408-854-1883 starts at $30 per hr home care

Affordable in home care | starts at $28 per hr

Raising capital gains tax , raising credit score and other news

Raising capital gains tax

As Obama continues to signal what he will propose during Tuesday’s State of the Union address, senior administration officials said during the weekend that he will call for raising the capital gains rate on top income earners and eliminating a tax break on inheritances. The revenue generated by those changes would fund new tax credits and other cost-saving measures for middle-class taxpayers, officials said.

Tax increases are rarely welcomed by congressional Republicans, who now hold majorities in the House and the Senate for the first time in Obama’s presidency. Obama’s tax proposals will likely be dismissed, if not outright ignored, by lawmakers outside the Democratic Party’s liberal base.

“Are they going to agree on everything? Absolutely not. I think we should have a debate in this country between middle class economics and trickle-down economics and see if we can come to an agreement on the things we do agree on,” White House senior adviser Dan Pfeiffer said Sunday on CBS’s “Face the Nation.” He said the theme of the speech would be “middle-class economics.”

Increasing your credit score

ask them validation or proof of your debt registered mail 30d

Checking out youtube, I learned how others increase their FICO score by getting more credit cards and disputing the smart way, asking for verification proof and mailing registered your dispute or calling.

Be creative in real estate, buy only income properties

I am forming alliances with others to buy only high cap rate income properties in the bay area.

If you want to reduce your income taxes as we help doctors and business owners in this way with business structure and financial strategy, email connie at motherhealth@gmail.com 408-854-1883

