Tuesday, January 30, 2007

Size Matters...2/7

From some avid readers:
Did anyone really look at that picture in the Snooze?

Dick looks like he was ready to take a bite out of something...

And Hud looks like he's ready to deliver...but maternity is on the North Campus.

Too bad we don't do hair transplants, 'cause Huddie looks like a before shot for Hair Club for Men.

Why is it that most of the people that Hud hires are short? Maybe he has that short-man syndrome, or Napoleon complex. Can't stand to have someone towering over him.

Maybe Hud came to Texas to feel larger, think Geico Insurance commercial--even geckos feel taller!

Monday, January 29, 2007

Lights, Cameras, Action......2/26

When Essent spends an hour flipping through the blog pages in the afternoon, they're generally checking to see if I've guessed/discovered what is going to happen next...lousy tell, guys. Then Connie Murchison was slinking around north campus all weekend. "When she showed up on Saturday, we just figured, hey, spot check....but then she did a walk through on Sunday too...hmmm"

Could it be another dog-and-pony show? Columbia Healthcare checked the blog as well, but so did Christus, ETMC, and Hopkins County. Who knows, maybe the hospital is back in play...or maybe Essent is trying for another poor slob....

If so, the walk-through will probably be today or tomorrow. Anyone have connections at the motels? Hampton would be my guess. Or they'll bring them in early, blow and go, and all we'll see is seat-of-the-pants and elbows.

Well, if we see a single group of slightly bemused people that are dressed funny on a tour (at this point, anyone in the market for a buyer and considering Essent would have to be bereft of an internet connection, and slightly addled, hence the 'dressed funny'), then they're trying the Muskogee routine, again. Multiple groups--they're selling.

Hopefully their medical Chief of Staff has the same skepticism that Muskogee's had and does some calling outside the tour.

Friday, January 26, 2007

Who Would You Like?...2/28

Time for proactive measures. In each of the acquisitions, Essent has sat back like a big spider, waiting for someone to dangle a morsel in front of it. Most if not all of the hospitals that Essent has tried for have hired firms to search for buyers. Why not get ahead of the game...save Hud some time (and shorten our association as much as possible!)

My proposal is that we limit comments (no, "Anyone but Essent" spikes) to those from former employees that have gone elsewhere, employees that wish they were with a former employer, or patients that have had a good experience(s) at other hospitals.

This might not have an application, now, but it could prove useful in a sale/bankruptcy situation. Look what happened the last time with nothing to go on.

I'll even entertain comments from employees of hospitals that are in acquisition mode, that are not former PRMC employees, if they discuss why they feel their hospital is a good place to work.

If we do get to the situation, we can trot out the list and ask for the negatives. Right now, go positive, folks!

If we have been bought, it would be interesting to see where on the list the new owners are....

Thursday, January 25, 2007

Just a Note...1/27

Good morning Mr. Connery,

Just a note from one of the former employees at your cash cow -oops, I meant to say hospital- in Paris, Texas. For 12 1/2 years of my healthcare career, I was gainfully employed in this facility, working with dedicated, motivated coworkers achieving a common goal- that of quality healthcare to the residents of this area.

Until shortly before I left, I was never ashamed of calling myself a McCusition/Christus/PRMC employee. That is, of course, until 2005.... What burned me on the facility was the policies brought down from Nashville- total disregard for employee handling procedures, reliance on agency personnel (who I feel are just as competent as any home-guard folks hands down), your mismanagement of the radiology affair, and the reliance on a former typist to handle the complex position of human resources.

Your remodeling tactics looked good on the north campus, but made the south campus look like the lobby of the No-Tell Motel. Vinyl flooring poorly disguised as wood is still vinyl. Paint and flat-screen TVs are poor substitutes for proper equipment needed to take care of patients. I have yet to hear of a TV that can properly monitor a patient's IV, or check vitals, or assist in reviving should the patient go into cardiac or respiratory arrest.

A broom closet does not an ER make. Even after remodeling, it's still a broom closet. There is too little room for nurses, doctors, allied health personnel, or EMTs to do anything except squeeze past each other. The ER is 1/2 the size it should be for a facility the size of PRMC. You can slap paint on a piece of feces, but it's still feces.

Your former CEO had no people skills, and I seriously doubt that the interim you brought in will do any better. By the way, wasn't he a head of a hospital that was sinking slowly in the west? Oh yes, just like Arcon- you DO remember Arcon, do you not, Mr. Connery?

As mentioned before, your HR department is under the control of a glorified typist who has little to no prior experience in this field. I don't know if anyone has mentioned this to you yet, but she is failing miserably. She has no more knowledge of what a certain department needs than the man in the moon.

