InsideTucsonBusiness.com
03.11.2011
Special Report
health care
2 MARCH 11, 2011
health care
Inside Tucson BusinesS
UMC Trauma Center hopes for some lucrative new ‘Friends’ By Tara Kirkpatrick Inside Tucson Business A dinner with Pentagon physicians just two days after the tragic Jan. 8 shootings may prove to be a fateful night for Dr. Peter Rhee and University Medical Center’s Trauma Center. For it was there, at the Arizona Inn, that Rhee met a premier group of perhaps the city’s most seasoned fundraisers, all dressed in black and pearls, celebrating a friend’s birthday. But that night, they were his biggest fans. “We are a birthday group and there we were, having a fun time, when we saw the doctors walk in,” recalls philanthropist Czarina Lopez. “We immediately recognized Dr. Rhee and congratulated him on what a wonderful job he was doing. We got carried away and told him we would do anything to help him!” That moment has since set in motion an entire fundraising movement, called Friends of the University of Arizona Trauma Center, to support Southern Arizona’s only Level 1 facility and help expand its reach. The center, designated for its ability to provide an entire spectrum of trauma care, treats almost 5,000 patients a year. It took the world stage after the shopping center shootings that killed six
and wounded 13 including U.S. Rep. Gabrielle Giffords. Rhee, UMC’s trauma chief, a U.S. Navy veteran and renowned surgeon with stints in Iraq and Afghanistan, was fortuitously on-call that day and, with UMC Neurology Chief Dr. G. Michael Lemole Jr. and others, became the poised public faces of a community rocked to its core. “We were so impressed with Drs. Rhee and Lemole and the way they handled themselves throughout all the interviews,” says Louise Thomas, another dinner guest who helped start Angel Charity for Children, Inc. and is Tucson’s go-to event planner. “We felt that they represented Tucson in such a dignified manner.” Lopez and Thomas, along with their venerable cronies that night, steadfastly became the first “friends” with a donation of $500 each, to be paid annually. The number of friends has since hit 18 with the hope of countless more. Indeed, a kickoff luncheon for the effort is planned for April 20 at Arizona Inn, in which Rhee, Lemole and Dr. Rainer Gruessner, chairman of the UA Surgery Department, will speak. Tickets are $150. And more events will follow, says Thomas. “We are just trying
Quality of Life
to raise as much money as we can,” she says. The UA Foundation received no donations for trauma in 2010, but after the tragedy, received $4,000 with pledges exceeding $25,000, says UA surgery development director Kari Schlachtenhaufen. State gaming revenue, one source of money courtesy of Proposition 202, contributed $3.2 million in 2009 but that final amount is expected to be down in 2010 because of the economy, Schlachtenhaufen says. Nonetheless, “it costs $47 million a year just to keep the trauma center open and ready to see patients,” she explains. “Everyone gets the same excellent quality of care no matter when they come in,” says Schlachtenhaufen. “If you are in a car accident at 2 a.m., you will get the same excellent care.” The center provides 15 sub-specialties of care at any time. A goal for the Friends campaign is to endow a chair for the trauma center — Thomas would like to see at least $3 million raised for it — that would enable Rhee to devote more time to life-saving research, such as his work with suspended animation, in which patients’ bodies are cooled to a precise temperature that inhibits excessive blood flow, and
Biz Facts Friends of The University of Arizona Trauma Center Kari Schlachtenhaufen (520) 626-2222 an artificial blood model that carries oxygen. His research is also focused on topical hemostatics, which can be applied to wounds to immediately stop bleeding. “I’ve never had anyone want to help me before like this,” says Rhee. “Philanthropy, as a whole, for trauma, which affects the young and everyone, has not been strong. To finally have a team of people who can do this and be on our side is exciting.” “We really appreciate this opportunity,” Schlachtenhaufen says. “There are a lot of opportunities to support the hospital and we are grateful for the donations people make. This is one really important program and we are very eager to share our capabilities.”
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InsideTucsonBusiness.com
MARCH 11, 2011
health care
3
Tucson Medical Center nears finish line on upgrades Tucson Medical Center is jumping into 21st century health care with extensive stateof-the-art technology updates, as well as major patient-care facility renovations. The improvements are costing millions of dollars, but will allow for more efficient business and medical practices. Local hospitals, including TMC, and physicians have long recognized the need to expand patient services, particularly in pediatric care, according to Michael Letson, a member of the hospital’s communications team. As a result, TMC is nearing completion of the first stage of a multiphase renovation that will cost in the area of $120 million. On March 1, pediatric patients were moved into the new 16,000-square-foot TMC for Children ward, which includes 26 new private rooms, family spaces and clinical support areas. Later this spring the renovation of existing rooms will be completed as part of the $12.5 million first phase and bring the total to 44 private pediatric rooms. Meanwhile, the hospital’s mother/baby unit is being redesigned and, when completed in late spring, will include 60 private suites. “It’s a beautiful unit that conveys a homelike, relaxing atmosphere,” said Letson. Forty-four of those rooms are now open. TMC for Children is funded through TMC Foundation and Children’s Miracle Network. The fundraising campaign, Letson said, is ongoing and the foundation has had heavy community participation. Last month the Children’s Miracle Network partnered with IHOP restaurants in a nationwide publicity drive. Participating locations offered free pancakes while encouraging diners to donate to their local Children’s Miracle Network-affiliated hospital. Future expansion projects at TMC may include at least one additional parking garage and possibly a patient tower as high as four floors. “Another ongoing improvement is construction on the road and trail systems around the outside of the building. The loop road has been partly widened, parking lots have been reconfigured and we’ve provided trails to tie in with the surrounding area,” Letson said. In addition, the hospital has applied for historic designation of several structures on the property. While construction plans were falling into place for TMC for Children, the hospital was getting an overhaul of a different sort. In June 2010 the facility went live with a complete electronic medical records system. Known in-house as OneChart, it replaces all paper patient files and has capabilities beyond what has been commonplace for health care providers in the past. Letson pointed out some important advantages of having patient records stored and
Christy Krueger photos
By Christy Krueger Inside Tucson Business
The TMC for Children’s family gathering space includes library and story-telling area
A private room at TMC for Children
retrieved electronically. “Medications have a bar code and so does the patient. We scan them and the system knows if there’s a contradiction. It prevents medical mistakes. It’s been effective for delivering medications to the right person at the right time. It also means a more efficient business environment. Everything is there for insurance or Medicare,” Letson said. Hospital personnel spent two years transferring paper records to the electronic program. They received a tremendous amount of support from Epic, the company that provided the electronic medical records (EMR) system, and new employees were hired to help. The overall cost was $20 million, which Letson said included the additional workforce, software and “a lot of hardware. There’s
Entrance of new TMC for Children
a computer at every bed.” He noted that TMC was the first hospital in Tucson to reach a totally functioning level of electronic record keeping. “We’re at the forefront of EMR. We have integrated with a number of physician practices and those with Saguaro Physicians group.” Eventually, all medical providers will be using electronic files, Letson said. “Other hospitals will be there because that’s where health care is going in the 21st century.” TMC already shares files electronically, with its own physicians, and other providers such as Radiology Ltd. MRIs and CT scans can be sent instantaneously to radiologists or primary care physicians. “It’s even possible to consult with a doctor in another country,” Letson acknowledged.
