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Opioid overdose deaths drop in Missouri, but rural areas fight stigmas, barriers to care
Opioid overdose deaths drop in Missouri, but rural areas fight stigmas, barriers to care

Yahoo

time5 days ago

  • Health
  • Yahoo

Opioid overdose deaths drop in Missouri, but rural areas fight stigmas, barriers to care

Narcan dispensing boxes are becoming more common across Missouri. Medicines like Narcan, also known as naloxone, help fight opioid overdose deaths, but officials say more investment is needed to treat addiction (Suzanne King/The Beacon). After years of exponential growth, opioid overdose deaths in Missouri are dropping. While health care workers, community groups and other officials say many factors may contribute to the drop in opioid overdose deaths, they agree that access to overdose-reversing drugs like naloxone, often provided under the brand name Narcan, is saving lives. 'I do think that Narcan is the reason for those trends statistically dropping,' said Cooper County Ambulance Chief Brandon Hicks. 'I see Narcan in a lot more homes than I used to, and I do see family members administering Narcan prior to us getting there.' In 2014, the state saw 360 opioid overdose deaths from drugs other than heroin. By 2021, that figure rose to 1,493, state data shows. After increasing through 2021, the trend started changing. The number of deaths flattened in 2022 and began dropping in 2023. By 2024, non-heroin opioid overdose deaths had fallen to 876. Central Missouri and the St. Louis area saw the largest drop in drug overdose deaths, dropping 38% and 35%, respectively. But after responding to opioid overdose calls for years, Hicks sees the need for more access to treatment and better coordination between emergency services and long-term care, especially in rural areas. That belief is shared across community health organizations. Access to things like peer support specialists and community resources is an essential piece of the puzzle, according to Derek Wilson, who runs harm reduction at the AIDS Project of the Ozarks, which serves 29 counties in southwest Missouri. 'I think there is a particular bit of challenge when you come up against some of these societal things,' Wilson said. 'When you get into a more rural area … there's a ton of stigma. There's still a lot of shaming, whether it's self-shaming or from outside sources.' Wilson hopes that a continued focus on naloxone distribution, coupled with community support and more access to medication-assisted long-term treatment, can continue making inroads in rural communities. In 2016, the Substance Abuse and Mental Health Services Administration began a new grant program for states to receive federal funds for addiction treatment, recovery and harm reduction services. The federal money and state settlement dollars from opioid litigation allowed Missouri to increase investment in addiction treatment and overdose prevention. Early funds were mostly used to support treatment efforts. But as the response evolved, the state began investing more heavily in distributing naloxone across the state. From 2017 to 2023, the Missouri Institute of Mental Health (MIMH) distributed nearly 430,000 naloxone kits across the state. In 2023 alone, nearly 250,000 kits were given out, including more kits shipped off to local health departments, social services and first responders, according to a report from researchers at MIMH. In their report, researchers connect the drop in overdose deaths with the availability of naloxone across the state. But other rural health researchers think more time is needed to truly understand the drop in deaths. 'It's encouraging, but I don't think we know exactly why it's changed,' said Kelly Price, a rural addiction researcher in Vermont. 'It'll be interesting to see how it plays out over time … It does sometimes seem like it takes a little bit longer to see those effects that you see nationally in some of these more isolated rural communities.' MIMH researchers also pointed to the westward movement of fentanyl across the country. Data show that eastern parts of the country see lower levels of fentanyl-related deaths, while they are rising in western parts of the country. Hicks sees the need for better data collection for health officials to truly understand the trends, especially in smaller counties where funds for autopsies may not align with death rates. He pointed to the prevalence of opioid-related cardiac events. 'We just did a community health assessment,' Hicks said. 'We identified that there's really not been any opioid deaths in Cooper County for quite some time. The problem is that they're getting ruled cardiac arrest.' 'At the end of the day this is a true statement, their heart stopped,' he added. 