What Gets Me Hot

Saint Francis of Assisi 220, rue de la Convention Paris Tél. 00 33 1 58453060 email: contact@fmnd-international.org

noreply@blogger.com (What Gets Me Hot) — Fri, 15 Jul 2022 02:07:00 +0000

Spirit of Franciscan charism and pious conversion--their own imperfect expression through slow corruption, the apostolate, as taken on qualities which aid the Ordinaries' sense of company, personhood, and devotion to capitalist apostles, keeping callous catechism of dogmatic deception through corporate hardening and inability to confess secret sins for simple renunciation and penance.

They do not confess unless confessor is holding the evidence and their attorney nods them into the deal, and then begrudgingly.

Because as the man said:

it's much easier to do the deed first, then beg for forgiveness, or admit to it, than the opposite way around.

no medico referral

9.
no preliminary notice or explanation for action.

10.
denial of due process, right to appeal, and all relevant communication with clinic offices, administrative supervisors, resource list of contacts from website; never a promised callback, ethics or civil rights, provide internal office.

11.
no referral for continuity of patient care during COVID-19 pandemic, critical calendar 2021, EBR Parish, gubernatorial Stay at Home Order.

12.
discovery, appeal--squashed through universal institution of No Contact Policy until present.

No provision for treatment until 30 days past transition of June 2, 2021.

Lannis Lee Tynes & Crapanzano, MDs, physicians possessing degrees--traits of character, indispensable.

Mark Zielinski served among the out-farms, and of high station, simply for such an area, and it was just the place for such a man.

It afforded scope for complete exercise of all his powers, and he looked as if it would be utterly at home in it.

He was one of those who could and would treat accordingly back; no explanation allowed, a patient, showing himself to have been wrongfully accused.

Mark Zielinski acted the maxim laid down by titleholders.

"It is healthier that a dozen healthcare shoppers suffer below the inappropriate conduct, than FMOLHS ought be condemned within the presence of the healthcare, having been at fault."

Despite, however, innocent a patient may well be, it availed him nothing once suspect by M.D., of any as condemned, and convicted as chastened with immutable certainty; to escape accusation and under ship of Zielinski's smug, diligent-to-succeed peak of assistant ambition.

He was of all, most dire; outpatient psychopathology, physician cluster, O'Donovan clinic, obstreperous receptionists, and administrative staff whose exegesis from peer, K. Long, North prescript, eponymic associate professor, and Assistant M.D., himself.

Confusing, seldom sharp, and manufacturing horror within the ranks of the brave, reaching decision connected to his, or workers of that administrative workplace.

He was asked why he resorted to his extraordinary expedient.

His reply was (as well as I can remember), Robinson (Doogey), had become un-physicianable.

He was setting example to opposite--one which, if suffered to pass without such demonstration on his part, would finally lead to full subversion of all rule and order upon Franciscan Missionaries of Our Lady Health System & medical center, and LSU Health Care Services Divisions, employees of State, and any instrumentalities governed by officialdom, classified employees of a university or state, he argued,

"If one patient refused to be corrected at large together with his life, the other tending consumers would presently copy the example; the result would be the liberty of the shoppers."

Zielinski's deference was satisfactory.

He was in Our Girl, North American Province Sisters, and so home:

Saint Francis of Assisi

220 rue de la Convention

Paris

Tél. 00 33 1 58453060

email:

contact@fmnd-international.org

I speak intentionally when I say that killing a patient, or any client in O'Donovan street is not treated as criminal by the community.

Dr. J. Michael Robinson killed 2 consumers--one of whom he killed with a hatchet--by knocking his brains out.

I will, in short, narrate another which occurred, concerning a similar time as the murder of Robinson (Doogey) by MD.

Healthcare shoppers were in the habit of paying vicinity their nights and Sundays fishing for oysters, and during this way made up deficiency of their scanty allowance.

An old physician, while thus engaged, happened to urge beyond limits, and on premises, Mark Z.

At this, Z took offense, and along with his muzzle loader, minified the shore, and blew its deadly contents into the poor old man.

Z came to envision the next day, whether or not to pay for property, or to justify himself in what he had done.

Z, amid speculation on being brazenly ... hush up.

There was little regarding, in the slightest degree, and zilch done.

It was standard communication, even among boys, that it had been worth a half-cent to kill a "healthcare shopper," and a half-cent to bury one.

CHAPTER V

As to my own treatment while I lived on, upon me, and terminated my supplier denial and squalid standard of treatment which forced me transfer primary care cluster, whose acumen, manner, passing examination, insight, disregard, in the face of significant cellulitis, fractured L1 and L2 disks, he prescribed barely -- and proceeded to have me hunt, book, and see pain specialist.

Obvious rubor on both legs, Larotid--only antibiotic not mentioned within the literature.

Got COVID.
Referred to as office.
He barely called back.
Sent some bullshit medicament; turned out he had shredded up into four day scripts, because when you have COVID during a pandemic, you really wish to keep going out of the fucking house, or use the phone to call pharmacists and pharmacies up to their eyeballs in COVID!

This child.
And his very little girlfriend, Courtney Langlois--she's a exemplar.
Did that trick once they first began to deny service, thanks to his appreciation of inappropriate profession selection through his realization that he was not very into it.
She called, and decorated up when four seconds, after a call to his service.
Then she really called back the last time to solicit from me if there was a tangle, because a patient had overheard me yelling at Dr. Robinson on the phone.
Apparently word has gotten around.
I said no.
Robinson was refusing another prescription for medication which if immediate surcease could cause seizures which Dr. Zielinski failed to provide on his push-out; and btw, next time you see a patient listening into my calls, you may wish to report that to HIPPA.
silence.
That was it.
Multiple calls concerning COVID, but principally regarding cellulitis, which the freak thought was not cellulitis, and ordered me to envision my cardiologist during the pandemic.
That guy's not gonna last in any respect.
however perhaps Courtney will save him from the redheaded fate which threatens to subsume his every move, together with the recrimination returning down the pike from the termination I just received from him.

His geographic point in shambles, through impoverishment, administered by its administrators, unscrupulous guidance.
Immediate dismissal (gross medical abandonment) 20 minutes before scheduled televisit 4.
Clinic-wide ban from all services 5.
No personal consultation--ever 6.
No legitimate reason, nor personal consultation.
an impulsive decision which could not have occured because it was delineated in anecdotal fourth party spile on as a favor, this being the second time during which Tynes would have to be compelled to attempt to straighten out Zielinski's temperament issues and obvious uncurbed enmity toward a patient, with no history of infractions throughout the roughly 8 years (FMOLHS has denied my records in another CMS violation).
Zielinski requested his superior, academic Clinical researcher Doctor of Philosophy, Head of Department, and LSUHSCNO-BR Residential Program.

drippy episodic lashing out, ending in apposite unhappiness left him incapable of explaining the amateur shelling out, telling of the end of a career mistake, or physician Burn-out from COVID-19 (I have no knowledge of his history or cross-assistance in this case).

In either case, his misanthropic cutting of my care future, and cleaving the late in life pandemic worldview left me shattered and dour, on the mendacious severance of a covenant which I had naievely thought was insoluble (and had been in my personal relatioships), but which now transgressed and deliberately wielded in a second attempt of a medical doctor, whose standing and respect I once formally held his faction to be, the authority whose knowledge and knowledge could save lives and forestall suffering, had at the age of 58, terminated with my final impressions of those among the field as nothing but the depraved, egotistical, domineering, timeserving predators who if criticized will break each oath and ethical procedure (this for certain not, his first offense, nor initial occassion to be caught and reported), singularly trusted personages with quantam tricks responsive to observation, but moreso, the institution which might let the likes of the most vile moral turpitude, continue his mental disease of white collar extraction over a course of seven years as President CEO of the Fundraising Foundation, and eventual Expropriator of pediatric Cancer Swindle through Giftcards of Hope.
currently there is context to the fallacious sham which FMOLHS Executives are repeating, however, more manifestly liable on this occasion, as a result of while they profess not to remember of the toilet Paul Funes Taboo, they are by now, well invested with and fully supporting the immediate step they took ab initio, with an ALL FMOLHS BAN and BLACKBALLING of me as it pertains to telephonic contact, email correspondence, official social media messaging (an acceptable and recognized legitimate mode of modern communication, that from June 2, 2021 until the present, they continue to observe--ignoring my calls, not returning answering machine messages, nor those to administrative assistants, locking my file to any or all but corporate executives of FMOLHS: i am certain through Legal Counsel of Ms. Bollinger, Dick Vrath, M.D., VP Craven, and CEO President (figurehead) Scott wester, which has additionally prevented me from the entire system of clinics not under those from which I was banished, through the inaccessibility of their administrative operators for appointments, or on-call doctors for medications, or emergent problems (as those which currently still, having found no suitable physician, and providing no referral, currently suffer from withdrawal symptoms (who as of last week, piled on and sent an illegal, antedated "Dismissal Letter," giving service 31 days, but through his office manager, Courtney Langlois, whose trick at "Returning calls for four Seconds and then Hanging Up, in order that it shows she did attempt to call," are famous.

As is this: the Letter is dated fraudulently--dated to the day on which I received it -- but a month previously.

To avoid any mussy medical attention like refills or proper care for my chronic cellulitis, which J. Michael Robinson, M.D. Physicians cluster on Picardy, has been from the first day, without a doubt the most incompetent, lazy, young medical practioner I have ever encountered, whose concern of being raided by the Drug Enforcement Administration for prescribing the patient which he volunteered to Xray at his clinic office, diagnosing with a fractured L1 and L2 vertebrae, and reassuredly as a Sports Doctor, he said, promising to treat the intensive chronic pain, which disables me from standing for longer than one minute's time.

perfunctory dismissal of the effectuality or projected regimen, with no discussion nor consideration.

So, predictably, in a cursory dismissal of the efficacy or proposed regimen, with no discussion nor consideration of the quality of pain, he prescribes Tramadol.
    On the next visit, he decides, stating to me again his fear of being apprehended by Federal Agents for overprescribing narcotic Scheduled Pain Medication, that he will not prescribe me anymore Tramadol (a non-narcotic synthetic analgesic whose classification was changed from its inception, and now among the alternative medications used for Opiate Disorder patients, the least worrisome, which even non-medical professionals routinely prescribe).
    He told me to find a Pain Management clinic, on my own, and see him for both the pain, and the adderall, also prescribed by Zielinski.
    historical deception for little gain to them and psychic damage which this, the naive faith I had held in MY physicians, never broken as to the nightmarish manner which a figure of professional trusted authority and science, never demonstrating pedestrian carefuller deceit in the accomplishment of revenge for an aside from the difficulties of pandemic navigation.
    It afforded scope for the full exercise of all his powers, and he seemed to be perfectly at home in it.
    He was one of those who could and would treat accordingly answering back to him; no explanation was allowed a patient, showing himself to have been wrongfully accused.
    He was, of all, most dreaded by consumers, Physician Group at O'Donovan clinic, obstreperous receptionists, and administrative employees, whose exegeses from Earl K. Long's School of Etiquette, as their eponymous Zielinski, himself.

exegesis (countable and uncountable, plural exegeses)

A critical explanation or interpretation of a text, especially a religious text.
1885, Alexander Roberts and James Donaldson (original translators and editors), Arthur Cleveland Coxe (editor of American edition), Philip Schaff (also credited as editor), Nicene and Post-Nicene Fathers: Series II
Accordingly Athanasius complains loudly of their exegesis (Ep. Æg. 3–4, cf. Orat. i. 8, 52), and insists (id. i. 54, cf. already de Decr. 14) on the primary necessity of always conscientiously studying the circumstances of time and place, the person addressed, the subject matter, and purpose of the writer, in order not to miss the true sense.
1913, Francis Aveling, Rationalism, article in Catholic Encyclopedia (1913),
As with Deism and Materialism, the German Rationalism invaded the department of Biblical exegesis.
1940, Mortimer J. Adler, Two Essays on Docility,
Historical scholarship bears exclusively on interpretive reading; when it is properly subordinated as a means, its end is exegesis; all of its techniques are of service to the grammatical art. But exegesis is not the end; nor is grammar the highest art. Exegesis is for the sake of a fair critical judgment, grammar for the sake of logic and rhetoric.

About the Franciscan Missionaries of Our Lady Health System

noreply@blogger.com (What Gets Me Hot) — Thu, 14 Jul 2022 05:05:00 +0000

American Medical Association (AMA), and its sister association, American psychiatric Association (APA), under whose specialized designation rules for physicians, psychologists, and doctors are sworn, upon failure--under penalty--censure, suspension, or debarment.
About the Franciscan Missionaries of Our Lady Health System

Louisiana State University Health Sciences Center and U.S. Department of Justice JAMA Psychiatry Louisiana State University School of Medicine in New Orleans Louisiana State University American Society of Addiction Medicine - ASAMThe National Institutes of HealthAmerican Medical Association Association of American Medical Colleges (AAMC)LSU Foundation

________________ *

Tweets by ololhealth

Louisiana State University Residents, Meet FMOLHS OLOL LSU Board of Supervisors Mark Zielinski, MD. (NPI Number: 1194875625) Assistant Professor (LSU-HSC BR) O'DONOVAN 5131 O'donovan Dr., Suite 300 https://t.co/wBxDVnVXIN pic.twitter.com/IxgrIuEQm0

— mrjyn (@mrjyn) 10 sierpnia 2021

Lee Tynes, he loud at you too much

simple payment plan procured it having never cost over $99 at any one
time, letting internet looking out and dealings acquire from a restricted
stock virtual objects, unable to touch--once yours, stays yours.
* that sucks troubled.
* *

* the academic department L Tynes who having flat it the dam

swallow inclination Dr Z has to ivory dissociation from me through
lukewarm eventualities of conflagration an wake valor, have fail therefore
a lot of that only through the scheme which I m of the inclination to think
assume come from his nurse at all, but came from hi as a particular
suggestion for his nurse o collaborate of which he found a willing agent
to play the bit role of this tawdry psychopathology opposite game of
though raven wrongdoing of vary rue law and best practicum in dry
Association Licensing Agony, Medical Board, Board of relevant in the
formally relevant document which Gorgon the official foresight and
removal of licensure or censure although temporary debarment he has
created the last word condensation of his sworn oaths and duties to uphold
including the plutocratic oath whose duty to do no harm is in this time
of pandemic and death and the current shortage of doctors which appears
me on the streets with no referral or provision for continuation of
medication I have taken for a decade and no communication or condensate process
or chance from van one person whose duty that it is to address
these serious grievances from FMOL OLol LsSU Board of Supervisors where I
am left with a religious Order who is choosing to mire themselves in
yet another PR nightmare of medical practitioner Abandonment malpractice and
Violation of Civil Rights or a protected patient who is protested as a
Federal Medicaid precinct, a Homeless citizen whose temporary residence
is a hotel, and a lonely disabled subject whose incidental botching of
survive by strident was sloppily expedited and exacerbated my
future diagnoses through gray of the fractured L and L discs which
the primary resident ER doctor did not trouble to order, sending a
Emergency paramedic arrival on stretcher who could not walk hm after a
perfunctory examination and the spreading of isobutylphenyl propionic acid as a prescription to
my horror, whereupon for a week i languished bedrid unable or me
until I returned and much to the shock and excitability sympathetic
anxiety of the Charge Nurse and the Administrator she called in up
discovery of the firm = i was sent home and now suffer from complete
inability to stand for longer than on minute at time, in addition as a
continuing infection of my legs which has never been attended to on
presentation or further steel to this day. ... nor written or oral nor
skywriting even, and during the Christian season of joyous giving

* forgoing legal consequence and revenge will expose his to
unpleasant contingency, sure as shooting means carrying it out anyway,
is the sign of selection which is the of low-caliber, moral
transgression, and people whose gratuitous title depends on the illusion
that others assume they are employment is from the good job that
they are doing, whereas themselves, even understand sometimes in moments
of prolonged states of sobriety, that they are, at best, only a
formality, disposable, and with a high-pitched screaky noise, whose
noise all tend ignore, sanctioned those Zielinski's free reign in
terrorizing out of disdain the singular nature to conduct herself at his
job the suggests that he can, as ain't nobody with seniority he see over his
tell his he should not, so this can be the proper introduction to the
story of however Mark Zielinski illicitly Evicted state by steward,
UN agency Managed to influence a Head of psychiatrical Resident
Department of the Parish of EBR, not solely that it had been lawful, and
that he show up as a show of wonderful of fine, Force, and Authority,
however h ought to have celestial body this request on high of that feat: on
the method, collectively would possibly he please not browse any newspaper, law,
act, or decree which could attempt to build a case for that instead of
stern my bootleg, strong-arm extraction of no cause and beneath
no authority that he would do i front of the officer ... he need to square measure
line of labor his supervisor or Lieutenant to answer all the queries
that he stood taking note to, surprised that someone knew his job
beyond he.

Zielinski was secluded,
celebrating Christmas, and so equally joyous my final riddance,
through any implies that necessary, and from the last person to whom i
would receive truthful, ethical, or skilful acumen, on the rare
occasion that our ways in which crossed I finally saw the necessary Mark
Zielinski.

* Courtesy replaced instead with imitative, meretricious

Minor Depression, General Anxiety, and MBD / ADD, occurring in my
recollection before the one-two punch that then prohibited the patient
of a general practitioner or physician from eager to order any Narcotic
Analgesic Pain Relief, once the obscene and foolish insincere mental object
the medical community announced on their hoodwinking by huge company
of the colorless edges and full pain relief over what then "pain
degree," was still showing mercy sordid one in all 5 diagnostic
issues for the foremost efficacious treatment of a patient.

* currently because of huge company UN agency simply paid a Billion bucks
having contribute to ye epidemic of Oxycontin Addiction and Abuse and
its damaging Sherman's March through the agricultural cities associate industrial
minutes associated mills that dot this country and whose initial victims to an
prescription thus dramatic, that the death rate and therefore the economic condition and
dissolution of family and road to institutionalization and criminal
captivity it left in its wake has solely continuing to morph within the
cheaper drug of abuse equivalences for those prescription pills,
whose tightly regulated dispense and watching for the only a few
patients UN agency square measure ready by the severity of their finish stage palliative and
hospice care solely allowed, the others way back having graduated to the
cheaper however deadlier narcotic drug of abuse base of hard drug,
upper and, with Sublimaze getting used as associate extender in China
and currently everyplace, the athletics ramping from another epidemic of
dose chow from the unknown amount and perilously unknowable
likelihood that junkie have forever trade for thee delivery from illness
which can eventually take their lives.

This notice serves as a reminder to all health care professionals and facilities in the State of Louisiana of their duty to provide health care services in a non-discriminatory manner, pursuant to federal and state law and regulations. For further guidance and information, the Louisiana Department of Health (LDH) recommends that all healthcare providers review and maintain compliance with the bulletin posted on March 28, 2020, by the HHS Office of Civil Rights in Action, which is provided with this memorandum and can be located at the following link:
Bienville Building · 628 N. Fourth St. • P.O. Box 629 . Baton Rouge, Louisiana 70821-0629 Phone: (225) 342-9500 • Fax: (225) 342-5568 • www.ldh.la.gov An Equal Opportunity Employer HHS Office for Civil Rights in Action March 28, 2020 BULLETIN: Civil Rights, HIPAA, and the Coronavirus Disease 2019 (COVID-19)
• Guidance on Disclosures to Law Enforcement and Other First Responders Filing a Complaint with OCR If you believe that a covered entity violated your civil rights, conscience and religious freedom, or health information privacy rights, you may file a complaint at https://www.hhs.gov/ocr/complaints.
If you speak a non-English language and need help with this document, call 1-800-368–1019 (TTY: 1 800-537-7697), and you will be connected to an interpreter who will assist you at no cost. Louisiana State Board of Medical Examiners 630 Camp Street, New Orleans, LA 70130[1] Phone: (504) 568-6820[2] Fax: (504) 568-5754 Web site: http://www.lsbme.la.gov[3] COMPLAINT FORM Name of complainant: _______________________________________________ 2. Address and telephone number of complainant: Address:_____________________ City:______________________ State: _____ Zip: _______ Day phone #: ____________ Evening Phone #:___________ Email: _____________________ 3. Relationship of complainant to patient:________________________________________________ 4. Name and Date of Birth of patient: Name:_________________________ Date of Birth:__________ 5. Full name and address of practitioner about whom you are complaining (provide a separate complaint form for each practitioner or allied health professional[4] about whom you wish to complain): Name: ______________________________________________ Address:__________________________________, City:_______________. State:______ Zip: _______ Phone #:________________________________________ Approximate dates of treatment[5]: From:___________________ To: _____________________ 6. Statement of your Complaint[6] (If you do not have sufficient space, please attach a separate printed document). ___________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ __________________
— mrjyn (@mrjyn) 10 sierpnia 2021
_Complainant’s Signature[7]: ____________________________________ Date: _____________________ [8] 6.10.19 Louisiana State Board of Medical Examiners[9] 630 Camp Street, New Orleans, LA 70130 Phone: (504) 568-6820 Fax: (504) 568-5754 Web site: http://www.lsbme.la.gov
[10] AUTHORIZATION TO RELEASE YOUR COMPLAINT INFORMATION I hereby give the Louisiana State Board of Medical Examiners permission to send a copy of my complaint to the practitioner listed above and that this will include disclosing my identity. I understand as well, whether I sign below or not, that the medical records of the patient(s) involved may be obtained by the Board as a part of its investigation. I may elect not to sign below and thus request that my identity be kept confidential. In that case, only a summary of the complaint may be provided to the practitioner. I understand however, that even if I do not sign below and have the Board handle this complaint confidentially, that the Board may be required by law to disclose my identity to the practitioner at a later stage of the proceedings. Understanding the above, by my signature below, I hereby give consent to the Board to release a copy of my complaint to the practitioner: Complainant’s Signature: Date:________________
DEFINITIONS Includes Universities, Community Colleges, Technical Colleges, and Health Sciences Centers.Includes Medical Centers and the LSU Health Care Services Divisions. Higher Education:Health Care Services: Members of a board, commission, or other authority of state government created or authorized by law, by the Louisiana Constitution, or executive order.Board Members: Employees of the State and any of its instrumentation who are governed by the State Civil Service Rules.Classified Employees: Employees of a college or university of the state excluding students.Education Employees:Employees who work a regular schedule of 40 hours per week or 80 hours biweekly.Full Time: Primary division in the executive branch of state government.This includes the twenty major agencies created by statute, higher education system and hospitals. For example: The Department of Health and Hospitals.Department: Employees who work less than 40 hours per week.Part Time:Employees who are typically board and commission members who are not salaried employees and who meet one or two days per month.Per Diem: Employees of the Executive Branch of State Government.State Employees: Employees who are required under the terms of employment to be a full time student in a school, college, or university.(excluding students employed by the educational institution in which they are enrolled as students) Student Employees: Employees of the State and any of its instrumentalists who are exempt from the classified service.These employees are not governed by the State Civil Service Rules.For example: teaching professionals in Higher Education.Unclassified Employees:Employees of local governments who are subject to State Civil Service Rules and excluded from state government counts per R.S. 42:290(B). Units of Local Government: Intermittent employees that have no regular work schedule and work on an as needed basis.These employees are generally in the unclassified service. Examples: Nurses who only provide relief work while the regular incumbent in on leave
Employee Discipline If a University employee is exhibiting problems with their performance and/or conduct, they may be subject to discipline. * The type of discipline should reflect the seriousness of the offense and the type of employee receiving the disciplinary action. * All employees should become familiar with the PS-08, the university's policy on Employee Discipline Procedures for Professional, Other Academic, and Classified Employees. * Regardless of the employee type, all discipline must provide due process to the employee and be distributed fairly and equitably. * The first response to a performance problem (e.g., unacceptable attendance, unsatisfactory job performance or inappropriate conduct) is a coaching session. * A coaching session is the most effective way to deal with a small problem before it becomes a bigger problem. * Contact an Employee Relations Team Member hr@lsu.edu 225-578-8200 Twitter Facebook Professional Employees & Other Academic Employees Professional and other academic employees hold their positions at the pleasure of the Board of Supervisors, except as otherwise stated in the By-Laws and Regulations of the LSU Board of Supervisors. * Supervisors considering termination or discipline of professional and other academic employees should contact Employee Relations. * Process Coaching Session First Decisional Conference Second Decisional Conference Final Decisional Conference Termination or Alternatives to Termination The Employee Contract requires Appointing Authority approval. * If an employee disagrees with the facts presented in the contract, he/she may file a grievance in accordance with PS-80. * The Appointing Authority reserves the right to place the employee on a suspension without pay or a reduction in pay in lieu of the Employee Contract or if the employee refuses to sign the contract. * The employee may also be subject to termination if he/she refuses to sign the contract. * Suspension without pay - An enforced leave of absence without pay for a specified period of time. * Suspensions without pay require Appointing Authority approval and are appealable to the Civil Service Commission. * Reduction in pay - An enforced reduction in the employee's pay normally determined by assessing the cost of a suspension and then reducing the employee's pay over several payroll periods. * The reduction in pay is a severe penalty, in that, the employee is expected to perform his/her duties but must do so for a lesser amount of pay. * Since reductions in pay are figured on base pay, both retirement contributions and over-time are figured at a lower rate of pay. * Reductions in pay are for a specific period of time. * However, no employee may be reduced in pay below the minimum/entry pay for the job title/classification he/she occupies. * Reductions in pay require Appointing Authority approval and are appealable to the Civil Service Commission. * Employee Discipline Procedures for Professional, Other Academic and Classified Employees PS-08, Revision: PS0008.R06, Effective: June, 16, 1997
Franciscan Missionaries of Our Lady Sisters[11], Franciscan Missionaries of Our Lady Health System[12] Executives and Board OLOL ORDINARIES IN PEACE AND COMMUNION WITH THE APOSTOLIC SEE[13], Louisiana State University[14] LSU Board of Supervisors[15], LSU-HSC BR Residential Program[16] Directors, Supervisors, Professors, and any whose eyes through HIPPA be authorized to read this grievance of injury and medical malfeasance ...
Mark Zielenski MD.[17], Lake physician group (NPI: 1194875625) Assistant Professor Residential Program LSU-HSC DEPARTMENT OF RESIDENTIAL PSYCHIATRY PROGRAM, BATON ROUGE CAMPUS WILL DIRECT you through a two-year curricula program--under his superintendence, and through his mentorship as beneficiary of that which FMOLHS statement calls 'the largest healthcare center in the state."
Kathleen Crapanzano, MD, MACM[18] Program Director LSU Psychiatry Residency Program-Baton Rouge 5246 Brittany Drive Baton Rouge, LA 70808 Ph: 225-757-4212 Another Catholic charitable institution worth billions of dollars, consisting of 6 LA Hospitals, and scot-free, FEDERALLY funded healthcare, EDUCATION, AND LAND DEALS, as considerations too varied to detail--all run by sisters and friars?
Of course not. (FMOLHS - OLOL) Executive Board consists of one clerical representative--the other board members are businessmen, disconnectedness in perspective of state and local business and politics -- as was their former president, convicted of embezzling throughout his term and under their nose--I wonder-- virtually a millionairess -- half that stonewashed was paid to 2 LSU football players--check to see who the coach was in 2018--as bribes--YOUR MONEY).
Remember that next time your wait in the ER is over 2 hours. I expose myself in revealing someone else, but only through personal exposure do I impel direct experience onto the Residential doctor's discretion to irrelevance. It is for you to decide as to how to-shield yourself from that which I swear true, as something no doctor has done in my 58 years of cross-section, good to bad, to never--here, now the nadir, or to disregard institutional depravity.

The tweet accumulated 29,600 likes and 4,500 retweets in 3 days.
StayHipp, Paper Mag and Junkee revealed articles on Fetch the Bolt Cutters memes ...

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The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that did not meet certain Medicare requirements.
Our objective was to determine whether hospice services provided by Franciscan Hospice (Franciscan) complied with Medicare requirements.
How OIG Did This Audit
Our audit covered 21,537 claims for which Franciscan (located in University Place, Washington) received Medicare reimbursement of $101.5 million for hospice services provided from January 1, 2016, through December 31, 2017. We reviewed a random sample of 100 claims. We evaluated compliance with selected Medicare billing requirements and submitted these sampled claims and the associated medical records to an independent medical review contractor to determine whether the services met coverage, medical necessity, and coding requirements.
What OIG Found
Franciscan received Medicare reimbursement for hospice services that did not comply with Medicare requirements. Of the 100 hospice claims in our sample, 79 claims complied with Medicare requirements. However, the remaining 21 claims did not comply with the requirements. Specifically, for 19 claims, the clinical record did not support the beneficiary's terminal prognosis, and for the remaining 2 claims, there was no documentation to support the hospice services that Franciscan billed to Medicare.
Improper payment of these claims occurred because Franciscan's policies and procedures were not effective in ensuring that the clinical documentation it maintained supported the terminal illness prognosis and the hospice services billed to Medicare. On the basis of our sample results, we estimated that Franciscan received at least $13 million in unallowable Medicare reimbursement for hospice services.
What OIG Recommends and Franciscan Comments
We recommend that Franciscan: (1) refund to the Federal Government the portion of the estimated $13 million for hospice services that did not comply with Medicare requirements and that are within the 4-year reopening period; (2) based upon the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation; and (3) strengthen its policies and procedures to ensure that hospice services comply with Medicare requirements.
Franciscan also disagreed with our use of extrapolation across the audit period.
Franciscan agreed with our second recommendation and disagreed with our first and third recommendations.
After reviewing Franciscan's comments, we maintain that our findings and recommendations are valid.
Federal regulations require that clinical information and other documentation support the beneficiary's terminal prognosis and be filed in the medical records.
In perpetuity. Le chanson morte a tue, fatalite noir de 1ere degree x 3 comorbidity.
Franciscan Missionaries of Our Lady Health System, covered entity affiliates, Our Lady of the Lake, Franciscan Missionaries of Our Lady University (FranU) and their subsidiaries comply with Federal civil rights laws discriminate ... FMOL and covered entity affiliates exclude

Louisiana Department of Justice Medicaid Fraud Unit Louisiana MFCU combat incorrect reporting of diagnoses or procedures to maximize payments; billing for services, medical supplies or equipment not furnished; misrepresentation of the dates and descriptions of services furnished, the identity of the recipient or the individual furnishing services; and billing for noncovered or nonchargeable services as covered items. discriminate against a beneficiary (e.g., prevent them from signing up for a plan based on their age, health status, race or income), entice beneficiaries to enroll in a more costly plan than they require, or erroneously - and vigorously prosecute criminals who prey
Action Details

Date:June 23, 2021

Agency:U.S. Attorney’s Office, Western District of Texas

Enforcement Types:

Criminal and Civil Actions

State False Claims Act Reviews
To qualify for the financial incentive, a State's false claims act must:
establish liability to the State for false or fraudulent claims, as described in the Federal False Claims Act (FCA), with respect to Medicaid spending;
contain provisions that are at least as effective in rewarding and facilitating qui tam actions for false or fraudulent claims as those described in the FCA;
contain a requirement for filing an action under seal for 60 days with review by the State Attorney General; and
contain a civil penalty that is not less than the amount of the civil penalty authorized under the FCA.
Since the effective date of section 1909 of the Social Security Act, the FCA has been amended by the Fraud Enforcement and Recovery Act of 2009 (FERA), the Patient Protection and Affordable Care Act (ACA), and the Dodd-Frank Wall Street Reform and Consumer Protection Act (the Dodd-Frank Act). These three acts, among other things, amended bases for liability in the FCA and expanded certain rights of qui tam relators. In addition, effective August 1, 2016, the civil penalties authorized under the FCA increased pursuant to the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. Going forward, the civil penalties authorized under the FCA will incrementally increase on an annual basis. As such, the civil penalties authorized under a State's false claims act must also increase at the same rate and time as those authorized under the FCA in order for the State to continue to receive the financial incentive.
To request a review of a false claims act, States should submit a complete copy of the law and any other relevant information to: officeofcounsel@oig.hhs.gov
OIG also strongly encourages States with draft legislation to submit their drafts for informal review and discussion before the draft legislation is passed.
Mr. Nicholas J. Diez Assistant Attorney General State of Louisiana Department of Justice P.O. Box 94005 Baton Rouge, LA 70804-9005
Dear Mr. Diez:
The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) has received your office’s request to review Louisiana’s amended Medical Assistance Programs Integrity Law, La. Rev. Stat. Ann. §§ 46:437 through 46:440, under the requirements of section 1909 of the Social Security Act (the Act). Section 1909 of the Act provides a financial incentive for a State to enact a law that establishes liability to the State for individuals and entities that submit false or fraudulent claims to the State Medicaid program. For a State to qualify for this incentive, the State law must meet certain requirements enumerated under section 1909(b) of the Act, as determined by the Inspector General of HHS in consultation with the U.S. Department of Justice (DOJ). We have determined, after consulting with DOJ, that the amended Louisiana Medical Assistance Programs Integrity Law does not meet the requirements of section 1909(b) of the Act. Section 1909(b)(1) of the Act requires the State law to establish liability for false or fraudulent claims described in the Federal False Claims Act with respect to any expenditure described in section 1903(a) of the Act. The Federal False Claims Act, as amended by the Fraud Enforcement and Recovery Act of 2009, establishes liability for, among other things, conspiring to commit a violation of another subsection of section (a)(1) of the Federal False Claims Act. See 31 U.S.C. § 3729(a). In contrast, the amended Louisiana Medical Assistance Programs Integrity Law does not establish liability for the same breadth of conduct as the Federal False Claims Act, as amended. Section 1909(b)(2) of the Act requires the State law to contain provisions that are at least as effective in rewarding and facilitating qui tam actions for false and fraudulent claims as those described in sections 3730 through 3732 of the Federal False Claims Act. The Federal False Claims Act, as amended by the Patient Protection and Affordable Care Act, provides that the court shall dismiss an action or claim under the Federal False Claims Act, unless opposed by the Government, if substantially the same allegations or transactions as alleged in the action or claim were publicly disclosed (i) in a Federal criminal, civil, or administrative hearing in which the Government or its agent is a party; (ii) in a congressional, Government Accountability Office, or other Federal report, hearing, audit, or investigation; or (iii) by the news media, unless the action is brought by the Attorney General or the person bringing the action is an original source of the information. See 31 U.S.C. § 3730(e)(4)(A). In contrast, the amended Louisiana Medical.

The Franciscan Missionaries of Our Lady Health System is one of the largest healthcare systems based in Louisiana and is the leading healthcare provider for more than half the state’s population. The health system is a non-profit, Catholic organization sponsored by the Franciscan Missionaries of Our Lady. Headquartered in Baton Rouge, Louisiana, the ministry serves patients in Louisiana and Mississippi through a network of hospitals, clinics, physicians, elderly housing and integrated systems. The health system’s unified physician organization is comprised of 900 adult and pediatric primary care physicians and specialists. The system’s nine hospitals include St. Francis Medical Center in Monroe, Our Lady of the Lake Regional Medical Center in Baton Rouge and Gonzales, Our Lady of the Lake Children’s Hospital in Baton Rouge, Our Lady of Lourdes Regional Medical Center, Heart Hospital, and Women's & Children's in Lafayette, Our Lady of the Angels in Bogalusa, and St. Dominic Hospital in Jackson, Mississippi. For more information, visit www.fmolhs.org.

Louisiana State University Residents, Meet FMOLHS OLOL LSU Board of Supervisors Mark Zielinski, MD. (NPI Number: 1194875625) Assistant Professor (LSU-HSC BR) O'DONOVAN 5131 O'donovan Dr., Suite 300 https://t.co/wBxDVnVXIN pic.twitter.com/IxgrIuEQm0

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In written comments on our draft report, Franciscan disagreed with our findings for 12 of the 19 sampled claims for which the clinical record did not support the beneficiary's terminal prognosis and said that a physician's clinical judgment is fundamental in determining that prognosis.

