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King's Daughters Medical Center, established in 1899, is a non-profit regional referral center in Ashland, Kentucky.A recipient of the Commonwealth of Kentucky Quality Award, the 385-bed facility is accredited by the Joint Commission on the Accreditation of Healthcare Organizations. Their goal is to care, serve, and heal the community through its world-class services.With more than 85 clinical services, KDMC specializes in comprehensive cardiac, medical, surgical, pediatric, rehabilitative, psychiatric, cancer, neurological, pain care, wound care, and home care services.The Cancer Resource Center is a 24-bed facility devoted to providing compassionate care for the cancer patients. Cancer education and support groups are offered.The Cardiovascular Recovery Unit, at the Center for Advanced Care, provides utmost care to the patients who had their open-heart surgery. It has eight cardiovascular intensive care suites and a family waiting area.The Paul G. Health Education Center has a 120-seat auditorium, with state-of-the-art audio-visual facilities, and six meeting rooms.Other facilities at King’s Daughters Medical Center include the Pain Center, Wound Center, Sleep Medicine Center, Chest Pain Unit, Heart and Vascular Center, Asthma Education Center, and Breast Care Center.The Outpatient Services Center, near the hospital’s main campus, offers physical, occupational, audiology, and speech therapies. Further, KDMC operates family centers at various locations in Ohio and Kentucky.To improve the health status of the community, free health screening and education programs are conducted. The Occupational Medicine program deals with work-related health issues.Rose Petals, a free membership resource program, is committed to the betterment of women and their families.In addition, King’s Daughters Medical Center manages the Ashland-area Meals-on-Wheels program, to cater delicious meals to the homebound patients
King’s Daughters Medical Center to Pay Nearly $41 Million to Resolve Allegations of False Billing for Unnecessary Cardiac Procedures and Kickbacks
Ashland Hospital Corp. d/b/a King’s Daughters Medical Center (KDMC) has agreed to pay $40.9 million to resolve allegations that it submitted false claims to the Medicare and Kentucky Medicaid programs for medically unnecessary coronary stents and diagnostic catheterizations and had prohibited financial relationships with physicians referring patients to the hospital, the Justice Department announced today.
Assistant Attorney General Stuart F. Delery of the Justice Department’s Civil Division, U.S. Attorney Kerry Harvey for the Eastern District of Kentucky and Special Agent in Charge Derrick L. Jackson at the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Kentucky region made the announcement.
“Hospitals that place their financial interests above the well-being of their patients will be held accountable,” said Assistant Attorney General Delery. “ The Department of Justice will not tolerate those who abuse federal health care programs and put the beneficiaries of these programs at risk by providing medically unnecessary care.”
The government alleged that, between 2006 and 2011, KDMC billed for numerous unnecessary coronary stents and diagnostic catheterizations performed by KDMC physicians on Medicare and Medicaid patients who did not need them. The government also alleged that the physicians falsified medical records in order to justify these unnecessary procedures, which allegedly generated millions of dollars in Medicare and Kentucky Medicaid reimbursements for KDMC.
“The conduct alleged in this matter is unacceptable, victimizing both taxpayers and patients,” said U.S. Attorney Harvey. “Treatment decisions motivated by financial gain undermine public confidence in our health care system and threaten vital federal programs upon which so many of our citizens rely. We will not relent in our efforts to protect the public from the sort of systematic misconduct alleged in this case.”
The settlement also resolves allegations that KDMC violated the Stark Law by paying certain cardiologists salaries that were unreasonably high and in excess of fair market value. The Stark Law is designed to limit the influence of money on physicians’ medical decision-making by prohibiting financial relationships between hospitals and referring physicians, unless these relationships meet certain designated exceptions.
In connection with this settlement, KDMC has agreed to enter into a Corporate Integrity Agreement with HHS-OIG, which obligates the hospital to undertake substantial internal compliance reforms and to commit to a third-party review of its claims to federal health care programs for the next five years.
“Medically unnecessary procedures can cause serious health issues, cost the taxpayers millions of dollars each year and drain the Medicare Trust Fund,” said Special Agent in Charge Jackson. “The OIG will continue to protect beneficiaries and hold health care providers accountable for improper claims.”
“This type of alleged conduct deceives individuals when they are seeking medical treatment and are vulnerable,” said Special Agent in Charge Perrye K. Turner of the FBI’s Louisville Field Division. “The level of funds involved in this matter is staggering. This money has been stolen from the patients and the taxpayers.”
The Commonwealth of Kentucky will receive approximately $1,018,380, which represents the state’s share of the recovered Medicaid funds. The Medicaid program is funded jointly by the federal and state governments.
This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $19 billion through False Claims Act cases, with more than $13.4 billion of that amount recovered in cases involving fraud against federal health care programs.
MANNING v. KING DAUGHTERS MEDICAL CENTER
Quizzie MANNING v. KING'S DAUGHTERS MEDICAL CENTER, A Mississippi Non–Profit Corporation.
Decided: March 27, 2014
¶ 1. In this medical-malpractice case, we must decide whether the Circuit Court of Lincoln County abused its discretion by dismissing Quizzie Manning's case with prejudice. We find that the circuit court did not abuse its discretion by dismissing the case with prejudice therefore, we affirm the circuit court's judgment.
FACTS AND PROCEDURAL HISTORY
¶ 2. This medical-negligence case arises from Quizzie Manning's May 16, 2008, visit to King's Daughters Medical Center's (KDMC) emergency room. Manning alleges that she sustained injuries as a result of KDMC's negligence during that visit. On May 7, 2010, nearly two years after Manning's visit to KDMC and less than ten days before the statute of limitations ran on her claim, attorney Alfred Felder sent KDMC a letter on Manning's behalf giving KDMC notice of Manning's intent to sue, as required under Mississippi Code Section 15–1–36(15). On July 14, 2010, Manning, purportedly acting pro se, filed suit against KDMC and other parties. Apparently, Felder drafted Manning's complaint even though he did not sign it. 1 As Manning filed her complaint pro se, she did not attach a certificate regarding consultation with an expert prior to filing suit, as required under Mississippi Code Section 11–1–58, because she was exempt from the requirement under Section 11–1–58(d). 2
¶ 3. The complaint was served on KDMC on November 10, 2010, 119 days after the complaint was filed and one day before Manning's time for service ran. The complaint included an address for Manning in Brookhaven, Mississippi. On November 18, 2010, KDMC filed its answer and propounded its initial discovery to Manning and served the documents on her by sending them to the address provided in the complaint via first-class mail. More than six months passed without a response from Manning. On June 27, 2011, KDMC filed its first motion to dismiss under Rule 41 of the Mississippi Rules of Civil Procedure or, alternatively, for summary judgment. KDMC noticed a hearing on its motion for August 1, 2011, and again served its motion and notice of hearing on Manning at the address provided in the complaint via U.S. Mail. However, on July 8, 2011, the documents KDMC sent to Manning were returned as “not deliverable as addressed, unable to forward.”
¶ 4. On July 11, 2011, KDMC wrote a letter to Felder and requested that he advise how Manning could be served. KDMC then attempted to have Manning served with its motion and notice of hearing via process server at the address provided in her complaint. However, the process server was unable to serve the documents. Counsel for KDMC represents that the process server was told by the residents at the address that Manning was not there and was currently in Georgia, and that their attorney, Al Felder, had advised them not to accept the documents or give the process server Manning's current address. Counsel for KDMC then called Felder in an attempt to obtain Manning's current address, but was not successful. Felder represented to KDMC's counsel that he was still reviewing the case and had not yet made a decision as to whether he was going to enter an official appearance. KDMC was unable to serve Manning with its motion or notice of hearing therefore, it did not move forward with the hearing.
¶ 5. On July 5, 2012, a year later, KDMC filed a supplement to its motion to dismiss or, alternatively, for summary judgment, and renoticed a hearing on the motion for Monday, August 6, 2012. KDMC again served its motion and notice on Manning via U.S. Mail at the address she had provided in her complaint and also served the motion and notice on Felder. On Friday, August 3, 2012, Felder filed Manning's response to KDMC's motion. Felder officially entered an appearance in the case on Monday, August 6, 2012.