What is the result of your leadership? Increased patient census (at other hospitals, not PRMC), low morale, general distrust among the locals. You may have the Paris News bamboozled or bought off, but not me. Not us. Not the good folks of Paris.

You, sir, are the captain of the Titanic, and the best you can do is rearrange the deck chairs. Your failure with Arcon, and the difficulties you have with Essent, are evidence that you have no idea about healthcare outside of what you feel is the bottom line.

Can I give you a hint? You're wrong. In the regular corporate world, maybe the money is the bottom line. In healthcare, however, the REAL bottom line is patient care. Patient care by motivated, caring people, working with modern equipment, by dedicated physicians (which we still have, no thanks to you), in an environment of compassion and care. In an institute backed by folks who care about, motivate, and encourage their employees to be their best.

Sadly, none of these are found at Paris Regional Medical Center.

This is not a letter from a disgruntled ex-employee. Rather, it's a notice to you that such facilities as I described 2 paragraphs ago exist and thrive. And, sadly, used to thrive in Paris until Essent came along. But, hopefully, can return if and when Essent is no more than a bad dream.

Thank you very much, Mr. Connery. Enjoy your coffee & Danish.

Must not be Starbucks...frank

Monday, January 22, 2007

An Open Letter...3/1

Dear Ladies and Gentlemen,

As a native Parisian, I am intrigued with the ongoing debate about healthcare in my hometown. I am a physician and have been in practice for 20 years in a neighboring part of the state of Texas. I have been following your plight with great interest, as my family remains there.

First, let me say that unfortunately, you as a community are caught in a rough spot. You are no longer a not-for-profit health care community. In this setting, bottom line will always be profit. There is only ONE solution, RETURN TO NOT-FOR-PROFIT status. As you can imagine, this would require someone buying the for profit people out. The community would have to become united behind a central process to root the for profit folks out.

If you are interested in pursuing this, I can organize the folks that can begin these discussions. However, please understand that this would promote a serious debate and would require a high level of sincerity on the part of both sides. Feel free to contact me.

Gary D. Boyd, M.D.

I have the contact telephone numbers, should people want to contact Dr. Boyd (just email me.) Here is the rub: A direct negotiation would be more expensive monetarily for the investors. Buying it on the Chapter 11 block would be more expensive for the community as a whole. In such a situation, we probably would be close to that '10%' left of employees. The hospital would be broken, both financially and in spirit.

Should it be on the auction block as court directed sale, the assets would probably be split. Through an Essent sale, it would probably be as a whole package...far from what I would care for, and far dearer than I would like, but talking never hurt.

I have my doubts that Paris will recover its former glory in healthcare: Too much water under the bridge, and our perceptions of 'what was' might be a little glorified with time. But it certainly could be better than what it has descended to....frank

Thursday, January 18, 2007

...Another One Bites The Dust....1/26

The CFO of Southwest Regional Medical Center got his walking papers, today. Probably was a suprise for him, the Essent goose-step is never fun in a suit.

Why, you may ask? Are they just running out of CEOs and had to keep their current one? Actually, you could say it was a pattern. And that tune has played in Paris.

Remember, Essent pushes quarters. They have to, being somewhat lean in the pockets. A decent CFO plans for the long-term, since playing the short game alone will cost you the round.

So one of two things happened: He was exceptionally bad...or he was going in a different direction....

Neither one will be apparent from the AHD figures, one thing is for sure: They didn't like the bottom line....another one bites the dust...another one bites the dust....

Monday, January 15, 2007

MLK Day...1/17

Martin Luther King polarized entire parts of this country by his actions. He crusaded for the rights of people, not just blacks, and the legislation that has come from that period in our history has been used by all segments of our population. This picture was submitted by a reader whose relative was there, in Selma, during the march.

We are engaged in a struggle, and it certainly will test our resolve. We take comfort that we know the worthiness of our efforts, and that the whole world is watching....

Friday, January 12, 2007

A Reminder...1/18

How soon we forget.....McCuistion used to be a locally-owned hospital before the sale to Presbyterian/Texas Health Resources.

Sorry you old St. Joseph hands, but the south campus has run out of room to expand--no more retail store space to acquire, and that Brookshire's isn't going anywhere anytime soon. Also, the ER was, and is, a cramped affair, as is the waiting area. At least the "Mac" had more ER pt. and waiting area space. There is scads of space on the north campus.

E$$ent claimed they were going to build new on the north side, but with the way they've FUBARed things, I'm not holding my breath. It's time to either return healthcare to local control, or get new owners. I'm not bagging on the old St. Joseph folks, because now you're all in this together- it's an equal-opportunity screwing.