'When it comes to pulling statistics, nobody sees the opioid deaths that we do have.' If someone's heart stops as a result of an overdose, naloxone won't revive them without chest compressions. Researchers at the American Heart Association found that of the 360,000 cardiac arrests from 2017 to 2021, 8% were caused by drug overdoses. Part of the problem in collecting that data, Hicks said, was funding for autopsies. If the county only budgets for a certain number of autopsies, it can be difficult to determine whether a death was related to drugs in other ways besides an overdose. 'I have one gentleman that I have (used Narcan on) three times that's been in cardiac arrest, and after the third time, he literally told me: 'See, I can do whatever I want. You're going to be here to save me,'' Hicks said. 'We can't save somebody who is dead, and they can't save themselves either. But if they get Narcan before we get there, usually they refuse care.' But Stephanie Malita, a health educator at the St. Joseph Health Department, says peer support specialists who are active in the area report that the number of overdoses someone experiences isn't relevant to their recovery outcomes. 'Peers will say time and time again that some of them overdosed multiple times,' Malita said. 'But eventually they got to the point in their lives where they were ready and had a support team around them to make that very scary leap into non-use.' Studies show that despite Good Samaritan laws, which offer legal protection for people who are witnessing or experiencing a drug or alcohol overdose, skepticism remains when it comes to calling first responders in the event of an overdose. Missouri's Good Samaritan law provides immunity from things like possession of controlled and synthetic substances or paraphernalia, as long as someone is actively seeking medical assistance. It also requires law enforcement to provide treatment resources. It does not protect against other crimes like distributing a controlled substance or active warrants. Hicks regularly runs into that fear when he responds to overdose calls. If 911 is called, the person overdosing often has already gotten a dose of naloxone, and law enforcement almost always arrives at the scene before EMS. 'People don't want law enforcement, they feel like they've done something wrong,' Hicks said. 'So we usually encounter somebody who is angry and upset … because they're scared of getting arrested. They didn't want to go to jail, they just wanted to live.' He and his staff take extra steps to differentiate themselves from law enforcement when responding to overdose calls. They don't wear button-up shirts or badges to try and make people feel more comfortable. 'I appreciate law enforcement,' Hicks said. 'But I don't want to be associated with them in these scenarios, because then I can't help somebody like we're supposed to help them.' Wilson and the AIDS Project of the Ozarks are working on ways to make naloxone more available across their coverage area. The group places drop boxes with naloxone kits in places like libraries and other public settings, so it is available to the community 24/7. To find where to access free naloxone, click here. It's an investment that Malita and the health department, which was one of the top county recipients for naloxone kits from the MIMH, are looking at making as they continue naloxone outreach. But more attention is needed when it comes to connecting naloxone recipients with longer-term addiction care. Things like distance to a provider, income, transportation and child care are often cited as roadblocks for rural patients seeking care. Hicks said he hopes to see more investment in things like transportation to crisis centers. He also pointed to integrating 911 and 988, the national suicide and crisis hotline, as a way to ensure Missourians are getting the care they need. 'The emergency room is just not the place for a lot of people in these situations,' Hicks said. 'More mental health support (is needed), not a physician that tells them to go seek care elsewhere once they've fixed a very temporary problem.' Price pointed to data that shows starting people on medication-assisted treatment, including buprenorphine or naltrexone, after an overdose and then connecting them with a long-term provider has been shown to be an effective approach. Things like expanded access to telehealth, where people can meet with providers in the privacy of their own homes, can also help people in smaller communities seek care in ways that are more fitting for them. Wilson said reducing stigma so everyone feels comfortable seeking care is a priority. 'I do think it is something that is thicker in rural areas, the idea of not wanting to get into it, and: 'Why don't those people just go take care of themselves? Why don't they stop?'' Wilson said. 'It's just not that simple, not with the way that substances interfere with our brain chemistry.' 'It's just a human being and things get away from them,' Wilson said. 'Then they find themselves in very, very horrible situations.' This article first appeared on Beacon: Missouri and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Ending Missouri's tampon tax won't make period products much more affordable
Ending Missouri's tampon tax won't make period products much more affordable