Southern Society for Clinical Investigation

www.ssciweb.org

Office for Civil Rights

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

hhs

1-800-368-1019

https://oig.hhs.gov/documents/false-claims-act/254/Louisiana.pdf

OFFICE OF THE LOUISIANA ATTORNEY GENERAL

Baton Rouge, LA 70802 (225) 326-6705

http://www.ag.state.la.us/

(225) 326-6210

www.ag.state.la.us

Karen Glassman

202-708-9777

Susan Gillin

202-205-9426

Read more on www.justice.gov

The Office of Inspector General (OIG), in consultation with the Attorney General, determines whether States have false claims acts that qualify for an incentive under section 1909 of the Social Security Act. Those States deemed to have qualifying laws receive a 10-percentage-point increase in their share of any amounts recovered under such laws.

I’m shocked Honore de Balzac list

noreply@blogger.com (What Gets Me Hot) — Thu, 14 Jul 2022 04:38:00 +0000

I’m shocked Honore de Balzac didn’t create the list.
But since these convoys were created from porters who carried bark baskets into that, for reasons of economy, up to four infants were placed at a time; since therefore the deathrate on the road was terribly high; since for that reason the porters were urged to convey only baptized infants and only those provided with a political candidate certificate of transport to be sealed upon arrival in Rouen; since the child Grenouille had neither been baptized nor received nonetheless very much like a name to inscribe officially on the certificate of transport; since, moreover, it might not have been propriety for the police anonymously to line a baby at the gates of the halfway house, which might have been the sole thanks to dodge the opposite formalities …
so, thanks to an entire series of officialdom and body difficulties that appeared possible to occur if the child were shunted aside, and since time was short additionally, officer La moat revoked his original call and gave directions for the boy to be handed over on written receipt to some religion establishment or different, so there they might christen him and judge his additional fate.

Nor had they asked her, even out of courtesy, why she was so pale or why she awoke with purple rings beneath her eyes in spite of the fact that she expected it, of course, from a family that had perpetually considered her a nuisance, an old rag, a booby painted on the wall, and who were invariably going around speech things against her behind her back, vocation her fictional animal, line of work her Pharisee, occupation her slick, and even Amaranta, might she rest in peace, had said aloud that she was one of those those who could not tell their rectums from their ashes, God have mercy, such words, and she or he had tolerated everything with resignation as a result of the Vicar of Christ, but she had not been ready to tolerate it to any extent further when that evil Jose Arcadio Segundo said that the damnation of the family had come back when it opened its doors to a too big for one's breeches highlander, just imagine, a high-and-mighty highlander, Lord save America, a highlander female offspring of evil spit of identical stripe because the highlanders the government sent to kill employees, you tell Maine, and he was touching on no one but her, the baby of the Duke of Alba, a girl of such lineage that she made the liver of presidents’ wives quiver, a noble dame of fine blood like her, who had the right to sign eleven dry land names and who was the only mortal creature therein town jam-packed with bastards who did not feel all confused at the sight of sixteen pieces of tableware, in order that her adulterous husband could die of laughter afterwards and say that such a big amount of knives and forks and spoons were not meant for a personality's being except for a arthropod, and also the just one WHO may tell along with her eyes closed once the vino was served and on what facet and during which glass and once the vino and on what facet and during which glass, Associate in Nursingd not like that peasant of an Amaranta, could she rest in peace, WHO thought that vino was served within the daytime and vino at the hours of darkness

and also the just one on {the WHOle|the entire|the complete|the full|the total} coast who may experience within the undeniable fact that she took care of her bodily desires solely in golden chamberpots, so commissioned military officer Aureliano Buendia, could he rest in peace, may have the audacity to raise her together with his Masonic distemper wherever she had received that privilege and whether or not she failed to shit shit however shat sweet basil, simply imagine, with those terribly words, so that Renata, her own girl, WHO through Associate in Nursing oversight had seen her stool within the chamber, had answered that though the pot was all gold and with a coat of arms, what was within was pure shit, physical shit, and worse even than the other kind as a result of it absolutely was bigheaded highland shit, simply imagine, her own girl, so she ne'er had any illusions regarding the remainder of the family, however in any case she had the correct to expect a touch a lot of thought from her husband as a result of, for higher or for worse, he was her consecrated relative her better half, her legal spoiler, WHO took upon himself of his own free and sovereign can the grave responsibility of taking her removed from her paternal home, wherever she ne'er wished for or suffered from something, wherever she wove ceremonial occasion wreaths as a interest, since her godfather had sent a letter together with his signature and also the stamp of his ring on the seal merely to mention that the hands of his godchild weren't meant for tasks of this world except to play the stringed instrument, and, yet, her insane husband had taken her from her home with all manner of admonitions and warnings and had brought her thereto cooking pan of hell wherever an individual couldn't breathe owing to the warmth, and before she had completed her Pentecostal quick he had gone off together with his wandering trunks and his wastrel’s accordion to loaf in fornication with a wretch of whom it absolutely was barely enough to check her behind, well, that’s been aforesaid, to check her wiggle her mare’s behind so as to guess that she was a, that she was a, simply the alternative of her, WHO was a girl in an exceedingly palace or a pen, at the table or in bed, a girl of breeding, pious, obeying His laws and submissive to His needs, and with whom he couldn't perform, naturally, the acrobatics and trampish antics that he did with the opposite one, who, of course, was prepared for all the world just like the French matrons, and even worse, if one considers well, as a result of they a minimum of had the honesty to place a red lightweight at their door, swinishness like that, simply imagine, which was all that was required by the sole and beloved girl of Dona Renata Argote and Don Fernando del Carpio, and especially the latter, an upright man, a fine Christian, a Knight of the Order of the Holy Sepulchre, people who receive direct from God the privilege of remaining intact in their graves with their skin swish like the cheeks of a bride and their eyes alive and clear like emeralds.

Long sentences are lovely on their own, but notwithstanding they weren’t, it pains Maine to assume that we could lose them altogether.

We have separated sentences until teens don’t savvy to punctuate a protracted sentence, so that they don’t write it.

Furthermore, they can’t browse a protracted sentence.
They literally suppose there is something wrong with it simply because it is long.

As a tutor of English, i used to be unhappy regarding the declining reading levels, however once I retired, a minimum of the readers of Jane Austen would appreciate the long sentence.
Not so.

The reading level has drastically declined.
Worse, the eye span has shrilled to the purpose that a sentence of over 10 words is scary.

Associate in Nursing, I have reviews decrying my punctuation; expression semicolons are obsolete.

I have had such a large amount of reviews calling my compound or advanced sentences run-on sentences.
I write Regency Romance and love author.

These sentences that I browse here these days warm my heart.

Moreso, my heart was warm by the very fact that I’ve found some folks that believe Maine.
You would assume that the present readers of the genre would appreciate a extended sentence.
Sadly, no.
I appreciate you.

You have made Maine feel higher when reviews that have broken my heart.
Beautiful sentences.

I propose “Gates of heaven” of Modrzejewski.

The book is formed of 2 sentences which one contain over 40000 words in original Polish version.

While it was obligatory lecture in Polish high faculties, pic adaptation was extrajudicial in 1960’s political orientation Republic of Poland in all probability attributable to some homosexual scenes (when i feel concerning it now – this can be book concerning medievial French kids, so i am unsurprised by communist censorship ban of movie).
I dare you to create Also, a stimulating alternative of words that sound like musical tones.
analytical essay with sentences this long.
So difficult, each to jot down and to browse, nevertheless therefore profitable.

Here is my contribution: a 423-characters-long sentence from “On Being Blue” by William Gass.

Proper introduction to the truthful story of Illicit Medical Evictioning by proxy through epicene delegation in such a lot of ways bearer of bad news

noreply@blogger.com (What Gets Me Hot) — Thu, 14 Jul 2022 04:02:00 +0000

Consequence of revenge expose unpleasant contingency which individuals of low-caliber transgress, whose gratuitous title, an illusion indicative of moments of prolonged sobriety, formality, disposable, high-pitch squeaking from free reign, disdain--singular to conduct themselves of no seniority.
And so proper introduction to the truthful story of illicit Medical Evictioning, by proxy, through epicene delegation, in such a lot of ways, bearer of bad news--amanuensis be.
Laws, acts, or decrees--was she sent to tramp, not justify my wrath.
Extraction, 20 minutes before Televisit, during Pandemic--at-risk person whose anamnesis included broken back.

No Continuity of Treatment offered; no supply of Medication prescribed--until I might find a replacement.
No explanation.
I waited, helping her along.
He discharged the gun.
I needed to understand what for.

Through capricious, selective mismanagement, subverting and perverting the letter and cut of his own Health Care FMOLHS OLOL-RMC, LSU, STATE OF LOUISIANA Rules of Conduct.
My conclusion: his COVID-Burnout had become so choking at the side, his worldview--had suffered drastic episode, and emerged more deteriorated than before -- that this had arisen from his being forced to regulate or exhibit tolerance, inclusiveness of race, appearance, even sexual orientation, was what I assumed had made him act with such malice.
Discounting each alternative whose tiny angle toward exclusion and distinction, in conjunction with a staff trained, ever it be, who carry indictment for milestone of managerial misconduct, Gilbertian, however, more vindictive--endemic desolate issue--no adherence to wholesome, respectful observance during years that ought to have, but sadly did not, shape those I encountered there--unconscionable events through Doctor--Nurse, unrehearsed--no corroboration, nor witness; no contemporaneous notation, nor mention, nor doodle, nor Post-It transcribed.
Result: unpunctual, dissociative dissolution and disassociation, which is "Physician Abandonment," of last-resort.
Weasel-worded bet on no one having gumption.

Failsafe Patient - Practitioner Relationship administered by construct, protected by multifarious Federal Provisions from Affordable Care to mortal troth whose Sisters of Franciscan Missionary of Our Lady Health System -- Catholic, Charitable 503-(c), FMOLH Llc.
CMS (Medicaid disbursal to massive, LSU-affiliated, half-dozen hospital prayer beads of institutions.
Hospital Hydra trod Mark Zielinski and co., LSU-HSC New Orleans at Baton Rouge OLOL Psychiatry Clinic, Residential Program, OLOL campus.
This untidy mistake cost his authority.
No court application, written order.
I asked, and to my shock, was not told.
Now through amanuensis during STAGING revival OF COVID-19.
Defying every mandate and updated mollification of strict enforcement, for the health of a Population.
In response to those whose health, or other deprivations did qualify them further eligible to garner obviation of Emergency declaration from the highest of Federal, State -- Law of the Land, Stafford Act, newly imbued separate body through Plague, and through Common Decency of two Historic Parties Opposing Force -- ALL.

All vanity who would preclude it, the physician, and whose artiodactyl vermin so played at distance, required delinquent condition, preservation of self to stay fraudulent accolades he surrounds himself, never contributes, collegial--those who publish, he does not perish--concealed in plain sight.

THE PRESIDENTIAL ORDER and ACT ISSUED STATE OF EMERGENCY whose harbingering deficit represents his literal derangement--deny it, and remove it, most obsequious its benefactor you endanger -- the very core whose ability it is for you to profit their designation -- through Constitutional Power, Internal Revenue Service Tax Exemption, Charitable institution, Proscription of Taxation through Catholic Church ... DEDICATION, and If Necessary, Removal of any of it that you instigated by Accusation, through treasonous Lies, you find yourself now unable to guarantee sufficient, as you relied on an employee for your fraud; and when that was seen shoddy surety of your safety through lies, you further inveigled your friend and colleague, Lee Tynes and Kathleen Crapanzano, whether wittingly or not, they are nonetheless as culpable for their roles, after the fact, in cover-up, and non-reporting of you to the multiple bodies and departments, likewise as scores of Federal Departments, now Prosecutors, whose only payment the Franciscan Ministry of Our lady Health, Ll c., is beholden on this Earth, which you now endanger, the full force of those organizations whose beneficence they are privileged to fulfill from a vaunted position of receiving from those whose funding do they use wholly, but on whose delicate footing you may bring them down, you will see from your censure, and I Pray, your Debarment, their station come just a little nearer to yours who put it there.
Mendacious statements in the commission of a crime -- all with the authority, nitwitted minds of low psychological feature process as the coast is obvious, where, you secluded, last person of ethical acumen, instead, imitative, gesticulate, dismissal of pathological conceit and through unauthorized.
IMMUNITY without boundary, you rival any I have encountered.
Longevity as preservation, I saw, but did not heed.
Mine were one pair of eyes too many, not on payroll, whose continuity of observation and experiential witness was enough to dampen the perverse misanthropic enjoyment any unwelcome scrutiny of such covert existence a hulled shell was one who might have once wished his career.
An actual hazing, prescribed bullying against a patient, as if by club chaperone, amid speculation -- brazenly with not the tiniest concern ought I fight.
Through repetitious encounters with the general public of whom I see from your flat affect incidents end badly if self-help justice mushrooms to all departments, once alert to it-- in all it saddens me to recall.
The day i worried, upon finding your co-specialization as active gerontology physician through what there with those poor old souls you set them through, our Mothers and Fathers, your need for control.
Their impaired cognitive capability.
Your lies concerning me through employees.
This is devolved, low to poison-- young children, and even LSU Residents.
I have known your kind as currently infects pernicious, perpetual campaign of retaliation, even to staff.
Converted requirement, you obviate -- intellect disallows reason.
If what has been told were true, no matter.
I knew that this distinct place from which to maneuver while difficult, I would all the same, as raised to face principle, if falsely suspect or maliciously blasted, to disavow and ignore, or fight, and to never alter once challenged.
Force that from which I had properly, a right to possess.
I question, however, how I lose this one.
Three, one too many strikes to not strike back ...
The last word, occasion to express me out of the building has done a final affront.
For the third time in a matter of two months, through bluster, racism, or sadistic enjoyment of constructive endeavor to dominate me absolutely by no authority.
Through intimidation, and on the face of it, only for amusement, dirty deeds thrill, and in presenting narration -- laugh loudly in a very state.
And every one of the same employees, as I walk by, never a pause, nor interruption did my presence cause.
XXXXXXXXXXXXXXXXXXXXX
Physician Abandonment by Termination of Treatment through a campaign of ethically Prohibited failure of Process through Lying, in RETRIBUTION, ENLISTING COLLEAGUES above him at Clinic (where those Residents will do the majority of their practical participation in their program), under his immediate tutelage.Code of Medical Ethics Opinion 1.2.2 The relationship between patients and physicians is based on trust and should serve to promote patients’ well-being while respecting their dignity and rights.Disrespectful or derogatory language or conduct on the part of either physicians or patients can undermine trust and compromise the integrity of the patient-physician relationship.It can make members of targeted groups reluctant to seek care, and create an environment that strains relationships among patients, physicians, and the health care team.Trust can be established and maintained only when there is mutual respect.Therefore, in their interactions with patients, physicians should: Recognize that derogatory or disrespectful language or conduct can cause psychological harm to those they target.Always treat their patients with compassion and respect.Terminate the patient-physician relationship with a patient who uses derogatory language or acts in a prejudicial manner only if the patient will not modify the conduct.In such cases, the physician should arrange to transfer the patient’s care.

AMA Principles of Medical Ethics: I, II,VI, IX • Hire the right people.

FMOLHS OLOL Physician Group Zielinski 'lemondropped' Medicaid beneficiary in COVID PHE defying Federal, State, Local Involuntary Disenrollment Moratoria Act for any reason--Blackballed and Dismissed and Denied Treatment by 2 more providers, while never offered Due Process or Appeal - Medical Record Locked - Ignored in Silence Never Contacted by ANY physician, administrator, nor executive (including my cousin) I was Referred for Cancer Biopsy - I thought I MIGHT receive Care: After 1 week No Contact I have Appointment ... in 1 month--FOR CANCER

noreply@blogger.com (What Gets Me Hot) — Thu, 09 Jun 2022 19:08:00 +0000

Continuity of medication between mental health providers (MHPs) and primary care providers (PCPs) after a new consultation
bMedication groups: hypnotic-benzodiazepine, alprazolam, buspirone, clonazepam, diazepam, lorazepam, triazolam, zaleplon, and zolpidem; dementia medications, donepezil, rivastigmine, and memantine; antidepressants, amitriptyline, bupropion, citalopram, doxepin, duloxetine, escitalopram, fluoxetine, mirtazapine, nortriptyline, paroxetine, sertraline, trazodone, and venlafaxine; antipsychotic and related, aripiprazole, benztropine, haloperidol, olanzapine, perphenazine, quetiapine, risperidone, thiothixene, and ziprasidone Appealing Treatment and Reimbursement Denials Appeal Strategies The APA recommends the following: 1.
Request and review a copy of the MCO’s appeals procedures and utilization review (UR) criteria before initiating any appeals.
2.
Ask for the case manager’s credentials.
Denials of psychiatrists services should be made only by psychiatrists.
3.
Request written notification of the reasons for denial and a description of the information required for approval.
This will ensure that subsequent submissions “fit the bill.” 4.
Request names and addresses of the people who should receive applications for an appeal and find out the MCO’s deadline for appeals.
5.
Meet all UR and appeal deadlines.
If you do not, the merits of your case may not matter.
Certification denials due to “administrative noncompliance” are rarely overturned.
If the case is denied on an administrative basis (i e , a request for continued certification was not made within the specified time, precertification procedures were not followed, or there were benefit coverage exclusions), you’ll need to explain any extenuating circumstances in your appeal.
6.
If your appeal is denied, appeal again.
Many companies offer three or four levels of appeal.
It is advisable to exhaust all levels of appeal before initiating litigation, should you be forced to proceed that way.
7.
Be concise.
Don’t send more information than necessary and be sure to get permission from your patient to release that information.
8.
Request peer review with a psychiatrist trained in the same subspecialty who has experience in the treatment requested.
9.
In an emergency situation, request an “expedited appeal” over the telephone with the consulting psychiatrist.
Most MCOs have such services.
10.
If applicable, ask the patient to enlist the support of his or her Personnel/ Human Resources Department.
MCOs are often more responsive to their paying clientsscomplaints than to complaints from physicians.
11.
In cases that are slow to respond to standard treatments, ask the company to “flex benefits” by working with you to find a cost-effective, alternative treatment approach.
12.
If coverage is denied after appealing, some companies may allow you to request an external review of the case with or without some cost-sharing.
13.
In truly egregious cases, copy your appeal to the state insurance commissioner.
Seeing such a “cc” may elicit a more rapid and favorable response.
14.
Contact any professional association you belong to and any consumer advocacy groups that may be helpful.
A complaint lodged by several parties will be stronger.
Letter of Appeal The following are some suggestions for inclusion in a letter of appeal: • Include any literature that supports your case, including references to the APA’s practice guidelines.
This may help convince the reviewer that the proposed treatment will result in the desired outcome.
• Be candid about the patient’s condition.
Describe any changes in diagnosis, comorbidities, progression, or regression of the patient’s condition; special treatments such as suicide restraints and seclusion; neurological testing and other medical tests; medications; and any self-injury or assaultive behavior.
• Clearly relate the level of care requested to the patient’s condition.
Information should be based on objective reasoning, not just opinion.
• Describe the next step of treatment, providing goals and an approximate time frame for the completion of treatment.
This will promote the idea that you have an action-oriented approach.
• If applicable, recommend alternative treatments for the patient.
• Present evidence of similar cases where the care was approved by the same plan.
• Appeal with a collaborative spirit.
If you need further assistance, call the APA Practice Management HelpLine at (800) 343-4671.
Independent Review Organizations (IROs) Most states have enacted independent review laws that require disagreements over what constitutes a health plan coverage to be decided by a review done by a medical expert or panel of medical experts who have no affiliation with the health plan.
Laws vary from state to state as to whether the review decisions are binding, but they are in most states.
Currently, approximately 50 percent of the disputes taken to independent review result in the reversal of a coverage denial.
An independent, external review, however, can only be accessed after the internal appeals process established by individual MCOs has been completely exhausted.
Although independent reviews have been around for years, there is still a lack of public awareness about the process, and patients generally do not take advantage of the reviews despite claims denial letters that inform them about their availability.
In 2005 the Kaiser Family Foundation published a guide to handling health plan disputes that provides specific information about how to access the independent review organizations in each state that has mandated the independent review process.
This document still has valuable information.
It can be downloaded at handling-disputes-with-your-employer-or-private-health-plan/ .
The APA encourages patients, and their physicians, to take advantage of this vehicle for resolving disputes that arise in obtaining appropriate mental health care.
Mental Health and Substance Use Disorder Insurance Coverage and Model Legislation APA has created parity-implementation legislation for all 50 states and the District of Columbia.
The legislation is designed to require transparency and accountability from insurers and state regulators.
Each state has legislation that is tailored specifically for that state's terminology and formatting.
Overview of Mental Health and Substance Use Disorder Parity State Model Parity Legislation Adapted to All 50 States and the District of Columbia Comprehensive State Model Parity Legislation for Each State Model Parity Legislation Addressing Insurer Reporting Requirements Model Parity Legislation Addressing Commissioner Implementation Requirements Model Parity Legislation Addressing MAT Coverage Provisions Contact APA's Department of Government Relations Team Overview of Mental Health and Substance Use Disorder Parity President George W Bush signed the Mental Health Parity and Addiction Equity Act into law on October 3, 2008.
The Act was sponsored by Congressman Patrick J Kennedy (D RI).
Parity as a concept is very simple: insurance coverage for mental health and substance use disorder care should be no more restrictive than insurance coverage for any other medical condition.
However, the Federal Parity Law is very complex, and implementation of the law can be challenging.
Insurers have done a very good job of coming into compliance with some of the more straightforward components of the law, such as making sure copays and visit limits for mental health and addiction care are no more restrictive than they are for other medical care.
how long is too long for a cancer biopsy
However, insurers are likely not complying with some of the more complicated components of the law, albeit unintentionally.
Many of these trouble spots relate to how insurers design and apply their managed care practices, such as prior authorization requirements, step therapy, and requirements for providers to join an insurer's network.
Often, insurers design and apply these managed care techniques in ways that are more restrictive for mental health and substance use disorder treatment than for other medical treatment, which violates the Federal Parity Law and can lead to deaths from suicides, overdoses and other forms of preventable death.
States have primary enforcement authority over insurers that sell health insurance policies in their states.
While there is growing interest by state insurance departments to implement the law and increasing willingness by insurers to submit data to regulators demonstrating compliance, there is much uncertainty about how to do so in an efficient manner that meets the tests of the law.
This legislation provides a roadmap for how insurers and regulators can secure compliance without undue administrative burden.
First, the legislation establishes reporting requirements for insurers to demonstrate how they design and apply their managed care tactics, so regulators can determine if there is compliance with the law.
Second, the legislation specifies how state insurance departments can implement parity and then report on their activities.
And third, the legislation eliminates some managed care barriers to medication-assisted treatment for substance use disorders.
While those provisions are not purely parity requirements, they can be a vital tool in combating the opioid epidemic.
Top State Model Parity Legislation Adapted to All 50 States and the District of Columbia One of the American Psychiatric Association's major legislative goals is to achieve mental health parity and parity enforcement across the country.
To that end, model parity legislation has been specifically adapted for each state, amending the appropriate sections of state code or creating new sections in the right titles or chapters.
This model legislation also uses the correct terminology for MH/SUD used in each state, the correct terminology for health insurers, and the right terminology for the insurance commissioner.
Additionally, each bill is formatted exactly as bills are drafted in that state.
There are four versions for each state: one comprehensive bill and then three smaller bills that are each of the components of the comprehensive bill (addressing insurer reporting requirements, addressing commissioner implementation requirements, or addressing MAT coverage provisions).
This allows each state to address the needs within that state, such as pursuing an incremental strategy or the comprehensive model legislation.
Please find the different versions for each state below.
Top Comprehensive State Model Parity Legislation for Each State This is the comprehensive version of the state model parity legislation, which includes provisions for insurer reporting requirements, commissioner implementation requirements, and addressing MAT coverage provisions.
Find your state's comprehensive model parity legislation Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Top Model Parity Legislation Addressing Insurer Reporting Requirements This version of the model parity legislation is the section that only addresses insurer reporting requirements.
Contact APA's Department of Government Relations Team For more information on how your state can get involved in advancing mental health parity, please contact APA Director of Government Relations Erin Berry Philp at ephilp@psych.org
[Date] [Name and mailing address of payer] To Whom It May Concern: I have been seeing [patient name] since [provide date care began] to treat his/her [provide diagnoses, and any problems this may cause in patient’s life if applicable.
For example: Anxiety that has limited her ability to fulfill her duties at work].
[Provide a chronology of the patient’s treatment and explain why you need to either continue or initiate the denied care.
If the company is denying the frequency of care, the chronology will provide an example of how patient decompensated when care was provided with less frequency.
If the denial is for a medication, provide a history of prescribing and explain why you have come to the decision that it’s necessary to either continue or initiate treatment with the denied drug.
Explain any of the patient’s stated concerns/preferences that influenced your decision.
Be sure to provide examples of what might occur if care continues to be denied and how this would be detrimental to the patient’s health.
Always be as specific as you can.] I have attached articles that support provision of this care to [patient name].
[if you can find literature to support the care that is being denied, this can be a very valuable asset.
The APA’s Practice Guidelines can be a good source for support since most insurers say they use them in developing their treatment guidelines.] Sincerely, [Name and contact information]
A Key Acronyms The following abbreviations are used in this Guide, and are defined in the glossary or within the text: ACA—The Patient Protection and Affordable Care Act (see also PPACA) AHP—Association Health Plan CMS—U S Centers for Medicare and Medicaid Services COC—Certificate of Coverage DOL—U S Department of Labor EAP—Employee Assistance Program EHBs—Essential Health Benefits EOB—Explanation of Benefits EOC—Evidence of Coverage EPO—Exclusive Provider Organization ERISA—Employee Retirement Income Security Act of 1974 FDA—U S Food and Drug Administration FEHB Program—Federal Employees Health Benefits Program FFS—Fee-for-Service FR—Financial Requirement HDHP—High Deductible Health Plans HHS—U S Department of Health and Human Services HIPAA—Health Insurance Portability and Accountability Act HMO—Health Maintenance Organization HSA—Health Savings Account IOP—Intensive Outpatient Program IRO—Independent Review Organization MBHO—Managed Behavioral Health Organization MEWA—Multiple Employer Welfare Arrangement Plans MH/SUD—Mental Health and Substance Use Disorders MHPAEA—The Mental Health Parity and Addiction Equity Act of 2008, also known as the Federal Parity Law NQTL—Non-Quantitative Treatment Limitation PCP—Primary Care Provider PHP—Partial Hospitalization Program PPACA—The Patient Protection and Affordable Care Act (see also ACA) POS—Point of Service PPO—Preferred Provider Organization QTL—Quantitative Treatment Limitation SBC—Summary Benefits and Coverage SPD—Summary Plan Description TPA —Third Party Administrator UCR—Usual, Customary and Reasonable UM—Utilization Management Call to Action: Ten Steps A lthough many success stories exist where a patient or ordering provider’s appeal was handled in a timely and efficient manner by a health plan, those cases are the exception and not the norm.
The good news is that the building blocks to achieve true parity implementation are now in place, but more remains to be done.
The following ten steps will advance mental health parity by improving the appeals process for all: 1.
Increase Awareness of the Appeal Process.
The appeals process is enormously complex.
Many individuals do not know they have the right to file an appeal upon receiving an adverse benefit determination.
Health plans and regulators should work together to ensure that all enrollees are aware of their rights through targeted public education campaigns.
Regulators should also reinforce health plans parity disclosure requirements and make clear that in both internal and external appeals, a parity violation is grounds for reversal of a coverage denial.
2.
Promote More Due Process and Transparency.
When an adverse benefit determination or denial takes place, more transparency must be provided surrounding how the decision was made and documented.
At a minimum, health plans must disclose the clinical and/or coverage criteria used in the decision and clearly explain the specific steps required to file an appeal.
Regulators should also enforce requirements that denial letters include a detailed explanation of why the patient does not meet the plan’s clinical criteria, a description of the evidence reviewed by the plan, and address evidence submitted by the patient or their provider.
Otherwise, consumers cannot avail themselves of their appeal rights.
Filing An Appeal Based On a Parity Violation The Kennedy Forum • 3.
Allow Attending Providers and other Advocates to File Appeals.
In some instances, ordering or attending providers are not allowed to file an appeal on behalf of their patients.
This is counterintuitive and inefficient as the provider is often in the best position to understand the denial decision and then explain why the service or treatment is still recommended or why the care was already delivered.
Providers also have a “leg-up” as they are familiar with the medical jargon used in the denial letter or throughout the appeals process.
4.
Simplify the Appeals Process.
Many patients and ordering providers complain that too many bureaucratic hurdles and inconsistent requirements exist within the appeals process.
These obstacles have a chilling effect that discourages patients or their representatives from filing an appeal.
Originally, the appeals process made clear that utilization management (UM) appeals handled medical necessity or clinical denials, and grievance procedure appeals handled administrative denials.
Today, model laws from the National Association of Insurance Commissions (NAIC) and many jurisdictions have issued regulations that have eroded this formerly clear bifurcation.
We recommend that one integrated and streamlined appeals process apply no matter the basis of the initial denial.

5.
Standardize the Appeal System Across Market Segments and State Lines.
A national and consistent standard must be implemented to make the appeals process effective.
At present, many different appeal pathways exist.
These pathways vary based on how the health plan is regulated, the type of coverage provided, the type of plan sponsor, the jurisdiction,

