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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 NICHE to put on display the harm that we feel CHS is doing to a great hospital system, LHN, without seeming to indict caregivers who work there. It is particularly galling to cast aspersion on those who, through compassion and professionalism, strive to care for patients in a culture that may value profits above top quality. NICHE knows that nurses and others succeed in providing good care in spite of less-than-expected support–burdens that may include low staffing levels, mandatory overtime or working with temporary staff who require on-the-job training to become team members. NICHE believes patients should feel absolutely confident in LHN physicians, nurses and caregiving staff, but they should recognize also the extra effort required of them.

Q: CHS has committed $22M to renovate and expand Bayfront Health in St. Petersburg and apparently is looking to build a replacement for Venice Regional. What other such commitments have been made by CHS? Is CHS solvent to make good on them?

A: NICHE views this Florida situation as so confusing as to be unpredictable. (More background is available here:…/under-new-ownership-bayfr…/2134565). CHS is short of cash and has stalled plans to build in Knoxville, Tenn. They have announced that they will build a $100 mm hospital in Fort Wayne. Admission numbers and earnings are declining across the U.S. Unless sales of hospitals yield enough to pay down debt to lower than present levels, interest costs will swallow over half of CHS’s earnings, leaving the capital budget covering depreciation and repair to compete with new construction. Our bet is that Bayfront will see upgrades to facilitate admissions but little else–and in Knoxville, that nothing happens any time soon.