¶ 6. A hearing on KDMC's motion to dismiss or, alternatively, for summary judgment, was held on August 6, 2012. At the hearing, counsel for KDMC argued that Felder's actions were unconscionable and the suit should be dismissed as a sanction. Specifically, KDMC argued that Felder had Manning file a pro se complaint because Felder could not comply with the requirements of Section 11–1–58, and that the suit had been “sitting still in the water for the last two years as a direct result of the acts of counsel in advising his client not to respond, not to accept, and not to advise where she can be found.” KDMC did not argue that it was entitled to summary judgment in the case.
¶ 7. Felder argued that he did not represent Manning in the court until he made an entry of appearance because his “understanding of being represented by an attorney in a piece of litigation is that you're on the pleadings or you've made an entry of appearance, one or the other,” and he had not entered an appearance at the time the complaint was filed. Felder further argued that, because Manning was not represented until he entered his appearance in the case, Manning had properly filed her complaint pro se and was not required to review her case with an expert witness prior to filing suit or to file the certificate contemplated by Section 11–1–58. As to why he had not entered an appearance until August 2012, Felder represented to the circuit court that he had experienced ongoing health problems since January 2010. Felder never denied that he had been involved with the case from the very beginning or that he had been advising Manning since at least the time he sent the notice letter on her behalf.
¶ 8. Felder represented that he did not remember whether he had spoken with Manning's relatives when the process server was attempting to serve KDMC's motion, but that normally he would advise someone not to accept papers that were not theirs. Felder also made an issue of the fact that KDMC never filed a motion to compel a response to its discovery and that the case had been on the docket for only two years, which he argued was not a long time, because many cases have been on the docket for two years or more. Felder argued that, given the totality of the circumstances, Manning's case should not be dismissed, and that, if he did something wrong, which he denied, he should be sanctioned personally.
¶ 9. During oral argument, the circuit court focused on whether or not it should dismiss the case based on Manning's behavior over the past two years, at one point asking Felder to give a “compelling reason” why the case should not be dismissed “based on Quizzie Manning's behavior over a two-year period.” In its bench ruling, the circuit court found that the case involved the worst gamesmanship that the court had ever seen. The court found that Manning personally had been “playing games” and that it would have to decide if Manning's actions should result in the ultimate sanction of dismissal.
¶ 10. The court noted that Manning, a pro se plaintiff, seemed to have an unusual grasp of the time limits set by the rules, but yet did not realize that it was her duty to provide a mailing address at which she could receive documents related to her case. The court further noted that Manning had responded to KDMC's motion to dismiss or for summary judgment on the Friday before the Monday hearing, and had never responded to KDMC's discovery. The court also found the argument that KDMC was required to file a motion to compel to be without merit, in part because the court found Manning did not have any intention to respond to discovery that had been outstanding for two years and because KDMC had no way to serve the motion to compel.
¶ 11. The circuit court found that Manning was not represented by Felder during the two years the case sat on the docket. The court concluded that, while Section 11–1–58 did not require a pro se plaintiff to review her case with an expert witness prior to filing suit or to file a certificate, “[t]his is an extreme example for two years of a pro se plaintiff who would not take part in the litigation process, did not give a valid address. That's at best. At worst, she took active measures through family members to avoid service of any type of document in this case.” The court reasoned that the consideration the Legislature gave to pro se plaintiffs did not apply in this case because of her obvious actions to avoid participating in the litigation. Therefore, as a result of Manning's actions, the court ruled that her case would be dismissed with prejudice and KDMC would be granted summary judgment.
¶ 12. In its order, the court found that Manning had filed a pro se complaint but had made no effort to respond to discovery propounded to her for more than two years or to respond to KDMC's motion to dismiss or, alternatively, for summary judgment until the Friday afternoon before the Monday hearing. The court specifically found that:
[W]hile § 11–1–58 (requiring a certificate of consultation with a qualified expert) does not apply to a “Pro Se Plaintiff,” the Legislature did not contemplate that an individual citizen be allowed to file a “Pro Se ” Complaint (which does not require compliance with Miss.Code Ann. § 11–1–58), and thereafter, at best, not take part in the litigation process she initiated, and not supply the Court and the parties with a current, valid address for service of pleadings, etc. and/or at worst, having filed suit, take active measures through family members to avoid service of any type of document in this case, thereby maintaining this Pro Se Plaintiff's suit at a literal standstill for two years, until this date.
The circuit court held that, under the circumstances, the motion to dismiss under Rule 41(b) or, alternatively, for summary judgment should be granted and the case dismissed with prejudice. Manning now appeals from the circuit court's order.
¶ 13. Manning raises the following three issues on appeal:
(1) that the circuit court erred in granting KDMC's motion for summary judgment
(2) that the circuit court erred in dismissing the case for failure to consult a physician prior to filing suit and,
(3) that the circuit court erred in dismissing the case under Rule 41(b).
I. Whether the circuit court erred in granting KDMC's motion for summary judgment.
¶ 14. Manning argues that the circuit court erred in granting KDMC's motion for summary judgment because she attached a doctor's affidavit, in which the doctor opined that the treatment Manning received at KDMC deviated from the standard of care, to her response to the motion for summary judgment. Therefore, Manning argues that her response created a material issue of fact that precluded summary judgment under Rule 56 of the Mississippi Rules of Civil Procedure. KDMC argues that Manning's and Felder's actions constituted gamesmanship intended to manipulate the judicial system in order to escape the requirements of Section 11–1–58 and that the circuit court's grant of summary judgment essentially disregarded the affidavit filed on the last business day before the hearing, thirteen months after the motion was filed. KDMC further argues that the standard for considering motions for summary judgment is not relevant to the issues in this appeal, as the circuit court's decision focused on the acts of the purportedly pro se plaintiff and found those actions justified dismissal with prejudice.
¶ 15. In its motion, KDMC first requested that the circuit court dismiss Manning's complaint under Rule 41(b) due to her lack of prosecution over the past two years, and alternatively requested that the circuit court grant KDMC summary judgment in the case because Manning had presented no evidence to establish a material question of fact. The circuit court did not find that Manning had failed to establish a material question of fact and did not dismiss her case under Rule 56. Although the bench opinion and order could have been more specific about what rule the court utilized to dismiss the case, the affidavit provided by Manning and whether Manning had created a material issue of fact were never discussed at the hearing or in the order. Rather, the circuit court's questions at the hearing, as well as its findings at the hearing and in its order, focused on Manning's lack of participation in the lawsuit for the past two years. We find that the circuit court dismissed Manning's case under Rule 41(b), not Rule 56. Therefore, we find that Manning's argument on this issue is misplaced and without merit.
II. Whether the circuit court erred in dismissing Manning's case for failure to consult with a physician prior to filing suit.
¶ 16. Manning argues that, to the extent that the circuit court dismissed her case because she failed to consult with a physician prior to filing suit, the court erred because she filed her case pro se and the statutory requirements of Section 11–1–58(6) did not apply to her. While KDMC argues that Manning and her counsel engaged in gamesmanship to avoid the requirements of Section 11–1–58(d), it does not argue that Manning's failure to consult with a physician prior to filing suit is a proper basis to dismiss her case.
¶ 17. Although the circuit court mentioned the requirements of Section 11–1–58, the court did not hold that Manning should have complied with the statute, even though she was purportedly acting pro se, and did not dismiss her case for failure to consult with an expert prior to filing suit. In fact, the court treated Manning as a pro se plaintiff and recognized that the Legislature intended to provide “special consideration” to pro se plaintiffs under the statute. The court did find that those special considerations did not give a pro se plaintiff license to allow her case to sit at a standstill for over two years. The circuit court did not base its ruling on Manning's failure to consult with an expert prior to filing suit, but rather based its ruling on Manning's conduct after she filed suit. Therefore, we find that Manning's argument on this issue is misplaced and without merit.
