Regarding "It's an inside job" (Sept. 22, p. 6): The fact that Edward Kangas, Tenet Healthcare Corp.'s nonexecutive chairman, refused to identify the other candidates for the post of the chief executive officer-a competition won by Trevor Fetter-reflects a degree of professionalism that is to be applauded.
Modern Healthcare's decision to identify the alternate candidates' names (unless it was with their tacit approval) is, however, outside the boundary of responsible journalism. I know that I would have concerns if I were a board member and/or a part of the core leadership teams of the investor-owned hospital chains mentioned, if I first learned of their executives being courted by Tenet by reading of it in your publication.
Tyler & Co.
CMS and rehab rules
Forty years after being paralyzed, the odds say I should not be where I am today, the founding president and chief executive officer of a healthcare system employing nearly 1,000 people. More than 68% of Americans with disabilities are unemployed. Acute-care hospitals are working miracles by saving lives today that just five years ago would have been lost. But there is a difference between merely living and life. Are we condemning those patients to live the rest of their years in an 8-by-10 room or will they be enjoying an active, productive life in their communities with family and friends?
The difference between the two is access to medical rehabilitation. Unfortunately, the CMS is considering rule changes that are designed to ease access to vital care but would in reality threaten it ("CMS' inpatient surprise," Aug. 4, p. 8). The current "75% rule" will be changed to require that 65% of admissions to inpatient rehabilitation facilities fall into one of 12 diagnosis categories (the current rules mandate that 75% of patients must be in 10 diagnosis groups).
That sounds like progress, but the problem is that the new categories do not reflect the reality of modern medicine. And they certainly do not reflect the needs of our patients. Cardiac rehabilitation is excluded. Services for transplant patients are limited. The list goes on, but the bottom line is the CMS must amend the proposed changes and allow us to make a difference in people's lives. The quiet heroism displayed by individuals in the aftermath of disabling injury or illness must not go unheeded. Every American with a disability deserves the same opportunity for success that was afforded me by way of skilled medical rehabilitation.
I appreciate the CMS' effort to ease the burden on inpatient rehabilitation facilities. We are, however, equally fearful of the unintended consequences of the proposed rule changes. This is a classic example of one step forward, two steps back. Hopefully, the CMS will revise the rule. But should we entrust our patients' recovery to hopes or actions? On Sept. 25, I was proud to join the American Hospital Association, Sen. Ben Nelson (D-Neb.) and Rep. Frank LoBiondo (R-N.J.) on Capitol Hill to raise awareness of this critical issue. Now we need you to join us. Write the CMS. Contact your senator and congressman. By doing so you will be positioning yourself as a true advocate and ally of your patients.
President and chief executive officer
National Rehabilitation Hospital