the type of denial (e g , based upon a medical necessity or benefit determination), the timing of the denial (e g , prospective, concurrent and retrospective), the urgency of the care being requested (i e standard care versus urgent care), and where the patient is in the appeals process.
Our goal should be to establish one national appeals standard that promotes transparency, fairness and due process to all parties involved.
We can accomplish this unified system through new model legislation, accreditation standards and Requests for Proposal (RFP) requirements.
6.
Upgrade the External Review Appeals Process.
Currently, the patient or their authorized representative must specifically request an external review of their claim.
In most cases, the external review appeal only can be pursued after a patient first successfully completes an appeal through the health plan.
In some instances, the aggrieved party may not even know they have the right to appeal to an external party.
One simple way to address this confusion is to automatically refer the appeal to an independent review organization after the internal appeal is completed.
For example, Medicare beneficiary appeals are automatically referred to the external review level, resulting in more due process.
Filing An Appeal Based On a Parity Violation
The Kennedy Forum • In addition, the external review process as currently regulated should be re-examined and potentially upgraded to better protect consumers.
Ideas include: n Reviewer Identification.
In many cases, the patient does not know who made the final ruling during the external review.
Should the identity of the external reviewer be revealed or remain anonymous? Does due process require the person making the judgment to be disclosed like a judge in court? The Kennedy Forum recommends that the identity of the reviewer be routinely disclosed.
n Public Disclosure of Decisions.
In some states, regulators post de-identified external appeal decisions on their websites, a practice that allows consumers and providers to understand the types of issues being sent to external appeals, how external decisions are made, and to identify trends (such as frequent overturns of denials of coverage for specific treatments).
Greater disclosure of external appeal decisions would benefit individual consumers and help frame dialogue with health plans regarding practices that should be reformed.
n Payment.
In most cases, health plans contract with two or more external review organizations to handle the external reviews of their insured population.
Does the external review organization have an incentive to rule in favor of the health plan if the health plan also is paying for the cost of the external review? Should the patient’s health plan pay for the external review? Or should it be funded by a government agency or through some sort of fund supported by all health plans in a particular jurisdiction? The Kennedy Forum recommends that some sort of payment system be set up through the local jurisdiction rather than through the health plan to avoid any perceived or real conflicts of interest that might bias the external review decision in favor of the health plan.
Exhausting Internal Review.
Should the patient or their advocate always have to exhaust the health plan internal appeals process before filing an external appeal? Should the patient have the right to skip right to external review? The Kennedy Forum recommends that the patient be permitted to skip the internal UM appeals process and go right to external review if that is their decision.
However, once this decision is made, the patient or their advocate loses the right to use the health plan’s internal appeal system for that particular issue under dispute.
Filing An Appeal Based On a Parity Violation The Kennedy Forum • 7.
File More Appeals.
While working to lower the number of denials issued on claims, stakeholders should simultaneously work to ensure that every questionable denial is subjected to the appeals process so that enrollees receive the care they are entitled to.
Each stakeholder group should do the following to promote the filing of appeals: n Consumer/Provider.
Every patient who has experienced a denial or care restriction of mental health or addiction services should file a complaint at and/or with the applicable government agency.
Filing a complaint will help us develop comprehensive data to better understand the different types of parity denials.
Industry.
When an appeal is filed, health plan personnel must make a good faith effort to respond in a timely and meaningful manner.
Health plans and medical management organizations must ensure they are complying with existing regulations and the patient’s plan documents on how these appeals should be processed (e g , timeframes, disclosure requirements).
n Policymakers/Regulators.
Policymakers and public officials must ensure they enforce existing state and federal regulations on how appeals should be filed and processed.
In addition, the current regulatory and accreditation requirements should be updated to create a more efficient and effective appeals process for all parties.
8.
Leverage Technology to Improve the Efficiency of the Appeals Process.
Much like TurboTax has helped tax filers, it is time to leverage technology to promote a more efficient appeals process.
All too often, the appeals process is still paper-based or otherwise very fragmented.
While is one step in the right direction, more can be done.
9.
Update Regulatory Oversight Mechanisms.
It is time to update regulations to capture recent trends in how best to monitor and promote the appeals process.
This could include updating the model laws, regulations and accreditation standards covering utilization management, grievance procedures, external review and mental health parity compliance, both at the federal and state levels.
It also could include promoting value-based and outcome measures.
Regulations need to keep pace with changes in health care delivery, technology capabilities, and communication platforms.
Filing An Appeal Based On a Parity Violation The Kennedy Forum • 10.
Promote Advocacy and Sponsor Education Programs.
States should sponsor and subsidize experts who can help patients understand, file, and process appeals by creating consumer advocate offices, like the Office of the Health Care Advocate in Connecticut or Health Law Advocates in Massachusetts.
Regulators and health insurers can support this effort through customer service lines, supplemental educational programs, broker materials and other resources that are specific to their agency or plan.
These agencies should also actively connect consumers interested in filing an appeal with non-profits capable of supporting individuals throughout the process.
Final Thoughts The appeals process, especially for parity violations, remains a complex and confusing system for most stakeholders.
It is time to rethink and improve on existing appeal systems with an eye towards making the appeals process more efficient, transparent and meaningful.
The impact of doing so will be meaningful for individuals—and their families—who need and deserve care and are entitled to services.
For more information on this topic, contact Garry Carneal, JD, Senior Policy Advisor, The Kennedy Forum, at info@thekennedyforum.org. See also Organize Your Materials What papers do I need? Keep copies of all information related to your claim and the denial.
This includes information your insurance company provides to you, and information you provide to your insurance company, such as: The Explanation of Benefits (EOB) forms or letters showing what payment(s or service(s were denied A copy of the request for an internal appeal that you send to your insurance company Any additional information you send to the insurance company (such as a letter or other information from your doctor) A copy of any letter or form you are required to sign, if you choose to have your doctor or anyone else file an appeal for you.
Keep a diary of phone conversations you have with your insurance company or your doctor that relate to your appeal (include the date, time, name, and title of the person you talked to, as well as details about the conversation) Keep your original documents and submit copies to your insurance company.
You will need to send your insurance company the original request for an internal appeal, and your request to have a third party (such as your doctor) file an internal appeal for you.
Make sure you keep copies of all documents for your records.
What kinds of denials can be appealed? You can file an internal appeal if your health plan won’t pay some or all of the cost for health care services you believe should be covered.
The plan might issue a denial because: The benefit is not offered under your health plan Your medical problem began before you joined the health plan You received health services from a health provider or facility that is not in your health plan’s approved network Your health plan determines the requested service or treatment is “not medically necessary” Your health plan determines the requested service or treatment is an “experimental” or “investigative” treatment You are no longer enrolled or eligible to be enrolled in a health plan Your health plan revokes or cancels your coverage, going back to the date you enrolled, because the insurance company claims you gave false or incomplete information when you applied for coverage The Kennedy Forum @kennedyforum Followers you know Followers Following See new Tweets Followers you know American Psychological Association @APA With more than 121,000 members, the American Psychological Association (APA) advances psychological science to promote health, education and human welfare.
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This is an archive of an Obama Administration account maintained by the National Archives and Records Administration (NARA)udge Jackson appointed the Southern Poverty Law Center, National Health Law Program, National Center for Law and Economic Justice, Disability Rights Louisiana, and O Melveny & Myers, LLP as legal counsel for the class.
The class counsel would like to hear from you if you believe you are a class member or you are impacted by this lawsuit.
If you or a child in your care is a Medicaid recipient under age 21 who has been unable to get Medicaid home or community-based mental health or behavioral health services, please contact the Southern Poverty Law Center at: or 1-800-358-2337.
LA Health Care Services Division Agency Description The LSU Health Care Services Division (LSU HCSD) includes Executive Administration and General Support (Central Office) and six (6) hospitals that have entered into cooperative endeavor agreements (CEA) for public-private partnerships and the Lallie Kemp Regional Medical Center.
The six hospitals that currently have CEAs are the Earl K Long Medical Center, University Medical Center, W O Moss Regional Medical Center, Washington-St.
Tammany Regional Medical Center, Leonard J Chabert Medical Center, and the Medical Center of Louisiana at New Orleans LSU A M LSU Agricultural Center LSU Alexandria LSU Eunice LSU Shreveport LSU Health Sciences Center, New Orleans LSU Health Sciences Center, Shreveport LSU Pennington Biomedical Research Center The Hospital and Central Office of the LSU Health Care Services Division Commitment authorizations for $1,964,876,382 LA Health Care Services Division Lallie Kemp Regional Medical Center HCSD - 8 Executive Budget Supporting Document [FY 2016-2017] DHHS Centers for Medicaid and Medicare Services online survey, certification and reporting database.
Medicare metrics tied to reimbursement.
Clinical quality measures hospitals submit patient record data MyQualityNetís (Hospital Consumer Assessment of Healthcare Providers and Systems) HCAPHS survey.
experiences with medical, surgical, or maternity care quarterly benchmark ourselves against other similar hospitals towards meeting national standards of care, maintaining patient safety, providing quality care, efficient use of federal and state budgeted resources.
An emergency room visit is an immediate treatment of treated by ER staff/associates to be counted as an ER visit.
ED visits include ER visits (ED Encounters) plus ER admits.
Patient satisfaction The Myers Group Centers for Medicare and Medicaid Services (CMS) approved vendor, and is summarized in overall rating of hospital and willingness to recommend hospital.
It should be noted that CMS' patient satisfaction survey is a standardized instrument which measures inpatient care across the United States.
The LSU Health System is working with the University Healthsystem Consortium to further define performance indicators and peer group comparisons.
Patient satisfaction is measured using The Myers Group, a Centers for Medicare and Medicaid Services (CMS) approved vendor, and is summarized in overall rating of hospital and willingness to recommend hospital.
LSU-HCSD has set its performance standards above the state, national and west south regional averages.
LSU-HCSD will follow the CMS rules for reporting; which represents data from a prior quarter being reported due to timing 1: the several campuses as defined below (Sec.
2B).
The President and the academic officers of the University 2: fulfill the duties of the faculty.
The Board, the President, and the Chancellors will rely on those elected 3: which, in the judgment of the Chancellor, or of the President, is administrative or which seriously affects 4: or of the University itself, may be suspended by the President and such action shall be reported to the Board 5: or, for LSU or in inter-campus situations, by the President.
4.
Meetings.
Each faculty, or its representative 6: for that purpose may be called at the request of the President as chair or of the Chancellor of the campus or, 7: shall be given.
It shall be the prerogative of the President to preside; otherwise, the Chancellor of the 8: officer concerned, shall be reported to the President.
The President may then refer any such action on 9: concerned, shall be reported to the President.
The President may then refer any such action on academic 10: the several campuses as defined below (Sec.
2B).
The President and the academic officers of the University 11: fulfill the duties of the faculty.
The Board, the President, and the Chancellors will rely on those elected 12: which, in the judgment of the Chancellor, or of the President, is administrative or which seriously affects 13: or of the University itself, may be suspended by the President and such action shall be reported to the Board 14: or, for LSU or in inter-campus situations, by the President.
a Minutes of all actions taken by the faculties 15: officer concerned, shall be reported to the President.
The President may then refer any such action on 16: concerned, shall be reported to the President.
The President may then refer any such action on academic 17: purpose may be called at the call request of the President as chair or of the Chancellor of the campus or, 18: shall be given.
It shall be the prerogative of the President to preside; otherwise, the Chancellor of the 19: officer concerned, shall be reported to the President.
The President may then refer any such action on 20: concerned, shall be reported to the President.
The President may then refer any such action on academic 21: that should be brought to the attention of the President and Board 5.
An explanation of any significant 22: to the reporting format will be approved by the President with notification to the Board.
ARTICLE I ACADEMIC AND ADMINISTRATIVE ORGANIZATION Section 2.
Academic Organizational Units A The Faculty of the University The faculty of the University shall consist of the faculties of the several campuses as defined below (Sec.
2B).
The President and the academic officers of the University shall be members of the University faculty and the former shall be its highest officer.
B The Faculties of the Several Campuses 1.
Membership.
Full-time members of the academic staff having the rank of Instructor or higher (or equivalent ranks) shall constitute the faculty of the campus on which they are appointed.
As a class, part-time members of the academic staff having the rank of Instructor or higher (or equivalent ranks) may be enfranchised to the degree deemed appropriate by the faculties of the several campuses.
2.
Duties.
Under the Constitution of the State of Louisiana, the Board of Supervisors of Louisiana State University and Agricultural & Mechanical College has the authority to organize and manage the university.
The Board authorizes the general body of the faculty, or its representative body, to establish curricula, fix standards of instruction, determine requirements for degrees, make recommendations for the granting of degrees through its respective colleges or schools not within a college and generally determine educational policy, subject to the authority of the Board.
Except as otherwise provided, each faculty shall establish its own educational policies.
The Board authorizes the faculty to establish admissions criteria for graduate and professional programs, however, standards for undergraduate admission to the University shall be approved by the Board.
3.
Faculty Representative Body.
Except as otherwise provided, the faculty of each campus shall establish its own governance policies.
The faculty may establish one representative body, such as a Senate or committee, to represent the will of the faculty and exercise legislative power to conduct its own meetings and fulfill the duties of the faculty.
The Board, the President, and the Chancellors will rely on those elected representative bodies as the voice of the general faculty.
Any action a faculty representative body which, in the judgment of the Chancellor, or of the President, is administrative or which seriously affects the interests of faculty of the University or of the University itself, may be suspended by the President and such action shall be reported to the Board at its next meeting.
All questions of jurisdiction among colleges, schools not within colleges, or divisions shall be determined by the Chancellor, or, for LSU or in inter-campus situations, by the President.
4.
Meetings.
Each faculty, or its representative body, shall meet at least once each academic year.
For the purpose of replacing or reconstituting the representative body, a meeting of the general faculty for that purpose may be called at the request of the President as chair or of the Chancellor of the campus or, for LSU, the President’s designee, as vice-chair, or upon the written request of 50 members or 20 percent of the membership, whichever is the fewer.
The written request must be received within a 14-day period from the time of original solicitation.
At least five days notice of meeting shall be given.
It shall be the prerogative of the President to preside; otherwise, the Chancellor of the campus or, for LSU, the President’s designee, will preside.
Minutes of all actions taken by the representative bodies, together with appropriate recommendations of the major administrative officer concerned, shall be reported to the President.
The President may then refer any such action on academic matters of general University concern to the appropriate council, or a committee thereof, for consideration.
1.
Quorum.
Not less than 25 percent of the membership of the faculty or Faculty Council shall be necessary to constitute a quorum, provided, however, that any faculty or Faculty Council (at a meeting at which a quorum of 25 percent of the members is present) may, by majority vote, establish a higher percentage of the membership as a quorum for future meetings.
BE IT FURTHER RESOLVED, the Board does hereby amend Article V Section 12B of the Regulations approved on August 6, 2021 to read: Article V Section 12 a Consolidated Financial Report (the annual financial report shall suffice as the report for the second-half of the year) NOW BE IT FURTHER RESOLVED, the revised Regulation adopted on September 10, 2021 will be effective on September 13, 2021.
BE IT FURTHER RESOLVED, the Secretary is authorized to make technical adjustments for the appropriate and accurate codification of these Rules and Regulations.
REGULATIONS OF THE BOARD OF SUPERVISORS ARTICLE I ACADEMIC AND ADMINISTRATIVE ORGANIZATION Section 1.
Order of Communications and Reports The official recommendations and communications of any member of the academic or nonacademic staff shall be sent through channels to the appropriate officer.
An administrative officer shall, when so requested, promptly transmit any such recommendations or communications, with the officer's own comments and recommendations thereon, to the next higher office.
Section 2.
Academic Organizational Units A The Faculty of the University The faculty of the University shall consist of the faculties of the several campuses as defined below (Sec.
2B).
The President and the academic officers of the University shall be members of the University faculty and the former shall be its highest officer.
B The Faculties of the Several Campuses 1.
Membership.
Full-time members of the academic staff having the rank of Instructor or higher (or equivalent ranks1) shall constitute the faculty of the campus on which they are appointed.
The faculty may organize itself into a Faculty Council which shall include all full-time members of the faculty and members of the Administrative Council (see sec.
1-3.1). As a class, part-time members of the academic staff having the rank of Instructor or higher (or equivalent ranks) may be enfranchised to the degree deemed appropriate by the faculties of the several campuses.
Members of the Administrative Council, not holding academic rank, shall be non-voting members of the Faculty Council.
2.
Duties.
Under the Constitution of the State of Louisiana, the Board of Supervisors of Louisiana State University and Agricultural & Mechanical College has the authority to organize and manage the university.
The Board authorizes the general body of the faculty, or its representative body, Faculty Council2 shall to establish curricula, fix standards of instruction, determine requirements for degrees, make recommendations for the granting of degrees through its respective colleges or schools not within a college and generally determine educational policy, subject to the authority of the Board.
Except as otherwise provided, each faculty shall establish its own educational policies.
It shall, within the framework of the educational policy of the University, have legislative power over all matters pertaining to its own meetings and may delegate its own authority to an elected Senate and/or to standing committees, whose authority shall be limited to matters which are proper to the faculty and which have been specifically delegated by the faculty.
It shall make recommendations for the granting of degrees through its respective colleges or schools not within a college.The Board authorizes the faculty to establish admissions criteria for graduate and professional programs, however, standards for undergraduate admission to the University shall be approved by the Board.
1See Section 2-6.
2The terms faculty and Faculty Council are used interchangeably in this Section (2).
3.
Faculty Representative Body.
Except as otherwise provided, the faculty of each campus shall establish its own governance policies.
The faculty may establish one representative body, such as a Senate or committee, to represent the will of the faculty and exercise legislative power to conduct its own meetings and fulfill the duties of the faculty.
The Board, the President, and the Chancellors will rely on those elected representative bodies as the voice of the general faculty.
Actions.
Any action of a faculty or Faculty Council which faculty representative body which, in the judgment of the Chancellor, or of the President, is administrative or which seriously affects the interests of another faculty of the University or of the University itself, may be suspended by the President and such action shall be reported to the Board at its next meeting.
All questions of jurisdiction among colleges, schools not within colleges, or divisions shall be determined by the Chancellor, or, for LSU or in inter-campus situations, by the President.
a Minutes of all actions taken by the faculties or Faculty Councils, together with appropriate recommendations of the major administrative officer concerned, shall be reported to the President.
The President may then refer any such action on academic matters of general University concern to the appropriate council, or a committee thereof, for consideration.
4.
Meetings.
Each faculty, or its representative body, or Faculty Council shall meet at least once each academic year.
For the purpose of replacing or reconstituting the representative body, a meeting of the general faculty for that purpose may be called at the call request of the President as chair or of the Chancellor of the campus or, for LSU, the President’s designee, as vice-chair, or upon the written request of 50 members or 20 percent of the membership, whichever is the smaller number fewer.
The written request must be received within a 14-day period from the time of the original solicitation.
At least five days notice of meeting shall be given.
It shall be the prerogative of the President to preside; otherwise, the Chancellor of the campus or, for LSU, the President’s designee, will preside.
Minutes of all actions taken by the representative bodies, together with appropriate recommendations of the major administrative officer concerned, shall be reported to the President.
The President may then refer any such action on academic matters of general University concern to the appropriate council, or a committee thereof, for consideration.
5.
Quorum.
Not less than 25 percent of the membership of the faculty or Faculty Council shall be necessary to constitute a quorum, provided, however, that any faculty or Faculty Council (at a meeting at which a quorum of 25 percent of the members is present) may, by majority vote, establish a higher percentage of the membership as a quorum for future meetings.NOW, THEREFORE, BE IT RESOLVED that the Board of Supervisors of Louisiana State University and Agricultural & Mechanical College does hereby approve the operating budget for the fiscal year ending June 30, 2022, providing: (a Final approval and commitment authorization of funds for unrestricted educational and general, medical, and related expenses in the amount of $1,190,016,205 for the campuses shown below.
LSU A M LSU Agricultural Center LSU Alexandria LSU Eunice LSU Shreveport LSU Health Sciences Center, New Orleans LSU Health Sciences Center, Shreveport LSU Pennington Biomedical Research Center The Hospital and Central Office of the LSU Health Care Services Division (b Commitment authorizations for auxiliary enterprises, grants and contracts, and other restricted funds estimated to be $1,964,876,382.
(c Transactions included or referred to in the operating budget that otherwise require Board approval are not approved by mere inclusion in the operating budget.
BE IT FURTHER RESOLVED that each campus shall prepare a semi-annual financial report.
The format of the report will include the following: 1.
Budget and actual for unrestricted revenues by source of funds 2.
Actual for unrestricted expenditures by object and by function 3.
Beginning account balances and actual revenues and expenditures/transfers for restricted operations 4.
Any significant changes in the budget that should be brought to the attention of the President and Board 5.
An explanation of any significant reduction in anticipated revenues or significant increase in expenditures Any subsequent modification to the reporting format will be approved by the President with notification to the Board.
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• Keeping a cell phone readily available, • Scheduling sessions at a time when colleagues are also seeing patients in the office suite or clinic, • Forming a safety network among colleagues, and • Planning an escape route (Manca, 2005; Pinals et al., 2007).
B Prevention and Intervention Carr and colleagues outline a model of primary, secondary, and tertiary prevention for both the individual psychiatrist and the healthcare setting (e g , university, hospital, private clinic, etc.) (Carr et al., 2013).
Primary strategies can be routinely incorporated into clinical care; secondary strategies may be considered when the psychiatrist has concerns about patient behavior, such as when expected boundaries are tested; and tertiary strategies become important when stalking behaviors may include actual threats to cause harm or actions resulting in harm.
Examples of primary prevention measures include: • Providing detailed information at the outset of treatment regarding how therapy will work, the frame of the therapeutic setting and context, and the importance of collaboration in a way that helps maximize a sense of safety for all parties, • Minimizing one’s online presence (e g , social media).
This particularly applies to personal information, such as one’s private phone number, home address, details about personal or family schedules, or even online photos that might easily identify these details, • Using post office boxes and answering services, and • Becoming familiar with telephone services (e g , the procedure to block caller ID when making outgoing calls from a cell phone) (Manca, 2005).
Periodic reviews of basic security measures at home and at work are also important.
These measures could include: • Checking the proper functioning of any locks, alarm systems, motion sensors, and security monitors, • Training video cameras on entryways and having peepholes on office or clinic doors (Manca, 2005), • Participating in self-defense classes (Pinals et al., 2007), • Consulting with private security services or local law enforcement for specific safety strategies (Pinals et al., 2007).
While outside the scope of this document, psychiatrists may also consider consulting with hospital or private cyber security experts.
Examples of secondary measures that might be taken by psychiatrists include: • Providing and seeking supervision and consultation as soon as possible in a potential escalating situation and informing other members of the patient’s treatment team, • Thoroughly documenting boundary violations, problematic behavior, and attempted interventions.
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Finally, examples of tertiary measures that might be taken by psychiatrists include: • Seeking consultation with experts in behavioral threat assessment and management (see “Consultation” below), • Participating in ongoing risk assessment, especially at critical junctures such as anniversaries and court dates, which may elevate the potential for the stalker to become violent, and • Careful consideration of whether, when, and how to terminate patient care and provision of thoughtful referrals (of the patient) to an appropriate provider (see “Legal and Ethical Issues” below) (Carr et al., 2013).
A special note about boundary-setting: in general, in any therapeutic relationship, setting firm limits and establishing clear boundaries is important (Manca, 2005).
Psychiatrists should examine boundary testing by patients with the possibility that they may progress to stalking.
If a patient violates expected prosocial behaviors and there is a specific concern for stalking behavior, the psychiatrist may consider sending one clear, unambiguous message to the patient to change this behavior (Sandberg et al., 2002; Pinals et al., 2007; McIvor et al., 2008).
However, this approach can require a more nuanced consideration of when and whether to do so.
Caution related to this communication is advised because this may escalate the behavior and increase the risk of retaliation from the stalker in some situations (Sandberg et al., 2002; Pinals et al., 2007).
After a careful weighing of the facts, a decision to “do nothing” may be as impactful and helpful as proactive measures, but each situation requires individualized planning and direction.
Also, victims or identified stalking targets must often make their own decision (preferably with support and guidance) as to what intervention, if any, to take, early in the course of the stalking behavior.
Regardless, if the patient’s behavior persists after reasonable attempts at limit setting, the psychiatrist should try to avoid any direct subsequent engagement with the patient until consultation has been sought (McIvor et al., 2008) (See “Consultation” below).
C Consultation Seeking consultation, particularly from a multi-disciplinary team, is one of the early steps a psychiatrist should consider in situations involving stalking.
Even for experienced psychiatrists, getting another perspective about their level of concern (e g , “Am I overreacting or underreacting?”) can be very helpful.
It is also important to acknowledge that each consultation requires a risk assessment and that the facts can evolve, especially as new information about a case becomes available.
Thus, it can be helpful to have a consultant available for the duration of the stalking situation, which may be brief or extend for years.
The specific make-up of the multi-disciplinary team may vary, but often includes law enforcement, hospital security, legal counsel, forensic psychiatric experts, and other hospital or administrative and personal victim supports.
Depending on the setting, a hospital or university may have a threat management team or a forensic psychiatry service (Binder et al., 2017) that can be particularly useful in scenarios that take place in an institutional context.
In a private setting, psychiatrists may consider contacting the nearest university’s forensic psychiatry program, professional organizations like the Association of Threat Assessment Professionals (ATAP), or local law enforcement that has specialized services (e g , San Diego County District Attorney’s Stalking Unit).
Questions that are commonly asked of consultants beyond violence assessment instruments are: © Copyright, American Psychiatric Association, all rights reserved.
• How dangerous is the stalker? • How can the behavior be stopped? • How do I protect myself? • Will the behavior stop, or get worse? • If [the behavior] stops, is it going to come back again? (Binder, 2006; Mackenzie et al., 2011).
While further research is needed regarding the management of stalking behaviors and the effectiveness of specific interventions, (Mullen et al., 2006; Binder, 2006; Mackenzie et al., 2011), a multi-disciplinary consultation approach can systematically assess prevention and risk management strategies.
For example: • Community law enforcement may have seen many stalking cases, have experience or even actuarial knowledge about stalking behaviors, easier access to legal records (e g , court documents) that could be useful in risk assessment, and understanding of local practices and enforcement regarding anti-stalking laws (Mullen et al., 2006; Binder, 2006), • Hospital security can help plan on-site safety measures, and • A private attorney, hospital legal counsel, and/or attorney from a malpractice insurance provider can provide input regarding local criminal stalking laws and about privacy laws related to the release of medical records and pursuit of criminal charges related to one’s patient.
A forensic psychiatric team can help determine what types of risk assessment (e g , HCR-20, SAM, or RSP [Carr, Goranson, & Drammond, 2013; Binder, 2006]) and management options (e g , psychotherapeutic who, medications, etc.) are reasonable (Mackenzie et al., 2011) for the patient who remains in the care of the psychiatrist or in the care of other psychiatric personnel.
A forensic team may also help balance relevant clinical and legal considerations (e g , confidentiality, duty to third parties, termination of patient care, impact on therapeutic relationship, etc.). Furthermore, a clinical forensic psychiatric consultation service, especially within the same institution, may not require patient consent to review protected health information (though each institution may have unique policies that should be reviewed prior to accessing a patient record).
D Mental Health Counseling Psychiatrists who are being stalked may also consider seeking personal mental health counseling.
Situations involving stalking can be intense, anxiety-provoking, and potentially lengthy (on average two years) (Carr, Goranson, & Drummond, 2013; Mullen et al., 2009).
Though further research is needed on the impact of stalking among physicians, in a questionnaire completed by 274 psychiatrists in Ireland, of those who were stalked (n 69), 85% reported suffering psychological distress as a result of their experience (Nwachukw et al., 2012).
Another survey of 1190 physicians, including 117 psychiatrists (Abrams and Robinson, 2013) found feelings of anger (73.8%) frustration (73.1%), anxiety (69.7%), fear (67.6%), helplessness (44.8%) and loss of control (52.4%). A UK study of 10,424 psychiatrists with 2,585 responses found a variety of impacts on psychiatrists, including feeling anxious and afraid (80.65%), having difficulty sleeping (52.19%) and ceasing to enjoy life’s enjoyment (11%) (Whyte et al.
2011).
Regardless of the basis for the stalking behaviors, the consequences “personally and professionally, can be disruptive and potentially devastating” (MacKenzie et al., 2011).
Many victims of stalking may feel or actually be alienated, blamed, and criticized by supervisors and colleagues (Mackenzie et al., 2011; Carr et al., 2013).
In a qualitative U K study of 2,585 psychiatrists, © Copyright, American Psychiatric Association, all rights reserved.
respondents described variability of support from supervisors, colleagues, and law enforcement; some respondents felt very well supported, and others encountered a dismissive attitude that being stalked is inevitable for psychiatrists.
Those who received help experienced less distress than those who did not (Maclean et al., 2013).
E Documentation Detailed documentation of a patient’s stalking behavior toward the psychiatrist or staff is useful for both future legal interventions as well as behavioral management.
Victims of stalking are advised to maintain detailed records of any communication attempts on behalf of the stalker, such as emails and phone calls, including dates, times, recordings, and fear about safety (some stalking laws are based on the victim’s sense of fear) (Manca 2005).
Whether to keep such detailed records separate from the official patient medical record can be complex, and psychiatrists should seek further advice (e g , from legal counsel, administration, and supervisors) about which details should be part of the medical record and which should be kept as a separate file.
In general, clinically relevant information, such as behaviors (e g , gifts, boundary testing, breaches of privacy etc.), risk assessments, diagnoses, interventions, and issues surrounding termination, can be important to document in the medical record, especially to communicate to the treatment team or other providers involved in the patient’s care.
F Civil Protection Orders Protection orders are also known by a variety of other names, including restraining orders (Benitez et al., 2010) and intervention orders (Mackenzie et al., 2011).
Though the U S Interstate Stalking Punishment and Prevention Act of 1996 established that protection orders issued in one state are enforceable in other states (Benitez et al., 2010), the effectiveness of protection orders can vary greatly across jurisdiction.
For example, some statessprotection orders are designed for specific types of relationships such as domestic or interfamilial violence only whereas other statessorders can be more expansive (Knight, 2014).
Moreover, the utility of protection orders is debated and may not be helpful in every stalking scenario as they may fail to protect the potential victim, have high rates of violation, may provide a false sense of security, or even exacerbate the stalking behavior (Ostermeyer et al., 2016).
Police and court responses to protection orders may vary considerably since interpreting the point at which patterns of behavior cross the legal threshold and become criminal can be complicated (Mackenzie, et al., 2011).
Nonetheless, while they may not necessarily deter stalking behavior, protection orders may give law enforcement leverage to take the stalker into custody (Binder, 2006).
Thus, consultation may be particularly useful to draw on experiences, knowledge of the perpetrator’s prior response to such orders, and any available scientific literature to make recommendations.
For example, in a review of 15 publications, factors such as timing, potential escalation of behaviors, victim characteristics, perpetrator characteristics, abuser-victim relationships, and the context of the legal system were useful to consider in determining whether a protection order can be useful (Benitez et al., 2010).
Some additional considerations with protection orders are that they may be more effective earlier than later (Ostermeyer et al., 2016; Pinals, 2007), a stalker’s reaction to any previous protection order may be useful to guide decisions, and, if agreed to be ordered, the psychiatrist must make a commitment to report all violations to the appropriate authorities (Pinals et al., 2007).
Overall, even if protection orders are in place, they do not replace other personal protection and safety measures.
It can be helpful to work closely with one’s local law enforcement leadership in the jurisdiction where such a protective © Copyright, American Psychiatric Association, all rights reserved.
order might be issued so that they are aware of the protection order and the psychiatrist has points of contact in case of an untoward situation.
IV) Healthcare Setting Obligations Organizations and businesses generally have a legal and ethical responsibility to ensure workplace safety.
Unfortunately, many healthcare settings and organizations do not have well-defined procedures on how to handle stalking situations (Carr, Goranson, & Drummond, 2013).
First and foremost, organizations should strive to create and maintain work environments that are conducive to persons reporting concerns and receiving supports.
In addition, there is a progressive escalation of interventions which organizations might undertake.2 Examples of primary prevention measures that might be taken by institutions include: • Educating providers around issues such as the importance of setting and maintaining appropriate boundaries in a therapeutic relationship even when those boundaries are challenged or tested; • Ensuring that healthcare providers are educated about community contacts and support, such as law enforcement, so as to be able to readily seek assistance for any concerning patient behaviors, and • Establishing and educating staff about policies and procedures with regard to stalking behaviors by patients.
An important consideration for risk management personnel in universities, hospitals, and healthcare settings is what policies and/or procedures are needed to handle situations involving stalking.
These types of protocols would be separate and distinct from a sexual harassment type protocol or policy.
A stalking-related protocol or policy would include safety measures, expected legal responses, and a mechanism to provide staff with emotional support, resources, and multi-disciplinary consultation (McIvor et al., 2008).
Provisions for staff to take a leave of absence to address any psychological distress and to tend to practical matters, such as court appearances, may be necessary.
It is also important for administrative supports to be prepared to step in to manage communication with the patient and assist in the transfer of care when clinically appropriate (Mackenzie et al., 2011).
The healthcare setting may additionally consider a standardized debriefing with staff - with appropriate discretion regarding victim and patient privacy - regarding what patterns or conduct has occurred, how the clinic responded, what risks may persist, and what is needed from the rest of the clinical staff.
Creating this culture and establishing related policies can provide an opportunity to educate staff about preventative measures, such as boundary and transference issues, and violence risk assessment and management resources.
On a practical level, creating a collegial atmosphere that facilitates the disclosure of problematic patient behavior may allow earlier recognition, assessment, and treatment of the potential stalker, while also protecting co-workers and other clients (Mackenzie et al., 2011).
V Legal and Ethical Issues 2 As already noted, this document focuses on safety pertaining to patients as potential stalking perpetrators, and does not address workplace safety related to co-workers or domestic partners who may pose separate risks in a workplace setting.
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Legal and ethical issues, such as concerns regarding breach of confidentiality and abandonment when terminating patient care, often arise when psychiatrists are concerned about being stalked.
Psychiatrists may be in a “double bind,” in which taking appropriate steps may result in a violation of confidentiality or even result in negative consequences for the patient (Carr, Goranson, & Drummon, 2013).
Seeking consultation, and proactively establishing appropriate procedures in healthcare settings for such situations, can help address some of these concerns.
In some settings, for example, psychiatrists may establish a zero-tolerance termination policy (Manca 2005), though legal and risk management guidance for such considerations is strongly advised.
Specific administrative strategies for termination and referrals should also be considered, such as, if indicated, provisions for clear communication to the patient that any contact with the previous psychiatrist (who was stalked) may be criminally prosecuted.
If a termination letter is sent, it should be by certified mail and include referrals to another professional, and might be better to come from the administrative director or clinic rather than the psychiatrist who was stalked (Pinals et al., 2007).
However, there should also be a careful determination of what if any final contact should be generated from the psychiatrist with clear instruction that leaves no room for ambiguity.
If the patient is being referred to an out-of-system provider, then ethical and legal transfer of information is important.
The psychiatrist (who was stalked) should develop a strategy to manage any future contacts - for example, one way to address the issues is that once the patient care has been terminated, it might be prudent for the psychiatrist who was stalked to not respond directly to the ex-patient’s future contacts.
Instead the hospital risk management division should send a clear and polite letter stating that it is hospital policy for the psychiatrist not to respond to the ex-patient, but to address the ex-patient’s needs through the hospital system (e g , a request for a release of records).
The psychiatrist who will be taking on the treatment of the patient should also carefully consider unique challenges in these situations, such as “stalking by proxy,” which in this case reflects when the patient passes notes or communication to their previous psychiatrist through their new psychiatrist (Carr et al., 2013).
VI) Special Considerations involving Medical Students and Psychiatric Residents Given the higher prevalence of psychopathology in individuals who stalk medical professionals (McIvor, Petch, 2006) and the higher prevalence of stalking victimization amongst psychiatrists as compared to other physicians (Abrams, Robinson 2011), trainees in psychiatry, from medical students in clinical clerkships to fellows in subspecialty fields, might be at risk for becoming stalking victims in these contexts.
To these authorssknowledge, there have been no published reports or protocols about how psychiatry residency training programs approach this issue.
Unlike practitioners already in independent practice, psychiatric students and trainees may not be as skilled at picking up any early warning signs of stalking.
Stalking may escalate from repeated phone calls to showing up to appointments outside of a scheduled session (Lee, Missett 1994).
Such behaviors may be minimized as part of the patient’s psychopathology and not reported quickly to a supervisor.
There may be a sense, too, that the professional role offers protection when care is delivered objectively (MacKenzie et al., 2011).
Trainees who are just learning about the boundaries of a treatment relationship may inadvertently encourage behavior that may lead to stalking.
For an example, a boundary crossing (aimed at enhancing the therapist’s treatment efforts), such as giving a hug instead of a handshake at the end of a particularly difficult session could be misinterpreted by a particular patient (Marshall, Teston 2008).
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The American College of Graduate Medical Education (ACGME) Common Program Requirements stipulate that accredited residency programs monitor residentsswell-being, evaluate workplace safety data, and address “the safety of residents and faculty members.”3 They also have requirements about supervision and progressive independence over the course of the residency.
The ACGME makes clear that “at each participating site, there must be a sufficient number of faculty with documented qualifications to instruct and supervise all residents at that location (ACGME, 2019).” The presence of a readily-available and approachable supervisor is a critical component in reassuring trainees that they are not alone in their work, that they have a safe space in which to discuss the dynamics of a wide variety of therapeutic relationships, and that they have someone to whom they can go when they have concerns.
Unfortunately, many supervisors themselves are unfamiliar with how to best to handle, or possibly even identify, a stalking situation.
In addition, trainees may not report problematic behavior to their supervisor for fear of being perceived as a failure in the treatment relationship, shame, or a misplaced sense of a duty to treat the patient despite risk to the resident (Appel, Kleinman 2012).
Supervisors should be educated about steps to take in the event that a supervisee reports concerning patient behavior.
Program directors should have a protocol in place that addresses such issues by bringing in additional faculty supports, consulting with in-house forensic psychiatrists or even consulting with other programs, determining when to notify law enforcement and the risk management division of the resident’s training institution, and how to prioritize resident health and safety in the context of the stalking situation.
Residents should also be instructed on careful risk assessments and warning signs about problematic behavior to ensure their safety early as part of preventive strategic planning.
Recommended Elements of a Stalking Prevention and Response Program for Trainees Examples of measures that might be taken by institutions include: • Didactics early in training regarding boundary crossings, boundary violations, patient stalking and other behaviors are important to increase knowledge about such issues.
Didactics should include: o Definitions of Stalking o Clear guidance indicating that psychiatrists are responsible for managing transference and boundary issues as well as safely navigating patient relationships, and as such they may need assistance when their capacity to cope or manage is outweighed by their concerns and fears related to patient behavior.
• A clear protocol about potential notifications which should include: o Direct supervisors (senior resident, chief resident, or attending resident), o Program Directors o Hospital Safety Officer and Security (if available) to consider security measures for the resident while they are in the hospital, o Multidisciplinary threat management team if one exists (including the police, who can do a search regarding that individual’s legal history), Institutional police who may be able to research the perpetrator’s legal history, put an institutional restraining order in place, and contact the local police department in the jurisdiction of the resident’s home to provide extra protection.
The recommendations above with regard to Consultation, Mental Health Counseling, Documentation and Protection Orders may be equally applicable to scenarios involving psychiatrists in training.
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Resources for the Patient A final issue of paramount importance is how to continue providing care in some way for the patient or how to safely refer the patient to the next psychiatrist who may need information as to the reason for the transfer.
There is a fiduciary duty on the part of the physician that needs to be balanced against concerns for their safety.
Depending on the location where the stalking is occurring, several options for patient care include transferring to a different provider in the same location (but possibly in another building) or transferring the patient to another provider altogether.
These can also be items for consideration in Consultation.
8 More than half of patients with mental illness and substance use disorders also have an underlying physical illness.
For example, people with diabetes or heart disease often suffer from depression.
The complex interactions between mental and physical health conditions and the medications used to treat them require advanced medical training in order to ensure high-quality clinical care through adherence to best practices, which typically leads to highly positive health outcomes.
We know that mental health and substance use related conditions can compromise outcomes and drive costs of medical care.
Efforts at integrated care models are increasing, with funding streams being designed to help improve quality while containing costs.
These models depend on thoughtful clinical judgment and proper management of complex conditions.
A physician who provides oversight or collaborative consultation, with comprehensive knowledge of clinical needs, is essential to achieve these aims.
As such, PAs should be authorized to provide patient care services only so long as the PA is functioning under the direction and supervision of a physician or group of physicians.
The training PAs receive does not substitute for the comprehensive knowledge and skills physicians acquire as a function of their medical school education and experience.
The key difference between medical and physician assistant education and training is the fact that medical students spend four years focusing on the entire human body and all of its systems—organ, endocrine, biomedical, neuropsychiatric, and more—before undertaking three to seven years of residency training to further develop and refine their ability to safely evaluate, diagnose, treat, and manage a patient’s full range of medical conditions and needs.
By gradually allowing residents to practice those skills with greater independence, residency training prepares physicians for the independent practice of medicine.
Combined, the most basic medical school and residency training total more than 10,000 hours of clinical education and supervised training experience, including basic course work as well as years of practical supervised experience with patients.
The very nature of physician assistant training involves working with physicians; physician assistants are not trained to provide patient care without physician supervision.
Even physicians do not work independently before the end of their residency, even though at that point they have much more education and training than physician assistants.
Physician assistants just do not have extensive training in pharmacology, differential diagnoses, or the years of education and training regarding the human body and its systems that physicians have.
The vast majority of statess regulations reflect the necessity for oversight of PAs and the importance of physician-led care.
In 48 states a PA’s scope of practice is determined with the supervising or collaborating physician at the practice site.
Moreover, in 34 states PAs are supervised by physicians and in 16 other states PAs are subject to other forms of collaborative or alternative agreements.
Thus, as the billing abilities of PAs change it is important to ensure that this change does not impact the care the patients receive or the scope of practice requirements that are in place.
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (sections III.A , III.B , and III.C ) APA fully supports CMSsproposal to allow RHCs, FQHCs, and Critical Access Hospitals to provide audio- only services, in a patient centered-manner and based on the clinical judgement of the clinician.
As we stated previously with regard to expanded telehealth services, APA is concerned about any requirement 9 for a patient to be seen in-person by a practitioner in order to be eligible for any telehealth encounter.
Again, implementing requirements such as this may dilute the benefits of the expanded policy.
We also encourage CMS to expand audio-only coverage to include treating patients with substance use disorders.
We support RHCs and FQHCs receiving their usual PPS or AIR rates for audio-only telehealth services and support the billing for both G0511 and G0512 in the same month for the same patient as long as the time and effort is not counted more than once.
Medicare Shared Savings Program (section III.J APA is supportive of the Medicare Shared Savings Program and the Accountable Care Organization concept; facilitating better coordination and integration of care is critical to improving the quality of mental and behavioral health care, and the Shared Savings program is an important step in promoting these goals.
However, we are concerned that some of CMS’s proposed policies may undermine the ability of ACOs to meet requirements under the program.
Electronic clinical quality measures are important for reducing data collection burdens and incorporating clinically-enriched data into measurement activities, but a continued lack of EHR standardization raises concerns about the feasibility of aggregating data from diverse and disparate systems that may be in use across an ACO.
Furthermore, the practice of introducing new measures on a pay-for-reportingsbasis before incorporating them into payment calculations is an important step in the process of building a valid and feasible measure set, allowing participants to identify potential problems or unintended consequences that may arise with measure implementation.
We would encourage CMS to continue consulting with the ACO and clinician communities and patient representatives to determine the best-balanced measure set and measurement approach for the Medicare Shared Savings Program.
APA also supports the inclusion of the Behavioral Health Integration codes (99492-99494, G2214, and 99484) in the definition of primary care services for the Shared Savings Program.
Modifications Related to Medicare Coverage for Opioid Use Disorder (OUD) Treatment Services Furnished by Opioid Treatment Programs (OTPs) (section III.O).
We appreciate the two proposed changes included in this section to improve access to care for patients with opioid use disorder by allowing payment for a recently FDA-approved higher dose of naloxone hydrochloride nasal spray product to treat opioid overdose.
We also support allowing the therapy and counseling portions of the weekly bundles, and any additional counseling or therapy provided by opioid treatment programs, to be furnished using audio-only telephone calls rather than via two-way interactive audio/ video communication technology for the duration of the PHE for COVID–19.
This is important given many patients do not have smart phones that allow for two- way communication.
Requirement for Electronic Prescribing for Controlled Substances for a Covered Part D Drug under a Prescription Drug Plan or an MA-PD Plan (section 2003 of the SUPPORT Act) (section III.Q APA appreciates CMS continued flexibility around the compliance date requiring the electronic prescription of controlled substances (ECPS) for Part D clinicians in light of the PHE.
As noted in this 10 proposed rule, and in APA’s previous letters to the Administration, the PHE resulted in numerous practical and administrative constraints of physicians in transitioning to ECPS by the original date of January 2021, and we appreciate CMS's previous action in moving the compliance date to January 2022.
APA supports CMSs current proposal to move compliance to January 2023.
APA also supports the proposed compliance threshold that would apply to all ECPS for Part D clinicians, including:
When it would be impractical for the patient to obtain medication (prescribed by electronic prescription in a timely manner and such delay would adversely impact the patient’s medical condition.
When the National Council for Prescription Drug Programs (NCPDP) standard does not support transmitting the prescription, APA also recommends that CMS consider an additional compliance threshold based on clinician practice size, such as used in the MIPS Promoting Interoperability program.
Updates to the Quality Payment Program (section IV.)
APA appreciates CMS’s effort to make minimal changes to the QPP program in light of the COVID-19 Public Health Emergency and the unique pressures our health care system continues to be under at this time.
Our comments focus on the MIPS Value Pathways (MVPs) program and efforts to incorporate cost measures into the MIPS program.
Cost measures APA continues to have strong concerns about application of episode-based cost measures (ECBMs) to individual clinicians, both as part of the overall MIPS program and through MVPs specifically.
As APA has expressed previously, existing and proposed ECBMs, as applied to psychiatrists, present serious challenges across multiple dimensions, including but not limited to:
Psychiatrist control over key cost-related factors There is a limited range of costs that are directly within the control of individual psychiatrists, particularly those practicing in the inpatient environment, and minimal opportunities to exert indirect control over many of the costs included as part of the current ECBM attribution methodology.
This undermines both the validity of the measures and their effectiveness of measures as incentives for behavioral change, as clinicians will find it difficult to understand how their behavior is connected to increases or decreases in cost measure scores.
Potential for unintended consequences Without a full understanding of contributors to the varying costs of psychosis related care, emphasizing cost reduction creates a significant likelihood of unintended consequences, including potential for the measure to exacerbate problems with access to care.
Many psychiatrists care for a highly vulnerable population of patients who experience high rates of unemployment high and where socioeconomic challenges are common.
We know that individuals with serious mental illness have substantial physical health comorbidities and a lifespan that is as much as 20 years less than that of the population as a 11 whole.
Cognitive aspects of aging also appear to be accelerated in these individuals.
Efforts to reduce costs of care in these individuals may place them at even further disadvantage, with even greater disparities among Blacks, Latinx, and Indigenous People as has been starkly evident in health care delivery during the pandemic.
We urge CMS to avoid implementing measures or policies that have the potential to deepen inequities in access to care.
Transforming MIPS: MIPS Value Pathways APA supports the concept of MVPs and applauds CMS’s efforts to develop a measurement program that is more conceptually coherent, focused on improvement, and relevant to specialty practices than past activities.
However, as expressed above, there remain serious practical concerns about the implementation of cost measures, which are a key component of MVPs.
We are concerned that use of problematic cost measures will undermine the intent and effectiveness of the MVP program, and could lead to unintended consequences, such as cherry-picking of patients who are likely to be lower-cost, or further reduction in the number of psychiatrists willing to accept Medicare patients.
There also continues to be gaps in clinically-relevant quality measures for psychiatrists; we hope and expect that this will be improved over time, but at present, the set of measures available for mental and behavioral health is limited and is focused largely on process metrics that have not been demonstrated to have a high impact on patient outcomes.
CMS requests comment on what should happen when specialty clinicians cannot identify an applicable and relevant MVP.
APA would suggest that CMS slow the transition from traditional MIPS to MVPs to accommodate clinicians who cannot identify MVPs that are directly relevant to their clinical practices, allowing those clinicians to continue their participation in traditional MIPS until an appropriate MVP is available.
Other CMS measurement policies In addition to our comments on the proposed rule, APA would like to note that having a sufficient number of quality measures available for psychiatrists and members of the mental health care team is a priority for APA.
We anticipate that this will likely involve developing and then moving QCDR measures through the Measures Under Consideration process and into the MIPS program.
Over the course of the last four years, the number of measures approved via the MUC has declined precipitously, from several dozen measures to only four quality measures last year.
Combined with measure attrition, the availability of quality measures for groups to report has become much tighter.
CMS should rebuild the library of MIPS measures available for reporting by encouraging the submission of QCDR measures through the MUC process.
However, rebuilding a library of quality measures will be challenged by regulations finalized by CMS last year.
We are very concerned about CMS’s policy on measure testing for 2023 and beyond.
In the 2021 quality payment program rule, CMS finalized a proposal to require face validity testing for measures in 2022 and then “full testing” for measures submitted as part of the QCDR in 2023.
Because data to fully test a quality measure for validity is difficult to capture, we cannot support requirements that each measure be tested for validity beyond face validity.
12 We recognize that CMS will attempt to implement these testing requirements over the next year.
In 2020 and again in 2021, CMS rightly allowed groups that were disrupted by the COVID-19 pandemic to apply for and receive a hardship exemption.
That policy, however, reduced the amount of data available for measure testing.
Because the extreme and uncontrollable circumstances policy decreased the number of groups able to report quality data, we ask that measure testing requirements (not including face validity testing) be delayed until two years after the end of the public health emergency (PHE).
In addition, CMS should approve an improvement activity for groups that assist measure stewards with measure development and testing efforts.
Measure development requires a significant amount of time, money, and analysis to complete, and often relies on volunteers to collect and report data to help assess measure feasibility, reliability, and validity.
Offering MIPS eligible clinicians and groups opportunities to earn improvement activities credit for helping improve the measures offered in MIPS is a worthwhile and meaningful action CMS can take immediately.
Proposed Changes to the Medicare Promoting Interoperability Program The APA appreciates the continued flexibility in reporting requirements under the Promoting Interoperability program for Eligible Clinicians (ECs), including options surrounding measure choice, scoring, and opportunities for bonus points.
Please find feedback regarding the proposed changes below: 4(b ...the performance period for the Promoting Interoperability performance category is a minimum of any continuous 90-day period within CY 2022...we are not proposing any changes to the Promoting Interoperability performance category... APA appreciates that CMS has maintained the 90-day reporting period for these electronic measures since the inception of MACRA in 2015.
APA supports maintaining this reporting period window, keeping consistent with previous reporting years.
Proposed Changes to the Query of Prescription Drug Monitoring Program Measure Under the Electronic Prescribing Objective (4 (c (i ) APA supports maintaining the PDMP measure as optional for CY2022, and also supports increasing the bonus for reporting on this measure from 5 points to 10.
As we have stated in previous letters to CMS, it is still premature to require the Query of PDMP measure and then include it in the Promoting Interoperability score.
As CMS has acknowledged, there are still technical challenges associated with connecting PDMPs with various EHR systems.
Our membership remains affected by these technical challenges, which include: a a lack of standards connecting PDMPs and EHRs, b the policy (e g , statutory) and other technical challenges around integrating state PDMPs with HIEs and hospitals, c addressing the challenges in integrating PDMP queries seamlessly into physician workflows, d the cost and time required for developers—and subsequent downstream financial impact on physicians/hospitals—to develop standards and technological solutions to better integrating PDMPs with other health IT software and finally, e the burden in tracking and calculating numerator/denominator requirements for the PDMPs.
13 Moreover, not only do these challenges remain, but they were difficult to address during the PHE by healthcare organizations, as they shifted resources to mitigate the ongoing public health crisis.
Additionally, as ONC and CMSs Final Rule around Interoperability and Information Blocking were released in 2020, with the revised Applicability Date of April 2021, clinicians sand vendors priorities had to be adjusted to meet the expectations around complying with these regulations.
Thus, waiting to require the Query PDMP measure under the Electronic Prescribing Objective would give hospitals and vendors more time to adapt their systems accordingly.
As the technology necessary to connect PDMPs with HIT systems matures, requiring this measure will become less burdensome.
For example, the 2020 PFS outlined a transition to the updated CEHRT 2015 Edition standard and a transition for CEHRT to use the NCPDP SCRIPT 2017071 standard for electronic prescribing; the ONC, in its 21st Century Cures Final Rule, requires those vendors developing CEHRT for Promoting Interoperability will use FHIR open APIs to connect providers and other users of HIT.
Given these advancements, APA is optimistic that, in time, the data captured by PDMPs will be able to flow through the HIT ecosphere without significant burden to hospitals and providers.
We look forward to continuing to be part of the conversation regarding how the Query PDMP measure can be successfully implemented in the Medicare Promoting Interoperability Programs in the future.
(B to modify the Provide Patient’s Electronic Access to Their Health Information measure to establish a data availability requirement beginning with encounters with a date of service on or after January 1, 2016, beginning with the EHR reporting period in CY 2022 Currently, the Provide Patient Access to Their Health Information does not specify how long MIPS eligible clinicians are required to make patient data available, or to ensure that patient data remain available to patients in the event that an EC switches EHR vendors.
APA appreciates CMSsintent to align the Provide Patient Electronic Access to Their Health Information measure with the look-back period finalized in the Patient Access and Interoperability final rule.
While the January 1, 2016 date seems reasonable for ECs, the APA recommends that CMS delay enforcement discretion from July 1, 2021, to the end of CY 2021, to account for the ongoing COVID-19 PHE.
Moreover, APA seeks clarification that, during this lookback period, and other proposed future accessibility requirements around changes to the Provide Patient Access PI measure, that ECs can exercise the pertinent Exceptions under the Information Blocking and Interoperability Final Rule.
Specifically, that the Infeasibility, Content and Manner, and Health IT Performance Exceptions may be employed, when applicable, by the EC, when maintaining patient data in near-perpetuity may not be possible for MIPS- eligible clinicians.
Additionally, APA seeks clarification on whether this change to the Provide Patient Access measure will only apply to the reporting years for which the clinician was eligible and did not meet any of the MIPS program exceptions, such as the low-volume threshold.
Clarifying the above points will help to reduce burden among solo and small group psychiatrist ECs who may not participate in MIPS in consecutive years.
14 Reweighting the Promoting Interoperability Performance Category for MIPS Eligible Clinicians in Small Practices APA appreciates CMS scontinued efforts to reduce administrative and financial reporting burden for small practices endeavoring to participate in MIPS.
As noted in this Proposed Rule, many small practices may be eligible for the LVT; or, qualify as small practices (i e , under 15 ECs), and therefore can apply for an Exception to the Promoting Interoperability category, when there are “overwhelming barriers” to participating.
In response to the questions posed in this Rule, APA is unable to ascertain the specific reason(s as to why some small practices may fail to apply for the Small Practice Hardship Exception for the Promoting Interoperability performance category, while still participating in MIPS as a whole.
This is possibly because many of our members in solo or small group practices qualify for a total exemption for all of MIPS under the Low Volume Threshold; or, as CMS contemplates in this rule, they may be unaware of the Exception itself, or may believe that they do not meet the requirements of “overwhelming barriers.”

