Persistance and Tenacity, requires a new chapter, a new beginning....

Friday, October 30, 2009

Book em' Danno! Or Donno, or I mean, sorry, Donny, Jerry and Steve, our guardians of some California justice

Why not these two?

Now we know if we caught Pam Ott, former CEO of the Kern Valley Healthcare District, charged with eight counts of elder abuse by the state of California, smoking some marijuana, she would be in jail, on "bail" in a jumpsuit, being cursed by board member, and media non-personality, Bob Jamison.

But, because it was a matter of governance, or lack thereof, we seem to have forgiven those who allowed a situation to occur in a hospital and nursing center which may have lead to the demise of residents who knew nothing of the politics which played a role in their care.

I was looking through the California Penal code, for the fun of it, a week or so ago as there are so many laws on the books which could be applied in our case here at KVHD. I sit here this fine Friday afternoon, late for appointments, wondering why there are not at least two more defendants for next week.

We know that there are documents that pertain to the responsibilities of those in charge of the nursing center or any nursing home. The administrator, the leader, is the top dog, according to the district policy and the laws of the state of California.

That should not be questioned.

But our administrator also had a second in command, who knew very well, what was going on. Ott even pointed that finger early in 2006, when Department of Health Services or "Public Health" (thank you, I'm scared already) questioned Ott's credentials.

As has been pointed out on this blog, which has reached an unmanagable 200 posts, (wow, let's celebrate! It took 200 blogs to explain this situation, but only one jury can send the message home) that Ott had help in the cover up.

Let's see the CNO of the time, she definitely knew; the CFO, Chet Beedle, who recently made fools of the board and current administration with his pharmacy analysis, was cutting out more jobs than the mortgage industry, which made for big gaping holes in the staffing, he knew.

And board members, Bob Jamison, Brad Armstrong, and Barbara Casas were either covering for the "leadership lite" administrative nightmare, or they were duped like most of us.

Either way, it's still malfeasance. They should have looked at the records, stopped the cover up, but they, instead, helped Miss Ott out of the "country" off to her new position at Sierra Kings District Hospital which has now met with trials and tribulations under her leadership. They are bankrupting their hospital. (we're just killing our business little by little here at the hands of a CFO, but, let's keep him, pay him, and allow him to continue down this path of fiduciary suicide)

But the CFO, was right in the middle of all of this, taking out personal personnel information to try and keep the employees in their places.

(Yes, we're going to have another holocaust blog for Monday. The first one didn't work out as I was straight out of surgery trying to write it, but now, I'm ready. Are you ready for Mien KVHD?)

How is it that other employees were fired for lesser issues, but, again, the administration gets a break?

Now, the former CNO, who currently works in quality control and the cardiac arrest her departments which were created out of scratch, those medicines off the charts, needs to be addressed in a courtroom.

Thelma and Louise of the SNF, Ott and Sharon Brucker, read reports to the board throughout 2006, with such concern as, "whoops" our patients lost 25 pounds, yes, we need to start weighing them. But only when we can find a way to bring them out without restraints.

Brucker the former CNO, was seen in court last month though, in the audience unfortunately, as Ott took a few minutes to show up and plead not guilty at all, what are you talking about, to the elder abuse charges.

Ott didn't have to post bail, it was all quite streamlined for her, so I asked the Department of Justice, (several times in fact) why she was treated with this "fast track" method of justice.

I have not received a suitable answer or actually any answer. It's not a rhetorical or hysterical question, Scott Gerber, bad boy of PR: I was serious: why would you treat her that way after the evidence shows she had no regard for anyone else, employees, residents of the SNF, or the law itself?

Come on DOJ, serve the "loco" motion

As I said, there are so many laws on the books which could easily be used in this case to make sure, double check, that we got all the people out of there who need to be made an example of for the rest.

Would it be crazy to press these charges? I don't think so. I'm quite certain that even though the DOJ's investigation was late, like me, and the evidence was shredded, and the tapes were lost, (though there were some other tapes made by Ott, which I'm wondering if they have been turned over to the DOJ) there is still evidence.

Maybe you can't get them all on elder abuse charges, but there are other lesser charges, easier to prove that would at least get them out of the hospital so they can't do any more damage. And maybe then, we can heal this place.

But we need felonies as the hospital does not rehire those with felonies on their record.

And you need to take the board members too. Do not let them think they can do this without some sort of slap on the wrist or fanny or something. They knew what was going on: Bob, Brad and Barbara, "the killer B's."

However, politics played a big role in all of this, but the unfortunate element was the residents: they didn't get a vote, on measure M, their staffing, or the drugs a certain nursing director decided to use.

They didn't have a choice, but we do

The residents of the Kern Valley Healthcare District skilled nursing facility didn't know the staffing was cut because there was a need to save money. They didn't know that when they rang their call lights, busy nurses were doing all they could just to keep up with the heavy load dumped on them in 2006 KVHD budget.

The residents also didn't know why the people they had come to love and care about, the nurse's aides, who were pushed beyond the call of duty, were helpless to stop the people at the top. The aides were threatened with licenses and forced to work overtime, and more overtime, sick or well, they had to come in or the nursing center would close.

The residents also did not know why the board of directors so coyly turned away from the employees who tried to blow the damn whistle, but only air and fear came out.

They didn't deserve the disrespect nor did they have any idea what was really going on around them which would lead to such a disaster.

And the families of the residents, how do they feel?

We are now on a new course at the skilled nursing facility, one with more compassion, "more staff", customer service, renewed research into better systems, and a new CCO, Cynthia Burciaga, who is monitoring the situation.

Our new CEO, Tim McGlew, has added a new element as he had the insurance liability carrier, Betagroup, do a risk assessment of the nursing center.

Though we are paying attention now, there was a serious problem for the families who feared for their loved ones in the SNF.

From all the information I have heard and seen, the families had to fight to get information and paperwork. (Yes, the paperwork was delayed, how convenient)

But along with that, they were treated as if they were simple "complainers" in some cases, by the CEO, Ott and even mentioned was CFO, Chet Beedle, whom I accused of this behavior at a recent meeting.

How could the families even watch the video of Bob Jamison calling the tragedy at KVHD, Pam Ott's resignation? I'm sure they felt great that Jamison followed it up by allowing Ott a full hour of radio time to propagate her agenda.

(See posts: Here's your witness Jerry Brown and "Hey Tokyo Rose, where's your Kimono?)

But now we, and I mean the government, the lawyers, the families of victims, the staff, the staff who were fired, the whistleblowers, have to come together and get the truth out there for those who want it, and more so, those who need it to move on from this mess.

"Ladies and Gentlemen of the Jury, the State of California has sufficient evidence to prove that Pam Ott, the spy, the media attack, the buffer, the number's guy, were part of a cover up of crimes against the residents of the hospital, but not only that, crimes against a community.