Prior to the nationwide introduction of EMR, there was talk of security concerns. But Letson said the TMC staff has found electronic record keeping to be more secure than paper. “With paper, you can’t track who has had access. With electronic records, you can’t get access unless you have the proper log-in, and if you do have access, it’s documented who, when and what you did when you were there,” Letson said. TMC’s launch of OneChart is good timing, Letson believes, as all the new rooms opening this spring will include state-of-the-art equipment that will immediately become part of the system. He said it’s great for the hospital and the patients that “we’re linking the upgraded facility in a context that will maximize the effectiveness of the new electronic system.”
4 MARCH 11, 2011
Inside Tucson BusinesS
health care
Sorting out some details
What the federal health care reform bill means to you By Peter Grier The Christian Science Monitor Nearly a year after Congress passed President Obama’s landmark health care reform bill, it remains a subject of legal and political challenges. In the meantime, employers and others are still trying to sort out everything that was in it. Here’s a look at the legislation and its potential effects.
Who must buy insurance? Most U.S. citizens and legal residents must purchase “minimal essential coverage” for themselves and their dependents. They can get this either through their employer or, if their employer doesn’t offer health insurance, they can buy it through new marketplaces that will sell policies to individuals. Those marketplaces would be called “exchanges.” • What’s the penalty for not buying insurance? You’ll have to pay a tax penalty to the federal government, beginning in 2014. This fine starts fairly small, but by the time it is fully phased in, in 2016, it is substantial. An insurance-less person would have to pony up whichever is greater: $695 for each uninsured family member, up to a maximum of $2,085; or 2.5 percent of household income. There are exceptions. Certain people with religious objections would not have to get health insurance. Nor would American Indians, illegal immigrants, or people in prison.
• Why require health insurance? It will help bring in new customers for health insurance firms, including healthy young people who might not need much healthcare, thus balancing out the losses these firms might incur if they can no longer deny coverage to people with preexisting conditions. • Who gets subsidized insurance? About 19 million lower- and middle-income American households will qualify for subsidized insurance, according to the Congressional Budget Office. • What’s the formula for aid? Let’s start with people who are unemployed, self-employed, or work for businesses that don’t offer insurance. Beginning in 2014, these people would be able to shop for coverage in new “health exchanges,” a sort of online bazaar in which insurers would hawk different kinds of plans. Congressional budget experts figure about 25 million people will shop for coverage in these exchanges and of those, about 19 million are likely to be eligible for financial aid. The cutoff level would be an income of four times the federal poverty level. For one person, that’s about $44,000 a year. For a family of four, the comparable figure is about $88,000. Subsidies would be figured on a sliding scale, with those who make less getting a bigger boost and those nearer the top getting a smaller one. The formula is complicated but basically, people who make three or four times the poverty level would get enough federal money so they would not have to pay more than
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about 10 percent of their income for a decent health insurance package. People who make less would have to pay a smaller slice of their income for coverage. For instance, individuals who make about $14,000, and four-person families with incomes of about $29,000, would not have to pay more than 3 to 4 percent of their incomes for insurance. And those who make even less – under 133 percent of the federal poverty level – would be able to enroll in a newly expanded Medicaid program. The federal subsidy would go straight to the insurer. It would look like a discount on the policy to the customer. • Anyone else qualify for a subsidy? If you work for an employer who offers health insurance but make less than the poverty cutoff level, you are still eligible for aid for the employer’s plan. The federal government will in essence, guarantee that you do not have to pay more than 9.8 percent of your income for your share of health insurance costs. There is a catch. The main way the feds would ensure this is to steer you too, into a health exchange. Your employer would give you a voucher equal to the amount of money it contributes to your policy and you would use that to shop for plans with other self-employed people. (The Congressional Budget Office doesn’t expect many people will do this. Only about 1 million.) The Department of Health and Human Services is the umpire making calls as to who does and does not get subsidies. There is also a process for appealing HHS decisions.
What’s a health ‘exchange’? Each state is required to set up an “exchange,” or marketplace, where people not
covered through their employers would shop for health insurance at competitive rates. Not everyone can use exchanges, but they’re an attempt to inject some retail competition into the marketplace. Theoretically, the exchanges allow individuals and small businesses to band together and get better prices and more variety in health insurance options – the kinds of breaks that big corporations can negotiate for their employees today. How these exchanges would be designed is being left up to states. In the initial years starting in 2014, the exchanges will be open only to those who work for firms with 100 or fewer employees, and to individuals looking to buy insurance for themselves. Because they’re self-employed, for instance. Or unemployed. Or retired but not yet eligible for Medicare. The exchanges are meant to be cooperatives that allow these individuals to band together and, for health insurance purposes, become like their own big firm. • What oversight powers and duties do exchanges have? The exchanges themselves would inspect offered policies to make sure they meet government standards. They’re supposed to make sure the plans are “in the interest” of buyers, according to the healthcare reform bill. They are prohibited from setting premiums. They can however, ask insurers to justify rate hikes – and if they’re unsatisfied with the answer, can use price as a reason to ditch that particular plan from their product lineup. Then the exchange would offer approved policies to interested buyers. They’re supposed to have four levels of plans to offer, of declining expense. The levels would be labeled “platinum,” “gold,” “silver,” and “bronze.”
3350 N. Country Club Rd. 520-881-4550 x278
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MARCH 11, 2011
health care
Without an employer’s health plan, individuals could buy health insurance online through “health exchanges.”
Yes, you would be able to buy health insurance for yourself outside the exchanges. They would not be monopolies. But an insurer would have to charge the same rates outside the exchange as it does inside, for comparable plans, among other new regulations.
What does this mean for business? The federal health care reform legislation affects business decisions on health coverage for employees at tens of thousands of firms. A dry cleaner and probably a restaurant might be too small to be affected by some of the most important business-related elements in the legislation. Employers with 50 or fewer workers would be exempt from coverage provisions. But for top executives at firms with 50 workers or more, the most important question may be this: Would the health care reform bill require us to offer health insurance to our employees? The answer to that is “no,” strictly speaking. But if you don’t, you might have to pay fairly large fees to Uncle Sam.
• How does it work for businesses? If you are a firm with more than 50 employees, and do not offer health insurance as a benefit, and at least one of your full-time employees gets a subsidy from the federal government to purchase health insurance on his or her own, you would have to pay Washington a fee of $2,000 for every one of your full-time workers. (Company accountants take note: you could subtract the first 30 of your employees from that assessment.) Also, even if you do offer coverage, you might have to take some extra action to help any of your low- or middle-income workers who want to buy insurance on their own. Take an employee who makes less than 400 percent of the federal poverty level, which is about $10,800 for an individual, or $22,000 for a family of four. Perhaps that employee is finding firmoffered insurance expensive. If their share of health premiums is more than 8 percent of their income (but less than 9.8 percent), they would have the option of going out and buying insurance on their own through the newfangled “exchange” marketplaces the health care reform bill would establish. And you as an employer, would have to help them. You’d have to provide them a “free choice voucher” equal to what the firm would have kicked in to provide coverage in the company plan. • When do the changes take effect? All of the above changes are scheduled to take effect Jan. 1, 2014. One final item: if you’re a firm with more than 200 employees and you do offer health insurance, you would have to automatically enroll your workers in the plan. They could opt out of the coverage. But they are the ones that would have to make that decision.
