Friday, August 31, 2007

From The Mouth....

Well, if you look at what has to happen if this commenter is anyone but Hud: First, the person has to be monitoring the blog. Then he has to come up with the response. Then he has to clear it with Huddie himself...because if it makes Hud look bad... Suffice it to say, there are several former players from corporate that found out the results....

"If THE COACH and other board members were being paid off as you have suggested multiple times on this site, then why would he ruffle feathers and challenge Essent's decisions? Your suggestion that the board is on the take is but one of many libelous statements that will soon catch up with you.

I don't know anything about the anest. group but, if I am not mistaken, wasn't Essent paid damages by the radiology group? If so, who was right, and who was wrong?

Thirdly, I also don't know the specifics of the rehab issue you raise. However, you stated that Essent had to pay $250,000 for an audit. What you failed to follow up on is what was the result of the audit? Was Essnet fined materially for wrongful behavior or was everything determined to be OK? Even in our personal lives, any of us can be audited by the IRS....just because they audit our taxes doesn't mean we did anything illegal, does it? Same goes for CMS auditing a healthcare provider.

Have a great weekend Frank just know that progress is being made in outing our dear little blogger.....who knows maybe you will be the Sen. Larry Craig of you spend alot of time in public restrooms, Frank? :) I wonder if you are upset because Hud didn't play footsie with you in the restroom and you just haven't been able to shake the rejection. Bye for now (also you still don't posts all of my submissions.....hmmmm do you like the word "submission" bad boy, you.)"
Now take a look at this comment sent to hospital impact:

"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."
Note the similarities? Whatcha think? Hud=Leon? You be the judge.... Both have gay fixations. Too much porn, huddie? This is the guy you want to share a table with at the Gala???

The site that was listed for Leon had three titles posted, no explanation, no comments since March. You can get comments about a post that says that grass is green! Funny, he even copied the template.

But, let's tackle the comments (sorry, coach.)

I said the board had voted for Essent, when the top bidder indicated that they would disband the board. Does the board receive compensation? The more radical comments were comments from the readers.

The anesthesiology group: One is still here, one was fighting cancer and, well, let me put it in their own words:

"To clear up a point, the "four long term anesthesiologists" were not fired per se, two of them resigned and gave ninety days notice, one was fighting a battle with cancer, and the fourth is still hard at work in PRMC, God bless him. The reasons for the resignations included our refusal to continue working with a certain surgeon (who no longer is employed in Paris), and the hospitals insistence on our firing our long-term billing company and allowing them, Essent, to assume billing and collections for us. They also wanted us to to hire the nurse anesthetists.

All this would have meant that we would be working for Essent and not necessarily for our patients. This situation was intolerable for a number of reasons.

Although I miss many dear friends made over twenty years, I wouldn't come back on a dare as long as Essent is in charge.
M.C. Young, M.D."
As for the radiology group, they were kind of held by the short hairs: It wasn't their building. So they had to convert an existing structure because of the time factor...which just happened to be right on the loop. They're more visable than the North Campus! Don't throw me in the briar patch, Brer Fox.

With the fines that are already racked up, should we keep on that track? I think a commenter mentioned the largest fines of any hospital in the state that stayed open...

Regarding the lawsuit, the hearing was backed up a week. Possibly the letter to the judge characterizing the actions as "patently illegal, unconstitutional and an abuse of process" had something to do with it.

One more thing to toss into the mess:

"This could be purely rumor that the Essent board is looking for a buyer for the company. Hud and the CFO were not consulted. At least one company was interested but did not have the funding."
Stay tuned...

Thursday, August 30, 2007

Board (or Bored) Woes....9/6

Who Knew? Another from the underground. Again I apologize, apparently these posts came during a maintenance period (when your side is active, but mine isn't) , and they just got lumped into the bottom of the "we'll get to it real soon, now"... pile

Word leaked from the meeting of the "make believe Board" is that Hud spent a long time praising Andrew; whereupon THE COACH asked him to cut the bullshit and come clean with the reason Hud was firing andy. Apparently there were three:

(1)he had two years to solve the Anesthesia problem

(2)Andy failed to solve the Radiology problem

(3)Rehab revenue is in the tank and Hud had to endure a medicare audit that cost him $250K.

It was also noted that Knizley was simply "burned out". Excuse me, has the board been on another planet during the last two years? It was Huds micro management that fired the four long term anesthesiologists that were here when E$$ent took over. I seem to also recall that rather than negotiating with the Clifford group, Hud took the same my way or the highway approach that has resulted in millions of revenue loss from out patients. (I have omitted the stupid fight with Dickey that has also cost millions.)

