The risks and opportunities of acquiring a distressed facility.

Often, distressed healthcare institutions have salvaged their deteriorating situations by merging or consolidating with or selling their assets and operations to a neighboring institution. This article reviews the analysis that should be undertaken by a financially sound institution when it considers acquiring a distressed institution. Acquiring a failing institution provides many good opportunities as well as many great risks. A healthy institution must depend upon good planning and execution to ensure a successful venture.

Filing for bankruptcy: a sign of failure or hope for the hospital?

Hospitals that file for bankruptcy are usually viewed as admitting failure or defeat. However, bankruptcy can become a constructive financial management tool if used appropriately. Under Chapter 11 of the Bankruptcy Code, hospital management can use bankruptcy to reorganize the failing financial situation of the hospital into one that is financially stable and able to continue operations indefinitely.

Shared service alternatives offer flexibility and tax benefits.

Because the performance of shared service and tax-exempt status under Section 501(c)(3) of the Internal Revenue Code can be incompatible, hospitals planning to provide services to each other or to other organizations on a fee-for-service basis may wish to do so through a separate corporate entity. Using either a Section 501(e) shared service organization, a Sub-chapter T cooperative, or a taxable business corporation, a compromise can be reached between operational flexibility and tax benefits.

Expression of gastric-associated antigens by human premalignant and malignant colonic epithelial cells.

A rabbit antiserum prepared to 2nd-trimester fetal organ extracts and absorbed with adult tissue (anti-STFa) was used to detect antigens common to 2nd-trimester fetal large bowel, normal adult stomach, several colon carcinoma cells (in primary and established cultures) and epithelial cells cultured from benign colonic polyps. The frequency of anti-STFa-positive cells was highest in cultures derived from benign tumors known to be associated with a greater degree of premalignancy. Thus, the percentage of antigen-positive cells increased from 18 and 43% to 70% of cultures from tubular, villotubular and villous adenomas, respectively. Considerable heterogeneity in the distribution of antigen-containing cells was evident within any given area of a positive culture. Absorption experiments, using a spectrum of fetal and normal adult tissue extracts, indicated that the adenoma-carcinoma specificity resides in fetal, but not adult, large bowel and normal adult stomach.

Personality, body weight and ultimate outcome in anorexia nervosa.

The Eysenck Personality Inventory, a highly standardized self-rating questionnaire, allows 2 measures of psychosocial functioning on independent scales entitled "emotionally" and "extroversion/introversion." A population of severely ill, low body weight anorectics revealed a high degree of "introversion" and variable amounts of "emotionality" on these measures. Low amounts of "emotionality" were associated with abnormally high "lie" scores. Following restoration of body weight to full matched population mean levels within an intensive treatment program, significant changes occurred on these measures--increased extroversion scores, decreased emotionality and lie scores. However, possibly qualitative changes had occurred in the state of emotionality since high levels were now related to good clinical outcome many years later. The nature of this phenomenon is discussed.

Impact of cancer therapy on survival.

Survival rates improved significantly for 28,036 lymphoma and leukemia patients studied between 1950 and 1973. Nine cancers reviewed demonstrated increased one, three and five year survival rates. Greatest improvement was acute lymphocytic leukemia survival. Least improvement was for chronic granulocytic leukemia. Analyses of age-specific trends in U.S. cancer mortality since 1960 indicates death rates decreased 20% for all ages up to 45 years. This included 70% of the population, but less than 10% of all cancer deaths. Age groups over 55 experienced an 8% increase in cancer mortality. Accurate determination of national cancer incidence trends is not presently possible. Available data, representing approximately 15 million population, indicate that cancer incidence rates increased between 1960 and 1973. Age-specific trend analyses indicate unusual divergences. For the group 15 to 29-years-old, incidence increased 28% in 13 years and there was a concomitant decrease of 20% in mortality.