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It’s been almost a year since Hurricane Maria slammed into Puerto Rico, battering the U.S. territory with heavy rain, flash floods and winds that blew up to 155 mph. Officially, the death toll stands at 64. But a new report estimates that 1,139 people lost their lives as a result of the Category 4 storm. The figure, published Thursday in the Journal of the American Medical Assn., is based on mortality data from Puerto Rico’s vital statistics system that was not previously available. (Kaplan, 8/2)

Nevada Republican Sen. Dean Heller's sliding positions last year on a long-held GOP promise to repeal Obamacare are providing plenty of fodder for Democrats and activists hoping to stymie his re-election. Heller, considered the most vulnerable incumbent GOP senator, opposed measures to dismantle former President Barack Obama's health care law before backing other versions that failed. The shifting stances drew attacks from the left and the right, and Democrats are not letting him forget it. (8/2)

New York City health commissioner Mary Travis Bassett announced Thursday that she will be leaving her job at the end of the month to take a position at Harvard University. Dr. Bassett, who was appointed to lead the city Department of Health and Mental Hygiene partly for her focus on community health and disenfranchised neighborhoods, has in recent weeks faced criticism for what responsibility her department might have had in a lead-poisoning scandal that affects children living in the city’s public housing system. (West, 8/2)

Senior researcher Amanda Woodrum found that employers often don’t offer health insurance to part-time or temporary employees, impose waiting periods for coverage, or require workers to contribute as much as 25 percent of their earnings toward insurance costs, making it unaffordable. Perhaps it’s not surprising that low-wage employers — think retail or food service — are least likely to provide coverage, offering health benefits to less than a third of their roughly 1.7 million employees in Ohio. (Candisky, 8/2)

Laura Kasten stood outside her mother’s house in Fullerton, a backpack pulling on her hunched shoulders. She fidgeted. The 51-year-old and her mom, Jan Rockwell, hadn’t spoken since arguing just before Christmas. Laura braced herself. “I’ve got your mail right on the table,” Rockwell, 79, said as they squeezed onto a faded living room couch. “I’d like to hug you if I can hold my nose.” (Do, 8/2)

The wait for immunizations at the Kansas City, Missouri, Health Department most afternoons this summer has been two, sometimes three hours – and it’s likely to get worse as the first day of school nears. ...The health department and other public health providers will also be immunizing children at Summerfest, the back-to-school bash Kansas City Public Schools is hosting Saturday. Last year, despite torrential rains that drenched the festival grounds, more than 5,000 KCPS families showed up. (Moxley, 8/2)

Frustrated hospital leaders say they will continue pushing for legislation to help struggling community hospitals after Massachusetts lawmakers failed in their last-ditch attempt to find consensus on a sweeping health care bill this week. (Dayal McCluskey, 8/2)

A billing policy change at Rocky Mountain Fire Protection District that went into effect Wednesday will ease the financial burden on residents who receive emergency medical transportation by ambulance. The district — which serves about 30,000 residents spanning a 65-square-mile area south and east of Boulder from Rocky Flats up to the city’s northern edge — is no longer billing district taxpayers for ambulance service costs not covered by their health insurance plans. (Lounsberry, 8/2)

A new treatment with the Zika virus might be able to target tumor cells in one of the deadliest childhood cancers. Kenneth Alexander, a doctor with Nemours Children's Hospital, says it could work as a treatment for neuroblastoma by attacking growing cancer cells, and leaving other more developed cells alone. (Prieur, 8/2)

The Portland area's main 24-hour mental health emergency room will be open to all new patients soon, but is still under a state investigation. On Tuesday, Unity Center for Behavioral Health barred transfers from local hospitals and ambulances, but allowed walk-in patients. Unity's staff and management are under scrutiny after an Oregon Health Authority investigation into complaints about assaults on staff and other patients. (Harbarger, 8/2)

Stanford Medicine hired Dr. Tait Shanafelt as chief wellness officer last year, not so much for the well-being of the patients — but of the physicians. An oncologist and hematologist by training, Shanafelt, 46, has become a national leader in the movement to end physician “burnout” — the cumulative effect of years of stress that can compromise patient care and cause doctors to leave medicine. After 12 years at the Mayo Clinic, Shanafelt now heads up Stanford’s WellMD Center, dedicated to physician health. He also serves as an associate dean of the Stanford University medical school. (Ostrov, 8/3)

A longtime Winterset physician failed to properly treat eight patients since 2013, state regulators say. This is the second time Richard Strickler Jr. has faced incompetence allegations from the Iowa Board of Medicine. Strickler, 62, practices family medicine. The board, which licenses physicians, said Strickler failed to order routine electrocardiogram tests for four patients who complained of chest pain or irregular heartbeats. The board also said Strickler improperly prescribed powerful antibiotics, including for upper respiratory issues, and inadequately addressed patients’ high blood pressure. (Leys, 8/2)

Hamilton County Justice Center inmates are getting vaccinated for hepatitis A after four were diagnosed with the infection that inflames the liver and can cause liver disease. Cincinnati Health, Hamilton County Public Health departments and the jail are working together to get the inmates vaccinated, officials said Thursday. (DeMio and Knight, 8/2)

Rush University Medical Center is working with the real estate firm JLL to manage its facilities, which is expected to net the Chicago-based academic medical center about $40 million in savings. Part of the cost reduction will stem from more energy-efficient assets, JLL said. JLL will use energy usage and cost data from other healthcare systems in the Chicago area and adapt Rush's 5 million square feet across 21 buildings accordingly. (Kacik, 8/2)