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Every team experiences good times and bad and no one at Trent Bridge would describe the current phase in Nottinghamshire's fortunes as a bright one. With few players combining experience and quality on the staff, they are heavily reliant on young players.
Some of them have shown great promise, but it will be some time before talents such as the 19-year-old Usman Afzaal and 18-year-old Paul Franks acquire the consistency that comes with maturity.
Nottinghamshire had only Durham beneath them in last year's Britannic Assurance table and pundits wonder if they might not even find the championship's newest county doing better this summer, especially under the captaincy of David Boon.
Their own captain, 32-year-old Paul Johnson, faces a stiff test of his leadership qualities. With both Nottingham Forest and Notts County relegated in the football season just ended, he does not want to complete a hat- trick for the city by finishing with the wooden spoon.
Johnson does not mind criticism but he does ask for fairness. He was especially annoyed to read Peter Roebuck's astonishing view that the county champions twice in the 1980s now barely merit first-class status.
"We have taken some criticism but it just drives us on to prove them wrong," Johnson said. "Peter Roebuck's comments were especially disappointing. Coming from someone who has only just left the game, they were particularly crass. Hopefully we will finish above Somerset and we can send him a copy of the table.''
Johnson's side were well beaten by Kent but with victories over Lancashire and Derbyshire in the two preceding matches they already have doubled last season's tally of wins. "We ended up with only eight fit men against Derbyshire and to win in that situation says a lot for what the side is capable of.''
The 10 highest run-scorers in Ashes series
1 D G Bradman (Aus) 974 average 139.14, 1930
2 W R Hammond (Eng) 905
average 113.13, 1928-19
3 M A Taylor (Aus) 839
average 83.90, 1989
4 D G Bradman (Aus) 810
average 90.00, 1936-37
5 D G Bradman (Aus) 758
average 94.75, 1934
6 H Sutcliffe (Eng) 734
average 81.56, 1924-25
7 D I Gower (Eng) 732
average 81.33, 1985
8 A R Morris (Aus) 696
average 87.00, 1948
9 D G Bradman (Aus) 680
average 97.14, 1946-47
10 G A Gooch (Eng) 673
average 56.08, 1993
Peerless Bradman
Don Bradman, considered by many as the greatest batsman of all time, made four hugely successful tours of England, establishing the record for the highest Ashes series aggregate - indeed the highest for any Test match series - on the very first in 1930, at the age of 21. Having begun the tour with 236 at Worcester, he made a century in the opening Test, a double hundred in the second and then 334 in the third Test at Leeds. On that tour he made 2,960 runs at 98.66 in first-class matches and topped 2,000 first-class runs in each of his subsequent visits.
Kent, who last won the County Championship in 1978, began this season with a pronounced sense of anticipation after finishing fourth last year, when they might have done better still had left-arm spinner Min Patel not lost his form at a critical stage.
The county hope the appointment of John Wright as a successor to Daryl Foster will bring about a seamless transition on the coaching side and there is already evidence that the side has begun the season in good fettle with wins over Sussex and Nottinghamshire.
Their credentials may be exposed to a stiffer test at Tunbridge Wells. Starting on Wednesday, they play Warwickshire, who have been hit by injuries but retain the competitive instincts instilled by Dermot Reeve.
Leaders Gloucestershire face an equally severe examination at Headingley, where Yorkshire will be attempting to build quickly on the fine win over Essex that they will complete at Ilford this morning. By Wednesday, Jack Russell's side may no longer be at the head of affairs. Champions Leicestershire will take over if they beat Lancashire today, although it is more likely that Glamorgan will go top by beating Durham, who are following on in Cardiff.
The name for a ball that passes beneath the striker's bat, particularly on or just inside the popping crease, has been in use since the 1860s but its origins are unclear. One theory makes a link with "yerker or yarker", said to be dialect for "jerker", but a more favoured explanation is that it is rooted in 18th and 19th century slang, when the phrase to "york" or "put Yorkshire on someone" meant to trick, cheat or deceive.
Colourful history of Kent's smallest but most beautiful home
Neville Ground, Tunbridge Wells
If nature gets its timing right, the Neville Ground in festival week has few rivals for visual beauty among English cricket venues. The combination of rhododendrons in bloom and a boundary ringed with marquees recreates a timeless atmosphere of the Home Counties at leisure.
Kent's smallest ground - in terms of spectator capacity if not playing area - has been hosting first-class cricket since Lancashire's appearance there in 1901, three years after it was opened by the Marquis of Abergavenny. The Neville's early history, like its famous purple flowers, is colourful. The Tunbridge Wells Cricket, Football and Athletic Club raised pounds 1,200 to build a pavilion in 1903 only for it to be burned down 10 years later during a protest by suffragettes. An identical structure was put up in its place, just in time for the ground to be requisitioned for the picketing of several hundred cavalry horses during World War One, which did nothing for the pitch.
Little has changed since then, although the land passed into the ownership of the local borough council in 1946. Of the other buildings in addition to the pavilion, the most important is the Bluemantles Stand, named after the club which originally shared the ground. Most facilities, however, including a souvenir shop, beer tent and even a bookmakers, are under canvas.
When the weather is favourable, deckchairs provide the most common vantage points, although the flat roof of the pavilion is popular with broadcasters and the press, providing an elevated view of the playing area.
Kent v Warwickshire (Britannic Assurance Championship) at Tunbridge Wells starts on Wednesday. The counties meet in the AXA Life League on Sunday.
Top of the form
Bowlers Wkts Last five (most recent on right)
1 D Malcolm (Derbys) 23 4-95; 5-50; 6-75; 4-24; 4-91
2 R Croft (Glam) 18 1-10; 4-84; 5-33; 3-54; 5-51
3 P DeFreitas (Derbys) 17 3-35; 7-64; 1-53; 5-46; 1-88
4 M Smith (Gloucs) 17 4-61; 6-45; 3-35; 1-44; 3-65
5 M Bowen (Notts) 16 0-8; 2-70; 7-75; 4-34; 3-103
6 A Caddick (Somerset) 16 1-59; 6-103; 1-16; 5-64; 3-50
7 K Evans (Notts) 15 6-40; 1-63; 1-68; 4-40; 3-115
8 M McCague (Kent) 15 1-54; 1-71; 7-82; 2-46; 4-33
9 A Johnson (Middx) 14 3-35; 4-26; 2-40; 2-66; 3-70
10 A Sheriyar (Worcs) 14 3-26; 0-30; 4-53; 5-54; 2-90
Batsmen Runs Last five (most recent on right)
1 S James (Glam) 382 52; 46; 54; 76; 153
2 S Law (Essex) 371 63; 118*; 84; 30; 76
3 G Rose (Somerset) 347 10; 109*; 191; 0; 37
4 D Lehmann (Yorks) 339 43; 177; 30; 8; 81
5 R Harden (Somerset) 336 136*; 103; 32; 50*; 15
6 M Ramprakash (Middx) 334 26; 145; 2; 50; 111
7 N Johnson (Leics) 308 87*; 38; 6; 24; 150
8 H Morris (Glam) 296 96; 18; 25; 21; 135
9 A Moles (Warks) 275 6; 33; 1; 67*; 168
10 J Crawley (Lancs) 273 19; 51*; 101; 41; 61Reuse content


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New Year's weekend babies arrive with a twist
Tales of New Year's babies are staples for local news media. But the latest turn of the calendar brought a few twists to a familiar tale.