Yahoo

time16-05-2025

  • Business
  • Yahoo

Ending Missouri's tampon tax won't make period products much more affordable

Jessica McClellan, president and founder of Giving Hope & Help Inc., wants her Kansas City nonprofit to help end period poverty and fight the stigma that surrounds menstruation (Suzanne King/The Beacon). Tucked in to legislation Missouri lawmakers passed last week is a provision that will do away with the state sales tax on period products. The measure doesn't represent a significant cost savings for consumers. It would only shave about 38 cents off a $9 box of tampons. But advocates raising awareness about the financial burden some people face with every menstrual cycle — and the resulting health consequences — argue that doing away with the state 'tampon tax' does have symbolic importance. 'It's not going to cost (the state) that much,' said Emily Swanigan, a spokeswoman for Period, an education and advocacy group, 'but it's going to demonstrate that women's health is a priority.' Missouri Republicans included the tax break on period supplies, along with diapers and incontinence products, in a bill passed May 7 that also eliminates the state's capital gains tax. In a statement, Republican House Speaker Jon Patterson of Lee's Summit called the bill 'family first legislation.' Gov. Mike Kehoe is expected to sign it. 'Cutting taxes on diapers and feminine hygiene products affects ALL Missouri families,' the statement said, 'and will have the greatest positive impact with low-income women and girls across Missouri.' Democrats, too, have supported cutting taxes on necessities like period products and diapers. They did not support this bill because of the capital gains tax provision, which they argued will largely benefit wealthy Missourians and leave the state in fiscal peril. But getting rid of the tax on period products and diapers is the right thing to do, said Rep. Jo Doll, a St. Louis County Democrat, who for five years has introduced legislation to remove the tax on menstrual products and diapers. 'The concept that we're taxing basic necessities as luxury items just seems absurd,' she said. 'I'm sure if you talk to anyone who uses diapers or period products, they can tell you they are not a luxury.' Missouri is one of 20 states that still charge sales tax on period products. Period, Swanigan's organization, estimates that Kansas collects just over $3 million annually on taxes assessed on period product sales, while Missouri brings in close to $8 million, a sliver of the state's $53 billion budget. Kansas lawmakers have also considered legislation to do away with that state's tax on period products, but so far that effort has failed. Still, advocates said, the fact that red states like Missouri and Kansas are considering the issue at all is evidence of growing awareness about 'period poverty,' the lack of access to affordable menstrual products. Alabama also recently passed a bill to eliminate its state tampon tax. Experts said the COVID pandemic may have helped fuel awareness. Supply chain issues and lack of access to products at schools and other public places during the pandemic made the problem even more pronounced and harder to ignore. Awareness helps in finding a solution to a problem that in past generations was rarely discussed, especially in public, Swanigan said. People are starting to see period products as an essential need, like medicine or food, she said. 'Even within the last two to five years, we've seen an increase in understanding about this issue,' Swanigan said. 'That's good news for future policy changes that could help more people.' In addition to calling for an end to all sales taxes on these products — counties and cities tax them, too — Period wants to see government programs like Medicaid cover them. Food assistance programs like SNAP and WIC do not. A 2023 survey commissioned by Period and Thinx Inc. found that a quarter of teens and one-third of adults struggled to pay for period products, which have been soaring in price. According to reporting by the Wall Street Journal, the price of tampons went up 36% between 2019 and 2024, while the cost of sanitary pads rose 41%. It's a major financial strain for many families, said Jeanette Higgins, a nurse practitioner at Children's Mercy Hospital. 'Especially for low socioeconomic households,' Higgins said, 'they may be forced to choose between buying a menstrual product or buying food.' The rising cost of menstrual products may be part of the reason Giving the Basics, a Kansas City-area nonprofit that provides pads, tampons and other hygiene supplies to shelters, food pantries and schools, has seen a sharp jump in demand for them. In 2024, the organization distributed 750,000 period products around Kansas, Missouri and 18 other states. That was a 56% jump from the previous year, said Ashley Allison, the organization's marketing coordinator. 'It's one of our most requested products for sure,' she said. 'It's a huge need.' Other Kansas City organizations, including Giving Hope & Help Inc. and Strawberry Week, also work on raising awareness and making supplies available to people in need. When people can't afford proper supplies to manage their periods they often miss work, which has economic consequences. Kids also miss school and school-related activities. That not only can cause them to fall behind in their classes, it can lead to depression and anxiety, Higgins said. 'Fearing that when they have their period, are they going to have a product?' Higgins said. 'Are they going to have to miss an activity or have to miss school?' Giving the Basics donates period products to 1,028 schools in Missouri and Kansas, including the Independence School District. Lori Halsey, that district's director of health services, said she wants every student to know they are welcome to take as much as they need for themselves and their family. In addition to donations from Giving the Basics, Halsey said the district relies on grants and funding from the state education department to meet the need. 'It is a struggle for girls to not have that resource,' Halsey said. There are also health consequences. The 2023 survey from Period found that 40% of teens and more than half of adults have worn period products longer than recommended. Higgins said using a pad or tampon too long can lead to infections or serious illness. Improvising with supplies not intended for that use can also cause infections, she said. While more schools provide free products to students, asking for them can be intimidating, especially for teens. Stigma is another major hurdle in the fight to end period poverty. 'Girls, especially young girls, have a lot of trouble just even talking about periods,' Higgins said. 'Having to go to the nurse to discuss their period cannot be comfortable to begin with, and then they have to discuss why they don't have products available to them.' That's why period products should be free and widely available, said Jessica McClellan, founder and president of Giving Hope & Help, a Kansas City organization that donates pads, tampons and other care items to people in need. Just as people can find free toilet paper in virtually any public restrooms, she said, people should also find free menstrual supplies. And the world should stop being afraid to talk about periods. 'There's power in the period,' McClellan said, as she walked around her organization's Midtown storage room, stocked floor to ceiling with pads, tampons and other hygiene products destined for schools, domestic violence shelters and, sometimes, communities on the other side of the world. 'This is not a woman's health problem,' she said. 'This is a world health care problem that we can easily solve. And it's a world health care problem that's right here in Kansas City.' This article first appeared on Beacon: Kansas City and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Missouri hospital mergers come with one inevitable: Bigger executive paychecks
Missouri hospital mergers come with one inevitable: Bigger executive paychecks