As to the Rehab situation; medicare rule changes have more to do with this than Knizleys failure. Hubilla needed a scapegoat to passify THE INVESTORS. Igor seems to be the man he brings in to dump the hospital. I just hope East Texas or Baylor would take it before there is nothing left.

Now you notice the snooze missed that, but so did I....until now!

And to all those following the court case: The hearing formerly scheduled for Friday has been moved back a week....frank

Tuesday, August 28, 2007

I Can't Get No....9/5

Survey Says: We aren't happy! Ha! Didn't have to do a survey to have that conveyed....

Let's dig back a bit. We apparently have people that have to use their own vehicles to go back and forth between campuses to perform their jobs---yet have to clock out. One would think that they would only have to change their department in the time clock to be covered--and paid, but nooooo, you're on your own. I missed a comment and thought I'd bring it to light.

I've been there and done this one. Yes they do pay you milage--no it's not enough milage, I can't remember what they said it was, but it took me 4 miles , and they paid me for i'm thinking 2.2 of them.

No I couldn't use the company car, because I may go home from that location,and yes you do have to clock out between places.

No one had an accident that I knew of, but technically you were off the clock between the two, and we all know what technically means if their ass is on the line.

If you didn't clock out, you could be fired to clock back in at your next location, you could be terminated.

Is it fair? No. Is it reality? Yes.
Wonder if a supervisor, having to get supplies or whatever downtown or at the other campus, would punch out and punch in when they got back??? Where are those cameras over the time clocks when you need them? I don't seem to remember that my job requirements included having a car and driver's license....

Let me put in my suggestion: Pay the people while they are in transit.....frank

badges?? We don't need no stinkin' badges....
P.S. The guy on the left is an engineer at Kronos.....

Thursday, August 23, 2007

From HCA?....8/30

...or Atlanticare, or Baylor, or ETMC, or the Lahey Clinic? All of these were perusing the blog in the general time period as this comment. I thought I'd covered this ground in earlier comments, but possibly it was too far back.

If there is going to be a significant downturn in revenue next year because of reduced reimbursements what would you do if you were running the company? Maybe you should send your resume to Essent's board. Layout out for them a business strategy that would work.

Let's see, so far we have (i) Criticized the company for making money, (ii) criticized the company for losing money, (iii) saying the reimbursement envirnoment is only going to get worse--which I totally agree with you, (iv) don't reduce expenses, (v) criticized for spending money for renovating patient floors, (vi) applauded Baylor-Plano for have flat screen TVs and all sorts of customer niceities and so on.

Also, I am not involved with Essent,contrary to what you think. I am a senior person at another healthcare company and know that we (and all companies) are one kook away from having someone inflict tremendous damage to one of our facilities like you have managed to do at Paris.

Finally, your other poster's reference to "OUR" blog is pretty pedestrian.
Last things first: You'd be surprised at how many people feel that way about the blog--and the hospital. The town still seems to refer to the facilities by their pre-Christus names, much less Essent.

As to the criticism inflicted on Essent, the bulk of it would never have come up, had the administration invested the employees in the process.

They made the mistake of doing it to, rather than doing it with the people that work here.

There have been several changes in style since MBO (Management By Objective) was developed. All of them seem to have one thing in common: The realization that the employees have to be on board with the changes, and that the process can actually accelerate if they are...when they feel part of it, rather than feel the brunt of it. The original "The Customer" program was far truer to that spirit. What we've seen in the one-man-show is ego.

Maybe Essent will never come out from under the shadow of what they initially did (we still call them the old Sears and Brookshires buildings, and they've been relocated for how long?), and maybe it will take another with a bit more people skills to turn Paris healthcare around. Time will tell.....frank

Thursday, August 16, 2007


With the comments that came from Essent, I had to go back and see if their predictions had come true in the past. Yep, another prediction from the big guy:

To date, Essent has acquired Crossroads Hospital in Wentzville, Mo., formerly known as Doctors' Hospital, and Merrimack Valley Hospital in Haverhill, Mass., which was previously called Hale Hosptial. Those hitherto financially failing institutions, Mr. Connery estimates, should turn a profit of at least 12 to 15 percent within two years.
Well, we know how Crossroads did, so how is MVH doing? -$87,205, per American Hospital Directory.

Don't you just hate that?

