Healthcare

[youthathletics]

This is personal for me. My wife has been undergoing tests to make sure the dialation in her small bile duct was not liver cancer. She got a clean bill of heath this morning from all of those tests. I've been so scared for the last few months. When someone you love may be seriously ill, your perspective on life changes in a heartbeat. I just finished crying my eyes out knowing that cancer is not the issue my wife is going to be okay...

Thanks for sharing your story cradle. Give her a big hug from your brothers here on FanLax.

[cradleandshoot]

This is personal for me. My wife has been undergoing tests to make sure the dialation in her small bile duct was not liver cancer. She got a clean bill of heath this morning from all of those tests. I've been so scared for the last few months. When someone you love may be seriously ill, your perspective on life changes in a heartbeat. I just finished crying my eyes out knowing that cancer is not the issue my wife is going to be okay...

Thanks for sharing your story cradle. Give her a big hug from your brothers here on FanLax.

She is a trooper. Two new hips, one new knee and soon to have a nerve in her neck ablated to stop the pain in her arm and shoulder. 40 plus of nursing takes its toll. One more year and she is done. I'm not lying, this cancer scare was the worst. Huge relief for both of us.

[jhu72]

This is personal for me. My wife has been undergoing tests to make sure the dialation in her small bile duct was not liver cancer. She got a clean bill of heath this morning from all of those tests. I've been so scared for the last few months. When someone you love may be seriously ill, your perspective on life changes in a heartbeat. I just finished crying my eyes out knowing that cancer is not the issue my wife is going to be okay...

Thanks for sharing your story cradle. Give her a big hug from your brothers here on FanLax.

She is a trooper. Two new hips, one new knee and soon to have a nerve in her neck ablated to stop the pain in her arm and shoulder. 40 plus of nursing takes its toll. One more year and she is done. I'm not lying, this cancer scare was the worst. Huge relief for both of us.

... great news!

[Farfromgeneva]

Over 1 million years of life lost to drug overdoses
Tina Reed
Tina Reed, author of Vitals

Data: Hall et. al, JAMA 2020; Chart: Will Chase/Axios
Adolescents and young adults lost an estimated 1.2 million years of life due to unintentional drug overdoses over five years, according to a study published in JAMA.

What they found: About 3,300 adolescents ages 10–19 years old died of an unintentional drug overdose in the U.S. between 2015 and 2019, representing about 187,078 years of life lost, researchers from Ohio State University said.

That number rises to nearly 22,o0o young people when expanding the age group to overdose deaths among those among 10–24 years old. Males collectively lost more years of life, the researchers said.
Why it matters: While previous reports have focused on adults, this specifically looks at the impact of unintentional deaths among young Americans. It's particularly alarming when considering the record numbers of overdose deaths reported since the conclusion of the study.

Years of life lost, as the authors point out, offers "important context to the overdose crisis by better representing what is meant to society by the loss of adolescents and young people."

[jhu72]

Good news on leukemia.

[Farfromgeneva]

Sorry for folks to sink their teeth into. (I did some debt related work around this company a while back personally thought they had more MOB and 24hr clinic type assets than hospitals at the time)

How a Small Alabama Company Fueled Private Equity’s Push Into Hospitals
Buying binge made Medical Properties Trust one of the biggest owners of U.S. hospitals; but its largest tenant piled up $800 million in losses

By Brian Spegele
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Feb. 14, 2022 9:56 am ET

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Private-equity firms have been buying hospitals in increasing numbers over the past decade. Several relied on an Alabama real-estate company to help pay for their purchases.

Medical Properties Trust Inc. MPW -2.58% was willing to buy the bricks and mortar, and lease the facilities back to the hospital operators. That provided financing for the deals and helped some of the private-equity firms take money out of their investments.

As a result, the Birmingham-based company became one of the nation’s biggest owners of hospital property. The real-estate investment trust, or REIT, offered investors an appealing story: It had long-term leases with tenants that provide essential services, and it paid a lucrative dividend.

Yet as the company grew fast and bought more properties, it faced large losses at its biggest tenant, financial filings show.