Tales of New Year's babies are staples for local news media. But the latest turn of the calendar brought a few twists to a familiar tale.
Medicaid expansion under the Affordable Care Act gained momentum in the first half of the year. But most observers believe the election of Donald Trump, who has promised to repeal the ACA, mean those efforts are dead.
President-elect Donald Trump and congressional Republican leaders are promising to make repeal and replacement of the ACA one of their highest priorities in the first 100 days after they take full control of the federal government in January. But they face a rocky road.
It was still a mystery at deadline who President-elect Donald Trump might pick to run HHS and its agencies. Sources told Modern Healthcare that Andrew Bremberg, an adviser to Senate Majority Leader Mitch McConnell and Wisconsin Gov. Scott Walker, would lead the transition team on healthcare policy.
Adeptus Health CEO Tom Hall is retiring sooner than expected in the wake of unexpected losses and a cash crunch in the third quarter.
More than 12 million Americans have gained coverage in states that expanded Medicaid eligibility under the Affordable Care Act. Those states may end up keeping that coverage, at least in some form, if the Trump administration and Republicans eliminate the law.
Brentwood, Tenn.-based LifePoint Health, which owns 20 home health and 10 hospice locations, has entered into a joint venture with LHC Group to manage the facilities.
Public health experts say Hurricane Matthew left pools of stagnant water ripe for mosquito breeding in areas that were already vulnerable to the breed linked to the spread of Zika virus.
Louisiana Gov. John Bel Edwards' administration may have brokered a deal between LSU and the research foundation operating its charity hospitals in Monroe and Shreveport. But just because everyone signed the paperwork, don't expect the vitriolic relationship to reach great new heights of...
This year we honor the 30th class for Modern Healthcare's Up & Comers awards. The program recognizes healthcare's rising stars—young men and women still in the early phases of their careers but who have already made their marks in the industry.
Acadia Healthcare, the nation's largest for-profit owner of psychiatric hospitals, is embarking on a strategy of entering joint ventures with not-for-profit hospital systems to open psychiatric beds.
Hospitals prepare for disasters all the time. But it's not until disaster strikes that you're able to gauge response and observe the heroics that follow. Through hardship, people rise up to support one another.

subset: commoncrawl


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Dried Pemmican With Juniper and Currant Berries
READY IN: 6hrs 30mins
Recipe by Montana Heart Song
This is an old recipe.It requires beef suet. I do not use. There might be a danger of mold. I have updated this recipe which can be used as a dried flavoring for sauces and soups or eaten dry.
Top Review by HotPepperRosemaryJe
This sounds like a pretty good recipe. I am keeping it so that when we go deer hunting next fall I can give it a go! Thanks, Jelly
See Discussion:1 Review
Ingredients Nutrition
- 907.18 g boneless beef top loin steaks or 907.18 g venison loin steaks or 907.18 g elk steaks or 907.18 g buffalo loin steaks
dried jerky with flavoring
- 59.14 ml sugar
- 9.85 ml salt
- 29.58 ml soy sauce or 29.58 ml Worcestershire sauce
- 2 crushed red pepper flakes, if desired
dried pemmican with flavoring
- 4.92 ml salt
- 10 dried juniper berries, crushed
- 10 dried currant berries, crushed
- 20 dried raisins, crushed
- 5 wild onions, bulbs, crushed or 29.58 ml minced dried onion
Directions See How It's Made
- For dried Jerky: Lay meat out on baking trays. Heat the ingredients slowly for jerky.
- You may substitute splenda for sugar and salt substitute for regular salt.
- Brush on each slice of meat. Let set for 1/2 hour.
- Bake 200* oven. Check after 2 hours, turn meat, baste with remaining flavoring. Bake until slightly dry. It will bend a little.
- Place in air tight bags or cans to store.
- For pemmican, crush with mortar and pestle: berries, raisins, onions.
- Mix with salt.
- Toss meat with crushed mixture. Shake off excess in bag. Lay on trays.
- Bake 200* oven. Bake until dry. You may lay outside in the air and sun if you have a protected place from bugs and animals.
- When totally dry, crush the dried meat. Put in small air tight bags, or double bag for the freezer. Use a survival food for camping, as a flavoring for soups or gravies, or sprinkle on noodles or rice.


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No way chrissy even gets that shot off on the and1 if favs is in the game. Beautiful rotation by our vets.
presenting, gregbroncs, writing at a time when we had a multiple game lead on LAC and a healthy Rudy Gobert
Originally Posted by gregbroncs
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We have young players at those positions who can use experience. Right now Lyles isn't getting it but I have confidence that he will be back on the floor rather soon. Favors is getting better, Exum is rounding into shape. We are not getting past the 2nd round, we are unlikely to get past the 1st round. None of the options listed or available change that in the slightest.
Originally Posted by CitizenofCapua
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It sort of happened again despite of Foye's big first half.
Edit; Thats what i wish as well. I find wins that our youngs at leading role more precious.
Y'all are sick. I want the Jazz starters to come in and be inspired by the bench, and lay on some points. Then I want the bench to come in and and fast-break over their defeated corpses and through down dunk after dunk after dunk. Then I want the game to be so far out of the reach, Jeremy Evans comes in the game and dunks on Ronny Turiaf.
Wonderin' 'bout Jazz and if they got what it take
"Ingles, he think he hard, tough guy of the clique
And Gordie, he walk around like he swear he the ****"
Sap the suck is gone
"les grandes défaites forgent les grands hommes" - Rudy Gobert
Good hard foul there by Big Al. Thats all we are asking for! Don't watch people drive in and score over you
WOW BIG AL the swat!!! I LOVE IT
Our offense is so dynamic.
