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	<title>Medical blog &#187; struggles</title>
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		<title>Medical Care Facility struggles through very difficult year</title>
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		<pubDate>Fri, 26 Dec 2008 11:52:56 +0000</pubDate>
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		<description><![CDATA[Friday, January 23, 2009 11:04 AM EST
 CASSOPOLIS &#8211; Isolated Cass County Medical Care Facility &#8220;experienced one of its most difficult years&#8221; in 2007-2008, Administrator Merri Terborgh and Dowagiac certified public accountant Rebecca L. Moore acknowledged to the Board of Commissioners Thursday night.
 A Sept. 30, 2008, audit conducted by Plante Moran chronicles alarming financial [...]]]></description>
			<content:encoded><![CDATA[<p>Friday, January 23, 2009 11:04 AM EST<br />
 CASSOPOLIS &#8211; Isolated Cass County Medical Care Facility &#8220;experienced one of its most difficult years&#8221; in 2007-2008, Administrator Merri Terborgh and Dowagiac certified public accountant Rebecca L. Moore acknowledged to the Board of Commissioners Thursday night.<br />
 A Sept. 30, 2008, audit conducted by Plante Moran chronicles alarming financial swings.<br />
 Cash decreased $451,000, from $1,971,866 on Sept. 30, 2007,<span id="more-16464"></span> to $1,520,858 a year later.<br />
 Accounts receivable increased $322,000 over the same period, from $824,466 to $1,146,152.<br />
 Accounts payable and liabilities mounted $393,000, from $463,641 to $856,257.<br />
 Total operating revenue eroded $13,000, from $6,294,976 to $6,281,993.<br />
 Salaries and wages climbed $181,000, from $3,199,805 to $3,381,118 in tandem with other expenses rising $561,000 12 months, from $3,008,582 to $3,569,527.<br />
 Operating income showed a $755,000 decrease, from a profit of $86,589 to a $668,652 loss.<br />
 The women said a substantial increase in expenses included fines and assessments.<br />
 Outside consultants and advisers who had to be brought in to return the nursing facility to compliance contributed to the drop in cash by year end.<br />
 Accounts receivable and accounts payable both increased considerably mostly due to problems with Medicare reimbursement lapsing last summer and a subsequent delay in issuance of payments to the facility, then the resulting lack of cash to pay vendors in a timely fashion.<br />
 The audit found administrative expenses soared $344,000 primarily due to fines and consultants brought in to address deficiencies and compliance issues.<br />
 Facility and plant operations jumped $75,000. Therapy services increased $50,000. And nursing services increased $255,000.<br />
 &#8220;Just so you know,&#8221; Moore advised commissioners, &#8220;we are starting down a path that&#8217;s going to take months. It&#8217;s probably going to be the end of this year before we have any good answers. We are putting pretty much anything that has to do with finances and accounting under a microscope out there and trying to determine if it&#8217;s being done the most efficient way, which we&#8217;ve already determined in many ways that is not the answer. We&#8217;re changing methodology. Everything&#8217;s subject to being looked at and changed. Little by little, that&#8217;s what our plan is right now. Nothing was being done out there in a timely manner.&#8221;<br />
 A glimmer of good news amidst the gloom, Moore noted, &#8220;Because the facility had been run so well for so long, in &#8216;06 they had 167 days cash on hand. In 2007, they had 174 days cash on hand. Even with the results of last year, they have 129 days cash on hand, which compared to the benchmark Plante and Moran uses of 104. We&#8217;re not financially destitute. We just need to get ahold of our problems and get them fixed. We haven&#8217;t lost so much ground that we can&#8217;t make it up. We just need to get a grip on things,&#8221; such as &#8220;lack of billing. There have been items out there that have not been billed properly. We&#8217;ve got to get things posted and up to date. For example, I went in there in December, when the auditors were starting. None of the bank accounts had been reconciled for the entire year. Financial statements were being prepared outside of the software, which to me is not a very trustworthy way to do it.&#8221;<br />