Again, we thank you for coming to be our jurors, and we know you will see through the facade, the collusion, to bring the leaders, the corporate administrators and elected board members, to justice for their roles in harming the public and obstructing the investigation.

We know you will be fair and impartial as you hear all the testimony of witnesses and victims of a case which lead to abusing elderly patients for the sake of saving money, (to pay Cal Mtg. I would say that, but they won't), and by the leaders who tried to cover their tracks and scapegoat the little guys. It could have been you, Jane or John juror, you could have been threatened with your job or fired, by an entrenched system of bullying and scapegoating."

That's how I would open my case...You have all that you need to convince a jury full of average folks who probably would not take kindly to hearing about high level, heavily reimbursed, bosses at a public healthcare district who allowed and even prolonged potential elder abuse.

I don't see any problems getting that message across to a jury. Feel free to utilize my little blog here and I've got many other bits of evidence around here at home too. Let's do lunch, then do KVHD...

(I'm trying very hard not to blow a fuse with the uploading problems with the video for Youtube. After three hours on Verizon's DSL, or supposed high speed internet, I managed to load one video last night. It's Chet Beedle though, and you should watch. I don't know what the problem is, maybe I'm competing with Jerry Brown throwing up all his gubernatorial campaign videos on Youtube...I dont' know. I'm still trying though. Aren't I?)

"Oh, we're goin' to the courthouse and we're gonna get prosecuted: Okay Jerry, Donny and Steve, you're up: but you forgot a couple

It's court time again folks, Superior Court, Kern County, elder abuse charges, what can the potential Governor do?

I've always liked Jerry Brown, but then I'm old enough to remember all of his terms in office, as well, as some of his campaign promises from the past. I also remember the idea of flat taxing which absolutely drove the inmates at the Capitol crazy, but, hey, I was all for it.

And I'm all for this too: Justice.

Can you do it Jerry Brown? You said you would. You sent people to our little village to investigate, even though I was here (not much I've been able to do).

But can you bring justice and finally, maybe, a conclusion to our drama?

You are a good writer, Mr. Brown, why I was just reading some of your stuff. It's promising that you understand how a "corporation" can use it's staff to commit crimes. In fact, this "whistleblower" story your office is working on is quite interesting.

So when two whistleblowers filed suit under seal in April 2008, attorneys from my office immediately investigated - examining hundreds of thousands of pages of documents, interviewing witnesses and subpoenaing records.

Do you think, Department of Justice, that you now have enough evidence to prosecute this case from the top, where it started? Did you read hundreds of thousands of pages of KVHD documents? I know you didn't because they were shredded. But you may have got a look at some of them, eh?

Is justice here in the KRV worth the same amount of time and effort as does a big, notorious, corporation? (I guess we're about to find out)

You see below the 2007 meeting post, and you read Miss Ott's words and you know as well as I do that she's lying through her teeth. You watch as the board let's her do it. (except for two board members who tried to get to the truth, but had no backing from this community, or the grand jury, or anyone in the media, except me-dia)

I can tell you if you put her in front of a jury and you let people talk, finally after feeling they've been on a stranglehold for three years, you will get the truth. You will know how this whole horrible drama came down from the top, the board, the CNO, and finally harming the patients.

You have the power, I have only more time than you. You also know that I will be there at court, both days, next Tuesday, Nov.3 and Wed. Nov. 4, for the prepre and preliminary (if indeed there is not a plead out).


I'll be the one wearing "Red, White, Black and blue."

I've been thinking that Pam Ott, former Kern Valley Healthcare District, CEO, the leader of the pack of trouble which hit this community hospital back in 2006 and 2007, thought she got away.

Her attorney in September, Jim Faulkner, criminal lawyer at large, told a reporter from the Bakersfield Californian that Ott's case, was well, basically, nothing. She's innocent and we're all idiots or persecutors, not prosecutors.

Fortunately, the Californian reporter didn't seem to be as dumb as her attorney was playing him, and neither are we. Especially those of us who lived through this nightmare.

We know what happened Pam. It was Christmas of 2006:

Yes, here's a photo op we took Christmas of 2006, Pam invited me over to the skilled nursing facility with my camera and my dog to sing to the residents.

I'm all for singing, though, Ott should be singing another tune right now, in my not so humble opinion.

If you look closely at the picture you can see the discomfort on the faces of the people being asked to fake as if there is nothing going on. Why they let this idiot reporter right into ground zero and I didn't see a thing. Except I did.

After the fake caroling, and the addition to our group of songbirds, of former KVHD CNO, Sharon Brucker, who, according to paperwork shown below, was in charge of the skilled nursing facility during the time it used physical and chemical restraints, but happened to duck out, during the holidays, as the chestnuts began roasting on the open fire.

The employees watched me with some regard as I walked the halls of the skilled nursing facility with Miss Ott.

A resident and her husband, began to get loud, and they were yelling. Ott stopped by and began talking to the man. (The wife is still in the SNF, her husband died recently. The woman is having problems, I visited her, she's got anxiety I'm sure from her husband's death, but then there was the thing about moving her out of her room she had with him. Oh, well. They know better than I do about these matters.)

Ott began talking really loud, like they couldn't hear her, but that wasn't the problem. She was trying to cover up the fact that they were saying something she didn't want me to hear. "help."

I've been in a lot of nursing homes, and have seen a lot of things happen in them. I had two grandparents in homes at some point, and would visit them regularly, or when I had the chance. So, I was not shocked or surprised by the behaviors seen in nursing homes.

But the whole thing seemed strange as Ott tried to quiet the couple as if I would suspect something. I say she was starting to get paranoid, which lead her to blaming almost everyone for the problems.

Let's just say it: she didn't know what she was doing. The system failure Ott speaks of occurred before Ott arrived. She was the system failure. The failure of the board of directors and former CEO to actually research Ott's background.

Now, how is she going to explain in court the resume. The college called Kennedy/Western University, an online, diploma mill, which hands out certificates to those who "pay."

But she couldn't do it alone. Where are the others Mr. Brown? It's Friday, why haven't we seen at least two more brought up on charges. I know, I know for a fact, you can prove it. I hope it's not the money. I hope we are currently running off priniciples and the idea that justice can be served even if it's not on a platter.

Let your witnesses speak. Go to court and you will hear the truth. No plea bargains.

Why is my case not listed?

I was just checking the Kern County Superior Court website to see if there were any new arrivals posted there.

I entered a couple names into the search engine and they didn't show up.

http://www.co.kern.ca.us/courts/crimcal/crim_index_case_detail.asp

Now, I know that there's a way to do this and a way not to do this. If I were Ott's attorney, I would be thinking, "good" they didn't bring in anyone else. Therefore, I can prove my case, by saying, "why just poor Pammy?"

You can't do that, blame it all on her. She had a CNO in charge of the nursing center, it's her fault.