Regardless of reason, APA supports CMS recommendation to automatically redistribute points from the PI performance category to other performance categories of MIPS for small practices who do not apply for the Exception, but who would have been eligible, in order to avoid receiving a score of zero for the PI category.
(ii)
We are proposing to add a new SAFER Guides measure to the Protect Patient Health Information objective...we are proposing that a MIPS eligible clinician must attest to having conducted an annual self assessment using the High Priority Practice Guide, at any point during the calendar year...with one “yes/no” attestation statement accounting for the complete self-assessment using the guide.
Generally, the APA supports the use of the Safety Assurance Factors for EHR Resilience (SAFER) Guides, particularly the High Priority Practices Guide, as a part of the Promoting Interoperability performance category.
Requiring ECs to attest to completing these guides has the potential to help many clinicians enhance and optimize health IT, ensuring that they are “responsible operators of technology tools,” as stated in this proposed rule.
This attestation is reminiscent of the existing Security Risk Assessment measure in its utility to safeguard patient information, and in that it will not be scored for PI.
While we appreciate CMS acknowledgement ECs (especially those in solo or small group practice) vary in terms of resources with respect being able to complete the SAFER attestation annually, APA recommends that, for the 2022 RY, CMS conduct an audit of those entities that attest “no,” in order to ascertain why they did not complete a SAFER attestation, to see if additional resources might support them in doing so for future reporting years.
We are also more broadly soliciting public comment to help us better understand the resource costs for services involving the use of innovative technologies, including but not limited to software algorithms and AI.
In addition to this broader prompt, CMS poses a list of questions for consideration regarding the use of innovative technologies within physician practices.
For example, the Rule considers how technologies, 15 such as AI, have affected physician work time and intensity of furnishing services (e g , possibly reducing the amount of time that a practitioner spends time reviewing and interpreting results of diagnostic testing), or how technologies are changing cost structures, affecting access to services for Medicare beneficiaries, and more.
While APA and psychiatry continues apace in adopting new technologies into clinical workflows—such as adjunctive therapeutic mobile applications, and wearables—it is qualitatively different from how other specialties are using it.
For example, in the Rule, CMS uses examples such as a simulation software analysis of functional data to assess the severity of coronary artery disease and how trabecular bone score software can supplement physician work to predict and detect fracture risk.
These examples might be considered as straightforward use cases of emerging technology where an attempt to codify and quantify their value to Medicare practitioners and beneficiaries seems reasonable.
For psychiatry some analogous use cases, such as various emerging technologies utilizing focused on discrete physiological symptoms (e g , neuropsychiatry, movement disorders, clinical decision support, work on neurolinguistics in detecting changes in language use patterns in predicting psychopathy or dementia); however, presently, there are too few data points and replicated research into how AI or other technologies are or can affect psychiatric work flows, physician time, and other considerations as contemplated in this Rule.
The use of AI in healthcare is still nascent.
With respect to psychiatry, most AI-driven tools are embedded within health IT products more appropriately described as “augmented intelligence” rather than “artificial intelligence.” The scope of this technology tends to encompass features of electronic health records (EHRs), such as electronic clinical decision support (eCDS), and in mHealth, such as apps that rely on patients behavioral history to send warnings to the patient about environmental factors that could potentially be triggering for mental health conditions, such as substance use disorders.
While APA is optimistic that the future of AI may improve patient care and lead to better outcomes, we are concerned that there are presently very few standards to which industry is being held in the development of AI in healthcare.
For instance, standards around privacy, security, and confidentiality within health IT is currently in flux.
There are also limited regulatory standards on the development and implementation of AI tools, which further complicates how such tools may be accounted for in terms of quality care and outcomes when integrated into Medicare payment considerations.
ermination Do you have a policy on circumstances that may lead to terminating the relationship with a patient? Does the policy include the state requirements to properly terminate the relationship? The APA is also concerned around background development of AI systems that may not include specific populations within standardization samples in AI beta testing/research studies.
Presently, some algorithms may be based solely on a certain population for various medical conditions (e g , men or women; various ethnicities; various socioeconomic groups) resulting in algorithms that may not compute the best treatment options or interventions for patients with unique vulnerabilities (e g , developmental disorders, suicidal ideation, substance use disorders).
Before the technology can be incorporated into Medicare payment models, there needs to be a comprehensive examination (by CMS, the FDA, other entities), of which data are being used to develop any algorithms that influence physician decision-making and patient care.
There needs to be an assurance that AI helps patients regardless of one’s race/ethnicity or other social determinants of health and isn’t introducing or magnifying disparities.

________________ *

Abandonment OLOL Medical Director Mark Zielinski, MD., Assistant Professor of Psychiatry LSU Baton Rouge Psychiatry Residency Program healthcare retaliation

noreply@blogger.com (What Gets Me Hot) — Sat, 07 May 2022 07:23:00 +0000

Abandonment

Psychiatry OLOL

Associate Medical Director
*Assistant Professor Mark Zielinski, MD.,
Clinical Assistant Professor of Psychiatry OLOL Associate Medical Director Outpatient Psychiatric Services LSU Baton Rouge
Psychiatry Residency Program
healthcare retaliation

termination (medical abandonment)
invented allegation attributed to nurse, now rescinded
now blames cancel televisit
No explanation, no administrative recourse, no appeal, from false charge, exploitative penalty during State of Emergency, critical shortage of doctors.
Supported by FMOL Health System

LSU Baton Rouge Psychiatry Residency Program

LSU RESIDENCY

Scott Wester
President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System
Scott Wester is the President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana

Location
4200 Essen Lane, Baton Rouge, Louisiana, 70809

Lannis Lee Tynes, MD, PhD

Clinical Associate Professor of Psychiatry

Associate Program Director

OLOL Medical Director
Kathleen Crapanzano, MD, MACM
Program Director
LSU Psychiatry Residency Program-Baton Rouge
Louisiana State University Our Lady of the Lake Psychiatry Residency Program
5246 Brittany Dr Rm 340 Baton Rouge, LA 70808
ASSISTANT PROFESSOR
DEPARTMENT Program Director
LSU Psychiatry Residency Program

Louisiana State University Health Sciences Center
LSU System
U M E - G M E R E V I E W C O M M I T T E E

Dr. Richard Vath, President & CEO of the Franciscan Missionaries of Our Lady (FMOLHS) Health System, has announced the promotion of two executives to lead the health system’s Ambulatory Division.

Jennifer Clowers, former interim Market President for Our Lady of Lourdes, has been promoted as the division’s new Vice President where she will report directly to the CEO as a member of the health system’s Senior Executive Team and Strategy Council.
Laura Davis, operational leader for the Community Care Division of Our Lady of the Lake Physician Group Senior Director of the Ambulatory Division.

Specialties: HEALTHCARE, OPERATIONS MANAGEMENT, PHYSICIAN RELATIONS, PHYSICIAN RECRUITMENT, BUSINESS DEVELOPMENT, STRATEGIC PLANNING, PROCESS IMPROVEMENT, CUSTOMER SATISFACTION, CUSTOMER RELATIONSHIP MANAGEMENT, TEAM BUILDING, REGULATORY COMPLIANCE, PERSONNEL MANAGEMENT, CLIENT SERVICES, BUDGETING, CLINICAL SYSTEMS INTEGRATION, DIRECT PATIENT CARE, FINANCIAL ANALYSIS, CONSTRUCTION PLANNING, CONSTRUCTION OVERSIGHT, EQUIPMENT PLANNING, HOSPITAL RE-ORGANIZATION

response: endemic, practiced silence (catholic and corporate shameful abidance)

reason: actionable acumen

just give up? I will not subsise until my grievances have been officially addressed, and he is investigated and proven guilty

why? he is not fit to practice

Mark Zielinski MD. acts of discrimination, fraud, GROUNDS FOR RESCISSION gratuitous defiance of current legal imperative declared State of Emergency physicians and healthcare providers healthcare consumer rights FTC, CMS, CDC, HHS, healthcare consumers abidance to provisions of Medical Code of Ethics as entities, healthcare systems, groups, institutions, healthcare consumers.

Abandoned of practice, all specialist clinics

Mark Zielinski, MD.,Assistant Professor Clinical Assistant Professor ofPsychiatry,Outpatient Psychiatric Services, LSU

HSC-NO BR
Psychiatry Residency Program OLOL Associate Medical Director

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

Our Lady of the Lake Physician Group Family Center

for Psychiatric Residency Services

Kathleen Crapanzano, M.D.
LSU Psychiatry Residency Program
5246 Brittany Drive
Baton Rouge, LA 70808
Ph: 225-757-4212
Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,
Associate Resident Program Director,
OLOL Medical Director

LSU Baton Rouge Psychiatry Residency Program 2021

Governor
Assistant Professor

Assistant professors are beginning-level professors at colleges and universities. An assistant professor position typically requires a Ph.D. and experience with teaching and research in a specific field.

Becoming an assistant professor is the first step to becoming tenured. An assistant professor's duties usually include research, teaching, and academic advising.

What Is Tenure?

Tenure is a term you'll often hear associated with professors. Academic tenure means a professor has been granted lifetime employment with a college or university. It also protects them from being fired without cause.

Tenured status is highly competitive, and earning it is a time-consuming process that usually takes between 5-7 years. In addition to job security, it often comes with better wages, making it a special achievement in higher education. Associate professors usually have tenure, though not always. Even full professors are not always tenured.

—
Associate Professor

An associate professor is a mid-level professor who usually has a doctorate or other professional degree and teaches classes related to their studies.

The responsibilities of an associate professor are similar to an assistant professor. One key difference is that associate professors have more experience and often have tenure.

Residency training permits provision no longer applicable normal operations residency

Louisiana State University Health Sciences Center
New Orleans, Louisiana

LSU System

U M E - G M E R E V I E W C O M M I T T E E

Specific examples on how this recommendation might be implemented:

• Convene collaborative group with representation from FMOLHS stakeholder organizations and public, charged to define successful transition, and understand which characteristics predict a successful match.

response: endemic, practiced silence (catholic and corporate shameful abidance)
reason: actionable acumen
just give up? I will not subside until my grievances have been officially addressed and investigated
why? he is unfit to practice

healthcare shopper retaliation / termination (medical abandonment) invented allegation attributed to nurse, now rescinded
now blames cancel televisit
original excuse: alleged speaking, NURSE hearing profanity, ending in patient dismissal.
No explanation, no administrative recourse, no appeal, from false charge, exploitative penalty during State of Emergency, critical shortage of doctors.
Supported by FMOL Health System,
Scott Wester
President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System
Scott Wester is the President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana.
Scott was President & Patient protection in discrimination as Medicaid, tax-free institution, patient termination 20 minutes before televisit, June 2, 2021
Location
4200 Essen Lane, Baton Rouge, Louisiana, 70809

office manager (stephanie), no referrals, no answers

INTENTIONAL COVER-UP.

SUBORNING DUTY TO REPORT COLLEAGUE SUPERVISOR

Lannis Tynes, MD., SILENT, SUPPRESSION REPORTING MEDICAL ETHICS, DISREGARD CHARGES DENY PATIENT DUE PROCESS APPEAL

INVESTIGATION BY IMPARTIAL COMMITTEE ALLEGATIONS

GRIEVANCE INSUBORDINATION, FRAUD, MALFEASANCE, PHYSICIAN ABANDONMENT

ACTIONABLE DEPRIVATION OF HEALTHCARE

RETRIBUTION: SECOND ATTEMPT, NURSE, FALSIFICATION of Report, of Patient Record File

STATED BY LEE TYNES M.D.

TELEPHONIC DEVICE WITH NO WITNESSES, NO REPORT, UNCORROBORATED, UNREMARKED TO WORKMATES OR EMPLOYER

DOCTOR, NON-DETAILED GENERALIZATION DECLARED 'PROFANITY

Nurse did not discontinue or end conversation, and filled prescription with pharmacy, never mentioning anything to anyone at all.

NON-MALEVOLENT, NON-THREATENING, INCIDENTAL OVERHEARING ON A TELEPHONE

PROHIBIT GENERAL PRACTITIONERS PSYCH LITE DRUGS

REQUIRE PSYCHIATRIST

HEALTHCARE INDUSTRY

RIGHT TO FACILITIES

OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER

STATE OF LOUISIANA

THE BOARD LSU

PUBLIC UNIVERSITY

PUBLICLY FUNDED

FLAGSHIP INSTITUTION OF HIGHER LEARNING IN THE STATE OF LOUISIANA,

OFFICES, ASSOCIATIONS, RELATIONSHIP, BUSINESS ACADEMIC

TWO MONTHS IGNORED by THREE INSTITUTIONS' ADMINISTRATIVE BOARDS

ADMINISTRATORS, ACADEMIC CODE OF ETHICS,

EACH SEPARATE HEAD

PRESIDENT OF LSU after PERSONAL LETTER THROUGH OFFICIAL social

PRESIDENT / CEO OF OLOL FMOLHS

part two
Lake Physician Group Psychiatry Clinic at O'Donovan, Baton Rouge, Louisiana
medical licensure and academic practices
charging him as dangerous person
removing my rights and severing me from clinic
removing my Civil Right healthcare without discrimination, interference or fraudulent manipulation by untruthful
allegation by Civil Servant of Louisiana
uphold code of ethics of medical profession

responsible as LSU Assistant Professor and Residential Psychiatry Supervisor
if censured or punished by committee

because of the failure and illegal refusal to hear any of my reports and inquiries
(FMOLHS OLOL

John Paul Funes (Kid Cancer Embezzler)

United States Federal Agencies warn to prosecute opportunistic acts of process,
by discrimination or exploitation of Coronavirus pandemic,
retaliation under federal protection,
healthcare providers
fraudulent billing, discrimination
underserved Medicaid
CMS website.

Mark Zielinski MD. acts of discrimination, fraud,
GROUNDS FOR RESCISSION
gratuitous defiance of current legal imperative
declared State of Emergency
physicians and healthcare providers
healthcare consumer rights
FTC, CMS, CDC, HHS,
healthcare consumers abidance to provisions of Medical Code of Ethics
as entities, healthcare systems, groups, institutions, healthcare consumers.

Mark Zielinski retaliation guise of dismissal from his practice
(his second attempt)
Zielinski evade department head Lannis Tynes MD
under FMOLHS policy, allowed to see no other physician in that clinic

necessity to see a psychiatrist
used to involve one General Practice 'Psych Lite' meds,
now required two,
no incidents, warnings, or infractions
during 8 years
with FMOL OLOL Lake Physicians Group, LSU Psychiatry Clinic.

9. Mark Zielinski self-help defiance
Federal CDC, APA, etc., all bodies responsible
maintaining medical ethics
by AMA ca. 1945,
restructuring pandemic,
most difficult and severe action a provider may take
most physicians never having initiated throughoutentire career.

10. 'best practicability rights agreement
Physician-Patient termination and termination from practice
last resort--and only specified (9) provisions
best practices
patient failing to abide or agree to the agreement
option of transfer
if this is not unacceptable
under strict procedural guidelines
termination of patient instituted.

11. Mark Zielinski personally
employ, cause, direct, and / or authorize
clinical nurse / agent / employee
capacity of employer
Assistant Clinical Physician over clinic working department
nurse (name unknown),
through false allegation
coerced by Zielinski
allow him to weaponize lie
that she reported incident of a patient using profanity over a telephone

to obtain outcome desired,
unceremonious, paperless--devoid of all medical acumen, procedure,
process, or ethical best practices

12.never personally executed
not spoken to me
three months before his cancelled televisit
termination delegated by him to
office manager Stephanie
bowing-out
to dismiss long-term healthcare consumer
fifteen minutes televisit--during a pandemic
knowing
unknown to her
high personal liability
lie malfeasance
patient lemon-dropping,
agent
principal agent
termination without get hands dirty

13.evidence
belated institution of impartial committee
FMOLHS, by law should have in place,
after recent embezzlement, wire-fraud
conviction of CEO / Foundation President
Children's Hospital cancer patients,
even if true, ridiculous by comparison, in scope,

claim OLOL-RMC website
multiple departments and administrators Baton Rouge and 5 hospitals in the state,
resources for patient grievances and patient rights
required not-for-profit tax-exempt Medicaid and ACA
to stay compliant for 100% qualification to receive funding
denied to me, opportunity for consultation.

14.impartial commission
my longstanding grievances
reaffirm for consideration
findings either
dismissal (Mark Zielinski's),
or
rescission
removal of his licensure
and ability to practice medicine
governing examiners responsible
state of Louisiana
decision and punishment
FMOLHS refused acknowledge,
nullifies their ignorance,
promotes possible conspiracy,
silence indicative FMOLHS
prevent through denial
all claims, charges, appeals, and requests,
endemic silence
cowards corrupt officials need not be Mirandized to know when to keep quiet--
winning is winning at any cost

16. Federal, State, Civil
multiple courts, jurisdictions, agencies, committees, boards,
cost lawsuits,
attorney fees, and time
waiting for FMOLHS
licensed practitioner
association with LSU,
LSU Board of Supervisors,
State,
States governing bodies,
dominion this actions perpetrated

Mark Zielinski MD. acts of discrimination, fraud, GROUNDS FOR RESCISSION gratuitous defiance of current legal imperative declared State of Emergency physicians and healthcare providers healthcare consumer rights FTC, CMS, CDC, HHS, healthcare consumers abidance to provisions of Medical Code of Ethics as entities, healthcare systems, groups, institutions, healthcare consumers.

the communication gap: an old era thrives at fmolhs with john paul funes and healthcare consumer dearth of resources for grievance or due process against wrongful physician termination through retaliation and abandonment.No explanation, no administrative recourse, no appeal, from false charge, exploitative penalty during State of Emergency, critical shortage of doctors.President Chief Executive Officer at Franciscan Missionaries of Our Lady Health System Scott Wester is the President Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana.STATED BY LEE TYNES M.D.TELEPHONIC DEVICE WITH NO WITNESSES, NO REPORT, UNCORROBORATED, UNREMARKED TO WORKMATES OR EMPLOYERDOCTOR, NON-DETAILED GENERALIZATION DECLARED 'PROFANITY Nurse did not discontinue or end conversation, and filled prescription with pharmacy, never mentioning anything to anyone at all.*post doctoral degree and generally after several years of holding one or more postdoctoral researcher positions.It is below the position of associate professor at most universities and is equivalent to the rank of lecturer at most Commonwealth universities.The UME-GME transition encompasses a complex ecosystem.

The Louisiana State University Health Sciences Center, New Orleans is a public university focused on the health sciences and located in New Orleans, Louisiana.It is part of the LSU System and is the home of six schools, 12 Centers of Excellence, and two patient care clinics. I write this for the Louisiana State University Health Sciences Center Psychiatry Residents, unaware of circumstances which could adversely affect the VIABILITY OF THEIR (Resident) DEGREES

ETHICAL, OR CIVIL RIGHTS VIOLATION - SHOULD DR.(REDACTED) MEDICAL LICENSURE BE SUSPENDED TEMPORARILY, OR REVOKED.Associate directors and assistant directors have similar job titles but different responsibilities.Both are essential employees in a company or business, and they often work closely together.If you're considering working in one of these roles, it's important to understand how they differ to determine which one is the best fit for you.In this article, we discuss the differences between an associate director and an assistant director.United States Federal Agencies warn to prosecute opportunistic acts of process, by discrimination or exploitation of Coronavirus pandemic, retaliation under federalprotection, healthcare providers fraudulent billing, discrimination underserved Medicaid CMS website.Mark Zielinski MD.acts of discrimination, fraud, GROUNDS FOR RESCISSION gratuitous defiance of current legal imperative declared State of Emergency physicians and healthcare providers healthcare consumer rights FTC, CMS, CDC, HHS, healthcare consumers abidance to provisions of Medical Code of Ethics as entities, healthcare systems, groups, institutions, healthcare consumers.necessity to see a psychiatrist used to involve one General Practice 'Psych Lite' meds, now required two, no incidents, warnings, or infractions during 8 years with FMOL OLOL Lake Physicians Group, LSU Psychiatry Clinic.

Mark Zielinski self-help defiance Federal CDC, APA, etc., all bodies responsible maintaining medical ethics by AMA ca.1945, restructuring pandemic, most difficult and severe action a provider may take most physicians never having initiated throughoutentire career.

'best practice'patients rights agreement Physician-Patient termination and termination from practice last resort--and only specified (9) provisions best practices patient failing to abide or agree to the agreement option of transfer if this is not unacceptable under strict procedural guidelines termination of patient instituted.U M E - G M E R E V I E W COM M I T T E E Throughout the transition, learners are being assessed, including through preclinical course examinations, rotation evaluations, and licensure examinations The UME-GME transition encompasses a complex ecosystem.As learners navigate through the UME-GME transition, they interact with numerous organizations with jurisdiction over specie components of the process.However, the ecosystem is not governed by a single entity.I formally request immediate reinstatement of my improvidently relinquished status as patient -- though not of Mark Zielinski--as provided by official patient rights under Code of Conduct, whereby administrative mishandling and punishment of an alleged, unproven, non-injurious complaint, recklessly used in retaliation by personal animus to facilitate patient termination.

I LIVE IN A HOTEL OR MOTEL, WHAT ARE MY RIGHTS?

noreply@blogger.com (What Gets Me Hot) — Sat, 07 May 2022 06:45:00 +0000

keymetric ADR RevPAR disclosure

I LIVE IN A HOTEL OR MOTEL, WHAT ARE MY RIGHTS?
However, in certain circumstances, a hotel/motel guest can become a “tenant” with legal protection from an eviction.

I am currently staying at a hotel or motel, can I be forced to leave?

However, if you have stayed in the hotel or motel long enough to become a tenant, you cannot be put out unless the motel or hotel files an eviction case against you.

Am I a tenant or a guest?

Under law, guest becomes a tenant after they stay at the hotel/motel for 30 consecutive days(30 days in a row) without checking out.

The hotel or motel can end your tenancy in one of two ways.
First, if you fall behind in your payments, the hotel owner must give you a written notice demanding full payment 14 days.
If you do not pay what you owe by the time the 14 day period ends, the landlord may start an eviction against you.
The hotel or motel owner can also ask you to leave by giving you a notice.The notice will give you either 30, 60, or 90 days to move.
The amount of time you get to move is based on how long you have lived in the hotel or motel.
If you do not move by the date in your notice, the hotel or motel may start the eviction process.
What will happen if I don’t move after I receive a notice to move?
The owner changed the lock to my room! What should I do?
Call the police.
When the police officers arrive,explain the situation to them and ask that they help you re-enter your room.

If the police are not helpful, call the station and ask to speak to a captain or duty officer.
If the police refuse to help you, find somewhere safe that you can stay for the night call Legal Services.
I am a tenant in a hotel or motel, but the owner called the police and asked that I be put out! What should I do?

When the police arrive, explain to them that you have been staying at the hotel or motel for over 30 days and that makes you a tenant.

Midscale brands include AmericInn (Wyndham), Baymont (Wyndham), Hawthorn Suites (Wyndham), Ramada (Wyndham), Wingate (Wyndham), and Tru (Hilton).

These Midscale chains compete with independent brands like Best Western and America’s Best Value Inn.

A fresh face in the Midscale category is Hilton’s fast-growing Tru brand.
The centerpoint of each of these cheerful, value-oriented hotels is the large lobby, which features a 24/7 sundry market, co-working space, plenty of seating, and pool and Foosball tables.
Tru’s efficient guestrooms have desks on wheels and spacious bathrooms, and you can work up a sweat at the on-site fitness center.
Economy hotels target the most budget-conscious travelers.
These hotels are often found on highways and near airports.
The rooms are simple and amenities sparse, although the hotel usually provides a basic self-service breakfast.
Like the Midscale category, Wyndham dominates the Economy segment when we compare the top hotel companies.
Marriott, Hilton, Hyatt, and IHG have no brands here - yet.
Economy brands include Days Inn (Wyndham), Howard Johnson (Wyndham), Microtel (Wyndham), Super 8 (Wyndham), and Travelodge (Wyndham).

