Consistency and personal attention are hard to come by in many nursing facilities because of significant and frequent staffing fluctuations, suggests a recent analysis by Kaiser Health News and the New York Times.

Of 110 nursing facilities throughout Summit, Stark, Medina, Wayne and Portage counties, 34 have average staffing levels, 24 are below average and 26 are much below average; 15 are above average and nine are much above average, the analysis found. Two nursing facilities in the region received no rating in the study.

There are particularly large staffing shortfalls on weekends, the analysis said.

Statewide, more than 75,000 people live in nursing homes and that number is expected to spike as Ohio’s population grows grayer.

The analysis suggests the staffing problems are worse than thought, following a switch in how nursing facilities report their staffing levels to the federal Centers for Medicare and Medicaid Services.

Until recently, nursing homes self-reported unverified data for two weeks and were then inspected, meaning homes could potentially anticipate an inspection and temporarily bring in more staff and “game the system,” the analysis said.

Now all nursing facilities must provide daily payroll records to verify their staffing levels, following a mandate from the Affordable Care Act of 2010, that more accurately illustrates how staffing levels vary from day-to-day. Data from 2017 became publicly available earlier this year and is now being factored into facilities’ overall five-star ratings.

The ratings are listed on the Nursing Home Compare website that was created by the Centers for Medicare and Medicaid Services to help consumers compare facilities.

About 70 percent of the nation’s nursing homes reported lower staffing using the new data-reporting method, with an average decrease of 12 percent, the analysis found.

In light of the findings, the Elder Justice Coalition is calling for congressional hearings to address how staffing shortages slipped under the radar. Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, said her group is continuing to lobby for minimum-staffing requirements.

There is no federal law that sets a minimum resident-to-staff ratio, but Medicare does require the presence of a registered nurse for eight hours a day and a licensed nurse at all times at its certified facilities.

Advocates in Ohio said they weren’t too surprised by the findings.

“We suspect insufficient staffing is the root cause of a number of our complaints,” said Erin Pettegrew, Ohio’s acting long-term-care ombudsman.

The second-highest statewide complaint received by ombudsmen in 2017 was staff members failing to respond to residents’ requests for help, with 428 complaints filed. The office receives about 11,000 total complaints a year, ranging from issues with eviction and discharges, the most common complaint, to poor resident hygiene, stolen property, injuries and medication errors.

Insufficient staffing can lead to serious issues, Pettegrew said. Residents who need help getting to the bathroom, for example, may try to go on their own if nobody comes to help, which could lead to a dangerous fall.

Facility operators say they’re not able to pay higher wages because a majority of their funds come from Medicare and Medicaid, at a rate set by the government. The median wage for a nursing assistant in Ohio was $13.37 an hour in 2017, according to the federal Bureau of Labor Statistics.

National unemployment is also low, about 4 percent, leaving nursing facilities competing with better-paying employers, such as hospitals and retailers, where work is less strenuous.

MASSILLON: A former physician of Affinity Medical Center expressed doubt this week that the facility would reopen as a full-service hospital.

The mayor, meanwhile, said her team has not wavered from the goal of re-establishing a major medical facility in the city, which has been negotiating with a handful of medical entities since May. Officials now say they’re close to bringing a proposal to City Council.

No one from the mayor’s office would offer details on whom the city has been talking with and what long-term services could return.

Dr. Nash Gabrail, an oncologist who previously referred patients to Affinity and had hospital privileges, said it’s more likely that the closed Affinity hospital would be sold to a drug rehabilitation center or become something far less than what it was.

According to Gabrail, who operates Gabrail Cancer Center in Jackson Township, a sound business model for a potential Affinity operator does not exist. Rehiring a hospital staff, training employees and re-credentialing medical services are costly responsibilities to inaugurate.

“You can’t meet payroll without revenues and hope people will start walking in,” said Gabrail, who points to the four to five weeks in winter that Affinity remained open after the announced closure. That is when, he said, a move needed to be made to save the hospital from closing.

Not the same

Gabrail was the catalyst of an effort in January to rally area doctors to raise funds to purchase Affinity and keep the hospital in business. The effort stalled after a couple of weeks due to a lack of financial backing from the physicians group. Gabrail had pledged $1 million toward the hospital.

Affinity’s main campus officially closed its doors Feb. 11.

Mayor Kathy Catazaro-Perry said opening a quality, sustainable hospital in Massillon is doable, and that goal has not been altered since the hospital closed.

“Our team is working hard to bring in a new entity,” she said. “I can’t think of not achieving what we’ve set out to do.”

The city’s preference is to have — but is not limited to — an emergency room, 12-bed intensive care unit, operating room, outpatient diagnostics and an unspecified number of patient beds. The mayor acknowledged that completely replacing Affinity services is not likely.

“It may not be the same hospital that left us, but we want to bring the best services back to the community we can,” Catazaro-Perry said.

The hospital is filled with assets that could assist a new operator with restarting a business. Surgical, lab and operating room equipment, X-ray and MRI machines, household appliances, heating and cooling units and maintenance and cleaning tools are among the many resources — from decorative artwork to kitchen and cooking items.

Although he has uncertainty about the hospital reopening, Gabrail said he would return in a heartbeat if it does. Doing so would be sound a business decision and right for the community, he said.

“I still think we need a hospital like Affinity [for trauma care, a local epidemic or disaster],” he added.

Deadline looms

The city still holds approximately $25 million worth of Affinity property and assets, which it acquired from Quorum Health in early May at a cost of $1. At the time, City Council approved legislation put forth by Catazaro-Perry to assume financial responsibility of the hospital, such as making payments on existing leases, building utilities, property maintenance and insurance and salaries for two employees.

The total approved by council was $621,649 for three months, which is slated to run out on or about Aug. 7.

When asked if the mayor’s office would need to request additional funds from City Council to keep hospital funding going beyond early August, Safety-Service Director Joel Smith said, “We’ve figured three months. As we monitor expenses, we’ll see what happens here. If the [decision] lingers, we will have to go back [to council]. But I don’t think that will happen.”

City Law Director Andrea Scassa said a proposal from a potential hospital operator could be presented to council this month or in early August.

“What we’re continuing to work on is bringing in someone to [run] the facility,” she said.

As many as five groups or entities are interested in the hospital, said Catazaro-Perry, adding that the majority are from Ohio. She declined to say whether any are from Stark County.

An Akron-area competitive dragon boat racing team, completely made up of breast cancer survivors, placed third in the world in Florence, Italy.

The Dragon Dream Team finished first among United States contenders and third among 124 teams worldwide at the international competition.

Seconds separated the top five finishers and tenths of a second separated the top finishers.

The Dragon Dream Team USA Akron finished its final 500-meter race in 2 minutes, 21.69 seconds. The Can Survive team from New Zealand finished second with a time of 2:21.28. The Knot a Breast team from Hamilton, Ontario, won the event with a time of 2:20.33.

All teams had raced a total of four heats over a two-day period on July 7 and 8.

Though placing in the final race was an important achievement, winning was not the point of the competition, said Amy Synk, president of the Dragon Dream Team.

Synk is a breast cancer survivor of seven years after having a double mastectomy, reconstructive surgeries and chemotherapy and radiation treatments.

“Our winning is an absolutely extraordinary achievement, but it is the overcoming of a breast cancer diagnosis that is our true victory,” said Synk of Medina, a member of the team for four years. “Being fierce in the face of fear is the definition of the Dragon Dream Team.”

In fact, it was never announced publicly how the top five teams placed at the festival, said Synk. After the final race, paddlers take off their team jerseys and all put on the same shirt to participate in a flower ceremony to honor those who have died from breast cancer.

The Portage Lakes-based Dragon Dream Team sent two teams with 45 of its 83 members to Florence for the 2018 International Breast Cancer Paddlers’ Commission Dragon Boat Festival.

A record 4,000 paddlers representing every continent raced in the dragon boating event. Dragon boating is a 2,000-year-old Chinese practice that involves 20 teammates paddling a 40-foot dragon-shaped boat while a drummer sits in the front and plays a beat to keep the team in sync. Akron’s team formed in 2007, 11 years after the first all-breast cancer survivor dragon boat team began in the mid-1990s when researchers found that upper body exercise is beneficial to patients.

Team comes together

The Akron-area team practices three times a week.

The team has come so far from the first such international event it participated in 2010, when it finished near the bottom of nearly 80 teams, said Barb Fox of Randolph Township, co-team operations manager, a founding member of the team and 12-year-cancer survivor. In 2014, the team placed 39th out of 102 teams at the races in Sarasota, Fla.

“The team is about paddling together, the emotional strength you get from one another. It’s about the camaraderie,” Fox said. “It will help our outreach as we support each other in life after breast cancer.”

