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Nurse Depression?

Why does NICHE focus so often on nurse/patient staff ratios? A recent study from the Ohio State University (OSU) states that depression is common among nurses and is linked to increased medical errors (https://news.osu.edu/…/nurses-depression-tied-to-increased…/). In...

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Would a CVS-Aetna merger lower health care costs?

In Fort Wayne, CVS is well known for its MinuteClinics, filling prescriptions, not selling tobacco, and being next door to Walgreen’s. But according to The Economist (https://www.economist.com/…/21730906-vertical-integration-c…), the pharmacy world is suddenly in a...

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Vera Bradley, Indiana University, and Cancer Survival

Using one’s own immune system to treat cancer is a promising area of research that has produced several effective therapies. The attached graph from the Journal of the National Cancer Institute shows progress in survival times. NICHE recently visited the Vera Bradley...

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Letter from Jerry Henry, Jr.

On Sunday, the Journal Gazette printed the letter below from Jerry Henry, Jr., Chairman of the St. Joseph Hospital Board of Trustees. Some background: - The share price of Community Health Services (CHS,) owner of Lutheran Health Network and St. Joseph’s, has been...

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IU Health: Competition Will Help

News-Sentinel Editor Kevin Leininger interviewed Dr. Geoffrey Randolph recently about IU Health’s growth in the Fort Wayne market (http://www.news-sentinel.com/ne…/local-news/2017/…/04/90049/). Said Randolph, “Competition is good for consumers and could improve...

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Surge pricing and concierge medicine

Everybody knows what happens when items are scarce: prices go up. If you need any evidence, try to get tickets to Hamilton or, after the show is over, hail an Uber driver. Now, surge pricing has hit medicine in the form of concierge medicine, also called “retainer...

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From Our Mailbag: Questions & Comments – Part 8

Q: As a Lutheran employee, I’m being asked DAILY what a bedside nurse or employee can do to help Lutheran or make an impact? Is this something you can address? A: NICHE believes that you can only help patients and fellow caregivers, the best you can for as long as you...

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From Our Mailbag: Questions & Comments – Part 7

Q: I understand your mission, and why you frame posts the way you tend to. But do you think there is room to increase the public's confidence in their care with LHN while still getting the message out there? A: First, thank you for understanding. It is awkward for...

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Shareholders push for changes at Community Health Systems

Bloomberg and Becker’s Hospital CFO Report note trouble at Lutheran Health Network-owner Community Health System (CHS). They cite quarterly financial losses that are likely to be seen as failing according to third quarter results. One telling quote...

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Forward-looking statements and fuzzy math

Following the Community Health Systems (CHS) third-quarter earnings call on Thursday, WANE-TV reported on what might be in store for Fort Wayne if CHS decides to sell more hospitals: ”CHS said it’s still pursuing other ‘interests for sale transactions involving...

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Defining “need” in the CON game

A Certificate of Need (CON) is a state-issued document that, in effect, gives permission for a healthcare facility to expand or build after public hearings have been held and studies of existing capacities have been done. In the 1970s, when CONs were introduced, the...

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From Our Mailbag: Questions & Comments – Part 6

Q: What do people mean when they talk about “syndication”? A: Syndication refers to partial physician ownership of a hospital system. In Fort Wayne, for example, approximately 20 - 28% of LHN and Dupont Hospital are physician owned. It is a structure of governance and...

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Leapfrogging to Better Care

Today, WANE-TV reported on the 2017 Leapfrog report comparing hospitals (http://wane.com/…/nonprofit-watchdog-group-releases-2017-h…/). As WANE reports, “Parkview Regional Medical Center received an A grade, while the three facilities run by Lutheran Health Network...

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From Our Mailbag: Questions & Comments – Part 5

Q: If it is true that LHN CEO Michael Poore gave LHN CFO Ed Romero a directive to modify 4th quarter projections because the originals were “too low,” is this legal? A: NICHE is not a law firm but does not believe it would be illegal merely to present a rosy outlook....

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Halloween for CHS: Toil and Trouble

In an article entitled “These Hospital Bonds Are On Life Support” (https://www.bloomberg.com/…/a-49-billion-hospital-emergency…), Bloomberg’s Lisa Abramowicz and Max Nisen report that Community Health Systems (CHS) debt is 20 times the value of its equities. Investors...

