Dr. James Kravec

By ED RUNYAN

Staff writer

YOUNGS-TOWN — Mahoning County Public Health’s medical director, who spoke out against public release of details on cases at long-term care facilities, also serves as a top medical officer for Youngstown’s Mercy Health district, which operates two local facilities reporting coronavirus cases.

Mercy Health operates Mercy Health Humility House Senior Living in Austintown, which has had eight cases; and Marian Living Center in North Lima, which has had three. Mercy Health also runs three of the major hospitals in the area — the St. Elizabeth Youngstown and Boardman hospitals and St. Joseph Warren Hospital.

Dr. James Kravec serves as both medical director for the Mahoning County Public Health (the county’s health department) and chief medical officer for Mercy Health’s Youngstown district. He was among several officials who spoke out in opposition to identifying Mahoning County long-term care facilities with COVID-19 cases during a recent teleconference with reporters.

Gov. Mike DeWine and Ohio Department of Health Director Dr. Amy Acton later decided they would provide the facility names and post them for the public to see.

The county’s health commissioner and a Mercy Health spokesman each deny that Kravec’s dual role creates a conflict of interest.

TWO SEE NO CONFLICT

Kravec did not reply personally to a call from The Vindicator seeking comment, but Mercy Health spokesman Jon Fauvie and Mahoning County Health Commissioner Ryan Tekac each stated Kravec does not have a

conflict, largely because they say the county health department does not have the kind of authority over local nursing homes that would be necessary for a conflict to exist. Instead, that power lies with the Ohio Department of Health.

“The Ohio Department of Health, they are the state agency that licenses and oversees all long-term care facilities. The local health departments don’t,” Tekac said. “They have a whole division at ODH for that. They do all of the enforcement and investigating complaints.”

In fact, Tekac said personnel from the Mahoning County health department “don’t even go out” to such facilities. “We’ve been working through the Ohio Department of Health during this pandemic.”

As a result of a call from Tekac, the Ohio Department of Health and U.S. Centers for Disease Control and Prevention sent two “strike teams” to Mahoning County and went into four long-term-care facilities that were having COVID-19 outbreaks Monday and Tuesday, Tekac said by phone Friday.

The goal of the strike teams was to give the four facilities “best practices and observe what you guys are doing and how we can give you some better practices to control the outbreak.”

The Mahoning County health board “coordinated it” over the phone. And at the end of the day Monday and Tuesday, the local health department was part of a phone briefing involving the state health department and CDC to keep the health board “in the loop” on what was happening, Tekac said.

Though local nursing-home operators regularly state that they’ve been working closely with the Mahoning County health department, Tekac said the contact between the health board and the nursing homes involves only specific COVID-19 cases.

Among other tasks local health departments do when notified of a COVID-19 case is trace back to learn with whom the patient has been in contact.

The health department inspects nursing homes only where food-service is involved, Tekac said.

MERCY HEALTH RESPONDS

In a statement emailed to The Vindicator, Fauvie said each of the long-term care facilities Mercy Health runs has “a medical director who oversees resident care that is separate from (Kravec, who is) our marketwide chief clinical officer.”

According to the Mahoning County Public Health website, Kravec has been medical director since February 2016 and is board-certified in internal, hospice and palliative (serious illness) medicine. He also serves as executive vice president for Mercy Health in Youngstown.

A Youngtown native, Kravec practices internal medicine in the Ambulatory Care Center at St. Elizabeth Youngstown and is an internal medicine faculty member at St. Elizabeth Youngstown.

As chief clinical officer, the doctor is responsible for providing physician executive leadership for the Youngstown region’s clinical enterprises and “oversees the overall mission, strategic leadership and assurance of quality care” for those enterprises, a Mercy Health biography says.

Ohio ethics laws are generally designed to prohibit a public official or employee from participating in matters that involve his own financial interests or those of his family or business associates, according to the Ohio Ethics Commission.

HOT SPOTS

At an April 7 Mahoning County health board teleconference with reporters, a great deal of discussion focused on the high number of Mahoning County COVID-19 deaths occurring at long-term care facilities such as nursing homes. The percentage is now 46.

A reporter asked Tekac whether he would identify the specific nursing homes or “hot spots” for the virus in the county, which has had the most or second-most COVID deaths in the state for several weeks.

Tekac said he would not identify the facilities. Kravec then added that identifying nursing homes or ZIP codes with high virus totals “from a physician’s standpoint are completely irrelevant. The county is a hot spot. The state is a hot spot. The United States is a hot spot. We assume patients are positive (for the virus) based on community spread, and we need to do social distancing to assume all of us have this. That’s how we have to handle this.”

When Tekac was asked about that Friday, he said he thinks Kravec’s comments were “pertaining to ZIP code level data because I know that was a big issue.”

A recording of the conversation shows that the specific conversation before Kravec made his remarks was about nursing homes.

A call Friday to Dr. Michael Miladore, president of the health board, was not immediately returned.

erunyan@tribtoday.com