Coming Collapse of the Middle Class with Elizabeth Warren

Coming Collapse of the Middle Class with Elizabeth Warren

Coming Collapse of the Middle Class with Elizabeth Warren

debt

expenses

house

bk7

  • Elizabeth Warren BENEDICT GOMBOCZ
  • 2. Personal details Personal details  Born June 22, 1949 in Oklahoma City, Oklahoma  Member of the Democratic Party (since 1996; was a Republican until 1996)  Graduate of George Washington University, University of Houston (B.S.), Rutgers School of Law-Newark (J.D.)  Senior senator from Massachusetts (serving with Ed Markey) since January 3, 2013  Special Advisor for the Consumer Financial Protection Bureau, September 17, 2010-August 1, 2011  Chairperson of the Congressional Oversight Panel, November 25, 2008-November 15, 2010 Official Senate portrait, 113th Congress
  • 3. Synopsis Synopsis  Elizabeth Warren (D-Mass.) is a Senator from Massachusetts who was elected to the U.S. Senate in November 2012 at age 63.  Warren formerly worked as one of President Barack Obama’s assistants who was involved in designing the Consumer Financial Protection Bureau, among a number of other positions.  Born on June 22, 1949, Elizabeth Warren was the first in her family to graduate from college; she acquired her law degree from Rutgers University.  She was chosen to supervise the National Bankruptcy Review Commission (NBRC) after she had a job as a law professor at Harvard University.  She also presided over the Congressional Oversight Panel for the Troubled Asset Relief Program (TARP) in 2008.  Four years later, Warren was elected to the U.S. Senate over her opponent Scott Brown, the incumbent Republican.
  • 4. Early Life Early Life  Born Elizabeth Ann Herding in Oklahoma City, Oklahoma on June 22, 1949, Elizabeth Warren was the youngest of four children (and the only daughter) of Donald and Pauline Herring.  Warren spent much of her early years on what she referred to as “the ragged edge of the middle class.”  Her father worked mainly as a maintenance man; when he suffered a heart attack that resulted in expensive medical bills, Warren’s mother made extra money by working at Sears’ catalogue-order department.
  • At the age of thirteen, Warren began helping by working as a table waitress at her aunt’s Mexican restaurant.  Yet money was still tight, in spite of attempts to eliminate the family’s financial stress; because there were few finances, Warren recalled her mother’s reluctance to take her to the doctor. Skyline of Oklahoma City from I-35
  • 5. Early Life – cont. Early Life – cont.  An intelligent student, Warren became a state debate victor and graduated from high school when she was only sixteen; she entered George Washington University on a full debate scholarship the same year.
  • Warren left the university after only two years there to marry her high school sweetheart, NASA mathematician Jim Warren; the couple moved to Texas, where Elizabeth completed her degree in speech pathology at the University of Houston, which made her the first member of her immediate family to finish college.  The couple moved to New Jersey, where Elizabeth worked in public schools and assisted children with disabilities; during that time, the couple gave birth to two children: a daughter, Amelia, and a son, Alex.
  • On the day that Amelia turned two, Warren started graduate school for law at Rutgers University; she obtained her J.D. in 1976, and practiced law in her living room. George Washington University
  • 6. University of Houston Rutgers University
  • 7. Elizabeth Warren as a student at the University of Houston in 1970, age 21
  • 8. Political Career  By 1978, she and Jim had divorced.  In the year after the annulment, Warren began to observe the challenges that the American middle class was dealing with; she specifically studied a 1978 law passed by Congress that made it easier for corporations and individuals to declare bankruptcy.  Warren decided to analyze the reasons that Americans found themselves in bankruptcy courts, and concluded that the majority of the financial victims belonged to middle-class families who lost their jobs, dealt with financial suffering from a divorce, or suffered diseases that destroyed their savings.  From there, she turned her attention to research on bankruptcy and commercial law, more specifically on how it affected financially distraught corporations and women, senior citizens, and the working poor.
  • 9. Political career – cont. Political career – cont.  In 1980, Warren married Harvard law professor Bruce Mann; she kept her last name from her first marriage.  Warren and Mann traveled around the United States together, with Warren teaching at schools like the University of Texas, the University of Michigan, and the University of Pennsylvania.  In 1995, the couple finally found a living in Harvard; the same year, she was asked to direct the new National Bankruptcy Review Commission.
  • During her tenure as chief adviser, Warren testified against Congressional attempts to restrict consumers’ ability to file for bankruptcy.  In spite of her best attempts, the bill was passed in 2005; it was seen as a triumph for the business lobby, and a defeat for Warren. Bruce Mann campaigns on behalf of his wife during the Massachusetts 2012 Senate election