III. Whether the circuit court erred in dismissing Manning's case under Rule 41(b).
¶ 18. As discussed above, this case was dismissed with prejudice on KDMC's motion to dismiss under Rule 41(b) or, alternatively, for summary judgment. Rule 41(b) “permits defendants to move for dismissal of any action ‘[f]or failure of the plaintiff to prosecute’ “ and “embodies the tenet that ‘any court of law or equity may exercise the power to dismiss for want of prosecution ․ necessary as a means to the orderly expedition of justice and the court's control of its own docket.’ “ 3 Although the circuit court did not clearly articulate what rule it used to dismiss Manning's case, it is clear from the transcript and order that the court dismissed Manning's case due to her failure to prosecute and the two-year delay in her case after she filed suit. Therefore, we analyze this case under Rule 41(b).
¶ 19. We review a lower court's dismissal of an action under Rule 41(b) for an abuse of discretion. 4 “Because the law favors a trial on the issues on the merits, a dismissal for want of prosecution is employed reluctantly.” 5 “[T]his Court may uphold a Rule 41(b) dismissal when there is: (1) a record of dilatory or contumacious conduct by the plaintiff and (2) a finding by this Court that lesser sanctions would not serve the interests of justice.” 6 While aggravating factors or actual prejudice “may bolster the case for dismissal,” they are not requirements. 7
¶ 20. The circuit court found that Manning initiated her complaint pro se, but failed to provide a valid address for receiving pleadings, made no effort to respond to outstanding discovery for two years, failed to respond to KDMC's 2011 motion to dismiss for more than one year and in fact did not respond to the motion until the Friday before the Monday hearing. The circuit court concluded that the case was at a “literal stand still for two years” due to Manning's actions. Manning argues that she was forced to spend time in Georgia receiving assistance from family due to the injuries she sustained as a result of the negligence alleged in her complaint, that no motion to compel discovery was ever filed, and that two years is not a long time for a case to be on the docket.
¶ 21. We find that the record supports a determination that Manning's conduct resulted in a clear record of delay. Not only did Manning fail to take any action in her case for two years after filing suit, she failed to provide an address where she could receive pleadings. We have held recently that a plaintiff's failure to respond to discovery for approximately seventeen months supported a finding of a clear record of delay, sufficient to warrant dismissal with prejudice. 8 Additionally, the first action Manning took in her case after filing suit was reactionary, which we previously have considered as a factor supporting a finding of a clear record of delay. 9 Furthermore, the fact that KDMC did not file a motion to compel Manning's responses to its outstanding discovery does not weigh in her favor, as the test regarding a clear record of delay “focuses on a plaintiff's conduct, not on the defendant's efforts to prod a dilatory plaintiff into action.” 10 As there is a clear record of delay in this case, a showing of contumacious conduct is not necessary. 11
B. Additional Considerations of Prejudice and Aggravating Factors
¶ 22. “The trial court may consider prejudice or the presence of a aggravating factor, and these considerations may help to bolster or strengthen a defendant's case in support of dismissal. These considerations, however, are not a prerequisite to dismissal under Rule 41(b).” 12 Delay alone may suffice for a dismissal under Rule 41(b). 13 In this case, the circuit court did not specifically consider the presence of prejudice or aggravating factors however, some findings made by the circuit court fall under these considerations.
¶ 23. The circuit court did not make a finding regarding prejudice to KDMC. Manning argues that KDMC has not shown any prejudice due to any delay attributable to her actions KDMC argues that it is impossible to know what prejudice it may experience, as Manning still has not responded to discovery and there is no way to know what information may have been lost.
¶ 24. The circuit court found that Manning, at best, failed to take part in the litigation process she initiated, keeping her case at a standstill for two years. We have determined that a plaintiff's dilatory conduct resulting in his case remaining stale for more than a year amounted to an unreasonable delay, and that “delay alone may result in presumed prejudice to the defendant.” 14
¶ 25. The circuit court did not specifically make a finding regarding aggravating factors. “The aggravating factors include: (1) the extent to which the plaintiff, as distinguished from his counsel, was personally responsible for the delay (2) the degree of actual prejudice to the defendant and (3) whether the delay was the result of intentional conduct.” 15 At the hearing, the circuit court found that Manning was not represented by Felder during the two years her case sat at a standstill on the docket and that she was personally “playing games” in her litigation. Furthermore, the circuit court referred to Manning as a pro se plaintiff in its order. Manning continues to argue on appeal that she was not represented by counsel until Felder entered his appearance a few days before the hearing on KDMC's motion, and has not argued that anyone other than herself was personally responsible for the delay in her case. Therefore, we find that the record supports a determination that Manning—not her attorney—was personally responsible for the delay in her case and that the first aggravating factor is present.
¶ 26. The record does not reflect any actual prejudice to KDMC thus, we find the second aggravating factor is not present. As to the third aggravating factor, the circuit court found that, at best, Manning failed to participate in the litigation she initiated and, at worst, took active measures through family members to avoid service of any type of document in this case. Manning argues that she did not intend to delay her case or absent herself from the litigation, but was forced to seek assistance from out-of-state relatives. We find that the record reflects that Manning knowingly and intentionally left the state and did not provide a forwarding address to receive correspondence related to the lawsuit she personally initiated. Therefore, we find that Manning intentionally failed to participate in her case for two years and, therefore, the third aggravating factor is present in this case.
¶ 27. We have held that “in determining whether the trial court abused its discretion when dismissing a case pursuant to Rule 41(b), we must consider whether lesser sanctions would better serve the interests of justice.” 16 “Lesser sanctions include ‘fines, costs, or damages against plaintiff or his counsel, attorney disciplinary measures, conditional dismissal, dismissal without prejudice, and explicit warnings.” 17 We have stated that, “[w]here there is no indication that the lower court considered any alternative sanctions to expedite the proceedings, appellate courts are less likely to uphold a Rule 41(b) dismissal.” 18
¶ 28. We have considered the fact that lesser sanctions were argued before the lower court and that the lower court considered all arguments prior to granting dismissal as factors showing that lesser sanctions were considered. 19 In this case, the circuit court did not specifically address lesser sanctions in its order. However, at the hearing, Felder argued that the case should remain on the docket and that, if he did anything wrong, he should be personally sanctioned instead of the case being dismissed. Felder further argued that dismissal of Manning's case would be an extreme sanction. The circuit court recognized that it had to “decide if the games that [Manning] played are going to result in the ultimate sanction for her case.” In its order, the circuit court found that, under the circumstances, dismissal with prejudice was the appropriate result. Therefore, the record shows that Manning urged the circuit court to adopt lesser sanctions and that the circuit court considered whether dismissal with prejudice was the appropriate sanction in this case.
¶ 29. We must now consider whether lesser sanctions would better serve the interests of justice in this case and find that they would not. As discussed above, the record clearly shows a two-year delay due to Manning's conduct and the presence of two of the three aggravating factors. We recently upheld a trial court's dismissal with prejudice of a case due to plaintiff's failure to respond to discovery or take any action in his case for more than a year. 20 In Holder, a case in which no aggravating factors were present, we found that a less-than-two-year delay resulted in presumed prejudice to the defendant and that the delay alone was enough to support the trial court's decision to dismiss with prejudice. 21 We find that Manning's behavior was more egregious than that of the plaintiff in Holder. Therefore, we find that lesser sanctions would not better serve the interests of justice in this case.
¶ 30. Justice Dickinson in dissent opines that the sanction of dismissal was inappropriate because “the defendant filed no motion to compel.” But, to the contrary, our rules and precedent make clear that a motion to compel is not a prerequisite to a motion to dismiss when, as here, there is a total failure of a party to participate in discovery. 22 The dissent's reliance on Caracci v. International Paper Co., 699 So.2d 546, 557 (Miss.1997), State Highway Commission v. Havard, 508 So.2d 1099, 1104 (Miss.1987), and Beck v. Sapet, 937 So.2d 945, 949–50 (Miss.2006), is misplaced, as all involve improper or incomplete discovery responses as opposed to a total failure to respond. Improper discovery responses are governed by Rule 37(a)(2) and necessitate a motion to compel. A total failure to respond to discovery is governed by Rule 37(d), 23 which states that “[i]f a party ․ fails ․ to serve answers or objections to interrogatories submitted under Rule 33, after proper service of interrogatories ․ the court in which the action is pending on motion may make such orders in regard to the failure as are just,” including an order dismissing the action. 24
¶ 31. For the foregoing reasons and considering our deferential standard of review in these cases, we find that the Circuit Court of Lincoln County did not abuse its discretion in dismissing Manning's case with prejudice. The judgment of the circuit court is affirmed.
