Becker's Spine Review

61 HEALTHCARE NEWS 24-clinic practice in Florida files for bankruptcy By Alan Condon B oca Raton, Fla.-based Path Medical has filed for Chapter 11 bankruptcy with $86.5 million in liabilities, South Florida Business Journal reported Sept. 2. The 24-clinic practice, which focuses on the treatment of acute trauma and acci- dent-related injuries, cited the "effects of the COVID-19 pandemic" as the reason it initiated the debt restructuring plan. Revenue declined during the pandemic as many of its patients are those involved in auto accidents and there have been fewer people driving, an attorney for Path Medi- cal said, according to the report. Path Medical has 281 employees, and all of its physicians at chiropractic and orthope- dic centers are independent contractors. The practice plans to continue to operate normally during bankruptcy proceedings and has received court approval to con- tinue paying its employees, South Florida Business Journal reported. Path Medical leases 17 clinics in South Flor- ida and seven more in the Tampa Bay area. It posted $30.1 million in 2021 revenue through August and $45.7 million in reve- nue in 2020, according to the report. The practice said it is profitable based on operations, but its debt service payments were too much. According to the case summary, Path Med- ical has assets of $30 million and liabilities of $86.5 million, with the biggest claims from creditors coming from Sierra Income Corp. ($20 million), Comvest Capital III ($15.4 million), Northport TRS ($15.4 mil- lion) and PhenixFin Corp. ($15.1 million). "Just as I am confident the world will manage and emerge more resilient from COVID-19, I am confident Path Medical will as well," Path Medical CEO Manny Fernan- dez said. "We owe it to our patients and our staff." n Q: Which patient safety goals are you on track to meet or exceed, and what do you attribute that to? Brian Kaminski, DO. Vice president of quality and patient safety, ProMedica (Toledo, Ohio): Although our serious safety event rate can ebb and flow over time, in the past 24 months alone, we have reduced our rate by approximately 50 percent, coming off a slight increase the previous year. Evidence-based practices, data-driven decision-making and the development of care pathways have enabled our system to deliver safe, high-quality care with limited and rapidly changing information. We even went as far as converting an existing hospital to care for only COVID-19 patients, capitalizing on an integrated and highly engaged care delivery model. e results of this model are evident in better-than-expected outcomes of our patients and the continued deployment of many of our methods throughout the various waves and surges in our community. Similarly, we are adopting an approach to address surgical site infections specifically. A multidisciplinary, evidence-based practice team has been assembled. ey have reviewed and synthesized the available literature and identified the "dirty dozen" ev- idence-based practices that have demonstrated a reduction in surgical site infections based on the best research available. e "dirty dozen" will be deployed through an [enhanced recovery aer surgery] platform for specific, high-risk surgical proce- dures across the system. We hope to see even further reduction in our serious safety events by tackling these infections using evidence-based standards. Dr. Hayworth: One of the many benefits of being in a multispecialty group is that we are able to leverage expertise among many specialties to inform our clinical policies and guidelines. Most recently, we reviewed and updated our pacemaker policies for CareMount's office-based surgical practices. A working group from the CareMount departments of cardiology and anesthe- siology reviewed our current practices and advised, among other things, that leadless pacemakers should be added to the exclusion criteria because these pace- makers do not have a magnet response, rendering them difficult to manage in an office setting. Leadless pacemakers are a relatively new technology and not yet a common consideration in most noncardiology practices. Dr. Christensen: We recently went through a 17-month period of zero central line infections for our entire system. Essentially, we have maintained our zero rates in pretty much all hospital-acquired conditions or have met our improve- ment goals in all categories of HACs this year. e COVID pandemic did add a layer of complexity to our quality and safety en- deavors. Despite this, we have succeeded by making the safety of our patients part of our culture. is has been done through transparency of results, learning from each situation, a nonpunitive approach to improvement and frequent celebrations as milestones are reached. Dr. Lee: Virginia Hospital Center is on track to meet or exceed our safety goals in many areas. For mortality rates, we have collaborated with Mayo Clinic to emulate best prac- tices: a multifaceted approach with strong nursing care, good protocols and pro- cedures and leveraging use of the Epic EHR platform to identify patients at risk for deterioration. We have created rapid response teams, in conjunction with hos- pitalist medical staff, to intervene. Another initiative we started this year follows patients discharged from the hos- pital with acute myocardial infarction and heart failure. is can be a challenging population to keep healthy, so we have assigned a nurse to work with the hospital- ist physicians to identify patients with these diagnoses. is specialty nurse meets them, coordinates care in house, and then follows them aer discharge. Anything from placement to medication management, physician follow-up, social services and food requirements are assessed and addressed. n

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