Steward Health Care System LLC accounted for 30% of the company’s revenue in 2020, according to a filing by MPT with the Securities and Exchange Commission. Steward lost more than $800 million between 2017 and 2020, its financial statements show, with Covid-19 adding to its financial challenges.

Since the pandemic began, MPT has struck a series of deals involving Steward and its chief executive that together resulted in hundreds of millions of dollars flowing from MPT to Steward.

Former MPT employees familiar with the company’s transactions said they saw deals with Steward as a way for MPT to provide it with cash as it notched losses, which in turn helped Steward make its rent payments and kept MPT growing.

In response to questions for this article, MPT said that during the pandemic it collected almost 98% of rents and interest payments and that its financial results demonstrate the success of its strategy.

Regarding Steward, the company said: “Since 2016, Steward has paid MPT roughly $1.2 billion in rent and mortgage interest—and has never been even one day late.” It said Steward accounts for a smaller portion of its total portfolio today than in previous years as MPT has invested in facilities run by other hospital operators.



CEO Edward Aldag co-founded MPT, one of the nation’s largest owners of hospital property.
PHOTO: STAN DIEL/THE BIRMINGHAM NEWS/AL.COM
MPT said a deal announced in September, under which it will sell part of its stake in several Steward hospital properties in Massachusetts for a profit, further validated its approach. Both that deal and another pending transaction would reduce MPT’s exposure to Steward.

Steward, which until 2020 was controlled by private-equity firm Cerberus Capital Management LP, said in a written response that it “continues to do well financially with more than adequate liquidity.” It said it had been burdened by one-time expenditures resulting from rapid growth, and that it had continued to invest in serving patients through the pandemic.

“There is NO ‘free money’ (or bailout) from MPT,” it said.

All told, MPT has investments in the real estate of more than 400 hospitals and other healthcare properties. In many cases, its deals provided the financing that helped private-equity firms get deeper into the hospital business.

Hospitals are highly regulated and dependent on a complex system of government and private insurance. That makes it harder for private-equity firms to quickly boost profit margins. Their investments included small-town and rural hospitals, which often struggle financially because their patients tend to be older and poorer.

By financing acquisitions through property sales, private-equity firms transfer some of the risk to the hospitals and MPT. The resulting leases can extend for many years after the private-equity firms sell off their stakes, as Cerberus has done with its Steward investment.

Rhode Island’s attorney general, a Democrat, has restricted two hospitals in that state from doing deals with MPT, citing concerns over the hospitals’ financial health. That decision followed a state probe of hospital operator Prospect Medical Holdings Inc., long backed by private-equity investor Leonard Green & Partners LP. Prospect had used proceeds from real-estate sales to MPT to pay down debt it had incurred partly to fund hundreds of millions of dollars in dividends to its investors, including Leonard Green.


That issue drew attention from some members of Congress. “It is not appropriate for private equity firms to generate returns for their investors by extracting hundreds of millions of dollars from safety net hospitals,” Rep. Katie Porter (D, Calif.) and four other lawmakers wrote in a letter to Leonard Green in July 2020.

Leonard Green responded that the dividends were paid before the Covid-19 pandemic began and that the investors who benefited included public and corporate pension funds.

Defenders of private equity say the investments benefit hospitals by providing money that can keep struggling facilities afloat and provide time and resources to turn operations around.

MPT was co-founded in 2003 by Edward K. Aldag Jr. , who now serves as chief executive officer. For years, big corporations sold their real estate to third parties and leased it back to free up capital for other purposes, deals known as sale leasebacks. MPT offered such deals to hospitals, which typically owned their buildings.

The company’s mission dovetailed with the desire of private-equity firms to finance hospital acquisitions and extract cash from their purchases to help pay dividends to investors. MPT struck deals with hospital operators owned by Cerberus, Leonard Green, Apollo Global Management Inc. and others.

Its rapid growth, coupled with the requirement that REITs pay out most of their income as dividends, made it a popular stock with investors searching for better returns in a low-interest-rate world. That, in turn, helped it to raise capital, which allowed it to make attractive offers to hospitals for their properties. The company’s debt has tripled since 2017 to $11 billion, and it raised more than $5 billion from stock sales in recent years.