Big Al and Sap increasing their trade value.
Originally Posted by NAOS
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Our offense is so dynamic.
Soooooo dynamic.
Jesus, we are having full-stop stalls.
Well, starters gave it back....
lead down to 7 -- how about a time out coach.
Last edited by mellow; 12-28-2012 at 08:49 PM.
Reason: Lead fell to 5
Homer Jazz fan since 1986
Our leaders!
There better not be a SINGLE Corbin apologist after this game.
Come on Ty. Bring in the second unit!
OK we are in danger zone.. Hit the panic button and bring in second unit.
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The toga was unique to Rome. It was wrapped and draped around the body over a tunic. Wearing a toga was a privilege reserved for adult male Roman citizens. When the son of a citizen reached puberty, he received his first toga as a rite of passage. Stripes of color on the border of a toga were emblems of political rank.
But not all eligible citizens had togas. A toga was expensive to start with, cumbersome to wear, and almost impossible to don without help. So in actual practice only wealthy citizens who could afford slaves wore togas. Everyone else just wore the tunic. Married women wore a garment called a stola over their tunics. It was wrapped and draped almost like a toga, but was lighter and less cumbersome.
If you're planning a college toga party you may not care about these historical niceties. That's not what a toga party is about! A toga party is about re-creating the decadence and perhaps debauchery of the waning Roman Empire. So have as much fun as you want. Just don't try to pass it off as historically accurate.


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Browse Austin Communities
Browse Austin Communities
Contact us anytime for more information about local areas!
Austin really is less of one city but a collection of multiple, charismatic neighborhoods that all contribute their own personality to make Austin, well...Austin. From the regal, historic estates of Pemberton Heights to the ever-so-charming streets of Clarksville, Austin's varied real estate provides a choice of lifestyle that few cities can offer.
Parts of Austin have been designated as Historic Districts such as Castle Hill and Harthan Street that contribute to the Austin ambiance. Other areas are being revitalized with older neighborhoods restoring their charm in areas such as Mueller and Rainey Street. Austin is experiencing a renewed growth with many neighborhoods and communities being "rediscovered" by developers and home owners alike.
Many in Austin like the wide open spaces and the master-planned communities like Circle C or the wonderful, tree-covered home sites that reside in Cat Hollow. Students and residents alike enjoy the unique atmosphere surrounding the University of Texas and the State Capitol. Out West, you'll find two of the more popular communities of River Place, complete with its own 18-hole golf course and private club to Steiner Ranch nestled near the shores of Lake Travis and Lake Austin.
The Central area of Austin is home to wonderful neighborhoods that go by the likes of Allandale, Hyde Park, Rosedale and Enfield. Just west of downtown you'll find the toney community of Tarrytown right next to the Lion's Municipal Golf Course.
Treks north take you to Block House Creek, Cat Hollow, Wells Branch and over to Pflugerville. Travel north on Mopac and visit Cat Mountain or Anderson Mill. The southern route takes you to the eclectic neighborhoods surrounding South Congress, or "SoCo" as the locals have so named.
Real estate in Austin and the surrounding areas is as eclectic as the people who live here. Austin has been regarded as one of the most beautiful places in Texas. Whether it be the upscale lifestyle offered by downtown living, on the pristine waterfront of Lake Austin, or a ranch estate in the serene hill country, Austin is the place to be!


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PCB cancels Pak players' NOC for IPL
In an apparent retaliation to the snub at the IPL, Pak Cricket Board today revoked all the NOC issued to its players.
Zeecric Bureau
Karachi: Humiliated again after Lalit Modi's denial that any IPL team had offered any contract to Abdul Razzaq for playing in IPL –III, PCB has decided to withdraw all no objection certificate given to all players who were put for the auction.
The latest move by PCB means that curtain has finally been drawn on the issue which has become a national debate. Today's announcement by PCB clearly meant that no Pakistani player would be seen in action during the premiere event.
A statement from the board said all the NOC`s issued to players for IPL-III stand revoked.
"In future, if any player receives an invitation for participation in IPL events, PCB will decide the matter on a case to case basis after consulting relevant government authorities," the statement said.
The announcement comes on the same day that the Indian hardline party Shiv Sena said it would not allow Pakistani players to play in the IPL and IPL commissioner Lalit Modi also said that no franchise could pick Pakistani players without his knowledge and approval.
All the 11 Pakistani players, including star all-rounder Shahid Afridi went unsold in the January 29 auction in Mumbai, prompting angry reaction in Pakistan.
The auction fiasco threatened to snowball into a diplomatic row between the two countries with top ministers also being drawn into the controversy.
Notwithstanding all the positive noises being made by the Indian and Pakistani government in the past few days, IPL Chairman Lalit Modi has refuted all claims that any offer has been made to any Pakistan players post the IPL auction.
" The auction is over, there are no spots open. If someone comes in now he can only come as a replacement for a player injured for the whole season. And if someone`s been injured for the whole season and I don`t know it, no one does," Modi was quoted.


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Newly discovered gene regulates hyperglycemia-induced beta cell death in type 2 diabetesJune 01, 2016
It's no secret that over time, elevated levels of blood glucose (hyperglycemia) can induce the death of the pancreatic beta cells. The death of these cells, which are responsible for the production of insulin, underlies much of the pathology of diabetes. Exactly how and why they die is not fully understood, but a new research report published online in The FASEB Journal by a team of Korean scientists, suggests that a protein called, "TSPAN2" may play a key role hyperglycemia-induced beta cell death and might serve as a new therapeutic target.
"The prevalence of Type 2 diabetes is significantly increased nowadays," said Ik-Soon Jang, Ph.D., study author and senior scientist in the Division of Bioconvergence at the Korea Basic Science Institute in Seoul, South Korea. "Our study will be potentially helpful to develop the medicine for the treatment of type 2 diabetes."
To make this discovery, scientists grew human pancreatic beta cells in culture and analyzed their gene expression patterns. They found that the highly expressed genes and proteins under hyperglycemic conditions can regulate cell death through various cell signals, but in general, the primary mechanisms of β-cell apoptosis includes signaling through FAS ligand and various pro-inflammatory cytokines.
"The revelation of a novel pathway related to the induction of pancreatic beta cells apoptosis could have exciting implications for future treatments for Type 2 diabetes," said Thoru Pederson, Ph.D., Editor-in-Chief of The FASEB Journal. "If drugs that inhibit the loss of these cells can be developed, it may be possible to attenuate disease progression."