¶ 33. The majority affirms the trial court's dismissal of Manning's lawsuit because
Manning's conduct resulted in a clear record of delay. Not only did Manning ․ fail to take any action in her case for two years after filing suit, she failed to provide an address where she could receive pleadings.
¶ 34. The majority's concerns with this case are not altogether unreasonable. While I can not deny that Manning's behavior leading up to her filing this lawsuit, and beyond, was less than admirable, I am not prepared to agree that the sanction of dismissal of her lawsuit, with prejudice, was in accord with our rules or precedent. So I must respectfully dissent.
¶ 35. Two primary reasons compel this dissent. First, according to many of his statements at the hearing on the defendant's motion to dismiss, the trial judge clearly based his dismissal on his erroneous belief that “Mrs. Manning, through her inactions or her inability to give a valid address, she literally just stopped the litigation process for two years.” In fact, Manning did no such thing. She provided an address. And according to Rule 5(b)(1) of the Mississippi Rules of Civil Procedure, to serve discovery requests upon Manning, the defendant had to do no more than to mail them to her at her “last known address, or if no address is known, by leaving [them] with the clerk of the court․” 25
¶ 36. The defendant—who clearly and understandably was frustrated—states that it did so and, indeed, the record bears this out. But if our rules and precedent are to be followed, the defendant—after receiving no response—should have filed a motion to compel. 26 Instead, the defendant chose to file a motion to dismiss. Our precedent and rules clearly and unambiguously require a motion to compel as a prerequisite to a sanction of dismissal for failure to respond to discovery. 27
¶ 37. The majority's disagreement with me seems to stem from its view that a motion to compel should be required only for “improper or incomplete” discovery responses, and not for a failure to respond. This position is flawed for two reasons.
¶ 38. First, the trial court's sanction of dismissal was not based so much on Manning's failure to respond to discovery, as on her alleged failure to “provide an address where she could receive pleadings.” But she did, in fact, provide an address that complied in every respect with Rule 5(b)(1).
¶ 39. But more importantly, the majority's views are in complete disagreement with this Court's holding in Beck v. Sapet, where the plaintiff failed to respond to discovery for nearly one year. We stated that the case “provides an excellent example of the proper way to document the efforts made to obtain and provide adequate discovery responses.” 28 We went on to state that “failure to make or cooperate in discovery should first be resolved by making a motion in the proper court requesting an order compelling such discovery.” 29 And “if the party fails to comply with this first order to compel, the trial judge may then sanction that party in accordance with M.R.C.P. 37(b), which includes dismissing the case with prejudice.” 30 Here, I find Manning's failure to respond to discovery only slightly more troublesome than this Court's occasional failure to follow consistently its own precedent by making unannounced changes in the application of rules.
¶ 40. The majority supports its position that no motion to compel is necessary by citing Palmer v. Biloxi Regional Medical Center, Inc. But in that case, the defendants filed a motion to compel, prior to seeking a motion to dismiss as a discovery sanction . 31 The majority also relies on Owens v. Whitwell for the proposition that”[i]f a party totally fails to respond to an interrogatory or his response is of absolutely no substance, subsection (d) of § 13–1–237 requires no prior order before imposing sanctions.” 32 Section 13–1–237 was repealed, effective July 1, 1991, and no longer is the law, so Owens does not stand for the proposition the majority purports.
¶ 41. Because the trial judge based his dismissal on an incorrect belief that the plaintiff prevented the defendant from serving papers and because the defendant filed no motion to compel, the sanction of dismissal of the lawsuit was inappropriate, so I respectfully dissent.
¶ 42. Because dismissal with prejudice is an extreme sanction under the circumstances of Manning's case, and because lesser sanctions would better serve the interests of justice, I respectfully dissent.
¶ 43. According to this Court, “dismissal with prejudice is an extreme and harsh sanction that deprives a litigant of the opportunity to pursue his claim, and any dismissals with prejudice are reserved for the most egregious cases.” Holder v. Orange Grove Med. Specialties, 54 So.3d 192, 197 (Miss.2010) (quoting Hoffman v. Paracelsus Health Care Corp., 752 So.2d 1030, 1034 (Miss.1999)). “A showing of delay or contumacious conduct is sufficient for a Rule 41(b) dismissal when a lesser sanction would not serve the best interests of justice.” Id. (citing Am. Tel. & Tel. Co. v. Days Inn of Winona, 720 So.2d 178, 181 (Miss.1998)) (emphasis added).
¶ 44. This Court continued, “[dismissals with prejudice] are reserved for the most egregious of cases, usually cases where the requisite factors of clear delay and ineffective lesser sanctions are bolstered by the presence of at least one of the aggravating factors.” Am. Tel. & Tel. Co., 720 So.2d at 181 (quoting Rogers v. Kroger Co, 669 F.2d 317, 320 (5th Cir.1982)) (emphasis added). And “[w]hile the requirements of a clear record of delay by the plaintiff and futile lesser sanctions have been articulated the most consistently, several other factors have been identified as ‘aggravating factors.’ “ Id. (citing Rogers, 669 F.2d at 320 n. 3) (emphasis added).
¶ 45. I have not wavered from my assertion in Holder that “[c]onsideration of lesser sanctions should consist of more than a passing, dismissive reference to a single option. Instead, the trial judge carefully should weigh all viable alternatives․” Holder, 54 So.3d at 202 (Kitchens, J., dissenting). The Holder majority referenced the following viable alternatives: “Lesser sanctions may include ‘fines, costs, or damages against plaintiff or his counsel, attorney disciplinary measures, conditional dismissal, dismissal without prejudice, and explicit warnings.” Holder, 54 So.3d at 200 (quoting Am. Tel. & Tel. Co., 720 So.2d at 181).
¶ 46. With regard to the issue of consideration of lesser sanctions by the trial judge, Holder is virtually indistinguishable from the present case. There, when the trial judge asked the plaintiff's counsel what sanctions would be appropriate, and counsel indicated that a mere warning would be appropriate, the trial judge responded: “What's the purpose of a warning? Everybody is supposed to know the rules.” Holder, 54 So.3d at 200. According to this Court, the circuit judge sufficiently “considered lesser sanctions in his holding.” Id. So too, here, the majority states, “Felder argued that the case should remain on the docket and that, if he did anything wrong, he should be personally sanctioned instead of the case being dismissed.” The majority continued, “Felder further argued that dismissal of Manning's case would be an extreme sanction.” The majority then reasoned that the circuit court's duty with regard to a consideration of lesser sanctions was discharged when “Manning urged the circuit court to adopt lesser sanctions” and the court declined to do so. But, as in Holder, the circuit court in the present case considered only one of the viable alternatives to dismissal with prejudice.
¶ 47. In contrast, the circuit court in Hillman v. Weatherly “explicitly considered lesser sanctions, including fines, costs, or damages against Hillman or her counsel, attorney disciplinary measures, conditional dismissal, dismissal without prejudice, or explicit warnings.” Hillman v. Weatherly, 14 So.3d 721, 728 (Miss.2009) (emphasis added). Similarly, in Cox v. Cox, “that lesser sanctions were argued before the chancellor, that the chancellor considered all arguments prior to granting dismissal, and that the chancellor denied [Plaintiff's] motion for reconsideration, in which [Plaintiff] argued that lesser sanctions had not been considered, is sufficient to show that lesser sanctions were considered and rejected.” Cox v. Cox, 976 So.2d 869, 876 (Miss.2008) (emphasis added).