The team raises money and provides outreach through its Boatloads of Hope. The program gives local hospitals, doctors’ offices and cancer centers boxes for patients containing a pashmina shawl and a note from the team saying they represent more than 100 years of survivorship.

This year, 300 shawls have been distributed.

The team has many survivors but has also lost a member every year Synk has participated. One team member had to pull out of the Italy race recently because her cancer recurred. The team got its strength from her and dedicated its races to her, Synk said.

The team will host its sixth-annual Dragons on the Lake Dragon Boat Festival at the Portage Lakes State Park on July 28. More than 30 teams are expected for the races. A gala is also held in the spring. Both are the main team fundraisers. For more information, go to http://www.dragonsonthelake.com.

Triumphant return

When the first group of team members arrived at the Akron-Canton Airport at midnight Tuesday, they were surprised by other teammates and family members who made a pink oar arch for the paddlers to walk through.

Carolyn Bernstorf of Wadsworth Township couldn’t believe her teammates surprised them at midnight.

Bernstorf, a team member for nine years and 13-year cancer survivor, said she can hardly describe the feelings she had as she and her teammates finished their final race in Italy.

“It was absolutely something I’ll just never ever forget. I’m just still even now so emotional, and I had tears of happiness when the race was over and we were crying,” Bernstorf said.

Bernstorf said she knew the team was good and they had progressed a lot since Sarasota four years ago. But she and other team members thought they’d finish in the top 15.

But Bernstorf’s husband, Allen, who has served as the team’s coach since 2014, had other goals. He just didn’t tell the team members so they wouldn’t feel pressured. (The team had two teams in Italy, with the “A” team being the more experienced or stronger paddlers.)

“My goal was top 10,” said Allen Bernstorf, a former soccer coach. “The only question in my mind was the level of competition we were going to meet.”

When he started coaching in 2014, it took awhile to convince the team members that they needed more endurance training. That training paid off.

He said he’s inspired by his athletes. The average age of his team is typically around 60. The oldest team member on Akron’s winning team was 81-year-old drummer Pat Donnelly of Akron. She also was the oldest U.S. participant.

Staff writer Katie Byard contributed to this report and was a member of the Dragon Dream Team B team. Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

MASSILLON: A $1.3 million pediatric primary care center operated by Akron Children’s Hospital is planned for a vacant commercial building on the city’s east side.

Work concluded last week to remove a loading dock adjacent to the one-story structure at 1149 Lincoln Way E., where the 14,000 square-foot medical center is slated to be housed.

“It’s going to happen,” said Frank Silla, the city’s chief building official, who provided a building permit application for the pediatric clinic earlier this week to the Independent. “The plans [for the center] were submitted a couple of weeks ago.”

Contractor for the project is A. Altman Co. of Canton, Silla said. There is no timetable for completion of an extensive interior and exterior remodel of the building, he said. Some work already done at the site was electrical and HVAC related.

Holly Pupino, a spokeswoman for the hospital, confirmed that the Massillon location will be a “new office for Akron Children’s Hospital Pediatrics network.” More information, such as the number of exam rooms and amount of jobs, will be available as soon as next week, she said in an email.

Additional details were not immediately available from the hospital.

David Maley, the city’s economic development director, called the eventual move into Massillon by Akron Children’s a service boost for the area.

“Anytime you get more medical facilities here it’s good,” Maley said. “It means more jobs, and they have an excellent reputation for helping kids.”

The opening of a medical center by Akron Children’s is not connected to the city’s effort in securing an operator for the former Affinity Medical Center, which closed last winter, Maley said.

Part of the building where the pediatric center will be located is already occupied by Living Water Church, which is remaining at its current site, Silla said. There will be a space between the church and medical center that is large enough to house a small business, he added.

The 35,527 square-foot commercial building was built in 1970 and is owned by Mass Wales LLC, according to Stark County auditor’s records.

The site is nearly 8 miles away from another Akron Children’s project also contracted out to A. Altman.

The hospital will offer pediatric primary and specialty care at a new three-story, 38,000-square-foot building to be constructed in North Canton on Aultman Hospital property as part of a long-term lease.

That facility is expected to open in 2019 at 6076 Whipple Ave. N. at a cost of $16 million.

Akron Children’s also has plans for pediatric centers in Boston Heights off state Route 8, in Portage County at a location still to be determined and in Mansfield, Akron Children’s Hospital President Grace Wakulchik said in December.

“We want to be closer to patients and families so they don’t always have to come to Akron” for routine care, she said. “We want to be able to provide service to those in the community.”

Summa Health’s new West Tower on its Akron City Hospital campus is taking significant shape overlooking the state Route 8 and East Market Street corridor near downtown Akron.

The $220 million, seven-story building — which will also become the health system’s new front door — is the centerpiece of the $270 million first part of a two-phase project over the next six or seven years. Other Phase 1 projects include a makeover at Barberton Hospital’s campus and a new proposed medical office in Kent. Phase 2 will include renovations to the departments moving to the new building, making upgrades and creating single-patient rooms, said Ed Friedl, Summa vice president of construction and property management. The overall project is expected to cost $350 million.

Dr. Cliff Deveny, Summa interim president and CEO, has described the rise of the new tower as a metaphor for “the rebirth of Summa Health System,” which has had a tumultuous year and a half after abrupt changes to its emergency room staffing, ousting of its former CEO and subsequent loss of its emergency medicine residency program.

The tower was designed by Hasenstab Architects and Perspectus Architecture.

When the new 343,000-square-foot space is complete by next summer, the tower will feature private patient rooms; expanded surgery suites; two floors dedicated to labor and delivery services; a breast center; a multipurpose conference center and two floors of private medical surgery patient rooms.

The building’s “front door” will move from Arch Street to Forge Street.

Drivers will be able to drop off patients or their cars on a circular loop — which runs off North Forge at North Adolph — for access to the new main hospital entrance, the emergency room or the North Adolph parking deck. That will become the hospital’s main parking deck, although all other hospital decks and the current “main entrance” to the hospital on Arch Street will remain open, Friedl said. There is no parking directly at the front door, although there will be valet services, he said.

Creating a new and distinct front door is needed, Friedl said.

“If you said ‘Go to the main entrance’ and didn’t know Akron, where would you go?” Friedl asked. “If you Google it, it takes you to the center of the hospital.”

Once the structure is complete, patients will be able to see and access the main entrance from state Route 8 with easy signage, he said.

Night view

A distinguishing feature on the new building will be a back-lit screen wall facing Route 8, which will be able to glow in the evening. Friedl said the color will mostly be white, though he’s already fielded questions about other colors.

“It’ll be a beacon of light when you go up and down Route 8,” he said.

The exterior front of the new tower will be a modern style, featuring mainly glass and textured gray metal panels. The back of the facility will blend the hospital’s past with the future, using some terra-cotta brick that is seen on many of the existing older buildings on the City Hospital campus.

A covered entrance will protect the visitors from rain and snow. Inside the front door, patients will find a two-story atrium with a grand staircase, reception desk and a long, connecting curved corridor that mimics the curve of the building’s exterior. Pre-admission testing, Summa’s breast health center and a gift shop will also be based on the same level, which Summa refers to as its ground floor.

Bridges will connect the new West Tower to the old campus and from the Adolph parking deck.

The construction, which began in May 2017, also incorporates more than $100 million in local trade labor, including $70 million for the West Tower project, Friedl said.

The new tower includes an increase by 30 percent for facilities dedicated to expectant mothers, labor and delivery and postpartum care, Friedl said. That’s because when women are in the hospital to have a baby, it’s one of the happiest times a person wants to be at the hospital. The hospital is also expecting a 30 percent growth in this area, he said.

“The mother also often makes decisions on which facility to go to, so once they’re here, they often will stay here” for future services, he said.

Floor plan

Here is what will be on the floors of the West Tower:

• Ground floor/Street level: Registration, Women’s Breast Center (moving from Hamlin Pavilion with all new imaging equipment, such as MRI and mammogram machines), pre-admission testing, Aladdin’s Restaurant, relocated gift shop, conference center and art gallery.

• First floor: Same-day surgery and expansion of existing general surgery area by eight new operating rooms.

• Second floor: Labor and delivery, including 18 labor and delivery rooms (four rooms with birthing tubs, up from one now); nine ante-partum rooms (for high-risk pregnancies before labor); 10 triage rooms; three C-section rooms and a 24-bed neonatal intensive care.

• Third floor: Mechanical floor — heating and cooling equipment, generators.

• Fourth floor: 36 new mother/baby in-patient rooms, along with a newborn nursery.

• Fifth and sixth floors: Each floor will have 36 private patient medical surgery rooms.

