HomeMy WebLinkAboutMINUTES - 08182015 - C.27RECOMMENDATION(S):
Approve the medical staff appointments and reappointments, additional privileges, primary department changes,
medical staff advancement, voluntary resignations, change to dentist privileges and approval of pain management
privileges as recommend by the Medical Staff Executive Committee, at their July 1, 2015 meeting, and by the Health
Services Director.
FISCAL IMPACT:
None.
BACKGROUND:
The Joint Commission on Accreditation of Healthcare Organizations has requested that evidence of Board of
Supervisors approval for each Medical Staff member will be placed in his or her Credentials File. The above
recommendations for appointment/reappointment were reviewed by the Credentials Committee and approved by the
Medical Executive Committee.
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved, the Contra Costa Regional Medical and Contra Costa Health Centers' medical staff
would not be appropriately credentialed and not be in compliance with the Joint Commission on Accreditation of
Healthcare Organizations.
APPROVE OTHER
RECOMMENDATION OF CNTY
ADMINISTRATOR
RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 08/18/2015 APPROVED AS
RECOMMENDED
OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
ABSENT:Federal D. Glover, District V
Supervisor
Contact: Anna Roth, 370-5101
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors
on the date shown.
ATTESTED: August 18, 2015
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: Chris Heck, Deputy
cc: T Scott, N Rios, Sana Salman
C. 27
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:August 18, 2015
Contra
Costa
County
Subject:Medical Staff Appointments and Reappointments – July 2015
CHILDREN'S IMPACT STATEMENT:
Not applicable.
ATTACHMENTS
July Attachment
Pain Management Privileges
Dentist privileges
MEC Recommendations – July Definitions: A=Active
C=Courtesy Aff=Affliate P/A= Provisional Active P/C= Provisional Courtesy Page 1
A. New Medical Staff Members
Nicole Baltrushes, MD Hospitalist
Chelsea Bowman, MD Hospitalist
Christopher Camilleri, MD Psychiatry/Psychology
Preeti D’Souza, DDS Dental
John Hartmann, MD Psychiatry/Psychology
Micah Hoffman, MD Psychiatry/Psychology
Deepak Kumar, MD Psychiatry/Psychology
Brian Laing, MD Family Medicine
Michael Rogers, MD Psychiatry/Psychology
Arshya Vahabzadeh, MD Psychiatry/Psychology
B. New Staff Affiliation
Lorinda Coombs, NP Internal Medicine
C. Travis Residents – Family Medicine
Carl Cassel, DO
Nicole Croley, MD
Daniel Gordon Hurtt, MD
Colby Neville, DO
Shelby Takeshita, MD
D. Request for Additional Privileges
Stephen Merjavy, MD Hospitalist
Lauren Wondolowski, MD Family Medicine, OBGYN, Internal Medicine
E. Advance to Non-Provisional
Fiona Barwick, MD Psychiatry/Psychology
Jafar Bozorgmehr, MD Psychiatry/Psychology
Robert Buckley, MD Surgery
Laura Cotter, MD Family Medicine
Jacqueline Dahan, Psy.D Psychiatry/Psychology
Scott Josephson, MD Internal Medicine
Larry Kean, MD Psychiatry/Psychology
Mauricio Kuri, MD Surgery
Stephanie Phillips, NP Internal Medicine
Lesley Splivalo, NP Family Medicine
James Walls, MD Family Medicine
F. Biennial Reappointments
Pyra Aarden, MD Emergency Medicine A
Frederick Adler, MD Emergency Medicine A
Semon Bader, MD Surgery A
Veda Bhatt, MD Family Medicine A
Lawrence Boly, MD Internal Medicine A
MEC Recommendations – July Definitions: A=Active
C=Courtesy Aff=Affliate P/A= Provisional Active P/C= Provisional Courtesy Page 2
Larkin Breed, MD Diagnostic Imaging C