(If I was her attorney, I would do that.)

So, bring them in, Jerry. Bring in all the trouble and let them twist while the rest of us testify to what we know.

I'll have more for us all to consider on Monday, the day before we find out if the state does have the ability to bring justice to an open wound which continues to fester while there are still those present at the hospital and on the board of directors who are responsible for the disaster.

You have the power. And I have a blog. (Gosh, that hurts.)

Paperwork and quotes coming up next: It was the CNO in charge, according to Ott's correspendence with the Department of Health Services, who by the way, has its own responsibility in this matter. Apparently, they are regular "visitors" to the hospital now, after the fact. But where were they? And where were the witnesses?

It's not over until it's...probably still not over...

Wednesday, October 28, 2009

Code blue skies for the Mt. Mesa Clinical Pharmacy: Breaking news from the Kern Valley Healthcare District Finance Commit me meeting

After last month's Kern Valley Healthcare District Board of Director's meeting where the pharmacy was looking like a lost cause, a weakened branch needing to be cut to save the whole tree: now, three weeks later, new data entered the picture and the pharmacy is getting another chance.


After board member, Bob Jamison, made a motion last month to close it down, as it was "inevitable", the board will again have the opportunity to view the new information, and possibly begin a new run at developing the customer base all over again.


But during the last Oct. KVHD meeting, the board members asked questions but didn't get the real deal regarding the information needed to make such a major decision...




Though, Brad Armstrong, voted in favor of looking at the pharmacy situation in detail, and even questioned if Chief Financial Officer, Chet Beedle had tried to market the slumping pharmacy, others at the KVHD board meeting next week may not look so good.


Chet Beedle gave us a detailed analysis which included a quirky twist, utilizing a ten year old report from a consultant firm which analyzed the hospital's problems back in 2000, which I imagine would look much different than the current situation.


My question to the board is do we really need a full time, Chief Financial Officer?


And I don't mean just this one who relies on an Ouija board or at the least, obscure data to educate the board and other administrators, like, CEO, Tim McGlew.


We are a small hospital where every penny counts and the position of CFO, maybe a place where we can save some money. (Now do you think the CFO ever thought of that, and if he did, would he really make the recommendation going against his own cozy situation.)


I say consultant. I also say consultant in human resources.


The question for our hospital is always how to survive on little money. We're a small business.


When they come to us now talking about the money problems even I could predict, I wonder how did they survive paying the salary of the former CEO, Rick Carter? Not just his salary but the plane tickets, lunches, train transportation and housing, to name a few too many.


The two million dollars which went in haste and waste to Sycamore Asset Management, a company which ambulance chased the hospital nursing center, finding a closure notice in the newspaper, said the owner of Sycamore, Don Ermel Doyle.


KVHD, in submission on it's back after the disaster in the nursing center, proceeded to write them up a time and materials contract. That is like giving them your credit card in front of the mall.


How did we survive this?


How did we make the bond payment from our long term debt to Cal Mtg? I guess we didn't pay all our vendors what we owed and moved money out of places where it should not have been taken. Maybe the pharmacy felt this pinch. And the vendor of pharmaceuticals (the real drug dealers), the distributor, did not like the slow pay and no pay status, and the stress began.


But I feel so much better that our bond payment was made even though we lost our footing because of it. And I'm so glad we never tried to negotiate with Cal Mtg. for a deference on the bond payments because we don't have anyone with a financial green thumb overseeing our "growth."


So, next week, the Kern Valley Healthcare District Board of Directors meeting Wed. Nov. 4, at 5:30 pm in the cafeteria at the hospital.


The update for now is the pharmacy will remain in operation with some staff cuts likely coming, and hopefully a new plan on how to get the medicines to the customers more quickly.


Other issues still smoldering, how to keep other losses down, like in the surgery department; and the skilled nursing facility is just on going; staffing properly not using that as a money saving tool as the CFO suggested; and many things like keeping patients at the hospital and keeping physicians of merit here.


Then the expanding must occur, and maybe even having a service that is so special it can't be found in most locations, whatever we have to do to bring service, follow it up, unlike getting mammography and never using it. (selling the trailer and parting it out, that's a huge failure we don't talk about much.)


We need plans for the future which can be effectuated, really manifested, not just talked about. I am so tired of hearing it and never seeing it, not just at KVHD, but with our government in general, but KVHD is so egregiously hypocritical that we have to start with what is in front of us: a nebulous future.


No more plans to cut a limb without first doing the homework. No more copying the homework from ten years ago. This is ridiculous, inane, and somehow there is always another excuse to go with it.


When does it end? The hospital has been under the direction of the CFO, who has not always been forthcoming, now using outdated data, and made the board and CEO look ridiculous as they were counseled to make a decision to close the pharmacy based on the financial officer's data.


What are we going to do about this situation? Let it go on, and lose more money? Make poor decision making into an art? Never knowing what is real or true in the financial reports?


I don't know, I guess I'll ask the board.

Friday, October 23, 2009

KVHD presents: Flu shots for the communtiy/Ott countdown/YouTube/Bob Jamison gets "cracked" on his show this morning

Quick update: Word is that there will be a drive thru seasonal flu shot clinic on Nov. 4, from 9 am to 2 pm in the front parking lot of the Kern Valley Healthcare District hospital.

Costs are $10, but those with insurance need to check with their providers to see if there is any reimbursement available.

So, a little late but worth the wait. Hopefully the hospital will have obtained enough of the vaccine to catch the rest of us who have not had our shots.

Got a court date with a former CEO I just can't miss:

I won't be at the drive thru shot clinic, because November fourth is a big day in this valley not just for vaccines: it's the preliminary hearing date for the elder abuse case starring the leader Pam Ott.
It will be worth missing the flu clinic to have the camera in court to see exactly what the state of California is going to do. Will it be plea deals or is the Attorney General Jerry Brown serious about following through...we will see won't we.
Next week: the countdown begins, and you will finally get a look at our video from Ott's resignation in 2007. There are only four new videos up currently on our YouTube site, but I'm going this afternoon to try and get you thirty more.
After six months of neglect, our YouTube site is being watered and manicured.
Look for: "Knight Grilling some Ott" "SNF part 1" "SNF part 2" and "Short staffing" are up now.
I've cut the videos into smaller segments, under two minutes, for easier viewing.

