Former nurse Charles Cullen, who confessed to killing dozens of patients at hospitals in Pennsylvania and New Jersey, pleaded guilty to 13 murders and two attempted murders at Somerset Medical Center, Somerville, N.J. In exchange for the plea and Cullen's promise to cooperate in the continuing investigation in counties throughout the two states, prosecutors said they have agreed not to seek the death penalty. The Somerset County prosecutor's office said, however, that it would seek two consecutive life terms with a minimum of a 127-year period of parole ineligibility. Cullen, who was hired at hospital after hospital despite a spotty and troubled work history, eventually became a suspect after two suspicious patient deaths at Somerset were reported to investigators in October 2003. He subsequently confessed that he was responsible for the deaths of as many as 40 patients at various hospitals during his 16-year career as a nurse. Prosecutors said they determined that Cullen's murder weapons were usually drugs that he took from the critical-care unit's Pyxis system.
Sutter reports 64% income jump
Sutter Health, Sacramento, Calif., reported a 64% jump in net income for 2003, thanks to increased patient volumes and continued belt-tightening. Net income for the not-for-profit chain of 26 hospitals reached $465 million in 2003, up from $284 million in 2002. Excluding investment income, earnings from operations climbed 47% to $389 million from $265 million the year before, representing a 7% margin. Total revenue grew 16% to $5.7 billion. Sutter has faced criticism for allegedly charging rates up to 80% higher than other California hospitals, and the California Public Employees' Retirement System has proposed legislation that would allow payers to scrutinize hospitals' proprietary financial information. Sutter is spending $5.7 billion over 10 years to upgrade or replace old facilities and $1.2 billion for new information technology. "We continue to believe that a 5% operating margin is the minimum level necessary to adequately fund our commitments," Sutter Chief Executive Officer Van Johnson said.
CMS to change rehab criteria
The CMS issued final regulations to change criteria used to determine whether a facility receives inpatient rehabilitation rates. Among other changes to the rehab criteria, the CMS eliminated polyarthritis from a list of 10 qualifying patient conditions and added four other arthritis-related conditions and post-surgical care for certain joint replacements. Providers vehemently opposed the CMS' initial proposal issued late last year, particularly the elimination of polyarthritis, saying many legitimate rehab hospitals would not meet the new criteria. The American Hospital Association said it wasn't much happier with the final regulations than with the proposal and would seek congressional intervention. Because of the services required, Medicare pays higher rates to facilities that meet its definition of rehab hospitals.
PPS regs issued for LTACs
The CMS issued final regulations to define details of a prospective payment system for long-term acute-care hospitals. The PPS regulation, effective July 1, raises the 2004-05 increase in Medicare payments to long-term acute-care hospitals to 3.1% instead of the 2.9% projected in January. The agency attributed the higher increase to more facilities than had been anticipated switching to the PPS immediately instead of opting for a transition period. Some 93% of the nation's more than 300 long-term acute-care hospitals-instead of the projected 70%-have chosen to be paid under the new system, the CMS said. As a result, Medicare payments to long-term acute-care hospitals are expected to total $2.96 billion in fiscal 2005.