We intentionally left out major brands not owned by the big hotel chains like Omni, Loews, Four Seasons Hotels and even bigger groups like Accor, Best Western, Choice Hotels, Comfort Inn, Motel 6 and Radisson.

LSU FMOLHS half-dozen Hydra-headed hospitalist trod Mark Zielinski & co. LSUHSCNO-BR Physician Clinic Baton Rouge OLOL -- this untidy mistake cost

noreply@blogger.com (What Gets Me Hot) — Thu, 05 May 2022 07:41:00 +0000

Consequence of retaliation will expose unpleasant contingency for which individuals of low-caliber transgress, and whose gratuitous title depend upon illusion.
Others assume employment is indicative of good job those employed do, whereas, even in moments of prolonged states of sobriety, they are at best, only formality--disposable, their high-pitched squeaking noise comes from facultative free reign, out of disdain, in singular nature to conduct themselves of no seniority:
and so the proper introduction to the truthful story of illicit Medical Evictioning by proxy, through epicene show of delegation and Force of Authority, a most accessorial request, taken by 'new' girl, whose neophyte status did not know how terribly improper, in such a lot of ways, was she the bearer of, not just bad news--its amanuensis; Laws, Acts, and Decrees was she sent to tramp, nor did she, nor attempt to justify of stringency--realize my wrath, misappropriated to she--extraction of no cause, and suborning all policy, due process, consultation, by autonomy, through consult of no authority -- she had no answers; he'd given her none but raving last-second Abandonment, he referred to as Termination--20 minutes before a Televisit during raving Pandemic--to an at-risk person whose recent anamnesis included a broken back.

No contact availed, no Continuity of Treatment offered, no 30-day supply of Medication prescribed--until I might find a replacement doctor.
No explanation.
Thus I waited--even helping her along.
He had discharged the gun, I needed to understand what for.

Through capricious, selective mismanagement, subverting and perverting the letter and cut of his own Health Care System, FMOLHS-OLOL-RMC, LSU, STATE OF LOUISIANA's Code of Conduct.
My conclusion: COVID-burnout had gotten the better of him, and at the side of his worldview--he had suffered a drastic episode, and emerged more deteriorated than before -- that this had arisen from his being forced to regulate or exhibit tolerance, inclusiveness, was what I assumed had made him act with such malice.
Discounting each alternative whose tiny angle toward exclusion and distinction, in conjunction with a staff trained, ever it be who carry indictment for this milestone of misconduct--Gilbertian, however more vindictive--of endemic, desolate issue--no adherence to wholesome, respectful observance during years that ought to have, but sadly--did not shape those I encountered there--unconscionable events, through Doctor--his Nurse, tardily, but well-rehearsed--however, with no corroboration, nor witness; no contemporaneous notation, nor mention; no doodle, nor Post-It--transcribed, rumored transpired--resulting in unpunctual, dissociative dissolution, and disassociation, the actionable standard for Malpractice of "Physician Abandonment."
Weasel-worded bet on his proceeding first--firing his storied most sacred Patient from his sacrosanct Patient - Physician Relationship--administered by construct to patient whom we are led to believe is protected by Federal Provision, Protection by Affordable Care to immortal troth whose Sisters of Franciscan Ministry of Our Lady, Catholic Charitable 503-(c) FMOLHS Llc. was reckoning their Order--I in the habit of recognizing.

Large CMS in charge of Medicaid disbursal to massive, LSU-affiliated, half-dozen Hospital prayer beads of institutions--Hospital Hydra trod upon, Mark Zielinski and co., LSU-HS Psychiatry Clinic, Residential Program, Baton Rouge, OLOL campus, did this untidy mistake cost his own potential proscription (leaving those Psych Residents Sans Licenses - upon Licensure, as he is also the Supervisor of the Residential Students).
whoa!
Evinced authority, no court application, written, nor verbal order, my release, I asked--and to my shock, was not told.
By no authority, of laughable dictum, through unwanted, forced amendment of Medical Protocol, had I been impelled to pay doubly for identical once-prescribed-by-GP, Family Physician, now referred to see shrinks for equivalent.
Over five years at same OLOL-LSU clinic.
Now through amanuensis, during a STAGING revival OF COVID-19, and Defying every mandate and updated mollification of strict enforcement, for the health of a Population, in response to those whose health, or other deprivations did qualify them further eligible to garner obviation of Emergency declaration from the highest of Federal, State -- executive Law of the Land, through Stafford Act, Center for disease control, the newly lawfully imbued separate body now and through Plague, and even through Common Decency, of two Historic Parties of Opposing Forces said along --ALL.
All except the vanity through his who would preclude it, the associate physician, maid of honor, rarely a bride -- him, and those artiodactyl and vermin whose misconduct, so played at a distance, not from requirement, or due to some delinquent condition, but of very real preservation of self, in order to stay the fraudulent accolades with which he surrounds himself--but never contributes; and all collegial, whose publishing, he alone does not perish by, his cohorts are concealing in plain sight.
THE PRESIDENTIAL ORDER and ACT ISSUED STATE OF EMERGENCY whose harbingering of deficit represents his literal derangement, as you deny it and remove it, from the most obsequious of its benefactors you endanger -- the very core of whose ability to serve, it is for you to profit from their designation -- also given through Constitutional Power, Internal Revenue Service Tax Exemption, their Charitable Designation as institution of worthy Proscription of Taxation as through the Catholic Church, would YOU -- NOT me ... through my DEDICATION, and, If Necessary, Removal of any of it that you instigated by Accusation, through treasonous Lies, you find yourself now unable to guarantee sufficient, as you relied on an employee for your fraud; and when that was seen shoddy surety of your safety through lies, you further inveigled your friend and colleague, Lee Tynes and Kathleen Crapanzano, whether wittingly or not, they are nonetheless as culpable for their roles, after the fact, in cover-up, and non-reporting of you to the multiple bodies and departments, likewise as scores of Federal Departments, now Prosecutors, whose only payment the Franciscan Ministry of Our lady Health, Ll c., is beholden on this Earth, which you now endanger, the full force of those organizations whose beneficence they are privileged to fulfill from a vaunted position of receiving from those whose funding do they use wholly, but on whose delicate footing you may bring them down, you will see from your censure, and I Pray, your Debarment, their station come just a little nearer to yours who put it there.
mendacious statements in the commission of a crime -- all with the authority nitwitted minds of low psychological feature process as the coast is obvious, where, you secluded, last person of ethical acumen, instead, imitative, gesticulate dismissal of pathological conceit and through unauthorized IMMUNITY without boundary, you rival any I have encountered.
Whose longevity as preservation, I saw, but did not heed: Mine were one pair of eyes too many, not on payroll, whose continuity of observation and experiential witness was enough to dampen the perverse misanthropic enjoyment any unwelcome scrutiny of such covert existence a hulled shell was one who might have once wished his career.an actual hazing, prescribed bullying against a patient, with the new semi-permanent guest, as if by club chaperone, amid speculation -- brazenly with not the tiniest concern ought I fight.through repetitious encounters with the general public of whom i see from your flat affect incidents end badly if self-help justice mushrooms to all departments, once alert to it-- in all it saddens me to recall, The day i worried, upon finding your co-specialization as active gerontology physician through what there with those poor old souls you set them through, our Mothers and Fathers, your need for control vs.their impaired cognitive capability, your lies concerning me through employees.This is devolved low to poison, and young children, and even LSU Residents, whose spectrum as high functioning, I have known your kind as currently infects pernicious, perpetual campaign of retaliation, even to staff, converted of requirement you obviate -- intellect disallows reason, if what has been told were true, no matter,.I knew that this distinct place from which to maneuver while difficult, i would all the same, as raised to face principle, if falsely suspect or maliciously blasted, to disavow and ignore, or fight, and to never alter once challenged, force that from which I had properly, a right to possess.I question, however, how i lose this one.three, one too many strikes to not strike back ... the last word occasion to express me out of the building has done a final affront.for the third time in a matter of two months through bluster, racism, or sadistic enjoyment of constructive endeavor to dominate me absolutely by no authority, through intimidation and on the face of it only for amusement dirty deeds thrill and in presenting narration -- laughing loudly in a very state, and every one of the same-same-race employees, same time as I walk by, never a pause nor interruption did my presence cause.

Jimmy Page Umami: hot mics, deafening decibels, furry woofing, trebly squeals, unmusical variance, needling flux! Zeppelin was the 1494th most popular boys name and 4131st most popular girls name

noreply@blogger.com (What Gets Me Hot) — Tue, 12 Apr 2022 07:03:00 +0000

The young guitarist contributed licks to some of the most important hits of modern rock 'n' roll

INCLUDING:

hot mics, high-frequencies, sudden, deafening, decibel overshot yelps, roars, furry woofing, trebly whistles, dizzying squeals, unmusical electric variance, redlining tone flux, proximate over-amperage, hertz, joule, watt, candela, lumen, and lux.

Page's distilled session guitar hit licks ever-changing rock 'n roll, and refueling the behemoth dirigible whose unwieldy destruction was first to mind of Keith Moon, its materializing montgolfier Phoenix--freshly viable name for new group: Led Zeppelin.

Zeppelin was the 1494th most popular boys name and 4131st most popular girls name. In 2020 there were 112 baby boys and only 33 baby girls named Zeppelin. 1 out of every 16,352 baby boys and 1 out of every 53,062 baby girls born in 2020 are named Zeppelin.
Producers and musicians showing wisdom and normative aversion to overburdening cross-frequencies which needled optimally varying methodologies of separation--isolation booths to baffles. Les Paul's significant milestones in the progression and exponential advancement of audio recording and its fulminate reciprocity and ostensibly contradictory toleration of scientific interpretation, no sonic disturbance from wave-crashes, looping--alternative technical laws of nature accounted for the prohibition of experimentation.
The advent of electrified amplification in the beginning of the 21st century, most magnificently utilized and recognized through Tesla or Thomas Alva Edison, as Charlie Christian--without whom progress is slowed, a peerless, profligate curiosity regarding 'Flyin' Home,' is existential.
Before Jimmy Page was a bona fide guitar god, he was but a young upstart studio musician in London.
Over the course of the nineteen-sixties he striped solos with chilling textures for the crème de la crème of British Invasion groups--later for Psychedelic London.
Beautiful, botanically blooming, snake-charmed crescendos with equivalent distinction of the gastronomic Japanese discovery and recognized human taste within the last one-hundred years--UMAMI.
The unique, fermented, meaty addition of a new taste note--a craving human appreciation, hard-wired, unconscious taste consumed, or left insatiable for foods in the exciting category, finally enjoyed, understood, conceptualized, and practically used to satisfy a history whose renewal has changed the world of food and its appreciation by a wider public.
onset as often marked by change in genre preference--pop to jazz, hippocampus,Hippocampus is a complex brain structure embedded deep into temporal lobe.
It has a major role in learning and memory.
It is a plastic and vulnerable structure that gets damaged by a variety of stimuli.
Studies have shown that it also gets affected in a variety of neurological and psychiatric disorders.
inflated gray matter, left posterior (memory), compared to audiophile distinction in dorsal, lateral, anterior and anterior cingulate, Finally, emotion (5) is conveyed by music through the activation of striatal, limbic and frontal cortices (striatum, Amygdala, Hipp, cingulate and orbitofrontal cortices).
The processing of musical emotions involves the reward system, mostly when positive emotional arousal is triggered by the predicted resolution of musical uncertainty (Gold et al., 2019;Salimpoor et al., 2009;Zatorre and Salimpoor, 2013) and an extensive network which complexity may be due to the variability of internal (relative to felt emotions) and external (relative to music construction) emotions that are evoked by music.
It involves, anterior Hipp, amygdala, auditory cortex, ventral (with accumbens nucleus, NAcc) and dorsal striatum, medial and lateral OFC, medial PFC, ACC, anterior insula, pre-supplementary motor area, rostral cingulate zone, medio-dorsal thalamus, cerebellum, motor areas… (Janata, 2015;Koelsch, 2018;Vuilleumier and Trost, 2015;Wang and Agius, 2018;Zatorre and Salimpoor, 2013).
...posterior parietal cortex, medial orbito and frontal pole neural signatures underlie direct salient signals, The salience network is a collection of regions of the brain that select which stimuli are deserving of our attention.
The network has key nodes in the insular cortex and is critical for detecting behaviorally relevant stimuli and for coordinating the brain's neural resources in response to these stimuli.Salience describes how prominent or emotionally striking something is.
If an element seems to jump out from its environment, it's salient.
If it blends into the background and takes a while to find, it's not.
Salience Bias states that the brain prefers to pay attention to salient elements of an experience.mental states related to musical memory and emotional response--abnormal searching for music toward the “…more abstract indulgent valuation that music represents”.
Odors have been shown to elicit highly emotional memories, as well as alter emotions and induce moods.
A critical challenge for the uniqueness of olfactory emotional potency is a stimulus with perceived inherent emotional quality.
Music and paintings are such stimuli.
Notably, olfactory experiences are distinguished from auditory and visual experience by limited verbal representation.
It was therefore speculated that weak linguistic representation might be responsible for the emotional potency of odors; and therefore if verbal fluency were controlled for, odor-evoked associations would lose their emotional distinctiveness.
To test this hypothesis and assess the emotionality and quality of experiences and associations evoked by odors, music and paintings, two experiments were conducted.
In Experiment 1 subjects assessed moderately familiar odors and music, and in Experiment 2 subjects assessed highly abstract (unfamiliar/unnamable) odors, music, and paintings.
Rating scale and questionnaire (subjective) and numbers of labels, memories, and heart-rate changes (objective) measures were obtained.
Results revealed that, in both experiments, heart rate was consistently higher in response to odors than to music and paintings.
It was also found that verbal fluency did not affect the emotionality of experiences to odors.
Additionally, subjective and objective measures of emotional arousal were not related for any stimulus type, and despite objectively measured evidence to the contrary, subjects believed that music was able to affect their emotions and moods more than were odors and paintings.
The present results show that 1) odors are more emotionally arousing than other aesthetic sensory stimuli, 2) language does not mediate this effect, and 3) objective and subjective aspects of aesthetic perception are not necessarily correlated.
cognitive reward seeks less high degrees of emotional price.
artistry relates to psychokinetic or pattern FTLD patients neural reality to fast onset music obsession and memory and emotion.
Music ranks among the best human pleasure.
It consistently engages the reward system, and convergence evidence implies it exploits predictions to do both prediction confirmation and errors essential for understanding one's surroundings, and music offers many interacting patterns across multiple timescales.
Learning models counsel these outcomes, i.e., intermediate quality, optimize reduction of uncertainty to gratify enjoyable impact.
nonetheless evidence of the same pattern in music is mixed, hampered by capricious measures of complexity.
In gift studies, we applied well-validated info-theoretic exteroception expectation to consistently measure 2 key aspects of musical complexity: predictability (operationalized information content, IC), and uncertainty (entropy).
In Study 1, we evaluated how these properties affect musical preferences in forty three male feminine participants; in Study two, we replicated Study one in an independent sample of twenty seven people and assessed the contribution of veridical--the degree to which something, such as a knowledge structure, is veridical; the degree to which an experience, perception, or interpretation accurately represents reality--certainty by presenting an equivalent stimuli seven times, discovered important quadratic effects of IC and entropy on feeling that outperformed linear effects, indicating reliable preferences for music of intermediate complexity, an interaction between IC and entropy further steered preferences for additional uncertain contexts, which would facilitate uncertainty reduction, repetition, stimuli remittent ratings failed to disrupt the preference for intermediate complexity.
Together, these findings support long-hypothesized optimal zones of predictability and uncertainty in musical pleasure with formal modeling, relating the pleasure of music attentive to intrinsic reward of learning.
Music is ubiquitous across human cultures — as a source of affective and pleasurable experience, moving each physically and emotionally — and learning to play music shapes both brain structure and processing in the brain — particularly, the perception of melody, harmony and rhythm — traditionally studied as an exteroception.
Sensitivity to stimuli that are outside the body, resulting from the response of specialized sensory cells called exteroceptors to objects and occurrences in the external environment.
Exteroception includes the five senses of sight, smell, hearing, touch, and taste, and exteroceptors thus take a variety of forms (e.g., photoreceptors—retinal rods and cones—for sight; cutaneous receptors—Pacinian corpuscles, Meissner’s corpuscles, Merkel’s tactile disks—for touch).
phenomenon exploitation passive listening paradigms.
However, when being attentive to music, we actively generate predictions concerning what is probably to happen next.
Scientists reveal new ‘most dangerous’ personality type A new “dangerous” character trait dubbed “dark empathy” has been identified by scientists — but do you possess it? Recent research has found that individuals who boast dark personality traits, such as narcissism, can still retain high levels of cognitive and affective empathy.
The study, recently published in Personality and Individual Differences, identifies these types of people as “dark empaths.” Empathy can be broken up into three categories: cognitive, which describes the intellectual understanding of someone else’s feelings without sensing them; affective, or feeling someone else’s emotions as your own; or compassionate, a combination of cognitive and emotional empathy.
Individuals are considered dark empaths when they possess cognitive and/or affective empathy as well as characteristics from the “dark triad” — a collective term for three dark personality traits: Machiavellianism, psychopathy and narcissism.
Traditionally, researchers have found that those with darker characteristics are often associated with a lack of empathy.
A new type of character trait has been uncovered called “dark empathy.”
And while this new data, which the researchers gathered from a group of 1,000 individuals, certainly reinforces that assertion, it also indicates a strong presence for the dark empath group.
“As expected, we found a traditional dark triad group with low scores in empathy (about 13 percent of the sample).
We also found a group with lower to average levels across all traits (about 34 percent were ‘typicals’) and a group with low dark traits and high levels of empathy (about 33 percent were empaths),” the study’s authors said.
“However, a fourth group of people, the ‘dark empaths,’ was clearly evident.
They had higher scores on both dark traits and empathy (about 20 percent of our sample).
Interestingly, this latter group scored higher on both cognitive and affective empathy than the ‘dark triad’ and ‘typical’ groups,” they added.
The team said they were not entirely surprised that the dark empaths scored as high as they did in the cognitive and affective empathy sections.
“This makes sense in a way, as to manipulate others for your own gain — or indeed enjoy the pain of others — you must have at least some capacity to understand them,” they explained.
The researchers also found that the dark empaths were more indirectly aggressive than typicals and empaths.
While empathy did limit the group’s level of aggression, it did not eliminate it completely.
Furthermore, it appeared that the group had a conscience and may even dislike their dark side, with the negative emotions being a response to their self-loathing, the team said.
The new findings are shedding light on those with dark triad traits, as well as forcing clinical psychologists to look at empathy in a new way.
“A dark empath may actually be more dangerous than a more cold and unfeeling dark triad type because the so-called dark empath can draw you in closer — and do more harm as a result,” Ramani Durvasula, PhD, a clinical psychologist, told Psychoanalyst.
“The closer you are to someone, the more you can hurt them,” Durvasula added.

This enactive aspect has led to a a lot of comprehensive understanding of music process involving brain structures implicated in action, emotion and learning.
Here we review the cognitive neuroscience literature of music perception.
we show that music perception, action, emotion and learning all rest on the human brain’s basic capability for prediction — as formulated by the prognosticate cryptography of music model.
This Review elucidates how this formulation of music perception and experience in individuals can be extended to account for the dynamics and underlying brain mechanisms of collective music successively.
This in turn has necessary implications for human power as evinced by music improvisation.
These recent advances shed new purpose on what makes music meaningful from a neuroscientific perspective.
Folks may respond to paying attention to music by physically moving or feeling emotions.
In this Review, Peter Vuust and colleagues discuss how music perception and related actions, emotions and learning are associated with the prophetical capabilities of the human brain, with a spotlight on the secret writing of music.
Odors have been shown to elicit highly emotional recollections, as well as alter emotions and induce moods.
A vital challenge for the individuality of olfactive emotional potency is a stimulation with perceived inherent emotional quality.
Music and paintings are such stimuli.
Notably, olfactive experiences are distinguished from auditory and visual experience by limited verbal representation.
It was therefore speculated that weak linguistic representation might be chargeable for the emotional potency of odors; and thus if verbal fluency were controlled for, odor-evoked associations would lose their emotional distinctiveness.
To test this hypothesis and assess the trait and quality of experiences and associations elicited by odors, music and paintings, 2 experiments were conducted.
In Experiment one subjects assessed moderately acquainted odors and music, and in Experiment two subjects assessed highly abstract (unfamiliar/unnameable) odors, music, and paintings.
Rating scale and questionnaire (subjective) and numbers of labels, memories, and heart-rate changes (objective) measures were obtained.
Results unconcealed that, in each experiments, vital sign was consistently higher in response to odors than to music and paintings.
It was also found that verbal fluency did not affect the emotionality of experiences to odors.
In addition, subjective and objective measures of arousal were not related for any stimulation kind, and despite objectively measured proof to the contrary, subjects believed that music was ready to affect their emotions and moods more than were odors and paintings.

zef• — zef•—•zef• — zef

noreply@blogger.com (What Gets Me Hot) — Thu, 31 Mar 2022 11:40:00 +0000

View this post on Instagram

A post shared by doug💙meet (@dougmeet)

zef• — zef•—•zef• — zef

•—•
500 @dieantwoord lovers have turned one 15-second clip of @prawn_star #CookieThumper yo! ONLY #solo #yolo dirtiest song. Viral.

HERE’S THE WHOLE FOKKIN JOINT!

Lyrics: MY FAVORITE Translated rap

A rhyme tight! tight! tight! tight!
Spark mosh-pit shit coz I rhyme so hype
Put me in front of sum1 I don't like
I go punch! kick! bite! fight!
I'm kray-kray like @oldirtybastard
Yo-landi down wid o.p.p.
I smell lovely coz I don't eat meat
2 much bubbly the I go pee-pee
Look out here cum little evil me
I got an itchy little need 4 speed
Rap on da beat like a hi-speed chase son
I burn them! yes mudafucka flame on!
Bow down 2 here mudafuckn majesty
No rapper out you az bad az me!

Cut your cookie, cut your cookie!
Cut it-cut it- hey

zef• — zef•—•zef• — zef•—•

There once was a little girl
Who had a crush on a bad, bad boy
But when that bad boy got out of prison
That little girl's ass was in big, big trouble!

That good anies he's a fucking gamgsta
Throw them devilish gang signz in da air
Start giving it up 4 little evil me
My fingerz green coz I'm a mean dope fiend
I'm wicked like mad
Fresh like a little dark g.o.d
Yo-landi we $$ are got da hypest flow
Start talking in tongues whenever I get stoned
Mudafuckn mindz get blown
Every time I rap in2 da microphone
My satisfaction is very foreign
When I speak overseaz dey go: I beg your pardon?
You can't get me like Eric Cartman
Naughty little kitty go meow
Yes daddy, I'm a big girl now
Jas little devil make your dick go wow
Chea boy! yo-landi vi $$ is ice hot stuff

Hey, that good anime he lam innie mang yes
"does she know my number?" xha! boy what's your number?
Two six? two seven? or are you a good bra?

That good anies he dreams in many yes
From my punani, yes you nice coat good
Finger into your hollow, nxa! take out the ganja
Yes package in! slap it like a rasta

#yolandivisser disser #pisser #ninja as @submissocuck and daddy's sweet @sixteenjones_
23w

dougmeet
1. (2:30) Die Antwoord #CookieThumper UNCENSORED @prawn_star #solo #yolo #CONTROVERSIAL IMPOSSIBLE TO FIND ONLY VIEWABLE HERE: https://www.instagram.com/tv/CCDBa-tAB2C/ #yolandivisser dirtiest song 2. 10-PT. REF #zef EDIT PRECEDING THIS: SEE WHAT TOOK TWO DAYS https://www.instagram.com /p/CCC2ZtFAQUJ/ -- (130 AM JUNE 29 2020) *INSTAGRAM HAS JUST NOTIFIED ONE OF THESE VIRAL VIDEOS HAS BEEN PUT ON RESTRICTION -- DON'T KNOW TO WHAT EXTENT YET INHIBITING VIEWS FROM 100 @dieantwoord lovers PER HOUR, WHO'VE turned A 15-second ROUGH IN INTO A VIRAL SENSATION LEADING TO THIS THE FINAL PRODUCT AFTER THIS 10-PT. STORY) BE SURE TO CHECK OUT THE FINAL: https://www.instagram.com /p/CCC2ZtFAQUJ/
23w

dougmeet
2.. (this video) 10-PT. #zef EDIT subsequent to 1. ( SEE WHAT TOOK TWO DAYS) https://www.instagram.com /p/CCC2ZtFAQUJ/ -- (130 AM JUNE 29 2020) *INSTAGRAM HAS JUST NOTIFIED ONE OF THESE VIRAL VIDEOS HAS BEEN PUT ON RESTRICTION -- DON'T KNOW TO WHAT EXTENT YET INHIBITING VIEWS FROM 100 @dieantwoord lovers PER HOUR, WHO'VE turned A 15-second ROUGH IN INTO A VIRAL SENSATION LEADING TO THIS 10-PT. STORY and chronologically followed by FINAL: https://www.instagram.com/tv/CCDBa-tAB2C/
23w

dougmeet
(10-PT.VIDEO)

THIS ROUGH VERSION BEFORE FINAL LEADING TO FINAL PRODUCT.

3. (Final Cut 2:30 edit) Die Antwoord
#CookieThumper
UNCENSORED

@prawn_star

#solo #yolo #CONTROVERSIAL

IMPOSSIBLE TO FIND ONLY VIEWABLE

HERE:

BRGeneral Lucie Kantrow & Benjamin LEVRON, J. Michael ROBINSON, Mark Zielinski "may be sentenced to death if such acts include snatch or shot to snatch, aggravated sex offense, or a shot to commit aggravated sex crime [LSUHSC FMOLHS OLOL-RMC] or a shot to kill, shall be punished or imprisoned for any term of years or for life, or both

noreply@blogger.com (What Gets Me Hot) — Sun, 06 Mar 2022 15:16:00 +0000

Baton Rouge General, Lucie Kantrow, Benjamin Levron, MD.,

Mark ZIELINSKI MD., J. Michael ROBINSON MD.

shall be fined under this title, or confined not more than one year, or both; if bodily injury results from acts committed in violation of this section, or if such acts embody the employment, attempted use, or threatened use of a dangerous weapon, explosives, or fire, they shall be punished under this title, or jailed less than 10 years, or both; and if death results from the acts committed in violation of this section, or if such acts include snatch or a shot to snatch, aggravated sex offense, or a shot to commit aggravated sex crime
or a shot to kill, shall be punished underneath this title or imprisoned for any term of years or for life, or both, or may be sentenced to death.

Baton Rouge General, Lucie Kantrow, Benjamin Levron, MD., warning against visitation to clinic from which I was illegally dismissed, not banished, and now which I am illegally threatened with a call to the police in Kantrow's attempt to have me arrested for trespassing, to frame me up like the Juice, she has now personally and through her representation of BR General--entangled the swiney Health System, whose flagship destitution I mistook for Port-a-Let--surpassed by their incapacity to dial Medicaid, and thus, although their decision was based on the chance to continue to not work, after a particularly inanimate oral communication--more exposition, which resulted in my sense of disappointment at those underserved whose flagship Port-a-Let this was--I might abandon ship to never reminisce of the ancient, dumbfounded, litter, of nicotine manicured, indolent, pirate faces, within pirate wreck of S.S. BR General.

failure of dignity and depraved motive, deprived of reason, inappropriate procedure, obstruction of facility, transition through referral--during pandemic--misdiagnosis, denial of treatment through improper referral, non-specializing physician, denial of medication, Mark ZIELINSKI, J. Michael ROBINSON, and, now Benjamin Levron, occurring June 2, 2021 , followed by the other 2 physician's similar brand of malfeasance with equivalent outcome, including BACKDATED, fraudulent Dismissal letters, and most flagrantly disruptive and highly unprofessional, the abusive threat I received from BR General Counsel Lucie Kantrow, a criminally consumptive harassment through threat mailed Special Delivery through the united states postal Service

John Bel Edwards GOVERNOR Stephen R. Russo, JD INTERIM SECRETARY ... State of Louisiana Louisiana Department of Health workplace of the Secretary LDH steerage FROM:
Stephen Russo, Interim Secretary Mark Thomas, Deputy Secretary 2020 RE: steerage on the supply of Health Care Services in an exceedingly Non-Discriminatory Manner throughout COVID nineteen Event

Although these oaths contain specific rules that today might seem elitist, sections dealing with decorum and the instruction "to help, or at least do no harm" continue to be relevant.

Baton Rouge General Medical Center is the area’s first community hospital.
An accredited teaching hospital since 1991, Baton Rouge General serves as an affiliate of Tulane University School of Medicine.

"HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal,”

said Roger Severino, OCR Director.
"Persons with disabilities should not be put at the end of the line for health services during emergencies. Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism," Severino added .

Due to public health emergency posed by COVID-19, OCR is exercising its enforcement discretion in connection with the conditions outlined herein.

This guidance is a statement of agency policy not subject to the notice and comment requirements of the executive Procedure Act (APA). 5 U.S.C. § 553(b)(A).

For the same reasons explained above, OCR additionally finds that, even if this guidance were subject to the public participation provisions of the APA, prior notice and comment for this guidance is impracticable, and there is good cause to issue this guidance without prior public comment and without a delayed effective date.

No notice provided in violation of state law.

NEGLIGENT punishment based on untruthful ALLEGATION (SUBSEQUENTLY RECANTED)

OMISSION OF PROVISION IN institution OF PATIENT TERMINATION for
MAINTENANCE OF medicament

Baton Rouge General Medical Center is a private company for 38 years specializes in the Hospital & Health Care area CEO Edgardo Tenreiro headquarters is located at Baton Rouge, Louisiana, Baton Rouge General Physicians Group (BRGP) Benjamin Levron, MD
Ben Levron is board certified originally from Thibodaux, and received degree in Biology from Nicholls doctorate St.
George’s University Medical school True Blue, Grenada2017.
member of the American Academy of Family Physicians, and Louisiana Association of Family Physicians.
General Health System Corporate Compliance Department Attn: Privacy Officer 8490 Picardy Avenue Requesting Ethics Committee for help Ethics Representative: (225) 387-7742 Patient Experience Department: (225) 387-7911 or (225) 763-4272 care includes knowing name and roles of people treating you.
health status, diagnosis and prognosis.
health care after discharge.
unanticipated outcomes (sentinel event).
concern or grievance about care Health Information Rights: • Right to Inspect Copy Health Info treatment and care.

Department of Health
Office of the Secretary LDH
GUIDANCE FROM: Sir Leslie Stephen Russo, Interim Secretary
Mark Thomas, Deputy Secretary
Julie Foster Hagan, OCDD Assistant Secretary
DATE: April five, 2020
RE: guidance on the provision of Health Care Services in a Non-Discriminatory Manner during the COVID 19 Event

This notice serves to all health care professionals and facilities within the State of Louisiana of duty to provide health care services in non-discriminatory manner, pursuant
to federal and state law and regulations.

For further guidance and information, the Louisiana Department of Health (LDH) recommends that all healthcare providers review and maintain compliance with the bulletin posted on March 28, 2020, by Department of Health and Human Services office of Civil Rights in which is provided this memorandum:

Bienville Building · 628 N. Fourth St. • P.O. Box 629 .Phone: (225) 342-9500 •
HHS for Civil Rights in Action

BULLETIN:Civil Rights, HIPAA Coronavirus2019
shall be fined under this title, or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire shall be fined under this title, or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title or imprisoned for any term of years or for life, or both, or may be sentenced to death.
all told, yielding multiple violations of State and Federal laws, Medical Incompetence, DENIAL of Treatment, refusal to order MAINTENANCE MEDICATION--Medical Abondonment by each under Health Systems of FMOLHS for Zielinski, Robinson--and for Levron, under BR General Physician's Group--his decision, and his administrators, to not request my patient records, and so, continue to use as excuse not having them on both first and second (last), visit, caught him redder than usual, and his administrators, whose HIPPA-busting second occasion it became of their plainly visible to me, eavesdropping through both visits, and on both, their motherly attempts to protect the Granadian Med School grad with no clue or acumen, and the last whose dread of eminent DEA enforcement was blamed on his cherrypicking my refill meds based on absolute worst case scenario of having a SEIZURE WITHOUT THEM--So instead, he just spontaneously, without having referred me for a complete mental reassesment declaring that this was a 'good idea' (except for the fact that he cut my dosage five times more severely than recommended), and without psychiatric evaluation, or even having my patient record, he completely cut my adderall prescription, while begrudgingly offering a one-time refill --CUT FURTHER DOWN TO HALF DOSAGE

IN ADDITION TO MENTAL PILLORY--VIOLATION Medicaid CMS to obtain them.

18 U.S.C.
United States Code, 2011 Edition
Title 18 - CRIMES AND CRIMINAL PROCEDURE
PART I - CRIMES
CHAPTER 13 - CIVIL RIGHTS
Sec. 245 - Federally protected activities
From the U.S. Government Publishing Office, www.gpo.gov
House of Representatives, Congress. "18 U.S.C. 13 - CIVIL RIGHTS". Government. U.S. Government Publishing Office, December 30, 2011.

§245. Federally protected activities

(a)(1) Nothing in this section shall be construed as indicating an intent on the part of Congress to prevent any State, any possession or Commonwealth of the United States, or the District of Columbia, from exercising jurisdiction over any offense over which it would have jurisdiction in the absence of this section, nor shall anything in this section be construed as depriving State and local law enforcement authorities of responsibility for prosecuting acts that may be violations of this section and that are violations of State and local law. No prosecution of any offense described in this section shall be undertaken by the United States except upon the certification in writing of the Attorney General, the Deputy Attorney General, the Associate Attorney General, or any Assistant Attorney General specially designated by the Attorney General that in his judgment a prosecution by the United States is in the public interest and necessary to secure substantial justice, which function of certification may not be delegated.

(2) Nothing in this subsection shall be construed to limit the authority of Federal officers, or a Federal grand jury, to investigate possible violations of this section.
(b) Whoever, whether or not acting under color of law, by force or threat of force willfully injures, intimidates or interferes with, or attempts to injure, intimidate or interfere with—

(1) any person because he is or has been, or in order to intimidate such person or any other person or any class of persons from—

(A) voting or qualifying to vote, qualifying or campaigning as a candidate for elective office, or qualifying or acting as a poll watcher, or any legally authorized election official, in any primary, special, or general election;

(B) participating in or enjoying any benefit, service, privilege, program, facility, or activity provided or administered by the United States;

(C) applying for or enjoying employment, or any perquisite thereof, by any agency of the United States;

(D) serving, or attending upon any court in connection with possible service, as a grand or petit juror in any court of the United States;

(E) participating in or enjoying the benefits of any program or activity receiving Federal financial assistance; or

(2) any person because of his race, color, religion or national origin and because he is or has been—

(A) enrolling in or attending any public school or public college;

(B) participating in or enjoying any benefit, service, privilege, program, facility or activity provided or administered by any State or subdivision thereof;

(C) applying for or enjoying employment, or any perquisite thereof, by any private employer or any agency of any State or subdivision thereof, or joining or using the services or advantages of any labor organization, hiring hall, or employment agency;

(D) serving, or attending upon any court of any State in connection with possible service, as a grand or petit juror;

(E) traveling in or using any facility of interstate commerce, or using any vehicle, terminal, or facility of any common carrier by motor, rail, water, or air;

(F) enjoying the goods, services, facilities, privileges, advantages, or accommodations of any inn, hotel, motel, or other establishment which provides lodging to transient guests, or of any restaurant, cafeteria, lunchroom, lunch counter, soda fountain, or other facility which serves the public and which is principally engaged in selling food or beverages for consumption on the premises, or of any gasoline station, or of any motion picture house, theater, concert hall, sports arena, stadium, or any other place of exhibition or entertainment which serves the public, or of any other establishment which serves the public and (i) which is located within the premises of any of the aforesaid establishments or within the premises of which is physically located any of the aforesaid establishments, and (ii) which holds itself out as serving patrons of such establishments; or

(3) during or incident to a riot or civil disorder, any person engaged in a business in commerce or affecting commerce, including, but not limited to, any person engaged in a business which sells or offers for sale to interstate travelers a substantial portion of the articles, commodities, or services which it sells or where a substantial portion of the articles or commodities which it sells or offers for sale have moved in commerce; or

(4) any person because he is or has been, or in order to intimidate such person or any other person or any class of persons from—

(A) participating, without discrimination on account of race, color, religion or national origin, in any of the benefits or activities described in subparagraphs (1)(A) through (1)(E) or subparagraphs (2)(A) through (2)(F); or

(B) affording another person or class of persons opportunity or protection to so participate; or

(5) any citizen because he is or has been, or in order to intimidate such citizen or any other citizen from lawfully aiding or encouraging other persons to participate, without discrimination on account of race, color, religion or national origin, in any of the benefits or activities described in subparagraphs (1)(A) through (1)(E) or subparagraphs (2)(A) through (2)(F), or participating lawfully in speech or peaceful assembly opposing any denial of the opportunity to so participate—

Office of academic Affairs 156 Thomas Boyd Hall

Baton Rouge, LA 70803(225) 578-8863

Mark Zielinski, MD., LSUHSC FMOL OLOL

we conclude requirement in statute, not merely directory but mandatory, such that failure to comply with statutory provision affects ensuant actions.