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IU Health’s announcement: some perspective

IU Health released a statement yesterday, laying out plans for a new primary care clinic in addition to a previously-announced pediatric facility. IU Health has “no immediate plans” to build a new hospital, according to the Journal Gazette...

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New IU Health Facilities: Growth and Competition

From yesterday’s News-Sentinel (http://www.news-sentinel.com/…/iu-health-planning-3-fort-w…/): “‘IU is committed (to Fort Wayne) for the long-term,’ said the source, who said construction of a full-service hospital, probably downtown, is possible later.” A...

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A Tale of Two Hospitals

With apologies to Charles Dickens, “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity...” Parkview Health (PH) recently announced 850 open jobs and...

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From Our Mailbag: Questions & Comments – Part 5

Q: What do people mean when they talk about “syndication”? A: Syndication refers to partial physician ownership of a hospital system. In Fort Wayne, for example, approximately 20 - 28% of LHN and Dupont Hospital are physician owned. It is a structure of governance and...

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From Our Mailbag: Questions & Comments – Part 4

Today’s post is part of an ongoing series wherein we answer questions and address comments made by our followers. If you have a question you’d like to address, post it or message us on Facebook, or send it anonymously via our website. Q: I was just informed that Dr....

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Vaccines: a net good

Today we bring you a topic that combines NICHE’s desire to improve the health of northeast Indiana residents with our penchant for diving into controversies. During the past decade, there has been much debate about the benefit of vaccinations. What was once...

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If CHS sold LHN: What then?

What would happen if Lutheran Health Network (LHN) were sold by Community Health Systems (CHS)? Could the past be recaptured? What would a new owner do to build confidence, regain trust and reverse a loss of market share--and guarantee a focus on clinical quality? We...

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Numbers don’t lie–or do they?

In 2012, Community Health Systems (CHS) fired CFO Gregg Becker from his position as CFO of Rockwood Clinic in Spokane, Washington. Becker claimed he was fired because he would not understate losses. The Spokane Journal of Business reports...

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Sajin’s Satire–and its place in the conversation about LHN

NICHE has a number of followers who comment, but none more inventive than Sajin Young. We doubt Sajin is a real person, but may be a persona based on a character like Sajin Komamura from the anime series Bleach. Whoever Sajin is--it’s unclear whether he, she, or they...

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CEO Michael Poore’s Letter to LHN–Consultants and Commitments

The letter below from Lutheran Health Network CEO Michael Poore brings us the good news that he will be “as transparent as [he] can be about the details” of CHS’s investment. However, even a cursory read of the letter shows it to be neither detailed or transparent. We...

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Music and Medicine

In something of a departure from NICHEs usual topics, today we’re building off this opinion piece from Sweetwater CEO and former Lutheran Hospital Board Member Chuck Surack: http://www.journalgazette.net/…/learning-to-play-and-playin… Many may recall that in 1975,...

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Tennessee Sells Community Health Systems Stock

From the Ledger-Gazette: “State of Tennessee Treasury Department decreased its stake in shares of Community Health Systems (CHS), Inc. (NYSE: CYH) by 50.6% during the 2nd quarter, according to its most recent 13F filing with the Securities & Exchange Commission. The...

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Attacking Healthcare Costs: The Attack on Hospitals

The trend is clear: ambulatory care is in, and inpatient care is out. Medicare has long had a two-tier rate system for payment. Even when the same room and supplies are used, for example, a surgical facility fee might be $1,800 if the procedure takes place in a...

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Healthcare Industry Problems: You Decide

Today, we have an exercise for you. Below are two scenarios that play a role in healthcare delivery in Fort Wayne. Your questions--should you choose to take on the challenge of answering them--are included after the scenarios. Situation #1 Modern Healthcare recently...

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CHS Statement of Beliefs

Yesterday, we posted a letter from Lutheran Health Network CEO Michael Poore, which included promises about LHN providing "a better, more convenient experience for our patients, better outcomes and ultimately lower costs for our patients and local employers." NICHE is...

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Letter from CEO, Mr. Mike Poore to LHN staff

NICHE has yet to hear from Lutheran Health Network CEO Michael Poore directly, but his letter to LHN employees, included below, provides an overview of his first 90 days. Keep them in mind as you reflect on outcomes. Think about hiring and firing and how quickly...