 Terborgh came on board in October. &#8220;In terms of positive changes for the facility, one of the first major decisions I made was to call Terry (Proctor, county administrator) to tap into your financial operation and get some help. He introduced me to Becky, and that has been the greatest positive change. One issue was that the Medical Care Facility became an isolated island. There was no input from the outside world in terms of regulations, how to document things to keep compliance. There&#8217;s never been a question that we provide good care,&#8221; but as far as the state is concerned, &#8220;If you don&#8217;t document it, it didn&#8217;t happen. If you don&#8217;t keep up on the rules, you don&#8217;t get things written down correctly. A lot of money went to high-powered consultants that the state recognizes. They saved the facility last summer. It&#8217;s like the MasterCard ads: Saving the facility. Priceless.&#8221;<br />
 Terborgh said Moore&#8217;s office &#8220;drug us into this century. Electronic transfers were not being done previously. We literally had staff running up and down the road with bank deposits. High accounts receivables are being worked, old bills are being cleaned up. All in all, the business office is beginning to hum and look like a real business.&#8221;<br />
 Terborgh stressed, &#8220;It&#8217;s not all been gnashing of teeth,&#8221; although she was confronted with converting more than 80 televisions to digital before Feb. 17. &#8220;Cable doesn&#8217;t come anywhere near our cornfield,&#8221; she said, but county Maintenance Supervisor Dave Dickey assisted. Residents enjoy 24 satellite and seven local channels, including one the facility can program.<br />
 The MCF also has a new maintenance director with 32 years of experience who can &#8220;fix a lot of things we previously had to hire out,&#8221; Terborgh said. &#8220;We for the first time have a licensed social worker, which if we ever want to go wild and impetuous and build another unit on, as the building was designed, that&#8217;s a necessary requirement.&#8221;<br />
 Although small community hospitals &#8220;are a long way from electronic medical records&#8221; that President Obama favors, &#8220;We pretty much are there. Ninety percent of our records are automated. The next step is to tie that into our billing. In a very short time we&#8217;re taking leaps.&#8221;<br />
 Terborgh recapped for commissioners the MCF&#8217;s &#8220;wonderful holiday season,&#8221; including a New Year&#8217;s Eve celebration with &#8220;hats and horns, a fake clock, shrimp, meatballs and live music.<br />
 &#8220;Residents voted to have it at dinnertime so they didn&#8217;t have to stay up late,&#8221; she said. &#8220;Everybody headed to bed about 9 o&#8217;clock and felt good the next morning. The staff are very warm, caring people who provide good care. They decorated the dining room.&#8221;<br />
 At Thanksgiving, &#8220;We did turkey dinners for 90 family members as well as our 80 residents. We did an open house with hors d&#8217;ouevres at Christmas for family members so they could be with their loved ones in a party setting,&#8221; Terborgh said.<br />
 &#8220;I&#8217;ve never seen such a turnaround,&#8221; praised Commissioner Carl Higley Sr., R-Ontwa Township, thanking Moore, Terborgh and Dickey.<br />
 Higley lauded Terborgh&#8217;s literal &#8220;open door&#8221; policy. &#8220;Used to be, the doors to the offices were closed. It was not like the public place it is.&#8221;</p>
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		<title>Arlington family struggles to cope after boy critically injured in &#8230;</title>
		<link>http://www.raganvirtualworkshops.com/21018.php4</link>
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		<pubDate>Sun, 23 Nov 2008 10:57:31 +0000</pubDate>
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		<description><![CDATA[Akron, OH
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			<content:encoded><![CDATA[<p>Akron, OH<br />
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		<title>Oceana County struggles with teen drug problem</title>
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		<pubDate>Tue, 05 Aug 2008 16:22:15 +0000</pubDate>
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				<category><![CDATA[Health]]></category>
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		<description><![CDATA[
Oceana County, with its pastoral fields brimming with asparagus and cherry trees, might seem an unlikely place for a teenage drug problem.
 But in this quiet area where the largest of five high schools will graduate fewer than 115 seniors, there is a growing number of young people entering treatment centers for drug abuse.