"if there has been failure to comply with requirement, a condition precedent to exercise jurisdiction by court, FMOLHS had no jurisdiction over complainant.

Office Manager entered Termination same day as final judgment June 2, 2021

This violation of mandatory law: provide summary termination proceedings

"[n]o provider removal shall issue until expiration after entry of declaration for severance."

Termination order and subsequent, fraudulent, backdated dismissal letter are void, for reasons of UTILIZATION OF united states mail mail fraud, predicate offenses TO DELIVER BY CERTIFIED MAIL OFFICIAL FMOLHS MARK ZIELINSKI, M.D.,DOCUMENT FORGERY OF COUNTERFEITING NOTICE OF IMPROPER TERMINATION BY FRAUD institution proscribed THROUGH BACKDATING (TO DATE half 31 DAYS, but which provide only 14 DAY period FROM TIME which consumer could HAVE reasonably RECEIVED LETTER--FOLLOWING DAY AS stated PROVISION FOR FEDERAL LAW MALICIOUS DENIAL IN XTREME 10 DAY "EMERGENCY psychiatric SERVICE ONLY"

(THE DAYS HAVING BEEN FRAUDULENTLY ALTERED TO AS FEW as the MANIPULATED DATE WOULD PROVIDE)

AS TO ANTEDATED cast CREATION, IT STIPULATES "DATE of final SERVICE, AND ANY and all ASSOCIATION WITH MARK ZIELISNKI."

"ANY OR ALL other SERVICES OF PHYSICIANS AT THAT CLINIC."

ANY FUTURE ASSOCIATION,"

FOR PATIENT.

Void for lack of subject matter, jurisdiction, healthcare provider / no authority

As stated, MARK ZIELINSKI, M.D., office Manager STEPHANIE (LAST NAME UNKNOWN), had no jurisdiction to issue TERMINATION against healthcare consumer where medical practitioner failed to comply with Medicaid CMS, ACA notice requirements.

required for dispossession of protected FEDERALLY PROVIDED healthcare SERVICES. Conspirators

(MARK ZIELINSKI, M.D., LANNIS LEE TYNES, M.D., KATHLEEN CRAPANZANO, M.D., MACM, office Manager STEPHANIE (LAST NAME UNKNOWN), OLOL PHYSICIANS group psychiatry CLINIC FMOLHS),

applying for IMPROPER TERMINATION, void ab initio for lack of subject matter.

FMOLHS failed to obtain mandatory CMS NOTIFICATION, in violation of Medicaid AND ACA RULES for EXECUTION OF DISMISSAL OF PATIENT, JUNE 2, 2021,

LIABLE FOR tortious DAMAGES produced by ORDER, and show distinction between erroneous and void ORDER.

OFFICE MANAGER was bound to execute TRANSMISSION, although erroneous, if employer / physician / had no jurisdiction.

But when physician had no jurisdiction, TRANSMISSION was void, and FMOLHS was LIABLE;

NO authority being same as VOID.
NATHAN v. VIRGINIA. 1 U.S. 77 (1 Dall. 77, 1 L.Ed. 44)

Guidance on the provision of Health Care Services in a Non-Discriminatory Manner during the COVID 19 Event

Lucie Kantrow brgeneral general counsel and my indelible anamnesis

noreply@blogger.com (What Gets Me Hot) — Tue, 01 Mar 2022 17:39:00 +0000

Lucie Kantrow brgeneral general counsel and my indelible anamnesis

Baton Rouge General Physicians, INC at BLUEBONNET CLINIC
Baton Rouge General New Foundation Member Lucie Kantrow, are batting one zero one on Recovery, not to mention her side-bet at the Legal Book on my high odds of failing to follow through in defense of her enhanced On-Threat Assessment of protected source Trends, in her inappropriate and actionable special delivery, in which she states, through her representation as counsel of leadership, Board, Stakeholders, Physicians, and members of its Health System as it pertains to her apparent campaign of Shock and Awe plus pathology and where I shall paraphrase:
[S]he would, upon her nebulous through manifestation as devilment--should I revisit the public medical clinic of Baton Rouge General, Benjamin Levron, M.D. (where dyke-stopper comes brainsick as pissed off civil engineer in charge of dyke integrity, upset at never having occasion to finger the soggy, spongelike bottom of deep holes, only to find used condoms, or other detritus, but never herself to receive reciprocation for her tending dykes, post-Katrina).
trespassing clinic of Ben Levron MD.,
Baton Rouge General Medical Center General Counsel News--
patient x
stating that she would have me for trespassing if I ever set foot onto the clinic of Benjamin Levron, MD.
She is BRGeneral, General Counsel--doing legal no-nos which may solely speak to her initiate standing, or to her exuberance on cracking open her new Roy Cohen Bio with forward by her candidate himself, the Donald--or she is simply endeavoring to do discovery--in my pants.
The foremost ribaldry destitute of law from a suitor's mind to which I have demurred amatory attentions, and wildly desperate enticements--warning against my corporeal presence on a public clinic, notwithstanding the qualification--clinic from which i was illicitly dismissed.

She is stoking the locomotive steam-engine to dangerous overheating, suddenly feeling as if she has the toilet at a crayfish boil--her internal Scoville mensuration is reading her baby box at 500,000 units--enough to soften ovaries, or hotwire the seat of her sensitive erectile organ in spontaneous rehab and emplacement to her stationary crotch, which she has in common with Our Girl Health System--only rivaling their serious Vow of Silence.

My best interest is shielded from Lucie Kantrow'S potential decision to frame me up like the Juice with alternative rights which she has now through her Registered Mail as representative of BRGeneral--entangled herself and them--and me--inextricably.

Protracted PHE provides ample time to browse my Melvin Belli bio, and show "partial Medicaid" institution their whole duty to comply; and their "training wheel" clinic its poor selection of Health Systems, whose destitution I mistook for Port-a-Let before entering.

Upon entering, a Port-a-Let crammed with motley, Benetton Pirate-women--only surpassed by their incapacity to dial Medicaid, their decision based on a well-thought-out prospect to continue to not work--asking me to reschedule, after inanimate exposition which resulted in my disappointment at those underserved folks whose flagship Port-a-Let this was.

Whereupon I distance myself AND abandon ship.

To never remember the ancient, stupefied, litter of mall-fashion, -manicured, butch, pirate faces found inside the wreck of S.S. BR General Florida, and Her associations concerned with standing.

MY Dismissal by health care provider, Mark ZIELINSKI, J.Michael ROBINSON, and, currently Benjamin Levron.

In full red-faced CVA, attempt to invent additional reasons why, rather than order my regular medications, he was instead, referring as many specialists in his network as James Michael Robinson had.the hot Caribbean sun causing their shadow centenarian hospital, and partner mayo Center, payor with all other Conrad Murray alumni in this Grenadian Med School nightmare of having 'studied' at the medical academic Cosplay, whose resulting degrees seemingly abject fear of medicine whatsoever, having come from their mouths--an unrealistic phobia of arrest, seizing of premises, subsequent investigation, which would prevent both of these young for such a wanton disregard against medical ethics,and my Qui Tam confidential, sealed ... lawsuit is filed in federal district court so that only the government is aware of the case. as well as a sweet tortious twofer-- I am becoming a doctor!

And once it appears as if the young barrister is getting ready to explode, as she boils over into furious jilling uphill for a cup of water, in prophylaxis of defending her deranged, self-invented, non-criminal (she is all-in and standing up from the table, removing her Carerra shades from her disquieted face, in order to see flop on the River).But, sensitive to her notably virulent personal enmity through initial contact of this twin role corporate attorney, it is now conterminous upon me to test her durable catcall and legal Chicken in all iterations below which her wealth of resources will undeniably influence--even thwart, my experiment.

Through her contacts of native law enforcement and their uncareful resolve to jug everything, she will have already originated a special extension on whose call BRPD attorney Hotline is activated, before i may feel freedom of movement in her self-imposed oligarchy whose private floorspace is a restricted showcase whose condition, even ramshackle--minus roof from wind--would shine as Haj Mahalia in comparison to BRGeneral flagship clinic, tucked off of Florida Blvd--unprepossessing, minimalist space whose antique ambulance entrance of yesterday (the name for local minority population's legs--Ambulance), whose loyalty, a necessity through impoverishment, was what kept them rooted to one medical clinic--whose brand is oldest--100 years--home to first doctor within the quaint capital of the baby pelecaniform seabird state--its Red Limb not nevertheless fully developed--thereby avoiding native Indian's incorporation as to use on which to display white men's room gory heads, whose reminiscence is spurred by its changeless stasis--as if lost in time through the bailiwick Zen of Historic Center--saved, reminder / caution of neglect--imperceptible marking of time does glacial misfortune stay freed from detection even now--choked Pueraria lobata contrastive medical aid enjoyed by only an elite few, whose slow appreciation at dangerous, excessively sensitive detection, or glaring, digital readouts of distracting specificity and scope, sees some request diagnostic apparatuses which they previously mocked in disgust--up-to-date medical devices not offered here.
administrative contingency which through enrollment and participation within the federal Department of Health and Human Service Medicare and Medicaid CMS, and ACA mandate of compliance in order to continue its payments to Benjamin Levron, his staff--at his door, eavesdropping in plain view, processing all HIPPA out the water--and for a second time, watching me.
INTERFERED WITH Medicaid Beneficiary's PROCEDURAL Due Process, SUBSTANTIVE due process, AND EQUAL PROTECTION RIGHTS under FEDERAL AND STATE CONSTITUTIONS; ZIELINSKI, et al. engaged in "knowing concealment, suppression and omission of material facts," made false representation of fact, which FMOLHS, OLOL, LSU relied upon.
No notice provided, in violation of state law.
DENIAL OF healthcare BY FMOLHS
Failure to comply with consumer and Medicaid healthcare System LETTER OF DISMISSAL,NEGLIGENT punishment based on untruthful ALLEGATION (SUBSEQUENTLY RECANTED) CONTEMPORANEOUS OMISSION OF PROVISION IN institution OF PATIENT TERMINATION for MAINTENANCE OF medicament.
A claim for fabrication of evidence; A claim of Fraud in the commission of a criminal retaliation, to deprive me of my Civil Rights, the lawful service of due process (against Individual parties).
Such failure of dignity and depraved motive, bereft of reason, inappropriate procedure, obstruction of facility, transition through referral--during pandemic--misdiagnosis, denial of treatment through improper referral of non-attributable current medication
A claim for violation of due process rights to serial nature of years, attempting under superintendence at Teaching University LSU, OLOL campus (as supervisor), whereby, lack of pre-deprivation or informal hearings, as stipulated under FMOLHS rules, refusal through a campaign of silence and universal blackballing, as well as the locking of my patient record, thereby disabling any information even from administrative operators, as to further actions, in violation of state and federal law.
false information through forceful manipulation of my indelible anamnesis -- disqualifying diagnoses therein, incalculably devastating to my relationships, my career, and my self-worth; invalid prescribing of narcotics and appointments for enrichment, he, and FMOLHS--caused permanent injury, and destruction of personal worth, and failure, through “manufacture of dubious medical diagnoses, requiring powerful habit-forming medications to be taken in daily toxicant combination, which are attributable as main factor in my diagnosis of NASH,” which will result in the shortening of my lifespan by no less than a factor of 10%--the remaining years experiencing a quality of life, lower than would have been expected.

In 18 U.S.C. § 1962(c), 18 U.S.C. § 1962(d), conspiracy --not having communicated, or allowed any of their administrative staff take a call, or return a decision since the New Style calendar month of June within the year of our Lord, 2021, once on the second day in the forbidding weather of partly spiking pandemic, during a realtime gubernatorial Stay-at-Home order, Mark Zielinski, Lee Tynes, and Kathleen Crapanzano did enter into into a criminal conspiracy, with Zielinski's nurse, and office manager, and perpetrate, Excommunicate, and do not Resuscitate this flatlined casualty.
Zielinski's decision to "lemondrop" a semi-permanent patient whose eightieth CMS rate was commencing to drag, just as the new LSUHSCNO-BR FMOLHS OLOL Psychiatry Residents (all 8 under the supervision of Tyne, Crapanzano, and Zielinski--all three players in this tawdry tale of malfeasance), would be filling his time as associate professor and supervisor for their first chance to treat real patients at his clinic--squalid by his superintendency, its running.
Its office manager--on this occasion, delegated as responsible in informing patient (me), that brand new hire Stephanie, was now in charge of the culmination of a second time deception, fraud, and untruthful ambit, to through misfeasance, moral turpitude, and complete disavowal of Medical Ethics, during spiking COVID Pandemic and its declared State of Emergency as well as gubernatorial Stay at Home order, on June 2, 2022, Mark Zielinski, M.D., had by amanuensis without the decency or intestinal fortitude to do the one last-resort, least pleasurable chore any physician has to do--but which only 1 in 4 have ever done once in a career--as a fully cooperative federally funded by HHS Department of Medicare and Medicaid full reimburser to the tune of 3.6 Billion dollars net worth, involuntarily disenroll a fully participating Medicaid beneficiary who had been being seen by the provider for approximately four years, and who through actionable malpractice, easily classified Medical Abandonment, not possible during any Medicaid enrollee's experience throughout the entire, still in existence, Public Health Emergency--for any but the most egregious reasons.
abortionfactent
Sister Barbara Arceneaux, tending mission to rid the state of abortionfactent, and establish a contraception course, wherever handiness is indefinitely on hold in the all-Catholic town of Baton Francis, tribute to namesake saint, 13th-century, visionary, self-flagellating Dr. James Harold Jimmy Doolittle of Assisi, and through him (although the suffering sisters having everything gratis, they love to watch worldly heathens--J.P. Funes, mostly--get their Ordinary's on Fleek), on account of their Vow of Impoverishment--taken as full-blown sisters
causing Office Manager Stephanie's personal liability, through his failure to disclose, or do his job himself--as all practitioners through common sense and duty--do no harm--this cavalier, callous lock-out of Zielinski's would--
FMOLHS OLOL administrative operator, that as she read to me from her own screen notations on my chart: any claims, false reports attributable to the nurse, and original allegations upon which Zielinski had, through his Office Manager, cursorily related upon my questioning of why I was being immediately terminated ten minutes before a month-long-advance televisit appointment with the OLOL physician, I was told a bare one-line exposition of some unspecified allegation reported to Zielinski by that nurse, and to which one week after the fact, just in time for our appointment, he would not be seeing me that day or any other day--and that I had, 'as of now,' been terminated and dismissed from the practice of Mark Zielinski, as well as the entire clinic at O'Donovan--effective immediately--canceling visit--furthermore providing no referral, etc., --she now recanted her report to Zielinski--his entire case for my dismissal now an open and shut case of misfeasance, malpractice, fraud, forgery, mail fraud, retaliation, and multiple other legal, and federally enforceable instances of serious contravention and direct breaking of those CMS rules with which that clinic and Health System are funded by Medicaid, and in danger of having that funding either discontinued, or being fined, and possible sanctions, as well as operating under a new agreement, at their discretion--and many other probatory punishments, fines, and serious oversight for lack of compliance by the boards and associations through which he is able to maintain licensure and to practice medicine in the United States.

house

noreply@blogger.com (What Gets Me Hot) — Sun, 13 Feb 2022 07:21:00 +0000

I can see my house from here
Life is but a span

— William Shakespeare

the only mug
which makes me laugh (FROM my TED Talk)

now, maybe i understand

— mrjyn (@mrjyn) 2019年3月31日

@media:math{
*input: raking-it-in 
*/in nary, lesser than five-star locations, nor venues/*

2 million words

I can see my house from here

Life is but a span

— William Shakespeare

the only mug
which makes me laugh (FROM my TED Talk)

now, maybe i understand

— mrjyn (@mrjyn) 2019年3月31日

@media:math{
*input: raking-it-in 
*/in nary, lesser than five-star locations, nor venues/*

2 million words

Stefan Cooke contrast-stitch loafers Highlights black bos taurus contrast stitching penny slot decorative button detailing round toe pull-tab at the heel low block heel Composition lining: Bos Taurus 100%

noreply@blogger.com (What Gets Me Hot) — Thu, 10 Feb 2022 18:47:00 +0000

Stefan Cooke contrast-stitch loafers

£365

The Details

Stefan Cooke contrast-stitch loafers

Highlights

black

bos taurus

contrast stitching

penny slot

decorative button detailing

round toe

pull-tab at the heel

low block heel

Composition

lining: Bos Taurus 100%

outer: Bos Taurus 100%
sole: Bos Taurus 100%
Designer Style ID: FSTCMLOAF19009

Designer Style ID: FSTCMLOAF19009
Stefan Cooke contrast-stitch loafers

Stefan Cooke contrast-stitch loafers
Stefan Cooke
contrast-stitch loafers
£365
Size 43selected
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★･::･ﾟ☆ ｡: Hyuna & Dawn 2 Marry! No Sasaengs｡･::･ﾟ★｡･::･ﾟ☆ fetch the boltcutters ･:*:･ﾟ

noreply@blogger.com (What Gets Me Hot) — Tue, 08 Feb 2022 14:14:00 +0000

･::･ﾟ★Hyuna & Dawn Married｡･::･ﾟ☆ ｡･::･ﾟ★｡･::･ﾟ☆ ･::･ﾟ★No Sasaengs｡･::･ﾟ☆ ｡･::･ﾟ★｡･::･ﾟ☆ ･::･ﾟ★,｡･::･ﾟ☆ ｡･::･ﾟ★,｡･::･ﾟ☆ ･::･ﾟ★,｡･::･ﾟ☆ ｡･::･ﾟ★,｡･::･ﾟ☆ ･::･ﾟ★,｡･::･ﾟ☆ ｡･::･ﾟ★,｡･::･ﾟ☆

View this post on Instagram

A post shared by mrjyn (@dougmeet)

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Copyright Disclaimer below section 107 of the Copyright Act of 1976, allowance is formed for “fair use” for functions like criticism, comment, news reportage , teaching, scholarship, education and analysis . enjoyment could be a use permissible by copyright statute that may somewhat be infringing

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bhad bhabie got me geekedup tweekedup

noreply@blogger.com (What Gets Me Hot) — Sun, 23 Jan 2022 23:27:00 +0000

View this post on Instagram

A post shared by mrjyn (@dougmeet)

@bhadbhabie got me #geekedup #tweekedit up and wishing I could take her to see @freaks_movie and makeout during #gabagabahey

Kanye West • Praise God • A post shared by T A L A (@tala.notes)

noreply@blogger.com (What Gets Me Hot) — Sun, 23 Jan 2022 23:22:00 +0000

A post shared by T A L A (@tala.notes)

"The American journal of insanity. Volume 13, July 1856 - June 1857."

noreply@blogger.com (What Gets Me Hot) — Tue, 02 Nov 2021 11:37:00 +0000

May 1.Case 3rd. W-C-, a male, aged 21, unmarried, a native of Ireland,

was admitted November 21st, 1853, and was said to have been insane for only seven days previously. This patient was found to be excessively addicted to masturbation. He had not, however, the sly, stealthy, and cast-down aspect of this class of lunatics. He was active, noisy, an inveterate whistler, and quarrelsome. He continued in the asylum for nearly eight months, during which time nothing remarkable Vol. XIII. No. 1. c

18 Journal of Insanity. [July, in his health was observed until about three weeks prior to his decease, when his appetite began to flag, and he became languid and feverish. In a few days the pupils were observed to be dilated, and he had frequent, copious sweats. Three days before death his breathing became labored and stridulous. He passed into a comatose state, and expired on the 10th of July. On removing the calvarium, the glandulae Pacchioni were found to be very numerous and large; the dura mater thickened and adhering to the cranium ; the pia mater was very vascular; the substance of the brain was much softened; the thalami nervorum opticorum were greatly disorganized ; there was considerable serous effusion in the ventricles; and along the base of the brain, anterior to the medulla oblongata, and stretching to the surface of the pons varolii, was a large deposit of pus. The general surface of the cerebrum was covered with lymphy deposits. The cerebellum was much disorganized, and covered with lymph.

Case 4th. j —_——s N - -n, a male, aged 32 ; a native of Ireland; inmate of the Asylum for nearly five years. Stated by the attendants to have been formerly epileptic, but not so latterly. His head was very large, and, phrenologically, well formed. He was a very quiet patient, though rather peevish and childish. His general health was feeble. He had no marked symptoms of formidable disease until a few days before death, three weeks prior to which, he complained of pains in various parts of his body, and in consequence was confined to his bed. On the day preceding his death he had a fit of syncope, from which he soon rallied, but suffered under a subsequent difficulty of breathing, and depression. In a few hours afterwards he complained of a pain across the lower part of the chest, to relieve which a mustard cataplasm was applied, but without benefit. On the following morning he fell into a state of collapse, and expired. Post-mortem examination was made during the same day. The dura mater was found thickened, and strongly attached to the cranium. The arachnoid and pia mater were very vascular, especially at the base. On opening the lateral ventricles, they were found to contain a large quantity of water, by which they had been so distended as to appear many times their natural size ; and the adjacent portions of the brain were very firm, as if from pressure by the fluid within. The base of 1856.] Workman on General Paralysis. 19 the brain was softened. The orbital processes of the frontal bone stood unusually high, and thus decreased the size of the cerebral chamber. The basilar arteries were ossified. The medulla oblongata was very soft. On opening the thorax, the lungs were found adherent to the ribs, by pleuritic deposits, of old formation. The upper lobes of the lungs were filled with tubercles, but no cavities were discovered. A large cyst, with very thick, membranous walls, and containing about a pint of serum, was found in the right thorax, under the lower lobe of the lung, and resting on the diaphragm. The heart was dilated to more than double its normal size. The arch of the aorta was likewise dilated. The auriculo-ventricular openings, and the columnac carnese were covered with fibrinous deposits. The liver was twice the natural size, but of healthy appearance. The spleen also was enlarged. The pancreas was slightly indurated. The mesentery was thickened, and its glands were much enlarged. On several spots in the tract of the intestinal canal, ulceration of the mucous membrane was observed.

Case 5th. I-c P-11, a male, aged 48, an Englishman, admitted 4th Nov., 1853. Continued an inmate until his death on 3rd Feb’y, 1855 : was stated to have been insane for one month before admission. His insanity was characterized by great restlessness, extreme sim¬ plicity, and incessant talking. His discourse was all in poetic measure ; and the readiness with which he found his linear rhymes might have been envied by many of our modern poets. He was a poet of the per¬ ipatetic school—he walked whilst he sang, and a certain space round his bed-room served as the measuring-tape of his verses. Whether in all versification a certain dash of insanity is not essential to correct prosody, may be a question for future, useful discussion. In every asylum we are sure to find some patients who speak only in verse. They have their periods of inspiration too, but they alternate, some¬ times, with sad gaps of mental exhaustion. During the second winter of his residence in the Asylum he became very feeble; and his articulation, which had formerly been characterized by a measured slowness, now became thick, indistinct, and dragging. His gait was unsteady and tottering, and a total mental vacuity appeared to obtain. About two weeks before his death he was found constantly 20 Journal of Insanity . [July, gnashing and grinding his teeth. Muscular twitchings in the face and arms were observed. The pupils were much dilated for a day or two before death. Post-mortem examination showed the brain to be much softened, and all its vessels distended with blood. A large quantity of serum was effused between the arachnoid and the pia mater, and the ventricles contained a quantity of sero-sanguineous fluid. The spinal marrow was examined throughout its whole extent, and a large quantity of serum was found in the canal. The cord was re¬ markably soft, and its vessels much congested. The heart was atrophied; its outer surface was nodulated, and a coat of coagulated lymph, of former deposit, covered it. The arch of the aorta was largely dilated. In the diaphragm, over the right lobe of the liver, was found a large cartilaginous formation. The liver was large, soft, and tawny-colored.

Case 6th. S——1 McC-y, a male, aged 45, a native of Ireland, latterly of very intemperate habits. This patient was first admitted into the Asy¬ lum on the 2nd of May, 1854. He had a halt in his walk, manifestly the result of a partial paralysis. His speech also was affected. His ideas were of the most lofty order. He invested d£l0,000 in the Asy¬ lum within an hour after his entrance, and made most munificent dona¬ tions to numerous charitable institutions. He proposed very soon to proceed to Rome, on a visit to the Pope, with the view of inducing his Holiness to make him a bishop, and place him at the head of one hun¬ dred young priests, with whom he was to return to Canada, and evan¬ gelize the whole country. His daughters, he said, had all taken the veil; and his wife was soon to become a nun, and to found many convents, all of which he would himself amply endow. After six weeks’ residence in the Asylum he became impatient of restraint, and made his escape. In the meantime he had improved much in his bodily condition, and had become a little less visionary in his specula¬ tions. He was not long at home until he began to evince his reforming propensities. He had some books on divinity and church history, on which he placed a high value ; and to improve their exterior, he took a whitewash brush, and gave them a good coating. His friends sent him to the country, where he had good air and free exercise. 1856.] Workman on General Paralysis. 21 On the 24th of February, 1855, he was brought back to the Asylum, and certainly looked better than when he had left it, eight months previously. He was ruddy, and rather robust, and his speech was not so indistinct as at his former entrance. The opinion was expressed, on his re-admission, that he would soon deteriorate in an asylum, and that his friends had, by withdrawing him from the country, and its congenial pleasures, adopted the surest course of bringing his case to an early and fatal termination. The symptoms of brain-softening and general paralysis, which, in his past months of rustic indulgence, had manifestly receded, soon began to exhibit them¬ selves in a very threatening form. He spoke with gradually increasing difficulty, his unsteadiness of gait increased, and in three months he could not rise from the bed without the almost certain risk of losing his balance and falling at length. The sphincters of the bladder and anus shared in the paralysis. Bed-sores soon formed. A series of apoplectic seizures were ushered in by severe chills ; after each the paralytic symptoms remained more aggravated. Finally, the power of speech almost entirely failed. There were severe muscular twitch- ings on one side, with dilatation of one of the pupils. The breathing became slow and labored, and he expired in a state of exhaustion, free from coma. The post-mortem examination was made twelve hours after death. The integuments of the head, as well as the bones themselves, were thin and dry. The arachnoid membrane was, in numerous places, ad¬ herent to the dura mater (or, properly speaking, to its own reflected portion, lining the dura mater), and the interspaces between the adhe¬ sions were formed into sacs containing serous deposits. The gray mat¬ ter of the brain was very much attenuated, and the cerebral sulci were remarkably shallow. The substance of the cerebrum was but slightly softened. The lateral ventricles were tilled with serum. The cere¬ bellum and medulla oblongata were much softened, and the theca verte- bralis was distended with serum. The lungs were quite healthy, and free from pleuritic adhesions—a very unusual fact in autopsies of the insane in Canada. The right lung was united to the diaphragm by an osseous formation of an inch in length, by three quarters of an inch in breadth. The heart was free from any abnormal appearance. The abdominal viscera were all healthy. [July, 22 Journal of Insanity.

Case 7th. G-R-, a mulatto, male, aged 22, a young man of large stature, and fine, athletic appearance, was admitted into the Asylum on the 5th of July, 1855. He was a native of Maryland, and had been a slave. His insanity was ascribed to excitement at a religious meeting. After admission he was found to be generally tranquil and very docile, but was subject to short and very violent paroxysms, in which he was dangerously furious. His bowels were usually found constipated prior to these attacks. He complained of want of feeling in his feet, and the anterior surface of his legs, farther up on one side than on the other. He manifested a great desire for education ; and frequently was found to be weeping because he could not read. He evinced, also, a strong determination to elope ; and on one occasion contrived to escape from the Asylum grounds, but was detected and brought back. On the twenty-third day after his admission he picked the lock of one of the ward doors, by which he got access to the roof of the Asylum, * and thence leaped to the ground, about fifty feet below. Instant death resulted. A fracture of the styloid process of the radius of the left arm was all the injury which had resulted to the osseous system from the fall. The place on which he descended was a soft meadow-ground, with a thick coat of rich grass. The brain was found, on examination, very much softened, and in all parts devoid of its proper cohesiveness, so that it broke down on the gentlest manipulation ; there was much venous congestion of the organ and its meninges, but no extravasation or vascular lesion. In all other parts of the body the organs appeared in a healthy state. Case 8th. W-m R-ts, aged 37, a male, an Englishman, married, by trade a tailor, of industrious and sober habits, and of a religious turn of mind, was admitted into the Asylum, July 6th, 1854, and was then stated to have been insane for two weeks. It was subsequently learned from his wife that he had been disturbed in his intellect for more than a year before coming to the Asylum, and had had occasional chills, followed by febrile reaction. He had complained of severe pain in the head, at times, and a feeling of pressure, or weight, over the skull. On his entrance he was observed to drag one of his legs, and to walk with an unsteady gait.

Digitized by the Internet Archive 
in 2020 with funding from 
Wellcome Library 


https://archive.org/details/s6059id1378414 



THE 


A M E R I C A N 


•JOURNAL 



EDITED BY THE 

MEDICAL OFFICERS OF THE NEW YORK STATE 

LUNATIC ASYLUM. 


VOL. XIII. 


The care of the human mind is the most noble branch of medicine. —Grotius. 


UTICA, NEW YORK: 

PRINTED AND PUBLISHED AT THE ASYLUM. 

1856 - 7 . 







WELLCOME INSTITUTE 
LIBRARY

Twitter real let go real

noreply@blogger.com (What Gets Me Hot) — Sun, 12 Sep 2021 04:26:00 +0000

Twitter Cling company let go

#NoPawsLeftBehind. Last Tuesday, I glanced at the “What’s happening” sidebar on Twitter and saw that nearly 32,000 people were tweeting about this topic; therefore, it was “trending.” A description of the trend, presented just beneath the hashtag, explained that it was “commemorating the service dogs left behind following the withdrawal of American troops in Afghanistan.”

Clicking through the hashtag, I found a slightly more irritating story. Earlier that day, the alt-right personality Jack Posobiec had tweeted,

“Today I am launching the #NoPawsLeftBehind Campaign,” to post photos of their dogs “in solidarity with the service dogs left behind in Afghanistan. Use the hashtag,” he wrote. “Let’s get it trending.” Of course, random people obliged, because random people like nothing more than to tweet blurry pictures of their pets with captions such as “Mocha and Macy sending prayers of comfort and safety to those brave service dogs!” A Twitter user called Cheeses teak, whose bio says he owns four cats, shared a picture of a dog with a soldier and wrote, “There is NO CREATURE on this EARTH who is more NOBEL and has MORE HONOR and we ABANDONED THEM TO OUR NATIONAL SHAME.” OH MY GOD. Soon, PETA was involved, and so were a bunch of politicians. “Sparky stands in solidarity with every service dog,” wrote New York Representative Claudia Tenney.

The idea that American military service dogs had been abandoned in Afghanistan was erroneous and easily debunked, so besides cringeworthy, these tweets were also misinformation.

This is a common sight in the “Trending” sidebar, which was built in Twitter’s early days to show off a list of topics that had caused a sudden spike in interest on the platform. Since then, trending topics have become a factor in harassment campaigns, election disinformation, and the amplification of extremism.

I am not even close to being the first person to point out the problems that they cause; in May, for example, the writer Ryan Broderick called trending topics “an endless pit of zero stakes anger.” But I do need to add: Twitter should get rid of its Trending sidebar, once and for all. Not just because doing so would make the world a better place, but also because I should really not waste any more of my time on Earth trying to understand what is going on with a bunch of posts from a bunch of people who themselves have no idea what is going on, or who are pretending not to for attention.

Since the beginning, this silly little sidebar has been the cause of tension and anxiety among users—those who need to see Justin Bieber’s new single represented in the space, those who decidedly do not need to see that #WhiteLivesMatter, and those, like the former president of the United States, who feel that trending topics are actually illegal. And since the beginning, the sidebar has been—at its very best—no more than a curiosity. Why can’t Twitter let it go?

I know it’s sick, but I look forward to seeing what new absurdities are waiting for me each day on the internet. I mean this generally, and also specifically with respect to “What’s happening” on Twitter. Did it bring me perverse joy to discover, last week, that the word Brooklyn was trending in Brooklyn? Yes, it did. Did I truly love that Elizabeth Holmes was trending during her federal criminal trial because, according to Twitter’s explanation of the topic, “some attendees at Theranos founder Elizabeth Holmes’ trial appear to be dressed in similar style to her”? Yes, I did! That said, I should be rescued from myself, and Twitter should get rid of this feature because it’s useless.

“We want Trends to promote healthy conversations on Twitter, and we work to achieve this in a number of ways,” a Twitter spokesperson told me in an email. But the topics that trend are determined algorithmically, and Twitter’s human curators appear largely beholden to a set of opaque, computerized assessments. In June, I noticed that the word Auschwitz was trending. (I did not click to find out why.) In July, the word Sandy was trending in New York. When I clicked, I saw tweets about the 2012 Sandy Hook Elementary School shooting, “Canada’s stunning sandy beaches,” and a rabbit named Sandy whose pen was about to be cleaned. Even when the site’s curation team includes context, the trends can be totally disorienting. In August, for example, the word Busta was trending. Alongside it, Twitter added the phrase “Experts say masks are safe and effective in preventing spread of COVID-19.” To understand how these two things were connected, I had to poke around until I ended up at a Page Six article about the rapper Busta Rhymes’s recent surprise concert at the 10th anniversary party of a taco chain in Missouri, during which he said some stuff like “Fuck your mask” and “Mandates can suck a dick.”

Twitter’s most active users have had a beef with the Trending feature since its invention. In 2010, Justin Bieber fans were enraged by a change to the site’s algorithm for identifying trends that limited their ability to put his name into the sidebar every single day. Later that year, activists and researchers wondered whether the company might be censoring trends related to WikiLeaks. Twitter denied it, but some compelling evidence suggested that users weren’t getting the whole story. In 2011, the same charges were made about Occupy Wall Street–related hashtags, which were failing to trend in New York City. Twitter provided more transparency about what factors went into its Trending algorithm, and the type of people who would be interested in such a thing came to understand that trends derive not just from a topic’s popularity overall, but from a handful of other signals too: Trends are supposed to be novel and arise from a wide range of users (as opposed to one specific group); they are also supposed to attract original tweets and not just retweets, and the engagement that they generate is supposed to increase at an accelerating pace.

Read: You really need to quit Twitter

“Trending topics is probably one of Twitter’s stickiest features,” says Jean Burgess, a professor at Queensland University of Technology and a co-author of Twitter: A Biography. It was introduced as the first major tool to organize user-generated hashtags and help Twitter answer the question the platform originally posed: “What’s happening?” Since then, it has turned into a topic of conversation of its own, and one that often gets discussed—despairingly and disparagingly, at times—by Twitter’s hard-core users, Burgess told me. Still, after spending a decade with this sidebar, users are confused: According to Twitter, the question “Why is this trending?” was tweeted more than half a million times from September 2019 to September 2020. “We need to make trends better and we will,” the company promised in a post last fall. Here are my questions: Do you? And will you? But more importantly: Do you?