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Summa Health will bring in an outside firm that specializes in performance improvement and corporate finance, but its leader said that’s not a sign of financial troubles.

Interim President and CEO Dr. Cliff Deveny sent a memo to the health-care provider’s roughly 7,000 employees Monday. Deveny alerted employees that the firm, Alvarez & Marsal (A&M) and its managing partner, Richard Cascio, or his colleagues may contact them during the 120-day contract.

In a telephone interview Tuesday, Deveny said there is nothing unusual about the firm coming in to evaluate. Summa has undergone a financial performance improvement project every year since 2013, when it entered into a 10-year agreement for Cincinnati-based Mercy Health to be its minority partner, Deveny said.

Last year, Summa invited Mercy to perform the audit, he said, and the Summa board decided to ask A&M to do it this year.

“This is just a board-directed continuation. It was not asked for by one party or another,” Deveny said, referring to Summa and Mercy. “This is to keep the pedal to the metal and continue to have a sustainable performance.

“At the end of the day, this health system needs to be in Akron to serve the needs of the community.”

In his memo, Deveny shared that “we have made a great deal of progress this year throughout Summa Health, but there still is a lot more work to do.”

There has been significant financial progress in the last 12 months, he said.

Current results through May show a year-to-date operating income of $7.2 million, or a positive operating margin of 1.3 percent. That exceeds Summa’s original budgeted operating margin of $6.1 million.

“To put this into greater perspective, for the same time period in 2017, Summa Health lost $31 million for an operating margin of negative 5.8 percent. It should be noted that this year’s performance has been bolstered by one-time gains that we don’t expect to receive again, however, we should all be very proud of this improvement,” Deveny said.

“At the same time, despite this better financial performance, the reality is we still continue to face extreme downward pressure on revenues and upward pressure on expenses,” he wrote in the memo.

The goal is to achieve approximately $40 million in additional improvement through initiatives “such as more efficient care for our patients and members, streamlining supply chain, improving revenue cycle and reducing pharmacy costs for both Summa and SummaCare.”

Deveny was hired as Summa’s interim president and chief executive officer last March following the resignation of CEO Dr. Thomas Malone amid demands by hundreds of doctors for a change in leadership. The situation was exacerbated with the abrupt changeover in Summa’s emergency room physician staffing in January 2017 and the subsequent loss of accreditation to train emergency medicine resident physicians.

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Akron Children’s Hospital once again ranked in the top 50 nationally in several of its pediatric specialties, according to the U.S. News & World Report’s 2018-2019 Best Children’s Hospitals.

The rankings, released Tuesday, listed Children’s as 41st in pediatric urology, 44th in pediatric orthopedics, 44th in pediatric neurology/neurosurgery and 44th in neonatology.

The new rankings highlight the top 50 children’s hospitals in 10 pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology.

Children’s Chief Strategy Officer Shawn Lyden said the hospital is always pleased to receive external recognition of the quality of its programs.

“Whether or not we are ranked does not impact the tremendous effort we invest in maximizing quality and outcomes across a wide spectrum of areas, and that is a priority that comes from the very top with our board of directors,” Lyden said. “Our day-to-day work is focused on delivering the highest quality care for our patients so honors like this are nice reminders that we are on the right path.”

Last year, the hospital ranked in two of its specialties, although it did have higher rankings in those areas — 30th in pediatric urology (41st this year) and 35th in neonatology (44th this year).

Dr. Daniel McMahon, medical director of urology at Children’s Hospital, said: “Pediatric urology has consistently been ranked by US News & World Report. We are confident that we provide state-of-the-art care to our patients. We are committed to constant and continued improvement in the care we offer our patients.”

Dr. Kerwyn Jones, chair of the Department of Pediatric Orthopedics, said he believes his department’s ranking reflects increased exposure and a growing reputation among their peers nationwide, along with a strong culture of quality and safety.

“The increased involvement of our providers at national venues includes research presentations and publications, active participation in national quality initiatives and leadership involvement with national orthopedic projects aimed at improving pediatric orthopedic health care,” Jones said.

Cleveland Clinic’s Children’s Hospital earned recognition in all 10 specialties: cancer (23), cardiology & heart surgery (26), diabetes & endocrinology (39), gastroenterology and GI surgery (23), neonatology (50), nephrology (49), neurology & neurosurgery (24), orthopedics (50), pulmonology (32) and urology (42).

University Hospital’s Rainbow Babies & Children’s Hospital ranked in eight specialties: cancer (22), diabetes & endocrinology (21), gastroenterology and GI surgery (44), neonatology (6), nephrology (43), orthopedics (22), pulmonology (20) and urology (24).

Statewide, Cincinnati Children’s Hospital Medical Center ranked second in the nation among all hospitals. It had been third for seven years. It also ranked among the top five in nine of the specialties: cancer (1), gastroenterology and GI Surgery (1), nephrology (2), neurology and neurosurgery (2), urology (2), diabetes and endocrinology (3), pulmonology (3), orthopedics (4), neonatology (5), cardiology and heart surgery (8)

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

A Norton widow is accusing Summa Health and its emergency medicine physician group of negligent care that she says led to the death of her 58-year-old husband.

In a wrongful death lawsuit filed Wednesday, Julie Bradshaw alleges that her husband’s death from a stroke last year was caused, in part, by negligent care and “deviations from acceptable industry standards” after Summa abruptly switched ER physicians and lost its emergency medicine residency training program.

In the suit, filed in Summit County Common Pleas Court, Bradshaw claims her husband wasn’t seen by an attending physician for about 20 hours after he arrived in the Summa Barberton Hospital emergency room for vertigo.

The physicians then failed to treat him for a stroke despite test results confirming he was experiencing the life-threatening condition, Bradshaw alleges in the suit.

The suit names 23 defendants, including Akron-based Summa; Canton-based U.S. Acute Care Solutions (USACS), which staffs Summa’s ERs; several physicians; and other health care providers.

According to the suit, Robert Bradshaw was taken by ambulance late in the morning on Aug. 1, 2017, to Summa’s Barberton ER. About three hours later, CT scan results “were suspicious for cerebellar stroke and Mr. and Mrs. Bradshaw were told he was having a stroke,” the lawsuit alleges.

Four hours after arriving in the ER, Bradshaw was seen for the first time by a doctor — an intern and first-year family medicine resident who “would have been approximately one month out of medical school,” according to the lawsuit. That physician did not activate a Stroke Team, the suit said.

A consultation by a neurologist also was ordered but no neurologist ever came, according to the suit.

Later in the evening, a third-year medical resident physician saw Mr. Bradshaw for “reported mental status changes” and “simply instructed the nurse to re-orient Mr. Bradshaw, and try to get him to relax despite his diagnosed cerebellar stroke,” according to the suit.

ER care

Despite being in the ER for 10 hours before being admitted to the hospital, “no emergency medicine physician or attending physician ever examined Mr. Bradshaw,” the lawsuit said.

The certified nurse practitioner and residents who saw Bradshaw were “all apparently practicing medicine and advanced practice nursing without any direct supervision,” the suit alleges.

The lawsuit cites the loss of Summa’s emergency medicine residency training program, including violations cited from the national accrediting body, as a factor in Bradshaw’s death.

In February 2017, the Accreditation Council on Graduate Medical Education (ACGME) revoked the program after determining there were delays in obtaining specialized care for patients with possible strokes, first-year residents and rotating residents were seeing patients without supervision and patients were being sent home without ever been seen or examined by an attending physician.

Summa saw an abrupt changeover of the longtime emergency medicine physician group on New Year’s Day 2017 after failed negotiations. The switch to USACS resulted in upheaval at Summa, including the resignation of the former CEO after hundreds of doctors voted no confidence in his leadership.

Patient deteriorated

In her lawsuit, Bradshaw says her husband’s condition further deteriorated and he was not seen by an attending physician for the total 20 hours he was at Summa Barberton.

Despite being paged by a nurse when Bradshaw’s condition worsened, the third-year resident never checked on him until after he had a heart attack, according to the suit.

Bradshaw’s cardiac arrest, the suit alleges, “caused by the failure to monitor and timely and properly treat Mr. Bradshaw’s cerebellar stroke.”

After the resident discussed Bradshaw’s case with an attending physician by phone, the patient was transferred to Summa’s main Akron City Hospital.

Bradshaw’s wife was told by a medical provider while at Barberton’s intensive care unit that her husband should have been transferred to Akron City earlier “in part because Barberton Hospital did not have neurology services,” the suit alleges.

Surgery at Akron City

Bradshaw had surgery at Akron City but died four days later.

His death certificate said he died of a “cerebellar stroke — cerebral edema.”