Oh, the story is interesting, but you should follow up with the videos for a real feel for these people.
Quite unbelievable radio today on QAB:
Bob Jamison, KVHD board member, Pam Ott supporter, and radio talk show host, got his name a bit smeared this morning by a listener who didn't like his regular nonsense about medical marijuana.
Apparently, Jamison had a flyer he said was "found" in Bodfish canyon, which was an invitation for medical marijuana event.
As he went on making this some hot issue, the police were supposed to be interested in (it's medical marijuana, Bob, and its quite legal) he took a call from the community.
Now this is really funny and quite fitting, as Jamison uses this radio outlet to attack all who come against him or something lodged in his mind.
This is what happened: The caller came on and asked about the flyer, then told Mr. Jamison she was the one who organized this event.
Then, she said, Bob you drink, so what are you talking about? He began to answer, and the caller told him that she and her son lived in the valley for 20 years and that Jamison was known to drink and beat his wife.
Yeah, we're all agog about this. He finally got a taste of his own medicine on the air for all who listen, (a few left I guess), and it was fitting.
I make no claim to know Jamison's alcohol intake or how he treats his wife, that's their problem or her problem or whatever. Maybe the caller knew more than I did about them, but I don't need to attack him on that level, it's way too easy simply criticizing his lack of ability as a board member.
It's the fact that Jamison was attacking someone on the air about their medical marijuana event, party or whatever, thinking that he was safe and then the caller turned it right around on him.
Go get him Kern River Valley...Don't let him think that he can broadcast an attack on you and not expect some retaliation.
(I've been under attack by Jamison, and for some reason, he seems to think that this is okay, but what I'm doing here on the blog isn't. Hypocrites and cowards always can dish it out, but can never take it. But I would not have attacked him personally regarding his drinking or his wife. The caller did that.
So, you know, both Mr. and Mrs. Jamison felt they could freely defame me, and called me a drunk and other fun things, in front and to people who know me. I'm not a drunk, but he and Mrs. radio broadcast, felt no compunction about this kind of attack. Aside from all the other ones about how I was slanting stories about the problems in the skilled nursing facility at the hospital, yeah, right.
How does it feel this morning, Mr. Jamsion, to be called out on your own Show? Smile. I am.)
Mr. Jamison, from 2007, his famous attack pose, threatening lawsuits, physical violence, and calling Pam Ott leaving the district, "a tragedy."
Jamison at a recent KVHD board meeting in 2009, looking more subdued, but nonetheless, still dangerous as his attacks on people in the community via QAB media, make him quite the popular dinner guest about town.

Tuesday, October 20, 2009

Some updates on the flu shots/and a hail to Reedley

Get ready for a little prick, as the Kern Valley healthcare District will indeed be getting flu shots for us this year: and we can still drive thru.

The district is expecting a shipment of the mighty seasonal, elixir, before the end of the month, and will be setting up dates and times for us to drive on by to get our shots.

I'll get you those dates as soon as they come available.

(I'm thinking this might be a good opportunity for the hospital to combine the drive thru flu shots and make a little extra cash doing say...tire inflation and window washing...or maybe even some other medical stuff, like, Podiatrist, Dr. Holly Spohn foot checks, or maybe a looksy down the throat and in the ears, or since we're getting new OBGYN's, a "mobile pap smear" only for those with reclining seats though.)

Hail to the straightforward people of Reedley

Since Reedley was put on the map recently (actually we in the KRV are now officially on the map with a pin stuck in us) as the town that hired on our former, elder abuse charged, CEO, Pamela Ott as the CEO for their hospital, Sierra Kings. (They didn't know about it when they hired her, don't misunderstand)

As has been reported on this blog, Miss Ott, was put on administrative leave, unpaid, by the Sierra Kings District board, when she was charged last month with eight counts of elder abuse stemming from her turbulent employment and leadership here at KVHD.

The CFO, Barabra Jennings, who was hired on by Ott, according to the chairwoman of the board, Trish Johnson, who also said that Ott never told them what the court date was about, that the charges came as a total surprise.

(Yeah, she was quite the surprise package here too)

But I like to keep up with the Reedley news as the hospital there is now in bankruptcy, though trying to salvage some of the plans of recovery, with an interim CEO and CFO.

The Reedley Exponent put up such an intriguing headline last week, I couldn't help but be impressed.

"Local Hospital Chairwoman under siege."

(Now I did have my "shock and awe" campaign, but that indeed is not as cool had I been able to put some of the KVHD board and administrators actually "under siege.")

I so like the attitude they have in Reedley about their healthcare. As we know healthcare can sometimes do more damage than good, so it is a dead serious issue. (coming soon: "A Patient's Plea," a rural healthcare nightmare)

According to the article, by Exponent editor, Cheryl Lingo, Trish Johnson received a visit from two members of the community, who on their own accord, asked that Mrs. Johnson step down from her role as Sierra Kings chairwoman.

Yes! Be direct, be honest, you're not doing the job, you're a public servant, and the public is asking you to do the right thing.

No...she didn't step down. (We know that from our local situation. I've not only said step down, I've yelled it, to their faces. But ego is tough skin to tear through. And there is also the fact these people in office, any kind of political office, think that we voted them in to serve themselves and not us. Did you vote for that kind of service?)

But good job Reedley for taking it to them and speaking out against mediocrity.

I would like to say that I am personally sorry you ended up with Pam Ott in your area. I'm sure had you not gotten the letters of recommendation from the likes of our "terminally" a board member, Brad Armstrong, or our famous public speaker, Bob Jamison, or even Aspen Street Architects, you may have looked beyond the facade.

(I wish there was a board of directors I could sit on and vote to close that radio station Mr. Jamison enjoys using as his play toy. I need to ask someone if the hospital is doing any advertising still with the station. Since I don't really like to listen anymore, I haven't noticed. I'll find out.)

So, thank you for again setting an example for the craven, apathetic and ill informed people of the Kern River Valley. I wish you a hospital of luck.

Friday, October 16, 2009

flooded with questions: Cal Water holds it's rate increase workshop

Rate increase workshop seemed to work as quite the fly catcher as the three O'clock meeting managed to bring in more than 35 people.
(A 6pm meeting was also scheduled)
But these people had questions and comments, when the power point session ceased, the questions came one after another.
Currently, Cal Water, has filed with the Public utilities commission for an increase of nearly 38% in 2011, which would be the earliest, it would take place, according to local manager, Chris Whitley. Then it's another three, then three and a half, on top of this increase.
It certainly seems daunting to those who said they were on a fixed income to be paying these rates.
Jim Froth, Engineer with Cal Mtg. gave the presentation, with a power point, and a large talking moose.
Well we were at the Moose Lodge, and Mooses are allowed to speak there.
Froth explained that there are many natural elements in the water which is unlike other areas. On the list was arsenic, boron, antimony, e coli, iron, and flouride.
With new regulations the company has to clean up the water, not necessarily eliminate, but reduce, certain, they are calling "naturally occurring" elements.
Foth said, "You see there is much to be done with the water before it's ready to drink and be used."
The audience, whose presence at this informal meeting probably meant that the issue is not going to be easily swallowed by the locals.
One person compared his service charge to the service charge in Bakersfield. He said in Bakersfield they have a lawn and a pool, and landscaping.
Here, he said, we pay more than double.
Whitley told them that with only 4500 customers up here you can't spread the costs around as you can in larger, metropolitan areas.
However, during the last increase in 2005, the rate payers advocacy group which monitors all increases on behalf of the consumer (supposedly) created a special program where some of the improvements made for our valley, were actually spread around to other cal water customers.
Groans could be heard from the audience every time a Cal Water representative used the words quality or drinking water.
"We all buy bottled water, we don't drink that stuff."
One resident even dared them to drink their own water.
(I told them I had my hair tested and I had 100 times the normal amount of uranium in my samples. As well as some arsenic too. They just looked at me rather stunned. Yeah, I did my own sampling boys.)