 Last [...]]]></description>
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<p>Oceana County, with its pastoral fields brimming with asparagus and cherry trees, might seem an unlikely place for a teenage drug problem.<br />
 But in this quiet area where the largest of five high schools will graduate fewer than 115 seniors, there is a growing number of young people entering treatment centers for drug abuse.<br />
 Last year, 42 Oceana County residents between the ages of 15-20 were in drug treatment. And, according to one recovering addict,<span id="more-3340"></span> that is a fraction of the number actually misusing drugs.<br />
 &#8220;There is a big problem here,&#8221; said 20-year-old Brittany of Rothbury, a recovering drug addict. &#8220;Everyone thinks Muskegon is so bad, but they sell the same stuff here as they do there. &#8230; Weed is a big deal everywhere, but prescription drugs you can get from just about anyone.&#8221;<br />
 Prescription drug abuse among young people in Oceana County has led to arrests, accidents and even the recent death of  a 20-year-old Hart woman.<br />
 Bruce C. Vanderhoof, a local substance abuse counselor, sees the consequences everyday.<br />
 &#8220;Alcohol and pot use nationwide has come down about 2 percent, but prescription drug use has come up,&#8221; he said. &#8220;We&#8217;re seeing it more and more and no one wants to admit we have a problem in the area.&#8221;<br />
 In August, Jessica Bruce, a former cheerleader at Hart High School and accomplished equestrian, died when she overdosed on drugs that included a Fetanyl patch. Her father, Steve Bruce, said his daughter had stolen other Fetanyl patches and prescription drugs from her mother in the past.<br />
 Many of the prescription drugs young people illegally use are stolen from their parents or someone they know, a fact Michigan&#8217;s Department of Community Health has hammered home this year with an aggressive advertising campaign.<br />
 But Oceana County residents said that message often goes unheeded.<br />
 &#8220;It&#8217;s very difficult to understand how it happens in a rural community with small-town values,&#8221; said Rev. Lorraine Boucon of Hart Congregational United Church of Christ. &#8220;You see people dying of drugs and it just doesn&#8217;t make sense.&#8221;<br />
 Steve Bruce said he discovered evidence his daughter, Jessica, had been &#8220;smoking&#8221; the prescription painkiller the morning he found her dead in her bedroom. His daughter had been living in the Bruce home about three months before her death.<br />
 Steve Bruce believes his daughter, who also was diagnosed with bipolar disorder in high school, started experimenting with drugs after being prescribed pain medication for an injury at age 13. He said he attempted to address his daughter&#8217;s growing drug problem for years, but after she turned 18, it was difficult to intervene, especially due to her bipolar disorder.<br />
 &#8220;Although (we) made multiple attempts to have the dual diagnosis problem of bipolar and drug addiction treated over an extended time period, they were continually stymied by a medical system that bureaucratically is unable to respond to this critical need,&#8221; Steve Bruce said.<br />
 The day of her death she was scheduled to go to rehab, he said.<br />
 &#8220;No parent needs to go through this. We talked very straightforward about things,&#8221; he said. &#8220;She had a good recognition of the problem. We had many discussions about the fact that everyone needs to be  responsible for their own actions at all times, whether with drugs or driving or any thing else.&#8221;<br />
 It takes courage for parents to speak out about a child&#8217;s drug problem, Vanderhoof said.<br />
 &#8220;Most parents and teachers look for the wrong things or they&#8217;re afraid to look. They worry, &#8216;If my kids experiment with drugs, am I a bad parent?&#8217; &#8230; This isn&#8217;t a blame thing,&#8221; he said. &#8220;I&#8217;d love to see more of these parents say, &#8216;My kid overdosed.&#8217; &#8221;<br />
 Some community leaders have begun to dig deeper into the local teen drug problem.<br />
 Boucon, who presided over Bruce&#8217;s funeral service, said her heart breaks to see the local youth &#8220;hurting.&#8221;<br />
 &#8220;We certainly as a church and as Christians have to find a way to approach it. We&#8217;re in the business of saving souls, but maybe we need to be in the business of saving young lives as well,&#8221; said Boucon.<br />
 Boucon said she spoke out at Bruce&#8217;s funeral about the dangers of drug use.<br />
 &#8220;I stressed to the young people that if they have a problem with drugs, they should speak up. I said, &#8216;You don&#8217;t want to end up the same way (as Jessica Bruce),&#8217;&#8221; said Boucon. &#8220;Living on drugs is not a life. Just because you&#8217;re breathing, doesn&#8217;t mean you&#8217;re alive.&#8221;<br />