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The fuzzy math around Community Health Systems’ hospital sales

A fairly strong condemnation of Lutheran Health Systems-owner Community Health Systems (CHS) yesterday from Axios, citing CHS's "history of deceptive communication practices." "Eight of the 30 hospitals in CHS' fire sale are in two states, Pennsylvania and Washington,...

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New CEO at Lutheran Hospital

A new Lutheran Hospital CEO, Paula Autry, will report to Mike Poore, Lutheran Health Network CEO. As the Journal Gazette reports, Ms. Autry comes to Fort Wayne most recently from Detroit where she was CEO of the Detroit Medical Center Sinai-Grace...

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Two News Briefs

Indiana Ranks Poorly for Health Indicators According to The Alliance for a Healthier Indiana, a not-for-profit group made up of advocates from across Indiana who are committed to improving the health of our state, Indiana ranks between 35th and 49th highest in drug...

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Why Can’t Lutheran Hospital Recruit Local Physicians?

NICHE has been told that, for the second consecutive year, Lutheran Health Network has chosen to hire no residents from the Family Medicine Residency at the Fort Wayne Medical Education Program. Why? We don’t know for sure--but there are likely reasons, some of which...

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From Our Mailbag: Questions & Comments – Part 3

More answers to the questions that have been asked by our readers. See the past two days’ posts for more discussion. Is the St. Joseph Hospital Burn Center verified or not verified? NICHE has spoken with the Chicago headquarters of the American Burn Association...

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Hospital Information Technology: Expensive & Difficult

Too often, it seems, we’re told that “no good deed will go unpunished!” For hospital electronic health records (EHRs) and Information Technology (IT) this appears to be the rule. In a recent incarnation, Lutheran Health Network (LHN) has---without fault we...

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Building trust

Lutheran Health Network’s hired crisis consultant from Nashville, TN, came to Fort Wayne the same day that The Journal-Gazette ran this editorial: Building Trust. We have no doubt that financially-beleaguered Community Health Services (CHS) is in need of advice from a...

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From Our Mailbag: Questions & Comments – Part 2

Yesterday, NICHE responded to some of the comments and questions shared with via our Facebook page and website. Here’s the second of three posts with more answers. Why don’t LHN nurses unionize? Dr. John Crawford, a City Councilman, has appeared at the Workers’...

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From Our Mailbag: Questions & Comments – Part 1

NICHE welcomes questions to our Facebook page and our website (where they can be submitted anonymously). Because NICHE is volunteer run, we can’t immediately respond to all the comments we receive—but we did want to take the opportunity to address some of the...

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Vagueness tempering enthusiasm for hospital

From today's Journal Gazette: "The most important question is whether Franklin, Tennessee-based CHS, which is reportedly carrying a $15 billion debt, can truly finance the investment in Lutheran Network that it's promised." See full article...

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Debt Sickened a Hospital Giant. Now the Doctors Are Revolting

From Bloomberg this week: https://www.bloomberg.com/…/debt-sickened-a-hospital-giant-… "The standoff over Lutheran provides a window into how CHS, once the largest for-profit hospital chain in the U.S., has allowed facilities to languish, possibly compromising care...

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Sources: New St. Joe Hospital could be preemptive strike

This WANE story recaps LHN's ham-handed announcement of its plans for a new hospital, the potential that CHS goes bankrupt within a year, and the rumor of a competitor coming into the market. It is likely not a good morning at LHN. See full article...

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Crisis Management at LHN

NICHE has learned that CHS is providing crisis management for Lutheran Health Network (LHN.) A top-flight Nashville firm will send a consultant to Fort Wayne to deal with what has been termed a crisis. What it Means: To be pedantic, "crisis" comes from the Greek,...

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CHS: Tone Deaf?

A brief breaking news item: NICHE has learned that Community Health Systems (CHS) intends to make an offer on downtown property for the stated purpose of building a hospital--”an investment in Fort Wayne.”. This would be property for which the City of Fort Wayne does...

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Dr. Steven Orlow Resigns from Lutheran Board

Dr. Steven Orlow, long-time cardiologist at Lutheran Hospital and recently Chief Medical Information Officer for Lutheran Health Network, has resigned from the LHN board. The very odd backstory leading to this unfortunate loss to the entire network is so long as to...