¶ 48. I declined to countenance the cursory analysis conducted in the lower court in Holder, and I decline to do so here. Approval of this approach permits our trial courts to deny litigants their day in court with a mere “passing, dismissive reference to a single option,” rather than conducting a reasoned and objective weighing of all viable alternatives prior to dismissal with prejudice, the ultimate sanction. Holder, 54 So.3d at 202 (Kitchens, J., dissenting).
¶ 49. The majority cites Holder for the proposition that “a plaintiff's dilatory conduct resulting in his case remaining stale for more than a year amounted to an unreasonable delay, and that ‘delay alone may result in presumed prejudice to the defendant.’ “ See Holder, 54 So.3d at 200. In my dissenting opinion in Holder, I pointed out that the majority presumed prejudice without explanation, and the majority does likewise in the present case. Holder, 54 So.3d at 202 (Kitchens, J., dissenting). The Holder majority relied on Cox, where this Court found that, in a case delayed for want of prosecution by fourteen years, prejudice was presumed. Cox, 976 So.2d at 879 (“Given the length of time that has passed in this case, ․ we find that [Defendant] is due some measure of presumed prejudice.”). In Holder, I noted that the delay was just over one year, or 435 days. Holder, 54 So.3d at 202 (Kitchens, J., dissenting). Here, Manning filed her complaint on July 14, 2010, and responded to KDMC's Motion to Dismiss on August 3, 2012. The delay was just over two years, or 731 days. This 731–day delay is substantially shorter than the fourteen-year delay which the Cox Court reticently determined warranted a presumption of prejudice.
¶ 50. This Court also cites the Hillman case, in which we held that “the fact that a plaintiff's sole activity was reactionary ․ supported a finding of a clear record of delay.” Hillman, 14 So.3d at 727 (citing Hill v. Ramsey, 3 So.3d 120, 122 (Miss.2009)). But there, Hillman was dilatory in responding to discovery for more than five years, and indeed “was personally responsible for spoliation of the evidence, because she did not disclose her prior medical history at her deposition, which prevented Weatherly from acquiring Hillman's medical records before their destruction.” Id. at 727, 729. Though the record reflects that Manning may have been dilatory, her conduct cannot be said to rise to the level of misconduct manifested by Hillman-again, Manning's procrastination lasted for just over two years. Her conduct certainly cannot be said to warrant a dismissal with prejudice. 33
¶ 51. Even if Manning should receive some kind of sanction for being dilatory, for not obtaining other counsel, or for being out of state trying to regain her health when she should have been at home answering interrogatories, I disagree that the ultimate sanction of dismissal with prejudice is warranted here. I would, therefore, reverse the judgment of the Circuit Court of Lincoln County and remand for a consideration of lesser sanctions. Accordingly, I respectfully dissent.
1. KDMC's counsel represented to the circuit court at oral argument on its motion to dismiss, in its motion to dismiss, and in its briefs filed in this Court that Felder had drafted the pro se complaint. Felder has not denied that allegation.
Healthy Spine, Stronger You
King's Daughters Spine Care Group works seamlessly with specialists in orthopaedics, neurology, pain management and physical therapy to address the underlying cause of neck or back pain &mdash rather than just treat symptoms &mdash addressing patients' need for a consolidated treatment program that can help them regain their active, pain-free lives. Pain or weakness does not always equate to surgery.
The Spine Care Group
The collaborative approach of the Spine Care Group offers patients quality, comprehensive and convenient care across the King's Daughters Medical Center community.
Mark Barron, MD, is the orthopedic and spine surgeon who leads the Spine Care Group. His goal: Get patients feeling better. "The biggest challenge is determining the cause of the pain," Dr. Barron said. "A lot of people I see are suffering from hip or buttock pain that could be caused from a number of locations &mdash their back, hip or other parts of the body. It's about figuring out when it hurts, why it hurts and what helps the pain." Dr. Barron relies on the patient's history and physical exam, along with X-rays and MRI or CT scans to determine a cause and diagnosis. He and his patient then discuss the range of treatment options available, from modifying activities, physical therapy and pain management with injections to surgery. "Before considering surgery, we try all nonoperative, conservative measures first," he said. "If the pain is still limiting the patient's daily activities, we then intervene with surgery." Dr. Barron relies heavily on the Spine Care Group to coordinate and give his patients the best-possible care.
He performs spine surgeries along with general orthopedic surgeries such as joint replacements and fractures. "This is one of the reasons I wanted to start my practice in Brookhaven," he said. "It gives me the opportunity to practice my specialty while helping patients with all types of pain and problems." He sees patients in the newly renovated KDMC Sports Medicine, Orthopaedic and Spine Clinic located at 601 Brookman Drive.
Justin Estess, MD, and Robin Nations, MD, are board-certified anesthesiologists who practice interventional pain management. They provide patients with small injections &mdash taking just 10 minutes &mdash to help treat back and neck pain until the condition worsens or requires further testing or procedures. If they think patients would benefit from this next step, they refer them to Drs. Barron or Berteau. Drs. Estess and Nations see patients at KDMC Pain Management Clinic located at 427 Highway 51 North.
Craig Berteau, MD, is a board-certified neurologist. He treats patients experiencing a range of problems that include migraines strokes epilepsy back, neck and arm pain numbness weakness balance issues fainting and pinched nerves, among other things. He helps to diagnose the underlying issue causing the pain with the help of tests. Electromyography (EMG) assesses the health of muscles and the nerve cells that control them, a magnetic resonance imaging (MRI) scan shows detailed images of the organs and tissues within the body and a computerized tomography (CT) scan combines a series of X-ray views to show images of bones and soft tissues. When a patient with spine pain comes to Dr. Berteau, he performs a physical examination and studies to further define the cause of the problem and then refers to either Drs. Estess and Nations for pain management intervention or Dr. Barron if surgery is necessary. Dr. Berteau practices at KDMC Specialty Clinic at 940 Brookway Boulevard.
KDMC Therapy Center is a state-of-the-art 9,000-square-foot outpatient facility, one of the largest therapy and rehabilitation clinics in the state. The full-service center offers physical, occupational, speech and sports therapies and is outfitted with advanced equipment and technology to help patients regain their strength and mobility.
Our therapists have obtained and continue training on the latest modalities for neck and back therapies. One of these is the McKenzie Method of therapy. With the McKenzie approach, physical therapy and exercise are used to extend the spine to help "centralize" the patient's pain by moving it away from the extremities (leg or arm) to the back. Back pain is usually better tolerated than leg or arm pain, and the theory of the approach is that centralizing the pain allows the source of the pain to be treated rather than the symptoms. Other features include an indoor warm-water therapy pool, indoor gait training/sports track and five private treatment rooms.
Back to You Again!
If pain is robbing you of your quality of life, let the King's Daughters Spine Care Group help. Call to schedule your appointment today.
The King's Daughters Spine Care Group wants to see you if you're experiencing any of the following symptoms:
Ashland dates back to the migration of the Poage family from the Shenandoah Valley via the Cumberland Gap in 1786. They erected a homestead along the Ohio River and named it Poage's Landing. Also called Poage Settlement, the community that developed around it remained an extended-family affair until the mid-19th century.  In 1854, the city name was changed to Ashland, after Henry Clay's Lexington estate and to reflect the city's growing industrial base. The city's early industrial growth was a result of the Ohio Valley's pig iron industry and, particularly, the 1854 charter of the Kentucky Iron, Coal, and Manufacturing Company by the Kentucky General Assembly.  The city was formally incorporated by the General Assembly two years later in 1856.  Major industrial employers in the first half of the 20th Century included Armco, Ashland Oil and Refining Company, the C&O Railroad, Allied Chemical & Dye Company's Semet Solvay, and Mansbach Steel.
According to the United States Census Bureau, the city has a total area of 10.8 square miles (27.9 km 2 ), of which 10.7 square miles (27.8 km 2 ) is land and 0.039 square miles (0.1 km 2 ), or 0.30%, is water. 
