changes to its bill-collecting practices, including eliminating tactics like putting liens on patients' homes and suing patients who are unemployed or unable to pay.

Centura also is developing a plan to provide financial assistance to patients with income of no more than 400 percent of the poverty line, or about $73,600 for a family of four. At this level, more than 80 percent of the uninsured would qualify, Nicholson said.

Hospitals, including Centura, typically charge uninsured patients who don't qualify for charity care full price for treatment, which can be up to five times the rate hospitals are reimbursed for insured patients, a Denver Post investigation of court records found in January.

Forbes says Centura's proposed policy changes don't go far enough toward easing the financial burden of the uninsured.

Centura approached Forbes in February, after he teamed up with the Colorado Consumer Health Initiative to run a series of radio advertisements, recruiting patients who had been harassed by hospital bill collectors and those who thought they had been overcharged.

'They said, 'We are going to correct this,' ' he said.

Forbes is running a national campaign to eradicate aggressive collection practices and negotiate what he says are fairer prices for uninsured patients.

Around the time Forbes began working with Centura, Consejo secured an agreement with Santa Barbara, Calif.-based Tenet, in which the 101-hospital chain agreed to discount uninsured patients' bills and to not place liens on homes or to sue patients for unpaid bills.

Tenet has since implemented the new bill-collection practices and is waiting for federal approval of its price discounts, Tenet spokesman Steve Campanini said.

Forbes gave Centura executives a copy of the Tenet compact, and they developed a similar policy that incorporated the faith-based values of the joint Catholic-Adventist venture.

Forbes and Meinhold reviewed the document in June, and in October, the groups were planning the announcement of the new policy. But then the hospital system abruptly pulled back, he said.

To see more of The Denver Post, or to subscribe to the newspaper, go to http://www.denverpost.com

(c) 2003, The Denver Post. Distributed by Knight Ridder/Tribune Business News.

HOSPICE PROGRAM FOR CHILDREN.(Spotlight on Health & Fitness) - Rocky Mountain News (Denver, CO)

Byline: Jenny Deam News Staff Writer

While there is probably nothing to lift a family's burden when a child is dying, a new hospice program may help to ease the load.

Children's Hospital Home Care, in connection with Centura Porter Hospice, has launched a new program designed for terminally ill children and their families.

It is called The Butterfly Program, borrowing from the symbolism of transition. In this case it is the transition into the final stages of life.

When a child is gravely ill, experts say, the family most often simply wants him or her to be comfortable and in familiar surroundings. That means home. But because of the child's condition as well as the emotional stress on all involved, families need help.

That's where The Butterfly Program comes in, said Dee Mueller, a spokeswoman for Centura Home Care and Hospice. Included in the hospice program are pediatric nursing services, therapy - both physical and emotional - and respite care for parents and siblings of the ill child. That can include anything from sitting at the child's bedside so parents can get some sleep to running errands and playing with other children in the family, who often feel neglected.

The program also provides bereavement counseling for the family after the child dies.

MOM'S MENTAL HEALTH KEY IN MURDER CASE WOMAN ACCUSED OF KILLING HER TWO CHILDREN HAD BEEN TREATED FOR POSTPARTUM DEPRESSION.(Local) - Rocky Mountain News (Denver, CO)

Byline: Kevin Vaughan Rocky Mountain News Staff Writer

JEFFERSON COUNTY -- A mother accused of killing her two children goes to court Monday, beginning a legal proceeding that experts said will hinge on her mental health.

Bethe Feltman remained under police guard Friday at Centura Health Porter Hospital in Denver, where she is undergoing a psychological evaluation. She has been charged with two counts of first-degree murder in the April 9 slayings of Ben, 3, and Moriah, 3 months.

``Unlike most cases, where some hedging of the bets is appropriate, I would say there's a 100-percent, take-it-to-the-bank guarantee that the sole defense at any trial will be mental status,'' said Denver attorney Scott Robinson.

Robinson said his belief is rooted in what he knows about the case.

According to court documents, Bethe Feltman had struggled with postpartum depression since the Moriah's birth New Year's Day.

Her husband, Wade, had come home April 9 to find both children dead and Bethe incoherent in the couple's Jefferson County home.

Coroner's investigators concluded that both children were given drugs, and that Ben was strangled and Moriah suffocated.

Bethe Feltman had spent time in the hospital in the week before the children were killed and was scheduled to see a doctor again the next day, according to court documents.

She is scheduled to appear in court at 1:30 p.m. Monday. There, her mental competency is expected to be raised. A judge will be asked to determine whether she is able to understand the proceedings and assist her lawyer, Craig Truman, in her defense.