Census will not pick up until after several things happen:

  • New ownership by a consortium, company, etc. with deep pockets.
  • Purchase of the equipment needed to do the job right An environment that
    empowers employees (trust me, there is such a creature.)
  • Refurb/remodel/redo what is needed (I mean really, that cheesy-looking
    floor in the south campus lobby.......the faux-wood look is trashy.)
  • Get the docs on board for proactive measures.
  • Involve local media, conduct tours, etc (put the fishwrap Snooze to work) to instill confidence.
  • And finally, positive word-of-mouth from satisfied customers who were served by folks who were not only proud, but committed (as they are now, but in a negative environment) to pt. service, with the stuff needed to do the job.

Maybe not in order, but task number 1 is to dump E$$ent, or force them to sell.

First tip of the day, thanks....frank

Thursday, January 11, 2007

A Sidebar...2/1

Just wanted to note that healthcare is a hot-button item here in Paris. A lot of communities have an outlet through Hey Martha! (Muskogee and Weatherford come to mind,) but the newspaper is the source to that, and frankly, I don't see them putting in such a venue that they can't control, despite the value to the public.

I ran a week's count, just to show what has transpired on the blog, with over 6,000 hits, it was about 5 times the usual count.

Thursday 11th January 2007 --555
Wednesday 10th January 2007 --553
Tuesday 9th January 2007 --794
Monday 8th January 2007 --782
Sunday 7th January 2007 --487
Saturday 6th January 2007 --658
Friday 5th January 2007 --1,066
Thursday 4th January 2007 --667

FYI: the count for the 4th of January was about 125 at 5PM when the Knizley post went in. The news release made it into the Snooze in the Friday edition...timing is everything.

I have had numerous emails that related directly to the care and treatment of patients in the hospital. Some I can confirm, and when sanitized, will use. I will not release HIPAA protected information (personal identification,) nor will I intentionally release anything that is identifiable to the commenter--I'd rather lose a story than hurt a source.

The ones I don't post I mainly use for my own context--and encouragement that this is a worthy effort. Some things that I have been privy to are far too traceable to a select few individuals, and my only recourse is to shelve them until they are more widely known.

In the meantime, please note that the site has had over 100,000 hits in less than a year. That says that something is wrong with the way the hospital is run. And, we need to do something about it! Get on the bandwagon: let others know about it, and finally, we do accept tips!

Monday, January 08, 2007

Hud without Bud...1/10

If things were so good between Hud and his bud, wouldn't Knizley have been giving the tour that the Paris Snooze showed on their front page? Instead it's just Hud and his roomy, walking the halls.

And why would anyone say that comment about him not having a position to move into. One could almost feel sorry for bud...almost.

After all, wasn't it also under his tenure that the cameras went up? The liens against patients? More than two years without a raise (and some getting only a nickel after that!) The debacle with the cardiac monitoring? Multitude of dismissals? The attempted eviction of Red River Radiology? (And subsequent departure from the hospital. But that worked altogether too well for RRR, as demonstrated by their continued success.)

But, don't feel sorry for bud, stock options and profit sharing lured him over to the dark side, and as ye sow, so shall ye reap! Besides, the blog didn't fire him, it just accelerated the process a bit.

Take a tip, Dick: Clean the building, put suggestion forms in the holders, hire more security, and give out the raises that the evaluations say the people deserve. Then, allocate the funds to fix the equipment. Finally, set up a system to log any patient light that isn't answered in an appropriate period. Then do something about it.

Saturday, January 06, 2007

Moving Out...3/10/11

Well, there are two moves happening this weekend:

  • Knizley out of his office

  • Richard out of Hud's house (how long has he been staying there, anyway, and did they carpool?) and on to Paris.

It wasn't as if this move was a secret--except for those in Paris.

Now, on to the search for a real CEO. I imagine that the timetable has been moved up a bit, but it's all good. Just read Hud's letter.

That must have been a scramble, in fact it was...don't you just hate to be scooped? By 16 hours, by my count. The letter from Hud extolled the virtues of outgoing and incoming CEOs, I guess Knizley's wife just had enough...but maybe she didn't know either??? I guess it's better to resign than be fired, even as you're being walked to the door....

Hey, even Vestar Capital Partners is getting concerned...about time! That call was a doozy!