Ashland's central business district extends from 12th Street to 18th Street, and from Carter Avenue to Greenup Avenue. It includes many historically preserved and notable buildings, such as the Paramount Arts Center and the Ashland Bank Building, which is built to Manhattan height and style standards and serves as a reminder of what Ashland leaders hoped it would become.
Ashland is in the humid subtropical climate zone, and distinctly experiences all four seasons, with vivid fall foliage and occasional snow in winter. The average high is 88 °F in July, the warmest month, with the average lows of 19 °F occurring in January, the coolest month. The highest recorded temperature was 105 °F in July 1954. The lowest recorded temperature was −25 °F in January 1994. Average annual precipitation is 42.8 inches (1,090 mm), with the wettest month being July, averaging 4.7 inches (120 mm).
|Climate data for Ashland, Kentucky (1991–2020 normals, extremes 1897–present)|
|Record high °F (°C)||80 |
|Average high °F (°C)||39.8 |
|Daily mean °F (°C)||31.2 |
|Average low °F (°C)||22.5 |
|Record low °F (°C)||−25 |
|Average precipitation inches (mm)||3.51 |
|Average precipitation days (≥ 0.01 in)||12.1||11.4||12.7||12.0||12.0||11.4||10.9||8.6||8.4||9.1||9.5||11.8||129.9|
|Source: NOAA  |
|U.S. Decennial Census |
As of the census  of 2000, there were 21,981 people, 9,675 households, and 6,192 families residing in the city. The population density was 1,984.4 inhabitants per square mile (766.0/km 2 ). There were 10,763 housing units at an average density of 971.7 per square mile (375.1/km 2 ). The racial makeup of the city was 95.84% White, 2.30% African American, 0.12% Native American, 0.39% Asian, 0.01% Pacific Islander, 0.22% from other races, and 1.12% from two or more races. Hispanic or Latino of any race were 0.59% of the population.
There were 9,675 households, out of which 26.8% had children under the age of 18 living with them, 47.4% were married couples living together, 13.5% had a female householder with no husband present, and 36.0% were non-families. 33.1% of all households were made up of individuals, and 16.0% had someone living alone who was 65 years of age or older. The average household size was 2.23 and the average family size was 2.82.
In the city, the population was spread out, with 21.9% under the age of 18, 8.0% from 18 to 24, 26.5% from 25 to 44, 23.7% from 45 to 64, and 19.9% who were 65 years of age or older. The median age was 41 years. For every 100 females, there were 83.9 males. For every 100 females age 18 and over, there were 79.3 males.
The median income for a household in the city was $30,309, and the median income for a family was $40,131. Males had a median income of $35,362 versus $23,994 for females. The per capita income for the city was $19,218. About 14.0% of families and 18.4% of the population were below the poverty line, including 28.3% of those under age 18 and 12.3% of those age 65 or over.
AK Steel Edit
American Rolling Mill Co. (ARMCO) opened its steel mill, Ashland Works, in 1922. The facility grew to cover 700 acres (280 ha) along the Ohio River. It set world records in production, and eventually employed about 7,000 people.   Local scrap drives were held during World War II to support production at the plant. 
ARMCO Steel partnered with Kawasaki Steel Corporation in 1994.  AK Steel eventually purchased Armco Steel Inc. At one time Armco employed over 4,000 people at its West Works, Foundry, and Coke Plant. AK Steel employed under 1,000 after the closing of the Foundry and Coke Plant and the downsizing of its West Works. AK shut down completely in 2019.  
King's Daughters Medical Center Edit
King's Daughters Medical Center is the fourth largest hospital in Kentucky, the 465-bed not-for-profit institution is the city's largest employer at over 4,000 employees.  It offers numerous inpatient and outpatient services for the region.
Annual cultural events and fairs Edit
- The Festival of Trees occurs at the Paramount Arts Center every winter
- Poage Landing Days
- Summer Motion
- Winter Wonderland of Lights
- Firkin Fest craft beer festival
Historical structures and museums Edit
The Paramount Arts Center, an Art Deco style movie theater built in 1930, is located on Winchester Avenue. The converted theater serves as an important venue for the arts in eastern Kentucky and the neighboring sections of Ohio and West Virginia. It is well noted for its Festival of Trees event during the winter season. The Paramount is also devoted to teaching children the importance of the arts. Summer classes are offered for school-age children.
Also along Winchester Avenue is the Highlands Museum and Discovery Center. Among its numerous exhibits, one about Country Music Heritage pays tribute to the music artists from along U.S. Route 23 in Kentucky. Two locals, The Judds from Ashland, and Billy Ray Cyrus from nearby Flatwoods, are included.
The Pendleton Art Center, formed in 2005, is located within the downtown. The works produced include paintings, stained glass, carved gourds, and wood carvings by local artists. They are displayed at the Pendleton the first Friday and Saturday of every month and at other times by appointment.
The Jesse Stuart Foundation, an organization dedicated to the preservation of the literary legacy of Jesse Stuart and other Appalachian writers, was at one time located within an earshot of the Pendleton Arts Center. Jesse Stuart, a well-known 20th-century author, was from nearby Greenup, Kentucky.
Ashland boasts a 47-acre (190,000 m 2 ) Central Park.
In July 1976, a new 10-acre (40,000 m 2 ) park at the former Clyffeside Park was envisioned.  Named after Commissioner Johnny Oliverio, it features several baseball diamonds, and is located along Winchester Avenue near 39th Street.
In 2004, the AK Steel Sports Park was constructed along Blackburn Avenue in South Ashland. The sports-oriented park features several baseball diamonds, soccer fields and an incomplete skate park. 
Local government Edit
Ashland is governed by a City Manager form of government.  The government switched from a council-manager to a city commissioner-manager form of government in 1950.  The City Manager is the chief administrative officer for the city who reports to a Board of Commissioners. Department heads ranging from the Police to Public Works report to the City Manager. The City Manager is currently Michael Graese.
The Mayor of Ashland is elected for a four-year term and is not term-limited. The mayor presides over City Commission meetings, is a voting member of the City Commission and represents the city at major functions. The current mayor is Matt Perkins.
Ashland's current City Commission members are Mayor Matt Perkins and Commissioners Josh Blanton, Amanda Clark, Marty Gute and Cheryl Wooten Spriggs.
In 1925, a new city hall was erected at the corner of 17th Street and Greenup Avenue. 
Federal representation Edit
The United States Postal Service operates the Ashland Post Office and the Unity Contract Station.  
The United States District Court for the Eastern District of Kentucky maintains courtroom and office facilities in the Carl D. Perkins United States Courthouse & Federal Building in downtown Ashland. 
All public schools within city limits are operated by the Ashland Independent School District. Public schools outside of city limits are operated by the Boyd County School District and the Fairview Independent School District.
Ashland has five public elementary schools, Hager Elementary, Oakview Elementary, Crabbe Elementary School, Poage Elementary and Charles Russell Elementary. Hatcher Elementary closed its doors in Spring 2010. Its students and much of its resources were consolidated with the other elementary schools in Fall 2010.  The former Hatcher Elementary building now serves as the Ashland Independent Schools Central Office.
There is one public middle school, Ashland Middle School, formerly known as George M. Verity Middle School and Putnam Junior High School.   The campus is home to Putnam Stadium which serves as the home field for Ashland Tomcats high school and middle school football.
One public high school serves the city of Ashland: Paul G. Blazer High School, named after philanthropist  and founder of Ashland Inc.,  Paul G. Blazer. The high school is home to the Ashland Tomcats and Kittens athletic teams. The Ashland Tomcats football program has achieved 11 state championships. The Ashland Tomcats (boys') basketball program has accomplished 1 national championship, 4 state championships, 32 regional championships, and 55 district championships. The Ashland Tomcats and Kittens (girls') soccer teams play at the Ashland Soccer Complex at the high school. The school's marching band competes in the AAA class of the Kentucky Music Educators Association(KMEA). The marching band is commonly called "The Pride of Blazer" for its excellent performance in many KMEA marching band competitions.
Westwood, an unincorporated community just outside the Ashland city limits, is served by the Fairview Independent School District. The district operates Fairview High School, grades 6-12, and Fairview Elementary School, grades K-5.