Submit to The FASEB Journal by visiting http://fasebj.msubmit.net, and receive monthly highlights by signing up at http://www.faseb.org/fjupdate.aspx. The FASEB Journal is published by the Federation of the American Societies for Experimental Biology (FASEB). It is the world's most cited biology journal according to the Institute for Scientific Information and has been recognized by the Special Libraries Association as one of the top 100 most influential biomedical journals of the past century.
FASEB is composed of 30 societies with more than 125,000 members, making it the largest coalition of biomedical research associations in the United States. Our mission is to advance health and welfare by promoting progress and education in biological and biomedical sciences through service to our member societies and collaborative advocacy.
Details: In-Hu Hwang, Junsoo Park, Jung Min Kim, Seung Il Kim, Jong-Soon Choi, Kyung-Bok Lee, Sung Ho Yun, Min-Goo Lee, Soo Jung Park, and Ik-Soon Jang. Tetraspanin-2 promotes glucotoxic apoptosis by regulating the JNK/β-catenin signaling pathway in human pancreatic β cells. DOI: 10.1096/fj.201600240RR ; http://www.fasebj.org/content/early/2016/05/31/fj.201600240RR.abstract
Federation of American Societies for Experimental Biology
Related Pancreatic Beta Cells Current Events and Pancreatic Beta Cells News Articles
Stem cells from diabetic patients coaxed to become insulin-secreting cells
Signaling a potential new approach to treating diabetes, researchers at Washington University School of Medicine in St. Louis and Harvard University have produced insulin-secreting cells from stem cells derived from patients with type 1 diabetes.
New procedure could improve success rate of cell transplant to cure type 1 diabetes
New research suggests pretreating cells with a peptide hormone may improve the success rate of pancreatic islet cell transplants, a procedure that holds great promise for curing Type 1 diabetes.
U-M researchers find noninvasive way to view insulin in pancreas
Scientists and doctors have wanted to know how much insulin a person has in their body, but haven't been able to know the exact amount without the patient being deceased and actually removing the pancreas," says Peter Arvan, division chief of Metabolism, Endocrinology & Diabetes at the University of Michigan.
Scientists discover molecular link between psychiatric disorders and type 2 diabetes
There may be a genetic connection between some mental health disorders and type 2 diabetes. In a new report appearing in the February 2016 issue of The FASEB Journal, scientists show that a gene called "DISC1," which is believed to play a role in mental health disorders, such as schizophrenia, bipolar disorder and some forms of depression, influences the function of pancreatic beta cells which produce insulin to maintain normal blood glucose levels.
Insulin-producing pancreatic cells created from human skin cells
Scientists at the Gladstone Institutes and the University of California, San Francisco (UCSF) have successfully converted human skin cells into fully-functional pancreatic cells.
TSRI team finds unique anti-diabetes compound using powerful new drug-discovery method
Scientists from The Scripps Research Institute (TSRI) have deployed a powerful new drug discovery technique to identify an anti-diabetes compound with a novel mechanism of action.
Microtubules act as cellular 'rheostat' to control insulin secretion
Microtubules -- cellular "highways" that deliver cargo to the cell membrane for secretion -- have a surprising role in pancreatic beta cells. Instead of facilitating glucose-stimulated insulin secretion, they limit it, a team of Vanderbilt investigators reported recently in Developmental Cell.
Rescuing intestinal stem cells from attack in type 1 diabetes
Up to 80 percent of people with long-standing type 1 diabetes develop gastrointestinal symptoms--abdominal pain, bloating, nausea, vomiting, diarrhea, constipation and fecal incontinence--that severely diminish quality of life.
Scientists report success using zebrafish embryos to identify potential new diabetes drugs
In experiments with 500,000 genetically engineered zebrafish embryos, Johns Hopkins scientists report they have developed a potentially better and more accurate way to screen for useful drugs, and they have used it to identify 24 drug candidates that increase the number of insulin-producing cells in the pancreas.
An imbalance of cellular bioenergetics in pancreatic beta-cells links to type 2 diabetes
Impaired activation of mitochondrial energy metabolism in the presence of glucose has been demonstrated in pancreatic beta-cells from patients with type 2 diabetes.
More Pancreatic Beta Cells Current Events and Pancreatic Beta Cells News Articles


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LAS VEGAS TRADE SHOW or ON-SITE EMBROIDERY SUPPORT
We just finished working the Magic Fashion Trade Show here in
Las Vegas. We provided embroidery service to an internationally known
bag manufacturer. We were hired to embroider small bags
which were given to attendees to visited the booth. We created two special one letter monograms, script and octagon, plus several small
fashion related designs.
We have a 6-needle embroidery machine with stand that can be brought to your location. This will allow you to provide embroidery to your customers on-site. Unfortunately, without computer digitizing software
on-site, we are limited to select designs which are required to be done
prior to arriving at your location or booth.
Trade Show or On-site Pricing is $100 per hour ($500 minimum) plus expenses
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Category Archives: CMS
Hospital May Lose Its Medicare Contract, Threatens CMS
Hospital is shocked to learn that its Medicare contract with Health and Human Services may be terminated by April 16, 2017. Medicaid services may also be adversely affected. The hospital was notified of the possible Medicare contract termination on March 27, 2017, and is faced with conceivably losing its Medicare contract within a month of notification. Legal action cannot act fast enough – unless the hospital requests an emergency temporary restraining order, motion to stay, and preliminary injunction and files it immediately upon learning that its Medicare contract is terminated.
The Center for Medicare and Medicaid Services (CMS) threatened Greenville Memorial Hospital, part of Greenville Health System, in South Carolina, that Medicare reimbursements will cease starting April 16, 2017. According to CMS, Memorial's emergency department is not compliant with Medicare regulations.
A public notice in the Greenville News says: "Notice is hereby given that effective April 15, 2017, the agreement between GHS Greenville Memorial Hospital, 701 Grove Road, Greenville, S.C. 29605 and the Secretary of Health and Human Service, as a provider of Hospital Services and Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated. GHS Greenville Memorial Hospital does not meet the following conditions of participation. 42 CFR 482.12 Governing Body, 42 CFR 482.13 Patients' Rights and 42 CFR 482.23 Nursing Services."
"The Centers for Medicare and Medicaid Services has determined that GHS Greenville Memorial Hospital is not in compliance with the conditions of coverage. The Medicare program will not make payment for hospital services to patients who are admitted after April 16, 2017."