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Inside Tucson BusinesS
TMC readying launch date of Accountable Care concept By Tara Kirkpatrick Inside Tucson Business Tucson Medical Center, chosen to pilot the idea of an “accountable care organization,” will soon launch its model, testing the idea of making quality patient care a shared responsibility with shared rewards. “We are really fired up,” says Dr. Jeffrey Selwyn, who has practiced internal medicine for 35 years and helped advise the ACO project. “There’s been so much work done and now you should see this launched within the next several months.” The concept of the Southern Arizona ACO is to bring together the hospital and its affiliated doctor groups to reduce costs while improving patients’ health — care coordination, communication and ultimately, technology being the keys to success. When the result is more efficient, quality care for the patient, the hospital and physicians share in the savings. That’s their incentive, and as ACO visionaries see it, a way to fundamental health care reform. Quality care, rather than quantity. TMC is one of five sites selected to pilot the ACO concept through a joint initiative of the Engelberg Center for Health Care Reform at the Brookings Institution and the Dartmouth Institute for Health Policy and Clinical Practice. The other test sites are Norton Healthcare, Louisville, Ky.; Carilion Clinic, Roanoke, Va.; Monarch Healthcare, Irvine, Calif.; and Healthcare Partners, Torrance, Calif. — all selected because they have strong resources, a conducive payer system, a patient population large enough to measure outcomes and integrated or aligned physician groups. TMC has worked diligently over the past year to lay the groundwork to launch the its pilot. “We are putting together the tools and systems to be successful,” says John Friend, TMC’s associate general counsel. “For example, how do we exchange data on a higher level? How do we apply care in a consistent and reliable fashion, eliminating redundancies? There is a lot of effort to create a more seamless data environment so when a patient presents in the system, the providers are well-informed of that patient. They know them well.” “When you leave the hospital and you return to your home, does that information efficiently follow you,” he adds. “Has there been a collaboration so there are no gaps in knowledge?” TMC also meets regularly with a physician steering committee. “What I see is very exciting,” says Selwyn, who has embraced the ACO concept since it first emerged in the 1970s. He practices with
“
“We are really fired up. There’s been so much work done and now you should see this launched within the next several months.” -Dr. Jeffrey Selwyn
New Pueblo Medicine, one of TMC’s affiliated doctor groups. “I think there is a lot of benefit for the patient and the physician. This is pay for performance, not for ordering more tests.” As it launches the ACO project, TMC and its physicians will be regularly measuring the outcomes, checking in either quarterly or semi-annually to determine the ACO’s efficacy. To that end, TMC and others are also awaiting new regulations from the Center for Medicare and Medicaid Services that will largely determine and refine the required attributes of TMC’s ACO and all other ACOs. “I’ve been a proponent of this for a long time,” Selwyn says. “Now that I’m at the end of my career and to see this happen, it’s a win for everyone. We are doing the right thing.” Adds Friend, “We believe this is the future.”
InsideTucsonBusiness.com
MARCH 11, 2011
health care
7
UPH program aims to keep more new doctors in Arizona By Shannon Maule Inside Tucson Business University Physicians Hospital will see new residents come July 1, thanks to a new expansion in their Graduate Medical Education residency programs. This will allow medical students to undergo their residency in Arizona, in hopes they will stay in the state after graduation, said Dr. Victora Murrain, assistant dean for Graduate Medical Education for UPH. The focus of these new programs is specifically to improve the healthcare people receive in rural areas. UPH will gain six resident physicians each to both its internal medicine and family medicine programs. Murrain said there are multiple levels to the expansion, but it began six years ago when she was approached to cultivate a growth. To her, she said, the additions have always been about “new training programs that would allow an increase in opportunity to train graduating residents in the state, recognizing the limited numbers of physicians in the rural area and also trying to increase the training positions so that there could be an increase in faculty.” She stressed that getting new programs approved takes much work. “We have to answer to the accreditation council. We couldn’t have two programs that look the same,” Murrain said. In order to obtain this permission, the focus for the new programs is to be community based. “Our goal is to train docs more in the community and the rural areas for primary care and continue to practice this,” she said. Once the programs were approved, the creation process began. Currently, UPH is accredited with six programs and one new fellowship. “This all happened pretty rapidly,” she said. “Generally it takes one year to get a program accredited by the Accreditation Council for Graduate Medical Education” (ACGME). In a press release issued last month, UPH said the goal is to increase the numbers of both internal medicine and family medical
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residents from 24 each to 30 each. This year, the total number of residents the University of Arizona and UPH Hospital Graduate Medical Education Consortium is 63 but will grow to 100 in July. Murrain said that although students are often skittish when it comes to applying for residency in new programs, she thinks that Arizona, as a desirable state, will attract
many. “We’ve been very successful in recruiting med students to our program,” she said. Come Thursday (March 17) medical students who have applied for residencies and the residency programs will find out who the incoming classes will be. “Match Day” takes place across the country, and both students and program administrators eagerly wait for that day.
“It’s a very big deal with a big ceremony,” she said. “I believe the event is even open to the public.” Future residents will be accepted into the following programs with UPH: Internal medicine, psychiatry, neurology, ophthalmology, family medicine, emergency medicine, and medical toxicology-which has just recently been accredited with the fellowship.