  • 10. Political Career – cont. Political Career – cont.  In November 2008, Senate Majority Leader Harry Reid (D-Nev.) appointed Warren to head the Congressional Oversight Panel (as a special advisor), which was established to keep a close eye on the $700 billion bank bailout known as the Troubled Asset Relief Program.  Warren led investigations, managed televised public hearings, directed interviews of government officials, and submitted recurrent reports demanding responsibility from banks.
  • For her efforts to identify errors, The Boston Globe named Warren “Bostonian of the Year” in 2009.  She took part in designing the Consumer Financial Protection Bureau as part of the Dodd-Frank financial reform legislation, in July 2011.  Policing credit financiers and stopping customers from inadvertently signing up for hazardous loans was the CFPB’s primary goal.  However, Warren was not selected to lead the agency, mostly because of opposition from Republicans.
  •  In August 2011, she resigned as special advisor for the CFPB; the following month, President Obama appointed her as his special assistant. Elizabeth Warren looks on as President Obama announces the appointment of Richard Cordray as the CFPB’s first director, July 2011
  • 11. Elected to U.S. Senate Elected to U.S. Senate  Warren formally announced her bid for the Senate on September 14, 2011, challenging Republican incumbent Scott Brown, who previously won the 2010 special election for the deceased Ted Kennedy’s seat against Paul G. Kirk.  Around the time of her announcement, a speech that Warren gave went viral on YouTube, recommending her to mainstream supporters.  In the clip, filmed in a casual living room meet-and-greet, the Harvard law professor demonstrated how everyone profits from roads, public safety, and the public education system in the U.S.; all of them are paid for by taxes.  “You built a factory and it turned into something terrific or a great idea—God bless!” she said. “Keep a big hunk of it. But part of the underlying social contract is you take a hunk of that and pay forward for the next kid who comes along.“
  •  The talk won some recognition for Warren’s rise in the polls. Warren waves as she speaks at a campaign rally in Boston’s Roslindale neighborhood, Friday, September 21, 2012
  • 12. Warren’s rise in the polls (June 2011-March 2012)
  • 13. Elected to U.S. Senate – cont.  In early 2012, Warren’s campaign faced legal trouble when she was in a media scramble regarding her Native American descent claims.  Reporters for the Boston Herald were unable to uncover any evidence of her alleged Cherokee heritage; her claim was also disputed by a Cherokee genealogist.  In an effort to overcome the dispute, Warren issued a statement to Boston’s WBZ-TV: “Growing up, my mother and grandparents often talked about our family’s Native American heritage. As a kid, I never thought to ask them for documentation—what kid would?”  Warren further clarified that, “I never sought nor gained personal benefit in school or job applications based on my heritage.”
  • 14. Elected to U.S. Senate – cont. Elected to U.S. Senate – cont.
  •  In June 2012, Warren secured the Democratic nomination in the Senate election; she was now running against Scott Brown in a tight race.  A September 2012 poll from Public Policy Pulling showed Brown in the lead with five points above Warren.  Later that month, however, Warren gained national experience as one of the speakers at the Democratic National Convention in Charlotte, North Carolina; this won her the favor of several critics as well as a small lead in the polls.  At the convention, she emphasized the necessity for economic and government changes: “America’s middle class is getting hammered, and Washington is rigged to work for the big guy,” Warren told ABC News. Scott Brown (R) speaks with Elizabeth Warren (D) during their third debate in Springfield, MA, Wednesday, October 10, 2012
  • 15. Warren speaks during the third day of the Democratic National Convention in Charlotte, NC, Wednesday, September 5, 2012
  • 16. Elected to U.S. Senate – cont. Elected to U.S. Senate – cont.  In November 2012, Warren won the election and her first term in the Senate; she defeated Brown by a slight margin.  To the residents of Massachusetts, Warren states on her website, “I won’t just be your senator, I will also be your champion.“  Warren, who has written numerous academic and popular works and is regularly mentioned in media interviews regarding the U.S. economy and personal finance, is seen as a leading voice among progressivism in the U.S.; she has often been mentioned as a possible presidential candidate for 2016, even though she has continually stated that she is not interested in running. Results of Massachusetts Senate election, 2012
  • 17. VP Joe Biden gives the oath of office to Massachusetts Senator-elect Warren, Thursday, January 3, 2013 Senator-elect Warren takes the oath of office again in a mock swearing-in ceremony in front of supporters in Boston; accompanying her are husband Bruce Mann, Senator John Kerry, and Justice Elena Kagan, Saturday, January 5, 2013
  • 18. Sources Sources  Sources:  http://www.biography.com/people/elizabeth-warren-20670753#elected-to-us-senate  Other links:  http://elizabethwarren.com/ (Elizabeth Warren’s website)  http://www.warren.senate.gov/?p=biographyhttp://www.warren.senate.gov/http://www.ontheissues.org/senate/Elizabeth_Warren.htmhttp://ballotpedia.org/Elizabeth_Warrenhttps://www.facebook.com/ElizabethWarren