The case has been assigned to Summit County Common Pleas Judge Jay Wells’ court. Spokesmen for both Summa and USACS said they could not comment on pending litigation.

Julie Bradshaw’s attorney, Megan Frantz Oldham, said, “Mr. Bradshaw’s family prays that this action will cause Summa to implement patient safety measures that will prevent a tragedy like this from happening to another family.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

On the heels of Stark State College offering practical nursing courses in Akron, a crosstown competitor is launching its own program.

Herzing University, a private school on Akron’s southern edge, is registering students now for a 12-month program that will train students to become licensed practical nurses. Classes begin Sept. 5.

“The demand is there” from prospective students as well as employers, Herzing-Akron Campus President Bill Cassidy said last week.

Specifically, long-term care and skilled nursing facilities in the region have expressed a desire for additional practical nursing training, Cassidy said.

Cassidy noted that according to the U.S. Bureau of Labor Statistics, Ohio is one of five states with the highest level of employment for licensed practical nurses.

In the Akron area, licensed practical nurses earn an average of $20 an hour, according to the bureau.

Herzing, in a remolded former grocery store building at 1600 S. Arlington St., enrolls about 300 students. Roughly 60 to 70 percent of Herzing students are focusing on nursing (associate degree of nursing and bachelor’s of science degree in nursing) and allied health fields, such as medical assisting and medical billing.

The nonprofit university’s associate of applied science in nursing degree trains students to become registered nurses.

Herzing plans to enroll about 30 students in the 37 credit-hour practical nursing program beginning this September.

Stark State, meanwhile, plans to cap each cohort in its 36-credit-hour program at 45 students, said Marissa Rohn, executive director of marketing and advancement at Stark State.

Stark State will offer its practical nursing classes beginning this fall at its building at 755 White Pond Drive in West Akron.

Tuition at Herzing, which is not state-supported, is $480 per credit hour, while tuition at Stark State is significantly less: $169 per credit hour.

Eligible students at both schools can qualify for federal and state financial aid.

Cassidy noted that Herzing’s program is designed so that students completing the practical nursing requirements can enroll into either the associate degree program or directly into the bachelor of science in nursing program.

Stark State does not offer its own bachelor’s degree in nursing. But it has transfer agreements with several universities. These agreements allow Stark State students with associate degrees in nursing to complete their bachelor’s at schools including the University of Akron and Kent State University.

Stark State’s program is a continuation of the 67-year-old Akron School of Practical Nursing.

The college will assume control of the practical nursing school from Akron Public Schools on July 1.

The program will be called the Stark State College Akron School of Practical Nursing. All of Stark State’s health care programs will remain at the White Pond building when Stark State begins offering classes this fall at its new Akron campus on Perkins Avenue, just west of state Route 8 north of the University of Akron campus.

Herzing, based in Milwaukee, Wis., has 10 campuses across seven states. It opened its Akron campus in 2006. In 2015, Herzing converted from a for-profit institution to a nonprofit one.

Katie Byard can be reached at 330-996-3781 or kbya[email protected].

Summa Barberton Hospital’s ER is now providing medication-assisted treatment and other services to ease drug cravings and jump-start recovery for addicts who seek emergency care for an overdose.

Through a pilot program supported by United Way of Summit County, Summa Health recently hired a full-time addiction care coordinator to work in the Barberton emergency department during the overnight hours, when statistics have shown that the majority of overdose cases occur.

The coordinator works with ER doctors to provide medication-assisted treatment in the emergency room for eligible patients who are interested.

Recovering addicts from Packard Institute serving as “recovery coaches” also are on call to come to the Barberton ER to guide the patients to recovery resources in the community.

United Way and Summa officials are hoping to expand the care-coordination program to a 24-hour model.

Too often, the same patients are treated in the emergency department for an overdose only to return after subsequent overdoses because they don’t know where to turn for help, said Dr. Gregory Smith, medical director of Summa’s Barberton emergency department and the health system’s other freestanding ERs.

“Patients want this,” he said of the new ER program. “Now we have measures to help them.”

Very few emergency departments across the state administer medication-assisted treatment with buprenorphine or vivitrol, which aid recovery from opioid addiction by reducing cravings, said Mairin Mancino, Summa’s director of advocacy.

The new program originally started as one of only three pilot programs in Ohio from a state grant at Summa’s Barberton campus earlier this year. The United Way got involved because the effort matches one of its “bold goals” to reduce overdose cases in area ERs to 1,000 countywide by 2025. In 2016, there were 2,400 and last year there were 2,300 cases, according to county health data.

Barberton has been particularly hard hit. According to a Beacon Journal/Ohio.com analysis, Barberton and Norton combined logged the most overdoses of any community in the county in recent years. The two cities share a ZIP code, so it wasn’t possible to separate them in the data.

The goal is to help any drug addicts, though officials know the vast majority of overdoses in the county — and especially in Barberton — are opioid overdoses, said Seth Kujat, vice president of community impact for the United Way.

“We are really treating emergency rooms as the front door for services for treatment,” Kujat said.

The program, which will take the majority of the United Way’s $500,000 funding for its bold goal, will involve about 10 other community partners.

The United Way has made a two-year commitment for the Barberton pilot program and hopes eventually to expand it to other Summa emergency departments, other hospitals and clinics in the area, Kujat said.

Before there was a care coordinator, patients were sometimes given “the options they could follow up with in the community, but nothing right then at the emergency department that would help them stay sober to get to the next level,” said Jaimie McKinnon, Summa vice president for behavioral health.

“That coordinator is setting up that source of referral services to link them directly so they don’t leave the emergency room without that next treatment option,” he said.

The coordinator also will offer resources to patients who are not ready for medication-assisted treatment or other programs to give them options.

Addictions — especially opioid addictions — remain stigmatized, said Dr. Michael Hughes, president of Summa’s Barberton campus.

“This is a disease, not a moral failure. We’ve got to address this,” he said. “This is not always someone’s fault … we have to have a cultural shift and I want to be part of that.”

The program had a soft launch last month and is ready for patients, officials said.

Partners in the project include community groups that will provide some wrap-around services and access to resources that could be barriers to a patient getting care, such as lack of transportation, child care and housing, Kujat said.

The Akron-based Packard Institute received a grant from the United Way to provide the recovery coaches working with patients at the Barberton ER.

It’s important for recovery coaches to be peers who can guide patients in their own recovery starting immediately after they are revived with the opioid antidote naloxone, known by the brand name Narcan, said Raynard Packard, founder and director.

“When you’re coming out of a Narcan haze and your body is revolting because the withdrawal is setting in, you’re going to need someone to get your wing,” Packard said.

Packard’s nephew, Corey Packard, 31, will be one of those recovery coaches.

“When somebody comes into a hospital setting, they’re not going to trust all the professionals,” said Corey Packard, who has been in recovery for six months. “They’re not going to trust the nurses. They’re not going to trust the people in uniform. They’re going to trust somebody who identifies with their problem on a human level at that moment and that’s why it’s going to work.”

He said he battled his addictions for 17 years.

Raynard Packard said the recovery coaches have their own coaches who continue to help them, too.

What coaches will do will vary with each case, from going to appointments to reaching out to family members or other resources, he said.

Though some other hospitals are starting to offer medication-assisted treatment, the collaboration of so many partners in and out of the hospital will make a difference, said Dave Rich, United Way director of community health.

“This is a mix of the hospital, which is the highest level of care, partnering with legacy treatment agencies and grass roots groups like Packard,” he said. “This is the first time I’ve seen that many layers within one cause working together so closely.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

“Patients want this. Now we have measures to help them.”

— Dr. Gregory Smith

medical director for Summa Barberton Hospital

“When you’re coming out of a Narcan haze and your body is revolting because the withdrawal is setting in, you’re going to need someone to get your wing.

— Raynard Packard

director and founder of the Packard Institute

“This is a disease, not a moral failure. We’ve got to address this.”

— Dr. Michael Hughes

president of Summa’s Barberton campus

Summa Health has a new senior vice president and chief financial officer, Keith Coleman, who starts later this month.

Summa on Tuesday announced it hired Coleman. The Akron health care organization described Coleman as a someone with significant health care organization experience, and a team-builder who is skilled in strategic planning, population health and health plans.

He starts on June 25 and succeeds Thomas O’Neill, who had been Summa’s interim CFO. O’Neill will return to his previous job as senior vice president and CFO of Summa Health System, the organization’s hospitals.

“We are thrilled with the addition of Keith Coleman to our executive leadership team,” Cliff Deveny, Summa’s interim president and chief executive officer, said in a news release. “His wide-ranging experience and vast skill set are a perfect complement to our organization. I look forward to his contributions.”