The findings came after an onsite audit was conducted on March 13, 2017. Memorial was notified of the report on March 27, 2017.
Memorial must have submitted a corrective action plan by April 3, 2017, but it has not been released.
The emergency department at Memorial treats about 300 patients per day. An employee of Memorial estimates that the termination would lose net revenue from Medicare and Medicaid could potentially reach around $495 million. Greenville Memorial received $305 million in Medicare funding and $190 million from Medicaid in the most recent fiscal year, accounting for nearly six in 10 patients, officials said.
While CMS and Memorial refuse to discuss the details of the alleged noncompliance, CMS' public notice cites three CFR cites: 42 CFR 482.12 Governing Body, 42 CFR 482.13 Patients' Rights and 42 CFR 482.23 Nursing Services.
42 CFR 482.12 requires that hospitals have governing bodies and plans to follow Medicare regulations. Subsection (f) specifically requires that if a hospital has an emergency department that the hospital must follow 42 CFR 482.55 "Conditions of Participation," which states that "The hospital must meet the emergency needs of patients in accordance with acceptable standards of practice.
(a) Standard: Organization and direction. If emergency services are provided at the hospital –
- The services must be organized under the direction of a qualified member of the medical staff;
- The services must be integrated with other departments of the hospital;
- The policies and procedures governing medical care provided in the emergency service or department are established by and are a continuing responsibility of the medical staff.
(b) Standard: Personnel.
- The emergency services must be supervised by a qualified member of the medical staff.
- There must be adequate medical and nursing personnel qualified in emergency care to meet the written emergency procedures and needs anticipated by the facility."
The Memorial audit stemmed from a March 4, 2017, death of Donald Keith Smith, 48, who died as a result of traumatic asphyxiation. After an altercation, the patient was placed on a gurney, supposedly, face-down. South Carolina's Department of Health and Environmental Controls Site Survey Agency investigated the hospital after the death and the audit found that hospital security officers improperly restrained Smith, strapping him face down to a gurney during an altercation, rendering him unable to breathe. The death was ruled a homicide.
Memorial terminated the security officers involved in the death.
Now the hospital is faced with its own potential death. The loss of Medicare and, perhaps, Medicaid reimbursements could financially kill the hospital. Let's see what happens…
Work Requirements for Medicaid?
Under the Trump Administration, some Republican governors may look to move their Medicaid programs in a more conservative direction. In his latest column for Axios, Drew Altman discusses the arguments about Medicaid "work requirements" and why few people are likely to be affected by them in practice.
via Don't Expect Medicaid Work Requirements to Make a Big Difference — The Henry J. Kaiser Family Foundation
Kaiser Foundation: Estimates of the American Health Care Act
This data note reviews the Medicaid estimates included in the American Health Care Act prepared by the Congressional Budget Office (CBO) and staff at the Joint Committee on Taxation (JCT).
via Data Note: Review of CBO Medicaid Estimates of the American Health Care Act — The Henry J. Kaiser Family Foundation
NC DHHS' New Secretary – Yay or Nay?
Our newly appointed DHHS Secretary comes with a fancy and distinguished curriculum vitae. Dr. Mandy Cohen, DHHS' newly appointed Secretary by Gov. Roy Cooper, is trained as an internal medicine physician. She is 38 (younger than I am) and has no known ties to North Carolina. She grew up in New York; her mother was a nurse practitioner. She is also a sharp contrast from our former, appointed, DHHS Secretary Aldona Wos. See blog.
Prior to the appointment as our DHHS Secretary, Dr. Cohen was the Chief Operating Officer and Chief of Staff at the Centers for Medicare and Medicaid Services (CMS). Prior to acting as the COO of CMS, she was Principal Deputy Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at CMS where she oversaw the Health Insurance Marketplace and private insurance market regulation. Prior to her work at CCIIO, she served as a Senior Advisor to the Administrator coordinating Affordable Care Act implementation activities.
Did she ever practice medicine?
Prior to acting as Senior Advisor to the Administrator, Dr. Cohen was the Director of Stakeholder Engagement for the CMS Innovation Center, where she investigated new payment and care delivery models.
Dr. Cohen received her Bachelor's degree in policy analysis and management from Cornell University, 2000. She obtained her Master's degree in health administration from Harvard University School of Public Health, 2004, and her Medical degree from Yale University School of Medicine, 2005.
She started as a resident physician at Massachusetts General Hospital from 2005 through 2008, then was deputy director for comprehensive women's health services at the Department of Veterans Affairs from July 2008 through July 2009. From 2009 through 2011, she was executive director of the Doctors for America, a group that promoted the idea that any federal health reform proposal ought to include a government-run "public option" health insurance program for the uninsured.
Again, I was perplexed. Did she ever practice medicine? Does she even have a current medical license?
This is what I found:
It appears that Dr. Cohen was issued a medical license in 2007, but allowed it to expire in 2012 – most likely, because she was no longer providing medical services and was climbing the regulatory and political ladder.
From what I could find, Dr. Cohen practiced medicine (with a fully-certified license) from June 20, 2007, through July 2009 (assuming that she practiced medicine while acting as the deputy director for comprehensive women's health services at the Department of Veterans Affairs).
Let me be crystal clear: It is not my contention that Dr. Cohen is not qualified to act as our Secretary to DHHS because she seemingly only practiced medicine (fully-licensed) for two years. Her political and policy experience is impressive. I am only saying that, to the extent that Dr. Cohen is being touted as a perfect fit for our new Secretary because of her medical experience, let's not make much ado of her practicing medicine for two years.
That said, regardless Dr. Cohen's practical medical experience, anyone who has been the COO of CMS must have intricate knowledge of Medicare and Medicaid and the essential understanding of the relationship between NC DHHS and the federal government. In this regard, Cooper hit a homerun with this appointment.
Herein lies the conundrum with Dr. Cohen's appointment as DHHS Secretary:
Is there a conflict of interest?
During Cooper's first week in office, our new Governor sought permission, unilaterally, from the federal government to expand Medicaid as outlined in the Affordable Care Act. This was on January 6, 2017.
To which agency does Gov. Cooper's request to expand Medicaid go? Answer: CMS. Who was the COO of CMS on January 6, 2017? Answer: Cohen. When did Cohen resign from CMS? January 12, 2017.