Truman declined to discuss the details of the case.

If the court determines Feltman is not competent, the proceedings would be on hold until her competency is restored.

A separate issue would be her sanity when the killings occurred. If she were to plead not guilty by reason of insanity, she would likely undergo an extensive psychiatric evaluation.

``If she's ruled sane, the chances are great the defense will ask for a second opinion - 100 percent,'' Robinson said. ``But if she's ruled insane, it's not inconceivable that the district attorney . . . might accept that.''

In that case, Feltman would be sent to the state mental hospital until she could demonstrate she wasn't a threat.

HEALTH AND FITNESS BRIEFS.(Lifestyles/Spotlight) - Rocky Mountain News (Denver, CO)

Byline: Compiled by Debra Melani

Magazine ranks Denver 6th fittest city in U.S.

Denver ranked as the nation's sixth fittest city in Men's Fitness magazine's ``America's Fattest Cities'' report, escaping the dreaded ``fattest'' list.

That designation - fattest city in America - went to Houston, followed by Detroit, Philadelphia, New Orleans and Columbus, Ohio, in that order.

Bumping Denver down to sixth place on the ``fittest city'' list were San Diego at No. 1, followed by a tie for the No. 2 spot with Honolulu and San Francisco. Seattle made the fourth spot, followed by Minneapolis at No. 5.

Men's Fitness found some key factors, such as the amount of open space and parks, commute time, availability of junk food and the quality of air and water, made a difference in a city's fitness level.

Health care systems join forces to help needy

Metro-area community programs in need of wheelchairs, beds and other medical supplies soon will have some headed their way, thanks to a medical partnership announced recently by Centura Health, Exempla Healthcare and HealthONE.

The three major health care systems each expect to donate about $100,000 worth of surplus items a year through the initiative called ``Hospital Attic.'' Providers' Resource Clearinghouse, a local nonprofit, will provide transportation, storage and distribution of donated goods and will act as a central referring point. Colorado nonprofits with 501(c)(3) status can contact the clearinghouse at (303) 296-8580.

Carbon monoxide poisoning increases in winter

What seems like the flu might be a deadlier poison making people sick this time of year, according to the American College of Emergency Physicians.

Carbon-monoxide poisonings increase during the winter months, when houses are sealed tightly and heaters, stoves and furnaces are continually in use. The gas is invisible and odorless and can kill quickly.

Symptoms of poisoning can mimic the flu, including headache, fatigue, nausea, dizziness, confusion and irritability. Continued exposure can lead to vomiting, weakness, miscarriage, brain damage, heart attack, breathing problems and death.

The ACEP offered the following precautions:

* Have fuel-burning appliances professionally checked annually.

* Choose appliances that vent fumes outside.

* Make sure appliances are properly installed, following proper venting directions.

* Never use a gas oven to heat your home.

A TURN FOR THE BETTER SYMPOSIUM AIMS TO HELP WOMEN TAKE CHARGE OF CHANGE.(Spotlight on Health & Fitness) - Rocky Mountain News (Denver, CO)

Byline: Leslie A. Young Rocky Mountain News Staff Writer

Change is one of life's few certainties.

At 31, Tracey Brummett of Denver knows that all too well.

For months she's been organizing Embracing Transitions: A Women's Health Symposium. During that time she's become the woman for whom she designed the conference.

In short, she and her husband have just hit a wall in their plans to have children.

``Intellectually, I thought I was prepared, but emotionally, I found it hit me really hard,'' she says.

Throughout the turmoil, Brummett has worked to maintain control. One thing that's helped is an emotional-fitness test designed by Susan Heitler, a Denver clinical psychologist.

Heitler will be the keynote speaker at the health symposium, to be held March 14 on the Auraria campus. The conference focuses on inevitable health crossroads women face and their options.

The conference goal is ``to raise women's consciousness about change and the fact that they have choices and they can help affect the changes in their lives,'' Brummett says. ``It doesn't just have to happen to them.''

Empowering women to face change represents a shift in psychotherapy, Heitler says.

``Initially, the field of psychotherapy looked at people who were emotionally injured and how to help them heal,'' she says. ``Emotional fitness looks at how people can prevent injuries.''

Heitler's test has 10 questions. A high score reflects a resilience that's like money in the bank for the challenges around the bend, she says. The woman probably possesses useful tools: a positive attitude toward herself; an openness not only to her own feelings but to the feelings of others; a talent for saying what's on her mind in a tactful way; an ability to take care of herself physically.

