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CREDENTIALING AND RECREDENTIALING ACTIONS December 4, 2003
CREDENTIALING AND RECREDENTIALING ACTIONS December 4, 2003



ATTACHMENT B

CREDENTIALING AND
RECREDENTIALING ACTIONS
December 4, 2003


1

ATTACHMENT B

CREDENTIALING AND RECREDENTIALING ACTIONS December 4, 2003

1. NEW APPOINTMENTS TO THE CLINICAL STAFF

RESOLVED that the recommendations of the Clinical Staff Executive Committee for appointment to the Clinical Staff of the University of Virginia Medical Center and the granting of specific privileges to the following practitioners are approved:

  • Atkins, Kristen A., M.D., Pathologist in the Department of Pathology; Attending Staff Status; Period of Appointment: September 2, 2003, through September 1, 2004; Privileged in Pathology.

  • Haizlip, Julie A., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Appointment: September 1, 2003, through August 31, 2004; Privileged in Pediatrics.

  • Harris, Ronald, M.D., Radiologist in the Department of Radiology; Instructor Staff Status; Period of Appointment: August 14, 2003, through August 10, 2004; Privileged in Radiology.

  • Houlihan, Christine M., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Appointment: August 25, 2003, through August 24, 2004; Privileged in Pediatrics.

  • Kimpel, Donald L., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Appointment: August 29, 2003, through July 31, 2004; Privileged in Internal Medicine.

  • Kumar, Shekar, M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Period of Appointment: October 31, 2003, through July 31, 2004; Privileged in Internal Medicine.

  • Larriviere, Daniel G., M.D., Neurologist in the Department of Neurology; Attending Staff Status; Period of Appointment: September 11, 2003, through August 31, 2004; Privileged in Neurology.

  • 2

  • Lipson, Lewis C., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Appointment: September 4, 2003, through September 3, 2004; Privileged in Internal Medicine.

  • Marzani-Nissen, Gabrielle R., M.D., Psychiatrist in the Department of Psychiatric Medicine; Attending Staff Status; Period of Appointment: September 25, 2003, through September 24, 2004; Privileged in Psychiatric Medicine.

  • Matthew, Leah G., M.D., Physician in the Department of Family Medicine; Attending Staff Status; Period of Appointment: October 1, 2003, through September 30, 2004; Privileged in Family Medicine.

  • Merritt, Clinton T., M.D., Physician in the Department of Internal Medicine; Instructor Staff Status; Period of Appointment: September 9, 2003, through August 31, 2004; Privileged in Internal Medicine.

  • Poulter, Melinda D., Ph.D., Pathologist in the Department of Pathology; Attending Staff Status; Period of Appointment: October 7, 2003, through October 6, 2004; Privileged in Pathology.

  • Prabhakar, Shashi K., M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Period of Appointment: September 26, 2003, through June 30, 2004; Privileged in Internal Medicine.

  • Saller, Devereux N., M.D., Obstetrician and Gynecologist in the Department of Obstetrics and Gynecology; Attending Staff Status; Period of Appointment: August 15, 2003, through August 14, 2004; Privileged in Obstetrics and Gynecology.

  • Shami, Vanessa M., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Appointment: September 24, 2003, through September 23, 2004; Privileged in Internal Medicine.

  • Shen, Francis H., M.D., Orthopedic Surgeon in the Department of Orthopedic Surgery; Attending Staff Status; Period of Appointment: August 29, 2003, through August 28, 2004; Privileged in Orthopedic Surgery.

  • 3

  • Yu, Pearl L., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Appointment: September 1, 2003, through August 31, 2004; Privileged in Pediatrics.

2. LOCUM TENENS APPOINTMENTS TO THE CLINICAL STAFF

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the appointment as locum tenens for appointment to the Clinical Staff of the University of Virginia Medical Center and the granting of specific privileges to the following practitioners are approved:

  • Menon, Mani, M.D., Physician in the Department of Urology; Locum Tenens Staff Status; Period of Appointment: September 17, 2003, through December 16, 2003; Privileged in Urology.