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Will Fort Wayne Be the Next Pottstown?

What Happened? Community Health Systems (CHS) owns and operates Pottstown Memorial Medical Center (PMMC), Pottstown, PA, as it readies it for sale to Reading Hospital System. CHS has outdone itself in that PMMC has unachieved a poor One-Star rating from CMS Medicare...

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Lutheran Hospital and Bayfront Hospital: Deja Vu?

The situation: A major, for-profit hospital chain offers cash to a local charitable foundation to buy a hospital property. The hospital chain wants full control, perhaps to sell the property at a better price. The Foundation sees the cash as an opportunity to expand...

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Mr. Smith Comes to Fort Wayne

Just before Labor Day, Community Health Services (CHS) CEO Wayne Smith crept into Fort Wayne, coming in on a corporate jet, going right to a meeting, and then back to the corporate jet for a flight out of town. He could have taken time to meet with Lutheran Health...

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Treat Lutheran more as partner, less as child

We can recall a time, not long ago, when Lutheran Health was respected and respectable because it was run by local professionals. The St. Joe Burn Center was properly verified, Dupont Hospital's four-star status was never in question, and physicians like Dr. Kachmann...

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Secret Hospital Inspections May Become Public At Last

Yesterday we discussed the upheaval that Joint Commission visits can cause—and why hospitals must tolerate them. As serious as these visits are, however, their findings aren’t always available to the public. As this article from ProPublica suggests, however, this may...

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“OMG! They’re Here!”

That was a Modern Healthcare headline eleven years ago, and little has changed when The Joint Commission (TJC) shows up at your hospital for a surprise inspection. That remains true because TJC inspections are relied upon by Medicare, Medicaid, and Insurers, among...

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Community Health Systems: Downgraded, Again

Once again, financial and operating weakness at CHS raises serious questions for healthcare in northeast Indiana. NICHE wants CHS to succeed in our region. To do so, CHS must invest for quality and growth – especially quality. As things are, Lutheran Health Network...

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Casualties of CHS

A few weeks ago, a commenter asked NICHE to list “the physicians that have been ‘rid’ from Lutheran” under the leadership of Community Health Systems. Developing such a list is challenging given that names continue to be added and some individuals have left quietly on...

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Dupont Hospital to Lose Its Four-Star Rating

NICHE has learned that Dupont Hospital will soon be only average, not a four-star hospital. Dupont will be reduced it to three stars on the Federal Medicare-Compare ratings service that collects data, inspects hospitals, and aggregates the data to rate and compare...

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No Plastic Surgery Coverage at Lutheran Hospital Emergency Room

NICHE has been informed by previous Lutheran Hospital (LH) employees that the contract designed to provide coverage for Emergency Room (ER) patients needing plastic surgery has expired. A new contract was anticipated by the Plastic Surgeons (PS) at about the time that...

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Ex-colleagues praise Lutheran network chief

Yesterday’s Journal Gazette included this profile of new Lutheran Health Network (LHN) CEO Mike Poore: http://www.journalgazette.net/…/ex-colleagues-praise-luther… The piece featured a number of quotes from friends and former colleagues who know Poore well,...

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Saint Joseph’s Burn Unit: Should Mike Poore Be Smiling?

This week’s announcements of Mike Poore as the new CEO of Lutheran Health Network were accompanied by a photo of his smiling broadly. Recent news at St. Joe, however, may give him little to smile about. The American Burn Association (ABA) has confirmed with NICHE that...

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Lutheran network chief has ‘traction’

From today's Journal Gazette. As the interview states, Poore's challenges will include coming up with specific ways to make good on promises made by his boss, CHS CEO Wayne Smith, during an early-August call with investors: “We continue to focus on quality...

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Mike Poore named LHN president

From Today’s Journal Gazette. Tim Hingtgen, CHS president and chief operating officer, says, "Under Mike Poore's leadership, LHN is accelerating its progress on key operational and strategic initiatives." NICHE will be interested to see how these initiatives will...

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Why Are Shares of CYH Up Today?

NICHE has no inside information. This appeared on the Internet: Activist investors seeks ouster of CEO at Community Health Systems, shares ahead 11% Aug. 21, 2017 12:34 PM ET|About: Community Health Syste... (CYH)|By: Douglas W. House, SA News Editor Institutional...