Real-estate research firm Green Street wrote in September that MPT’s deal to sell stakes in several Steward hospitals in Massachusetts was a stamp of approval on Steward, particularly “given the murky visibility on the fiscal health” of MPT’s tenants.


After Covid-19 arrived, Steward told Pennsylvania’s government it would close Easton Hospital unless it received financial relief.
PHOTO: KEVIN HAGEN FOR THE WALL STREET JOURNAL
MPT’s stock is worth about $13 billion, putting it among the largest 15% of U.S.-traded REITs, according to FactSet data. It paid $568 million of dividends in 2020, up from $327 million in 2017.


Mr. Aldag earned about $17 million in 2020, according to MPT’s financial filings. He holds more than $75 million of MPT stock, according company filings, after having sold $15 million worth last year.

MPT said it has around 120 employees. Birmingham airport records show it also had three Gulfstream jets in a hangar there.

When asked about the jets last year, the company said it used private aircraft for investment due diligence. MPT disclosed corporate aircraft in a November securities filing.

The Federal Aviation Administration later provided flight records to The Wall Street Journal showing that over the last three years the jets made 141 trips between Birmingham and Fairhope, Ala., where public records show Mr. Aldag owns a waterfront home on Mobile Bay.

Asked about those flights, MPT said its employees had been working remotely during the pandemic while its offices were closed.

No hospital company was more important to MPT’s growth than Steward. Private-equity firm Cerberus began building Steward in 2010 by buying six hospitals from a struggling operator affiliated with Boston’s Roman Catholic archdiocese. Steward now has dozens of hospitals across nine states.

In a 2016 deal, MPT paid Steward $600 million for five of its hospital properties, with Steward agreeing to lease them back. Steward also got another $600 million of mortgage financing from MPT for four other properties. Steward said the deal helped it pay down debt.

Several hundred million dollars of the proceeds went to Cerberus from the deal. As part of the transaction, Cerberus and members of Steward’s management acquired 10 million shares of MPT, filings show. MPT also took a stake in Steward, further tying the companies together.

Steward’s revenues nearly doubled between 2017 and 2019 as it acquired more hospitals. MPT financed that growth by buying the real estate, at times paying premium prices. In 2019, Steward bought a West Texas hospital for $11.7 million. The same day, it sold the hospital’s real estate to MPT for $26 million, agreeing to lease it back.

MPT said its investments are based on extensive underwriting, and that the price for the West Texas property reflected assessments about what returns Steward could generate from the facility compared with its former owner. MPT and Steward said proceeds from the deal funded improvements in the Texas hospital.

Although Steward isn’t a public company, MPT has had to disclose Steward’s audited financial statements. SEC guidance urges companies to release such information when a tenant makes up more than 20% of their assets.

Mr. Aldag told analysts in 2018 that Steward was on track for a “record year.” When the company’s financial statements came out, however, they showed Steward had actually lost around $271 million, compared with a net loss of roughly $207 million the prior year. MPT said Steward had record revenue and total assets that year.


Some of Steward’s hospitals reduced services or shut their doors completely. In Youngstown, Ohio, a Steward hospital closed about a year and a half after a deal to sell its real estate to MPT. The hospital was the last to offer childbirth in the city.


Steward closed this hospital in Youngstown in 2018.
PHOTO: NATE SMALLWOOD FOR THE WALL STREET JOURNAL
Steward said it closed the hospital because of growing losses and low occupancy, and that it had never closed a facility because of its lease payments to MPT. It said other hospitals in the nearby area still provide maternity services. It said it continues to pay MPT rent on the property.

Despite the MPT-financed growth, Steward struggled to turn a profit. Former Steward executives said the company at times delayed paying vendors, and it has been sued by a nurse-staffing company for allegedly withholding more than $40 million of payments, which Steward has denied. Steward said its finances and operations are in strong shape. Steward has sued the nurse-staffing company for alleged price gouging. That company said it charges market rates, which Steward had agreed to pay.

After Covid-19 arrived, Steward told Pennsylvania’s government it would shut down one of its hospitals in the state unless it received $40 million of financial relief. That hospital was saved when a local nonprofit operator agreed to buy it from Steward. Steward got more than $441 million of government relief funds in 2020, according to its financial statements, but saw its annual net loss reach $408 million.