Yahoo

time21-02-2025

  • Business
  • Yahoo

Missouri hospital mergers come with one inevitable: Bigger executive paychecks

St. Luke's executives landed bigger bonuses and retirement windfalls in 2023 (Suzanne King/The Beacon). igger bonuses, higher executive salaries and a few eye-popping retirement payouts. That's how St. Luke's Health System closed the books on its final year as a nonprofit independent hospital chain, according to recent tax filings. The $2.5 billion hospital system, which merged with St. Louis-based nonprofit BJC Healthcare at the start of 2024, paid one-third more in bonuses and incentives to its top-earning employees in 2023 compared to the previous year. Combined total compensation for those employees, whose salaries are included in the hospital system's 990 tax filings, was up 27%. Not surprisingly, executives at the top of the organizational chart saw the biggest paydays. Dr. Melinda Estes, who retired as CEO when the merger was completed, had total compensation of $4.4 million, including a $2 million base salary, a $1.57 million bonus (46% bigger than the previous year's) and a $752,000 payout from a supplemental executive retirement plan (SERP). Chief Financial Officer Chuck V. Robb, who now is chief financial officer at BJC, pulled in total compensation of $7.8 million, thanks in large part to a $5.66 million retirement plan payout. (Robb had worked for St. Luke's for three decades.) Meanwhile, his 2023 bonus of $1.17 million, more than three times his 2022 bonus, was more than his $747,000 base salary. And Julie Quirin, who became St. Luke's president at the end of 2023 and is now president of BJC's western region, got total compensation of just under $1.9 million in 2023, including $960,000 base pay and a $521,000 bonus (24% more than the previous year). St. Luke's did not respond to requests for comment. While noteworthy, the health system's compensation packages are consistent with the broader nonprofit health care ecosystem. For decades, the trend has been to pay top hospital executives higher salaries as hospitals and health systems consolidate. In that context, executive salaries paid during St. Luke's last year as a standalone system are unsurprising. When compared with executives at other nonprofit systems, they aren't even exceptional. In 2021, nonprofit hospital systems Sentara Healthcare, CommonSpirit Health and Nuvance Health each paid their CEOs more than $30 million in total compensation, according to the Lown Institute, a nonpartisan health care think tank. Across the board, executive salaries at nonprofit hospitals are rising, surpassing what average hospital workers make caring for patients by ever-growing margins. In a study released last year, economists at Rice University found that CEO pay at independent hospitals and health systems jumped 30% between 2012 and 2019, from an average of around $996,000 in 2019 dollars to $1.3 million. Registered nurses, by contrast, had mean wage growth of 2.3% over the same period, from $75,652 in 2019 dollars to $77,460. Dr. Vikas Saini, Lown Institute president, said surging executive pay packages at nonprofit hospitals have been a long time coming. When Medicare was created in the 1960s, more people were insured, so hospitals gained a new source of revenue. Saini argued in an article published in Health Affairs that more revenue led to shifting attitudes in health care. Hospitals drifted from community-focused nonprofits toward behaving like big businesses. They added more corporate leaders to their boards, who made financial gains a newly important part of their mission. Merger between Kansas City and St. Louis hospital systems could mean bigger medical bills 'We pretend that hospitals are like other businesses,' he said. 'It's true, we don't want them losing money. We do want them to be solvent. But there's a difference between being solvent and serving the community and going all out like a business to maximize your revenue.' And along with the shift in attitudes about hospitals' missions came highly paid executives. Derek Jenkins, a health economist at Rice University, said he and his colleagues are studying whether the growing salaries are associated with better hospital quality. The answer is unclear. But another correlation is hard to dispute. 