Coleman most recently was the CFO for Crozer-Keystone Health System, an $800 million four-hospital health system in eastern Pennsylvania.

Prior to that role, he was at Warbird Consulting Partners and Trinity Health, where he served as senior vice president and CFO for Mount Carmel Health System in Columbus.

He also was CFO for the Geisinger Health System in Danville, Pa., and has been CFO of other nonprofit and for-profit organizations.

Earlier, he was president for six years of University Hospitals Faculty Service, the management services organization for University Hospitals Health System in Cleveland.

He began his health care career as a senior internal auditor for the Cleveland Clinic.

He is a graduate of Marietta College and is a certified public accountant, certified internal auditor and chartered global management accountant.

Coleman and his wife, Debbie, live in Solon. They have two grown children.

A legal battle between two rival Akron hospitals has been settled, with the terms kept confidential.

The resolution permits Dr. Michael Beeson to continue as the program director for Summa Akron City Hospital’s pending effort to re-establish its emergency medicine residency program.

Summa Health’s emergency room physician provider, Canton-based U.S. Acute Care Solutions (USACS), filed a complaint Thursday in Summit County Common Pleas Court. USACS sought a temporary restraining order and preliminary injunction to stop cross-town competitor Cleveland Clinic Akron General from enforcing a non-compete agreement that would prohibit Beeson from working within a 10-mile radius for one year from his employment.

Beeson gave his notice to Akron General on March 31 to work for USACS as the program director. Akron General terminated him on May 23, after hospital officials said they discovered he was actively helping his new employer with its efforts to re-establish its program.

The lawsuit put the restart of Summa’s ER training program, targeted for next July, in jeopardy.

Attorneys for the two sides negotiated Friday and Monday, reaching an agreement Monday afternoon.

“It’s a lot better to resolve disputes than to engage in costly litigation,” said Chris Niekamp, who represented Beeson. “This allows each hospital to have a residency program.”

Cleveland Clinic Akron General and USACS said in a joint statement Tuesday morning that the hospital and USACS agreed that Beeson may direct Summa’s ER program and that Beeson “will honor his agreement with Akron General by not clinically practicing outside of that role for the next year.”

“We jointly recognize the importance of education for the next generation of emergency medicine physicians,” the statement continued.

USACS said in a court filing that it believed the noncompete was not enforceable, especially in emergency medicine departments where physicians do not bring patients. USACS also said not allowing Beeson to work would jeopardize its application, cause Beeson to leave town to find work and put at risk USACS’ ability to fulfill its contract with Summa.

Lawyers for Akron General said in court documents that another emergency physician has announced he is going to Summa Health and raised concerns about “an effort to raid Akron General’s emergency department through six-figure signing bonuses and other unfair competition.”

The turmoil at Summa began last year after an abrupt changeover of the longtime emergency medicine physician group on New Year’s Day after failed negotiations. The switch to USACS resulted in upheaval at Summa, including the resignation of the CEO after hundreds of doctors voted no confidence.

The emergency medicine residency program then lost its national accreditation after the Accreditation Council on Graduate Medical Education heard complaints that patients were being sent home from the emergency room after being seen only by residents, not the supervising emergency room physicians; allegations of intimidation of resident doctors; and lack of necessary experience among the new teaching staff to train new doctors.

The demise of the emergency medicine residency program, effective last July, meant 21 trainees had to find new training programs. Most left the area; a few went to Akron General.

Summa and USACS re-applied in April and have a site visit set for June 21, according to court filings. The site visit must be completed before the end of June for the hospital’s board to take up the request at its September meeting and for the ER program to begin accepting new students by next July.

Stephanie Warsmith can be reached at [email protected], 330-996-3705 and on Twitter: @swarsmithabj.

The legal fight between cross-town hospitals is not about whether one hospital should get its emergency medicine residency program re-established, but whether a physician who left one competitor for the other should be allowed to break a contract he signed, Cleveland Clinic Akron General said in a reply filing late Friday.

Also at question is whether Dr. Michael Beeson, who gave his notice to Akron General on March 31 but was terminated May 23 after hospital officials discovered he was actively helping his potential new employer with its application, used Akron General’s templates while still employed.

Among other allegations raised by lawyers for Akron General is that another emergency physician has announced he is going to Summa Health “and the real concern that this is the beginning of an effort to raid Akron General’s emergency department through six-figure signing bonuses and other unfair competition,” the hospital said in its filing.

The case started on Thursday in Summit County Common Pleas Court with Canton-based U.S. Acute Care Solutions (USACS), which runs Summa’s emergency rooms and is attempting to re-establish its suspended emergency medicine residency program. The complaint is filed against Akron General Health System and its emergency medicine physician group, Partners Physician Group.

The case was assigned to Summit County Common Pleas Judge Tammy O’Brien. Chief Magistrate Kandi O’Connor, standing in for O’Brien, heard arguments from both parties Thursday and held a teleconference Friday. O’Connor did not rule on USACS’s complaint and request for a temporary restraining order and request for a preliminary injunction.

USACS is seeking the restraining order to stop Akron General from enforcing a noncompete agreement that Beeson signed, which would not allow him to work within a 10-mile radius for one year after his employment ended. USACS in its original filing, said it does not believe noncompete clauses are enforceable, especially in emergency room settings where physicians do not take patients with them.

The complaint also alleges the contract is inapplicable because Beeson will be working for USACS and not Summa. The complaint says Ohio courts have not supported noncompete agreements.

In its reply filing, Akron General said it did not matter whether Beeson was working for USACS or Summa as it still violated the contract.

“This is not a case about Summa’s ability to re-commence its Emergency Medicine Residency. Defendants, like others in the community, would like to see the return of an accredited program. We simply ask that the Program Director not be an individual who willingly signed a negotiated, noncompete agreement which precludes his employment with a competitor doing business less than ten miles away,” Akron General said.

Pending contract

Akron General said the only way Beeson will not be able to work for USACS or Summa would be by a court order.

Beeson has a pending contract with USACS to serve as the program director in charge of education in Summa’s pending application to regain national accreditation for its Emergency Department physician trainee program.

In its reply, Akron General said Beeson left for a significant signing bonus and the hospital only learned of his plans to go to Summa “once they reviewed an email reflecting Dr. Beeson’s active involvement in creating ‘Goals and Objectives’ for Summa Emergency Medicine Residents.” The brief said Beeson was doing this while still employed at Akron General, and “we believe that Dr. Beeson may have been using an Akron General template, while working for Akron General, for purposes of completing Summa’s paperwork for accreditation.”

In a second legal filing by plaintiff USACS earlier Friday, attorneys said “Cleveland Clinic lacks any legitimate competitive interest in preventing Dr. Beeson from serving as an educator. It is only for illegitimate and unlawful reasons that it has threatened to enforce the Non-Compete Provisions and to prevent Dr. Beeson from performing vital services, in a remarkably unique role, and for which he has devoted his entire career.”

Beeson would be forced to leave the area to continue his employment in “a position far below his level of expertise and qualifications” if the noncompete agreement is enforced, the filing said.

‘Substantial risk’

Attorneys for USACS also said without the temporary restraining order, “there would be substantial risk” that the physician group would be unable to perform its duties under its contact with Summa “as a result of being unable to provide a physician eligible and qualified to oversee the re-establishment of Summa’s emergency medicine residency program.”

The turmoil at Summa began last year after an abrupt changeover of the longtime emergency medicine physician group on New Year’s Day after failed negotiations. The switch to USACS resulted in upheaval at Summa, including the resignation of the CEO after hundreds of doctors voted no confidence.

The emergency medicine residency program then lost its national accreditation after the Accreditation Council on Graduate Medical Education (ACGME) ruled on accusations that found patients were being sent home from the emergency room after being seen only by residents, not the supervising emergency room physicians; allegations of intimidation of resident doctors and a ruling that the new teaching staff lacked the experience to train new doctors.

The demise of the emergency medicine residency program, effective last July meant 21 trainees had to find new programs. Most left the area, with a few going to Akron General.

Summa and USACS reapplied in April and it has a site visit set for June 21, according to court filings. The site visit must be completed before the end of June for the hospital to meet a filing deadline for a September meeting that could determine whether the program can admit new students by next July.

On Thursday, Summa Interim CEO Dr. Cliff Deveny said the hospital was moving forward with its application.

Beacon Journal/Ohio.com medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter.

Cleveland Clinic Akron General will begin using its Health & Wellness Express mobile unit this weekend to bring awareness about premature birth risks to communities where infant mortality rates are high.

Akron is one of nine communities that the Ohio Equity Institute identified as accounting for 86 percent of black infant deaths in Ohio in 2016.