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1
Tucson, AZ 85723
tucson.va.gov
2
Carondelet St. Mary's Hospital 1601 W. St. Mary's Rd. Tucson, AZ 85745
(520) 872-3000 comments@carondelet.org carondelet.org
3
218,257
402
84,231
Nonprofit
1,770
8 MARCH 11, 2011
Acute-Care Hospitals Rank 2011 2010
Business Address
Phone Company e-mail Website
1
Southern Arizona VA Health Care System 3601 S. Sixth Ave. Tucson, AZ 85723
(520) 792-1450 N/A tucson.va.gov
675,153
285
N/A
Nonprofit
2,100
2
Carondelet St. Mary's Hospital 1601 W. St. Mary's Rd. Tucson, AZ 85745
(520) 872-3000 comments@carondelet.org carondelet.org
218,257
402
84,231
Nonprofit
1,770
3
Northwest Medical Center 6200 N. La Cholla Blvd. Tucson, AZ 85741
(520) 742-9000 kimberly.chimene@northwestmedicalcenter.com northwestmedicalcenter.com
192,058
300
72,383
Profit
1,758
4
Carondelet St. Joseph's Hospital 350 N. Wilmot Rd. Tucson, AZ 85711
(520) 873-3000 comments@carondelet.org carondelet.org
175,982
471
96,543
Nonprofit
2,135
5
University Medical Center 1501 N. Campbell Tucson, AZ 85724
(520) 694-0111 N/A azumc.com
114,002
467
120,983
Nonprofit
3,618
6 3 NL
Sierra Vista Regional Health Center 300 El Camino Real Center Northwest Medical Sierra Vista, AZ 85635 6200 N. La Cholla Blvd. Tucson, AZ 85741
(520) 458-4641 N/A (520) 742-9000 svrhc.org kimberly.chimene@northwestmedicalcenter.com northwestmedicalcenter.com
90,000 192,058
88 300
20,265 72,383
Nonprofit Profit
800 1,758
7 4 8 6 8
Oro Valley Hospital 1551 E. Tangerine Rd. Carondelet St. Joseph's Hospital Oro AZ 85755 350 Valley, N. Wilmot Rd. Tucson, AZ 85711 University Physician's Healthcare 2800 E. Ajo Way Tucson, AZ 85713
(520) 901-3500 N/A (520) 873-3000 orovalleyhospital.com comments@carondelet.org carondelet.org (520) 874-2000 N/A uph.org
83,041 175,982
144 471
20,112 96,543
Profit Nonprofit
550 2,135
56,211
197
36,037
Nonprofit
653
5 5 9
University Medical Center 1501 N. Campbell Tucson, AZ 85724 Carondelet Holy Cross Hospital 1171 W. Target Range Rd. Nogales, AZ 85621 Sierra Vista Regional Health Center 300 El Camino Real Tucson Medical Center (TMC Healthcare) Sierra Vista, AZRd. 85635 5301 E. Grant Tucson, AZ 85712
(520) 694-0111 N/A azumc.com (520) 285-3000 comments@carondelet.org carondelet.org (520) 458-4641 N/A 327-5461 (520) svrhc.org N/A tmcaz.com
114,002
467
120,983
Nonprofit
3,618
39,232
56
17,648
Nonprofit
232
90,000 32,500
88 612
20,265 137,000
Nonprofit Nonprofit
800 2,966
11 7 10
Carondelet Heart & Vascular Institute Oro Hospital 4888Valley N. Stone Ave. 1551 E. AZ Tangerine Tucson, 87504 Rd. Oro Valley, AZ 85755
(520) 696-2328 (520) 901-3500 comments@carondelet.org N/A carondelet.org orovalleyhospital.com
17,442 83,041
60 144
11,318 20,112
Nonprofit Profit
317 550
8
University Physician's Healthcare 2800 E. Ajo Way Tucson, AZ 85713
(520) 874-2000 N/A uph.org
56,211
197
36,037
Nonprofit
653
9 12 9
Carondelet Holy Cross Hospital Kindred Hospital Tucson 1171 W. Target Range Rd. 355 N. Wilmot Rd. Nogales, AZ 85621 Tucson, AZ 85711
(520) 285-3000 (520) 584-4500 comments@carondelet.org N/A carondelet.org khtucson.com
39,232 420
56 51
17,648 11,711
Nonprofit Profit
232 110
10
Tucson Medical Center (TMC Healthcare)
(520) 327-5461
32,500
612
137,000
Nonprofit
2,966
11
Carondelet Heart & Vascular Institute 4888 N. Stone Ave. Tucson, AZ 87504
(520) 696-2328 comments@carondelet.org carondelet.org
17,442
60
11,318
Nonprofit
317
1
3
2
6
5
2
7
9
6 NL 10 4
8
7
NL
No. of Patients No. of Treated Last Licensed Year Beds
Inpatient Days
Profit or Nonprofit
No. of F-T Local Employees
mental health
Jayendra H. Shah
Cardiovascular services, ADA certified diabetes care center, wound healing center, accredited chest pain center, 54-bed state-of-the-art emergency center; 40-bed critical care unit, behavioral health acute intervention, stabilization and extended care unit, cardiac telemetry monitoring unit, cardiac rehabilitation program, inpatient and outpatient chemotherapy, inpatient acute care dialysis, diagnostic and interventional medical imaging services with PACS Remote Image Distribution, gastroenterology lab, general medical and surgical inpatient services, hospice inpatient and home care services, outpatient IV Specialties therapy, neurology and neurosurgery services, noninvasive neurodiagnostic services, orthopedic surgery services, outpatient oncology and hematology services, inpatient and outpatient pulmonary services, 28-bed A teaching hospital, providing primary care and full-service inpatient rehabilitation specialty care in surgery, medicine,services, neurology and comprehensive mental health outpatient rehabilitation services, sleep center, outpatient diagnostic surgical services, Cardiovascular services, ADA and certified diabetes care urologywound services, complex wound care program, base center, healing center, accredited chest pain for Arizona Lifeline air medical transport center, 54-bed state-of-the-art emergency helicopter center; service, critical Faith Community nursing program, 40-bed care unit, behavioral health acute telemedicine services intervention, clinical stabilization and extended care unit,
Wanona Fritz
Emergency department, cardiac care, neurology and cardiac telemetry monitoring unit, cardiac rehabilitation neurosurgery, outpatient imaging, oncology, surgical program, inpatient and outpatient chemotherapy, weight loss program designated as a center inpatient acute care dialysis, diagnostic and of excellence interventional medical imaging services with PACS Remote Image Distribution, gastroenterology lab, general medical and surgical inpatient hospice Neurology/neurosurgery, women's care,services, diagnostic and inpatient and home care services, outpatient IV imaging services, diabetes care center, 24/7 emergency therapy, neurology and neurosurgery services, nondepartment and emergency neurological care, heart invasive neurodiagnostic services,and orthopedic surgery and vascular services, orthopedic rehabilitation services, oncology hematology services, outpatient sugical services, sleepand center, regionalservices, eye inpatient and outpatient pulmonary services, 28-bed center, behavioral health services full-service inpatient rehabilitation services, Oncology, transplantation, Diamond Children's Medical comprehensive outpatient rehabilitation services, sleep Center, emergencydiagnostic and level Iand trauma services, center, outpatient surgical services, perioperative services, intensive including urology services, complex woundcare careunits program, base neonatal and pediatric cardiovascular services, for Arizona Lifeline - airICU, medical transport helicopter rehabilitation services andnursing radiological services service, Faith Community program, telemedicine clinical services Cardiac rehabilitation, critical care services, diagnostic imaging, hospice, maternal childcare, unit,neurology infusion/wound Emergency department, cardiac and care, medical/surgical department, medical telemetry/ neurosurgery, outpatient imaging, oncology, surgical pediatrics , outpatient weight lossdepartment program designated assurgery a centercenter, of perioperative excellence services Minimally invasive surgery, gastroenterology, cardiology Neurology/neurosurgery, women's care, diagnostic and imaging services, diabetes care center, 24/7 emergency department andservices, emergency neurological care, heart Cardiovascular emergency services, and vascular services, orthopedic andhemodialysis, rehabilitation neurosciences, orthopaedic services, services, sugical services, sleep center, regional eye inpatient and outpatient surgeries, radiology/nuclear center, behavioral health servicesservices, psychiatric medicine/imaging, rehabilitation services, care unit,Diamond toxicology, diabetes, family Oncology,intensive transplantation, Children's Medical care clinics Center, emergency and level I trauma services, perioperative services, intensive carediagnostic units including Surgical