They have added a little feature to the site, an estimate of how the IPPS changes will affect the reimbursement percentage. MVH goes from 2.8 to -1.1%.

Whose whatsis is puckering?

'bureaucratic nightmare'....8/28

An article in Modern Healthcare caught my eye as it related to HIPAA.

For many years I was a chief information officer. Time passed and I became a chief executive officer. The whole Health Insurance Portability and Accountability Act discussion has for years fascinated me. First of all, the database maintained by the insurance industry has for many decades violated patient privacy. Any person with private insurance—life and health—gave employers and insurers the right to view one's clinical history, drugs ordered, diagnoses and other personal data. HIPAA has done nothing to change that. When you sign the application form for the insurance, you allow this to occur.

HIPAA was passed in the 1990s and became a so-called privacy protection. Instead I think it has become a bureaucratic nightmare.

For four years I was the CEO of a hospital in Monterrey, Mexico, and am now CEO of a division to put primary-care clinics in supermarkets. Imagine this scenario. A person wants to know his cholesterol. He appears at one of our clinics and requests that a specimen be drawn for the tests. He is charged our retail rate for the test. With his receipt is a password. When he gets home, he dials into our Web site, logs on and enters his password. He sees his result. If he wants to consult a physician, he can return to the clinic and see a doctor. This person did not have to make an appointment in a doctor's office and therefore did not have to pay that fee before the test. He can appear at his convenience. There is free parking at the market. Another possibility is his physician ordered a number of tests. Again the patient comes to the clinic in the supermarket and has specimens drawn. He can see his own results, as can his doctor. None of this is possible in the U.S., and part of the reason is the HIPAA law.

What about quality? Our chief of pathology was named national pathologist of the year. We are in the process of seeking accreditation from the Joint Commission and the College of American Pathologists.

As a longtime healthcare worker in the U.S., I began as a chemist. I always felt every system, technology and service was superior. When I saw the quality in Mexico and then understood the costs, I was truly surprised. I think the reason people are seeking care in other countries is based on price. However, without quality, this trend would surely die. I think an exploration and comparison of morbidity and mortality figures would amaze the American public. Disparaging other countries in the long run will not work. If healthcare in the U.S. represents 16% of the gross national product, and it is half of that in Japan with better outcomes, something must change. One of those things is the ridiculous HIPAA law.
David Libenson

Santa Engracia Hospital


Wednesday, August 15, 2007

Opinion Survey....1/3

I'm running a totally unofficial survey above the cluster map. This week it has the question: Wool-gathering, just wait.....

Do you feel that the coverage by the Paris News is: 25%-Sparce, 6%-Over-played, 8%-Balanced, or 65%-Slanted?

How many times a week do you hear the-paris-site mentioned (email counts)? 21-Never, 36%-(1-5x), 21%-(6-10x), 9%-(11-20x), 11%-(21x or more)

Should Suddenlink break the anonymity of the blog, would you continue with their service? 12%-Yes, 61%-No, 25%-Don't, and wouldn't use....

Do you feel that the judge ruled correctly? 12%-Yes, 84%-No, 3%-Undecided

Is Essent leaning down the tax base and getting rid of the excess property, or are they selling off the extraneous to make it more desirable to a buyer? 3%-Lean strategy, 57%-Sale prep, 25%-both, 14%-credit neither

Should employees be paid for the time in transit between campuses? 4%-No, 96%-Yes

Do you feel that employee suggestions are given the scrutiny they deserve?
5%-Yes, 87%-No 7%-No idea

Should the expectation of privacy(anonymous blogging) be compromised by a Civil Suit? 9%-Yes, 91%-No

Will Essent finish their Cardiac Center of Excellence by years end? 10%-Yes, 2%-Undecided, 87%-No Note: Even Administration is now in the 'No' column....

Previous week on attitude: Have you seen changes in the attitudes of the staff?
20%-No, 11%-Better, 68%-Worse

Do you feel that Holly and her family were unfairly targeted by PRMC?
93%-Yes, 6%-No, 1%-Undecided

Do you think this site violates HIPAA?
95%-No Remainder split between Yes and Undecided.

I'll try to get more creative in the future, but it's a start. It does a six-day calculation. I also take suggestions, with the usual profanity exclusions. Mostly at the level of what you can hear on network TV.

Along with this week's survey (again, all comments posted anonymously are anonymous), any specific examples are welcome.