On January 14, 2017, a federal judge stayed any action to expand Medicaid pending a determination of Cooper's legal authority to do so. But Gov. Cooper had already announced his appointment of Dr. Cohen as Secretary of DHHS, who is and has been a strong proponent of the ACA. You can read one of Dr. Cohen's statements on the ACA here.
In fact, regardless your political stance on Medicaid expansion, Gov. Cooper's unilateral request to expand Medicaid without the General Assembly is a violation of NC S.L. 2013-5, which states:
SECTION 3. The State will not expand the State's Medicaid eligibility under the Medicaid expansion provided in the Affordable Care Act, P.L. 111-148, as amended, for which the enforcement was ruled unconstitutional by the U.S. Supreme Court in National Federation of Independent Business, et al. v. Sebelius, Secretary of Health and Human Services, et al., 132 S. Ct. 2566 (2012). No department, agency, or institution of this State shall attempt to expand the Medicaid eligibility standards provided in S.L. 2011-145, as amended, or elsewhere in State law, unless directed to do so by the General Assembly.
Obviously, if Gov. Cooper's tactic were to somehow circumvent S.L. 2013-5 and reach CMS before January 20, 2017, when the Trump administration took over, the federal judge blockaded that from happening with its stay on January 14, 2017.
But is it a bit sticky that Gov. Cooper appointed the COO of CMS, while she was still COO of CMS, to act as our Secretary of DHHS, and requested CMS for Medicaid expansion (in violation of NC law) while Cohen was acting COO?
You tell me.
I did find an uplifting quotation from Dr. Cohen from a 2009 interview with a National Journal reporter:
"There's a lot of uncompensated work going on, so there has to be a component that goes beyond just fee-for service… But you don't want a situation where doctors have to be the one to take on all the risk of taking care of a patient. Asking someone to take on financial risk in a small practice is very concerning." -Dr. Mandy Cohen
New Revisions to Stark Law: Beware the "Per-Click Lease" – Maybe?
Scenario: You have an arrangement with your local hospital. You are a urologist and your practice owns a laser machine. You lease your laser machine to Hospital A, and your lease allows you to receive additional, but fair market value, money depending on how often your machine is used. Legal?
A new Final Ruling from the Centers for Medicare and Medicaid Services (CMS) provides murky guidance.
CMS finalized the 2017 Medicare Physician Fee Schedule (PFS) rule, which took effect on January 1, 2017. There have been few major revisions to the Stark Law since 2008…until now. The Stark Law is named for United States Congressman Pete Stark (D-CA), who sponsored the initial bill in 1988. Politicians love to name bills after themselves!
Absent an exception, the Stark Law prohibits a physician from referring Medicare patients for certain designated health services ("DHS"), for which payment may be made under Medicare, to any "entity" with which the physician (or an immediate family member) has a "financial relationship." Conversely, the statute prohibits the DHS-furnishing entity from filing claims with Medicare for those referred services.
Despite the general prohibition on potentially self-interested referrals, the Stark Law permits Medicare referrals by physicians to entities in which they have a financial interest in certain limited circumstances. But these circumstances are limited and must be followed precisely and without deviation.
These exceptions are created by legally excluding some forms of compensation agreements and ownership interests from the definition of "financial relationship," thus allowing both the relationships and the referrals. See 42 U.S.C. § 1395nn(b)-(e).
One of such exceptions to the Stark Law is the equipment lease exception.
This equipment lease exception to Stark law allows a financial relationship between physicians and hospitals for the lease of equipment, only if the lease (1) is in writing; (2) assigns the use of the equipment exclusively to the hospital; (3) lasts for a term of at least one year; (4) sets rental charges in advance that are consistent with fair market value and "not determined in a manner that takes into account the volume or value of any referrals or other business generated between the parties"; (5) satisfies the standard of commercial reasonableness even absent any referrals; and (6) meets "such other requirements as the Secretary may impose by regulation as needed to protect against program or patient abuse."
For example, like the scenario above, a urology group owns and leases a laser machine to Hospital A. As long as the lease meets the criteria listed above, the urologists may refer Medicare patients to Hospital A to their hearts' content – even though the urologists benefit financially from their own referrals.
However, what if the monetary incentive is tied to the amount the machine is actually used – or the "per-click lease?"
In a court case decided in January 2015, Council for Urological Interests v. Burwell, a D.C. circuit court decided that CMS' ban on per-click leases was unreasonable.
In CMS' Final Ruling, effective January 1, 2017, CMS again re-issued the per-click lease ban. But CMS' revised ban appears to be more parochial in scope. CMS states that it "did not propose and [is] not finalizing an absolute prohibition on rental charges based on units of service furnished" and that "[i]n general, per-unit of service rental charges for the rental of office space or equipment are permissible." As CMS had previously stated, the per-click ban applies only "to the extent that such charges reflect services provided to patients referred by the lessor to the lessee."
Considering how unclear the Final Rule is – We are banning per-click leases, but not absolutely – expect lawsuits to clarify. In the meantime, re-visit your equipment leases. Have your attorney review for Stark compliance – because for the first time since 2008, major amendments to Stark Law became effective January 1, 2017.
Step Right Up! CMS Announces New Medicare-Medicaid ACO Model
Come one! Come all! Step right up to be one of the first 6 states to test the new Medicare-Medicaid Affordable Care Act (ACO) pilot program.
Let your elderly population be the guinea pigs for the Center for Medicare and Medicaid Services (CMS). Let your most needy population be the lab rats for CMS.
On December 15, 2016, CMS announced its intent to create Medicare/caid ACOs. Currently, Medicare ACOs exist, and if your physician has opted to participate in a Medicare ACO, then, most likely, you understand Medicare ACOs. Medicare ACOs are basically groups of physicians – of different service types – who voluntarily decide (but only after intense scrutiny by their lawyers of the ACO contract) to collaborate care with the intent of higher quality and lower cost care. For example, if your primary care physician participates in a Medicare ACO and you suffer intestinal issues, your primary care doctor would coordinate with a GI specialist within the Medicare ACO to get you an appointment. Then the GI specialist and your physician would share medical records, including test results and medication management. The thought is that the coordination of care will decrease duplicative tests, ensure appointments are made and kept, and prevent losing medical records or reviewing older, moot records.
Importantly, the Medicare beneficiary retains all benefits of "normal" Medicare and can choose to see any physician who accepts Medicare. The ACO model is a shift from "fee-for-service" to a risk-based, capitated amount in which quality of care is rewarded.
On the federal level, there have not been ACOs specially created for dual-eligible recipients; i.e., those who qualify for both Medicare and Medicaid…until now.