and rehabilitative services, imaging, neonatal andbirthing pediatric ICU, cardiovascular services, lab services, services, gastrointestinal rehabilitation services and radiological laboratory, bi-national clinical rotation,services sponsor Border Health/Diabetes Cardiac rehabilitation, critical care services, diagnostic imaging, maternal child unit, infusion/wound Maternity,hospice, pedatrics, neuroscience, cardiac, care, medical/surgical medical telemetry/ orthopedics, behavioraldepartment, health, hospice, senior services pediatrics department , outpatient surgery center, perioperative services Heart and vascular, designated as cardiac arrest center Minimally invasive surgery, gastroenterology, by the Arizona Department of Health Services,cardiology Bureau of EMS and Trauma System, 60 beds totally dedicated to cardiothoracic vascular services, 14 bed intensive care unit, 24/7 services, emergency department with one of only Cardiovascular emergency services, three Accreditedorthopaedic Chest Pain services, Centers in southern AZ, neurosciences, hemodialysis, modern surgery offering off-pump bypass and inpatientcardiac and outpatient surgeries, radiology/nuclear minimally invasive cardiac surgery, two catheterization medicine/imaging, rehabilitation services, psychiatric suites, one electrophysiology room, one diabetes, special family services, intensive care unit, toxicology, procedures/catheter lab room, offers HeartSaver CT for care clinics early diagnosis of heart disease Surgical and rehabilitative services, diagnostic imaging, Long-term acute care lab services, birthing services, gastrointestinal laboratory, bi-national clinical rotation, sponsor Border Health/Diabetes Maternity, pedatrics, neuroscience, cardiac,
Ranked by the number of patients treated last year 5301 is E. provided Grant Rd. N/Ais ranked alphabetically in case of ties. Other businesses were contacted but either declined or did not respond by deadline. There is no charge toorthopedics, health, hospice, senior services Ranked information by business representatives at no charge and be included behavioral in Inside Tucson Business listings. 85712provided WND=would not disclose *=lasttmcaz.com 4 NL=not listed Tucson, last year AZ N/A=not year's data
Nursing Care Centers 10
Rank Business 2011 Address 2010
Phone Company e-mail Website
12 1
(520) 296-6181 (520) 584-4500 N/A slazurek@devongables.com khtucson.com devongables.com
NL 1
Devon Gables Assisted Living and Kindred Hospital Tucson 355 N. Wilmot Rd. Independent Living AZRd. 85711 6150Tucson, E. Grant Tucson, AZ 85712
No. of Licensed No. of Patients Beds Treated Last Year 312
420N/A
Levels of Care
A, 51 I, P, N, S 11,711
ALTCS Participant
Y Profit
Long-term acute care
A
Ranked by the number of patients treated last year 1 294-0005 240 200 but either All declined or did not respond Y by deadline. There is no charge Y Ranked information is provided representatives at(520) no charge and is ranked alphabetically in case of ties. Other businesses were contacted to be included in Inside Tucson BusinessAlistings. Avalon SW Healthby & business Rehabilitation NL=not listed last year N/A=not provided WND=would not disclose *=last year's data hgreason@avalonhci.com or
2 NL
2900 E. Milber St. Tucson, AZ 85714
Inside Tucson BusinesS
Top Local Executives
Year Establ. Locally
Jonathan H. Gardner Linda K. Reynolds Jayendra H. Shah
1928
Wanona Fritz
1880
Kevin Stockton Ron Patrick Andrew Wills Farron Sneed Jan Offret
1983
Odette Bolano
1961
Kevin Burns
1971
Margaret Hepburn Kevin Stockton Ron Patrick Andrew Wills Farron Sneed Jan Offret Shawn Strash Odette Bolano
1963 1983
Diane Rafferty
2004
sanderson@avalonhci.com avalonhci.com
2005 1961
Kevin Burns
1971
Wanona Fritz
1991
Margaret Hepburn Judy Rich
1963 1943
Odette Bolano Shawn Strash
1997 2005
Diane Rafferty
2004
Wanona Fritz Heidi Miller
1991 1994
Judy Rich
1943
Heart and vascular, designated as cardiac arrest center Odette Bolano by the Arizona Department of Health Services, Bureau of EMS and Trauma System, 60 beds totally dedicated to cardiothoracic vascular services, 14 bed intensive care unit, 24/7 emergency department with one of only three Accredited Chest Pain Centers in southern AZ, modern cardiac surgery offering off-pump bypass and minimally invasive cardiac surgery, two catheterization Licensed Medicare Licensure Quality Top Local suites, one electrophysiology room, Rating one special Executives procedures/catheter lab room, offers HeartSaver CT for early diagnosis of heart disease
Y 110
1880
Heather Heidi Miller Friebus Paula Johnsen
1997
Year Establ. Locally 1962 1994
Steve Anderson Melissa Rideout Hilary Greason Charlotte DunkcleeTotten
1982
3
Posada del Sol 2250 N. Craycroft Rd. Tucson, AZ 85712
(520) 733-8701 N/A pima.gov/depts/posada.html
149
135
H, I, P, N
Y
Y
N/A
Patricia Wilson
1971
4
Mountain View Care Center 1313 W. Magee Rd. Tucson, AZ 85704
(520) 797-2600 N/A N/A
120
700
A, H, N, S
Y
Y
5*
Maria J. Montion
1995
4
Santa Rita Nursing & Rehabilitation Center 150 N. La Canada Dr. Green Valley, AZ 85614
(520) 625-0178 info@santaritacare.com santaritacare.com
120
600
H, N, S
Y
Y
4*
Carl K. Zimmerman
1974
6
Villa Maria Care Center 4310 E. Grant Rd. Tucson, AZ 85712
(520) 323-9351 N/A villamariacc.com
83
N/A
N, S
Y
Y
5*
Damacio Marquez
1969
7
La Hacienda at La Posada (Healthcare) 700 S. La Posada Cir. Green Valley, AZ 85614
(520) 648-8388 steve@laposadagv.com laposadagv.com
60
260
H, I, S
Y
Y
5*
Lisa Israel
1987
8
Handmaker Jewish Services for the Aging 2221 N. Rosemont Blvd. Tucson, AZ 85712
(520) 322-7035 cturner@handmaker.org handmaker.org
58
160
N
Y
Y
5*
Arthur Martin
1963
9
La Rosa Health Care Center at Santa Catalina Villa 7500 N. Calle Sin Envidia Tucson, AZ 85718
(520) 742-6242 tdelgado2@brookdaleliving.com brookdaleliving.com
42
200
N
N
Y
A
Thomas A. Hines Damacio Marquez
1998
3
4
5
6
7
7
9
1 Formerly La Colina Care Center Ranked by the number of licensed beds Ranked information is provided by business representatives at no charge and is ranked alphabetically in case of ties. Other businesses were contacted but either declined or did not respond by deadline. There is no charge to be included in Inside Tucson Business listings. NL=not listed last year N/A=not provided WND=would not disclose Levels of Care: A=Alzheimer's Units, H=hospice, I=intermediate care, P=personal care, N=skilled nursing, S=subacute or hospital Licensing: Facilities are licensed by ADHS for two year''s if no deficiencies are found, otherwise the license is granted for one year Medicare Certified: Required when the agency offers skilled nursing care. The agency is subject to a federal inspection in order to offer Medicare-reimbursed treatment. Accreditation: If yes, the accrediting organization could be CARF or JCAHO. Certifications: CNA=certified nurses assistant LPN=licensed practical nurse RN=registered nurse. Licensure Quality Rating: Ratings are given from A to D, with A being the highest rating awarded ^=Avalon Health Care was previously known as La Colina Health Care
InsideTucsonBusiness.com
MARCH 11, 2011
Rehabilitation Centers Rank 2011 2010
Business Address
Phone Company e-mail Website
1
La Frontera Center 502 W. 29th St. Tucson, AZ 85713
(520) 884-9920 N/A lafronteraaz.org
Ages Covered
No. of Physicians, Services Offered Nurses, Therapists, Support Staff
Top Local Executives
Year Establ. Locally
18,708
N/A
P: 34 N: 16 T: 47 S: 42
Mental health and substance abuse treatment
Douglas Long Daniel J. Ranieri
1968
2
CODAC Behavioral Health Services, Inc. 1650 E. Ft. Lowell Rd., Ste. 202 Tucson, AZ 85719
(520) 327-4505 info@codac.org CODAC.org
10,316
12+
P: 19 N: 18 T: 26 S: 311
Outpatient and residential treatment for mental health and substance W. Mark Clark use disorders for individuals and families ages 12+. Integrated primary care and behaviaral health care. Prevention programs to promote positive, healthy behavior and strong communities.