Deals that year resulted in more cash flowing from MPT to Steward.

In May 2020, MPT formed a joint venture with Steward Chief Executive Ralph de la Torre, acting in a personal capacity separate from his role at Steward, to pursue international opportunities. MPT took a 49% stake in the venture, with the rest held by Dr. de la Torre and other executives, according to MPT.


MPT formed a joint venture with Steward CEO Ralph de la Torre.
PHOTO: MICHAEL NAGLE/BLOOMBERG NEWS
MPT lent the joint venture $205 million, which bought Steward’s existing international assets and rights to future international opportunities, MPT said in an SEC filing. Steward’s financial statements say it received $200 million from the deal. It valued the assets sold at $27 million, and Steward booked a large cash gain, according to the statements.


Mr. Aldag told analysts the money opened new international opportunities for MPT, including in Colombia, where Dr. de la Torre had been laying the groundwork to operate hospitals. Steward said it believed it was compensated appropriately for the assets sold. Through Steward, Dr. de la Torre declined to comment.

In another case, Steward had acquired two properties in Utah as part of a broader 2017 deal financed by MPT. In July 2020, MPT converted the mortgages into leases and paid Steward an additional $200 million, according to securities filings.

The total price tag worked out to about $2.4 million per licensed bed for the Utah properties, compared with about $350,000 per bed for the other properties MPT acquired in the 2017 deal.

Steward said it was paid an “appropriate if not conservative price” for the Utah properties, and that valuing the properties on a per-bed basis wasn’t appropriate since the Utah properties generated significant revenue from outpatient services.

“We are highly confident that our investment in our Utah properties does not exceed their fair values,” MPT said.

Cerberus has cashed out of its stake in Steward. First, it transferred control of the company to Dr. de la Torre and other members of management, with new debt being exchanged for the company’s equity. According to Steward, Cerberus earned more than $1 billion from its ownership of the company.

Early last year, MPT issued a $335 million loan to Steward’s new owners to repay the Cerberus debt. Besides serving as Steward’s landlord and its minority shareholder, MPT had become a significant lender to Steward’s new investors.

MPT has since taken steps to reduce its exposure to Steward. It has announced plans to sell a 50% stake in the Massachusetts real estate it bought from Steward in 2016 to global investment firm Macquarie Asset Management. The deal is expected to bring in $1.3 billion for MPT, which has called the pending transaction a validation of its strategy.

Steward also has struck a deal to sell the operations of five of its hospitals in Utah whose property MPT owns, further cutting MPT’s exposure.

Write to Brian Spegele at [email protected]

[jhu72]

Red states dominate the list of 25 worst states in providing healthcare.

... 19 of the worst 25 are red states
... 17 of the worst 20 are red states
... 14 of the worst 15 are red states
... 10 of the worst 10 are red states

[cradleandshoot]

Red states dominate the list of 25 worst states in providing healthcare.

... 19 of the worst 25 are red states
... 17 of the worst 20 are red states
... 14 of the worst 15 are red states
... 10 of the worst 10 are red states

None of your stats mean diddly Jack chit. If you go to the ED at Rochester General Hospital you will be treated by medical personnel bombarded by numbers their ED department can't handle. You visit their ED you will wind up on a gourney parked in the hallway parked bumper to bumper with all the other folks. You can forget about HIPPA and your right to privacy. Whatever your doctor discusses with you will be heard by the derelict on the gourney behind you puking on your feet. I've been there and done it. My hat goes out to the people that work in the ED. They don't give a chit about red or blue. IMO both colors are not doing their job. How many of you folks have visited your local ED recently???

[jhu72]

Red states dominate the list of 25 worst states in providing healthcare.

... 19 of the worst 25 are red states
... 17 of the worst 20 are red states
... 14 of the worst 15 are red states
... 10 of the worst 10 are red states

None of your stats mean diddly Jack chit. If you go to the ED at Rochester General Hospital you will be treated by medical personnel bombarded by numbers their ED department can't handle. You visit their ED you will wind up on a gourney parked in the hallway parked bumper to bumper with all the other folks. You can forget about HIPPA and your right to privacy. Whatever your doctor discusses with you will be heard by the derelict on the gourney behind you puking on your feet. I've been there and done it. My hat goes out to the people that work in the ED. They don't give a chit about red or blue. IMO both colors are not doing their job. How many of you folks have visited your local ED recently???