 Boucon, who moved to the Hart area from Grand Rapids 10 years ago, said she&#8217;s floored drug problems are so prevalent in small-town America.<br />
 &#8220;It&#8217;s a puzzle. It&#8217;s a really beautiful, peaceful place. I call it &#8216;Happy Valley.&#8217; But people here have the same kind of pain and struggles that anyone else does,&#8221; she said.<br />
 Law enforcement officials said they also have a hard time getting a grasp on the prescription drug problem.<br />
 &#8220;It&#8217;s not necessarily illegal for someone to possess OxyCotin,&#8221; said Lt. Tim Priese of the Oceana County Sheriff&#8217;s Department of the strong painkilling medication. &#8220;It makes the enforcement of that more difficult. You run into more dead-end roads, whereas, if someone has cocaine or meth &#8212; the case is done.&#8221;<br />
 Education for young people also is lacking, said Oceana County Prosecutor Terry Shaw.<br />
 A lack of federal and state funding has ended some drug-education programs that operated in Oceana County for years, such as D.A.R.E (Drug Abuse Resistance Education), Shaw said.<br />
 The program, which operates in many communities across the country, is an officer-led series of classroom lessons that teaches children from kindergarten through 12th grade how to resist peer pressure and live drug- and violence-free lives.<br />
 Law enforcement, prevention and treatment are key to battling the drug problem, Shaw said.<br />
 &#8220;You need prevention and treatment and sometimes there isn&#8217;t enough resources,&#8221; he said. &#8220;Until there is an equal amount of all three, we won&#8217;t be successful in combating the issue,&#8221; he said.<br />
 Oceana County recently received a boost in educational resources when it secured a portion of an $11.75 million grant earlier this year that will be distributed across 16 state substance abuse agencies to help bring the issue of alcohol and drug abuse to the community&#8217;s attention.<br />
 The Northern Michigan Substance Abuse Agency, which serves 29 other counties and administers the aid money, is conducting two initiatives with the grant money: One in Oceana County to focus on underage drinking and auto crash fatalities, and the other on illegal prescription drug use.<br />
 Shaw said he believes prescription drugs have evolved into &#8220;more of an issue&#8221; than &#8220;street drugs.&#8221;<br />
 &#8220;There is a stigma that (street drugs) are worse, but things like OxyCotin are deadly,&#8221; he said.<br />
 Vanderhoof said local teens are generally referred to his office by the juvenile court system.<br />
 &#8220;It ebbs and flows,&#8221; he said of the number of teens he sees each month. &#8220;But the court officials are getting better at identifying it.&#8221;<br />
 Vanderhoof believes it&#8217;s a lack of education among parents, teachers and teens that has contributed to more teens using recreational and prescription drugs.<br />
 &#8220;We have no education for these kids. We have no education for parents,&#8221; he said. &#8220;No one is pointing the finger. No one is trying to blame anyone, but this community has got to come together.&#8221;<br />
 New generation, new challenges<br />
 The first line of defense against prescription drug abuse is parental awareness, said Vanderhoof.<br />
 He points to a generation of teens that is taking &#8220;self-medicating&#8221; to an extreme &#8212; &#8220;if it feels good, take five. If five feels good, take 10.&#8221;<br />
 Law enforcement officials also are dealing with newer forms of drug abuse.<br />
 Pentwater Police Chief Mike Schuitema said he recently learned that a &#8220;farm party&#8221; has nothing to do with teens gathering on property to drink beer and listen to music.<br />
 &#8220;Pharm,&#8221; it turns out, is short for pharmaceuticals and refers to party-goers bringing pills they steal from relatives or friends and placing them in a bowl to be blindly passed around and ingested by those at the party.<br />
 Bowls and baggies of random pills often are called &#8220;trail mix&#8221; and, according to Internet chat sites, collecting pills from the family medicine chest is called &#8220;pharming.&#8221;<br />
 &#8220;It&#8217;s scary. How much of this is going on?&#8221; Schuitema said. &#8220;It&#8217;s so under the surface, but I&#8217;m sure it&#8217;s in every community.&#8221;<br />
 Last May, two teen girls in Pentwater overdosed on an illegally obtained prescription drug &#8212; Ativan &#8212; received from an 18-year-old student on school property, according to police reports. After ingesting the drug, one of the teens crashed her car into a tree, but, fortunately, was not injured.<br />
 And in Shelby, Police Chief Tim French said middle-schoolers, ages 12 and 13, already are sampling recreational and prescription drugs and the complaints are piling up.<br />