Thursday, January 04, 2007

Buffed up...1/9

The new administrator for PRMC is not new to Essent, nor Hud. As a matter of fact, he even fell on his sword for both about five years ago. Essent was being investigated for collusion in the bidding process for property. Richard's resignation was meant to pacify the authorities. Since then his fortunes, or the fortunes of those he worked for, haven't been the greatest: His last position was CEO for a hospital(under Cambio management) that went chapter 11. He was also in the Crossroads debacle, and doesn't this press release sound familiar:

Doctors Hospital To Become Crossroads Regional Hospital
More than 200 entries submitted during name change contest
WENTZVILLE, Mo. - Doctors Hospital will change its name to Crossroads Regional Hospital effective July 1 following a community-wide contest to select a new name for the hospital that reflects its service to this growing area.

Hundreds of entries were submitted for the hospital's new name, 37 of which were a variation of "Crossroads". Scott Schultz of Wentzville submitted the winning name. He will receive a one-year membership to the Greater St. Charles County YMCA.

"We were delighted to see this level of community participation," said Richard Salerno, vice president of hospital operations for Essent Healthcare.

Also about Crossroads purchase:

Richard Salerno, Essent's senior vice president of hospital operations, said
Doctors Hospital's 1999 financial results appear to be in line with 1998, when
the 94-bed hospital made a $1 million profit on $18 million in revenue.
So then comes the question as to what happened to the hospital when Essent got it? Which year out of the five did they actually make money? The first, or the last?

No stranger to Texas, between his position in Essent and lately with Cambio (Baptist and Carraway assignments) and, Richard was CEO of North Austin Medical Center, then senior vice president of operations for Austin Surgical Hospital.

But he and Hud have even more of a history, Arcon comes to mind, his resume reflects ARCON Regional Vice President and that Arcon 'sold off' its outpatient facilities. Possibly so, but under court direction, and the Texas clinics a year after they closed.

In the corporate world, you either progress, or you are sloughed off into a corner. Richard progressed up (and past) the CEO position that our facility would have commanded over 10-15 years ago. And now, going from a 615 bed facility to at best less than half...one might say it's not only his last chance, but PRMC's as well, with Essent.

Eat your heart out, Snooze...and the Nashville Business News....

Knizley in the Wind?...3/13

Andrew Knizley, CEO of PRMC has his walking papers...but maybe he doesn't know it yet!

Who does know? Most of E$$ent.

Richard Salerno, will be taking care of our little problem in Paris, despite having some baggage of his own.

Richard just left a sinking ship, a little late, however, since the hospital had already gone under. Carraway Medical, a 615 bed facility, filed Chapter 11 in September, at which time Dick was the COO. They're in the midst of being purchased by a group of approximately 54 physicians.

In the interm, he's been made the CEO--at least on their website. Rumor has him seen in extensively in Nashville.

Guess Andrew needs to pack up his Rolls.... Guess Essent just spat....

...But We Aren't Laughing...1/21

No matter how you slice it, dice it or saute' it...Hud is a dud. So, consequently, Essent is a joke!

Management,...what management?! PRMC could not possibly be handled any worse. Where is our fearless leader, Andrew? How come the only person we ever hear from is Cheryl Perry? Is anyone at the helm of PRMC or...are we just drifting with the tide?

PRMC should be the most updated and profitable hospital in the N.E.Texas area. Instead, it is the least likeliest place preferred for treatment. Our own Paris community shuns us!

Someone once commented that the blog is just a place for gossip. NO! It is a medium for expression of legitimate concerns and/or problems by both staff and concerned patients and community members.

If, indeed,Essent management is listening...Please express your concerns! Does Essent really expect to profit --
  • from a facility with a constant turnover in staff?

  • from a facility with out dated equipment?

  • from a facility with no permanent Doctors/Radiology?

  • from a facility that does not pay their employees/no pay raises?

  • from a facility that has no reward or incentive program to maintain a "higher standard"?

  • from a facility that does not help employees maintain licensure that is needed to be employed?
  • from a facility that does not listen to employees, pt family members, or patients?
And this is but a few concerns. I love to care for people. It is what I do for a living.

Yet, at this facility I am held back by either too much politics or dunder-headed policies made by people who have no idea what they are doing! At one time people wanted to come here for treatment and care...not anymore. Essent is capable of turning this place around. So, either spit or get!
(From the mailbox, and get might be the operative...stay tuned!...frank)

Wednesday, January 03, 2007

Back to Rio Rojo...1/15

What are those big boxes being brought into Paris Imaging? Could it be a belated X-mas present...well, in a way. It's the new Gamma camera for their nuclear medicine addition! When hardly anything in PRMC x-ray is generating income except nuclear medicine studies, it's hard to ignore. This could cut heavily into the revenue stream.

So, let's lay it out, Paris Imaging has the newest and fastest equipment in town, including:

  1. ultrasound,

  2. digital mamography,

  3. diagnostic x-ray,

  4. CT,

  5. MRI,

  6. and now nuclear medicine.