One more thing, seriously: If you really do think that there is a HIPAA violation, email or comment to me where it is. I'll run it by either the HIPAA blog, or there are a few sites that have picked up on this that seem to have resident experts that I will try. I've said from the beginning that I had no intention of being in violation of the Act.

Friday, August 10, 2007

How Essent Really Feels....8/15

I've gotten some comments that I've held back...more for your comfort than mine, but with the advent of the lawsuit of bloggers 1-10, with me being #1, I thought I'd actually put them in.

Who sent them? Well, Hud has a pre-occupation with certain phrases, and they pretty well single him out. His bible is the WSJ (Wall Street Journal for those of you in Rio Linda), so that gives you a clue.

But, note how he really feels...I don't think this is an act. Several accquantices have mentioned his temper, and Dickie sure demonstrates that birds of a feather....

(Anonymous) 7/17/07

Paris Texas has to be a lovely community. I bet petty bickering and gossip permeates every aspect of community iife in the little god forsaken hamlet. Based on my periodic scanning of this site I conclude that you folks

1. are mad that no one else wanted to pay up for your hospital,

2. Don't like Essent for having done so.

3. Think Essent is only in it for the money and

4. Blah blah blah blah anything else you may want to bitch about depending on when the mood strikes.

I am most intrigued by the "in it for the money" criticism. If I am not mistaken every doctor on staff, every vendor that sells to the hospital, every business owner in town that buys health insurance is in it for the money. Honestly, why should Essent be any different.

The radiology group in that town is known to play things pretty close to the edge when it comes to business dealings and aren't quite set up as a charitable foundation. If you could do better than Essent at running the place then why don't some of you big dick posters stop bitching and moaning and step up to the plate, raise the dough and buy the place? After all, that is what Essent's CEO and other CEOs did to start their companies.

If current management are such idiots, you shouldn't have any trouble selling your turnaround plan to a capital partner. I guess the presentation to raise the money would go something like this: "we need $X million to buy the hospital. Once we own it we will hire 20% more staff, give every one an across the board 20% pay raise, cut prices by 10% and duplicate services at both campuses."

I bet you could raise a bucketful of money. Good luck to you.

(Anonymous) 7/17/07

it is not prmc doing this to TJ, his wife started ... it is not prmc doing this to TJ, his wife started this and his company finished it. holly just did not do things in the right way. to post things on this blog, then ask to not be reported is insane. she made the bed, lay in it

(Anonymous) 7/13/07
frankie boy," this is not an anti essent site it is an alternative to the current business model........ "what business model? you offer nothing. you are just a sick, sorry and disgruntled individual who does nothing, i repeat nothing for the health and well being of the you even know what a business model is?why don't you come out from your hole you call the blog? scared huh?you and the people that support you are just chicken shit....plain and simply. no balls no guts. post this you fool.dick

(Anonymous) 7/17/07
Audit? You freaking idiot don't you think investors in Essent and comparable companies require audit from the same Big Six firms that audit Fortune 500 companies? Of course they guess is you think someone besides Lee Harvey Oswald shot JFK.....You are the poster child for conspiracy theorists! I don't have any idea if Essent put up cameras, etc. but any reading of the WSJ---that would be the Wall Street Journal for those of you in Rio Linda as your hero Rush Limbaugh would say......would suggest that companies do that all the time..... Why? to try and protect their franchises from numb nuts like you.If Essent wasn't the highest bidder, why did they win? Sue Christus for violating their fiduciary responsibility? Why bitch and moan about Essent not being the highest bidder and then say it is all about money? If it were all about money wouldn't Christus have gone with the highest bidder? Dufus? If Essent had sold Crossroads earlier you would have slammed them for that,,,,,so it is damned if they did and damned if they didn't. Face it, Frankster you are a low life loser in Paris jacking off as you manage this web site. I am a non Essent employee but think you are worth fucking with now......let's meet somewhere at an appointed time and place in Paris (or Dallas) or any point in a man you litttle chickenshit coward. As I write this you are probably jacking off to some child porn web site.....Frankster.....your little butthole has to be tightening just a weeeeeee little bit as the lawsuit proceeds......Where are all of your little ball-sey posters? You are a classic Paris big dick......all hat and no cattle.

(Anonymous) 7/28/07

Frank, unless I missed it, you chose not to publish my message RE the fact that right, wrong or indifferent, you may win a jury trial, but the financial cost and emotional stress you would encounter in pursuing such a course of action would be extremely high. Extremely.

You may have a different opinion from what I am about to say, but you need to take a couple of deep breaths and at least think about it.

