Sunday, April 29, 2007

Seven things...5/8

I checked the new CEO's website, and if he implements all of his seven points, he's going to be following Andy's route, with an escort.

Patient first? When has Essent aspired to that??? Heck, one of the CEOs (can't remember which many preceded ....) said they didn't really need Paris behind them.

The Golden Rule for Customers? From the description, he's been through "The Customer." Well, the employees are also the customers of the hospital, and a call to the Better Business Bureau on their behalf would be in order for this place.

Manditory fun. All the skipped raises put us in a great mood. Paste a smile on your kisser, or your keester is going to hit the bricks.

People are a hospital’s most important asset! We've been shedding assets for three years, now. LCDs are heading up the list of personnel replacements.

Employees need to take risk and challenge the status quo! Like that's going to happen...people even get fired for contributing to the blog. Suggestion boxes, anyone????

Practice Scottish spending! Actually, I agree. But, there needs to be a willingness and ability to pull out the wallet when it's necessary. Essent hasn't been terribly willing...and possibly not able....

I left this for last: Always try to exceed...expectations! I really think the blog has....

Friday, April 27, 2007

Agreement, Tacit, But Agreement...5/1

From an email:
"Paris is not the regional medical hub that it once was, and steps must be taken to restore the medical community to its former glory and move it to new heights in the future...we are convinced Walters will be a shot in the arm for a regional medical community that shows some signs of ailing."

Interesting that the editorial tacitly assumes that there are major problems at PRMC that need correcting. Yet the Snooze has never printed a single news story that documents this decline in the hospital aside from the articles hand-written by Essent about the layoffs and about Andrew's firing (actually, they never even said he was fired, did they?)

What's happening...Paris healthcare ailing? How can that be? The Snooze usually portraits Essent as the second coming, our savior rising from the ashes of Christus....

Give me a break....

Essent was an opportunistic monolith with an over-inflated ego. It's what caused the Crossroads debacle, and from what stems our problem. Essent did poor research, "due diligence" as it were, and found themselves with a dichotomy: A purchase which doubled the number of beds in their system, yet had the weight to sink the corporation. The weight being what was needed in upgrades...and I don't mean paint and LCDs....

Essent should have passed us by...Muskogee would have been a far better choice as to plant and facility. Christus was letting us coast, as it were, and siphoning off what they could from Health Solutions, while putting almost nothing into the maintenance of the facilities.

What should have happened is a larger corporation, with deeper pockets, needed to take the bid. While we wouldn't have been the "showplace" (can you imagine what vanity that played to???), we wouldn't have been left out in the the cold--15 year old equipment that is the difference between your life and death???

What Essent has at this point, is a dilemma: Sell off Christus, which loses half their beds, and, what, $383 Million of their cash flow, or ride it down the drain..... You've all heard the commercials, "I've increased my cash flow to 2 gazillion a year! Ain't I special!" What counts is the bottom line: Reported income for the current period is $288k, the previous was $1.6M. You do the math: That is 18% of the income reported for the previous period. Yeah, real special....

While I keep hitting them with Crossroads, I feel that it was true to form: They held on to it because to dump it earlier would have been an admission of failure! Their very first hospital tanks! ...and after putting in $38 Million! Would the PRMC board have chosen them then?

Maybe Hud thought that Paris carried well with "French Lick", the original name for Nashville. Sorry, but the French nuns that helped establish St Joseph's would be rolling over in their graves, and Dr. McCuistion would be likewise. Neither would cherish the changes that have befallen us, their one probable point of agreement.

Wednesday, April 25, 2007


David Kreye going to the Baptist system in SA???

Didn't realize that he was so fond of Texas, or that Baptist had a CEO spot open. At least Hud didn't come right out and say that he had no prospects and that Davie was quitting for 'personal reasons.' Sounds like Davie was ahead of the power curve.

I guess with the comment retraction of Amarillo as a destination, our western brethren are breathing a sigh of relief.

But, with four CEOs gone in about a twelve month period, one has to wonder about three things:

Why is everyone leaving?
Why do they change CEOs like underwear?
What is it about Essent that is inconsistent with CFOs?

Which begs the question: What's wrong with Essent????

Think about it, in the three plus years, they've lost one hospital, multiple CEOs /CFOs, and fired a good portion of corporate administration. Does anyone think that Hud might be a teensy bit hard to work for?

Quality issues are in play, patients are avoiding the facilities unless they have no choice, and employees are only staying because their families anchor them, not because of any loyalty to Essent.