 &#8220;Shelby has observed additional drug-related complaints and arrests in 2007 from prior years,&#8221; said French. &#8220;In general, the Shelby Police Department&#8217;s complaint load has more than doubled &#8230; from last year,&#8221; he said.<br />
 The use of prescription drugs, like OxyCotin, Vicodin and Codeine, is increasing, French said, due to &#8220;household availability&#8221; and the fact the pills are &#8220;no cost&#8221; to teens who take them from medicine cabinets.<br />
 French maintains that the issue is getting worse due to a lack of &#8220;parental guidance.&#8221;<br />
 French advises parents to focus on &#8220;drug education&#8221; and &#8220;limit friendships that you see as having a negative influence.&#8221;<br />
 &#8220;Strengthen your bond with your children so they know they can approach you about anything. Teach them respect for you and other adults. Do not give up,&#8221; French said.</p>
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		<title>Rural hospital in Missouri struggles to survive</title>
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		<pubDate>Wed, 16 Jul 2008 18:43:30 +0000</pubDate>
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				<category><![CDATA[Health]]></category>
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		<description><![CDATA[Associated Press
 10.24.08,
					1:55 PM ET
   SWEET SPRINGS, Mo. -
 They hoped to attract five patients a day, but on average only three show up. The medical clinic sits in a doublewide trailer. And now Medicare wants back more than $1.5 million it mistakenly paid the rural Saline County hospital.
 High hopes greeted the [...]]]></description>
			<content:encoded><![CDATA[<p>Associated Press<br />
 10.24.08,<br />
					1:55 PM ET<br />
   SWEET SPRINGS, Mo. -<br />
 They hoped to attract five patients a day, but on average only three show up. The medical clinic sits in a doublewide trailer. And now Medicare wants back more than $1.5 million it mistakenly paid the rural Saline County hospital.<br />
 High hopes greeted the I-70 Medical Center when it opened less than three years ago as a community-based nonprofit with just 15 beds. Residents in<span id="more-5388"></span> the town of 1,600 and surrounding communities held bake sales and church fundraisers, collecting nearly $500,000 toward the hospital&#8217;s construction costs.<br />
 The honeymoon quickly wore away. Now, faced with mounting debts, few patients and not enough doctors willing to work more than one hour from the nearest big city, a divided board of directors has voted to sell the hospital to the same for-profit company that manages it.<br />
 The decision has strained friendships, fractured loyalties and prompted an inquiry from the state Attorney General&#8217;s Office, which is reviewing the proposed sale.<br />
 &#8220;I am apologizing to everybody that I asked for money for this thing to start out, because we said it was going to be a community hospital ran by our community,&#8221; former Sweet Springs Mayor Dan Merrick said at an August public hearing convened by the attorney general. &#8220;This management corporation could not have ever got this pulled off without us.&#8221;<br />
 That company, HMC/CAH Consolidated Inc. of Kansas City, submitted a purchase bid after larger medical networks such as Saint Luke&#8217;s Health System in Kansas City, Bothwell Regional Health Center in Sedalia and Fitzgibbon Hospital in Marshall declined the smaller hospital&#8217;s overtures.<br />
 Even with an $8 million construction loan guaranteed by the federal government as part of an incentive program for rural hospitals, the I-70 Medical Center&#8217;s finances were shaky from the start, acknowledged James Noble, who wears three hats at the 55-employee hospital: medical lab director, head of technology and marketing expert.<br />
 &#8220;We kind of financed on the back of our creditors. We call it &#8216;aging accounts,&#8217;&#8221; he said. &#8220;In private citizens&#8217; parlance, it&#8217;s called not paying your bills.&#8221;<br />
 For many locals, the notion of a hospital to call their own was too good to pass up. They fondly recall Sweet Springs&#8217; first community hospital, which was built in 1960 before shutting down three decades later after changes to the federal Medicare reimbursement formula prompted a wave of similar closings.<br />
 Sixteen years later, the ghost of that first hospital remains &#8211; literally. Blocks from Sweet Springs&#8217; small downtown district, discarded electrical transformers, rusting wheelchairs and other scraps of unused medical equipment sit idle at the empty building, where overgrown vines and broken windows greet visitors.<br />
 The pain of that loss lingers, said Bill Cook, a former Sweet Springs resident who supports the proposed hospital purchase.<br />