Despite what you feel about Hud Connery and the Essent management team, you fail to realize that Essent has two very large institutional investors in the company. These firms have put literally tens, if not hundreds, of millions into Essent. Paris is the flagship.

Now put yourself in their shoes for a moment. If you thought a blog such as the one you created was negatively impacting the value of the investment, would you not, with every resource imaginable available to you, try and find out who was behind this?

My "word on the street" is at least two law firms have been engaged, one in New York and one in Washington, to leave no stone unturned in trying to find out who is behind this. This really has very little to do with Hud and his team. This has to do with major institutional investors--pension funds, insurance companies, etc that have invested in Essent's capital sources. Word is they are not happy and are advised by some very high powered law firms that libel has occurred on mulitple occasions as has at least one HIPAA violation. They are not used to having to deal with a lawyer buddy from Paris who may advise you that you are "OK". They rely on much more authoritative sources than "HIPAA blogs".

I will only tell you again (as I did in the message you decided not to post) that the continuation of this thing can only make matters financially worse for you if it plays out like I think it well may.

There is much speculation that discussions may be taking place with the Suddenlink (I think that is there name) to reveal certain information. I say this without the tone of a threat, but I fear it is getting really dicey, really fast.

Honestly, whatever damage you have wanted to inflict, message you have wanted to deliver or point you wanted to make, has been made. You really have much more to lose by keeping inflicting damage on yourself.

You really don't need to publish this either. I really am not interested in the back and forth bitching and moaning and gossip mongering. I am interested in this case because of the very compelling issues it raises from a legal perspective----first amendment rights, libel, etc.

I don't know how to contact you personally, but if you just send some sort of notice in a fac_p said type blog post that would give some indication, I would be interested in following up with you.

(Anonymous) 7/19/07
RE: your comment about sitting on a posting filled with four letter words that challenged you to come out.....(Maybe with the lawsuit you will be "outted" in a second way :)

I find it interesting that you sit on postings you don't like or don't agree with. As for your problem with four letter words, I guess that is worse than posting comments that fuel racism/religious discrimination which you were pretty good at some time ago.

Come on little fellow, be a man and post everything. While you're at it, you and others that have challenged the board's integrity should try standing face to face with one unnamed ex football coach, be a man and accuse him of being "on the take"? Probably the best thing that would come out that for you is you may then become eligible for long term disability after you recovered from making such a false acusation.

Come on Frank....come out, come out wherever you are. It is only a matter of time. Is the sphincter tightening just a little? You might want to pull a Scooter Libby and have all of your little buddies establish your legal defense fund! How do you spell "chilling effect"?

As to a legal defense fund, I just might…but what I may do is just add the advertising that most blogs have…and have it go directly to the lawyer. When retaining him, I was told by other lawyers that he was the smartest lawyer in town. Since Essent is apparently using a couple additional law firms, guess I need that.

Monday, August 06, 2007


Got a new comment, and while this wasn't the post I was anticipating running, it is important to several parties. Was that obtuse enough? You be the judge (okay, enough puns....)

Does the phrase "sacrifice one to save the others" mean anything to anyone?? That question was posed to me regarding the termination of a veteran nurse of the psychiatric unit, North campus. She was fired following administrations blunders. To my understanding those who blundered were untouched. Just wondered if anyone could bring some clarity. Seems that JCAHO was interested in her termination. I was present on 04/26/07, and will gladly stand up for injustice (if she is a reader of the blog).
To my way of thinking, she could certainly use someone in her corner.

Email me and should she do the same, I'll play matchmaker. Sort of e-harmony, or E(ssent)-Disharmony. But, I think you'd better be straight up, with her. She's been poorly turned out by the hospital, from what I gather, and some rectification of that wrong should be done.

For those wondering, my response to the Suddenlink/Essent agreement went in Monday. Stay tuned.... Think it was a suprise on several levels.....frank

Wednesday, August 01, 2007

A Great Loss....8/4

I received a comment that will go in as a post:

I know this is not on the subject at hand, but I wanted to stop and take a moment to let the people know of the great losses that PRMC has suffered. Two of the greatest nurses lost their lives in a horrible auto accident. Anthony West, RN in ICU and Debra West, RN in case management.

Both were the very best in their field. Anthony and Debra was always a pleasure to work with. Both were always professional while being fun to work with. I learned how to be a nurse from Anthony, by his example. I will really miss both of them.

God Bless their family.

You guys were the best....frank