'It's definitely fair to say that higher profit (at the hospital) is associated with higher compensation,' he said. That's why most experts agree the trend toward higher executive pay goes hand-in-hand with a wave of hospital mergers that has led to far fewer stand-alone, community hospitals and the emergence of larger systems. In 2022, seven out of 10 hospitals were parts of larger systems, compared to just over half of hospitals in 2010. Last year, health systems announced 72 mergers, the most since 2020 when 79 were announced. St. Luke's merger with BJC was one of 65 planned in 2023. Hospitals argue that they need to merge to compete. They point to market forces like an insurance industry that controls prices and argue they will be stronger if they are bigger. When St. Luke's and BJC announced they had reached a definitive agreement to merge in late 2023, the hospitals said becoming Missouri's largest hospital system would help them recruit top talent, bolster medical research and help them address health care disparities. In reality, some economists say, the cost of care goes up when mergers reduce hospital competition. Even mergers between hospitals that don't compete in the same market can lead to higher prices for patients, some studies have found. But while there is no consensus about how hospital consolidation helps or hurts hospitals and patients, there is wide agreement about what it does to executive pay. In fact, Lawton Robert Burns, a professor of health care management at the University of Pennsylvania's Wharton School, argues that higher CEO compensation that results from mergers is the primary driver of consolidation. 'You get bigger systems and bigger systems have bigger pay,' he said. 'It has nothing to do with quality or access or other things they say. … It's all designed to enrich themselves.' Nonprofit hospitals argue they need to pay more to attract top executive talent. They can't provide stock options like their publicly traded counterparts, but they can pay large incentive bonuses, offer housing perks and set up and fund deferred retirement plans for top executives. SERPs, also known as 'top-hat' plans, allow select employees to defer income before paying taxes. According to the Lown Institute, hospitals often fund them through cash value life insurance purchased by the hospital or company providing the plan. Similar to a 401(k) retirement plan, which is typically available to every employee in an organization, income is invested in SERPs before taxes are paid. Taxes are only due once money is withdrawn. But unlike 401(k)s and other retirement plans known as qualified plans, top-hat plans don't limit participants' annual contributions. That means the eventual payout has the potential to be much bigger. In a study of top-hat plans in private industry, the Institute for Policy Studies found marked income disparities, even between top-earning CEOs who have access to SERPs and those who don't. The study crunched the numbers for two theoretical CEOs who each invested $1 million a year over seven years. Researchers found that the CEO with a top-hat plan, who didn't have to pay taxes up front, could potentially earn $6.6 million from the investment. But the executive who had to pay income taxes before investing the money would come out with $5.3 million. Of course, a regular employee with access to a 401(k) or other tax-deferred retirement plan has far less income potential. Even if an employee has enough of their paycheck left over to invest the maximum allowed, that maximum contribution by law was only $23,000 in 2024. (Workers who are at least 50 years old can make additional catch-up contributions.) Sarah Anderson, an author of the Institute for Policy Studies' report on top-hat plans, said the disparity in retirement benefits is another example of the vast wealth gap between executives at the tops of organizations and the employees who work there. And that gap also applies to nonprofit hospitals. Until relatively recently, many employers maintained pension plans to fund employees' retirements. Employers made the financial investment, and employees were guaranteed payments once they retired. St. Luke's discontinued its pension plan at the end of 2021, according to an independent audit report. But as labor unions lost power, Anderson said, pension plans were replaced by defined benefit plans like 401(k)s 'where burden and risk is on individual employees,' she said. Meanwhile, top executives who qualify for top-hat plans have comparatively enormous retirement accounts. 'You know, there's a number beyond which it's not about food on the table or making sure your kids can afford to go to college, or even that you have a vacation home,' Saini said. 'There's a number beyond which you have all that, and at that point, what is the point?' This article first appeared on Beacon: Kansas City and is republished here under a Creative Commons license.