Eat your eggs to promote hypocretin or orexin since absence of these neurotransmitter for happiness/joy can lead to obesity, depression and narcolepy (irresistible sleepiness)

Eat your eggs to promote hypocretin or orexin since absence of these neurotransmitter for happiness/joy can lead to obesity, depression and narcolepy (irresistible sleepiness).

Asset Protection Iron Triangle by Charles Lamm

Asset protection is not just for the wealthy any longer. When a middle class home can easily run a half million dollars in Florida or another state, and over a million in California or other state, anyone can become a target of lawsuits, divorce courts, and the IRS.  You have to dig a well before you are thirsty, or in this case, build a legal fortress before invading barbarians reach your gate.

Your tools to protect your assets are:

  • “no asset” C corporation
  • Limited liability company (LLC)
  • Beneficiary controlled trust

C Corporation

  • A “no asset” C corporation will be the management company for your LLC. The two work together to protect your property from those who would take it from you.
  • You are employed by the C Corp, not the LLC. You can also be the sole shareholder and hold all of the officer positions. Your corporation owns nothing but a checkbook.

Your corporation can pay for:

  • medical insurance for the officers
  • life insurance ($50 thousand limit)
  • retirement plan

As an officer, you can be reimbursed for out-of-pocket medical expenses through a medical expense reinbursement plan (MERP).

Entertainment expenses directly related to the business can include:

  • training expenses
  • travel
  • meals
  • computer expenses
  • phone expenses
  • business gifts up to $25 per recipient
  • Never let your corporation pay for personal items. Commingling of funds could pierce the corporate veil and make you personally liable for corporate debts in the event of a judgment against the corporation.
  • Consult your CPA or tax advisor for the latest changes in allowable deductions.

LLC

  • Your limited liability company is where you earn your income. Your LLC should also own any vehicles, equipment, computers, copiers, printers, and real property.
  • You want your Operating Agreement to make your corporation the Manager of your LLC.
  • Your LLC should also pay the bulk of your operating expenses for your office, supplies, travel, fuel, utilities, phone, computers, and more.
  • Your interest in the LLC will be as a 99% member will be owned by the trust.

Beneficiary Controlled Trust

  • A beneficiary controlled trust is the crown jewel of asset protection.
  • While I will not go into detail here, a BCT works like this:
  • Someone other than yourself establishes an irrevocable trust with you as the beneficiary and as the Investment Trustee. A second entity or person is required as the Distribution Trustee.

Seek Advise

Charles Lamm’s company, _________Services, Inc., can act as your Distribution Trustee if you want to keep your affairs private from your friends and relatives.  __________ to take advantage of Florida’s excellent trust laws, as well as no state income tax.

  • The Grantor can put up to $12,000 per year into the trust without gift tax considerations, and you have an immediate right to withdraw the money as it is a Crummey defective grantor trust.
  • It’s complicated, but the idea is to leave the assets in the trust and use the trust to own the LLC and to take care of your needs.
  • The trust can purchase property, pay for your education and medical expenses, and take care of your physical well-being. You have full control over the trust assets without actually owning anything.
  • As the Investment Trustee, you control how the assets are used, and you can replace the Distribution Trustee at any time.

Summary:

  •  You are now isolated from lawsuits, creditors, judgments, ex-spouses, and the IRS.
  • Location within Broward and the state of Florida
  • Location within Broward and the state of Florida (Photo credit: Wikipedia)
  • Charles Lamm is a retired attorney who owns Trustee and RA Services, Inc., in Coral Springs, Florida. His asset protection blog can be found at http://trusteeandraservices.ml

Pope Francis, son of migrant, visit to the Philippines

pope family

Son of migrants Lolo Kiko: Pope Francis in the eyes of the Filipino

Exactly 86 years before the Pope flies to the Philippines, his family ended a life-changing voyage by sea – eventually producing the first Pope who, in his own words, came “from the ends of the earth.”

It was January 1929. The Bergoglios arrived in Buenos Aires, Argentina, after fleeing the fascist regime of Benito Mussolini in Italy.

The Bergoglios came from Portacomaro village in an Italian region called Piedmont, a name based on medieval Latin words that mean, “at the foot of the mountains.”

In his biography, El Jesuita (The Jesuit), the Pope described the Bergoglios as neither rich nor poor. In fact his grandparents owned a café. Still, the elder Bergoglios “wanted to go to Argentina in order to be near their siblings,” who had lived there since 1922.

The Bergoglios had another, more pressing reason to leave Italy: “the advent of fascism,” according to the Pope’s sister, Maria Elena, in an interview quoted by La Stampa.

Their grandmother, Rosa, strongly rejected fascism. Maria Elena told Italian journalist Andrea Tornielli: “Grandmother Rosa was a heroine for us, a very brave lady. I’ll never forget when she told us how in her town, in Italy, she took the pulpit in church to condemn the dictatorship, Mussolini, fascism.”

POPE’S PARENTS. The Pope’s father, Mario Jose, married Regina Maria Sivori – ‘the daughter of a Piedmontese woman and an Argentine descended from Genoese people,’ according to El Jesuita – in 1935. Mario Jose and Regina Maria met at a Mass in 1934. Photo courtesy of Sergio Rubin/Clarin/AFP

In contrast, Argentina “held the promise of seemingly untold job opportunities, better pay, the chance of an education for all, and considerable social mobility….a land of peace and progress,” authors Sergio Rubin and Francesca Ambrogetti wrote in El Jesuita.

Political and economic turmoil loomed in Argentina, however. The Great Depression damaged the country’s economy, and its military launched a coup in 1930.

Against this backdrop, Jorge Mario Bergoglio – born on December 17, 1936 – grew up in a family of 5 children. His father, Mario, worked as an accountant in a railway company, while his mother, Regina Savori, stayed home to raise the Pope and his siblings.

In an interview quoted by author Paul Vallely, the Pope said the Bergoglios “had nothing to spare, no car, and didn’t go away on holiday over the summer…but still never wanted for anything.”
MIGRANTS’ CHILD. A young Jorge Mario Bergoglio (R) poses with unidentified schoolmates in Buenos Aires, Argentina. Photo courtesy of Sergio Rubin/Clarin/AFP

Like the Pope’s family, around 2.97 million Italians migrated to Argentina for various reasons from 1857 to 1940 alone. Italians made up around two-fifths of the immigrants to Argentina during this period.

At around the same time, thousands of Filipinos also began to leave the Philippines for a better life abroad. More than 100,000 Filipinos fled to the United States, mostly in Hawaii, from 1906 to 1934, according to the Center for Migrant Advocacy. The Filipinos in Hawaii mostly worked as plantation workers and farmers, as the Philippines remained an American colony.

The Philippine government, as of 2012, pegs the number of overseas Filipino workers (OFWs) at 10.49 million.

The president of the Catholic Bishops’ Conference of the Philippines (CBCP), Lingayen-Dagupan Archbishop Socrates Villegas, said the plight of migrant workers “brings Pope Francis close to Filipinos.”

The Bergoglios “know the meaning of being separated from the family, being uprooted from your own country, in order to seek greener pastures,” Villegas told Rappler. “That’s really very Filipino, right? Our OFW culture is really in the Bergoglio line.”

LEAVING HOMELAND. Families from southern Philippines sail to Sabah in search of a better life. Photo by AFP

Eight decades after his family fled Italy, OFWs can take comfort in the words of the first Latin American pontiff, who considers the care for migrants a hallmark of his papacy.

“Migrants and refugees are not pawns on the chessboard of humanity,” Francis said in a message in 2013. “Dear migrants and refugees! Never lose the hope that you too are facing a more secure future, that on your journey you will encounter an outstretched hand, and that you can experience fraternal solidarity and the warmth of friendship!”

 
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Buy an acre of land in Arizona for a free trip to the Philippines

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Contact Connie Dello Buono 408-854-1883 motherhealth@gmail.com or conniedbuono@gmail for this all paid one acre lot.

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Health is about Consciousness

HEALTH It’s All About Consciousness
Published by: http://www.namastepublishing.com
Sickness isn’t something that just “happens” to us, and neither is
health something that can be achieved simply with the right foods,
medicines, exercise, and mental attitude.
Health and sickness are a reflection of our essential being, and hence
the potential for health resides in each of us at all times.
When we are grounded in the universal consciousness the author calls
our One-Self, our entire being is in balance, which gives rise to
wellness. This is because there is no fracturing within our One-Self,
which knows nothing but well-being. It is whole, or “holy.”

To the degree we are in harmony with our One Self, we enjoy an easy,
flowing aliveness and vibrancy. Dis-ease only occurs when this flow is
in some measure blocked. There’s no longer an easiness about us, no
longer an abundance of energy, no longer a suppleness.
Ivan Rados’ insight into how we can consciously reconnect with our One
Self enables us to address illness at its source—the mind, which
through thought and emotional reactivity blocks the flow of our
essential being.

By clearing out anxiety, delusion, projections, belief
in separation, and our sense of limitation, we restore the health that
is intrinsic to our humanity.
This book is for anyone who wants to live in tip-top condition. It
shows us how to get well, and how we can enhance our current state of
being and avoid future illness.

health ivan
http://www.ivanrados.com

March 16, 2015 deadline for business structure execution

Unless otherwise indicated, all deadlines related to TAXES are at 11:59:59 P.M. (one second before midnight) local time.

See also IRS Publication 509.

March 31, 2014

November 15, 2014

  • Start of 2015 open enrollment at the Health Insurance Marketplace.
  • This applies to uninsured taxpayers who want to avoid possible penalties on their 2015 tax returns, which are filed in 2016.

January 5, 2015 (evening)

  • The Intuit Electronic Filing Center begins accepting and holding (“stockpiling”) 2014 tax returns that are final and able to be e-filed.
  • The IRS starts processing stockpiled returns on January 20.

January 15, 2015

  • Due date for fourth installment of 2014 estimated tax payments.

January 20, 2015

  • The IRS starts processing previously stockpiled returns. Most (but not all) are processed on a first-in, first-out basis.
  • The IRS will run a small number of stockpiled returns through their systems up to a week before this date for testing purposes.
    • If yours is one of them, please note that your tax refund (if any) will not be processed until after January 20.

February 15, 2015

  • End of 2015 open enrollment at the Health Insurance Marketplace.
  • This applies to uninsured taxpayers who want to avoid possible penalties on their 2015 tax returns, which are filed in 2016.

March 16, 2015

  • Deadline for filing a 2014 corporation or S-corporation return or extension.

April 15, 2015

  • Deadline for filing a 2014 personal, partnership, or estates/trusts tax returns or extension.
    • The return or extension must be postmarked or transmitted for e-filing by Wednesday, April 15, 2015.
    • To avoid late payment penalties and interest, any additional taxes you owe must be paid by this date even if you filed an extension.
  • Due date for first installment of 2015 estimated tax payments.

April 20, 2015

  • Deadline for resubmitting or paper-filing a rejected federal return that was originally e-filed by the April 15 deadline if you did not file an extension.
    • Note: The last day to resubmit a rejected 2014 return is October 20; however the April 20 deadline applies to taxpayers who owe taxes and want to avoid the late-filing penalty.
  • Deadline for resubmitting or paper-filing a rejected extension that was originally e-filed by the April 15 deadline.

June 15, 2015

  • Deadline for filing a 2014 personal return for U.S. citizens or residents living and working abroad, including military duty.
  • Due date for second installment of 2015 estimated tax payments.

September 15, 2015

  • Final deadline to file your 2014 corporation, S-corporation, partnership, or estates/trusts tax return if you filed an extension.
  • Due date for third installment of 2015 estimated tax payments.

October 15, 2015

  • Final deadline to file your 2014 personal tax return if you filed an extension on or before April 15.

October 20, 2015

  • Final deadline to resubmit a rejected 2014 return that was originally e-filed on or before October 15.
    • If you’re expecting a refund and miss the October 20 e-file cutoff date, you have until April 16, 2018 (October 15, 2018 if you filed an extension) to file a paper return and claim your 2014 refund.

Connie’s comments:

Financial strategy and business structure execution should be made before March 16,2015. We at Harding Financial are helping doctors and business owners reduce their income taxes thru a business structure (C or C and S corporations) and  financial strategy.

Please contact Connie Dello Buono 408-854-1883 motherhealth@gmail.com or conniedbuono@gmail.com

Medicare Overbiller buying Hospitals like O’Connor’s

The FBI is interviewing witnesses about billing practices at Prime Healthcare Services, the hospital chain that has charged Medicare for treating elderly patients with rare medical conditions at far higher rates than other California hospitals.

The FBI would neither confirm nor deny an investigation, but at least two former Prime medical coders say they were approached by the agency to discuss the chain’s billing practices, which have been the subject of a yearlongCalifornia Watch investigation.

Anneke Doty and Danika Fedeli both confirmed that an FBI special agent contacted them about statements they made in October to California Watch. At that time, the coders detailed how the billing practices changed soon after Prime acquired one San Diego hospital.

Based in Ontario (San Bernardino County), the hospital chain, which owns 14 California hospitals and one hospital in Texas, has been the subject of state and federal investigations for the way it handles its billings.

California Watch has analyzed millions of patient admission records contained in state data to identify a pattern at Prime hospitals of billing for rare and serious medical conditions that typically generate bonus payments to hospitals.

Doty and Fedeli both worked at Alvarado Hospital Medical Center in San Diego and attended a meeting in late December 2010, just weeks after Prime took over. They said Dr. Prem Reddy, who owns the Prime chain, urged doctors in attendance to document rare medical conditions that entitle hospitals to more taxpayer dollars than common maladies.

A spokesman for Prime said the chain is unaware of an FBI probe.

Company’s reaction

“Prime Healthcare Services is an award-winning management company, and federal accreditation agencies frequently audit its hospitals and laud their practices,” spokesman Edward Barrera said. “Any scrutiny will show that our hospitals are committed to following all state and federal laws and regulations.”

Exaggerating a medical bill, called “upcoding,” is illegal. Prime has maintained that it has never engaged in the practice. The chain has emphasized that physicians, not executives, are responsible for diagnosing patient medical conditions. Chain leaders also have broadly labeled former employees who have questioned company practices as disgruntled.

The state Department of Public Health conducted a probe of Prime septicemia cases after research by the Service Employees International Union revealed that some chain hospitals reported the nation’s highest rates of the bloodstream infection.

Regulators concluded earlier this year that they lacked evidence to cite the chain for documentation shortcomings. However, a department official said the inspection findings were forwarded to agencies that focus on billing reviews for Medi-Cal and Medicare.

In the California Watch story published in October, former coders Doty and Fedeli recalled that Reddy urged physicians to document autonomic nerve disorder in cases in which patients have fainted.

Fainting is one symptom of the rare disorder. Affected patients also may experience erectile dysfunction, major constipation and other symptoms.

Hospitals billing Medicare can earn about $7,000 for treating fainting patients who also have multiple complications. Hospitals documenting the nerve disorder can earn about $12,500 for patients with one major complication.

Patient billing data at Alvarado Hospital Medical Center is not yet publicly available. But at other hospitals, the chain reported higher rates of the conditions Reddy mentioned at the December 2010 meeting.

Other Prime hospitals reported, for instance, that they saw autonomic nerve disorder nearly 90 times more often than other California hospitals.

In addition to the nerve disorder, Fedeli and Doty recalled that Reddy encouraged doctors to document “accelerated hypertension” in cases in which doctors see blood pressure above a certain threshold.

Medical coding

Fedeli said medical coding software recognized the term as “malignant hypertension,” which is a sudden and severe form of high blood pressure that can cause the eyes to bleed. The National Institutes of Health estimates that the condition afflicts about 1 percent of hypertension patients.

A California Watch analysis of Medicare billing data found that California hospitals report that 2.6 percent of hypertension patients had the malignant form in 2010. At hospitals owned by Prime, the rate was 19 percent.

California Watch is a project of the nonprofit Center for Investigative Reporting. Contact the author atcjewett@californiawatch.org. For more, visit californiawatch.org.

Connie’s Comments: We want good benefits for nurses and doctors, service to low income patients and stop abuse of Medicare by over billing it. Prime Healthcare is buying hospitals in the bayarea and was investigated by the FBI years ago for Medicare fraud.