  • Peabody, James O., M.D., Physician in the Department of Urology; Locum Tenens Staff Status; Period of Appointment: September 17, 2003, through December 17, 2003; Privileged in Urology.

3. RE-APPOINTMENTS TO THE CLINICAL STAFF

RESOLVED that the recommendations of the Clinical Staff Executive Committee for reappointment to the Clinical Staff of the University of Virginia Medical Center and the granting of specific privileges to the following practitioners are approved:

  • Albert, Martin P., M.D., Physician in the Department of Family Medicine; Attending Staff Status; Period of Reappointment: February 29, 2004, through February 28, 2006; Privileged in Family Medicine.

  • Altes, Talissa A., M.D., Radiologist in the Department of Radiology; Attending Staff Status; Period of Reappointment: January 20, 2004, through January 19, 2005; Privileged in Radiology.

  • Balogun, Seki A., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: January 25, 2004, through January 24, 2006; Privileged in Internal Medicine.

  • 4

  • Baum, Victor C., M.D., Anesthesiologist in the Department of Anesthesiology; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Anesthesiology.

  • Blackhall, Leslie, M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: January 16, 2004, through January 15, 2006; Privileged in Internal Medicine.

  • Bourgeois, F. John, M.D., Obstetrician and Gynecologist in the Department of Obstetrics and Gynecology; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Obstetrics and Gynecology.

  • Brown, Gerald L., M.D., Psychiatrist in the Department of Psychiatrc Medicine; Attending Staff Status; Period of Reappointment: January 1, 2004, through January 31, 2006; Privileged in Psychiatric Medicine.

  • Bubb, Lori C., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: January 2, 2004, through January 1, 2006; Privileged in Internal Medicine.

  • Crampton, Richard, M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Internal Medicine.

  • Crosby, Ivan K., M.B.B.S., Surgeon in the Department of Surgery; Attending Staff Status; Period of Reappointment: February 21, 2004, through February 20, 2005; Privileged in Surgery.

  • DeGood, Douglas, Ph.D., Psychologist in the Department of Psychiatric Medicine; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Psychiatric Medicine.

  • Drake, David B., M.D., Plastic and Maxillofacial Surgeon in the Department of Plastic and Maxillofacial Surgery; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Plastic and Maxillofacial Surgery.

  • 5

  • Forbes, John W., M.D., Physician in the Department of Family Medicine; Attending Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2005; Privileged in Family Medicine.

  • Foster, William C., M.D., Orthopedic Surgeon in the Department of Orthopedic Surgery; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Orthopedic Surgery.

  • Irvin, William P., M.D., Obstetrician and Gynecologist in the Department of Obstetrics and Gynecology; Attending Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2006; Privileged in Obstetrics and Gynecology.

  • Kahler, David, M.D., Orthopedic Surgeon in the Department of Orthopedic Surgery; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Orthopedic Surgery.

  • Kaufman, David A., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Pediatrics.

  • Kirk, Susan E., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2006; Privileged in Internal Medicine.

  • Laurencin, Cato, M.D., Ph.D., Orthopedic Surgeon in Chief in the Department of Orthopedic Surgery; Attending Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2006; Privileged in Orthopedic Surgery.

  • Long, Todd J., M.D., Ophthalmologist in the Department of Ophthalmology; Visiting Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2006; Privileged in Ophthalmology.

  • Lopes, M. Betriz S., M.D., Pathologist in the Department of Pathology; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Pathology.

  • 6

  • McConnell, Kevin, M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Internal Medicine.

  • Meakem, Timothy, M.D., Anesthesiologist in the Department of Anesthesiology; Visiting Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Anesthesiology.

  • Michel, Robert S., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Reappointment: February 1, 2004, through January 31, 2005; Privileged in Pediatrics.

  • Nadkarni, Mohan M., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Internal Medicine.

  • Pappas, Diane, M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Reappointment: February 1, 2004, through December 31, 2006; Privileged in Pediatrics.

