Summary of Health Care Experience
ACUTE CARE HOSPITALS
My first experience with acute care hospital claims and litigation management was in 1990, when I was Senior Litigation Supervisor for Dynamark, a TPA that was a subsidiary of the Johnson & Higgins brokerage firm. My clients were self-insured hospitals, including Columbia Healthcare Corporationís first hospitals in El Paso, Texas. I performed all of the traditional claims and litigation management functions for these facilities. In 1993, I served as Columbiaís Corporate Claims Manager, while an employee of Healthcare Insurance Services, a division of The Galtney Group in Houston. This involved developing a claim program and philosophy for Columbiaís 25 hospitals, most of which were located in Florida and Texas. In 1994, I moved to Nashville, to bring ďin-houseĒ, the claim program of OrNda Healthcorp. This involved 50 hospitals in about 15 states, with a heavy concentration of these facilities being located in Florida, Texas and California. We were self-insured for $3,000,000 per occurrence, and I personally managed Florida and Texas, and had Claim Managers who managed the other states.
In terms of my experience with acute care hospitals, I have managed hundreds of claims, settled many claims on my own, or through authority granted to defense counsel, or via mediation. I have dealt with nuisance value slip and falls and multi-million dollar "bad baby" cases in Miami and Houston, as well as serious exposures in other dangerous venues. I actually worked in a hospital for one week each year at OrNda with the Risk Manager, so I could learn more about hospital operations and risk management from a more local perspective.
In 1998, I was Vice President of Risk Management at Behavioral Healthcare Corporation, a company of 43 psychiatric hospitals in about 15-16 states. As the only person in the risk management department, I managed all the claims and litigation, thus I am intimately familiar with the issues relative to evaluating these exposures.
From 1988-1990, I was a Claims Attorney for Insurance Corporation of America, a physician carrier based in Houston. I literally handled 375 claims/lawsuits at a time, primarily in Texas. In 1997, I served as Vice President of Claims at MedPartners in Birmingham. At the time, this company was the largest physician practice management company in the country, with physician practices in over 40 states. I managed much of this litigation, and supervised Claim Managers in Fort Lauderdale, Chicago and Long Beach, California.
LONG TERM CARE
In the early 1990ís, I served as a Claims Manager for a surplus lines carrier in Houston that insured many Texas nursing homes. In the late 1990ís, I served as Director of Claims for Mariner Post-Acute Network, a provider of over 430 facilities in over 35 states, including 100 facilities in Texas, 60-70 in Florida and 30-40 in California, representing three of the most volatile jurisdictions in the country for long term care litigation. I have mediated long term care cases pursuant to 4 Texas bankruptcies, Texas Health Enterprises, Harvest Communities, Heart of Texas and Autumn Hills, as well as Integrated Health Services and Centennial Health Care. I have also mediated these cases in Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Virginia, Washington State, West Virginia and Wisconsin. To my knowledge, I am the only mediator in the country who has worked for both an insurance carrier and long term care provider mediating these complex cases.
Over the years, I have been fortunate enough to evaluate probably a couple of thousand claims from many different perspectives, for insurance companies, a TPA and 4 health care providers. This gives me a unique insight as to any case, especially when there are multiple defendants, for in these cases, the biggest dispute often isnít the value of the case, itís apportioning exposure among the co-defendants.
I would invite you to take advantage of this background in health care to amicably resolve your cases prior to trial.