Some spoke of shower heads blackened by elements in the water.
There were many questions as to why billing is still sent when no water is used.
Manager, Whitley, told them that they can call Cal Water and shut off the meter prior to leaving on vacation or for whatever reason, and they will come out and shut it off for free. As well as restore it for free.
I hope he meant it.
One of my initial predictions is the fire hazard. Four years ago, when they came to us for the 75% increase I said you're going to change the landscape here and create potential fire hazards.
I had quotes from a fire chief who agreed that if plants were not watered properly they would pose a risk which would involve more structures.
"We look like a desert up here," he continued, "I honestly think your rates up here are a fire hazard."
So, look for your notices as the PUC will have a formal meeting regarding the increases. We've done this before.
It's hard times for all and an increase like this is really not something this community is going to be able to handle.
"We can't even have a garden," one woman said.
There will be a lot to say at this meeting in December or January. It will be on record, and all who spoke today may again air their grievances.
Thank you Cal Water for the head's up. I hope we can find another solution other than the extra $5 to offset the service charge.
Then there's the water rationing we're hearing about up and down the state. That will be an interesting element.
Much like they did with electricity, usages over a certain amount are costly, that will probably be added to the new rates, the drought rates.

Monday, October 12, 2009

Ocktoberfest KVHD board meeting: all beer and sausage












“…Because we have a lot of people in this community who need the assistance of a psychiatrist,” Tim McGlew with the quote of the night taken out of context, but even in context it’s still funny. Read on.

One week ago we had the Kern Valley Healthcare District Board monthly board meeting and I’m still reeling from what I heard that night. I wanted to make sure to cover this properly and have spent much time pulling quotes, as I will let them speak for themselves.

The issues which were at the forefront of the meeting were some I had identified almost a year ago, the cost of the skilled nursing facility, a risk assessment of the SNF, staffing, paying the revenue bond debt, and now a few others.

The new “bad debt” caused by the uninsured who don’t pay their bills and are recalcitrant about filling out forms to apply for charity programs where the hospital receives reimbursement.

And, the annual increases in Medi-Cal have been frozen by the state, thus taking away nearly a “half a million dollars” we put in the budget and thought we would have to spend. We never had the money, but we expected the increase, with obviously no contingency plan, like we always do.

Now we have to live with increases, but with no increase in reimbursement, according to our CEO, Tim McGlew, and verified, by our CFO, Chet Beedle.

Then there’s the fact that we have only enough cash on hand to run the hospital for five or six days if we’re lucky.




(And you, the audience thought it was just going to be about the pharmacy, didn’t you? We should be so lucky. )




No, Chief Financial Officer, Beedle, in no uncertain terms announced trouble paying the bond debt, and looking to the future, next August when we pay the big chunkaroo, 1.1 million, it will be amazing.

So, where do we start here. Well, there are some new beds being put in around the nursing facility, and Medicare won’t be paying for them. However, local gardeners will be volunteering their time to work and actually furnishing these aesthetic upgrades, flowerbeds, in three of the courtyards.


"I represent the KRV Garden group and our group is going to be doing a beautification of three of your courtyards and we are going to be calling them, healing gardens," Shirley Real explained to the board, while holding up a copy of the Kern River Courier talking about the media coverage on the group.

(Healing gardens, I like that whole concept. We already have the "healing murals" but that cost a bit more. Always interesting timing.)

Shirley Real told the audience about her informal garden "club's" project, which will bring in new plants, fire safe types, low water, and there will be a grand opening in March as spring is the time to see the project bloom.

(I know what you’re thinking who cares, give us the gory details. These gardeners are trying to do their part for the community, for the hospital and its residents, so they get a plug.)


And, of course, Alicia Audette, known for her very positive reports to the board on the activities of the hospital’s auxilliary group. The auxilliary runs a very profitable thrift store off the Lake Isabella strip.

Alicia Audette, showing her muscle as she reports high earnings at the thrift store.
"As usual, we are doing very well, our daily revenues have gone up."


The Hospital Foundation reported the Peddler’s Fair went well, and Mary David, Director of the Youth 2000 teen pregnancy program, propagated information regarding that program.

Chief Clinical Officer, Cynthia Burciaga, took to the podium, and an information waterfall spilled out. She gave us a lot of details regarding her work with the skilled nursing facility, such as staffing milestones, and we were introduced to our new Director of Nursing, Michael Goospy.







"He comes to us from Carlsbad, New Mexico, with a significant level of experience in the Skilled Nursing Facility areas as well as some acute care experience in critical care. He's been such a welcome to our healthcare community," Burciaga told the board audience.

"And he's jumped in looking at the policies and procedures, meeting with various personnel, becoming acquainted with each resident and their specific needs..." she added.
Goosby, who is taking over a critical position in the skilled unit, quietly received his applause, which he deserves considering the job and location thereof.
Burciaga then lead into the story about a recent look around by the Department of health services.

"We did have a visit from the state yesterday, we did good. And overall we're doing very well consistently. You know they come here and there, find the time, to just check up on things," she explained.


"We'd like to share with the staff and community that when the state comes to visit it's not a less than positive event. When the state comes to visit they share experience with us, they see current trends, just checking up on the various practices to make sure we are following those and other items...they come in and look at the staff they are very well pleased with our practices."

(And where was the state health department in 2006/2007 sharing their knowledge and practices? Now, they just drop in for a "visit")

Burciaga, who works sometimes personally in the nursing center when the need arises, said that staffing is going well, although the nurse's aides are opting to go to school to achieve the next nursing level, LVN, and some of the LVN's are going back to become RN's, so there is some shifting of staff going on.
The CCO said that the nursing facility is now meeting all its staffing requirements and has even exceeded them. "And our average patient care hours per day is 3.24 and so we stay above the 3.2 level."
Can we get our flu shots? If so, where and when?