And now they've discarded any pretense about the board, it's now a 'Hospital Advisory Board'. Let's see what kind of advice Hud takes....

Tuesday, April 24, 2007

Rumor Mill...4/26

I heard through the grapevine...(that things are getting thinner in Nashville)... and Hud's about to l-o-o-o-s-e his mind.... Anna Jean and Mal have walked the plank, who's next? If only Dick was still there, he might have had his chance!

You kind of have to consider who has the largest amount of stock options--Joe Pinion and Hal Andrews were probably at the top of the list. Dick was already gone, and now Anna Jean and Mal have met their untimely demise. Dick is back, but if he's holding on to the FTI position, maybe he can tell which way the wind is blowing...rather than waiting for the big one...or the other shoe.... The twisted thing about it is not that he fired them, it's that they were listed as friends** from way back or fast-burners under his tutelage...but, hey, it's just business....

Corporate used to be a safe bet--only the head honcho might be trimmed off. Heck, that's how Hud moved up in Health Trust---the previous CEO had to dry out, so suddenly Hud is running things.

Don't think that that is about to happen, but we can always hope.

**People mistakenly believe that Hud is their friend but Hud has no friends, just people he uses until they no longer serve his purpose.

Monday, April 23, 2007

New CEO??...5/2

Rumor has a possibility on an in-bound CEO. Hopefully they've been keeping track of what's in store. There have been some additional hits from Nashville, so maybe they're girding up their loins....

Whatever the case, hopefully they have more independent nature than the previous ones....

And, if it's true, Dickie can follow Kreye's path to PA, since apparently he resigned as well....

Friday, April 20, 2007

Ghost Writers of Radiology...5/11

Radiology reports are transcribed, but transcription is 10 days behind. Since they use locums, how are they able to review and sign (electronically) their dictation when they bring in a non-regular? Is someone signing for them in Helen Keller mode? Could be a problem---fraud might be rearing again.

........the 2 transcriptionists that are left are hopelessly behind. ....said 250+ inpatient transcripts and 10 days behind on outpatient...even though they're working 12 hour shifts. She said that the radiology staff is sick of saying "sorry, the report's not ready yet".....

And one more point that was brought up: Essent dismissed one locum for being drunk or drinking when she came in to do a breast biopsy, were the reports that were pending her electronic signature re-read, or did they slip away into obscurity, Caspered as it were, suddenly appearing signed?

Thank God they got rid of those nasty, profit-minded's been over a year...haven't things been so much smoother????

Wednesday, April 18, 2007

Going International....4/22

Received an email from a blogger...from the Netherlands. He wrote a couple articles based on the-paris-site for a newsletter. He was mainly curious, since no one has done that over there (blogged a hospital corporation.) I posted to a site that had a nifty screen shot of the 'site' and he wanted to do a contributory article. However, I have a feeling that he also contacted Essent...the power of the threat of lawsuit....

This has certainly gotten bigger than I thought it might.

One nice thing about the popularity is perspective. I had only my own viewpoint, with little idea how this had affected other parts of the hospital. Then I started getting emails--ones 'not for publication'. Some were blowing off steam, some were too identifiable, some--when combined with other information--completed a picture. First it was the hospital, then other hospitals in Essent, now I'm getting a corporate view.

Remember, this is an anonymous blog, and in that situation, confidentiality agreements and non-disclosures are moot. You'd be suprised who Hud has pissed on...and pissed off. This provides an avenue for their comments, criticisms, suggestions, and recollections. If you feel that email is too traceable and just want to run it by me, post it as a comment with a 'Do Not Publish' in the top line. Even a cell phone view shows that much.

And I just know that there is going to be something fairly soon that will curdle the milk in Hud's morning tea--wait for it....

Monday, April 16, 2007

Do Ya Wonder???...4/29

I had noted a response to a comment (I made) on another blog a bit ago, it was kind of a cheap shot, but hey, I'm a big guy, I can take it...and then I got curious.... So I did follow back on the URL that was supposedly from the responder, and lo and behold, the blog was three topic lines, no input from the blogger, and no comments...and started on the first of March--the day the responding comment was made. Darn, do you get the impression that Essent was trying a dis-information campaign?

The following is the last comment I made in that thread, with the shot that the other commenter made in quotes:

"Frank Pasquale's ideas may be good but his delivery cheapens them. He is too personal. I went to his blog about a hospital in Paris TX- but it is really about his feelings for the CEO. Must have been a romance gone bad which is better left to blogs of a different ilk than hospitals."