  • Perrotto, Judith A., M.D., Radiologist in the Department of Radiology; Attending Staff Status; Period of Reappointment: February 25, 2004, through February 24, 2005; Privileged in Radiology.

  • Pruett, Timothy L., M.D., Surgeon in the Department of Surgery; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Surgery.

  • Rice, Sydney A., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Reappointment: February 3, 2004 through February 2, 2006; Privileged in Pediatrics.

  • Russell, Mark A., M.D., Dermatologist in the Department of Dermatology; Attending Staff Status; Period of Reappointment: February 12, 2004, through February 11, 2006; Privileged in Dermatology.

  • 7

  • Wang, Gwo Jaw, M.D., Orthopedic Surgeon in the Department of Orthopedic Surgery; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2004; Privileged in Orthopedic Surgery.

  • Wasserstrom, Gretchen L., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Pediatrics.

  • Winther, Birgit, M.D., Otolaryngologist in the Department of Otolaryngology – Head and Neck Surgery; Attending Staff Status; Period of Reappointment: December 25, 2003, through December 24, 2004; Privileged in Otolaryngology – Head and Neck Surgery.

4. SECONDARY RE-APPOINTMENT TO THE CLINICAL STAFF

RESOLVED that the recommendation of the Clinical Staff Executive Committee for secondary reappointment to the Clinical Staff of the University of Virginia Medical Center and the granting of specific privileges to the following practitioner are approved:

  • Wilson, Douglas F., M.D., Anesthesiologist in the Department of Anesthesiology; Attending Staff Status; Period of Reappointment: January 1, 2004, through December 31, 2005; Privileged in Anesthesiology.

5. STATUS CHANGES TO CLINICAL STAFF

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the status changes in clinical privileges for the following practitioners are approved:

  • Brashers, Valentina, M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Date Change from May 25, 2003 to May 24, 2005.

  • Davis, Walter S., M.D., Physiatrist in the Department of Physical Medicine and Rehabilitation; Attending Staff Status; Date Change from May 1, 2003 to March 31, 2004.

  • Gillenwater, Jay Y., M.D., Urologist in the Department of Urology; Attending Staff Status; Date Change from July 1, 2003 to June 30, 2004.

  • 8

  • Pfeffer, David M., M.D., Urologist in the Department of Urology; Visiting Staff Status; Date Change from July 1, 2003 to June 30, 2004.

  • Rogol, Alan D., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Date Change from October 1, 2003 to September 30, 2004.

  • Smyth, Katherine M., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Date Change from July 1, 2003 to June 30, 2005.

6. RESIGNATIONS FROM THE CLINICAL STAFF

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the resignation and expiration of clinical privileges to the following practitioners are approved:

  • Calfee, David P., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Effective date of Resignation: November 7, 2003.

  • de Alarcon, Pedro, M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Effective date of Resignation: December 24, 2003.

  • Everett, Allen D., M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Effective date of Resignation: November 1, 2003.

  • Fox, William E., M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Effective date of Resignation: November 1, 2003.

  • Friedman, Daniel, M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Effective date of Resignation: November 1, 2003.

  • Gardella, Lynn E., M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Effective date of Resignation: November 30, 2003.

  • Hammond, William, R. M.D., Physician in the Department of Internal Medicine; Visiting Staff Status; Effective date of Resignation: September 30, 2003.

  • 9

  • Lamkin, Thomas, M.D., Pediatrician in the Department of Pediatrics; Attending Staff Status; Effective date of Resignation: October 15, 2003.

  • Morse, James H., M.D., Physician in the Department of Internal Medicine; Attending Staff Status; Effective date of Resignation: September 12, 2003.

  • Spradlin, Wilford, M.D., Psychiatrist in the Department of Psychiatric Medicine; Attending Staff Status; Effective date of Resignation: October 24, 2003.

7. PRIVILEGES FOR NEW ALLIED HEALTH PROFESSIONALS

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the granting of privileges to the following Allied Health Professionals are approved:

  • Bopp, Jane, R.N., F.N.P., Family Nurse Practitioner in the Anticoagulation Clinic, Northridge; Period of Privileging: October 10, 2003, through October 9, 2004; Privileged as a Family Nurse Practitioner.