The Boyd County Public Schools serves the rural part of Ashland and the remainder of Boyd County. It has four elementary schools, those being Ponderosa Elementary, Cannonsburg Elementary, Catlettsburg Elementary and Summit Elementary. Boyd County Middle School serves grades 6-8, while Boyd County High School serves grades 9-12.
The two private schools serving the Ashland area are the Holy Family School and the Rose Hill Christian School. Holy Family is affiliated with Holy Family Catholic Church and currently offers K–12 education. Rose Hill is affiliated with the Rose Hill Baptist Church and also offers K–12.
Post-secondary educational opportunities include Ashland Community and Technical College which has multiple campuses within the city. Morehead State University also has a satellite campus located in Ashland.
Ashland has a public library, a branch of the Boyd County Public Library. 
Ashland is home to two newspapers: The Independent and The Greater Ashland Beacon.
The Daily Independent is a five-day morning daily newspaper which covers the city and the surrounding metropolitan area. In addition, it offers national, state and regional news/sports coverage via reprints of Associated Press and CNHI wire reports and columns. The newspaper is often called "The Independent" or the "Ashland Daily Independent" by locals, as these were its former names. One of the paper's claims to fame is the first printings of a supposed image of Jesus in the clouds of Korea in 1951. 
Ashland's other newspaper is The Greater Ashland Beacon. It is a free weekly circular published in full color every Tuesday. "The Beacon", as it is known by locals, is "hyper-local," meaning it is exclusively dedicated to covering the community. Highlights include, but are not limited to, local events, sports results, outdoor recreation and personal interest articles and columns penned by freelance Ashland-area journalists and quasi-celebrities. 
|Call sign||Frequency||Format||Description / Notes|
|WKAO||91.1 FM||Contemporary Christian music||Owned by Positive Alternative Radio, Inc. Licensed to Ashland and identifies as "Walk FM".|
|WDGG||93.7 FM||Country||Owned by Kindred Communications. Licensed to Ashland with studios located in Huntington, West Virginia. Identifies as "93.7 The Dawg".|
|WPAY-FM||98.3 FM||Classic Country||Owned by Expression Production Group of Huntington, WV.  Licensed to nearby Garrison, Kentucky with its transmitter tower located just outside of Garrison in Greenup County, Kentucky and its studios located in Portsmouth, Ohio. Identifies as "Country Superstars WPAY".|
|WLGC-FM||105.7 FM||Oldies||Owned by Greenup County Broadcasting, Inc. Licensed to nearby Greenup, Kentucky with studios located in downtown Ashland. Identifies as "Kool Hits 105.7".|
|WCMI||1340 AM||Sports talk||Owned by Kindred Communications. It was founded by the Ashland Broadcasting Station whose owners were the Daily Independent on April 29, 1935.  It was sold to Nunn Enterprises in 1939. Identifies as "CAT Sports 93-3 and 1340".|
|WOKT||1080 AM||Christian Talk & Teaching||Located in adjacent Cannonsburg, it is owned by Fowler Media Partners of South Point, Ohio. It currently simulcasts its programming on "WJEH" 990 AM of Gallipolis, Ohio.. Identifies as "The Tri-State's 24 Hour Christian Talk and Information Station ".|
Ashland residents receive their network television primarily from stations in Huntington and Charleston, West Virginia. In addition, WKYT, the CBS affiliate in Lexington, Kentucky, is shown on cable TV in Ashland when its programming is different from Charleston's CBS affiliate WOWK. There are also two television stations licensed to Ashland itself. Those are:
|WKAS||Digital 25||Owned by the Kentucky Authority for Educational Television. PBS/Kentucky Educational Television (KET) affiliate|
|WTSF||Digital 44||Owned by Word of God Fellowship, Inc. Daystar affiliate|
Located just north of the city in Worthington is the Ashland Regional Airport. This airport is used for general aviation. The then-named Ashland-Boyd County Airport opened in 1953 and featured a 5,600 ft (1,700 m). runway with a 3,000 ft (910 m). clearance. 
Tri-State Airport, located in nearby Ceredo, West Virginia, provides commercial aviation services for the city.
Amtrak serves Ashland with the three-days-a-week Cardinal, connecting New York City, Washington, Charlottesville, VA, Indianapolis, and Chicago. Westbound trains are scheduled to stop Sunday, Wednesday, Friday in the late evening. Eastbound the stops are early morning Wednesday, Friday, Sunday.
The Amtrak station is located at the Ashland Transportation Center, formerly the Chesapeake and Ohio Railway freight depot, located on 15th Street near the Ohio River. It does not have an Amtrak ticket counter or QuikTrak ticket machine, but E-tickets can be obtained from either Amtrak's website or mobile app.
The C&O freight depot, constructed in 1906 on the former Aldine Hotel site,  had become an abandoned derelict. Then in the late 1990s it was renovated to become the city's unified transportation hub.
The former C&O passenger depot, at 11th Street and Carter Avenue, had been completed in 1925 but abandoned in the 1970s in favor of a downsized depot in nearby Catlettsburg.  The rail lines to the building have since been removed. Today the building itself serves as the downtown branch of PNC Bank. Passenger rail service was moved from Catlettsburg to the Ashland Transportation Center in March 1998.
Greyhound Lines is the sole provider of intercity bus transportation out of Ashland. It operates out of the Ashland Transportation Center, along with the Ashland Bus System that provides five local bus routes.
Ashland is served by US 23 and US 60, several state routes, and is in close proximity to US 52 and Interstate 64. The state routes include:
- never enters the city limits of Ashland, however does serve a sizable area surrounding the city. crosses through the south Ashland region and is referred to as Blackburn Avenue and South Belmont Street. Connects US 60 and 13th Street with KY 5 is known as Boy Scout Road.
Law enforcement Edit
In the late 19th century, what is now the Ashland Police Department was organized when the town was still known as Poage's Landing.  The first executive officer was a town marshal, who was soon replaced by a professional police department.
The city of Ashland currently has 49 sworn officers, three civilian employees who function as administrative support and six parapolice who handle tasks that do not require the services of a sworn officer. 
In 1896, a group of community-spirited women formed the Norfolk City Union of The King's Daughters to provide medical care for indigent mothers and their children. They established a free clinic and visiting nurse service and in 1961 built The King's Daughters' Children's Hospital, with 88 beds and a variety of services. In 1979, the name was changed to Children's Hospital of The King's Daughters.
In the 1980s, CHKD surgeon Donald Nuss developed a procedure to correct pectus excavatum, and CHKD remains a leading center for the Nuss procedure. 
The CHKD hospital campus sits in southwest Norfolk, adjacent to Sentara Norfolk General Hospital and Eastern Virginia Medical School. CHKD serves as the main pediatric training location for EVMS students, and along with EVMS, sponsors an ACGME-accredited pediatric residency training program.
Today, the CHKD Health System operates primary care pediatric practices, surgical practices, urgent care centers,  multi-service Health Centers and satellite offices throughout its service region. It also hosts the only donor human milk bank in Virginia. 
In 2017 UVA Children's Hospital partnered with Children's Hospital of The King's Daughters to improve care for children throughout the region.  
In 2018, CHKD earned a full Level I Pediatric Trauma Center status. "CHKD earned provisional status as a Level I Pediatric Trauma Center in September of 2017. In July 2018, a multidisciplinary Health Department team conducted a follow-up site visit to verify the hospital’s adherence to Virginia trauma center standards. During the provisional period, CHKD’s trauma team cared for almost 600 trauma patients. The follow-up site visit resulted in unanimous recommendation for approval from all reviewers." 
In response to community assessment surveys that showed mental health services for children to be a top priority, the hospital began a multimillion-dollar initiative to expand mental health services for children. In 2019, the hospital system broke ground for a $224 million mental health facility that will have 60 inpatient beds, indoor and outdoor exercise areas, and rooms for outpatient services and a “partial hospitalization” program. The 14-story center will be on the same campus as the main hospital at 601 Children's Lane in Norfolk. 