Interesting speculation, but this was the company that was being sued by a gay couple in MA for denial of healthcare benefits.

Sensationalism sells, bunky. One can write an article that is factual, to the point, and nothing left out...and no one reads it. The same article put in the perspective of the public persona generates identification. That is what generates readership.

Does it cheapen the message? Possibly, but if no one hears the message, what value does it have to cheapen?

By the way, Essent withdrew from their last attempt in Hammonton, NJ.
That's three....

But, here is the thing: Could he be planting a false trail? We know that Dick is spending an awful lot of time in Hud's houseguest...and Hud is divorced.... Makes you wonder if the commenter hit closer to the mark than he intended--and the boss said cool it! But, that's just idle speculation....

Either way, it makes no difference to me, I'm not a homophobe. But if the comment was too close to the mark, it could project some interesting connotations to the Essent structure, and cause speculation about the past and recent firings within the walls of corporate headquarters...and it could explain the abrupt silence from "Leon".

Tuesday, April 10, 2007


Had a special request, so I added Cluster Maps, which shows the hit activity areas on a map.

Just goes to show, I do requests!

I did hate to put it up, actually, since the count seems to be wrong. The listing from statcounter has 457, and Cluster Maps has 375 for yesterday's visits. It also miscounted on the first couple days, but it does give a representation of where the hits are coming from....the light went on! There are unidentified hits that would account for the discrepancy! All's well with the world!

Backing Water?...4/16

Apparently, Essent seems to want to weasel out of the new hospital in Ayer.... The CEO of NVMC is quoted as saying that their 1.9% profit is not enough to justify the endeavor. (Where does that put Haverhill?) Personally, I wouldn't say that even a 2.5% would be enough to dump in 50Million, but what do I know....

They are trying to get a 20 year tax abatement, but wasn't this all taken into account when they purchased the hospital? Sounds like a new Essent strategy--be prepared, you other locations, the abatement train may be pulling in sooner than you think!

Saturday, April 07, 2007


Just contemplating an idea that occurred: Hud hired the darlings of development ' find...opportunities', quoting from the Nashville Business Journal,

"The $340 million Nashville company has brought in Gregory Schonert and Austin Craun to find development opportunities.

CEO Connery's new executives have backgrounds in REIT financing and health care analysis. He'll need them both because, for every potential deal, the company has to look at a dozen others. "You've got to turn over a lot of stones," Connery says."

So, in nearly two years, they've been paid to look for opportunities...and just haven't quite managed it.

They fired Anna Jean, possibly because of the non-compliance fines. Several others because they made Hud look bad. One because he was causing internal strife (disagreeing with Hud.)

So, what about not producing what they were hired for? It's not like he is their mentor, or friends for 20 years....

Yep, the boys better watch their backs--after all, Hud certainly knows what can crawl out from under rocks, or stones, that is....

Wednesday, April 04, 2007


"We're not down-sizing, we're right-sizing...." is the tune that Essent might whistle while they whittle staff away. But what is the right size? Obviously more, if the hospital is running closer to capacity. We aren't, and their solution is lay-offs. Which impacts care...which increases complaints...which decreases utilization...which leads to more lay-offs! It's a vicious cycle, more like a death-spiral. We'll know they're really hurting when they start laying off more people from corporate....

But, what would a better solution be? Obviously, getting people into beds here, rather than Dallas, Tyler, Texarkana, etc. Offering additional services, demonstrating changes in outcomes, perks, and advertising. And, getting the staff on board...the only thing the staff wants to do at this point is jump ship....

But, all that takes more, not less, staff. And to attract experienced personnel to this location, you either have to pay them a premium, or make it more attractive to them: Perks, Pay, Praise, and Pride. Currently, the count to the plus side is zero.

So, we either have a company with policies that takes healthcare for the Paris area down the drain,...or they get their act together and become more pro-active, rather than reactive. Their choice, our future....

Monday, April 02, 2007

How Can You Be In Two Places At Once....4/16

...when you're not anywhere at all....

Ah, but Richard, we don't like sharing...with FTI. And while Carraway has lost you like a bad hair piece, FTI still keeps you prominent as Director of Corporate Finance.

And could there be some pumping of the CV? Eight hospital manager in a startup for-profit? Or don't you even include Essent? (A three or four facility startup, when he was there, originally.)

But, be that as it may, you've certainly gained the respect and trust of the staff--look how long it took Andy (Knizley) to get to where you are already....