[Farfromgeneva]

They’ve got an erectile dysfunction wing at your hospital? Do you have the holes punched for a free wax job on your frequent visitor card?

[cradleandshoot]

They’ve got an erectile dysfunction wing at your hospital? Do you have the holes punched for a free wax job on your frequent visitor card?

They have an anal dysplasia unit. I'm sure they can squeeze you in for an appointment. Time you get that oversize rectum checked out...

[cradleandshoot]

Red states dominate the list of 25 worst states in providing healthcare.

... 19 of the worst 25 are red states
... 17 of the worst 20 are red states
... 14 of the worst 15 are red states
... 10 of the worst 10 are red states

None of your stats mean diddly Jack chit. If you go to the ED at Rochester General Hospital you will be treated by medical personnel bombarded by numbers their ED department can't handle. You visit their ED you will wind up on a gourney parked in the hallway parked bumper to bumper with all the other folks. You can forget about HIPPA and your right to privacy. Whatever your doctor discusses with you will be heard by the derelict on the gourney behind you puking on your feet. I've been there and done it. My hat goes out to the people that work in the ED. They don't give a chit about red or blue. IMO both colors are not doing their job. How many of you folks have visited your local ED recently???

You ever been to the ED at Rochester General Hospital?They are the perfect hospital for you. Maybe they can help you clear up those pesky genital warts you've been dealing with?
https://www.whec.com/rochester-new-york ... e/6269571/

This is high quality medicine for any ED department... a freaking MASH TENT. RGH recently completed a new 70 million dollar addition to the hospital. Too bad they did not invest a freaking dime in improving the care in their ED unit. This is not a criticism of the medical personnel that serve in the ED unit at RGH. I truly hope that Doc 72 after he is done giggling brings his own family member to RGH to go sit in the MASH tent. When your a rich liberal democrat like Doc 72 you can afford " concierge" medicine. Right Doc??? Would you ever allow your loved ones to sit in the ED for hours or days??? Go ahead and laugh FUZZBALL...

[Farfromgeneva]

They’ve got an erectile dysfunction wing at your hospital? Do you have the holes punched for a free wax job on your frequent visitor card?

They have an anal dysplasia unit. I'm sure they can squeeze you in for an appointment. Time you get that oversize rectum checked out...

My spot is tight!

[jhu72]

Deer tick virus on the rise??

[Brooklyn]

Quantifying health coverage losses under Trump


https://www.hsph.harvard.edu/news/hsph- ... der-trump/


Between the years 2016 and 2019—the majority of President Donald Trump’s current term in office—the number of Americans without health insurance jumped by about 2.3 million, and that loss of health coverage led to at least 3,399 deaths and possibly as many as 25,180, a new analysis found.

In a November 3, 2020 Healthline article, John McDonough, professor of the practice of public health at Harvard T.H. Chan School of Public Health, said that the analysis accurately pinpoints how healthcare has suffered under the current administration.

McDonough, who was not involved in the study, worked on the development and passage of the Affordable Care Act while he was a senior adviser on national health reform to the Senate Committee on Health, Education, Labor, and Pensions. He noted that while the number of uninsured people declined for six years during the Obama administration, the number has only gone up during Trump’s time in office.

“We can connect this rise in uninsurance to policy decisions by the Trump administration, including the cessation of nearly all federal support for enrollment navigators and assisters, the reduction in the individual mandate penalty to zero, and the expansion of junk, short-term health insurance plans, among other interventions,” he said.



Trump causes the death of thousands of poor Americans (he killed many more than did OBL) die while forum right wingers defend him. Why am I not surprised that they love someone who happily kills Americans?

[jhu72]

British Medical Journal finds republican majority counties have higher mortality rates than democratic majority counties.