A private, not-for-profit organization, King's Daughters' Health (KDH) is focused on delivering exceptional health services to families throughout southeast Indiana and portions of northern Kentucky. The main campus, including King's Daughters' Hospital, is located at 1373 E. State Road 62 in Madison, Indiana. We also maintain physician (provider) offices in Versailles (Indiana), Vevay ( Indiana ), Hanover ( Indiana ), Carrollton (Kentucky), and Milton (Kentucky). Additional resources include an award-winning Cancer Treatment Center, a full-service Rehabilitation Center and a Convenient Care Center.
Mission and values
The mission of King's Daughters' Health is to improve the health of our patients through care, service and education.
All KDH locations, including the Indiana hospital and all provider offices, are tobacco-free. This includes all parking lots, sidewalks and landscaped areas. Thank you for helping us maintain a clean and tobacco-free environment for all of our patients, guests and visitors.
The inspiration of 12 local women became a reality when Drusilla Cravens, a wealthy widow, agreed to donate the house that was used as the first hospital on Aug. 25, 1899. Since that time, King's Daughters' Health has grown into a regional healthcare facility, serving families from more than five counties. Formerly located in historic downtown Madison, KDH opened its new, hilltop campus in early 2013. Throughout this time, our mission has remained the same.
1899: First hospital opened on August 25.
1915: KDH moved to its former location (downtown location on Presbyterian Avenue).
1937: Dr. Thomas and Martha J. Sanderson Addition opened.
1957: Dr. Evan C. Totten Wing opened.
1971: Fourth floor added: Druscilla Home Addition.
1978: Rinda F. Rains Wing completed.
1984: Two floors added to Rinda Rains Wing.
1986: Versailles Medical Building opened.
1992: KDH Rehabilitation Center opened on Madison's hilltop.
1994: KDH Cancer Center opened.
1996: Madison Internal Medicine joined KDH.
1997: Madison Clinic joined KDH.
1999: Trimble County Medical Building opened south of Milton.
2001: Medical Office Building opened downtown—adjacent to former hospital.
2008: New hospital project approved for hilltop campus.
2010: Groundbreaking for the new hilltop campus.
2013: New hospital and hilltop campus opened.
2015: New Cancer Treatment Center opened on main campus.
King's Daughters Medical Center
- Founded 1913
- Incorporated MS
- Annual Revenue $87,296,441.00
- Employee Count 490
- Industries General Medical And Surgical Hospitals
- Contacts Alvin Hoover
KING'S DAUGHTERS MEDICAL CENTER. is a business service. Based in Brookhaven MS. Established in 1913.
King's Daughters - A Brief History
In 1897, a group of women in Ashland, Ky., met at the home of Rosetta Fisher on Carter Avenue and organized a circle under the auspices of the International Order of King's Daughters and Sons. The order was only 11 years old, having been established in New York City in 1886. There were 10 charter members: Ann Broughton, president Sarah Bagley, Bertha Boggis, Rosetta Fisher, Nannie Hopkins, Elizabeth Horstman, Carrie McElmurray, Mrs. E.M. Marker, Alice Martin and Louise Suddith.
The organization owes its names to Psalms 45:13: "The king's daughter is all glorious within: her clothing is of wrought gold." The name of the local chapter became the "What-So-Ever Circle," From John 14:13 - "And whatsoever ye shall ask in my name, that will I do, that the Father may be glorified in the Son."
Shortly after its founding, the What-So-Ever Circle, at the urging of local physicians, began to concentrate its charitable work toward establishing a hospital to serve the area.
The local medical community unanimously agreed to support this initiative during a meeting held in early 1898 at the office of Dr. John W. Martin.
The first move was to open an emergency "hospital" in three rooms on the second floor of the Poage, Elliott & Poage Drug Store on 16th Street. Nurse Harriet DeBord of Greenup, Ky., was named the hospital's first superintendent. The very first patient to be treated in the new hospital suffered from typhoid fever. The first surgery was a leg amputation, the result of a railway accident.
Within 18 years of its founding, the hospital moved four times, seeking additional space to keep up with the growing need for medical care.
In June 1899, the hospital moved to a two-story, seven-room frame home on the north side of Greenup Avenue. In July, the hospital officially incorporated as King's Daughters' Hospital with a official opening date of July 10, 1899. The hospital remained at the Greenup Avenue location for nearly seven years, although little is known of its operations there.
In 1906 the What-So-Ever Circle purchased a two-story, nine-room frame house at East Winchester Avenue. This became the new home of the hospital, where it remained until 1917. The hospital delivered its first baby at this location on Aug. 26, 1906.
By 1913, the Boyd County Medical Association was drawing up a proposal for a Boyd County General Hospital. Seeking broad support, it formed and advisory board with one member from every civic, religious, fraternal and benevolent organization in Boyd County. A committee appointed by the medical association met with members of the What-So-Ever Circle to solicit their good will and cooperation in establishing the new hospital. A member of the What-So-Ever Circle would serve on the new hospital board of trustees but, in the association's view, the King's Daughters members were simply not qualified to build and manage the type of facility that was being proposed. The Circle rejected the proposal.
The Move to Lexington Avenue
On March 9, 1916, fund-raising began for construction of a new hospital. The goal was to raise $50,000 in five days. The $40,000 that was raised was enough to begin construction at the hospital's new - and permanent - home in the 2200 block of Lexington Avenue.
On May 9, 1916, construction began on the new facility, which was to be two stories and have 50 beds. In November 1917, the hospital staff began the move into the new facility.
Although there have been numerous expansions, renovations and changes to King's Daughters since 1917, the hospital remains in the same location today: 2201 Lexington Ave.
&lsquoChange is a four-letter word in the Shenandoah Valley&rsquo
On a windy evening at Veritas Vineyards in 2019, a minister stood in front of a room filled with tables covered in white linens and guests dressed in formal wear for Augusta Medical Center&rsquos 25th anniversary gala. It was a celebration of the hospital&rsquos achievements since it first opened in 1994.
&ldquoChange is a four-letter word in the Shenandoah Valley,&rdquo said Rev. Peterson in a way that made everyone laugh before he began to take the room down memory lane:
During the 1980s hospitals in small towns across America were closing.
King&rsquos Daughters' Hospital didn&rsquot have enough of a reserve fund. And while Waynesboro Community Hospital was operating in the black, its building was old and no longer met the new demand for more outpatient services. The hospital needed to relocate.
Declining patient volume and problems with health insurance, Medicare and Medicaid and third-party pay systems were the trends facing health care.
The option was put on the table that both hospitals consider a move to a centrally located area between both towns in Fishersville.
Questions and Answers about King's Daughters Medical Center
How would you describe the pace of work at King's Daughters Medical Center?
Fast paced and overwhelming as most employees are extremely rude.
If you were in charge, what would you do to make King's Daughters Medical Center a better place to work?
I would get opinions from my staff on what they feel would improve their current work loads.
How long does it take to get hired from start to finish at King's Daughters Medical Center? What are the steps along the way?
Hiring process was pretty easy.
Letting go, not so easy.
On average, how many hours do you work a day at King's Daughters Medical Center?
How often do raises occur at King's Daughters Medical Center?
I spent 7 years without a single raise then when they finally gave them out it was for 7 cents- insulting
What benefits does King's Daughters Medical Center offer?
What is the interview process like at King's Daughters Medical Center?
Training course is boring & took the whole day.
How do you feel about going to work each day at King's Daughters Medical Center?
I honesty dread it. It's a 40 mile drive for me just to be treated like a dog while the head of out patient services struggles to keep his head above water
How flexible are your working hours at King's Daughters Medical Center?
What tips or advice would you give to someone interviewing at King's Daughters Medical Center?
Just relax. They do there whole own thing you will either get the job or you won’t. However if you apply and don’t get the job they will throw out your application every time you apply after without even considering you. I’ve applied for nursing positions for a second job during the pandemic and my skills and previous job history is outstanding and they will not even consider it after me not getting one position I applied for and I’m eligible for rehire too.