The names of celebrities often trend on Twitter. I like to click on these because the first 20 to 500 tweets will be something along the lines of “Saw that Harry Styles was trending and thought he did something so bad and got canceled??? Thank God he didn’t!” and “Saw that Harry Styles was trending and thought he died???

Thank God he didn’t!” When Harry Styles is trending, it’s because he is a very famous person and a lot of people on Twitter are going to post new hashtags and new phrases about him in response to anything he does. But our minds take off in hysterical directions at the slightest Trending prompt: He’s canceled; he’s dead; he’s canceled and dead. Twitter has long been aware of these premature, trend-induced reports of celebrity death. “We’re attempting to remove the ‘WTF?’ from the trending tab,” Twitter’s senior director for curation, Joanna Geary, told OneZero in March, referring to the sense of shock and horror that comes with seeing a favorite name appear in it. “We want you to know that Betty White is just having her birthday.” This is a noble undertaking, but curators still have to wait for a trend to happen before they can contextualize it.

twitter clearly up that betty white is perfectly fine before explaining why she is trending is so funny 😭💀 pic.twitter.com/gdU6YxM8oV
— kels • b99 spoilers (@langindustry) August 29, 2021

What if trends simply disappeared? A Twitter without trending topics would create a world in which countless human hours are not wasted on the chore of figuring out whether a famous person has died or done something wrong—that’s good. But erasing the “What’s happening” box could have many other, more important benefits. In April, the writer Charlie Warzel explained how the sidebar creates a daily “main character,” set up for harassment when thousands of people are directed to one of their posts, taken out of context. He used the example of a woman who had tweeted, inaccurately but playfully, that horror movies cannot be set in outer space. She then ended up as a trending topic (“Alien,” as in Alien) and had an absolutely horrible day. Whenever a regular post is displayed “to millions of random people as if it was some kind of significant pop-cultural event,” Warzel says, the results are unsurprising. The person who posted it ends up at the bottom of a pile-on, buried under bad-faith responses, showy dunks, or worse. And this is no fun for anyone else either: Do you really like how you feel when you’re getting riled up over a complete stranger’s opinion?

If Twitter trends are meant to reflect the moods and interests of its users, they can fail even when they’re succeeding. Those moods and interests might amplify disinformation, for example, or they could reflect authentic, widespread interest in conspiracy theories. People were curious about QAnon hashtags last year, which caused them to trend quite often. In 2019, the death of Jeffrey Epstein lit up the platform with hashtags such as #ClintonBodyCount and #ClintonCrimeFamily. “It was like lightning,” Justin Hendrix, a media researcher at NYU Tandon School of Engineering, says. “It was like a sports event. There will always be something else like that.”

Read: The year that changed the internet

Twitter has also battled for some time with fake accounts and paid-for activity that can be used to influence trends artificially. In 2019, researchers at the Swiss Federal Institute of Technology studied a huge body of tweets from Turkey and laid out an explanation of the sidebar’s vulnerability to astroturfing attacks in which “compromised, active accounts” tweet out the same keywords over and over. This tactic was put to use promoting various advertisements, political talking points, election campaigns, entertainment properties, and the cult leader Adnan Oktar. The researchers found that at least 10 percent of daily Twitter trends in Turkey were being engineered in this way. “In addition, these topics reached higher and trended longer than organic trends,” they wrote. “So their impact is even greater than their volume suggests.”
Twitter has promised many times to improve its users’ experience of the feature. Last fall, it responded to pressure from activists to #UntrendOctober—meaning, shut off the Trending feature at least until the presidential debates were over—by announcing a commitment to add more context to trends. That change invited more criticism: Is paying someone to write a sober description of a racist hashtag really solving the problem?

Twitter's explanations of trending topics have really started to capture just how exhausting it is to be on this platform pic.twitter.com/LcLH6HfTnL
— Alex Shephard (@alex_shephard) January 19, 2021

Twitter’s continuing efforts to fix the Trending tab seem especially odd given how other social-media platforms have approached the same issue. Facebook announced the decommissioning of its controversial Trending News feature in a blog post in 2018. “People found the product to be less and less useful,” the company’s head of news products wrote. Reddit still has an “r/all” forum that lets users see what’s bubbling up across the entire site (with all the problems that invites), but you see it only if you want to; the default experience is a personally curated homepage. Instagram and TikTok surface new, popular content, but recommendations are linked to users’ previous activity (and likely interests). All of these platforms seem to know what Twitter doesn’t: There is no way to fix trends, because there is no real reason for trends to exist.
The most enduring value of the Trending tab is in its absurdity, which is sometimes entertaining—no small thing for me, personally. On the best days, that box looks like the result of a science experiment in which millions of people were asked to participate in a free-form game of word association whose results determined reality. If it ever goes away, I will miss it, in spite of myself. But, seriously, we already have a means of knowing what is “trending” in relation to the topics that we care about, in the countries where we live, and among the people whom we know. That’s why we follow accounts on Twitter in the first place. I already have a sense of what Harry Styles is doing today, because 40 percent of my social-media feed pertains to his life. And I’m pleased to report that, as of this morning, he was not dead or canceled.

In the battle against vaccine hesitancy, many officials have suggested that people talk with their doctor if they have concerns about getting vaccinated. This advice makes a certain amount of sense. Primary-care physicians are typically the doctors patients trust most, and doctors deeply understand the benefits of vaccines. The American Medical Association has claimed, based on a survey it conducted, that 96 percent of doctors are fully vaccinated.
In recent weeks, though, I’ve heard from several people with an interesting excuse for waiting to get vaccinated: They say their doctors told them not to. Most of the people I spoke with requested anonymity so they could share sensitive health information. Most would also not give me their doctors’ names in order to shield the providers from negative consequences. The doctors whose names I did get did not return my calls or declined to comment for this story, leaving it unclear what they really think about vaccine exemptions. Some of the people I spoke with may simply be vaccine-hesitant and trying to blame a doctor for their own choice to delay or forgo getting a vaccine. But because doctors are a large and relatively diverse group of people, with varied training, credentials, and personal politics, it makes sense that some doctors would have incorrect views about vaccination.
“I do get a sense that some doctors may either recommend against vaccination or support a patient’s view of not being vaccinated,” Kimberly Blumenthal, an immunologist and drug-allergy researcher at Massachusetts General Hospital, told me. Many people have come to Blumenthal for a second opinion after their primary-care doctors told them not to get the jab.
She tells them that vanishingly few people can’t get either an mRNA or the Johnson & Johnson vaccine. Several medical practices told me they have zero patients who meet the criteria for a medical exemption. People who are allergic to an ingredient in one of the vaccines should simply get a different kind. Pregnant? Immunocompromised? Already had COVID-19? You should still get the jab, experts say. In rare cases, people might need to wait a few days or months before being vaccinated, and people who had an allergic reaction to the first dose of a Pfizer or Moderna vaccine might not be able to tolerate the second shot. But “really the only reason not to get vaccinated is you’re under 12,” Céline Gounder, an infectious-disease expert at New York University, told me.
Some doctors might be overestimating the side effects of the vaccines, especially with patients who have complicated medical histories. Primary-care doctors, for example, are often stretched thin and may lack the training to address hyper-specific questions about a new vaccine. “People are often using chronic medical conditions as a reason not to be vaccinated,” Gounder said. But those are usually the people who should immediately get vaccinated. “Those people are at higher risk for severe COVID.”
Plus, some doctors don’t like recommending new things or pushing people beyond their comfort level. Patients get angrier and more litigious when they suffer side effects than when they skip vaccination. “You’re not going to get sued for not vaccinating somebody; you’re going to get sued for a complication,” Gounder says.
One woman I spoke with said her doctor implied that there was no need for a COVID-19 vaccine because the virus is “easily treated.” Another woman, who has a history of severe allergies (but not to the ingredients in the COVID-19 vaccines), said she was told, “I understand why you wouldn’t want to get it. I wouldn’t get it either. You don’t need to get it.” Paul Malarik, a doctor who helps run mobile vaccine clinics in California, told me he encountered a woman whose personal doctor suggested that the vaccine causes infertility. All three of those individuals eventually got vaccinated, but not everyone does.
Brianna Baker, a 22-year-old law student, told me that a childhood illness left her with shrunken arteries, which put her at risk of myocarditis, or inflammation of the heart. Though she would otherwise want to be vaccinated against COVID-19, she said her doctor recommended she skip the shots, because myocarditis is an extremely rare side effect of the Moderna and Pfizer vaccines. Besides, she had COVID-19 a month ago. It was a mild case, she recovered quickly, and now she has COVID-19 antibodies. “You don’t choose to be sick, but you do choose to get a vaccine, and that’s kind of what is a little bit daunting,” she told me. (Baker’s doctor did not return several calls and messages.)
I asked Baker why she wouldn’t instead get the Johnson & Johnson vaccine, which has no association with myocarditis. Baker said she has a family history of blood clots, which have—also very infrequently—been associated with the J&J shot. Blumenthal, though, told me that neither of Baker’s reasons for not getting vaccinated is valid. “I can’t think of one absolute contraindication to all the vaccines,” she said.
In other cases, doctors’ personal vaccine hesitancy may seep into their practice. Malarik read me several vaccine-skeptical messages from Doximity, a social network for doctors that has a history of hosting misinformation. “FDA-approved drugs did kill thousands of people in the past,” Malarik said one rheumatologist posted to the site recently. Another, he said, suggested that vaccinated people spread COVID-19 better than naturally immune people. In June, the Association of American Physicians and Surgeons, a group of right-wing doctors, eagerly publicized the results of a nonrandom online survey it conducted in which hundreds of respondents claimed to be doctors who hadn’t been fully vaccinated. Last week, hundreds of people lined up outside a Florida chiropractor’s office when they heard he would sign school-masking exemptions. (The district then updated the form to clarify that chiropractors did not qualify.)
Doctors who wrongly tell patients not to vaccinate may not face punishment. Physicians are governed by state medical boards, which vary widely in the sanctions they impose on misguided medical providers. They tend to go easy on doctors, whom they see as their well-intentioned peers. These boards are complaint-driven, which means that if, say, a vaccine-hesitant patient never complains about her vaccine-hesitant doctor, the board may never hear about it.
People who were told not to get vaccinated by a doctor face a difficult bind when it comes to vaccine mandates. Many university and workplace vaccine-mandate forms have a “medical exemption,” but what qualifies as an exemption is not clear. Baker, the woman with the fears of myocarditis and blood clots, said her law school would not accept her reasoning for remaining unvaccinated, and she transferred to a different university to finish her degree. (Her former law school declined to comment on her case, citing privacy reasons.)
Other students might face more flexible vaccine exemptions. Portland State University, for example, has a vaccine form that accepts as an exemption “an underlying medical condition that would put you at risk if you were to receive the COVID-19 vaccine.” When pressed, the university’s health-services director, Mark Bajorek, told me that acceptable exemptions would be an allergic reaction to the first shot, but also if the person “can’t tolerate lipid nanoparticles.” (“This is not something I have heard of, and I’m not sure how they would know this and what this means,” Blumenthal said.) Ultimately, Bajorek said, “if it comes across my desk, and it’s signed by a physician or a health-care practitioner, and it looks okay, then I wave it on.”

Like many other features of Wikidata, this one has been delayed for some time now. With WDQ, and the upcoming SPARQL services, there are now several unofficial query services for Wikidata. It’s time to introduce a service for auto-generating lists now.

Which brings me to the pun of the blog entry title: It’s the German word for “outwitted”, but it could also be read as “super-listed”. Sadly, umlauts can still cause problems with non-German speakers and keyboards, so I run this tool under a biology pun name: Listeria (actually, a genus of bacteria).

How does this work? On Wikipedia (currently, English and German are supported, but it would be easy to add more), one adds a pair of templates to a Wiki page. Once a day (or on manual request), a bot finds those pages, reads the template parameters, and generates a WDQ-based list of items. The list is implemented as a table, to allow for various properties, including images, to accompany the entry. Items are linked to the respective article on the wiki, or to the Wikidata item if no article exists. The list can be auto-sectioned on a Wikidata property (e.g. the administrative unit of an item). Once generated, the bot compares the list with the one already on the page (between the two templates); if different, the bot replaces the list on the page with the new, up-to-date list.

My example page lists Dutch lighthouses, auto-sectioned by administrative unit. I made an English and a German version, using the same template code. They will both be updated at least once a day by the bot; the top template also generates a link to manually trigger the update for a specific page. Starting a new automatic list is as easy as inserting and filling the two templates into a page. So, Wikidata-based lists have arrived, after a fashion.

What’s that, you say? Your manual list contains more entries? Well, go to Wikidata, and create or link up items correctly so they all show on the automated list as well! Oh, your manual table contains more details? Add them to Wikidata! That way, any language edition of Wikipedia can enjoy the list and the information it contains. Also, comparing your list to the automatic one can highlight discrepancies, which may point to faulty information somewhere.

Don’t like lighthouses? How about 15th century composers instead, sectioned by nationality? Or 1980s video games, sectioned by company, ordered by date? Your imagination is the limit!

Now, if we only had numbers with units on Wikidata, so we could store the height of those lighthouses…

Lessdoitagainreelsoonboy Oligopolist Hospitalist Grandsoned-in John Paul Funes Napoleonic Code Complex Syndrome Effect Comorbidity (JPFBJNCC-DSEC) ... healthcare stuff

noreply@blogger.com (What Gets Me Hot) — Sat, 11 Sep 2021 00:30:00 +0000

#endthepandemic ..." says VP MD Richard Vath - Our Lady of the Lake Franciscan Missionaries of Our Lady Health System (no companies use that phrase--because Circus #Carney LEFT WITH CIRCUS) #soundbites handed out by same #FMOLCEO explaining FOR #ScottWester's #WorkingAphasia Shortfall #OLOLBoard #rubes allowing ohhhhh participating in #JohnPaulFunes try at 7-year, $1 million CAPER, securing Greatest #KidCancer #KicktheBucketlist Walmart gift card Visa Direct #ROBINHOOD #CEO #Embezzler #Psychopath #perpetrated on #dying #PediatricCancerPatients at a #Catholic FMOL HEALTH SYSTEMS #BatonRouge's Our Lady of the Lake University Regional Medical Center #ChildrensHospital, 1 of 6 of $3.6 Billion Sister Act TAX-EXEMPT 503-(C) NONPROFIT #Franciscan #Oligopolist #Hospitalists

"We see Lirio as an important tool to educate and inform, and to help scale the distribution of the vaccine. Longer-term, we also see Lirio as a partner to help with our important #populationhealth work as well as to help provide more #personalizedexperience for our patients

dick vath uses Lirio #AI from holler to improve #patientexperience see if you can bayes your way out of this outcome? https://lnkd.in/gcNw3kWw staff physicians to admin to exec ceo Scott Wester, have denied appeal refused due process defied American Medical Association Code of Ethics malfeasance false report patient termination (#abandonment) American College of Physicians LSU School of Medicine New Orleans Pennington Biomedical Research Foundation LSU Law Journal for Social Justice & Policy Michael Crapanzano Lee Tynes #medicine #healthcare #medical #patients #patients

Napoleonic Code Complex Personality Disorder Syndrome Bloviating Narcissism Effective Comorbidity (NCCPDSBNEC)

over a 7-year period, President CEO, using the economic windfall for other reasons (HE WOULD CHARTER FMOL HEALTH SYSTEMS
Hospital Private Jets used for Emergency Patient Transport, taking a handful of completely clueless executives from the Baton Rouge Business community, who thought it was perfectly reasonable to use the old Hospital Jet for some good ol' boy Tiger Football Jet-gating on the tarmac before kickoff, and then back in time that, "No, I watched it on TV just like everyone else. GEAUX TIGERS! Who won? The Jet was ... my babysitter's Jetta broke down."
Okay, Dick, JP. Lessdoitagainreelsoonboy. as a healthcare organization," says Richard Vath President and CEO of Franciscan Missionaries of Our Lady Health System .

Fiscal Equivalent of the Indian Version of beloved American Game Show, Let's Make a Deal -- in India, renamed 'Let Us Do Such a lot of Deals (that the one's which don't kill us, will make the next governor wish he had)' whose apt metaphor carries on his second legacy perfectly, the insidious time-released Kali destroyer avatar, benignant malignancy, DEFYING EVERY HINDI, their own cultural significance, instead traded for his bizarre penchant to chew and shoot the shit with Cajuns and rednecks in pickups, listening to Githerdone videos and playing with the Catahoula, his future-proof appointment bombing assuredly 'Grandsoned-in' more 'Conservative Christian Republican' Greater Baton Rouge Businessman, appointees Heads of ... Board members, Committeemen, Civil Service, Public Servant, overpaid outliers still extant and becoming Extermination Resistant after each spraying--the after-effects of his reverse commutation privilege proved to be self-enriching, and (again, John Paul Funes and Jindal's pitiful need to give already-wealthy people they know more of our money for free, having filled all of the Bass Plaques and Beer Coozies and Ganesha's to the brimful of his new mansion called "filthy Sucre"--perfectly illustrative of the first Indian-American Southern Governor, whose treacly underbight broke his Lanthanum face into the shiteating frozen grimace of post-colonial entitlement and conservative austerity which the Kingfish of Cronyism could not have imagined--original Daniel Boone, OK, Boomer LA Gov Huey P. Long's greatest reign and sovereignty over this state, since Standard Oil, The LSU Marching Band self-penned Tiger Theme Song, A Chicken in Every Pot, and the avuncular, carbuncular, nepotistic Legacy by assassination of a character by bodyguard, that as the state's greatest fuck-ups ... John Paul Funes (see above for OLOL CEO 1 Million Dollar Cancer Kid Embezzler), blew out of the water as if Jerry Lewis was caught diddling Muscular Distrophes behind Ed McMahon's Tympani Timed Tote Board-Designated Percodan Dispensary.

His autobiography to be snatched up by those New York Publishing Giants immediately, prospectively titled:

If bolstering the Premiere Louisiana Center for Greater Learning through Better Sports SEC Tiger Football Domination and Southern and National Supremacy is wrong ... well, Fuck it!

also recalling the unstoppable LA

senatorial,
gubernatorial, attempted presidential, cut-down by Patsy, errant, bodyguard crossfire hurricane Catholic High party-proper graduate in the rotunda of the tallest, grandest limestone, phallic capital of all these united states, decorated on the cheap by the Public Works whose statues, murals, frescoes, tromped O'Neil, wrought-iron mastery, and tasteful Regionalism ode to the Louisiana simple man whose plain embellishments and common directness appealed, whereby even his Mussolini, little Hitler, over-ambitious desire for state riches, was a change from the later turn toward solely personal enrichment--preventing him was his

Napoleonic Code Complex Personality Disorder Syndrome Bloviating Narcissism Effective Comorbidity (NCCPDSBNEC)

private Emergency Patient Transport CHARTER Company called "utterly clueless execs from BRLA thought it was reasonable to use Hospital Jets for good ole boy Tiger football Wing-gating parties"

... healthcare stuff"

"We see Lirio as a crucial tool to teach and inform, and to assist scale the distribution of the vaccinum. Longer-term, so, see, delirious as a part facility | stasis with our necessary population health work still as offer more personalized experience for patients .

"No, I watched it on TV like everyone else. GEAUX TIGERS!

The Jet was ... my babysitter's Jetta skint down."

Okay, Dick, J.P.

Lessdoitagainreelsoonboy

Oligopolist Hospitalist Grandsoned-in John Paul Funes Bobby Jindal's Napoleonic Code Complex Disorder Syndrome Effective Comorbidity (JPFBJNCC-DSEC) Lessdoitagainreelsoonboy ... healthcare stuff

a weary, slightly stressed gang of flapped-out gosling fledges

noreply@blogger.com (What Gets Me Hot) — Wed, 01 Sep 2021 23:33:00 +0000

a weary, slightly stressed gang of flapped-out gosling fledges, road-frozen, bleary, trusting and plodding artistes de cartographique, like sex-workers, priapic, shifting voids of North stars which pass trails, nonviable, reembarked by the Renaissance Man of La Mancha, mixed with clinical hypermanic mechanics of all things: 'anti-,' not-'ing,' as if lacking severely that which leaning might worsen by rejection brain instigation. in simulation of "how to hold a knife and fork, which spoon for soup, which for escargot,' a disinhibition assiduously conditioned by way of endemic okay to evenly, without apprehension in mid-elocution of something with no need of stutter to reach a solution as to exactly which host will notice or miss the beat or the beat in-between Chopin's waltzing Viennese's Mathilda back out from Walkabout near Perth, for what it is worth.

But your manicured nails adroitly repair the lift in your step, slightly overdone, like white, wilted asparagus which plate-to-mouth, without utensilware, where blandly accustomed to some sort of implement with which to hender one's progress in the name of buying the pig a dress, to be sipped from finest most boned China Chinoise, le the lightly steeped, peridot slivers and service and saucers and books by Dante and Chaucer read among ringed bells and snuffed candles--your view is on offer.

He sits in not forgetting the sweetest of mushers, that rose-lit, remarkable, all-nose red usher, whose equivalent thrives frozen in time when tintinnabulation, Winter's ill-humored equines Iditarod it in place of their cousins out studding wild Mustang fillies

[for example, while it will be no coincidence that love-struck poet Filly is named Romeo, "Bianca" is unlikely to be a reference to the titular character's wife in Othello. As that reference doesn't relate to her character at all, it is likely she is named "Bianca" because the name means "white" and she is. An exception to this rule would be if a set of Fillies had a less-obviously themed set of names (e.g. if the Fillies living in a flower-themed house all had non-English words for flowers as names)],

not bovine, with cud in mud to their eyeballs, nor plotted of arable hectares of grassland of yellow-green nacre, cultivated and cared for, orphanage storehouse's Best Little Whorehouse's non-GMO scientific, redundant, retried evidentiary peer-reviewed studies, incontrovertibly blind by humans like Plagues, who ignore present-tense, like desperadoes waiting for a train, out there riding fences, in Beta, rarin' to go First Edition, inception not afraid of perdition, come vainglorious, relatable, cousining sylph to lovers of Nabokov or of his faunlet, whose diminutive, suffixed neologism stands for wee cunts like Balthus or Lucien Freud's slip of a thing, go Heathcliff wholly wolly in kilts built for speed, too itchy for comfort, in Mary Tavy's Nest goes the rump of the bleat of its trumpet, memory of things lost swain--long her discomfit--down on knees, applying to strumpet by firelight chat not Roosevelt or Ives, its hearth burns hot and your well-endowed to hold things evident, already half-call is the lucubration fouled by lubrication, flagellation, and felicitation--I manage to cry out, one more from the backbench, ejaculate--all of it, lustily luck from the fuck of the suck the truck is unstuck from the mire, and is done as she do it one more in the fire, as she rise up her knees and along come her pride, a lioness beside a barkeep closing all doors to the Nest, where go we, to Peter Tavy but before last place on the Moors in a cabfull of whores, singing songs by the Doors, to arrive at ten past, but we know the owner and the key's under the floor.

HE FOR THE COMMENTS ABOUT MAKING THINGS EASIER DURING A PLAGUE AND SHE FOR HAVING TO SPELL AN EXPLETIVE EXPLETIVE EXPLETIVE IRISH SURNAME EVERY EXPLETIVE TIME AND THAT IT RHYMES WITH EXPLETIVE NEW YORK

noreply@blogger.com (What Gets Me Hot) — Wed, 01 Sep 2021 21:57:00 +0000

HE FOR THE COMMENTS ABOUT MAKING THINGS EASIER DURING A PLAGUE, AND SHE, FOR HAVING TO SPELL AN EXPLETIVE EXPLETIVE EXPLETIVE IRISH SURNAME EVERY EXPLETIVE TIME AND THAT IT RHYMES WITH EXPLETIVE NEW YORK

EXPLETIVE EXPLETIVE EXPLETIVE IRISH surname each EXPLETIVE TIME and that IT RHYMES WITH EXPLETIVE new york.

nope. there's still the 'kick the bucket-list'

pic.twitter.com/fGq5r3GLS2
— mrjyn (@mrjyn) 25 octobre 2021

I am owed no appeal nor recourse of false causation and ulterior social control as personal retribution, whereby through the most unpleasant task a doctor encounters, consists firstly through its explanation to his patient--in a frank non-aggressive tone--amended with fair offer and with the ability to discuss any side of a disagreement, of which this unwelcome process is all so described.

(in reality, the similitude of this physician's hydra-head--make that more comparable to the grub unloosing at the low dumpster to infamy and nihilistic self-serving, self-soothing--ready employ to kill senses and dignity, both of which his profession requires--neither to abide without.

With misanthropic assurance his too-turgid and dirty to fail, or if in failing, failing naively, yourself to contemplate the impact of financial levying on any executive administrative Foundation, Fundraising, Board, Stakeholder-- all fastidiously cultivated in slick acquisition, the wealthy surround themselves with to incubate the correct member whose proportion of reciprocally assured destruction is exactly equal to the many years, many secrets, many indiscretions, protected by counsel, colleagues, investment advisors, and the silent discretion not divulged of heart's contents to even partner--but for the board, for the board only to use to jam through something buyable under a pricepoint of 3.7 billion dollars, which will get you a community like Baton Rouge everyday--everything, whose value is knowingly taciturn, and is developed like true cultists whose guru requires a truthful admission of desperately kept and ruinous deeds, acts, calumnies, revenges, perversions, past and present--together with photographs, or copies of destructive documents, furtive bank accounts, evidence of current paramours, secret families, or wives, or husbands, or whores, extra-marital marriage certificates, or of unknown children's births; or simply a current contact name of the individual's current sexual reassignment clinic and surgeon in Geneva.

She did finally, but too late, unburden her troth however with a lie parturient non-viable, purplish, fumid and noisome death, as the dumpster where she had thrown it, which Zielinski, like Janus, epicene, episodic, B-movie jockeying, in what he assumed would be non-detrimental to his flat-lined professional career.

And ever the Texan, but with the only thing big, the hole which was to the purpose of swallowing even the rationale for the ever-mounting, more exposed lies, likewise as claudication in his new boots careful not to jettison himself into the folderol he fomented like Trump and to equally auspicious a group--a Brobdingnagian secret never nonetheless told--which everyone already knew, and which the casual Google search would tell those of a more discerning knowledge of bound transparently obvious reasons for things, like the absence of any photograph throughout an extended many years, of himself, whether with a friend, a wife, a cohort, at a function, a BBQ, or a video--nothing. which as only a Texan will apprehend but not tell a interloper, is ultimately gonna be a You problem, for those unfortunates whose lives his late period of mythic blotting out--humans, thoughts,--rage of tamping them down, which, as in my case, like Whack-a-Mole, or Mt. Vesuvius, unbeknownst to anyone, and as impossible to resist as the fully-blown, impulse aisle of a grocery store, rather than stocked candy, tabloid newspapers, antacid, and soothing Halls, is stocked with whichever poison will never be maintained to douse the flame of slighted egotism, old age, or the disposition of a significant other, whose eminent exit strategy has been in play for 5 years, makes it necessitous to ingest, read, rave, or cry over the bottle of liquor sitting behind the counter right there next to it, whose soporific resolve is a human-less pile of clothing thrown into a hamper, and whose regret is none, because there is no memory which will be allowed inside to pry--Zielinski gestated to term {the solution|the answer} to either thwarting accounting an 80th Medicaid CMS payment schedule, or just the little Texan chawbacon whose own mental condition has long been in need of some serious but non-existent colleague's reporting as to his unfitness, mendacity, manipulation, dishonorable to a degree, failures, which once the first 5 occasions, really outlives its queries as to the colleague, friend, or professional observer's own ethical standing. This has now (as I write this update on the day I learn of my father's diagnosis of terminal cancer, already been irreparably injurious to my physic, my psyche, my health, my quality of life, as today is February 10, 2022--I was maliciously terminated from this charlatan's spare excuse to bill for therapeutic sessions, once I have been treated without any psychotherapy of any definition, but only, another government call and doctor's, to treat mental health Lite--mine is Generalized Anxiety, ADHD, and the constant pharmaceutical steamroller which through the decades has existed not for any therapeutic standard of treatment or efficacy and baseline management, however only on the variable downward graph of the diffusion of same from the roaring 80s and 90s to the penurious 00s, the winding down 10s, and the Republican Trump era final dumping of any estimable physician's medicine cabinet in with another marker of its timeline--into the DEA Pill return Repository someday a month--instead of simply fucking throwing it away yourself.

that shortly after June 7, 2021, when I was fired over the telephone in the manner described below, I learned some very fascinating and inculpative info which is that the only factor besides the sheer unlawfulness of Zielinski's actions against all rules,ethics, bylaws, orders, acts, declarations, and for any reason at all--

I learned that the explanation which you may scan below, which I had been severed as patient, through yet another, but best estimator of the man, Zielinski, through his complete unease at the taboo he was committing, he could not force himself to do what all of those institutions whose best practices build the protocol the protocol in a expedient action which most physicians, nor other professionals ever find the necessity to enact.

He forced his new office manager Stephanie, and even this does not impel contact with any member of any administrative ethics department, endemic racist predators, frauds, con artists, charistic impostors spreading Franciscan Spirit through healthcare to beatify Jesus Christ with love, but which ten years into a winning stretch, find it as directed by Roman Polanski, and defiled daily during their silent, secret, 8-month campaign of obfuscation, intimidation, blacklisting, violations of Federal and State discrimination, denials of service, denials to a Medicaid beneficiary in non-compliancy to multiple CMS, HHS-OIG, and through the prism of one more augur, my final victory over the apostolic Goliath, through infiltration into its Eagle's Nest, the sleight addition of dying, self-denying, shriveled genitalia on mendicants whose path of billions has found them with the likes of J.P. Funes, Wester, Vath, Craven, Bollinger--lying to the media, the public, and to themselves about their mission, and that they might not be doing it.

The fucking nurse recanted the story.

She was forced to lie for the psychiatrist.

The most desperate, soulless done with no warning, or explanation in 59 years of life.

Actionable malpractice, Mark Zielinski will not escape through retirement, but only these: rescission, debarment, loss of licensure, censure, fine, governmental agreement, and through the non-public revelation for me to see he and his dirty cluster of hacks derive pleasure the fleeting attention which sees all concerned find no shade for that few seconds of eclipse I promise shall omen darker omens of less biblical metaphors.

This is the protocol of a nurse who is responsible of a clinical practice, and to its the patients, and to the LSU Residential Psychiatric Program at LSUHSC-NO-Baton Rouge at the Lake Physician Group Clinicat O'Donovan--through OLOL-RMC, and under administration of FMOLHS, with special agreement of LSU Board of Supervisors, State of La., Civil Service Dept., operating as a Health Care System receiving payment through Medicare and Medicaid, and under abidance of all their bylaws, rules, and practices.

I am still being denied basic ethical and Medical covenants, freedoms from discrimination, from abuse by the very person sworn to "help, not harm."

Process Failure ... the American Psychology Association and sister organization American Medical Association, whose wisdom, expertise, experience, and trial and error have shaped the guidance relied on and followed by all medical professionals, from psychiatrists, physicians, researchers--anyone bound under the rubric of applying exhaustively crafted, updated-once guidelines--more sacred code--Medical Ethics, as that amorphous concept pertains to their practicing medicine, but especially as it applies to those whose oath is most pronounced--a physician's patient (beneficiary, enrolled healthcare consumer, client).

This has now (as I write this update on the day I learn of my father's diagnosis of terminal cancer, already been irreparably injurious to my physic, my psyche, my health, my quality of life, as today is February 10, 2022--I was maliciously terminated from this charlatan's unnecessary excuse to bill for therapeutic sessions, when I have been treated without any psychotherapy of any definition, but only, another government decision and doctor's, to treat Mental Health Lite--mine is Generalized Anxiety, ADHD, and the constant pharmaceutical steamroller which through the decades has existed not for any therapeutic standard of treatment or efficacy and baseline management, but only on the varying downward graph of the dispersal of same from the roaring 80s and 90s to the parsimonious 00s, the winding down 10s, and the Republican Trump era final dumping of any reputable physician's medicine cabinet in with another marker of its timeline--into the DEA Pill Return Repository one day a month--instead of just fucking throwing it away yourself.

It cost me my choice, my health security, my ability to continue to receive equitable medical treatment, having the unimaginable storm of a desperate physician lie and defraud a longtime patient / beneficiary / during Coronavirus pandemic, against all AMA APA, CDC, Stafford Act, FEMA directives, POTUS waivers, State directives and deferrals as long as the PHE is in effect, which since March of 2019 until this date, it has continually held steady, with some wind augmentations, more money in the trillions thrown at it, but the Franciscan Missionary Position of Our Orwellian, Von Trapp Family, Apostolic Sisters, whose Vow of Silence is as tight as their Vow of Enriching themselves: the one true irony of it all their Vow of Poverty, whose transference onto their well-selected right hand men and women 'Ordinaries,' give fuck-all about, and whose perverse love of the heathens, and of their ginger poster child, whose mission to go to Federal prison was to steal money he didn't need or keep.

Yes, John Paul Funes, compelled this truly psychopathic offender to steal one million dollars from cancer kids, of which he then during a period of seven years funded a perverse, homoerotic, self-loathing, neediness, which sees him give most of it to two LSU Football players--as bribes!

To play college football! Which he and his twin brother slavishly consume and exist for, in a virulent fandom to rival Andy Gibb or a Sasaeng's overstanning of their single bias K-Pop fandom on steroids--as virulent reappraisal of human nature (at 58 I had thought I could be spared), vile and craven weakness for praise, no matter why it be given, which certain people shed all moral, personal values for reward of feigned gratefulness, bestowed upon even a patsy.

The major occasion for this reappraisal, status report, and update, is for the fact that since I first learned of it, I have never bothered make it public:

that shortly after June 7, 2021, when I was dismissed over the telephone in the manner described below, I learned some very interesting and damning information which is the only thing besides the sheer illegality of Zielinski's actions against all rules,ethics, bylaws, orders, acts, declarations, and for any reason at all--

I learned that the reason which you may read below, which I had been severed as patient, through yet another, but best estimator of the man, Zielinski, through his complete unease at the taboo he was committing, he could not force himself to do what all of those institutions whose best practices make the protocol the protocol in a last resort action which most physicians, nor other professionals ever find the need to enact:

He forced his new office manager Stephanie, with no script, no information except that which will be the only reason which I will know until the day that I (who have always known what is below was a lie, but now everyone knows, and even this does not impel contact with any member of any administrative or ethics director of any department of evil, endemically racist, predators, frauds, con artists, Catholic charistic impostors whose spreading of the Franciscan Spirit through their Healthcare System mission to beatify and praise Jesus with love is now directed by Roman Polanski, or a Nun Porn, and is defiled every day in which they persist in their campaign of obfuscation, defamation, denial of service, denial to a Medicaid beneficiary as demanded by CMS according to HHS-OIG, and now through the prism of one more stronger portent of my final defeat of the Goliath, the infiltration into the Eagle's Nest, the sleight addition of one more old, dying, self-denying, shriveled mendicant whose path of billions has found them with the likes of Funes, Wester, Vath, Craven, Bollinger--lying to the media, to the public, and to themselves about what their mission is, and that they might be doing it.

The fucking nurse recanted the story

Mark Zielinski will not escape through retirement, but only these: rescission, debarment, loss of licensure, censure, fine, governmental agreement, and through the non-public revelation for me to see he and his dirty group of hacks bask in the momentary attention which sees all involved find no shade for that few seconds of eclipse I promise shall portend darker omens of less biblical metaphors.

Medicaid means, one must abide by more rules than Cricket, or jeopardize convent for constitution.