[CU88]

I know that r's will not trust any sort of treatment that cures or prevents illness, but this is an amazing situation:

https://www.npr.org/2022/06/07/11035453 ... unotherapy

NPR HEALTH
This experimental drug could change the field of cancer research

"A tiny group of people with rectal cancer just experienced something of a scientific miracle: their cancer simply vanished after an experimental treatment.

In a very small trial done by doctors at New York's Memorial Sloan Kettering Cancer Center, patients took a drug called dostarlimab for six months. The trial resulted in every single one of their tumors disappearing. The trial group included just 18 people, and there's still more to be learned about how the treatment worked. But some scientists say these kinds of results have never been seen in the history of cancer research."

[a fan]

I know that r's will not trust any sort of treatment that cures or prevents illness, but this is an amazing situation:

https://www.npr.org/2022/06/07/11035453 ... unotherapy

NPR HEALTH
This experimental drug could change the field of cancer research

"A tiny group of people with rectal cancer just experienced something of a scientific miracle: their cancer simply vanished after an experimental treatment.

In a very small trial done by doctors at New York's Memorial Sloan Kettering Cancer Center, patients took a drug called dostarlimab for six months. The trial resulted in every single one of their tumors disappearing. The trial group included just 18 people, and there's still more to be learned about how the treatment worked. But some scientists say these kinds of results have never been seen in the history of cancer research."

It's a trick designed by the libs to take away their freedom. What are you, a sheep or something, CU88? It's more of the conspiracy by the medical mainstream to keep patients from having an early, horrible, entirely preventable death...and we can't have that, now can we?

Like all rational Americans, I'm sitting this one out (pun intended) until I get the real truth from Joe Rogan.

[lagerhead]

I know that r's will not trust any sort of treatment that cures or prevents illness, but this is an amazing situation:

https://www.npr.org/2022/06/07/11035453 ... unotherapy

NPR HEALTH
This experimental drug could change the field of cancer research

"A tiny group of people with rectal cancer just experienced something of a scientific miracle: their cancer simply vanished after an experimental treatment.

In a very small trial done by doctors at New York's Memorial Sloan Kettering Cancer Center, patients took a drug called dostarlimab for six months. The trial resulted in every single one of their tumors disappearing. The trial group included just 18 people, and there's still more to be learned about how the treatment worked. But some scientists say these kinds of results have never been seen in the history of cancer research."

It's a trick designed by the libs to take away their freedom. What are you, a sheep or something, CU88? It's more of the conspiracy by the medical mainstream to keep patients from having an early, horrible, entirely preventable death...and we can't have that, now can we?

Like all rational Americans, I'm sitting this one out (pun intended) until I get the real truth from Joe Rogan.

I swam in numerous Swim Across America fundraisers. 5 man relay from Tappan Zee to battery park. Now there’s a lab named for the organization at MMS I’ve heard from other SAA swimmers the research in that lab contributed to this.

[a fan]

I know that r's will not trust any sort of treatment that cures or prevents illness, but this is an amazing situation:

https://www.npr.org/2022/06/07/11035453 ... unotherapy

NPR HEALTH
This experimental drug could change the field of cancer research

"A tiny group of people with rectal cancer just experienced something of a scientific miracle: their cancer simply vanished after an experimental treatment.

In a very small trial done by doctors at New York's Memorial Sloan Kettering Cancer Center, patients took a drug called dostarlimab for six months. The trial resulted in every single one of their tumors disappearing. The trial group included just 18 people, and there's still more to be learned about how the treatment worked. But some scientists say these kinds of results have never been seen in the history of cancer research."

It's a trick designed by the libs to take away their freedom. What are you, a sheep or something, CU88? It's more of the conspiracy by the medical mainstream to keep patients from having an early, horrible, entirely preventable death...and we can't have that, now can we?

Like all rational Americans, I'm sitting this one out (pun intended) until I get the real truth from Joe Rogan.

I swam in numerous Swim Across America fundraisers. 5 man relay from Tappan Zee to battery park. Now there’s a lab named for the organization at MMS I’ve heard from other SAA swimmers the research in that lab contributed to this.

Do I understand that your fundraisers helped pay for this? Cool!

Stoked to see the future testing on dostarlimab to see if it really, truly works. Crazy stuff, science.