1971
3
Tucson Physical Therapy PC 5501 N. Oracle Rd., Ste. 101 Tucson, AZ 85704
(520) 293-5551 tptdriscollpt@aol.com tucsonphysicaltherapy.com
3,638
9+
P: 0 N: 0 T: 10 S: 20
Outpatient orthopedic and sports physical therapy, hand therapy, work injury management including acute physical therapy, work conditioning, pre-employment testing and FCEs
Dennis Driscoll
1984
4
HealthSouth Rehabilitation Hospital of Southern Arizona 2650 N. Wyatt Dr. Tucson, AZ 85712
(520) 325-1300 N/A rehabinstituteoftucson.com
2,800
18+
P: 0 N: 50 T: 35 S: 245
Physical rehabilitation for people recovering from a stroke, injury or major illness
Jeff Christensen
1988
5
Maximum Impact Physical Therapy 6970 N. Oracle Rd., Ste. 130 Tucson, AZ 85704
(520) 219-5825 N/A maximumimpactpt.com
1,618
6+
P: 0 N: 0 T: 6 S: 18
Certified hand therapy, back program, neck program, sports therapy, chronic pain
Darren M. Bayliss
2005
6
Noonan Physical Therapy and Associates (520) 885-4636 5956 E. Pima, Ste. 140 noonanpt@gmail.com Tucson, AZ 85712 mikenoonanphysicaltherapy.com
1,285
13+
P: 0 N: 0 T: 6 S: 8
Specializing in musculoskeletal injuries from the neck and back down to the foot and ankle, reducing pain or stiffness, restoring function after surgery, preventing recurrent injury, improving physical performance and maintaining wellness
Michael R. Noonan
2001
7
La Posada Outpatient Therapies1 700 S. La Posada Cir. Green Valley, AZ 85614
(520) 648-2200 N/A laposadagv.com
1,045
2+
P: 0 N: 0 T: 4 S: 10
Physical therapy, occupational therapy, speech therapy, Parkinson's, water therapy
Lisa Israel Joni Condit
1987
7
Sierra Tucson 39580 S. Lago del Oro Parkway Tucson, AZ 85739
(800) 842-4487 Outreach@SierraTucson.com SierraTucson.com
1,045
18+
P: 9 N: 40 T: 71 S: 32
Specialized inpatient treatment programs for coexisting disorders, chemical dependency, eating disorders, mood and anxiety disorders, pain management, trauma recovery, sexual compulsivity, progressions (for advanced recovery skills). Complex assessment and diagnosis offered on inpatient or outpatient basis.
Patricia L. Ryding, Psy.D. 1983 Robert R. Johnson, D.O. Christi Cessna Nancy O'Donnell, M.A., LPC, EAP Susan Hollingsworth Brandy Barbour Jane Hawksley, M.S., R.N., PMH-CS
9
Ft. Lowell Physical Therapy, PC 2560 E. Ft. Lowell Rd. Tucson, AZ 85716
(520) 323-9086 info@fortlowellpt.com fortlowellpt.com
820
8+
P: 0 N: 0 T: 3 S: 5
Outpatient physical therapy
Don Snyder
1984
10
Noonan Physical Therapy and Associates (520) 574-0200 2 N/A 7545 S. Houghton Rd. mikenoonanphysicaltherapy.com Tucson, AZ 85747
807
10+
P: 0 N: 0 T: 1 S: 2
Physical therapy
Michael R. Noonan
2010
11
Teen Challenge of Arizona, Inc. 8464 N. Oracle Rd. Tucson, AZ 85704
(520) 292-2273 mail@tcaz.org tcaz.org
624
12+
P: 0 N: 0 T: 0 S: 80
Outreach and prevention, residential recovery, re-entry
Rev. Snow Peabody
1965
12
Tygiel Physical Therapy 6606 E. Carondelet Dr. Tucson, AZ 85710
(520) 296-8513 TygielPT@aol.com N/A
600
2+
P: 0 N: 0 T: 6 S: 4
Orthopedic manual physical therapy, neck and back care, shoulder, Philip Paul Tygiel elbow, hip, knee and ankle rehabilitation, fall prevention therapy, Carol Ickes geriatric weakness, gait and balance therapy, vestibular rehabilitation Carrie Oliver Campbell Lynn Garcia Stacy Yungkurth Lora Amelunke
1974
13
Central Hand Therapy, PC & Southern Arizona Community Occupational Therapy Associates 2810 N. Alvernon, Ste. 600 Tucson, AZ 85712
(520) 321-1495 N/A centralhandtherapy.com
504
Newborn+
P: 0 N: 0 T: 3 S: 2
Specializing in restoration of motion and relief of pain in upper Julia Grover extremity conditions of the shoulder, elbow, wrist and hand, for adult and pediatric populations
1998
14
Therapeutic Riding of Tucson (TROT) 8920 E. Woodland Rd. Tucson, AZ 85749
(520) 749-2360 trotarizona@aol.com trotarizona.org
330
2+
P: 0 N: 0 T: 2 S: 5
Therapeutic riding and horse-related activities for children and adults with special needs. Physical and occupational therapy for children 2 6 years of age. "Heroes on Horses" program for injured Veterans.