If your score indicates you're emotionally weak, that means you're susceptible to emotional injuries that ``show up as depression, anxiety disorders, excessive anger, angry outbursts or irritability,'' Heitler says.

The test isn't highly scientific, she says. ``It's more like a quick little checklist to get a very quick overview of where you stand emotionally at this point in your life.''

Brummett took the test during the symposium's initial planning phase, then again after her crisis.

``My score is lower right now,'' she says. ``I'm in a more emotionally brittle state.''

This self-understanding isn't trivial, Heitler says, because emotions are like traffic signals: ``Emotional fitness involves the abiliy to accurit from emn street ce up in orhere. Soment is happening here.' ''

Heitler sashe also us the ``RTD system'': R means gs, T is to think abtably, humhree level, she says. Recognizing feelings can be difficult. For some, it's easy to ignore them, but ``there's enormous power in being able to put a label on something.''

And if you don't think through your feelings, ``you're at risk for letting feelings go straight from your gut to your mouth,'' Heitler says.

The ``doing'' applies to yourself, she emphasizes. It's easy to decide what someone else should do, she says, but taking responsibility for your actions is empowering.

In sorting through her crisis, Brummett doesn't need traffic signals to tell her she's in pain, but she says the emotional-fitness test has helped her understand how she handles problems, and most important, it's helped her identify her support systems.

INFOBOX

IF YOU GO:

Embracing Transitions: A Women's Health Symposium, 11 a.m. to 5:30 p.m. March 14, University of Colorado at Denver, North Building. The conference is sponsored by Bea Romer's Colorado Women's Health Campaign, American WholeHealth, Colorado Parent and Centura Health. Cost: $35, with proceeds donated to the Colorado Women's Health Campaign. On-site parking: $2. Registration: 320-1000.

Questions from the Emotional Fitness Test:

* I feel irritated at home, at work or on the road: (1) pretty much every day, (2) from once to a few times a week, (3) rarely

* I find that I smile warmly, talk openly and express affection to people close to me: (1) less than once a week, (2) several times a week, (3) pretty much every day.

* I think negative thoughts about myself (thoughts like, ``That was dumb!''): (1) often, (2) sometimes, (3) rarely.

- By Susan Heitler, Ph.D.

CAPTION(S):

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HEALTH WORKERS FACE SMALLPOX DECISION; 1ST SHOTS ON FRIDAY.(NATION/WORLD) - The Capital Times

Byline: Associated Press

Across the country, doctors, nurses and public health officials are making some hard choices about whether to get the smallpox shot for the good of the country.

In the coming weeks, health care workers will be deciding whether to volunteer to be vaccinated so they can be ready to respond to a smallpox bioterrorist attack. The first shots will be given Friday in Connecticut, the first state ready with the vaccine.

Nebraska, Vermont and Los Angeles County also had received vaccine shipments by Wednesday but were waiting at least until next week to begin vaccinating.

Worries about the vaccine's fierce side effects and the threat that it may even sicken people near those vaccinated have prompted a number of nurses to refuse.

As an emergency room nurse in Milwaukee, Lisa Hass-Peters knows she is a prime candidate for a smallpox response team.

But her husband, Jeff, has had two liver transplants, leaving his immune system weakened. That means the smallpox vaccine - made from a live virus related to smallpox - could make him sick. He could be infected from the scab on her arm caused by the vaccine.

'I didn't hesitate to decline,' said Hass-Peters, who works at Milwaukee's Froedtert Memorial Lutheran Hospital. 'If I truly was exposed, I guess I would be weighing my options again. But I don't feel a threat at this particular moment.'

In a recent survey, 63 percent of 2,600 nurses responding said they would get the smallpox shot, 13 percent said they wouldn't and 24 percent were undecided, according to the National Network for Immunization Information, a coalition of several health trade groups.

Ultimately, the government plans to vaccinate nearly 500,000 health workers. But even some major hospitals are refusing the vaccine, including Colorado's largest chain, Centura Health with 10 hospitals; and Grady Memorial Hospital in Atlanta, home of the Centers for Disease Control and Prevention, which is shipping vaccine to the states.

The risk of a smallpox attack is unknown, and the chance that any given person will be exposed is small, an advisory panel for the Institute of Medicine said recently.

But the risks of the vaccine are well-known. Some people may have sore arms and fever or feel sick enough to miss work. As many as 40 people out of every million vaccinated for the first time will face life-threatening reactions, and one or two will die.

The vaccine is not recommended for people with skin problems, such as eczema, or those with weak immune systems, such as HIV, transplant or cancer patients.