Regulators warn Missouri hospital that lab's ‘deficient practices' could put patients at risk
Regulators warn Missouri hospital that lab's ‘deficient practices' could put patients at risk

Yahoo

time31-01-2025

  • Health
  • Yahoo

Regulators warn Missouri hospital that lab's ‘deficient practices' could put patients at risk

St. Mary's Medical Center officials said they are correcting problems called out by regulators (Suzanne King/The Beacon). Regulators recently warned officials at St. Mary's Medical Center in Blue Springs that 'deficient practices' at its laboratory, including lax testing procedures and insufficient training, could endanger patients. The Missouri Department of Health and Senior Services informed hospital officials that they had found the lab to be in 'immediate jeopardy,' the most severe level of noncompliance in health regulation. The state's Dec. 20 letter said the finding was based on a 'complaint survey' completed on Dec. 17. This survey, or inspection, included an onsite visit Dec. 10-11, a phone interview Dec. 16-17 and additional documentation, the state's report said. Citing federal regulations, the letter said a finding of immediate jeopardy was made because the lab's noncompliance 'has already caused, is causing, or is likely to cause, at any time, serious injury or harm, or death, to individuals served by the laboratory or to the health and safety of the general public.' In a written statement, the hospital acknowledged the finding and said it had submitted a corrective action plan to the state. 'We take survey findings very seriously and have taken proactive steps to implement changes addressing issues identified by the Missouri Department of Health and Senior Services,' the hospital said. The hospital's statement said the hospital is fully operational with 'comprehensive laboratory services.' 'No St. Mary's patients were ever identified as being harmed throughout the survey process,' the statement said. The Missouri Department of Health and Senior Services (DHSS) conducts surveys of health care facilities in the state on behalf of the U.S. Centers for Medicare and Medicaid Services (CMS). In this case, said Sami Jo Freeman, a DHSS spokeswoman, CMS identified concerns and directed the state agency to perform a complaint investigation into the laboratory, which led to the immediate jeopardy findings. Freeman confirmed that St. Mary's officials had responded to the state report in writing. 'Their response has been forwarded to, and is currently under review by, CMS, who will decide if the response is adequate and decide the next steps,' Freeman said in an email. St. Mary's, an 80-bed hospital owned by the for-profit chain Prime Healthcare, said the immediate jeopardy finding was related to blood bank processes and based on inspections conducted in October 2023, a month before the hospital shifted blood bank services to St. Joseph Medical Center, another Kansas City-area hospital owned by Prime. St. Mary's statement said blood bank services 'will continue to be provided to St. Mary's patients uninterrupted through this partnership.' A hospital spokeswoman did not explain why the blood bank process had been shifted to St. Joseph Medical Center in 2023. She also didn't answer questions about more recent issues raised in the state's December report. The report said the laboratory 'failed to provide blood bank procedures for all blood bank processes that started October 2023.' The hospital spokeswoman also declined to respond to questions about concerns raised in the report that did not involve blood bank services. A finding of immediate jeopardy could result in fines, onsite monitoring and the loss of Medicare accreditation. Such a finding is relatively uncommon. One study from 2021 found that less than 3% of hospital citations reached that most serious level. In 2022, St. Mary's Hospital faced another immediate jeopardy finding, according to a database of inspection reports. That time regulators raised concerns about physical force used against patients in the hospital's emergency department. The immediate jeopardy finding was removed after the hospital implemented an action plan, which included the dismissal of an employee directly involved, executives spending more time in the department and staff education. The state's December report cited a range of problems with St. Mary's laboratory, many of them relating to testing procedures, documentation, quality control and training. Overall, the report said, the lab's director 'failed to provide overall management and direction of the laboratory.' This included failure to 'ensure overall operation' of the lab's blood bank; failure to properly train staff before they performed patient testing; a lack of remedial actions when 'significant deviations' were identified; and quality control lapses, such as a failure to ensure that follow-up crossmatch testing was performed. The lapses, regulators said, could lead to inaccurate patient test results, which could cause issues or delays of patient diagnosis and treatment. The failures, the report said, 'have a significant potential to cause patient harm.' The position of lab director is currently posted as an open job on the hospital's website. It isn't clear who was director during the period of time covered by the inspection. The state also called out the lab's failure to maintain analytic systems, including a lack of laboratory procedures and a failure to perform and document quality control measures. For example, the report found that the lab didn't document the inspection of whole blood before issuing it. In one case in November, the report said, blood was given to a patient 'without units being labeled and proper procedure was not followed.' The report said the lab also did not perform alarm inspections on a blood bank refrigerator, and lacked or failed to document certain test control procedures. The state called out problems with the lab's procedures for urinalysis, saying the machine used in tests, a urinalysis centrifuge, was operating at the incorrect speed. In another instance involving a test for vitamin B12 levels, a test control was not within acceptable limits for several hours, the state said. This article first appeared on Beacon: Kansas City and is republished here under a Creative Commons license.

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