  • Casavant, Jennifer M., R.N., A.C.N.P., Acute Care Nurse Practitioner on 6 Central/6 West; Period of Privileging: August 29, 2003, through August 28, 2004; Privileged as an Acute Care Nurse Practitioner.

  • Danilich, Victoria M., R.N., C.R.N.A., Certified Nurse Anesthetist in the Operating Room; Period of Privileging: September 2, 2003, through September 1, 2004; Privileged as a Certified Nurse Anesthetist.

  • Deivert, Mary, R.N., A.C.N.P., Acute Care Nurse Practitioner in the SICU; Period of Privileging: August 13, 2003, through August 12, 2004; Privileged as an Acute Care Nurse Practitioner.

  • Gardner, Amber, Ph.D., Audiologist in the Vestibular and Balance Center; Period of Privileging: October 28, 2003, through September 7, 2004; Privileged as an Audiologist.

  • Guarini, Eleanor Jane, R.N., F.N.P., Family Nurse Practitioner in Palliative Care; Period of Privileging: October 22, 2003, through October 19, 2004; Privileged as a Family Nurse Practitioner.

  • 10

  • Hiles, Amy, R.N., A.N.P., Adult Nurse Practitioner in the Cardiac Cath Lab; Period of Privileging: September 15, 2003, through September 14, 2004; Privileged as an Adult Nurse Practitioner.

  • Jayne, Robert K., R.N., C.R.N.A., Certified Nurse Anesthetist in the Operating Room; Period of Privileging: August 4, 2003, through August 3, 2004; Privileged as a Certified Nurse Anesthetist.

  • Johnston, Paul, P.A., Physician's Assistant in Neurosurgery; Period of Privileging: October 17, 2003, through September 21, 2004; Privileged as a Physician's Assistant.

  • Johnson, Sheri L., P.A., Physician's Assistant in TCV Surgery; Period of Privileging: August 13, 2003, through July 27, 2004; Privileged as a Physician's Assistant.

  • Kroening, Jodie L., P.A., Physician's Assistant in TCV Surgery; Period of Privileging: August 19, 2003, through July 27, 2004; Privileged as a Physician's Assistant.

  • Nguyen, Tanya, R.N., F.N.P., Family Nurse Practitioner in Neurosurgery; Period of Privileging: September 11, 2003, through July 27, 2004; Privileged as a Family Nurse Practitioner.

  • Raible, Daniel C., P.A., Physician's Assistant in TCV Surgery; Period of Privileging: August 13, 2003, through July 27, 2004; Privileged as a Physician's Assistant.

  • Ratliff, Catherine, R.N., G.N.P., Geriatric Nurse Practitioner in the Wound Clinic; Period of Privileging: August 29, 2003, through August 28, 2004; Privileged as a Geriatric Nurse Practitioner.

  • Wentzel, Karla, R.N., C.R.N.A., Certified Nurse Anesthetist in the Operating Room; Period of Privileging: September 4, 2003, through September 3, 2004; Privileged as a Certified Nurse Anesthetist.

11

8. RENEWED PRIVILEGES FOR ALLIED HEALTH PROFESSIONALS

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the renewal of privileges to the following Allied Health Professionals are approved:

  • Beard, Michelle, R.N., A.C.N.P., Acute Care Nurse Practitioner in the Department of Internal Medicine; Period of Privileging: January 23, 2004, through January 22, 2005; Privileged as an Acute Care Nurse Practitioner.

  • Blincoe, Christine, M.Ed., Audiologist in the Department of Otolaryngology; Period of Privileging: February 1, 2004, through January 31, 2005; Privileged as an Audiologist.

  • Buchanan, Leslie, R.N., E.N.P., Emergency Nurse Practitioner in the Department of Emergency Medicine; Period of Privileging: January 1, 2004, through December 31, 2005; Privileged as an Emergency Nurse Practitioner.

