Quality Of Care

Just months after Erickson Retirement Communities filed for bankruptcy, the company's new owners say they are poised for expansion with the same business model that seized up along with the housing and credit markets last year. Local entrepreneur Jim Davis, whose Redwood Capital Investments LLC bought Erickson for $365 million this month, said the Catonsville-based company is more financially sound than ever after wiping out most of its debt through the bankruptcy. That will enable Erickson to move forward in the next year with new housing at about a dozen of its existing communities that are not fully developed, he said.

YOUR MARCH 20 editorial, "Curbing the power of HMOs," contained a number of factual errors. The most blatant one was your assertion that "medical decisions are made not by physicians . . . but by bean-counters. . . ."I have been a sole practitioner for 25 years in Columbia. My specialty is family practice and I belong to several HMOs (over two-thirds of my patients are members of HMOs).I have never been told how to practice medicine by any HMO.I have been given practice guidelines on selected diseases (like asthma and heart failure)

A Tennessee-based company that has provided medical services to most of Maryland's prisons for the past five years announced yesterday that it failed to win a new contract for inmate medical care potentially worth tens of millions of dollars. America Service Group Inc. of Brentwood, Tenn., said in a statement that it had not yet received formal notification from Maryland officials that its subsidiary - Prison Health Services Inc. - lost the state's business in a bidding process that began last fall.

STATE regulators placed Maryland hospitals on a rate-loss diet a few years ago, but the bureaucrats may have overdone it: For some medical centers, it has turned into a starvation diet that could threaten patients' well-being. Indeed, there is evidence that regulators' cutbacks on hospital rate charges helped precipitate staffing reductions at Shady Grove Adventist Hospital in Rockville, especially nursing shortages, that led to serious medical problems for patients. Shady Grove's accreditation is now threatened.

Her family knew Sophie Bernstein could be demanding, but they were stunned when told she was about to be evicted from her nursing home. Too difficult, a nursing home official told them, after she'd been living there three weeks. She wouldn't sleep in her bed. She refused to cooperate with staff. Sometimes, she'd wander into other people's rooms. Dena and Hillel Soclof, her daughter and son-in-law, were at their wit's end -- until they found the one employee at Levindale Hebrew Geriatric Center and Hospital in Northwest Baltimore who could come to their aid. They asked for help from Heather Allen, the nursing home's patient advocate.

Financially troubled St. Joseph Medical Center ended its search for a new owner Friday, announcing that it has entered an agreement to become part of the rapidly expanding University of Maryland Medical System. The announcement was greeted with cheers at the Towson hospital, said Dr. Paul McAfee, head of spinal surgery. "If the doctors in the operating room and emergency room had flowers, they would have thrown them," he said, adding that UMMS plans to upgrade the facilities and turn the hospital into a major surgery center.

At a time when physicians and policymakers alike are being asked to reduce health care costs without sacrificing quality care, it's crucial that we unleash the enormous potential for savings that could come from exciting new advances in health information technology. There's no better example of the revolution under way in medical care than electronic medical records and electronic prescribing systems, which not only allow doctors to generate prescriptions and orders electronically and transmit them directly, but provide instant access to drug reference information and a patient's complete medical history.

MOSCOW -- Dr. Mikhail Alshibaya, one of Russia's leading heart surgeons, has mixed emotions about President Boris N. Yeltsin's decision to have a bypass operation in Russia at the end of this month.Alshibaya says the president's decision was "the best advertisement we could get" for bypass surgery, an uncommon operation in Russia.But he says it probably would be safer for the president to go to the West for the operation.Heart disease is the leading cause of death in Russia, as it is in the United States.

Officials seeking a partner for Howard County General Hospital say they have eliminated a for-profit suitor, easing the concerns of many in the community.In their first large public meeting on the search for a larger health care conglomerate, the hospital's two main leaders -- Alton J. Scavo, chairman of the board and Victor A. Broccolino, president -- spoke to more than 100 community leaders, residents and hospital staff members Saturday at the county's Board of Education headquarters."We are narrowing it down to two institutions, and I can tell you that a for-profit entity is not an alternative," said Scavo, who noted there are now three contenders.

If you want to understand a major reason medical costs are out of control, breaking the federal budget and dividing the country, look at the types of people enrolled in XLHealth's Medicare insurance plans. Most suffer from diabetes, congestive heart failure or other long-term illness. They're like the millions of chronically ill Americans who visit doctors half a dozen times a year or more and, by some measures, account for 80 percent or more of all spending by the Medicare program for senior citizens.