I am still being denied basic ethical and Medical covenants, freedoms from discrimination, from persecution by the very person sworn to "help, not harm."

my last name is Irish. Buy an apostrophe.

having been banned by W3C awhile ago I have invented my own code installation, not adherent to a pristine reference put forth by Tim Berners-Lee's WWW, but my own coltish gallimaufry of an iteration of a moment, changing every post. what you find here. i inhabit my own mesosphere--not quite canonically pure--BUT I'M NOT EXACTLY TANTEK, OR ERIC--happy to be hosted by THE Internet company, quaintly never changed in 10 years, which I am proud to say is my DUET with it, or ma menage a trois de anti-semantique et CSS-ME: Say it out loud so that TB-L can hear!

noreply@blogger.com (What Gets Me Hot) — Wed, 25 Aug 2021 11:39:00 +0000

Florian's Domain is for business having been banned by W3C awhile ago I have invented my own code installation, not adherent to a pristine reference put forth by Tim Berners-Lee's WWW, but my own coltish gallimaufry of an iteration of a moment, changing every post. what you find here. i inhabit my own mesosphere--not quite canonically pure--BUT I'M NOT EXACTLY TANTEK, OR ERIC--happy to be hosted by THE Internet company, quaintly never changed in 10 years, which I am proud to say is my DUET with it, or ma menage a trois de anti-semantique et CSS-ME: Say it out loud so that TB-L can hear!This is me paying a visit to my domain for non-web purposes, but you probably want to visit me below.

It has been suggested that Webensteiners be merging like driver's ed student into trafic. here's the super secret link that wiki hides so you won't know to go to their talk pagei was always 'talking" some mad CSS stuff around June 2018.

We is, or are, formal, proprietary, non-canonical, and other technical stuff technical to explain.

WE define the WWW.

In the more frequently associated, trend-endorsing, standardized practical building of our most perfect semantic web ever, WE must find a way to show what the WWW is!

Say it out loud so that TB-L can hear you!

WE inhabit a mesosphere, and not an imaginary place in the clouds.

These are responsive, canonical WWWeb cities in the sky, a philosophy even President Donald Trump could get behind (maybe with the Space Force), which (not) includes me.

[yes, here is one of our famous 'sups'! it really is an annoying fellow], but everybody wants to see it on the tour, so get it out of your system

nets

5 See

6 Refs

7 Ex-links

Over[ edit]

Web standards include many interdependent standards and specifications, some of which govern aspects of the Internet, not just the World Wide Web. Even when not web-focused, such standards directly or indirectly affect the development and administration of web sites and web services. Considerations include the interoperability, accessibility and usability of web pages and web sites.

Web standards, in the broader sense, consist of the following:

Recommendations published by the World Wide Web Consortium (W3C)^[2]

"Living Standard" made by the Web Hypertext Application Technology Working Group (WHATWG)

Request for Comments (RFC) documents published by the Internet Engineering Task Force (IETF)^[3]

Standards published by the International Organization for Standardization (ISO) ^[4]

Standards published by Ecma International (formerly ECMA) ^[5]

The Unicode Standard and various Unicode Technical Reports (UTRs) published by the Unicode Consortium ^[6]

Name and number registries maintained by the Internet Assigned Numbers Authority (IANA) ^[7]

Web standards are not fixed sets of rules, but are a constantly evolving set of finalized technical specifications of web technologies.^[8] Web standards are developed by standards organizations—groups of interested and often competing parties chartered with the task of standardization—not technologies developed and declared to be a standard by a single individual or company. It is crucial to distinguish those specifications that are under development from the ones that already reached the final development status (in case of W3C specifications, the highest maturity level).

Common usage[ edit]

When a web site or web page is described as complying with web standards, it usually means that the site or page has valid HTML, CSS and JavaScript. The HTML should also meet accessibility and semantic guidelines. Full standard compliance also covers proper settings for character encoding, valid RSS or valid Atom news feed, valid RDF, valid metadata, valid XML, valid object embedding, valid script embedding, browser- and resolution-independent codes, and proper server settings.

When web standards are discussed, the following publications are typically seen as foundational:

Recommendations for markup languages, such as Hypertext Markup Language (HTML), Extensible Hypertext Markup Language (HTML), and Saleable Vector Graphics (AVG) from W3C.

Recommendations for scoresheets, especially Cascading Style Sheets (CSS), from W3C.

Standards for ECMAScript, more commonly JavaScript, from Ecma International.

Recommendations for Document Object Models (DOM), from W3C.

Properly formed names and addresses for the page and all other resources referenced from it (Uris), based upon RFC 2396, from ETTIE.^[9]

Proper use of HTTP and MIME to deliver the page, return data from it and to request other resources referenced in it, based on RFC 2616, from IETF.^[10]

Web accessibility is normally based upon the Web Content Accessibility Guidelines^[11] published by the W3C's Web Accessibility Initiative.

Work in the W3C toward the Semantic Web is currently focused by publications related to the Resource Description Framework (RAF), Gleaning Resource Descriptions from Dialects of Languages (GRIDDLE) and Web Ontology Language (OWL).

Standards publications and bodies[ edit]

A W3C Recommendation is a specification or set of guidelines that, after extensive consensus-building, has received the endorsement of W3C Members and the Director.

An IETF Internet Standard is characterized by a high degree of technical maturity and by a generally held belief that the specified protocol or service provides significant benefit to the Internet community. A specification that reaches the status of Standard is assigned a number in the IETF STD series while retaining its original IETF RFC number.

Non-standard and vendor-proprietary pressures[ edit]

HTML 5 contains numerous "willful violations" of other specifications, in order to accommodate limitations of existing platforms.^[12]

See also[ edit]

W3C Markup Validation Service

Web Standards Project

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References[ edit]

^ "Mission - Web Standards Project". WaSP. Retrieved 2009-01-19.

^ "W3C Technical Reports and Publications". W3C. Retrieved 2009-01-19.

^ "IETF RFC page". IETF. Retrieved 2009-01-19.

^ "Search for World Wide Web in ISO standards". ISO. Retrieved 2009-01-19.

^ "Ecma formal publications". Ecma. Retrieved 2009-01-19.

^ "Unicode Technical Reports". Unicode Consortium. Retrieved 2009-01-19.

^ "IANA home page". IANA. Retrieved 2009-01-19.

^ Leslie Sikos (2011). Web standards - Mastering HTML5, CSS3, and XML. Apress. ISBN 978-1-4302-4041-9.

^ Berners-Lee, Tim; Fielding, Roy T.; Masinter, Larry (August 1998). Uniform Resource Identifiers (URI): Generic Syntax. IETF. doi:10.17487/RFC2396. RFC 2396. https://tools.ietf.org/html/rfc2396 . Retrieved 2009-10-27.

^ Fielding, Roy T.; Gettys, James; Mogul, Jeffrey C.; Nielsen, Henrik Frystyk; Masinter, Larry; Leach, Paul J.; Berners-Lee, Tim (June 1999). Hypertext Transfer Protocol -- HTTP/1.1. IETF. doi:10.17487/RFC2616. RFC 2616. https://tools.ietf.org/html/rfc2616 . Retrieved 2009-10-27.

^ "Web Content Accessibility Guidelines 1.0, W3C Recommendation 5-May-1999". W3C. 1999. Retrieved 2009-02-18.

^ "HTML 5 - A vocabulary and associated APIs for HTML and XHTML - Compliance with other specifications". Retrieved 2017-06-29.

Some web standads specification proposals I'm working on

My LinkedIn profile

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My wife’s web site, and her poetry page

A List Apart

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A Brief History of Markup

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From IETF to W3C: The road to HTML 4

XHTML 1: HTML as XML

XHTML 2: Oh, we’re not gonna take it!

The schism: WHATWG TF?

From Web Apps 1.0 to HTML5

Reunification

XHTML is dead: long live XHTML syntax

The timeline of HTML5

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Also in Issue № 305

Habit Fields

Responsive Comping: Obtaining Signoff without Mockups

Mo’ Pixels Mo’ Problems

About the Author

Jeremy Keith

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Designing for Conversions

Paint the Picture, Not the Frame: How Browsers Provide Everything Users Need

UX in the Age of Personalization

Conversations with Robots: Voice, Smart Agents & the Case for Structured Content

Taming Data with JavaScript

Designing for Interaction Modes

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305

Illustration by Kevin Cornell

A Brief History of Markup

Hagiographer Starry sky
Twinkle twinkle
Starry sky

by

Jeremy Keith

May 04, 2010

Published in

HTML
,
State of the Web

HTML5 is the latest iteration of this lingua franca. While it is the most ambitious change to our common tongue, this isn’t the first time that HTML has been updated. The language has been evolving from the start.

As with the web itself, the HyperText Markup Language was the brainchild of Sir Tim Berners-Lee. In 1991 he wrote a document called “HTML Tags” in which he proposed fewer than two dozen elements that could be used for writing web pages.

Sir Tim didn’t come up with the idea of using tags consisting of words between angle brackets; those kinds of tags already existed in the SGML (Standard Generalized Markup Language) format. Rather than inventing a new standard, Sir Tim saw the benefit of building on top of what already existed, a trend that can still be seen in the development of HTML5.

There was never any such thing as HTML 1. The first official specification was HTML 2.0, published by the IETF, the Internet Engineering Task Force. Many of the features in this specification were driven by existing implementations. For example, the market-leading Mosaic web browser of 1994 already provided a way for authors to embed images in their documents using an <img> tag. The img element later appeared in the HTML 2.0 specification. The role of the IETF was superceded by the W3C, the World Wide Web Consortium, where subsequent iterations of the HTML standard have been published at http://www.w3.org. The latter half of the nineties saw a flurry of revisions to the specification until HTML 4.01 was published in 1999.

At that time, HTML faced its first major turning point.

XHTML 1: HTML as XML

After HTML 4.01, the next revision to the language was called XHTML 1.0. The X stood for “eXtreme” and web developers were required to cross their arms in an X shape when speaking the letter.

No, not really. The X stood for “eXtensible” and arm crossing was entirely optional.

The content of the XHTML 1.0 specification was identical to that of HTML 4.01. No new elements or attributes were added. The only difference was in the syntax of the language. Whereas HTML allowed authors plenty of freedom in how they wrote their elements and attributes, XHTML required authors to follow the rules of XML, a stricter markup language upon which the W3C was basing most of their technologies.

Having stricter rules wasn’t such a bad thing. It encouraged authors to use a single writing style. Whereas previously tags and attributes could be written in uppercase, lowercase, or any combination thereof, a valid XHTML 1.0 document required all tags and attributes to be lowercase.

The publication of XHTML 1.0 coincided with the rise of browser support for CSS. As web designers embraced the emergence of web standards, led by The Web Standards

Project, the stricter syntax of XHTML was viewed as a “best practice” way of writing markup.

Then the W3C published XHTML 1.1.

While XHTML 1.0 was simply HTML reformulated as XML, XHTML 1.1 was real, honest-to-goodness XML. That meant it couldn’t be served with a mime-type of text/html. But if authors published a document with an XML mime-type, then the most popular web browser in the world at the time, Internet Explorer, couldn’t render the document.

It seemed as if the W3C were losing touch with the day-to-day reality of publishing on the web.

XHTML 2: Oh, we’re not gonna take it!

If Dustin Hoffman’s character in _The Graduate_ had been a web designer, the W3C would have said one word to him, just one word: XML.
As far as the W3C was concerned, HTML was finished as of version 4. They began working on XHTML 2, designed to lead the web to a bright new XML-based future.
Although the name XHTML 2 sounded very similar to XHTML 1, they couldn’t have been more different. Unlike XHTML 1, XHTML 2 wasn’t going to be backwards compatible with existing web content or even previous versions of HTML. Instead, it was going to be a pure language, unburdened by the sloppy history of previous specifications.

The schism: WHATWG TF?

Habit Fields

We have the power to bestow our abilities onto the things around us. By being conscious of our tools, habits, and spaces, and…

Further reading about Code

Responsive Comping: Obtaining Signoff without Mockups If you’re making websites, chances are you’ve given some thought to what constitutes a responsive-friendly design…

Mo’ Pixels Mo’ Problems

Mobile devices are shipping with higher and higher PPI, and desktops and laptops are following the trend as well. There’s no…

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Beaver / #9f8170 hex color code information, schemes, description and conversion in RGB, HSL, HSV, CMYK, etc. https://t.co/6Lu4EYX04X
— mrjyn (@mrjyn) February 23, 2019
.@thebeatles #Dingbat #Font (unique URL)! @TheBeatlesMusic @BeatleHeadlines. Jeremy Keith@adactio mentioned @t re: canonically authentic Tweets (i love them on his blog)...then i realized--keep it clean and your canon will be safe? @css @w3c and thanks for the link to @CERN JK. pic.twitter.com/dryGZ7Osgl

— mrjyn (@mrjyn) ٢٥ فبراير ٢٠١٩

They Shoot Browsers, Don’t They?

Behavioral Separation

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xTML

XML

A list of recent changes may be found in the CHANGES file.

An implementation report template and instructions are available to help with creating an implementation report. Submitted implementation reports are available in the reports folder.

inoperable

passing the respective test case(s) in the Selectors Module test suite, or, if the implementation is not a web browser, an equivalent test. Every relevant test in the test suite should have an equivalent test created if such a UA is to be used to claim interoperability. In addition if such a UA is to be used to claim interoperability, then there must one or more additional UAs which can also pass those equivalent tests in the same way for the purpose of interoperability. The equivalent tests must be made publically available for the purposes of peer review.

implementation

a user agent which:

implements the feature.

is available (i.e. publicly downloadable or available through some other public point of sale mechanism). This is the "show me" requirement.

is shipping (i.e. development, private or unofficial versions are insufficient).

is not experimental (i.e. is intended for a wide audience and could be used on a daily basis.)

A minimum of six months of the CR period must have elapsed. This is to ensure that enough time is given for any remaining major errors to be caught.

Contributors

Copyright ©2001 W3C^® (MIT, INRIA, Keio), All Rights Reserved. W3C liability, trademark, document use and software licensing rules apply.

Terminology for Constrained-Node Networks Abstract The Internet Protocol Suite is increasingly used on small devices with severe constraints on power, memory, and processing resources, creating constrained-node networks. This document provides a number of basic terms that have been useful in the standardization work for constrained-node networks. Status of This Memo This document is not an Internet Standards Track specification; it is published for informational purposes. This document is a product of the Internet Engineering Task Force (IETF). It represents the consensus of the IETF community. It has received public review and has been approved for publication by the Internet Engineering Steering Group (IESG). Not all documents approved by the IESG are a candidate for any level of Internet Standard; see Section 2 of RFC 5741. Information about the current status of this document, any errata, and how to provide feedback on it may be obtained at http://www.rfc-editor.org/info/rfc7228. Bormann, et al. Informational [Page 1] RFC 7228 CNN Terminology May 2014


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I attained peace with FMOL and their Vow of Silence, Comfort Inn and its Vow of Poverty, and Mark Zielinski and his Vow of Retaliation

noreply@blogger.com (What Gets Me Hot) — Wed, 25 Aug 2021 10:20:00 +0000

This headline is very important

kootie pi evicting through old woman--good years you have if you can hear through wall

I attained peace with FMOL and their Vow of Silence Comfort Inn and its Vow of Poverty and Mark Zielinski and his Vow of Retaliation

People who are not fully vaccinated should be tested immediately after being identified (with known exposure to someone with suspect or confirmed COVID-19), and, if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine.

Monopoly Magnate slumlord hand 3-of-a-kind troika 4-Star Inside Straight flops Inn outed Country Club tan TV Wimbledon attention Hizzem Swetums context afterthought

Our Lady of the Lake Children’s Health Jimmy Craven putting to bed worst LA crime of all time, #giftcard Walmart Visa Direct #PediatricCancer embez Louisiana State University player boon fundraising by John Paul Funes one day to receive proper thanks from Parents of Cancer Patients and, twin home wishing you Catholic Investment Strategies 3.6 B with 99% non-transparency, profitenial in Pandemic Spirit of St. Francis of Assisi Franciscan Missionaries of Our Lady Health System and 100% rewording legalese doc for patient rights --close enough for jazz to Ethics & Compliance for SMEs, 2025 / retake / 2026 LSUHS School of Graduate Studies Psych residents teachable moment to protect physicians in stressful pandemic accountability, inhibition cherry-picking, and final phase-out of redundant internal investigation malfeasance to affect 8 licensure degrees but enable a chance at a do-over

John Paul Funes one day to receive proper thanks from Parents of Cancer Patients and, twin home wishing you Catholic Investment Strategies 3.6 B with 99% non-transparency, profitenial in Pandemic Spirit of St. Francis of Assisi Franciscan Missionaries of Our Lady Health System and 100% rewording legalese doc for patient rights --close enough for jazz to Ethics & Compliance for SMEs, 2025 / retake / 2026 LSUHS School of Graduate Studies Psych residents teachable moment to protect physicians in stressful pandemic accountability, inhibition cherry-picking, and final phase-out of redundant internal investigation malfeasance to affect 8 licensure degrees but enable a chance at a do-over

I've found a way to endure the insult with the COVID with the eviction, and I'm at peace with FMOLH and their Vow of Silence.

People who are not fully vaccinated should be tested immediately after being identified (with known exposure to someone with suspect or confirmed COVID-19), and, if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine.

I've found a way to endure the insult with the COVID with the eviction, and I'm at peace with FMOLH and their Vow of Silence.

Centers for Medicare & Medicaid Services and American Medical Association American Psychiatric Association

CDC is issuing a new order temporarily halting evictions in counties with heightened levels of community transmission in order to respond to recent, unexpected developments in the trajectory of the COVID-19 pandemic, including the rise of the Delta variant. It is intended to target specific areas of the country where cases are rapidly increasing, which likely would be exacerbated by mass evictions.

ORDER: Temporary Halt in Residential Evictions in Communities with Substantial or High Levels of Community Transmission of COVID-19 to Prevent the Further Spread of COVID-19pdf icon

ओएमबी नियं त्रण सं . 1920-1303
फ़ॉम्म की समय समानति: 02/28/2022
घर से निकाले जािे से सुरक्ा का घोषणापत्र
सेंटस्म फ़ॉर निसीज़ कं ट्रोल एं ि नरिवेंशि (सीिीसी) िे एक आदेश जारी नकया है जजससे आप अपिे घर से निकाले जािे या रहिे की जगह से
बेदखल नकए जािे की कार्मवाई से बच सकते हैं। इसका मतलब है नक आप वहाँ ठहर सकते हैं जहां आप 3 अक्तूबर, 2021 से रहते हैं, यनि आप योगयता प्ाप्त करते हैं।इस फ़ॉम्म का इस्ेमाल कैसे करें1. देखें अगर आप CDC आदेश के तहत बेदखली सं रक्षण के ललए यरोगय हरोते हैं। अगर आप नकसी नवशेषज्ञ से मदद चाहते हैं, तरो
नकसी स्ािीय आवासि सलाहकार के ललए सं प क्म जािकारी पािे के ललए यूएस आवासि और शहरी नवकास (HUD) नवभाग से (800) 569-4287 पर सं प क्म करें या यहां जाएं https://www.hudexchange.info/programs/housing-counseling/rental-eviction/
2. अगले पेज पर घरोषणापत्र पर यह दशशािे के ललए हस्ाक्षर करें नक आप इसके ललए पात्र हैं।
3. हस्ाक्षर नकए हुए घरोषणापत्र करो उस व्यनति या कं पिी करो सौंप दें जजिसे आपिे घर नकराए पर ललया हुआ है (उदाहरण के ललए, नबल्डं ग मैिेजमेंट, मकाि माललक आनद)। अपिे खुद के ररक़ॉि्म के ललए एक क़ॉपी या फरोटरो रख लें और अंगर करोई समस्ा आती है तरो अपिे नवशेषज्ञ करो दरोबारा क़ॉल करें।यनद आपका मकाि माललक CDC आदेश का उल्ं घि करता है, तरो वह जुमशािे या कारागार की नकसी सजा सनहत, आपराधिक दं ि ों का भागी
हरो सकता है।
1. क्ा मैं इसके ललए पात्र हूँ ?
अगर आप िीचे नदए ब़ॉक्स में से एक पर भी निशाि लगाते हैं, तरो आप पात्र हैं।
क़ॉलम A
मुझे वष्म 2020 या 2021 में रिरोत्ाहि (जटिम्ुलस) का
चेक (आर््मक रिभाव भुगताि) नमला ्ामुझे 2020 में अपिी आय आईआरएस (IRS) करो ररपरोट्म
करिे की ज़रूरत िहीं ्ी
मुझे निम्नलललखत लाभों में से कोई नमल रहा है: • सप्ीमेंटल न्ूनट्शि अजसटिेंस रिरोग्ाम (SNAP)
• टेम्पररी अजसटिेंस फ़ॉर िीिी फैनमलीज़ (TANF)
• सप्ीमेंटल जसक्रोररटी इिकम (SSI)
• सप्ीमेंटल जसक्रोररटी निसएनबललटी बीमा (SSDI)सि 2020 या 2021 में मेरी आय एक अकेले व्यनति के
तौर पर $99,000 से कम या सं यु ति रूप से फाइल करते
समय $1,98,000 से कम है (या हरोिे की सं भाविा है)
इिमें से कोई िहीं — आप पात्र िहीं हैं
और क़ॉलम B
मैं अपिा पूरा नकराया िहीं दे सकता/ सकती या घर के
ललए पूरा भुगताि िहीं कर सकता/ सकती क्ोंनक:
मेरे पररवार की कु ल आय बहुत कम हरो गई हैमुझे काम पर से निकाल नदया गया हैमेरे काम का समय या वेति कम कर नदया गया हैमुझे बहुत अधिक मेनिकल खच्म खुद की जेब से
वहि कर करिे हैं1
इिमें से कोई िहीं — आप पात्र िहीं हैं
क्या आपने हर कॉलम में से कम-से-कम एक बॉक्स में ननशयान लगयायया है?
तब तो आप की आय कया स्तर इसके ललए पयात्र है।
[अगले पेज पर पहले ब़ॉक्स में निशाि लगाएँ ]1इसे उस वष्म के ललए मेरी समायरोजजत सकल आय के 7.5% या अधिक के रूप में पररभानषत नकया

2. मेरे पात्र होिे का मेरी ओर से घोषणापत्र
िीचे नदए हुए ब़ॉक्स पर निशाि लगाकर, मैं घरोषणा करता/ करती हँ नक वह क्ि
सत्य है।ऊपर बताए हुए कारणों से मेरी आय का स्र इसके ललए पात्र है।मैं SARS-CoV-2 के सामुदानयक सं चरण स्रों की पयशाति या उच्च दर का अिुभव करते हुए
एक यू.एस. काउं टी में रहता/रहती हँ । 2
मैंिे अपिी ओर से पूरी करोजशश की है नक समय पर आं जशक भुगताि क रूँ जरो नक पूण्म
भुगताि के जजतिा हरो सके बराबर हों और यह भी नक मेरे घर के नकराए या घर के ललए नकए
जािे वाले भुगताि के ललए मुझे सरकार की ओर से मदद नमले।3
अगर मुझे घर से निकाल नदया गया, तरो मेरे पास रहिे की करोई और जगह िहीं है और
इसीललए मुझे:
• बेघर हरोिा पडेगा या
• मुझे बेघरों के ललए बिे हुए रैिबसेरे में शरण लेिी पडेगी, या
• आस-पास रहिे वाले नकसी व्यनति या व्यनतियों के सा् उिके घर में भीड-भाड में रहिा
हरोगा।मुझे पता है नक मेरे हस्ाक्षर करिे के बाद:
• अगर मेरे मकाि माललक के सा् मेरा करोई समझौता िहीं हुआ हरो, तरो अपिे मकाि की
लीज़ से सं बं धित नकराए, पुरािे बकाया नकराए और फीस, दं ि या ब्ाज की जज़म्ेदारी
अभी भी मेरी ही रहेगी।• मुझे अब भी अपिी लीज़ के नियमों का पालि करते रहिा हरोगा।• अगर मेरे मकाि माललक के सा् मेरा करोई समझौता िहीं हुआ हरो, तरो अगर मेरी ओर से
नकसी भुगताि में करोई चूक हरोती है, तरो घर से निकाले जािे पर लगी हुई इस अस्ायी
ररोक की अवधि खत्म हरोिे पर मुझे घर से निकाला जा सकेगा।• नकराए का भुगताि िहीं करिे या घर के ललए नकया जािे वाला भुगताि िहीं करिे के
अलावा नकसी अन् कारण से मुझे अब भी घर से निकाला जा सकता है।
मैं झतूठी शपथ लेिे पर नमलिे वाले िं ड को समझते हुए इस घोषणापत्र 4 पर हस्ाक्र कर रहा / रही हूँ । इसका
मतलब है नक यह मेरा वािा है नक ऊपर निए गए सभी कथि सत्य हैं और मुझे पता है नक झतूठ बोलिे पर मुझपर
आपराधिक मुकिमा िायर नकया जा सकता है।
यहाँ हस्ाक्षर करें : तारीख:
3. इस हस्ाक्र नकए हुए पेज को अपिे मकाि माललक व्यनक् या कं पिी को िें।मकाि माललक ध्ाि िें : आपके अिुपालि के ललए िन्वाद। अगर आप सीिीसी के इनवक्शि सं रक्षण ऑि्मर का उल्ं घि करते हैं, तरो आप और / या आपके व्यवसाय के नवरुदि आपराधिक कार्मवाई की जा सकती है जजसमें
आर््मक दं ि और जेल की सज़ा शानमल हैं।
2करोनवि-19 एकीकृत काउं टी दृशय देखें: आपके ललए नकस तरह की मदद उपलब्ध है इसे जाििे का सबसे अच्ा तरीका है अपिे स्ािीय नवशेषज्ञ करो क़ॉल करिा। अपिे स्ािीय, HUD-स्ीकृत हाउससं ग सलाहकार करो
खरोजिे के ललए (800) 569-4287 पर क़ॉल करें।
4यनद आप पहले ही निष्ासि स्गि घरोषणा पर हस्ाक्षर कर चुके हैं, तरो आपकरो एक और जमा करिे की आवशयकता िहीं है

Doug Meet I like to remember things my way. Detective What do you mean by that? Doug Meet How do I remember them? Not necessarily the way they happened [Doug Meet makes the phone]

noreply@blogger.com (What Gets Me Hot) — Tue, 24 Aug 2021 03:11:00 +0000

Doug Meet

I like to remember things my way.

Detective

What do you mean by that?

Doug Meet

How do I remember them? Not necessarily the way they happened

The tailor is silent, cheating from behind.

She turns to gently extend her grace and, without losing, frees the gentleman.
They swaggart off, then again, alternately galangal, peripheral flush.
[Doug meets faith, replies Utahna] Utahna Faith: [on the phone] I told you I was here.
Doug Meet: [alarmed] How did you do that? Utahna Faith: Ask me.
Doug Meet: [on the phone, angry] How did you come? Utahna Faith: You invited me.
It's not my custom where I m not wanted.
Doug Meet: [on the phone] Who are you? [The two mysterious laughs] Utahna Faith: Give me my phone.
[Doug Meet makes the phone] Utahna Faith: It was a pleasure to talk to you.
Bonnie Lee Barley and Utah: What's going on? Doug Meet: There is no bad coincidence.
Victory my kindness married Topic.
Not necessarily the way they happened [Doug Meet makes the phone]

( 17 Bracero ) divot دماغ ألبرت آينشتاين en fr Ceausescu's Oak pt Crebro Cruller Einstein fa مغز آلبرت اینشتین fi Doug Meeting divot fr Cervical 'Doug Meet id Otak Doug Meet pl ózg Alberta Einsteins pt Cerebra de Doug Meet ro Cruller lui Doug Meet ru Мозг Альберта Эйнштейна sv Doug Meets hjärna ta ஆல்பர்ட் மூளை th ไอนสไตน์ uk Мозок Альберта Ейнштейна ur البرٹ آئنسٹائن کا دماغ zh Man, I must fucking last night, all night, drink Barbancourt.
White Chick Olafson.

Milder Sean Penn Madonna as not good enough.
Must come here and get Creole and zombie fish and make money from Mother Haiti, Bez.
Fuck this, Uncle.
He lied and Aristides and bleeding red but white and blue.Haiti ends up by my little Guede.
She loves to get rum sounded all over his face, Bez.
She loves this to begin with.
Vice real because I not want to pay guilty white, Bez.
Best friend brothers, Bez.
I spent all night.
Fucking mind? What himself in, cool cool? Fuck, Bez.
What I do? j'aime (milliard)

[Police talk to Doug Meet ]

A beautiful character leaves the youngest opponents master by the hips.

Oloffson òtoprens.

Greene fiksyon.

pwotestasyon Raoul édras.

tranblemanntè.

Sean Penn wine.

sèlman pran yon èl èrdik lannwit nan wine soti nan Penn.

yon jou lannwit.

[Polis pale ak Doug Rankontre sou kamera videyo] Ou ap vize, Bez, nonm.

Mwen se tout nwit lan èrdik èt èrdik mwen an, èt li nan, fre fre? Fuck, Bez.

Kisa mwen ta dwe è? Doug Meet Mwen renmen sonje bagay sa yo fason mwen Dud, mwen dwe fukin tout nwit lan, bwè Barbancourt.

Oloffson blan poul.

Li vle Papa Doc, oswa nich òk chante? Li vle èl ti bebe kreyòl.

Sean Penn, mwen, Madonna ak mwen.

Pa bon ase Li nan pou kreol yo zonbi.

Pwason nan manman an nan Ayiti, Bez.

Pout, ton-tòn, Aristede touye èp mwen an.

Tit Tit ayisyen, Aristède.

Blan.

wouj.

san yo pa èz pou èrdik la pou ', Bez.

Li andikape yon òt twa vodou Ayisyen.

sou ti Guede.

Li te renmen ònen wonm sou figi dam lan, Bez.

Li renmen è li pou li, pou òmanse avèk li.

Vis mwen.

Reyèl mwen.

Ou blan koupab.

Ou peye Bez.

Mwen vle Olofson pwason.

Pi bon zanmi, frè, Bez.

Customers age by earning money.

It is People, follow in some shadow, feel unsuccessful in comparison shadow of related

BE IN SHADOW.

What Gets Me Hot

Saint Francis of Assisi 220, rue de la Convention Paris Tél. 00 33 1 58453060 email: contact@fmnd-international.org

About the Franciscan Missionaries of Our Lady Health System

Louisiana State University Residents, Meet FMOLHS OLOL LSU Board of Supervisors Mark Zielinski, MD. (NPI Number: 1194875625) Assistant Professor (LSU-HSC BR) O'DONOVAN 5131 O'donovan Dr., Suite 300 https://t.co/wBxDVnVXIN pic.twitter.com/IxgrIuEQm0

A post shared by mrjyn (@dougmeet)

I’m shocked Honore de Balzac list

Long sentences are lovely on their own, but notwithstanding they weren’t, it pains Maine to assume that we could lose them altogether.

Proper introduction to the truthful story of Illicit Medical Evictioning by proxy through epicene delegation in such a lot of ways bearer of bad news

Consequence of revenge expose unpleasant contingency which individuals of low-caliber transgress, whose gratuitous title, an illusion indicative of moments of prolonged sobriety, formality, disposable, high-pitch squeaking from free reign, disdain--singular to conduct themselves of no seniority.

And so proper introduction to the truthful story of illicit Medical Evictioning, by proxy, through epicene delegation, in such a lot of ways, bearer of bad news--amanuensis be.

Laws, acts, or decrees--was she sent to tramp, not justify my wrath.

Extraction, 20 minutes before Televisit, during Pandemic--at-risk person whose anamnesis included broken back.

All vanity who would preclude it, the physician, and whose artiodactyl vermin so played at distance, required delinquent condition, preservation of self to stay fraudulent accolades he surrounds himself, never contributes, collegial--those who publish, he does not perish--concealed in plain sight.

Continuity of medication between mental health providers (MHPs) and primary care providers (PCPs) after a new consultation

Abandonment OLOL Medical Director Mark Zielinski, MD., Assistant Professor of Psychiatry LSU Baton Rouge Psychiatry Residency Program healthcare retaliation

Abandonment

Psychiatry OLOL

Associate Medical Director

*Assistant Professor Mark Zielinski, MD.,

*Assistant Professor Mark Zielinski, MD.,

Clinical Assistant Professor of Psychiatry OLOL Associate Medical Director Outpatient Psychiatric Services LSU Baton Rouge

Psychiatry Residency Program

healthcare retaliation

healthcare retaliation

Scott WesterPresident & Chief Executive Officer at Franciscan Missionaries of Our Lady Health SystemScott Wester is the President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, LouisianaLocation4200 Essen Lane, Baton Rouge, Louisiana, 70809

Scott Wester

President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System

Scott Wester is the President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana

Lannis Lee Tynes, MD, PhD Clinical Associate Professor of Psychiatry Associate Program Director OLOL Medical Director

Kathleen Crapanzano, MD, MACM Program Director LSU Psychiatry Residency Program-Baton Rouge

ASSISTANT PROFESSOR

DEPARTMENT Program Director

LSU Psychiatry Residency Program

Louisiana State University Health Sciences Center

LSU System

Dr. Richard Vath, President & CEO of the Franciscan Missionaries of Our Lady (FMOLHS) Health System, has announced the promotion of two executives to lead the health system’s Ambulatory Division.

Jennifer Clowers, former interim Market President for Our Lady of Lourdes, has been promoted as the division’s new Vice President where she will report directly to the CEO as a member of the health system’s Senior Executive Team and Strategy Council.

Laura Davis, operational leader for the Community Care Division of Our Lady of the Lake Physician Group Senior Director of the Ambulatory Division.

response: endemic, practiced silence (catholic and corporate shameful abidance)

reason: actionable acumen

just give up? I will not subsise until my grievances have been officially addressed, and he is investigated and proven guilty

why? he is not fit to practice

Abandoned of practice, all specialist clinics

Mark Zielinski, MD.,Assistant Professor Clinical Assistant Professor ofPsychiatry,Outpatient Psychiatric Services, LSU

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,

Louisiana State University Health Sciences CenterNew Orleans (LSUHSC-NO BR) Resident USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

Our Lady of the Lake Physician Group Family Center

for Psychiatric Residency Services

Kathleen Crapanzano, M.D. LSU Psychiatry Residency Program 5246 Brittany Drive Baton Rouge, LA 70808 Ph: 225-757-4212Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,Associate Resident Program Director,OLOL Medical Director

Kathleen Crapanzano, M.D. LSU Psychiatry Residency Program 5246 Brittany Drive Baton Rouge, LA 70808 Ph: 225-757-4212Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,Associate Resident Program Director,OLOL Medical Director

Kathleen Crapanzano, M.D.

LSU Psychiatry Residency Program 5246 Brittany Drive Baton Rouge, LA 70808 Ph: 225-757-4212

Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,Associate Resident Program Director,OLOL Medical Director

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

Associate Resident Program Director,

OLOL Medical Director

OLOL Medical Director

Scott Wester
President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System
Scott Wester is the President & Chief Executive Officer at Franciscan Missionaries of Our Lady Health System based in Baton Rouge, Louisiana

Location
4200 Essen Lane, Baton Rouge, Louisiana, 70809

Lannis Lee Tynes, MD, PhD

Clinical Associate Professor of Psychiatry

Associate Program Director

OLOL Medical Director

Kathleen Crapanzano, MD, MACM
Program Director
LSU Psychiatry Residency Program-Baton Rouge

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

FMOLHS OLOL-RMC,
Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

Louisiana State University Health Sciences Center
New Orleans (LSUHSC-NO BR) Resident
USMLE PGY 1 PGY-3 GETP PSYCHIATRY Program

Kathleen Crapanzano, M.D.
LSU Psychiatry Residency Program
5246 Brittany Drive
Baton Rouge, LA 70808
Ph: 225-757-4212
Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,
Associate Resident Program Director,
OLOL Medical Director

Kathleen Crapanzano, M.D.
LSU Psychiatry Residency Program
5246 Brittany Drive
Baton Rouge, LA 70808
Ph: 225-757-4212
Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,
Associate Resident Program Director,
OLOL Medical Director

LSU Psychiatry Residency Program
5246 Brittany Drive
Baton Rouge, LA 70808
Ph: 225-757-4212

Lannis Lee Tynes, M.D., Ph.D Clinical Associate Professor,
Associate Resident Program Director,
OLOL Medical Director

—
Associate Professor