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Investor Group Accuses Community Health Systems—Why?

Headline: ASL Strategic Value Fund Sends Letter to Community Health Systems(CHS) Board of Directors accusing noncompliance with Federal Court approved settlement requirements. They suggest that it is time to change management. Some background: After settling claims of...

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Congratulations, Lutheran and Parkview

NICHE was created to educate and report on healthcare, and we’re as interested in pointing out what’s being done right as we are in shedding light on difficult topics. Today, it’s our pleasure to commend both Lutheran and Parkview for their significant investments in...

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Breaking CHS and LHN News

We are pleased to report happy news and congratulate a few LHN executives for receiving promotions. We understand that decisions were made to fill vacant and currently temporary posts at Lutheran Health Network and were reported over a joyful dinner party with...

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Will Wayne Smith Agree?

Meet Tianqiao Chen, the owner of 21% of Community Health Systems (and, therefore, Lutheran Health Network). This profile in yesterday's Straits Times highlights his interest in health and neuroscience demonstrated by his and wife’s $115 million gift to California...

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The borrower is servant to the lender

Let’s imagine your annual earnings are $200,000. Sounds pretty good, right? We’ll not so fast. Let’s also assume that your debts—mortgage, car loans, student loans, etc.—equal $1.6 million. Interest on those loans costs you $120,000 per year. You have some assets...

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Acknowledging the dedication of LHN’s professionals

In case you missed it this weekend: this letter to the Journal Gazette editor from http://www.journalgazette.net/…/20170…/letters-to-the-editor Dick and Adie Baach acknowledges the dedication of LHN's professionals while calling for more support for them from...

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Shanda increases stake in CHS

Yesterday, NICHE reported considerable activity on the CHS stock (ticker symbol CYH). We now know who the buyer is: Shanda, which went from owning 13.64 percent of the company with more than 15 million shares to 22.1% and more than 25 million shares. Clearly, Shanda's...

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The collapse of Community Health Systems

If the headline isn't clear enough about CHS's prospects, how about this quote?: "CHS sits in a massive hole after a string of missteps, according to industry insiders. And it's not likely to get better for CHS, or the local communities that rely on a CHS facility..."...

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Who Owns CHS Now?

Community Health Services (CHS) is a publicly traded stock. Friday was a wild day for CYH (the stock exchange symbol for CHS) when 29.13 million shares were traded—nearly ten times the usual number and 26 percent of the shares overall. One trade of nearly a million...

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Dupont: A closer look at the numbers

On Friday, NICHE posted about planned job cuts at Dupont Hospital. In response, Dupont Interim CEO Lisa Dolan sent an internal memo that claimed “This information is absolutely untrue. The claims made and opinions expressed in the post were made by people who do not...

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Come to Fort Wayne, Wayne

Wayne Smith is the CEO of Community Health Systems (CHS)—the company that owns Lutheran Health Network (LHN). Those who keep track of such things say that he has visited Fort Wayne and Lutheran Hospital but once in ten years despite LHN being one of CHS’s leading...

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CHS to cut 75 jobs at Dupont Hospital

NICHE has it on good authority that job cuts are imminent at Dupont Hospital. Specifically, we are hearing that 40 positions are on the chopping block and 75 long term--a significant number given that total employment at Dupont is approximately just over 600. (Math...

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Quiet as a…

Mr. Poore: Too many people know. People who care about Lutheran Hospital, people who work short staffed, people who clean and care for the equipment, the people who drove the truck. People who talk to each other and who have talked to us. Perhaps media training is...

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Two months–and several questions

This week, NICHE celebrates two months of existence. It's been a whirlwind summer, with a tremendous amount of volunteer time and effort driving the process. But the most important element is you, the people who read our posts and visit our Facebook page. YOU are...

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Good on ya, Marty Bonick

Good on ya, Marty Bonick We, at NICHE, don’t know why Marty Bonick has resigned his position as Community Health Systems (CHS) President of Operations for the division that includes Lutheran Health Network (LHN). That may become clear over time, but we’d like to think...

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Marty Bonick resigning

More than rumor but less than certain is that Marty Bonick is leaving Community Health Systems (CHS), where he is Division President for the region that includes Lutheran Health Networks (LHN). Bonick came to CHS after serving as President of long-troubled Jewish...

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