 &#8220;That was the most heart-wrenching thing that I have ever gone through in my life,&#8221; said Cook, a Waverly pastor. &#8220;It was like losing a family member. I just gave money to have a hospital for Sweet Springs, to get it back, regardless of who owns it.&#8221;<br />
 Opponents of the sale argue that the medical center hasn&#8217;t been given enough time to turn a profit. They note the three vacancies on the 13-member hospital board &#8211; which narrowly approved the sale in a 6-4 vote &#8211; and the personal, political, and financial ties among several members of the board, which does not have a conflict of interest policy.<br />
 They also question how a company that reported annual losses at the medical center of $1.4 million in 2006, $600,000 the next year and $400,000 through the first eight months of 2008 can be expected to turn a profit.<br />
 State regulators share some of those concerns, said Paul Wilson, Attorney General Jay Nixon&#8217;s chief litigator and deputy chief of staff.<br />
 Missouri law requires the attorney general to ensure that a nonprofit&#8217;s charitable assets are properly preserved when the organization sells to a for-profit company. In the case of the proposed purchase by HMC/CAH Consolidated, the company plans to set aside $250,000 in a foundation reserved for college scholarships. They hope to use the scholarship fund to lure students who would commit to working at least two years at I-70 Medical Center.<br />
 The other issues raised about the possible sale, though important to community members, are not part of the state&#8217;s more limited legal review, Wilson said.<br />
 &#8220;Our job is to decide whether basic legal requirements were met,&#8221; he said. &#8220;We don&#8217;t come in here and second guess and try to decide whether or not we could have negotiated a better sale or found a better buyer or done a workout plan that would have precluded having to sell.&#8221;<br />
 HMC/CAH Consolidated says it can offer the medical center plenty &#8211; including a hefty bank account to pay off more than $8 million in construction loans and the Medicare overpayments and accompanying interest.<br />
 &#8220;Without an influx of cash it is going to be difficult for this hospital to stay open,&#8221; said Robert Schneiders, an attorney representing the prospective buyer.<br />
 The proposed purchase contract includes a requirement that within the first year HMC/CAH Consolidated will build a 6,000- to 8,000-square-foot medical building to replace the current trailer as well as open clinics in nearby Concordia. Another clinic must open in Alma within 18 months.<br />
 Luring doctors to work at a facility 60 miles from both Kansas City and Columbia is hard enough without having to justify a medical clinic housed in a doublewide, said I-70 Medical Center chairman Dean Hoch.<br />
 &#8220;It looked great up by the Bates City trailer park, but not so good for an actual medical office building,&#8221; he said.<br />
 HMC/CAH Consolidated Inc., a subsidiary of Hospital Management Consulting, was created last year with the specific intent to purchase &#8220;critical access&#8221; hospitals. The designation refers to rural hospitals located at least 35 miles from the nearest competitor and allows such facilities to receive full Medicare reimbursements, plus an additional 1 percent payment.<br />
 The company owns critical access hospitals in Drumright, Okla.; Washington, N.C.; and Hillsboro, Norton and Oswego, Kan., with plans to eventually build a 40-hospital network.<br />
 Noble, who joined the company after working at the Bothwell system and commutes from Sedalia, considers Sweet Springs his second home. From his perspective, the acknowledged financial missteps of the past are less important than preserving a community hospital residents of Sweet Springs, Concordia, Alma, Houstonia and other small towns can still call their own &#8211; regardless of owner.<br />
 &#8220;If you had a chance to get a hospital in your community and you knew it was your last chance to do it, that there was not ever going to come an opportunity again &#8230; after all the work and effort and fundraising, would you let that stop you?&#8221; he said. &#8220;I don&#8217;t think so. It didn&#8217;t stop any of us.&#8221;<br />
 Copyright 2008 Associated Press.  All rights reserved.  This material may not be published broadcast, rewritten, or redistributed</p>
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		<title>Gaza&#039;s main hospital struggles to stay functioning</title>
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		<pubDate>Tue, 20 Nov 2007 22:59:16 +0000</pubDate>
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		<description><![CDATA[GAZA, Jan. 3 (Xinhua) &#8212; The sudden and violent beginning of Israel&#8217;s areal onslaught into Gaza Strip was bigger that the emergency plans drawn up earlier by the Palestinian health care system, Gaza doctors say.
