How Low Can You Go?....8/25

If true (and only those actually at the hospital can confirm) this little snippet is pretty damning for Essent's profitability:

Last week Nashoba Valley Medical Center set a new record for their inpatient census. There was a grand total of FOUR INPATIENTS. Yes, I said FOUR INPATIENTS.

Essent should start thinking about changing from a FOR PROFIT status to NON-PROFIT status. Staff continues to be sent home daily and there aren't many elderly still choosing NVMC for their healthcare needs. The next generation knows to stay clear of NVMC and travel another 20 minutes to the next facility.

While census is usually lower during the summer, the depth of this low sends an obvious signal: Not viable in its current configuration.

Reactions....8/16

Some people only read the posts--a mistake on their parts. I can kick a topic to life, but the people that are living it may have several different viewpoints on the subject matter. These were generated by the last post:

Tell Todd/Matt that if the blog has lost steam it's because some people are afraid to post lest they lose their jobs. The lawsuit has done more to damage Frank's rep and his business than the other way around!

I know what he means...fear is always a factor....

Todd/Matt/whoever this guy is writes (most likely on his company's time):

"Frak-a-rino:
I only check your blog every few weeks anymore.....You have run out of steam, bro'. Looks like despite your best efforts you have been singularly unsuccessful in bringing Essent to its knees.

This may be a good response in your court case.....you haven't caused a whit of damages, so why the h@#$ are they wasting their time and money suing you? "

Do your homework, Toddster- had you read some of the posts and did a little homweork (in between playing solitaire and tetris on your company's computer), you would have read this company is awash in red ink. From a heavily profitable year (50 grand- woofreakinhoo) to the 4.5 million loss recent reported.

Essent doesn't need Frank's help in FUBARing its facilities, swallowing up all that investment money. They're doing just fine all by themselves. All this humble blog is doing is reporting the truth, which in itself is a dangerous weapon. THAT is what Essent has their shorts in a wad over- people are paying attention to the man behind the curtain, and not the smoke-and-mirrors display run by Dud, dick and Duckboy.

Actually, I must give Essent a little credit- they're the perfect model of how NOT to run an allegedly for-profit company.

-The poster NOT known as Frank a/k/a John Doe number any

When it comes down to it, they are just trying to blanket all possiblities with the 1-10 thing. Even if it's determined that my comments were not libelous, they can say that the only way to find the 2-10 is through my account. Were it true, that would be one thing. Now, even with the settings set to forward, blogger doesn't and I haven't even a clue when comments are made.

"According to the latest American Hospital Directory (AHD.COM)data, when you add up the fiscal performance of all Essent hospitals for fiscal 2007, the company lost $4.5 million. Contrast that to fiscal 2006 when the combined operating profit was $55,000. How long are these idiots going to be able to keep their jobs with losses like these?"

Waitaminit...........this is a for-profit chain, right? Supposed to make some money, right? If I were pouring millions of dollars into a corporation, I'd expect them to make a little money, right?

This ain't a for-profit anything- it's a massive tax write-off, a money pit. Pouring good money after bad is not what I call a sound investment.

Matt/Todd/whatever the h___ his name is this week mocks this blog for "not bringing Essent to its knees". I'd say Essent and it's carload of circus clowns are doing a nice job of wrecking this company all by itself- what could this little ol' blog from Texas do, other than report on the train wreck taking place in Nashville, Paris, Ayer, Sharon and SW Pennsylvania.

And, finally:

Seems not much different than when the big mining companies ran the towns and the company store. Essent may be hoping that the Judge forgot that era, and the laws that prevent slavery....

So, you see, the posts aren't the fun part: the reactions are. You have to click a few times, but it's all there.

Vote, and Vote Often (Part Deux....7/4

A question has been asked:

Any news yet? Or is the ozone cloud that is emanating from the judge's brain still hanging over the courthouse, as he ponders this decision.......

Watch it come down to a coin flip: heads, guilty; tails, innocent.....

......and Essent provides a two-headed coin.

Actually, I'd hate to be in his spot. Basic liberties vs the largest single employer in town (might not be any more with the outsourcing, but for argument's sake let's say it is)...and with an election coming up. The dissection of his decision will be in the legal reviews as well as the boardroom.

But, I'm not wild about mine, either. Legal representation is not free, and I'm going to hate being back in the state court of appeals. As Todd (formerly known as Matt) comments:

Frak-a-rino:
I only check your blog every few weeks anymore.....You have run out of steam, bro'. Looks like despite your best efforts you have been singularly unsuccessful in bringing Essent to its knees.