  • Burgdorf, Rosella, R.N., F.N.P., Family Nurse Practitioner in Regional Primary Care; Period of Privileging: December 15, 2003, through August 28, 2004; Privileged as a Family Nurse Practitioner.

  • Demko, Saundra, R.N., A.N.P., Adult Nurse Practitioner in the Heart Center; Period of Privileging: December 13, 2003, through December 12, 2005; Privileged as an Adult Nurse Practitioner.

  • Diepold, Amy, R.N., A.C.N.P., Acute Care Nurse Practitioner on 6 Central/6 West; Period of Privileging: February 10, 2004, through February 9, 2006; Privileged as an Acute Care Nurse Practitioner.

  • Dix, Janet, P.A., Physician's Assistant in the Department of Surgery; Period of Privileging: February 24, 2004, through February 23, 2006; Privileged as a Physician's Assistant.

  • Dort, Kathryn, R.N., F.N.P., Family Nurse Practitioner in the Infectious Disease Clinic; Period of Privileging: February 1, 2004, through January 31, 2006; Privileged as a Family Nurse Practitioner.

  • 12

  • Dougherty, Patricia, R.N., C.N.M., Certified Nurse Midwife in the Midlife Center, Northridge; Period of Privileging: February 26, 2004, through February 28, 2005; Privileged as a Certified Nurse Midwife.

  • Dubroff, Christine, R.N., F.N.P., Family Nurse Practitioner in the Department of Family Medicine; Period of Privileging: December 30, 2003, through December 29, 2004; Privileged as a Family Nurse Practitioner.

  • Hutchinson, Jennifer, R.N., F.N.P., Family Nurse Practitioner in the Department of Pediatrics; Period of Privileging: December 15, 2003, through December 14, 2005; Privileged as a Family Nurse Practitioner.

  • Maling, Barbara, R.N., A.C.N.P., Acute Care Nurse Practitioner in the Cardiology Clinic, Primary Care Center; Period of Privileging: February 1, 2004, through January 31, 2006; Privileged as an Acute Care Nurse Practitioner.

  • Skinner, Kimberly, P.A., Physician's Assistant in the Department of Neurosurgery; Period of Privileging: February 10, 2004, through February 9, 2006; Privileged as a Physician's Assistant.

  • Stack, Mary, R.N., F.N.P., Family Nurse Practitioner in the Medicine Service Center; Period of Privileging: January 1, 2004, through December 31, 2005; Privileged as a Family Nurse Practitioner.

9. STATUS CHANGE FOR ALLIED HEALTH PROFESSIONAL

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the status change of privileges of the following Allied Health Professional is approved:

  • Foster, Lisa, P.A., Physician's Assistant in the Department of Neurosurgery; Privileged as a Physician's Assistant; Date Change from September 9, 2003 to September 8, 2005.

13

10. RESIGNATIONS OF ALLIED HEALTH PROFESSIONALS

RESOLVED that the recommendations of the Clinical Staff Executive Committee for the resignation of privileges to the following Allied Health Professionals are approved:

  • Dougherty, Deborah J., R.N., F.N.P., Family Nurse Practitioner in the Ryan White Program; Effective Date of Resignation: June 7, 2003.

  • Marto, Marjorie, P.A., Physician's Assistant in the Bone Marrow Transplant Unit; Effective Date of Resignation: October 1, 2003.

  • Rogers, Sarah S., M.Ed., Speech Pathologist at Kluge Children's Rehabilitation Center; Effective Date of Resignation: August 2, 2003.

  • Schlag, Katharine, R.N., F.N.P., Family Nurse Practitioner in the Department of Medical Management; Effective Date of Resignation: December 31, 2003.

  • Whitney, Bruce B., P.A., Physician's Assistant in the Department of TCV Surgery; Effective Date of Resignation: September 11, 2003.

  • Zavacky, Barbara, R.N., A.C.N.P., Acute Care Nurse Practitioner in the Cardiac Cath Lab; Effective Date of Resignation: June 30, 2003