Leslie Esselburn
1974
15
Amity Foundation at Circle Tree Ranch 10500 E. Tanque Verde Rd. Tucson, AZ 85749
(800) 381-3318 N/A circletreeranch.org
300
18+
P: 0 N: 1 T: 13 S: 12
Specialized curriculum for substance/alcohol dependence, posttraumatic stress disorder, and trauma in a teaching and therapeutic community
Rod Mullen
1969
16
Avalon SW Health & Rehabilitation2 2900 E. Milber St. Tucson, AZ 85714
(520) 294-0005 hgreason@avalonhci.com or sanderson@avalonhci.com avalonhci.com
200
23+
P: 5 N: 65 T: 10 S: 30
Sub-acute care, long term care, physical therapy, occupational therapy, speech therapy, nutrition services, memory care community (Alzheimer's and dementia care)
Steve Anderson 1982 Melissa Rideout Hilary Greason Charlotte Dunkclee-Totten
17
The Haven 1107 E. Adelaide Dr. Tucson, AZ 85719
(520) 623-4590 thehaveninc@aol.com thehaventucson.org
175
18+
P: 1 N: 1 T: 2 S: 11
Residential treatment of substance use disorders for women and women with children
Margaret Higgins MBA, PHD
1970
18
Handmaker Jewish Services for the Aging 2221 N. Rosemont Blvd. Tucson, AZ 85712
(520) 322-7035 cturner@handmaker.org handmaker.org
160
65+
P: 1 N: 5 T: Contracted out S: 190
Physical therapy, occupational therapy, speech therapy
Arthur Martin
1963
19
Mirasol Eating Disorder Clinic 1615 E. Ft. Lowell Tucson, AZ 85719
(520) 546-3200 info@mirasol.net mirasol.net
125
18+
P: 3 N: 6 T: 8 S: 35
Treating eating disorders and co-occuring conditions
Jeanne Rust, PhD LPC
1999
20
Casa De Palmas 100 S. Avenita de Palmas Tucson, AZ 85716
(520) 770-1880 N/A casadepalmas.org
30
18+
P: 1 N: 1 T: 2 S: 10
Alcohol treatment, drug treatment and co-occuring disorders
Chris O'Dell, LPC LISAC Margaret Higgins, PhD.
2008
1
2
5
7
15
NL
8
9
NL
NL
NL
10
NL
11
NL
NL
13
12
NL
14
No. of Patients Treated Last Year
1 Formerly La Hacienda at La Posada 2 Formerly La Colina Care Center Ranked by the number of patients treated last year Ranked information is provided by business representatives at no charge and is ranked alphabetically in case of ties. Other businesses were contacted but either declined or did not respond by deadline. There is no charge to be included in Inside Tucson Business listings. NL=not listed last year N/A=not provided WND=would not disclose P=physician, N=nurses, T=therapists, S=support staff *=last year's data
9
10 MARCH 11, 2011
Inside Tucson BusinesS
Home Health Care Agencies Rank 2011 2010
Business Address
Phone Company e-mail Website
No. of F-T Healthcare Providers
Services Offered
Therapies Offered Licensed Medicare Accredited Certifications
Parent Company Headquarters
1
AristoCare 698 E. Wetmore, Ste. 210 Tucson, AZ 85705
(520) 577-4825 info@aristocare.net aristocare.net
327
Skilled nursing, case management, medication management, personal care, live ins, sleepovers, respite, medication reminders, meal preparation, light housekeeping, transportation
None
N N CNA, LPN, RN
CareGiver Connection Dana Rambow of AZ, LLC Tucson
1999
2
Bayada Nurses 6367 E. Tanque Verde Rd., Ste. 130 Tucson, AZ 85715
(520) 721-8800 tucson@bayada.com bayada.com
257
Personal care, nurse supervised and Medicare services for O, P, SW the greater Tucson area, Oro Valley, Green Valley, Vail and Cochise County
Y Y CNA, LPN, RN, T
Moorestown, NJ
Karen Rizzo
1997
3
Dependable Health Services 1120 S. Swan Rd. Tucson, AZ 85711
(520) 721-3822 homehealth@dependablehealth.com dependablehealth.com
156
Skilled nurses, private duty staff, home health aides, home medical equipment, sales and service
Y Y CNA, LPN, RN, T
Tucson
Joseph M. Schifano Larry J. Johnson
1992
4
Interim HealthCare, Inc. 5055 E. Broadway, Ste. D-104 Tucson, AZ 85711
(520) 747-1800 darenyork@interimaz.com interimhealthcare.com
100
Wound care, rehabilitation, chronic disease management, O, P, S, SW orthopedic patients
Y N CNA, LPN, RN, T
Boca Raton, FL
Daren York
1971
4
NurseCore of Tucson 2980 N. Campbell Ave., Ste. 160 Tucson, AZ 85719
(520) 791-2300 N/A nursecore.com
100
Companionship, personal care and skilled nursing
PT, OT, ST, SW
Y Y CNA, LPN, RN, T
Arlington, TX
Lisa Rambaud
1974
6
Home Instead Senior Care 3208 N. Tucson Blvd. Tucson, AZ 85716
(520) 770-9943 info@homeinsteadtucson.com homeinsteadtucson.com
85
Companionship, meal preparation, light housekeeping, medication reminders, errands and incidental transportation
None
N N N
Omaha, NE
Scott Ehrsam Kathy Ehrsam
1996
7
Watermark at Home of Southern AZ 5830 N. Fountains Ave. Tucson, AZ 85704
(520) 886-4400 ocortinas@watermarkathome.com watermarkathome.com
80
Medicare certified home health and private duty agency
O, S, P, SW
Y N CNA, LPN, RN, T
Tucson
Olivia CortinasRomero
1977
8
Catalina In-Home Services, Inc. 1602 E. Ft. Lowell Rd. Tucson, AZ 85719
(520) 327-6351 care@catalinainhome.com catalinainhome.com
60
Personal and support services for older adults in their homes
None
N N CNA, RN
Tucson
Judith Clinco Betty Oren
1981
9
NSI - Nursing Service, Inc. 3075 N. Swan Rd. Tucson, AZ 85712
(520) 731-1117 admin@nsinursing.com nsinursing.com
56
RN case management, RN and LPN skilled nursing, wound care, respiratory care, CNAs, HHAs, ACWs, personal care, light housekeeping, meal preparation, Medicare, private insurance, private pay, ALTCS, DDD, ACCCHS etc.