This may be a good response in your court case.....you haven't caused a whit of damages, so why the h@#$ are they wasting their time and money suing you?

That's a question for the ages. Hud's ego, initially. Now, probably the point is moot. They want my name, but probably not for an actual trial. It wouldn't gain them anything, and more than likely hurt them--I do have enough to prove what I say. They can impose economic sanctions without that--just look back at Holly and her family. Come to think of it, it probably is still ego. These are still Hud's picked cronies. Dick is still at Essent. Browder was picked by Hud. Dickie picked Duckie.

Smoke Gets the Ayes!....8/25

In roughly two months the entire campus will be smoke-free. Finally, something I agree with! I never could understand why a patient that was sooo sick that they had to use a bedside commode--that was unable to bear the pain of sitting up on their own--could beat a street racer to the door to go out and puff. Besides, it takes a surgical patient about 20% longer to recover if they smoke after surgery. Oxygenation of tissue....



The excuse that was used: It's the norm for Dallas hospitals. Yeah, right. Since when has Duc-boy been concerned with what was done in Dallas--unless the advent was in his favor. One thing it will get rid of--smokers.



If you have to go off campus to smoke, then you have to punch out to smoke. Anyone who doesn't---off with their head! And, last I heard, only two breaks were allowed plus lunch, per shift. So when they're Jonesing over that smoke, and they either find a place to blow it out the window, or punch out so many times they have to pay the hospital to work here....gotcha!



And you wondered how they were going to thin out ranks before transitioning to the North? Meet the new boss...same as the old boss....

News From Connecticut....11/26

An interesting tidbit from the CT branch of Essent. Sharon hospital had seemed detatched from the problems plaguing the rest of the hospitals. However the article does refer to the nursing ratio concerns, as well as the all-consuming debt that Essent carries.

From TCExtra.com

Lakeville Journal
Sharon Hospital opens its books
By TERRY COWGILL
05/29

SHARON — It’s been six years since the first hospital conversion in Connecticut from nonprofit to for-profit.

When Sharon Hospital was under nonprofit ownership, its operations were essentially an open book. Its tax-exempt status required it to reveal much of its finances to the Internal Revenue Service and to state officials.

Essent Healthcare, the privately held company that acquired the nearly 100-year-old hospital in 2002, is required to report less to those authorities. Now Essent executives such as new Chief Executive Officer Michael Browder have decided to disclose unusual amounts of data regarding the hospital’s operations, finances, patient care and comparisons with competitor facilities.

“We want to be more connected to the general public,” said Ben Heller, a member of the hospital’s governing board. “For so long it’s been this mysterious entity.”

Aggressive investing

Heller, Browder and Sharon Hospital CEO Charlie Therrien spoke with this reporter and Lakeville Journal Company publisher Janet Manko last week in the hospital’s board room.

In a four-page insert purchased for insertion into this week’s Journal, hospital officials also revealed that Essent is carrying a significant debt load, which has funded the company’s aggressive expansion. When Essent was founded in 1999 by venture capital firm Thoma-Cressey, Essent’s board of directors and then-CEO Hudson W. Connery saw the firm invest $120 million right away. Since then, Essent has taken on $115 million in debt — borrowed mostly from GE Capital. Essent hopes to retire that debt, or refinance to lower its obligations, by 2013.

“Sharon Hospital today is strong and so is Essent,” said Browder, who replaced Connery last year after the founding CEO was reportedly forced out. “We are comfortable with the debt load. By pure market standards, we are underleveraged.”

From a high of $3.6 million three years after Essent acquired it, the 78-bed hospital’s net income declined to $1.734 million last year. During that time, interest expenses have risen more than 18 percent to $1.729 million, eating into the hospital’s operating profits. However, under nonprofit ownership, the hospital had lost about $16 million in the six years before Essent bought it. Essent owns four other hospitals: two in nearby Massachusetts and one each in Texas and Pennsylvania.

Decline in patient volume

The three men said that Sharon Hospital’s challenges are quite simple. Increasing patient volume remains a priority. From 2004 to 2006, for example, Sharon’s discharges went down 5.3 percent and emergency room visits declined by 5.4 percent. Browder and Therrien said patient volume is down at Sharon’s principal competitors (New Milford, and Torrington’s Charlotte Hungerford) by a similar percentage.

