Tuesday, April 22, 2008

L. Ray's LTACH... Another Waste of Money

A Little History...

Long-Term Acute Care Hospitals (LTACHs) are specialty care hospitals designed for extended stay patients with chronic conditions. Patients are admitted to LTACHs following treatment in a traditional acute care hospital, but they no longer require intensive diagnostic procedures.

The care provided is more individualized and resource-intensive than is provided in a skilled nursing facility or nursing home.

LTACHs operate as freestanding facilities or as a “hospital within a hospital," with each type of facility operating under a different set of regulations. The average length of stay for LTACH patients is 30 days. Under Medicare guidelines, patients admitted to LTACHs must be in need of hospitalization for greater than 25 days and typically have multiple or complex medical complications.

Long-Term Acute Care Hospitals (LTACHs) have been around for nearly 20 years, but they may soon become extinct in American health care. First created to fill a vacuum in the continuum of care between the short-term acute care hospital and other post-acute care venues, LTACHs have provided a much-needed supplement to patient care, particularly the medically complex, long-stay patients that the venue was legislatively intended to serve.

Now, after several years of chipping away at LTACHs by the Centers for Medicare and Medicaid Services (CMS), Congress has imposed a 3-year moratorium on new LTACHs and additional LTACH beds.

A hospital-within-hospital LTAC must be:
  • Separately owned and licensed
  • Must maintain a separate board and administrative structure and must have a separate medical staff
  • The hospital must operate for a minimum of six months under acute care PPS to establish its average length of stay at greater than 25 days before it can be certified by CMS as a long term acute care hospital for Medicare payment.

Here we go again...another one of Ray's misguided attempts to salvage the dying DRMC. The "hospital within a hospital" description should tell you all you need to know about the fiscal "organization" of an LTACH.

Here's how it works... Hospital official to patient: "Well, Mr. Jones, you are not sick enough for us to keep you in our hospital any longer (CMS won't pay us anymore), but we are going to transfer you to our LTACH, (three blocks away), so that you can continue to benefit from our specialized treatments." (Rehabilitation for which we can get paid by CMS). "Admission to our LTACH will greatly enhance your recovery."... (and our reimbursement as long as you don't die within 25 days of admission).

Get the picture? A properly run LTACH can be a valid alternative to home health or a nursing home, but given DRMC's history, you can bet the only one that will benefit from this new "medical service" is L. Ray Humphreys!


Saturday, April 12, 2008

The Debts of our Forefathers

Anonymous said...

LET IT GO...it is 2008 and neither myself, my parents nor my grandparents were slave owners. At some point, we all have to move forward and stop dwelling on the past.

I work as a medical professional and I can tell you that I have many black, white, filipino, hispanic and asian colleagues. They all got there the same way I did - hard work, determination, and sacrifice. Say what you want, but the only thing holding people of ALL colors back is their own poor choices and lack of motivation.

I am SICK to death of hearing this bull. I don't care if you are purple polka dot, you can still make a life for yourself in America if you have the drive. Enough of the racial mumbo jumbo. And, as for Obama - I think a lot less of him since he has defended just last week Rev. Wright.

There is no good exucse that anyone should accept about such behavior no matter what color you are and what your beliefs are. Preaching hate and negativity only produce more. Positive words go a lot further with all of us.

My point exactly. How many generations must suffer for the sins of our forefathers? Three, five, ten, fifty, or do we just keep harping on slavery ad infinitum? Basically, all descendants of the pilgrims can be traced back to traitors and heretics who thumbed their noses at England and the Queen as they defected to the "new world". Should we hang our heads and offer monetary reparations to England for their loss of taxpayer revenue?

My great, great, great grandfather shot and killed two chicken thieves he caught in his back yard. Does that make me a murderer? Should I bare a sense of guilt for an action that happened 100 years before I was born? No, slavery happened and it was a bad thing, but there is absolutely nothing anyone can do to change that fact today. No amount of money, racial quotas or public assistance will erase the memory of slavery, nor should it.

We need to heed the lessons that slavery taught us as a nation and focus on the future to ensure that such an atrocity never happens again. Our children are taught the history of the Civil War, not as a morality lesson, but as a lesson of how ignorance, apathy and greed can become a drug which numbs the minds of a democratic and free society.

My parents and grandparents instilled in me the belief and skills needed to overcome the obstacles that I would face in my generation. They spoke to me of the past to remind me not to make the same mistakes and to learn from others foibles.

As a human being I deeply regret slavery; I also regret Auschwitz, Hiroshima and 911. The only thing we can do as a society is learn from these tragic events in our past and work together to ensure that they never happen again. To dwell on the sins of our past only distracts us from the enemies whom we currently confront.


Friday, April 11, 2008

Racism in America

Article: A Brief for Whitey by Patrick J. Buchanan
Posted: 03/21/2008

How would he pull it off? I wondered.

How would Barack explain to his press groupies why he sat silent in a pew for 20 years as the Rev. Jeremiah Wright delivered racist rants against white America for our maligning of Fidel and Gadhafi, and inventing AIDS to infect and kill black people?How would he justify not walking out as Wright spewed his venom about "the U.S. of K.K.K. America," and howled, "God damn America!"

