Select Page

News

Chinese investor Chen buys more stock in CHS

Mr. Tianqiao Chen, whom we profiled this summer, has purchased more stock in Community Health Systems (CHS)--about $400,000 worth (https://www.sec.gov/…/0001318400170…/xslF345/primary_doc.xml), bringing his total ownership stake to 25,507,846 shares or about 23% of...

read more

Holiday warnings from NICHE

Amino (https://amino.com/) is a healthcare database company in San Francisco that provides free access to healthcare data. They modestly submit that visitors to their site can “Get access to information you can’t find anywhere else—from cost estimates at facilities to...

read more

Has Lutheran Health Network (LHN) Listened to NICHE?

The answer appears to be yes, if one believes this snippet in a recent News-Sentinel story (http://www.news-sentinel.com/…/lutheran-health-ceo-investm…/): “Lutheran Health Network will have invested $100 million in 100 construction projects and 300 capital and...

read more

How Do the Aetna/CVS Merger and MinuteClinics Affect You?

CVS has been very much in the news, given its purchase of Aetna Health--pending Federal antitrust review--for $69 billion. The review will be done either by the Justice Department or the FTC, both of which have jurisdiction--the FTC being the more lenient according to...

read more

Questions we’ve been asked

Editor's’ note: The remarks that follow are opinions based on the best information we can find from public sources and from private interviews, with and without attribution. We believe them to be factual. Will IU Health hire physicians from Parkview and Lutheran...

read more

Medicaid and emergency room visits

Bob Herman reports at Axios.com, using 2014 data, that Medicaid now pays for more ER visits than any other source. The trend is shown in the graph below and represents, in great part, the expansion of Medicaid under the Affordable Healthcare Act (ACA). In October...

read more

Modern Healthcare Spotlights Falling Hospital Margins

Hospital profit margins from treating Medicare patients have fallen from a positive 2.2% in 2002 to a negative 7.1% in 2015, and they are expected to fall to a negative 10% this year. Medicare has never fully covered the cost of care but the gulf has widened, hospital...

read more

The CDC’s guide to the new shingles vaccine

The Centers for Disease Control and Prevention (CDC) now provides a guide to Shingrix™ (https://www.cdc.gov/vaccines/vpd/shingles/public/index.html), a newly-licensed vaccine for shingles and related complications, recommended for healthy adults aged 50 years and...

read more

North River Property Abandoned by LHN

Earlier this week, News Channel 15 reported on Lutheran Health Network’s decision to cut the North River property from the list of potential sites for a St. Joseph's Hospital replacement (http://wane.com/…/lutheran-health-network-rules-out-north-…/). “We are focused...

read more

Is capitalism to blame for our healthcare woes?

Is capitalism to blame for our healthcare woes? In October, we posted about a New York Times article entitled "Shouldn’t Doctors Control Hospital Care?" (https://www.facebook.com/IndianaCitizens4HealthcareExcellence/posts/1957844474488391). Last week, Spencer Norton...

read more

The Next Hospital Reform?

Dr. Neel Shah, Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, recently wrote an article for Politico about the unfortunate assumption that hospital patients need beds--and not room to walk...

read more

Hospital-employed physicians drain Medicare

So read the headline in Modern Healthcare on 14 November 2017. The article was based on several studies: a Northwestern University, Kellogg School of Business article entitled “Price Effects of Cross Market Hospital Mergers”...

read more

The Checkup: Physician Depression

Yesterday we posted about the costs that come with burnout of healthcare professionals, including nurses. Today, we’ll focus on the same issues affecting physicians. This article in the New York Times is a good...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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....

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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....

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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,...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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,...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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’...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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,...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

“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...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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,...

read more

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...

read more

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...

read more

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...

read more

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...

read more

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...

read more