Many hospitals across the nation are experiencing similar declines since mid-2006, owing perhaps to the alternatives including walk-in clinics, outpatient surgical centers, hospices, home therapy and visiting nurses. Browder said he believes that recent improvements in pharmaceuticals and a declining economy have also kept would-be patients away from hospitals. In acquiring new facilities, Essent has always looked for hospitals that do not have a proximity to outpatient surgical centers, Browder said.

The physicians associated with Sharon Hospital, most of whom work as outside contractors to the hospital, are also vying for patients’ attention.

“Doctors are trying to plug the hole and do more in their offices, so they are also our competitors,” Browder explained.

Births at the hospital, however, have been a bright spot. They’ve increased about 10 percent since Essent acquired Sharon. A new 11,000-square-foot women’s services center finished last year could have something to do with that.

Financial advances, stability

In the six years it has owned Sharon, Essent says it has retired the hospital’s previous debt, financed an $8-million renovation project, helped fund a locally controlled community health foundation worth between $16 million and $20 million, and restored the hospital’s long-term fiscal health — all without a reduction in patient services.

And there was last year’s $17 million capital improvement project, which included not only the birthing center, but a new emergency department, an addition to the radiology department and a new 1,200-square-foot facility to house the magnetic resonance imaging equipment.

Through its first five-and-a-half years of ownership, Essent says it has spent more than $34 million in additions and improvements to Sharon Hospital’s physical plant and equipment. That amount is greater than the hospital’s net annual revenue when it was purchased.

Response to community concerns

Still, in the statements put out by its governing board in this week’s Journal, Essent officials concede that patient “volume has not yet sufficiently increased Essent’s significant investments [and] the debt created to increase business is large.”

In a letter to the editor in The Lakeville Journal earlier this year, Victor Germack, a financial analyst and member of the Community Association To Save Sharon Hospital (CASSH), a group that opposed the sale to Essent, raised what he called “several troubling issues.” Therrien acknowledged that today’s insert in The Journal is, in part, a response to Germack’s letter.

Germack went to Hartford to the headquarters of the state Office of Health Care Access, whose approval was critical to the Essent sale. He reported that of Essent’s five hospitals, “only Sharon Hospital was marginally profitable. The four others showed net losses for fiscal 2006.” Germack raised questions about Essent’s debt load, its overall financial condition and was particularly concerned about staffing levels and the degree of charitable care given at Sharon.

Indeed, The Lakeville Journal received a letter last April complaining that “as a result of the spending on the physical appearance of the hospital, the nursing staff has had considerable changes to their working conditions.”

The letter, which was signed only as “a group of concerned employees at Sharon Hospital wanting quality healthcare,” said nurses are “being forced to work” under a lower staff-to-patient ratio and that often “nursing personnel are being canceled and told to stay home.” Complaints to the administration fall on deaf ears, the letter claimed, so there have been some discussions about “joining a healthcare union.” Therrien said those employees’ concerns have been addressed.

“We follow national standards and our own determinations. I feel confident that our staffing levels are appropriate,” Therrien said. “There will always be people who disagree, but we have worked with nursing leadership to make sure they have the right support and resources.”

Finding quality doctors

Another significant challenge for Sharon Hospital is recruiting doctors. Shortages exist in adult and pediatric primary care, where Therrien said he would like to have four more physicians; and in endocrinology/diabetes, where the hospital could use one more.

The ranks of medical school graduates have been declining nationwide, Therrien noted, in part because of increased demands on physicians’ time and resources in order to comply with regulatory burdens and insurance. Combined with the cost of living in the Northwest Corner and an ailing national economy, the climate for finding qualified physicians leaves a lot to be desired.

“Recruiting doctors is hard,” said Heller. “Stop to think what it costs to buy a house here.”

Therrien has had less trouble recruiting qualified nurses, but was quick to “knock on wood.” He also insisted that Sharon Hospital fulfills its legal obligation to care for those who cannot afford care.

“We do not screen for financial ability,” Therrien explained. “We do go through a process to see what people can pay. Whether you have insurance or not is not necessarily the determining factor.” He added that Sharon Hospital has financial counselors who work with patients and direct them to local services that can help them further, if needed.

But all three men emphasized the importance of the concluding sentence of this week’s insert: “Finally, we are faced with the largest problem of all: How can the nation’s 2,000 small community hospitals survive in today’s atmosphere of intense governmental, economic and medical pressures?”


© Copyright 2008 by TCExtra.com

Just remember: Sharon Hospital is profitable. One of two in the Essent chain. They are talking about retiring Sharon's debt in that time frame, not Essent's.