The CMS is requesting states to volunteer to participate in a pilot program instituting Medicare/Medicaid ACOs. CMS is looking for 6 brave states to participate. States may choose from three options for when the first 12-month performance period for the Medicare-Medicaid ACO Model will begin for ACOs in the state: January 1, 2018; January 1, 2019; or January 1, 2020.
Any state is eligible to apply, including the District of Columbia. But if the state wants to participate in the first round of pilot programs, intended to begin 2018, then that state must submit its letter of intent to participate by tomorrow by 11:59pm. See below.
I tried to research which states have applied, but was unsuccessful. If anyone has the information, I would appreciate it if you could forward it to me.
Participating in an ACO, whether it is only Medicare and Medicare/caid, can create a increase in revenue for your practices. Since you bear some risk, you also reap some benefit if you able to control costs. But, the decision to participate in an ACO should not be taken lightly. Federal law yields harsh penalties for violations of Anti-Kickback and Stark laws (which, on a very general level, prohibits referrals among physicians for any benefit). However, there are safe harbor laws and regulations specific to ACOs that allow exceptions. Regardless, do not ever sign a contract to participate in an ACO without an attorney reviewing it.
Food for thought – CMS' Medicare/caid ACO Model may exist only "here in this [Obama] world. Here may be the last ever to be seen of [healthcare.gov] and their [employee mandates]. Look for it only in [history] books, for it may be no more than a [Obamacare] remembered, a [health care policy] gone with the wind…"
As, tomorrow (January 20, 2017) is the presidential inauguration. The winds may be a'changing…
Key Medicaid Questions Post-Election
Disclosure: This is the opinion/facts from the Kaiser Family Foundation, not me. But I found this interesting. My opinion will be forthcoming.
Kaiser Family Foundation article:
Medicaid covers about 73 million people nationwide. Jointly financed by the federal and state governments, states have substantial flexibility to administer the program under existing law. Medicaid provides health insurance for low-income children and adults, financing for the safety net, and is the largest payer for long-term care services in the community and nursing homes for seniors and people with disabilities. President-elect Trump supports repeal and replacement of the Affordable Care Act (ACA) and a Medicaid block grant. The GOP plan would allow states to choose between block grant and a per capita cap financing for Medicaid. The new Administration could also make changes to Medicaid without new legislation.
A repeal of the ACA's coverage expansion provisions would remove the new eligibility pathway created for adults, increase the number of uninsured and reduce the amount of federal Medicaid funds available to states. The Supreme Court's 2012 ruling on the ACA effectively made the Medicaid expansion optional for states. As of November 2016, 32 states (including the District of Columbia) are implementing the expansion. The full implications of repeal will depend on whether the ACA is repealed in whole or in part, whether there is an alternative to the ACA put in place and what other simultaneous changes to Medicaid occur. However, examining the effects of the ACA on Medicaid provide insight into what might be at stake under a repeal.
What happened to coverage? The ACA expanded Medicaid eligibility to nearly all non-elderly adults with income at or below 138% of the federal poverty level (FPL) – about $16,396 per year for an individual in 2016. Since summer of 2013, just before implementation of the ACA expansions, through August 2016 about 16 million people have been added to Medicaid and the Children's Health Insurance Program. While not all of this increase is due to those made newly eligible under the ACA, expansion states account for a much greater share of growth. States that expanded Medicaid have had large gains in coverage, although ACA related enrollment has tapered. From 2013 to 2016 the rate of uninsured non-elderly adults fell by 9.2% in expansion states compared to 6% in non-expansion states.
What happened to financing? The law provided for 100% federal funding of the expansion through 2016, declining gradually to 90% in 2020 and beyond. Expansion states have experienced large increases in federal dollars for Medicaid and have claimed $79 billion in federal dollars for the new expansion group from January 2014 through June 2015. Studies also show that states expanding Medicaid under the ACA have realized net fiscal gains despite Medicaid enrollment growth initially exceeding projections in many states.
What other Medicaid provisions were in the ACA? The ACA required states to implement major transformations to modernize and streamline eligibility and enrollment processes and systems. The ACA also included an array of new opportunities related to delivery system reforms for complex populations, those dually eligible for Medicare and Medicaid and new options to expand community-based long-term care services.
A Medicaid block grant or per capita cap policy would fundamentally change the current structure of the program. These policies are typically designed to reduce federal spending and fix rates of growth to make federal spending more predictable, but could eliminate the guarantee of coverage for all who are eligible and the guarantee to states for matching funds. States would gain additional flexibility to administer their programs but reduced federal funding could shift costs and risk to beneficiaries, states, and providers.
How would it work? Block grants or per capita caps could be structured in multiple ways. Key policy decisions would determine levels of federal financing as well as federal and state requirements around eligibility, benefits, state matching requirements, and beneficiary protections. Previous block grant proposals have determined a base year financing amount for each state and then specified a fixed rate of growth for federal spending. Under a Medicaid per capita cap, the federal government would set a limit on how much to reimburse states per enrollee. Payments to states would be based on per enrollee spending multiplied by enrollees. Spending under per capita cap proposals fluctuate based on changes in enrollment, but would not account for changes in the costs per enrollee beyond the growth limit. To achieve federal savings, the per capita growth amounts would be set below the projected rates of growth under current law.
What are the key policy questions? Key questions in designing these proposals include: what new flexibility would be granted to states, what federal requirements would remain in place, what requirements would be in place for state matching funds, what is the base year and growth rates, and how would a potential repeal of the ACA work with a block grant proposal? Given the lack of recent administrative data, setting a base year could be challenging. These financing designs could lock in historic spending patterns and variation in Medicaid spending across states, resulting in states deemed "winners" or "losers."
What are the implications? Capping and reducing federal financing for Medicaid could have implications for beneficiaries, states, and providers including: declines in Medicaid coverage or new financial barriers to care; limited funding for children (the majority of Medicaid enrollees) as well as the elderly and those with disabilities (populations that represent the majority of Medicaid spending); reduced funding for nursing homes and community-based long-term care (Medicaid is the largest payer of these services); reductions in federal revenues to states and Medicaid revenues for safety-net providers. A block grant would not adjust to increased coverage needs during a recession. Block grants or per capita caps would not adjust to changes in health care or drug costs or emergencies. Recently Medicaid costs have increased due to high cost specialty drugs and Medicaid has been used to help combat the growing opioid crisis.
The Administration could make changes to Medicaid without changes in legislation.