My hunch was right. Barack would turn the tables.Yes, Barack agreed, Wright's statements were "controversial," and "divisive," and "racially charged," reflecting a "distorted view of America."But we must understand the man in full and the black experience out of which the Rev. Wright came: 350 years of slavery and segregation.Barack then listed black grievances and informed us what white America must do to close the racial divide and heal the country.

The "white community," said Barack, must start "acknowledging that what ails the African-American community does not just exist in the minds of black people; that the legacy of discrimination -- and current incidents of discrimination, while less overt than in the past -- are real and must be addressed. Not just with words, but with deeds ... ."And what deeds must we perform to heal ourselves and our country?

The "white community" must invest more money in black schools and communities, enforce civil rights laws, ensure fairness in the criminal justice system and provide this generation of blacks with "ladders of opportunity" that were "unavailable" to Barack's and the Rev. Wright's generations.What is wrong with Barack's prognosis and Barack's cure?

Only this. It is the same old con, the same old shakedown that black hustlers have been running since the Kerner Commission blamed the riots in Harlem, Watts, Newark, Detroit and a hundred other cities on, as Nixon put it, "everybody but the rioters themselves."Was "white racism" really responsible for those black men looting auto dealerships and liquor stories, and burning down their own communities, as Otto Kerner said -- that liberal icon until the feds put him away for bribery.

Barack says we need to have a conversation about race in America.

Fair enough. But this time, it has to be a two-way conversation. White America needs to be heard from, not just lectured to.This time, the Silent Majority needs to have its convictions, grievances and demands heard. And among them are these:First, America has been the best country on earth for black folks. It was here that 600,000 black people, brought from Africa in slave ships, grew into a community of 40 million, were introduced to Christian salvation, and reached the greatest levels of freedom and prosperity blacks have ever known.

Wright ought to go down on his knees and thank God he is an American.

Second, no people anywhere has done more to lift up blacks than white Americans. Untold trillions have been spent since the '60s on welfare, food stamps, rent supplements, Section 8 housing, Pell grants, student loans, legal services, Medicaid, Earned Income Tax Credits and poverty programs designed to bring the African-American community into the mainstream.

Governments, businesses and colleges have engaged in discrimination against white folks -- with affirmative action, contract set-asides and quotas -- to advance black applicants over white applicants.

Churches, foundations, civic groups, schools and individuals all over America have donated time and money to support soup kitchens, adult education, day care, retirement and nursing homes for blacks.We hear the grievances. Where is the gratitude?

Barack talks about new "ladders of opportunity" for blacks.

Let him go to Altoona and Johnstown, and ask the white kids in Catholic schools how many were visited lately by Ivy League recruiters handing out scholarships for "deserving" white kids.

Is white America really responsible for the fact that the crime and incarceration rates for African-Americans are seven times those of white America? Is it really white America's fault that illegitimacy in the African-American community has hit 70 percent and the black dropout rate from high schools in some cities has reached 50 percent?Is that the fault of white America or, first and foremost, a failure of the black community itself?As for racism, its ugliest manifestation is in interracial crime, and especially interracial crimes of violence.

Is Barack Obama aware that while white criminals choose black victims 3 percent of the time, black criminals choose white victims 45 percent of the time? Is Barack aware that black-on-white rapes are 100 times more common than the reverse, that black-on-white robberies were 139 times as common in the first three years of this decade as the reverse?

We have all heard ad nauseam from the Rev. Al about Tawana Brawley, the Duke rape case and Jena. And all turned out to be hoaxes. But about the epidemic of black assaults on whites that are real, we hear nothing.

Sorry, Barack, some of us have heard it all before, about 40 years and 40 trillion tax dollars ago.

Okay, we don't all agree with Patrick Buchanan, but he begs a salient question.... how long do we have to suffer for the sins of our forefathers? No other nation in history has done more to right the wrongs of our past and yet we are still viewed as a racist, segregated nation.

How much "equality" must we endure? When do racial quotas become "reverse discrimination"? This is 2008 and even in the South, race is no longer a limiting factor. Laziness, ignorance and "self-entitlement" are the only barriers to success that remain in our society.

Monetary reparations for slavery? What a ridiculous concept. At some point, we ALL need to let it go.


Thursday, April 03, 2008

Too Close to Call?

Thanks to all that have contributed to this very lively and insightful discussion of our Presidential rivals. It is obvious that this is going to be a very close race... which begs these questions:

If the election can not be determined by a majority electorate vote, what are your feelings about letting "Super-delegates" determine the outcome? Who are these people and how are they chosen? Several have already proclaimed their vote, so doesn't this bias the election?

I am a bit concerned that the next President could be chosen by a handful of wealthy, influential politicians who may or may not have the best interests of our country at heart. The potential for corruption and pay-offs seems quite likely in such a situation.

Trusting this election to "super-delegates" will be like auctioning the job on E-Bay! Let's hear your thoughts.