Ohio Medicaid data show Summit County had the highest premature birth rate in the state last year and ranked fourth highest in infant deaths the year before.

Pre-term birth is the leading cause of infant mortality in Ohio, according to the Ohio Perinatal Quality Collaborative.

Being born prematurely can cause short-term complications like breathing and feeding difficulties, but can also have a lifelong impact through birth defects or other chronic health issues.

Akron General received a grant of $20,180 from the Women’s Endowment Fund from the Akron Community Foundation to provide neighborhood-based perinatal education to women at risk of premature birth (before 37 weeks of pregnancy).

The mobile unit team also will seek to educate family and friends who act as caregivers and supporters of pregnant women, the hospital said in a news release.

“Our focus with this new outreach program is on the community’s role in supporting pregnant women and empowering residents to actively participate in improving birth outcomes,” said Dr. Jennifer Savitski, chair of obstetrics and gynecology and medical director for Akron General’s PATH Center. “There are several factors that we can address to help a mother prevent a premature delivery, including appropriateness for progesterone treatment, increasing birth intervals, following safe sleep practices, and smoking cessation.”

Savitski is a member of the mobile unit crew, which include medical residents and nurse practitioners on the obstetrics and gynecology staff.

• Sunday: Noon to 2 p.m., Healthy Baby Conversations, Mount Calvary Church, 442 Bell St.

• Wednesday: 12:30-2 p.m. – Mom-ME Time, AMHA Joy Park Homes, 524 Fuller St.

• June 19: 11 a.m. to 2 p.m., Dave’s Supermarket, 871 E. Exchange St.

• June 27: 5:30 to 7:30 p.m., Mom-ME Time, AMHA Joy Park Homes, 524 Fuller St.

Summa Health’s path to try to restart its embattled emergency medicine residency program has now headed to the courtroom in a battle with Cleveland Clinic Akron General, its crosstown rival.

That legal fight could jeopardize the hospital’s pending application to regain national accreditation to train physicians by next July.

At the core is whether a noncompete contract for the Akron General doctor hired to lead Summa’s re-established program can be enforced.

However, a national emergency medicine industry expert said the legal complaint and result of the noncompete contract could jeopardize the hospital’s application or push the potential start of the program back by a year.

But Summa Interim CEO Cliff Deveny Thursday night said the hospital and its Graduate Medical Education Committee, the group of other residency directors in charge of the application, are moving forward.

“We’re not a party to it,” Deveny said of the legal complaint filed by U.S. Acute Care Solutions (USACS), which staffs Summa’s emergency departments and is trying to re-establish the residency program.

“We support USACS as our partner and they have been committed to getting the emergency medicine residency application in and getting it certified and getting a class in here as soon as possible,” said Deveny.

Dr. Michael Beeson was hired recently by Canton-based USACS to serve as the new program director of Summa’s emergency medicine residency program.

The program director, with the department’s chairman, oversees the faculty and education of the residency trainees.

But Beeson, who worked for and taught residents at Summa for 27 years before going over to Akron General eight years ago to be its emergency medicine program chair, signed a noncompete clause in his contract. That clause prohibits him from working for a competitor within a 10-mile radius for one year after he leaves Akron General.

On March 31, Beeson gave his 90-day notice to Akron General and on May 23, Akron General terminated Beeson without cause, according to a civil complaint filed in Summit County Common Pleas Court on Thursday morning by Beeson, USACS and its physician group, Emergency Medicine Physicians of Cuyahoga County. The complaint is filed against Akron General Health System and its emergency medicine physician group, Partners Physician Group.

Noncompete contract

In the complaint, the plaintiffs allege the noncompete clause is not enforceable, as well as inapplicable because Beeson will be working for USACS and not Summa. The complaint also says Ohio courts have not supported noncompete agreements, “especially disfavored in the physician context because of the enormous impact they have on the public.”

In his new role, Beeson will not be taking patients or business from the defendants since patients going to an emergency room do not choose their doctor and Beeson “has not obtained any trade secrets” from Akron General, the complaint said.

Additionally, USACS said “the community will be greatly harmed by the enforcement” of the noncompete provision, “because in doing so, Summa’s Emergency Medicine Residency Program, which is the process of recertification, would be significantly and negatively impacted without the residency director input to be provided by Dr. Beeson.”

In a May 23 letter, Littler Mendelson, the law firm representing the Cleveland Clinic, informed Beeson that the Clinic intended to file suit against him and USACS if he goes to work for the rival company.

“It is our understanding that you will be performing identical duties for our competitor, Summa. We are particularly disturbed by the fact that, while still employed at Akron General, you provided substantive and extensive services on behalf of Summa’s Residency Program, and, indeed played a primary role in Summa’s effort to obtain ACGME accreditation for its emergency medicine residency,” the letter from attorney Robert Wolff wrote.

Attempts to reach Beeson were not successful. A message was left with Beeson and a request was made to interview him through USACS.

USACS spokesman Marty Richmond declined further comment until after a court hearing scheduled for Friday afternoon.

Cleveland Clinic Akron General spokesman Joe Milicia said the health system’s policy is not to discuss pending litigation.

Industry reaction

The turmoil at Summa began last year after an abrupt changeover of the longtime emergency medicine physician group on New Year’s Day after failed negotiations. The switch to USACS resulted in upheaval at Summa, including the resignation of the CEO after hundreds of doctors voted no confidence.

The emergency medicine residency program then lost its accreditation after the ACGME ruled on accusations that found patients were being sent home from the emergency room after being seen only by residents, not the supervising emergency room physicians; allegations of intimidation of resident doctors and a ruling that the new teaching staff lacked the experience to train new doctors.

The demise of the emergency medicine residency program, effective last July meant 21 trainees had to find new programs. Most left the area, with a few going to Akron General.

What happened at Summa is still big news in the national emergency medicine industry, said Dr. Robert McNamara, Temple University emergency medicine chairman who is past president of the American Academy of Emergency Medicine.

“People are still talking about this,” said McNamara. “The destruction of program was the first time it’s ever happened. … It’s a black mark on the specialty.”

Beeson is a big name in the emergency medicine community and has a solid reputation, said McNamara. However, McNamara also said he believes “the pool of highly qualified residency directors who would step into that program wasn’t that big” given what happened.

Hiring Beeson with his noncompete was a big risk, McNamara said.

While the national group McNamara is involved in does not believe in noncompete agreements for emergency medicine physicians, the issue with USACS/Summa and Akron General goes to an additional level of the establishment of a competing residency program and fighting to recruit qualified trainees, he said.

McNamara, who is not currently involved with the ACGME but has been on accreditation teams in the past, said he believes it will be important to ACGME if the program director’s status has been challenged.

Dr. John Zografakis, president of Summa’s medical staff, said he believed the committee of residency program doctors at the hospital “is going to do everything in its power to make sure we have a strong application to re-establish a strong residency with community.”

If that means “delaying it a year, if it’s in the best interest of system, community and any incoming residents that may be training so we may not have any disruption training in the past. … I trust they’ll make the best decision for the institution.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Alyssa Apostolakis wanted to be a counselor to help children and young adults struggling with drug addictions.

Alyssa’s own battle with drug addiction started at age 12, when she was prescribed opiates after surgery to repair a leg she broke on a trampoline. She then underwent a series of oral surgeries after she hit her head coming down a waterslide at Disney World.

Her drug use escalated. She had many ups and downs, often staying clean for long lengths of time, said her parents, Lea Heidman and Brian Malone.

But even access to some of the best treatment programs in the country couldn’t save her.

Now her parents are fulfilling her desire to help others by donating a total of $300,000 in her memory toward an effort to launch an Addiction Services Program at Akron Children’s Hospital.

The program — announced Wednesday afternoon — is focusing its first phase on education, prevention, screening care coordination, community outreach and referrals at Children’s locations throughout Ohio. It also will offer medically assisted treatment for opiate addiction and an outpatient clinic as the program grows.

Ohio has the second-highest rate of overdose deaths in the country and is at the epicenter of the opioid epidemic, said Children’s Hospital President Grace Wakulchik.

“As a leader in pediatric care, we felt the need to be more strategic in our services — with the ultimate goal of preventing today’s children and teens from becoming the next generation of adults struggling with lifelong addiction,” she said.

For Alyssa, her drug use became worse in high school.

The Montville Township native overdosed when she was 16 and spent time in Akron Children’s Hospital’s partial hospitalization program. She left that program and went directly to a residential program in Utah, where she stayed for 11 months. She then transitioned to a behavioral boarding school in North Carolina, where she graduated and went to college in North Carolina.

Her parents tried to be strict with her, limiting her access to money and requiring her to take a drug test every other week and meet with a psychologist.