Those questions currently cannot be answered in this story (get info soon), but Burciaga broached the subject talking about the precautions the hospital will be taking during the flu season, and with H1N1 on the loose. Gloves, masks and handwashing, as well as flu shots for staff and residents.
But where do we get our flu shots. According to Burciaga, there will be no "drive thru" clinic through the hospital, and patients are being urged to contact their doctors about the problem.
Currently, Rite Aide is out of flu shots but Sienna Wellness is hoping to have shots for their patients by November, as the shots are on order, even the swine flu vaccine.
(More on this topic, as I need to speak with Public Health as we have a high concentration of seniors who will likely need flu shots. And we need to know where to find them. Yeah, we might actually have to go to Bakersfield.)
A few technical problems didn't stop the chairwoman

As Kathryn Knight opened the meeting, the microphone apparently was borrowed from a local "jack in the box" as the crackling came out of the speakers after each word Knight spoke.

(I noticed a maintenance man there, he was more concerned with the cord to our video camera than he was about the distortion coming from the PA system. I'm sure he hasn't been cross trained yet, as is planned for the staff.)

(My time is running short here as the electricity is out because two drops of rain poured on the valley which always causes outages. I'm on my battery watching it drop while I write in the dark. So, we will see what happens, I've only got 35% to go...oh no.)
Secretary of the board, Victoria Alwin, asked for clarification on the consent agenda, as there was a question as to the pharmacist dosing Vancomycin, an aminoglycoside antibiotic which is known to be ototoxic and can cause permanent hearing loss.
I, myself, have taken Gentamycin, another aminoglycoside, and now I have no visual stability, balance, and it is permanent damage.
I'm glad that there has been discussion as to how to administer and dose these very strong and dangerous antibiotics. These types of antibiotics are used in cases of serious infections such as staph.

Two reporters narrowly missing each other at the meeting. "Don't look at me and I won't look at you," describes this close encounter of the lawsuit kind.



As Knight's microphone screeched and scratched, Dr. Robert Gross lent her his microphone, then needed it back later to ask Chet Beedle a few questions during the financial, or lack thereof for brand new reasons, report.
Chet chat, oh my what's that he said?
Beedle opened the report, "The Kern Valley Healthcare District had a very difficult month in the month of August, relative first to volume, the volume was down, under what it was the same month the previous year, in virtually every venue."
But not every venue, as Beedle surprisingly brought up a positive posting for the nursing center. "...for the first time in fours years the skilled nursing facility has made money."
Beedle said part of that was that the hospital has taken out most of the traveling nursing and registry, which sent staffing costs through the roof.
"The SNF can function, it needs, I've always said, it needs 70 patients a day and we almost had that at 69.15 and it needs no registry utilization and it had a small amount, but it was under its budget in registry utilization and it kept the salaries in line. Those three things together, you put them together, you will do well financially in the skilled nursing center."
(I think he left out the part where where we had millions in registry, consultant firms, and contractors, taking money by the bucketfull out the door to some other community. Maybe that has something to do with our current condition. So, why didn't we do this before?)
Chief Executive Officer, Tim McGlew, also talks about the closing the barn door after the horses got out, by doing a risk assessment in the nursing center, later in the story.
(I'm under 10% battery power, so we are both going to have to wait for Southern California Edison to get the power back on.)
It was a miracle
Well, we did it, we paid the bond reserve payment this year for both February and the month of August. Beedle initially reported at the beginning of the year that we would have to take money out of the reserve account which is part of the contract for insuring the debt, with Cal Mtg.
How we did it, was not explained, and the question was asked over and over again, "how can we make this payment without taking money from the resesrve, which Cal Mtg. doesn't like?"
The answer came a few months later, when Beedle said we did indeed have to take 155K out of the account.
But we paid our large million plus payment in August, with only a portion of the reserve.
"We made that payment which I think was a feat in itself," Beedle said.
"What that means is we had to dip into our cash, to make our semi-annual bond payment of 1.1 million dollars."
Cash, what cash?
The CFO explained that other hospitals on average, (he says he likes to compare our hospital with others around the state and nation, bringing us gems of comparative information.) have around 23 days the can operate with their cash on hand.
However, KVHD, has hit rock bottom at five to six days of viability without any money coming in.
"We could operate with the cash we had for six days...a year ago it was twenty days."
The economy and the uninsured: our newest excuses
I don't think anyone didn't see this economy coming down like a brick fireplace during a temblor, but it seems the hospital didn't quite plan for the situation.
Now the complaint is that more people are uninsured here in the valley, (I'd like to see the statistics on that for reference) and they utilize the emergency room services because they not only aren't insured, but they have no money to pay the sliding scale the hospital offers.
These people need to fill out "charity forms" for programs offered through the state so the hospital can get some sort of reimbursement. Otherwise, Beedle said, the services rendered would be part of the "bad debt" mounting at the hospital.
"They can have their bill reduced or written off."
Beedle talked about the amount of money this is costing the hospital, which should make you swoon: $300,000. Somehow, I'm not quite as impressed as I was when I added up the consultants fees and it came to "three million" dollars.
(It reminds me of the scene from Austin Powers when Dr. Evil asked for one million dollars in ransom)
I do, however, enjoy the new thriftiness being utilized in accounting at KVHD, but so much money was wasted over the last three years, and now Mr. Beedle talks about what can be done.

"Chet, I know you can't look at a crystal ball, but what do you think the future holds for us in the next six months, or in the future..." Dr. Robert Gross, DO, board member and hospitalist asked the CFO.


"What the hospital can do to deal with this economic climate, one of those things is looking at services which are non productive...one of those things is a staffing reduction. One of those things is other types of things that they do. For us, relatively speaking is the reduction in variable expense is limited. The reason I say that is because the number one, the largest share of variable expense is labor."
(That statement scared me a bit and I'm sure would do nothing for the morale of the employees.)
Dr. Gross then asked, "Do you expect that the number of uninsured patients coming to this hospital are going to continue to rise?
"I don't know if it's going to continue to rise, but it's not going to go down."
"And how long could this hospital absorb that?" Gross replied.
"That's an interesting question, that goes back to the statement I had before, if we don't increase the revenue in ten months...

Then CEO, Tim McGlew, wedged his way into the conversation.
"I think I'm going to jump in on that. The bottomline, obviously, we can't be in a position where we are standing still, we have got to find new sources of revenue, we got to look as Chet said before, things that are costly as like you know, we really need to make some decisions and we're going to talk about that later tonight." (the pharmacy)
McGlew expanded his explanation, into needing to start new programs such as wound care and pain management. He also talked about new specialists coming up to the valley.
"We can't just stay static we have to change the scope of things and find new choices," he said.
Beedle shared his hidden wisdom regarding asnwers to these pressing issues. "The real secret for us is volume." (Ssssshhhh)
I told Beedle I had read an article in the Bakersfield Californian, an AP story, regarding Medicare cuts. I asked how that would impact our nursing center.
The CFO explained that Medicaire does not cover most of the residents, and I remembered the coverage only lasted maybe 100 days for rehabilitation.
He said that the Medicare patients are usually utilizing "swing beds" which are paid by Medicare, paid well, and that isn't changing.
(Maybe that accounts for why Sierra Kings District decided to add swing beds there in the plan they concocted before filing for Bankruptcy.)
So, good money in swing beds from the feds, but cutting out other ancillary programs that help residents of nursing homes get proper attention.
What will we do about Cal Mtg. ?
Beedle used the phrase, "limp along," which means that something is going to take a hit, this time probably not the nursing center, as there might have been a learning experience there.
But Beedle wouldn't be considering taking on Cal Mtg. would he?
"The real issue is going to be, we're having difficulty funding our long term debt, I think we're going to make it for the first annual payment in February, I'm extremely concerned about the August payment that where the rubber is going to meet the road."
He went on to explain, without invoking Cal Mtg., what could potentially be done about this shortfall.
"Understand there's our half million in reserve there but we're talking about 1.2 million dollars. What happens if we don't? There's insurance that we bought when we did the bond, the will actually pay for it, so it will get paid. But there are all kinds of that go along with it."
Yes, there are many things that could happen if we didn't pay our friends at Cal Mtg. I'm sure you can read about it on the blog or go on the web and read the state plan for 2007: that should help you understand the situation we are in.
Beta Group: Risk management assessment of SNF
In his montly report, CEO, McGlew, happilly spoke of a "free" service given by the hospital's liability company which assesses risk potential and offers help in reducing the possible problematic outcomes.
(Isn't that great? Wish we would have done it before, but McGlew said Beta had just come up with this nursing center type survey. Gee, Beta, I guess its better to fight a dozen lawsuits than it is to survey the businesses you insure. I don't know maybe it works out for you.)
"The general findings from them was excellent, the team that was here was extremely complimentary of the staff and the quality service they provide. They did give us a list of suggestions to continue to make improvements, Cynthia is working with her team on that," McGlew explained.
McGlew updated on the radiology contract with Truxtun Radiology to do our digital media over the computer, as Dr. Eleanor Frazier, our on-site radiologist, retired last month.
Things seem to be going well, he said. And they will be looking for coverage for the night shift too. That contract will come to the board soon.
McGlew then announced the hiring of a psychiatrist for the nursing facility who is now being utilized at the Rural Health Clinic (I hope all who work there get a discount and use him) seeing patients, "because we have a lot of people in this community who need the assistance of a psychiatrist."
What is the fate of our "poor side of the lake" pharmacy?
McGlew made his reccomendations to the board that the pharmacy should be closed as it is losing money and not able to fulfill its obligations to the community.
The idea is to move out of the building and move the pharmacy into the hospital. (we could put it right in the hallway between the cafeteria and acute care) This way it would serve the residents, employees, and the patients.
However, Kathrynn Knight, was not as keen on the idea and asked questions about the accounting of the costs in the pharmacy. More questions need to be asked, and we will have the opportunity, as four board members voted to look at the situation prior to closing.
"The Drug Store" in Kernville, would take much of the brunt of the overflow if indeed Mesa Clinical Pharmacy is found to be unsalvagable.
The hospital would then have a building with no pharmacy license tied to it, and no stock, and they could sell, lease or even do something like another thrift store. Gosh, they do well.
We will go into the details on the blog as to the pharmacy, it's credit problems, and the lack of flu shots here in the valley.

Brad Armstrong, the poster boy for term limits, voted to take another look at the pharmacy rather than just cut it out of the picture.
He even asked the CFO if they had been doing any marketing of the pharmacy.
(Our motto: You'll get your medicine on time, if you pay for our shipment. We only do COD)
There are currently only three wholesalers who dominate the pharmaceutical industry and we have not made them happy by slow paying. But other pharmacists believe that Mesa Clinical is viable and could make money.
CCO, Burciaga, said in the event the pharmacy does close, the employees would be able to work at the hospital. Right now, the pharmacy staff is getting cuts to their hours, but staying on anyway.

Bob Jamison, the only "no" vote to take another look before closing the only pharmacy serving the southside, seemed to be unimpressed and rather bored last Wednesday.

Sorry, Bob, we didn't mean to wake you.





More to follow: "A Patient's Plea" , Youtube videos, and the final cut of the 2007 board meeting.
Next week: the countdown to court continues, why can't I get public info and answers, The Guardians, and "where they are now."

Sunday, October 11, 2009

The Kern Valley is being eaten alive: Hello Cal WATER, you're having a rate increase workshop? (not you Cal Mtg. relax)

It has been about the health of the valley...

I know this blog has been directed specifically at the Kern Valley Healthcare District which has had a myriad of serious problems, and happens to be one of the "hubs" which keeps the valley from becoming a ghost town, but there seem to be many issues taking bites out of the economy here.

I got a nice invitation to a "rate increase workshop" being given by our friends at Cal Water Company.

This is the warm up to the rate increase meeting which will be held by the Public Utilities Commission in December or January, according to the notice.

Some background, the Environmental Protection Agency, lowered the amount of arsenic "allowed" in drinking water causing water companies to have to upgrade to meet this federal mandate.

A few years ago Cal Water asked for a 75% increase which would come over a period of time as they spent money on new equipment and projects.

They're back.

As I said before there are chunks being taken out of the valley, our fragile economy is being hit just about everywhere: fishing industry; camping and access; price increases; a leaking dam; rising costs of gas; cuts in services available in the valley; and of course, utilities costs, such as water.

The Cal Water situation is one which concerns me because, not only the stress put on people with a fixed income, retired, laid off, but the fact that this valley will become more of a fire hazard.

Yes, there is a push up here for fire safe plants, low water, low maintenance, and suggesting to people that they dig up their trees and yard, and landscape, desert style.

A small percentage of people will do this, the rest will not have the money to put into landscaping, and underwatering will likely occur, making the plants around homes prone to fire.

Just like when gasoline prices rose, a small percentage turned in their gas guzzlers for an economy car, the rest stopped driving as much.

The people who don't have low water landscaping, will water less as high utility bills come in the mail.

So, its time to take action again, and the citizens of the valley need to understand that it is now time to make the stand.

I see many people who are trying to help this valley, and their efforts are appreciated. But more are needed as these problems become more numerous and are taking time to resolve. (Look at how long I've been at the hospital, and its not over by a long shot)

Cal Water workshop: Learn how to raise rates this Thursday, at 3 and 6 pm, at the Kern Valley Moose Lodge in Lake Isabella.

See you there...

Thursday, October 8, 2009

The KVHD board round up: brought to you by "Better Hospital's and Gardens"

Welcome to the KVHD round up where we spare all detail so that you can get your news, headline style:


Hospital adding flower beds

Verb missing from district by-laws: without it action cannot be taken

Nursing center passes risk management assessment, now

Pharmacy prescribed a reprieve for board to study potential closure

See you tomorrow, with pics and quotes...

Thursday, October 1, 2009

Today at Finance Commit me: Think of yourself not as a charity case, but a "write off"

Well, as usual, I was running late, and I had no where to put my new tiny dog, Johnson. I had to feed the cat, the dogs, wake the Macaw, get the temperature right in the house, close her door, and then throw on a happy face, and skidoodle out the door.

So, Johnson, our new arrival, playmate for my Boxer, Walter, had to go to the meeting. I hid him in my coat, thinking nobody would notice and maybe attribute the movement in my jacket to a gastrointestinally troublesome bowl of chili.

But not.

That new CCO, Cynthia Burciaga, busted me with my illegal cargo.

I explained I didn't have a babysitter this morning, and it would be too dangerous to leave him understaffed, I mean, alone at home, and then Miss Burciaga cut me a break and let the little Johnson stay for the meeting.

Johnson slept through the meeting, which is usually what I want to do, but there was something about this month's meeting that was different.

We were talking about the "real" problems, such as we don't have money, staff or money to put away for our true friends at Cal Mtg.

Stopping the leaks

One of the areas of concern is the fact that the hospital treats people who have no insurance or money, which is by law what they have to do.

With so many people out of work and struggling, there is an increase in need for services without insurance.

Now, that is fine. If you are sick, don't hurt yourself by not seeking medical care and don't think of yourself as a "charity case."

One of the most damaging psychological problems is when people lose their jobs and are unable to support their families. Men tend to be more difficult to get to go be treated by a doctor anyway: and they sure don't like it if they can't pay for it.

Here's the deal, if you don't have insurance, your life has become like so many across the country, you don't have money for anything extra, but you may qualify for some of what they call the "charity programs."

I don't like the word either, and I think since the hospital is complaining, that they would euphemize the word, and call it something like, "payment protection programs."

All this says is that you are signing forms so that the hospital may bill one of the many indigent (here's another great word that should make you feel good about yourself) programs available through the state.

If you can't do sliding scale which is available, then you may be eligible for one of many programs.

When you get treatment and don't fill out this paperwork you are costing the hospital money; you're now featured in the bad debt section of the financials.

But before you come down to the hospital, grab your proof of income and residence, and fill out the forms.

This way the hospital will be paid through the state, you will get your medical treatment, and it will not be a bad debt that goes on "your credit report" too.

Running back, Quarterback, and tight end/multi-purpose team

We've been talking about the staffing issues for a loooonnnnngggg time now, and I've heard many different things from different voices at the hospital.

We spoke again about: having multi-purpose staff who are trained in several areas and work in several areas; the great CNA (nurse's aide) educational jump, as many of the nurses have decided to upgrade their education and are in LVN (the next stop on the nursing journey) school; and that the CCO has been coming in when the staffing is tentative.

Two comments here, one that we still have a problem, but the second part that our administrator is willing to come in when there is a shortage and work whatever role necessary.

Kudos to you Cynthia.

Yeah, it doesn't make me necessarily feel better that she has to do this, that a solution hasn't been pinpointed, but it does make me and all of us, should realize that somebody is going above and beyond their call of duty. And we thank her.

(I'm guessing that is why our new CEO, Tim McGlew, wasn't present at Finance. He was actually fixing the sprinklers and removing trays from the kitchen. He's strong, he can carry a lot of trays.)

Where are we going: where have we been

The community needs new services, but so does the hospital so it can make money.

Bandaids are not big money makers.

There was a whole list of services bandied about yesterday, which included orthopedic surgeons, cardiac services, wound care specialists for the nursing center, as well as a lot more dreaming, but it felt short of planning.

Yes, I would wish this for all of us, my list includes oncology and chemotherapy, and cardiac services, as well as endocrinology, Ear nose and throat (they'd make a fortune there with all the allergies we suffer up here from the lake bed blowing in the wind, and winter with all its wood burning stoves), eye/cataract, Gynecological, oh, yeah, and mammogram.

(Yes, we did have a mammogram machine, but apparently, we had no one to run it. Then we advertised it, then we sold it. We're a bunch of boobs)

There is a shortage of ortho's anyway, so that is a pipe dream. But I had an appointment with my endocrinologist yesterday, which took me off my mountain and down into the city. I spent 30 minutes, we talked, read my records, wished me good luck, and off I went.

That was not worth the trip down. We could have done it by phone. It wasn't worth the gas money, nor the chronic risk of the canyon. I like the doctor. In fact, he's spectacular when it comes to doctors, but it's the drive.

All I ever think about is retired and elderly people going down the canyon trying to get services. And certainly, with age comes more doctor visits, so how many times are these people going down the canyon to get care?

The hospital should wonder about that too.

I say use your strength's right now to make money. I'll say it first here on the blog: From everything I've heard we have a great physical therapy department. They do things that others don't.

If you need physical therapy and you don't have insurance, don't forget there is a sliding scale program.

My impression of all of this talking, was there is no plan in effect, we are just dealing with issues randomly without an outline of the reasonableness of the solutions, with no fixed goals figured.

But that has been a problem for a long time, don't let me tell you it just came up yesterday.

I have all the paperwork from the strategy meeting from 2006. There were tremendous goals back then and each KVHD board member had a task to do to accomplish these things. Great!

Never happened. Not one of those things. I looked through it. In fact we've come way backward.

We need planning and development with input from the community. The hospital should spend a few bucks, throw an open house and let the community know what there is to offer. (They could call it, "a penny for your thoughts.")

Again, we have "great" physical therapists.

Which side of the lake you live on

As we were discussing the pharmacy issue, which they want to tell you about. I'm glad, I don't want to tell you about it. So you might want to show up for the October regular board meeting, Wed. Oct. 7, at 5:30 pm in the Cafeteria.

(You've been alerted, there's a board meeting. If you don't attend, whatever happens, you cannot complain about. My new rule.)

Anyway, in this conversation something was said that has bothered me all night.

And that is that the "reality" of our positions of life and stature in this valley depend on which side of the lake we live on.

As if I were going to agree, it was said that "we all know" (common knowledge) that the money and power structure is greater on the Kernville side of town.

Oh gag.

Not that it isn't true to some degree. Yes, they do have money over there, the housing is quite nice, the shade trees, high speed internet, the business center, why it's a veritable Camelot.

Now here on the South Lake side, we don't have high speed internet, our phone service is a joke, we have a grocery store we're proud of, but we are the local lesser people I guess according to the common knowledge.

The context of this conversation came when we were discussing the pharmacy in Kernville, "The Drug store."

It makes money, but this poor side of the lake, can't do it.

Our low real estate values and apparently low human values, make this side of the lake less appealing to business and those providing services.

I'm actually glad to hear this out in the open so I can respond properly.

Listen, the whole valley is what has been called, "the ugly stepsister" of the county. One suburb of Orange County could buy this whole place, fishing permits and all.

But that is where I find the problems in that there are those who came to this valley in hopes of being that big fish in this little pond.

Next up: Scared and impaired

More on this soon, gotta go...