yzerman19

Ha! I hadn’t thought about that irony before...but I’ve never bought into 12 years from annihilation either.

Better to scale back than live with a bad decision...kinda like getting married. healthcare is not a booming industry. Customers don’t want to have to pay for it...

It is vastly more likely that they made this decision based on industry trends and their own financial plan than an inability to place bonds. My point is NOT about the financial position of Altru- as you can see by my other post, there are many reasons to be conservative. My point is that it is improbable that they couldn’t get the bonds placed. as for running ones own business- tons of respect for the entrepreneur. I will likely consider running my own business when I finish running this $14B one.

So...not sure what local places would be involved in a discussion of the initial subscription of a bond issue. Perhaps in the “friends” clause they would be guaranteed some bonds. For the record, I once worked on the trading desk of a municipal bond (including healthcare revenue bonds) underwriter, so I’m pretty well versed in the process. You are correct that a downgrade changes the market expectation of interest. However debt is still historically cheap, and bond insurance is also a common solution to fear of default. I don’t really feel like crunching the numbers on cash flow this morning- I’m enjoying my coffee and the fact the Sioux are #1 in the Pairwise. To be in the situation you describe, they would’ve had to have abandoned the industry standard approach as well as their historical approach to their detriment.

As an industry expert, Here are some notables to consider: 1. Altru is remaining independent, which creates G & A pressure in terms of scale and shared services. Simply put, administration costs more per service because of this Costs more than it does at larger systems. 2. Serving the entire community as an independent requires a breadth of services that limits the opportunity to focus Solely on centers of excellence with strong margins. In other words, they have some major loss leaders on services important to the region. They could jettison some of those and make people drive to Fargo- they would if they were for-profit or part of say Sanford. The investment required for related tech is also costly with a longer payback period due to less usage. 3. Cost of care focus from payors as well as technology And care advances have tilted the model to lower margin office and outpatient treatment. Gone are the days of big loss leading pcp network to feed profitable specialty to feed lucrative admissions. Volume of lucrative admissions is declining. Think OP ortho- prime example. 4. Govt payments I.e. Medicare and Medicaid doesn’t cover costs and is tightening. The single largest payor for all delivery systems doesn’t pay the rent, is tightening, and is a growing % of services with an aging population. Revenue forecast not looking so hot. 5. Skilled labor costs continues to put pressure on mid-market regionals like Altru. Nursing and physician markets are tight. Their market rate is not benchmarked to the local wage structure. Bottom line is operating pressures that have turned many smaller community hospitals into nothing more than birthing centers and triage are progressing up market. Altru’s commitment to stay locally owned creates additional challenges economically, but also keeps jobs and decision making in GF. I think they are being judicious given the environment. As for quality of care and experience issues for patients, that’s a separate animal. I’m only speaking to the business side of the industry.

Highly unlikely. A bond issue of that scale would be marketed by the investment bank they chose- historically in NY or Chicago, which would have no trouble over -subscribing the issue if priced correctly. Which the bank would help them do. Tax-exempt revenue bonds are generally very attractive to the bond market.

Doug Woog will be remembered as one of the greats of all-time in Minnesota hockey. Moreover, he was a genuinely great guy. My two favorite personal Woog moments: 1. Having met him previously, I went over to him (in a bar) where he was watching a DU game. He was short with me to the point that i went back to my seat. When the intermission came. Doug made a beeline to me, apologized profusely and explained that the Gophers were playing DU the next weekend and he needed to watch for work. We chatted hockey over a beer and he treated me like an old friend. 2. At the Ralph with my son who was maybe 3 years old at the time. Doug’s in town doing the game. I see him in the entry before the game- he’s headed up to go on camera, but He see’s me and my son looking at the murals and trophies. He comes over to us and leans over and says to my son “pretty impressive isn’t it? It’s a great program”. Rest In Peace Doug. God Bless You.

Well earned boys!

Don’t forget who first coined the reward!

Waldo’s tavern is a good dive bar close by

By the way as a man with real Sioux genes...”lets go Sioux”

Either you’re 12 or a Troll or seriously in need of some help

Although rumor has it Hrkac’s motor has ties to Medellin Columbia

Now I like Stech, but I have to think this is a little over the top. No insult intended, Stoney. He was a solid player, but motors? I think Sykes, Hrkac, Naumenko, Panzer, Parise, Osh, Even Grimaldi.

Let’s not get too cocky...I’ve seen this rivalry flip outcomes far too many times. Never get too high or too low playing the Gophers.

I don't disagree, but I think its up and down on the ability to create up front.

still not Canalis or Valentinos

Hoping a green angel sets up a live stream for those of us in California....

I have to disagree with you. All 5 skaters have three zone responsibility. The fact we only had 18 shots get through in 3 periods is not all on the forwards. Offense from the D is huge, not just as safety valves or bombs from the point, but also transition and high-low play.

Great player, great kid, great family. He’ll get some NHL reps.

He mixes in some really interesting deeper stuff too...things that I only think goalies think about....I was trying to be a little punchy, but he is actually quite good.

Well...he is not running fortune 500 companies nor providing life saving medical services...thank GOD...but all in all, he ain't too bad...he's got a homey feel...Roseau town and all

Dirtiest thing said in college hockey last weekend “Brad, you were a little hard on the beaver last night”

Wow...pull two drafted underclassmen...really not liking this lineup choice. Only way Blaisdell or Hain should sit over those guys is if they’re dinged up. Berry is reacting tonight rather than building, IMHO... Although he also knows the status of every player, and I don’t.