Resolutions To Do Business Globally in 2008

Hope you had a very Merry Christmas and that these resolutions I wrote about for Small Business Trends inspires you to take your business global in 2008!

Back with you in the new year. Enjoy.

What Rewards for the Whistle Blower?....1/03

Saw an article about an Atlanta Hospital which settled with the government for $26 Million in order to avoid charges of Medicare fraud.

The whistle-blower, a former employee, collected almost $5 Million.

One of the charges in the lawsuit is that I accused PRMC of Medicare fraud. A comment said that it cost the hospital over $250,000 to clear itself during an audit. If that money was paid to the government, isn't that like deferred prosecution? You're guilty, but they just want you to clean up your act? They don't say that a hospital is guilty, but you can draw your own conclusions....

I didn't actually accuse the hospital, but one might characterize a guilty conscious as being overly sensitive...and you wonder if someone pocketed about $45,000!!!

RBN – New and Improved Storm Botnet for 2008

Obviously the Russian Business Network (RBN) is working overtime during the Christmas and New Year holiday, no doubt planning for many in the ISP security and anti-spam arena to be on skeleton staff.

Many will now have already seen reports of the Storm Botnet outbreak which started on December 24th “MerryChristmasDude” with good write up at ComputerWorld and for technical details at ISC Sans or HolisticInfoSec (links on footer). This picture is changing rapidly and by December 26th there were new web sites “Uhavepostcard” , “HappyCards2008” and no doubt more to come over the next few days.


Three of the key web sites have the following registrant information, all registered via “ANO REGIONAL NETWORK INFORMATION CENTER DBA RU (Russia)” in chronological order:
Domain Name: MERRYCHRISTMASDUDE.COM - Creation Date: Nov 27 2007
Domain Name: UHAVEPOSTCARD.COM - Creation Date: Dec 23 2007
Domain Name: HAPPYCARDS2008.COM - Creation Date: Dec 26 2007


The key objective for the RBN is to rebuild the Storm Botnet which is shown in various reports over the last few months, from a few million enslaved PCs to more recently a few 100,000’s. One can only further guess as to what the RBN’s main goal is to use a rebuilt Storm Botnet for, e.g. earlier DDOS (Denial of Service attack) on Estonia.


There are some interesting elements concerning which make this attack innovative:

# Although much of that detected is conventional spam, however there is also a large amount of spam which is getting through many anti-spam defenses due to the use of “fake” BlogSpot (Blogger) links for example on a small sample;

hxxp://dantipXXXX.blogspot.com/?soapwerzpordeecaspewtkk153trajspeak hxxp://isakovkapitonXXXX.blogspot.com/?harkwerzpordeecaspewtkk153trajfloor

The common part of the suffix is “pewtkk153traj” which redirects to Geocities web sites and then a further redirect to the Storm exploit domains.


# Although most have identified as the Zhelatin Storm email worm or variant, it is also as the more recent fake codec downloads, dependent upon where the unfortunate user has come from. This now shows a “polymorphic” format, i.e. the virus or exploit has the ability to alter its signature in an attempt to combat anti-virus tools.


# The fast-flux technique used to avoid detection in this case is actually “double-flux” characterized by multiple nodes within the network registering and de-registering their addresses (see sample maps below taken within one hour periods and show the fast-flux DNS changes). It is also safe to say this newer Storm Network has now also has improved defense mechanisms, if examined too closely.

Computerworld - Storm Worm Christmas
Computerworld - Storm New Year
ISC Sans - Anticipated Storm
HolisticInfoSec

A heart attack at PRMC's Emergency Room....8/9

I received this as an email which had the patient's name and a lot of additional information as to his identity. I suggested that he consider it carefully and he agreed to my removing overt identification. However, I'm sure that his friends and the hospital personnel know who he is and who they are.

On the morning of Aug 1, 2005, I awoke about 4am at home with severe chest pain. It was an intense pain I had never had before.

Heartburn is something I almost never have, but I got up and chewed a couple of Alka-mints. The pain did not go away and seemed to gain intensity, so I woke my partner, significant other or whatever you want to call him. We have been living together for over 33 years and we have lived in ____ 22 years. He is also an ex-EMT basic. He had me lie down and administered oxygen. This helped a little bit, but I still had chest pain and trouble breathing. We decided I needed to go to the ER in Paris.

He drove me there and we arrived at 5:46am. Once in the ER, I sat at a desk while a nurse took my name, address, etc. and finally I was laid down and hooked up to a monitor with my blood pressure all over the chart and pulse as low as 37. When my pulse dropped below 40, an alarm went off and no one came in. I had to tell the nurse that it had gone off. She just looked at me with a blank look on her face.

Over several hours, I was given an Xray, an ECG and had blood drawn. I was left unattended all of the time while they worked on a couple of more patients that they said were critical. I was there forty-nine minutes before I was given nitro several times with no let up of chest pain.

I was never given any aspirin or any other drug of any kind. I was never asked if I had a history of heartburn or upset stomach. Dr Hobbs came in only once for a very short visit. He never listened to my heart or lungs or asked any questions about my history. My partner was in the room with me when asked by nurse Debra Crews who he was. He replied that he was my significant other.

After that statement, the atmosphere seemed to change and I was left lying there with only occasional checks on the monitor. Thirty minutes after shift change at eight a.m., Dr. Rowe came and stood in the door. He said I had GERD and gave me a prescription for a prev-pak ($300). He said my sugar level was high at 146. I asked what should it be and he said "140". Then he sent me home.

All the time Dr. Rowe was in the room he didn't come near me. He never examined me or listened to my heart and lungs. He never asked me any questions or medical history. I went home and the chest pain mostly went away late that afternoon. This visit cost the VA over $2,500. I believed the doctor and thought I had GERD.