Still, Alyssa struggled and hid her addictions from those closest to her, said Heidman, president and CEO of Golden Alliance Inc., which owns five McDonald’s locations in in Montrose, Norton, Wadsworth, Macedonia and Medina.

In March 2015, Alyssa seemed to be doing well, said Malone, Alyssa’s stepfather, who raised her and two siblings since they were young.

Her family thought she was clean.

“We knew that she had a couple of lapses, but we did not know that the addiction had taken her so severely as it did. She was so stealth in hiding her addiction, even from her closest friends,” her mother said.

On St. Patrick’s Day that year, Alyssa stayed in her dorm room in North Carolina and studied instead of going out drinking, even though she had turned 21 the month before.

The next day, on March 18, Heidman and Malone received a phone call from the sheriff.

Alyssa was dead from a heroin overdose.

Her family is unsure what happened. They only know that she overdosed on straight heroin. She was supposed to see the family for vacation in five days.

“What was ironic about Alyssa,” said Malone, “was she wanted to help others rather than help herself. Even when she was going through all of this addiction, she’d be helping others through addiction, helping homeless people, but not looking at herself in the mirror and saying ‘I need help myself.’ ”

The family quickly turned their grief into action. They established a nonprofit organization, Fighting for Alyssa, (http://www.fightingforalyssa.org) which is dedicated to the awareness, prevention, and treatment of substance abuse and addiction.

The foundation is issuing its largest gift — $100,000 — to support the new addiction services at Children’s. Heidman and Malone also are personally giving $200,000 to the effort, to total $300,000 from their family and foundation over a five-year period.

A total of $800,000 has been donated to the hospital to start the program, including a $250,000 donation from FedEx Custom Critical and contributions from Marci Matthews, Harvey and Kim Nelson, Friends of Akron Children’s Hospital, Bob and Regina Cooper and Don Sitts.

The opioid crisis “is having a major effect on our community and we must address it with the highest sense of urgency,” said Virginia Addicott, president and CEO of FedEx Custom Critical.

The funds will be enough to support a new case manager, Stephanie Strader, who will connect patients with resources and services at the hospital and in the community.

Younger children and teens tend to experiment with other substances and move to opioids as young adults, said Dr. Sarah Friebert, founder and medical director of the hospital’s Haslinger Center Palliative Care Center.

But hospital staff are seeing the effects of the opioid epidemic, from addicted pregnant moms and their babies to toddlers accidently ingesting drugs and school-age children “who live in homes where drug use is rampant and they’re not getting their basic needs met,” Friebert said.

The new program will centralize some of the hospital’s inpatient and outpatient efforts and services at its pediatric offices to screen for substance abuse and offer assistance, she said.

The program can be reached at 330-543-3343.

“There have been pockets of things we’ve offered throughout the organization, but there hasn’t been any way to pull all of that together, to try to come together with a comprehensive strategy and one number to call,” Friebert said.

“If we’re getting in early enough with these kids, if they never pick it up in the first place, if we are able to get in and get kids hooked up with appropriate counseling, they may not progress to addiction.”

The educational materials handed out as part of the new center will be branded “Alyssa’s Promise,” in honor of her nickname, AP, and “the promise that she always wanted to help other people,” said her mom. “She’s doing that.”

Heidman said she hopes the efforts can spare other parents from the pain of losing a child to an overdose death.

Alyssa wanted to beat her addiction and was ashamed by it, her stepfather said. She also lost two boyfriends to heroin overdoses and still couldn’t get out of the addiction cycle. Heidman and Malone said they understand there was a mental health element, too, and their daughter may have been predisposed to addiction.

“She was tormented by this,” said Malone. “We provided her with every opportunity we could and we would have continued to have done that but she just couldn’t get out of that cycle. It’s tragic.”

Heidman said she had to fulfill her daughter’s wishes by starting the foundation to help stop the opioid epidemic.

“How do you breathe in the last breath of your daughter? You do it through other people. So we chose to take her mission to help others.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

COLUMBUS: Imagine the terror of being diagnosed with cancer.

Your doctor writes up your prescription, which you hope is going to save your life. You go to the hospital or oncology clinic’s in-house pharmacy. The medicine is right there on the shelves, but you’re told the only way your insurance will cover your medication, which might cost $10,000 or more per month, is if you get it through the mail.

So you wait. If you’re lucky, the medicine will arrive in a couple of days. But it could take up to a month.

Countless Ohio cancer patients don’t have to imagine this dilemma. They have experienced it, because health insurers and the pharmacy benefit managers hired by insurers dictate it.

They require that prescriptions be filled at mail-order pharmacies that are often owned by the pharmacy benefit managers rather than allowing patients to get the drugs immediately.

“With medications as good as we have today, speed to therapy is important. Even a few days can make a difference,” said Curt Passafume, vice president of pharmacy services for OhioHealth.

Insurers and their pharmacy benefit managers like to tout mail-order operations as a convenient alternative. But in the world of expensive cancer drugs, the companies use their clout to force patients away from hospital or clinic-based pharmacies and into their own mail-order operations.

It creates another revenue stream for pharmacy benefit managers, or PBMs, the little-known middlemen in the health care system. PBMs are hired by insurers or employers to negotiate prices and rebates with drugmakers, decide which medications are covered, and set rates paid to pharmacies.

‘Maximizing profits’

Elvin Weir of Blacklick is battling advanced colorectal cancer. He recently was told that his health plan, Blue Cross and Blue Shield of Michigan, would cover his new chemotherapy pills only if he filled them through Alliance Rx’s mail-order pharmacy. Two times he ordered the medication, and two times he faced big problems, he said.

The first time, he was forced to wait nearly two weeks for his medicine, and then was given incorrect instructions on dosage. The pharmacy said to send the pills back so they could be destroyed — all $20,000 worth of them.

The second time, Weir said he was shorted pills.

Both times, he was asked to wait while the mail-order pharmacy got its act together. And both times, the 52-year-old Weir refused, unwilling to further delay the fight against the cancer growing inside him.

His oncologist told him, “We know that if we don’t have you on chemo medication, it spreads like wildfire,” Weir said. “To have the oncologist use words like ‘wildfire’ and these guys saying ‘well, let’s just wait’ — I’m not waiting. That doesn’t work for me.”

Helen Stojic, a spokeswoman for Blue Cross Blue Shield of Michigan, said Weir’s access to his drug, Lonsurf, was restricted by its manufacturer, Taiho Oncology, to preferred providers, and that is why he had to get it from a mail-order pharmacy.

However, Christine Pfaff, a pharmacist for the Zangmeister Center, a Columbus cancer treatment facility, said the center’s pharmacy had the drug on its shelves — because it’s one of the preferred providers.

Behind the thicket of reasons Weir couldn’t get his medicine at his cancer clinic lies a common motive, said Ted Okon, executive director of the Community Oncology Alliance, a national group representing community cancer centers.

“This is not about expediting the cancer drug,” he said. “It’s about jockeying for control and maximizing profits.”

Disruption of care

Ohio cancer care providers said that forcing patients into mail-order pharmacies seriously disrupts the continuum of care they receive at cancer centers.

The cancer centers say that they can deliver the best care when lifesaving drugs are in the same place as doctors, non-pill treatments and patient records.

“It’s very frustrating, for as much as we want to take care of our patients, the [health] plan or the PBM is forcing them to their mail-order plans,” said Julie Kennerly, assistant pharmacy director at the James Cancer Hospital at Ohio State University.

Ohio’s insurance program for 3 million poor and disabled residents forbids its Medicaid managed care plans from requiring the use of mail-order pharmacies.

“In fact, if medically necessary, managed care plans must make arrangements for home delivery for medication — even if it’s same-day delivery,” said Medicaid spokeswoman Melissa Ayers.

Focusing on attitude

Weir tries not to get too worked up over the repeated hassles in getting his cancer medication, believing that a good attitude is the best medicine. He knows he’s more fortunate than many. He feels good enough to continue working as a project manager, is renovating a cabin in southeastern Ohio with his wife, Mary Jo, and has earned three master’s degrees since his diagnosis in February 2012.

He also is able to keep after his mail-order pharmacy to make sure he gets the drugs he needs.

“We have enough frustrations daily even if you’re not sick that you don’t need to deal with the bureaucracy that is really out for No. 1 and not out for the patient. When you throw in Stage IV cancer and everything else that we’re dealing with in life, it’s just frustrating,” Weir said.

“I’m lucky that I have a positive attitude, and my wife has a positive attitude, and that keeps us from going off the deep end,” he said.

COLUMBUS: Josh Cox says that CVS will go pretty far in trying to wrest the lucrative business of filling cancer prescriptions away from oncology clinics.