 The crisis emerged widely in al-Shifa hospital, the only main sanatorium for Gaza&#8217;s 1.5 million population. The hospital&#8217;s floors were [...]]]></description>
			<content:encoded><![CDATA[<p>GAZA, Jan. 3 (Xinhua) &#8212; The sudden and violent beginning of Israel&#8217;s areal onslaught into Gaza Strip was bigger that the emergency plans drawn up earlier by the Palestinian health care system, Gaza doctors say.<br />
 The crisis emerged widely in al-Shifa hospital, the only main sanatorium for Gaza&#8217;s 1.5 million population. The hospital&#8217;s floors were colored in red, and also the grass in its yard, as doctors and volunteers offered first aid to hundreds<span id="more-13470"></span> of wounded people on the floor.<br />
 &#8220;We have got more than 500 case in the hospital in the first minutes of the attacks and, in later hours, the number dramatically rose, exceeding the 585-bed capacity of the hospital,&#8221; said Raed al-Arini, a spokesman for the al-Shifa hospital.<br />
 At one of the operation rooms, three wounded persons laid to undergo surgeries at the same time, though the facility is prepared to deal with one case. &#8220;There is only six operation rooms in the hospital,&#8221; says Dr. Basel Baker, director of the surgery at the hospital.<br />
 &#8220;Tens of serious cases were thrown in the yards of the hospital on the first couple of days and we were unable to know who needed a surgery, &#8220;I have not seen such thing in Gaza in my career,&#8221; the 54-year-old surgeon recalled.<br />
 The Israeli intensive attacks in Gaza killed up to 430 Palestinians since their start on Dec. 27, more than half of them died on the first day of the offensive as the warplanes launched simultaneous strikes at tens of police and security stations across the coastal enclave.<br />
 According to the Palestinian Center for Human Rights (PCHR), 165 Hamas policeman were among the dead, the majority of them passed away when their posts were bombed.<br />
 The strikes continued, adding houses and mosques to their range of fire.<br />
 Outside the operation room, three children of Hedaya al-Arini, were crying as they waited to hear news about their mother, seriously hurt when an F16 fighter jet struck at a house of a Hamas activist in Gaza city on Thursday. &#8220;The rocket (shrapnel) cut my mother&#8217;s legs and demolished our house,&#8221; screamed Huda, the12-year-old daughter as tears flowed over dark red spots the shrapnel and debris made on her face.<br />
 &#8220;We are poor and our house is modest, its ceiling is made of very fragile sheets of asbestos that fell on us when we were asleep,&#8221; she added as she tried to relief her younger brothers.<br />
 The nonstop arrival of wounded and dead bodies, by ambulances and civilian vehicles, caused shocked among the doctors who have been locked in the hospital for more than a week. A nurse at the reception did not control herself and went crying crazily after she saw pile of flesh brought in on a stretcher.<br />
 Fawzi al-Nabulsia, director of the Intensive Care Unit (ICU), said most of the cases they received were clinically dead. &#8220;Most of them are injured in the head and heart,&#8221; he affirms.<br />
 He also warns that the hospital suffers from shortage in most of the medical supplies that are needed in the day-to-day work. The same warning was released by the health ministry, which says that 105 sorts of the medicines have ran out, in addition to 220 apparatuses stopped due to lack of spare parts.<br />
 As the electricity is cut most of the time, the doctors say the fuel is running out, adding more troubles to the work of the medical teams who, from the outset, do their job in extra ordinary circumstances.</p>
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