The rest of the week was spent in agony. My arms hurt, my legs hurt, I couldn't eat, my blood pressure stayed very low and averaged about 70/50 which is really not enough for kidneys to work properly. By Friday morning, August 5th when I went to Bonham to the VA clinic, my blood was toxic and my heart in really bad shape.

They did an EKG and sent me by ambulance to the Bonham hospital to stabilize me before I was sent to Wilson N. Jones Medical Center in Sherman to the emergency room to be sent to a heart cath lab. There I had one stent put in and angioplasty. They left some blockages because I was on the verge of kidney failure, and more dye would have probably shut down my kidneys. I was told by the renal specialist that I came very, very close to death. Fortunately, I have good kidneys and passed the toxins quickly.

I was released on August 7th. Two days stay at the hospital in Sherman cost the VA $140,000. Later the next week, I was charged over $43 for a copy of my medical records from Paris Regional Medical Center to give to my VA doctor. There were no strips from the monitor in the ER in these records or doctor notes.

When I picked up the records, I asked if I was getting a copy of everything in my medical records and was assured that I was. The ECG in these records clearly showed abnormal heart functions.

On August 20th, I had chest pain and it felt as if I had a heavy weight on my chest. I called the Dallas VA hospital and was told to call 911 or go to the nearest ER. I told them I would rather take my chances on the road to Dallas than to go to the ER in Paris again. I went to the ER at the Dallas VA hospital and was admitted and had another heart cath on Monday, August 22nd. They put in another stent and more angioplasty. I was released on the 23rd with medications for my heart and will do follow-up in the cardiology clinic there.

I believe I was denied medical care for the heart attack I was having when I came into the ER at Paris Regional Medical Center for several reasons. First, I did not have the blank check of Medicare or Medicaid. Second, the personnel at the ER seemed to have no training in treatment of chest pain (heart attack) patients which is simply an aspirin and nitro glycerin under the tongue immediately. Third, Dr. Hobbs and Dr. Lowe acted like they really didn't care about me at all and neither listened to my heart, lungs or asked any questions and seemed to have no training in ER procedures.

I truly believe that if my heart attack had been diagnosed properly at the ER at Paris Regional Medical Center, I would not have gone through so much pain and agony and damage to my heart would have been minimal. By not treating me at all, Paris Regional Medical Center has taken years from my life and is liable for all medical expenses, ambulance trips, medicine and all other expenses incurred by the Veterans Administration clinic and hospitals.

So this is the organization that wants to put in a specialty Heart Hospital? Is this the same place that put up the signs for 'The Chest Pain Center'...and then didn't bother to inform the ER, nor staff appropriately?

And the gay issue...do all Essent hospitals have a problem with that? Personnel need to park their personal beliefs at the door. A patient is a patient is a patient...and they need your care. If you can't provide that, you need to get out of the medical field.

Yes, patients can have their own beliefs--and we have to respect them. That's part of the job. That's part of your training. 'First: Do no harm.' That includes 'by omission', as well.

Christmas 2007....1/18

As in the words of Tiny Tim (A Christmas Carol):

"God bless us, every one!"

Merry Christmas.....frank

World Greetings

One of the real joys of the holiday season is the opportunity to say thank you to all our readers and wish you the very best for the new year.

Our toast to you is this: Here's to taking your business global in 2008!

Interest Revived?....1/11

You wonder if Essent is back up on the block. Searches from several corporations that would seem directed towards that end. Even the Aussies appear back in play.

And, it would be a good thought: Buy low.

I have been thinking about the Essent finances. The first significant loss was with Crossroads. Their version of buy high and sell low. Now that happened prior to the blog, although I did mention in the postings around Nov.

Even before the blog got rolling, MVH had serious problems, and their gay rights lawsuit didn't help that a whole lot. I think the Lahey Clinic has positioned themselves well in any case.

Sharon Hospital just keeps on producing.

NVMC is keeping its head above water.

Southwest (odd how a corporation with a Texas presence names a hospital in PA "Southwest") has their own problems. The blog didn't seem to really catch on out there, but there are several loyal followers. They just needed a cash infusion for an update. Essent was part of the baggage.

Paris. Paris had its own problems. How Christus was bamboozled into buying Big Mac is beyond me. Maybe the bean counters really believed that two hospitals that were losing money combined would lose it half as fast rather than twice as fast????

The 'due diligence' conducted by Essent missed an awful lot, and Monty was burying as much as he could at that juncture. On paper, the facility looked good (doubling the corporate beds!)...and yes, there were savings areas that were obvious. But, the duplication of services, the number of properties, and the mind-set were essent-ially ignored. When they looked at it rationally, the building of a new facility at the North Campus might well be a fantasy--unless a non-competitive buyer (like the VA) could be found for the South, or a re-designated use (rehab, LTAC) that could stabilize costs could be found.

The cuts were to be expected. The problem is, few realized that. The community was used to a not-for-profit environment, that could deficit spend. The attitude was it doesn't matter what we lose, we'll still have jobs. Essent didn't dissuade that notion during the courtship, but then there is hammer time.

Possibly the way to have gone, was to have involved the community more. But they are in a fix. The heart hospital sounds good "on paper" (again), but the proximity of Dallas, with cheaper pricing and newer facilities, puts a hole in that. Advanced Heart has been directing patients that way for years.

What will play out? Who knows. The lawsuit that Essent is pursuing (you thought it was over????) has to show two things: One, my posts were false. Second, by circulating said falsehoods, enough credence was given that financial losses were incurred. They are hindered by a several things, history, common knowledge, and their own policies.