The company, which operates a retail pharmacy chain and manages prescription drug payments for millions of Americans, has long sent unsolicited faxes to cancer doctors, using confidential patient information, in an attempt to steer business to its own pharmacies, said Cox, pharmacy director for the Dayton Physicians Network.

CVS says that it does not engage in deceptive practices.

But two weeks ago, Cox said, the company took things to a new level when a representative called and told Cox that he would be breaking the law if he didn’t transfer a particular patient’s prescription to CVS’ mail-order pharmacy. Cox said that claim was false.

And he would know. In addition to being pharmacy operations director for a large oncology practice, Cox sits on the Ohio State Board of Pharmacy.

“I was told it was against the law for our pharmacy to fill the prescription, which was very disturbing to me, because not only is that certainly untrue — there are no federal or state or local laws that dictate where a patient can get their prescription — but it took the whole trolling of prescriptions to a whole new level,” Cox said.

CVS has been accused by some pharmacists and lawmakers of using its dominance as Ohio Medicaid’s leading pharmacy benefit manger to cut reimbursements to competing retail pharmacies and send letters offering to buy them out.

Pharmacy benefit managers are hired by insurers or employers to negotiate prices and rebates with drugmakers, decide which medications are covered, and set rates paid to pharmacies.

Ohio pharmacists also say that CVS uses its access to Medicare patients’ information to steer them to its own mail-order and retail pharmacies. Now it and the other dominant PBMs also are being accused by patients and hospital administrators of forcing cancer patients into the PBM’s own mail-order pharmacies, leading to confusion and delays in getting expensive, life-saving drugs, critics say.

On Friday, CVS defended its outreach and its other business practices.

“It is not our policy or practice to mislead or intimidate patients or providers,” spokesman Mike DeAngelis said in an email. “It is common for CVS Caremark to fax prior authorizations and refill requests to providers. A patient’s specialty prescriptions may be moved to CVS Specialty if a client has switched to a preferred or exclusive network when making a change to their plan design. Patients are notified in advance if their plan sponsor chooses to make such a change.”

Cox found the company’s behavior to be unacceptable.

“It was deeply disappointing to me that the process of trying to acquire business, so to speak, had devolved into intimidation tactics among pharmacies,” Cox said.

LeBron James has long had a group of dedicated grandmas rooting for him.

But now he has a bunch of kids from Akron, Cleveland, Dover, Fairview and Mayfield Heights also in his corner.

All babies born during the NBA Finals at the Cleveland Clinic’s five birthing units, including Akron General and the newly acquired Union Hospital in Dover, will get a special “Whatever It Takes” onesie to show off some hometown pride.

The Cavs and that team from out West are making a fourth straight run for a title, and this has become a tradition for the Clinic — although James and a certain other NBA Finals all-star by the name of Stephen Curry were born at rival Summa Akron City Hospital.

If you believe in streaks, proud new parents Halle and Paul Ricard believe the Cavs will snatch victory this time from the team’s nemesis Golden State Warriors.

The Copley Township couple have confidence that newborn son Lukas, who sported his Whatever It Takes onesie on Thursday for Game 1 of the series, will be a difference-maker like that other hometown superstar.

Their other son, Jacob, was born in May 2016, when the Cavs were in the middle of a historic playoff run that ended with an improbable Game 7 victory against the Warriors.

“We were bummed that he was born too early to get a onesie,” said Halle, who works in finance for Dominion.

Like the last time, the couple planned to watch the Cavs win a playoff game from the hospital.

“We joke that the Cavs have never lost when we’ve had a baby in the hospital,” said Paul, who is an attorney.

Lukas made his entry into the playoff run at 9:18 a.m. Wednesday at Akron General.

With their infant son at 6 pounds, 1 ounce, and measuring a mere 17 inches, Mom and Dad are not holding out too much hope for him entering the NBA anytime soon.

“He’s going to have to be a point guard,” Paul said. “But he probably won’t be in the starting lineup.”

They just hope he will have the same winning mojo of his older brother.

“Lukas says we are going to win,” Halle said looking down at her son. “Look at him — he knows basketball.

“He’s just a kid from Akron.”

Craig Webb can be reached at [email protected] or 330-996-3547.

SummaCare has completed its big move down East Market Street to a new headquarters in the former Goodyear Tire & Rubber Co. headquarters.

The Akron-based health insurance plan, which is celebrating its 25th anniversary, has moved from its home for the last 20 years at North Main and West Market streets.

SummaCare becomes the first office tenant — and the largest — in the renovated building that housed Goodyear until 2013, when the tire company built a new headquarters around the corner. A charter school, ICAN, also has been operating in the former headquarters.

The new SummaCare location also creates a “medical corridor” on Market Street with Summa’s Akron City Hospital campus nearby.

“We’re so excited to stay in Akron,” said Anne Armao, SummaCare vice president of marketing, Medicare and individual products. “We helped revitalize Main and Market. Just by moving a little farther east to East Market, we’re helping to revitalize [the] Middlebury [section of Akron], which the mayor is very interested in.”

Movers spent the last three weekends relocating groups of employees from the five-story building at 10 N. Main St. to the new location at 1200 E. Market St.

The previous location on the site of the former Portage Hotel served the insurer well, but was too big for its needs, said SummaCare President Dennis Pijor. The company is going from about 88,000 square feet to 65,000 square feet in The East End development.

“We are proud beyond words,” Pijor said of the company’s new home. “This is an incredible milestone for the company. I can’t think of a better way to celebrate SummaCare’s 25th anniversary than with our dedicated employees in a great new location in an area of town that is truly on an upswing.”

SummaCare celebrated the move with a ribbon-cutting event Wednesday morning, attended by executives from the insurance company, its parent Summa Health and city and county officials. SummaCare officials also unveiled a new logo for the wholly owned subsidiary, which complements a recently redesigned logo for Summa Health.

Carol Smith, senior vice president and director of development services for the East End’s developer, Industrial Realty Group, also known as IRG, said, “We are extremely grateful that a tenant with such a long standing history in Akron has chosen the East End Offices as their new home.”

Smith said there is about 400,000 square feet of space remaining in its East End office complex. “There are multiple other prospective tenants interested in the building. There have been over eight showings within the last two weeks,” she said.

The office complex also will have a cafe that will be available for the employees and their guests and a fitness facility available for office tenants’ use.

Across the street, the former Goodyear Hall has 105 apartment units, which are over 92 percent leased, and a theater with seating for 1,500 and a 20,000-square-foot gym that is being used by Rubber City Sports.

Smith said there also is a barbershop and “we are pursuing a micro brewery and other locally owned restaurants for our remaining space in the former Goodyear Hall complex.”

Employee groups

For SummaCare, going into a newly renovated space allowed the insurer to get all of its employees on one floor, instead of five, and group employees and departments that work together often near each other, Pijor said.

“Since we were just moving in, we put people close to their working relationships,” he said.

The company has 300 employees — about 250 are in the new headquarters and 40 customer service representatives work out of Summa Health’s Gorge Boulevard headquarters to combine operations with Summa’s call center. Additionally, during open enrollment season in the fall, when customers are signing up for their health-care benefits for the next year, SummaCare typically hires about 20 seasonal employees.

SummaCare serves about 73,000 members throughout Ohio, including 24,000 Medicare Advantage customers. The insurer has commercial plan members in about 20 counties in the state and 31 counties with Medicare.

The company is back on track to profitability for 2018 after some challenging years, said Pijor.

SummaCare was under sanctions in 2014 by the Centers for Medicare and Medicaid Services for violations in the way it handled consumer appeals and grievances. The sanctions were lifted within six months, “but there have been some lingering effects of the sanctions,” Pijor said. The company was profitable in 2016, but in 2017 lost money because it still was paid as a 3.5 star-rated plan (out of 5) instead of a 4-star plan because Medicare reimbursements lag, he said.

The company is back to being a 4.5-star plan and has a strong balance sheet, he said.

“All of those things are behind us and we are looking forward to a real positive fall,” Pijor said.

Akron schools

Akron Public Schools purchased the former SummaCare building from owner Signet LLC and as part of a land swap between the city, the county and United Way of Summit County for several properties and parking downtown. The district will consolidate its two administrative buildings into the new location at Main and Market streets while keeping ownership of the administrative buildings.

SummaCare has been leasing the building from the schools since the purchase was completed in April and will completely vacate the property by the end of the month.

The school district plans to occupy its new home sometime between October and December after renovations are complete, said school spokesman Mark Williamson.

There are no plans yet for either of the school’s administrative buildings — the existing administration building, known as the Sylvester Small Administration Building at 70 N. Broadway, or the Conrad C. Ott Building at 65 Steiner Ave., Williamson said.

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty