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Sushisaur

Sushisaur

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Sushisaur's Latest Activity

  1. In the California midterm elections this week, we are being asked to vote on PROP 8, a proposition attempting to introduce cap profits at dialysis centers (which 70% statewide are owned by the same corporation, and have an average for 5x the profits of the average CA hospital). Their intention apparently with this prop is to force reinvestment in patient care and the work force and drive down costs by putting limits on profits and controlling costs (the monopoly can't be helping this). There would also be legislation to require clinics to accept all forms of insurance. A record amount of money has been spent against this proportion. AMA is against it, I think likely for the strain it may cause on ERs if clinics did close. I just wanted to reach out and see if anyone has a good sense of this proposition or if any of you can offer insight based on experience in California dialysis centers - either working or in admin. Thank you from a Humble Med/Surg RN. More of the topic: [h=4]The Question[/h]Should outpatient dialysis clinics be required to rebate money to private insurers if their revenue exceeds allowable costs by more than 15%? [h=4]The Situation[/h]People suffering from End Stage Renal Disease, the final stage of kidney disease, must receive dialysis to survive. Dialysis filters out waste and toxins from blood. It is typically done in a chronic dialysis clinic three times a week with each treatment lasting up to four hours each time. These clinics are licensed by the California Department of Public Health (DPH) using federal certification standards. Approximately 588 licensed clinics operate in California. The majority of the clinics are owned and run by one of two private for-profit companies. Estimated annual revenue of the private companies is $3 billion. Most dialysis is paid for by Medicare and Medi-Cal. These programs pay a fixed rate established by the regulations and are close to the average cost of treatment. Private insurance also covers dialysis with payment rates fixed by negotiation with the providers. On average those rates are multiple times higher than that paid by the government programs. [h=4]The Proposal[/h]This proposition requires the companies that own clinics to rebate certain payers, mostly private insurance companies, if the clinic chains' corporate annual revenues are more than 15 % higher than a cap defined in the proposition. The cap is based on the total allowable costs of "direct patient services care" and "health care quality improvement costs." The costs of non-managerial staff salary and benefits, drugs and medical supplies, staff training, patient education, and electronic health information systems fall within the cap. Certain staff such as medical directors and nurse managers are required by federal law. It is not clear if such staff falls within the allowable cost category. Adjustments to the amount of the cap are allowed if the clinic owner operators prove to a court that the revenue cap is so low that it is an unconstitutional taking of the value of the business. The challenger bears the burden of proving what cap would be appropriate. [h=4]Fiscal effect[/h]The fiscal impacts of this proposition are dependent upon the response of the clinics to it and on interpretations of what allowable costs are by the DPH and the courts. It appears that initially rebates will be paid which reduces the profits of the clinics. The impact on state and local governments varies from a net savings of tens of millions of dollars to a similar net cost. [h=4]Supporters say[/h] Prop. 8 provides incentive for dialysis clinic companies to lower their costs and improve the quality of patient care. When insurance companies are charged less for dialysis the overall cost of insurance will decrease for everyone. [h=4]Opponents say[/h] Prop 8 sets arbitrary limits on what insurance companies pay for dialysis treatment will not cover the complete cost of running a clinic. Clinics will reduce operations or close, depriving patients of access and increasing the risk of poor medical outcomes. Why Proposition 8 Is One Of The Most Contentious, And Confusing, Ballot Measures In Play - capradio.org
  2. Sushisaur

    Providence TIP Program 2017

    Have you spoken directly to the main contact at the recruitment support team (onboarding) yet? The initial recruiter should have put you in contact with this person - it's the person most of those auto preboarding e-mails are from (NOT the [COLOR=#003779]"Preboarding Licensure & Certification Specialist" who asked for your BLS). I would recommend calling your person directly and find out what the status of your preboarding is. No news is honestly good news, you're probably right on track so they have no reason to worry about you and are dealing with candidates with hold ups. I know mine was delayed in contacting me, I had to call her myself. Just bug them. Good luck! :)[/COLOR]
  3. Sushisaur

    Providence TIP Program 2017

    Congrats MoroccoRN! Everyone I know currently in the TIP program loves it!
  4. Sushisaur

    Providence TIP Program 2017

    My onboard specialist was pretty MIA until after my drug test cleared, and then she was on top of it. For me, she gave me links to all the documentation I needed via e-mail to bring with me first day and told me to contact my manager for more specific directions related to my floor. I was called for my physical pretty quickly afterward, however it was scheduled for the end of March. Hope that helps!
  5. Sushisaur

    Providence TIP Program 2017

    April 10th start date! I was offered a position at St. Josephs at the end of Feb, but as of last week I believe there were still interviews going on at least at some of the locations. I think each location is different, not to mention not all candidates accept... Best of luck to you all, let us know if you hear back!
  6. Sushisaur

    Providence tip hospital program 2017

    I interviewed 2/17/17 at Providence St. Joes Burbank and was offered the job the next day. I accepted a position on their bariatric med/surg floor, which despite the name, isn't really just a bariatric floor. While they do bariatric surgeries twice a week, new grads don't touch those patients for at least a year as policy. It's primarily a functional GI/GU med/surg floor (my fav systems!). At the time, it sounded like St. Joes was having both their tele and med surg interviews the week I interviewed- however, if you haven't heard that's a good thing! There's still another month, they're looking for the right people! @MoroccoRN - They did not look at my recommendations or care to look at my portfolio whatsoever either and I got the job. It's probably because they do the pre-work. Also FYI, for Providence, they require 5 digital surveys be sent out in lieu of/in addition to written recommendations - from at least 2 managers and 3 others (teachers, ect). So think of who you want to recommend you because the turn around is quick! For new grads who may not have managers who know them well (nursing or otherwise), clinical instructors can be substituted so don't panic! I hope to see all of your on April 10th!
  7. Sushisaur

    New Nurse - Meal Period Waiver

    I am a new nurse too, and by the sound of it EVERYBODY waives the second meal period in CA. It's very busy on the floor, and if you don't waive the second meal period, you by law have to clock out (and not get paid) for a break you may or may not be too busy to take.
  8. Sushisaur

    bariatric nursing a good job?

    I have two new grad offers from "bariatric floors"; I was initially going to decline since I'm looking for a more varied M/S experience, however managers of both say they really only have 5% bariatric patients at a time (since surgeries are only 3 times a week) and that the rest are GI/GU pre/post op and med overflow in ~40-bed units. Is this common for bari units? This seems so strange to me since the posts here seem to indicate that bari care is usually its own thing. However, if this is normal - why on earth are they called bariatric floors? I'm sure the managers aren't trying to be misleading (don't get me wrong, i'm very happy to have a m/s varied floor), it just seems strange to designate a floor for a procedure that seems to be relatively rare. It ultimately doesn't matter, I was just thinking maybe there's a simple explanation i'm overlooking!
  9. Sushisaur

    Torrance Memorial March '17 New Grad Residency

    I've decided to accept the position at TMMC. I was initially going to decline, but apparently the nurse recruiter accidentally told me 6E was orthopedics (it's a mixed med surg floor) - which is what I wanted! I'm interested in starting a fb group, let me know if you've been accepted and I'll add you! For those of you still waiting, good luck!
  10. Sushisaur

    Torrance Memorial March '17 New Grad Residency

    Update: I just received an offer for an orthopedic night shift position this morning. I'm not certain I will be accepting, but just know calls are coming in!
  11. For those who have gone through the New Grad Program at Presbyterian Intercommunity Hospital at Whittier or Downey, did you feel it was helpful/satisfactory/safe? Or, if you are a nurse at PIH, in your opinion does the program seem to churn out fairly confident and competent nurses/co-workers? Some background: The program at PIH in Whittier has a very short orientation on med/surg (2wk general orientation + 4-6wk 1:1 preceptorship). In comparison, the "gold standard" Versant program is a whopping 18-20wks (admittedly, certainly not the norm). At PIH I have been offered a job on my ideal floor! I really connected with the manager who hired me, everyone seems extremely friendly and, in general, people I know who work there seem to really enjoy it. However, I have offers from other hospitals with somewhat longer programs and while I may be less keen on the culture/commute of these alternates, I'm ultimately looking for the best education and support possible for my first few years of nursing. Thank you kindly in advance for any insight into the PIH New Grad Program!
  12. For those who have gone through the New Grad Program at Presbyterian Intercommunity Hospital at Whittier or Downey, did you feel it was helpful/satisfactory/safe? Or, if you are a nurse at PIH, in your opinion does the program seem to churn out fairly confident and competent nurses/co-workers? Some background: The program at PIH in Whittier has a very short orientation on med/surg (2wk general orientation + 4-6wk 1:1 preceptorship). In comparison, the "gold standard" Versant program is a whopping 18-20wks (admittedly, certainly not the norm). At PIH I have been offered a job on my ideal floor! I really connected with the manager who hired me, everyone seems extremely friendly and, in general, people I know who work there seem to really enjoy it. However, I have offers from other hospitals with somewhat longer programs and while I may be less keen on the culture/commute of these alternates, I'm ultimately looking for the best education and support possible for my first few years of nursing. Thank you kindly in advance for any insight into the PIH New Grad Program!
  13. Boy, ain't that the truth. It's bananas.
  14. I think it's more related to the differential. Night-shift differential is $7 at PIH - at least at Whittier.
  15. Sushisaur

    Torrance Memorial March '17 New Grad Residency

    I had an interview today for Med/Surg Tele. I was told a decision would be made by end of next week, latest early the following week. They will still be interviewing next week. However, I do not know if that applies to all positions at TMMC or if that even applies to to all med surg. I hope it's not too long, I have an offer from PIH that I don't want to wait too long on. Good luck everyone!
  16. Sushisaur

    CSUN ABSN 2015

    ncr86 - I've received literally nothing. They're not picking up at the office (straight to voicemail), and I've received no e-mail about tomorrow. What info do you have thus far??
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