    Guess the Boyz are back in town....


Austin Craun and Greg Schonert may be looking outside the healthcare industry. Rumor mill has Black River Capital interested in the boys. Both had REIT experience prior to Essent, so it isn't too great a stretch...is it?

Zurich American Insurance has been looking at our Northeastern brethern.

Partners Healthcare Systems Inc and one other has been checking out Dr. Rimas Maurukas. Is he looking for a new affiliation? One would hope that they would be a bit wary, as the investigative process hasn't ended.

I have no idea why so many folks from so many countries are searching for the same string of items: "Paris Essent Hud". But, I've had hits from Estonia, Iran, Vietnam, Korea, USSR, and a great number from the 'west' as well. Someone must be passing around an email that has to be titilating.

Oh, and Vestar Capital has been checking us out. That probably means that Essent burns the midnight oil trying to do a risk analysis...hey guys, it's all at risk!

Monday, January 01, 2007

Giving Thanks in the New Year...1/3

I received this e-mail the other day. I do spell check, and in some cases reformat as needed.

I never realized what all I had to be thankful for, until I started my new job. I was in shock when I was terminated from PRMC, having worked there for a number of years. You get into a rut, not wanting to make a change, and you find all sorts of reasons to not hop the fence. They made it for me. And, because I was there so long, I had no other history that a new employer would verify. The flighty might have an advantage.

I would say the main reason I got the job is recommendations that former co-workers had given me (they had wanted me to switch years ago, but I thought that things would 'get better') and they now worked here.

But, I was hired and immediately started seeing differences: They actually solicited my opinions! They were happy to see me! I was made to feel I had worth! And they checked back later, to see if during my initial time I had seen anything that they could do better---I was blown away. And the people were so darn cheerful, and so am I, in retrospect.

I see more and more people here that used to work at PRMC, and while I welcome those who join me, I worry about those that are left. Make the move before the move makes you!

There's at least one more of my fellow co-workers joining us, and the commute gets old, but maybe we'll start a Paris expatriate community.
(There would be several, I would imagine....frank)

Another, which was quite similar, gets added:

The expatriate mentioned in your newest article is me. I couldn’t have written a better explanation of how welcome I’ve been made to feel, and I haven’t even started my new job yet!! HR at PRMC could learn a thing or two about how to treat people.

Disclosure seems to be their forte rather than cloak & dagger politics. Not to mention department heads have exactly the same attitude. The motto seems to be “We want you, are extremely pleased you accepted the position and we are behind you 200 percent!” After trying to relearn how to live in the normal world, the attitude seemed unreal, and once again I am looking forward to working in a hospital atmosphere.

I grudgingly admit that PRMC put such a damper on my outlook of things, it was hard coming back from all of the disillusionment forced upon me by Essent's policies. I thought I had lost my desire or capability to function in that environment ever again.

But with the New Year, fresh starts do happen. As mentioned in the article, I was forced to leave as well, but not through blatant dismissal, it was more insidious, it was through position elimination and an offer to continue at a much lower level, all the time requesting that it would be appreciated if I would use my licensure for the benefit of the department. Certainly I should have no problem with that. How demeaning!

Pretty much the credo of a now ever present problem in Paris. I tried moving onto other things, but apparently, healthcare is in my genetic structure, not to be denied. I was terrified that I would not be able to land a job at any other healthcare provider, as the referrals, again, would only be through fellow co-workers and contacts made during my position at Essent. It truly was a worry on my part. However, happy endings do exist, as the position was offered and I was ecstatic over the prospect.

So I happily start my New Year, with a fresh and upbeat state of mind. Much engendered by a company and Administration that practices what they preach. I still hold a great deal of resentment over the state of affairs here in Paris, and probably will for a very long time. And I will fight to be the first in line to cheer Essent's departure. Hell, I’ll even learn to play drum cadences to help them march out of town! Again, thanks for a much needed vehicle for folks to voice their opinions and vent.

I have no problem in your use of this email, edit as you wish. At this point I would be willing to get a magnetic sign to put on my car extolling the virtues of Essent/PRMC, just not sure if I could get the print big enough! HA!

However, don’t use the name, I still have great friends that work there, and would be afraid Essent would vent on them as a result of my opinions. Truly a sad state of affairs!
Happy New Year, and please continue the blogsite, it is good for our souls!

This was sent by a blogger, which kind of represents our reaction towards PRMC:

I guess we r stuck hear with E$$ent!

The New Year has a tradition, that being resolutions. I hope this year Essent resolves to re-evaluate and move on--without us!