Daniel Cremin, MD Internal Medicine A
Bridget Dyer, MD Emergency Medicine A
Catherine Frances, DO Psychiatry/Psychology C
Stuart Gluck, MD Psychiatry/Psychology C
Dharmini Harichandran, MD Psychiatry/Psychology A
Frederick Houts, MD Psychiatry/Psychology C
Bryan Hyler, MD Psychiatry/Psychology C/P
Meltem Karatepe, MD Pediatrics A
Charleen Kim, MD Surgery A
Edward Kim, MD Internal Medicine C
Diane Kwan, MD Surgery P
Bailey Lee, MD Diagnostic Imaging C
Susan Lessin, MD Internal Medicine A
Sara Levin, MD Internal Medicine A
MyHoang Nguyen, MD Family Medicine A
Frederick Osborne, MD Pediatrics C
Maria Pagtalunan, MD Internal Medicine C
Ronald Power, DDS Dental A
Adolfo Romero-Duran, MD Family Medicine A
Macey Rosenthal, MD Psychiatry/Psychology C
John Rostkowski, MD Psychiatry/Psychology C
Parminder Sethi, MD Surgery C
Nishant H. Shah, MD Family Medicine A
Shobha Sharma, DO Internal Medicine A
Gabriela Sullivan, MD Internal Medicine A
Brandon Vance, MD Psychiatry/Psychology C
Ian Wallace, MD Family Medicine P
G. Biennial Renew of Privileges
Cynthia Hellman-Wylie, NP Family Medicine Aff
Renan Sagum, NP Family Medicine Aff
Howard Shaw, NP Family Medicine Aff
Karen Weiss, NP Family Medicine Aff
H. Voluntary Resignations
Lisa R. De la Fuente, CNM OBGYN
Trinh Green, MD Family Medicine
Karen Marcus, MD Psychiatry/Psychology
Contra Costa Regional Medical Center
Privileges Request Form
D FP, ANE, IR N/A N/A
N
/
A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years
4
c
a
s
D FP, ANE, IR N/A N/A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years
D FP, ANE, IR N/A N/A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years
D FP, ANE, IR N/A N/A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years Departments (s) NumberPrivilege Descriptions D/C/UPAIN
2
Placement of Spinal Drug
Delivery Systems for
Outpatient Use *
PAIN
3
Placement of Centeral or
Peripheral Neurostimulation
Systems *
Practitioner Name: _______________________
PAIN
1
PAIN
4
Percutaneous Neuroablative
Procedures *
Diagnotic and Therapeudic
Injections:
Requiring fluoroscopic
guidance, including epidural,
caudal spinal, facet joint,
selective nerve sleeve,
discogram peripheral
ganglion, and sympathetic
blocks * GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
U= Unrestricted
Chronic Pain Management Current Competence Requested Experience* Separate proctoring required
PAIN MGT Updated MARCH 2015 Page 1 of 2
Contra Costa Regional Medical Center
Privileges Request Form
Departments (s) NumberPrivilege Descriptions D/C/U Practitioner Name: _______________________ GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
U= Unrestricted
Chronic Pain Management Current Competence Requested ExperienceD FP, ANE, IR N/A N/A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years
2
c
a
s
D FP, ANE, IR N/A N/A
U
Successful
Completion of
Fellowship in Pain
Management
10 4 cases in last 2
years
U FP, ANE, IR 10 4 cases in last 2
years
PAIN
6
Evaluation and Management
of Chronic Pain Patients for
Providers without General
Outpatient Privileges
PAIN
5 Lumbar Kyphoplasty
I certify that I have reviewed the Contra Costa Regional Medical Center Privilege Criteria, and that I meet the specified
criteria for education/training, experience, and current competence for the privileges that I have indicated above.
Signature of Department Chairperson
Signature of Requesting Practitioner
Date
Date
* Separate proctoring required
PAIN MGT Updated MARCH 2015 Page 2 of 2