O, P
Y N CNA, LPN, RN
Tucson
Carole Little
1985
10
Accessible Home Health Care of Pima County 7301 E. 22nd St., Ste. 16E Tucson, AZ 85710
(520) 886-0501 irex@ahcglobal.com accessiblehhc.com
36
Medical and non-medical home health care, senior care, None and elder care to all individuals from newborns to seniors
N Y CNA, LPN, RN
Coral Springs, FL
Ismael Rex William Madison
2007
11
Christian Companion Senior Care 6711 E. Camino Principal Tucson, AZ 85715
(520) 296-0085 N/A christianseniorcare.com
35
Spiritual encouragement, personal care, house cleaning, cooking, transportation, companionship
None
N N CNA
Oklahoma City, OK
Ron Swager
2009
12
Access Wisdom Eldercare 360 W. Vista Hermosa Dr. Green Valley, AZ 85614
(520) 393-0300 info@wisdomaz.com wisdomaz.com
32
In-home care, care management, assisted living residences
None
N N CNA, RN
Wison Eldercare, Inc. Chicago, IL
Ellen Reed
1996
13
ComForcare 1670 N. Kolb Rd., Ste. 142 Tucson, AZ 85715
(520) 297-4333 pimaaz@comforcare.com pimaaz.comforcare.com
30
Non-medical, private duty home care services for people of all ages
None
N N N
Bloomfield Hills, MI
Renee Starnes
1996
14
Homewatch Caregivers of Tucson 3483 W. Courtney Crossing Ln. Tucson, AZ 85741
(520) 297-9349 phc@homewatchcaregivers.com homewatchcaregivers.com/Tucson
10
Companionship, caregiving, shopping, assistant to None appointments, medication reminders, medication set-ups
N N CNA
Denver, CO
Margaret "Margie" M. Lannon
2009
14
SunLife Home Care 627 N. 6th Avenue Tucson, AZ 85705
(520) 888-1311 sunlife@sunlifehomecare.com sunlifehomecare.com
10
Skilled nursing, physical therapy, occupational therapy, home health aides, medical social workers and speech pathology
Y Y CNA, LPN, RN, T
Tucson
Rob Murphy
2005
2
3
1
7
5
6
NL
11
13
15
12
NL
10
14
NL
O, P, R, S, SW, I
O, P, S, I
Top Local Executives
Year Establ. Locally
Ranked by the number of full-time health care providers (2 P-T = 1 F-T) Ranked information is provided by business representatives at no charge and is ranked alphabetically in case of ties. Other businesses were contacted but either declined or did not respond by deadline. There is no charge to be included in Inside Tucson Business listings. NL=not listed last year N/A=not provided WND=would not disclose Therapies: O=occupational therapy P=physical therapy R=respiratory therapy S=speech therapy SW=social work I=home infusion therapy Licensing: Home health care agencies are licensed annually by the Arizona Department of Health Services. Medicare Certified: Required when the agency offers skilled nursing care. The agency is subject to a federal inspection in order to offer Medicare-reimbursed treatment. Accreditation: If yes, the accrediting organization could be CARF or JCAHO. Certifications: CNA=certified nurses assistant LPN=licensed practical nurse RN=registered nurse T=therapists CCG=cardiovascular cartography. *=last year's data
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health care
MARCH 11, 2011
11
Legal wrangling goes on over federal health-care plan By Warren Richey The Christian Science Monitor The wrangling over federal heath care reform goes on. The latest installment happened when a federal judge in Florida, who struck down the law a month ago, issued a stay of that order—while insisting the government launch a fast-track appeal. In a tartly-worded order, Senior U.S. District Judge Roger Vinson issued the stay March 3 under the condition that government lawyers seek an expedited appeal of Vinson’s ruling by Thursday, March 10 either to the 11th U.S. Circuit Court of Appeals in Atlanta or directly to the U.S. Supreme Court. “Almost everyone agrees that the constitutionality of the act is an issue that will ultimately have to be decided by the Supreme Court of the United States,” Judge Vinson said. “It is very important to everyone in this country that this case move forward as soon as practically possible.” Judge Vinson became the second federal judge to strike down a key portion of President Obama’s Affordable Care Act. In a Jan. 31 decision, Vinson declared that Congress exceeded its authority under the Constitution’s commerce clause by requiring every American to purchase a government-approved level of private health insurance. But the judge went further. He also ruled that since the so-called individual mandate was the centerpiece of the entire reform effort, all 450 provisions in the law must also be rendered void as well. The Pensacola-based judge did not issue an injunction specifically commanding the Obama administration to immediately halt all efforts to implement health-care reform. He did not believe an injunction was necessary. His Jan. 31 ruling says in part on page 75: “There is a long-standing presumption that officials of the executive branch will adhere to the law as declared by the court. As a result, the Jan. 31 declaratory judgment is the functional equivalent of an injunction.” Immediately after Judge Vinson issued his decision, senior administration officials said they would continue to implement the health-reform law as the appeals process moved forward. Some well-known provisions have already taken affect, including a bar on denying coverage for preexisting health conditions and allowing parents to maintain coverage of their young-adult children. In addition, several states are taking concrete steps to prepare for the broader implementation of the law and are accepting federal money to fund the effort. Many legal analysts had expected administration lawyers to seek a stay of Judge Vinson’s Jan. 31 ruling to extend during an appeal. But rather than immediately file an
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“There is a long-standing presumption that officials of the executive branch will adhere to the law as declared by the court. As a result, the (Jan. 31) declaratory judgment is the functional equivalent of an injunction.” -Senior U.S. District Judge Roger Vinson appeal, the Justice Department waited 2½ weeks before it sent an unusual motion to the judge. The government wanted the judge to “clarify” whether his 78-page decision was intended to bring an immediate halt to the entire Affordable Care Act. Lawyers for the 26 states challenging the constitutionality of the ACA told Vinson the effort was a “transparent attempt … to obtain a stay pending appeal.” Judge Vinson issued the requested clarification on Thursday and it is apparent from the tone of the 20-page order that he was not amused by the government’s conduct. He told the government lawyers that his Jan. 31 ruling used language that was “plain and unambiguous.” And he accused the Obama administration of ignoring his ruling to continue moving forward with health-care reform. Vinson said if the administration was unable to comply with his decision striking down the ACA, officials were entitled to seek an immediate stay of the ruling. “It was not expected that they would effectively ignore the order and declaratory judgment for two and one-half weeks, continue to implement the act, and only then file a belated motion to ‘clarify,’ ” he wrote. The judge said he was agreeing to issue a stay of his ruling because halting the ongoing implementation of the health-care reform effort would be “extremely disruptive and cause significant uncertainty.” The judge cited the case of residents and
public officials in Michigan, where a different federal judge has ruled that the ACA is in full compliance with the Constitution. To date, three federal judges have upheld the ACA as constitutional and two have struck it down as unconstitutional. The cases are all under appeal. Vinson said the complicated healthreform effort, combined with the ongoing constitutional challenges, have generated uncertainty and confusion across the country. “The sooner this issue is finally decided by the Supreme Court, the better off the entire nation will be,” he said. A Justice Department spokeswoman praised Vinson’s decision to issue a stay of his earlier ruling. “We appreciate the court’s recognition of the enormous disruption that would have resulted if implementation of the Affordable Care Act was abruptly halted,” said Tracy Schmaler, deputy director of the Justice Department’s Office of Public Affairs. She said the stay would allow the continuation of tax credits to small businesses and distribution of millions of dollars in federal grants to states to help cover healthcare costs. Georgetown Law Professor Randy Bar-
nett said Vinson’s most recent order was “another masterful opinion from a heroic judge.” Barnett, a commerce clause scholar, said in a statement that the government’s motion to “clarify,” had given the judge an opportunity to defend his Jan. 31 ruling from criticism, “while effectively compelling a fast-track appeal to the Eleventh Circuit.” Ilya Shapiro of the Cato Institute also viewed Vinson’s action as a positive move for those challenging the constitutionality of the health-reform law. “Judge Vinson’s latest ruling exposes the government’s disingenuousness with respect to his earlier invalidation of the entirety of Obamacare,” Shapiro said. “He has now put the government’s feet to the fire, making clear that if the government doesn’t appeal – and ask for expedited appeal – within a week, it must stop implementation of Obamacare.” In her statement on behalf of the Justice Department, Schmaler said there was “clear and well-established legal precedent that Congress acted within its constitutional authority in passing the Affordable Care Act and we are confident that we will ultimately prevail on appeal.”
12 MARCH 11, 2011
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