How can changes be made through guidance? A new administration can reinterpret existing laws through new regulations and new sub-regulatory guidance. While there are rules that govern how to change regulations, a new administration has more flexibility to issue or amend sub-regulatory guidance, such as state Medicaid director letters. Rules promulgated by the Obama administration could be rolled back or changed.
How can changes be made through waivers? Throughout the history of the Medicaid program, Section 1115 waivers have provided states an avenue to test and implement demonstrations that, in the view of the Health and Human Services Secretary, advance program objectives but do not meet federal program rules. Longstanding federal policy has required waivers to be budget neutral for the federal government.
What kind of waivers may be considered? Seven states are using waivers to implement the ACA Medicaid expansion, including Indiana. The Indiana waiver, implemented under then Governor Pence, includes provisions to impose: premiums on most Medicaid beneficiaries; a coverage lock-out period for individuals with incomes above the poverty level who fail to pay premiums; health savings accounts; and healthy behavior incentives. The Obama administration has not approved waivers that would require work as a condition of Medicaid eligibility. It also has denied Ohio's waiver request to impose premiums regardless of income and exclude individuals from coverage until all arrears are paid on the basis that this would restrict or undermine coverage from existing levels. Many other states are using waivers to implement payment and delivery system reforms. The incoming administration could decide whether or not to renew existing waivers and can approve a new set of waivers to promote its own program goals.
Another Win! 12 Million Dollar Recoupment Reduced to $896 – But There is a Twist
One of our clients in New Mexico had an alleged Medicaid recoupment of over $12 million!! Actually, $12,015,850.00 – to be exact. (See below). After we presented our evidence and testimony, the Judge found that we owe $896.35. I call that a win!
In this case, the Human Services Department (HSD) in New Mexico had reviewed 150 random claims. Initially, HSD claimed that 41 claims out of 150 were noncompliant.
But, prior to the hearing, we saved over $10 million by pointing out HSD's errors and/or by providing additional documentation.
And then the ALJ's decision after we presented our evidence and testimony –
Boom! Drop the mike…
…………………………….not so fast…
……………………………………………..picking the mike back up…
You see, in New Mexico, the administrative law judges (ALJs) cannot render decisions. Look in the above picture. You see where it reads, "Recommendation?" That is because the ALJs in New Mexico can only render recommendations.
Because Medicaid has a "single state agency" rule; i.e., that only one agency may render discretionary decisions regarding Medicaid, and HSD is the single state agency in New Mexico charged with managing Medicaid, only HSD may render a discretionary decision. So in NM, the ALJ makes a recommendation and then the Secretary of HSD has the choice to either accept or reject the decision.
Guess whether HSD accepted or rejected the ALJ's recommendation?
Now we will have to appeal the Agency's Decision to overturn the ALJ recommendation.
Here, in NC, we obtained a waiver from the Centers of Medicare and Medicaid Services (CMS) to allow our ALJs to render Decisions. See blog.
I still consider this a win.


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Sex Ratio, Length Weight Relationships and Condition of Eight Fish Species Collected From Narreri Lagoon, Badin, Sindh, Pakistan
Khawar Parvez Awan1,2, Nazia Qamar1, Noureen Farooq1 and Sher Khan Panhwar1*
About Through-Cultivation of Two Commercial Bivalve Molluscs
Delik D Gabaev*
The Present and the Future Works on the Algae's Valorization for Production of our Future Energies?
Moulin Pascale*
Notes on the Presence of Mustelus sinusmexicanus and Hexanchus nakamurai (Chondrichthyes: Elasmobranchii) in Mexican waters
Adrián F González-Acosta1*, Rocio Rodiles-Hernández2, Alfonso Angel González-Diaz2
and Manuel Mendoza-Carranza3
Metabolic rates in hatchery-reared European lobster juveniles (Homarus gammarus L.)
Asbjørn Drengstig1*, Asbjørn Bergheim2, Stig Westerlund2 and Ann-Lisbeth Agnalt3
Recent Advances of Micro-Algal Biotechnology in Brazil
Leonardo Brantes Bacellar Mendes*
At MedCrave we believe that knowledge should be shared. We also believe that Read more...
In regard to the novelty and excellence of the manuscript MedCrave Group (MCG) Read more...
MedCrave loves to recognize all the outstanding services delivered in the realms Read more...
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MedCrave Group is ardent to provide article reprints at an instant affordable
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|Prep for USMLE
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Yasir Anzar
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Yasir Anzar. Other than the fact that rigorous practice helps with competence and ultimately confidence of an individual to perform well in any given task, however, I am interested to know what students have done to improve and sustain their high level of confidence throughout the preparation of Step 1 exam?
Edited by Yasir Anzar on Jul 13, 2016 - 6:48 AM. : grammatical mistakes
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Artistsignal - Scam
This company is a cheat the same person always wins the contest sound like an inside job I do.They do not care if you purchase Facebook votes even though I suspect that some of the people are cheating.
This is not fair why should the same person win from month to month without people know they are cheating.
What I suspect what this company is doing is money lauding so they can have a clean stash and give it bands they like.I have never come close to being on the top 50 artist the same artist wins all the time it getting annoying.
Review about: Music.
I liked: Music.
I didn't like: Scam.
Review #591999 is a subjective opinion of a user.


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Alabama is one of the most agriculturally diverse states in the country, growing everything from soybeans to sweet potatoes and cattle to catfish. These stories and recipes introduce you to the farmers who grow our food and highlight some of Alabama's best cooks monthly.
Recipe Search
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June 2017
Country Kitchen, June 2017
When dairy farmers Judy and Mickey Childers began making ice cream for the Morgan County Farmers Federation's annual meeting, they had no idea they'd still be churning it out for the group 25 years later. more
May 2017
No matter what county in Alabama you find yourself in, a field full of cows is somewhere nearby. Farmers in every county in the state raise cattle, and Alabama is No. 16 in national beef cow production. As demand for versatile, easy-to-cook, delicious beef continues to rise in the U.S. and around the world, cattle farmers like Darrell and Linda Lee of Winston County rise early each day to ensure the world has enough beef. more
April 2017
Alabama is a state that loves meat, and for good reason — chickens, cattle and pork are all raised locally and are widely available in restaurants and retail stores. But there's another meat gaining traction that's worth adding to the rotation: lamb. Many folks are scared to cook lamb because it's not as familiar as other meats. But Henry Dorough, Alabama Cooperative Extension System agent and owner of HD Farm in Calhoun County, said it's much simpler than people imagine. more


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Thoroughly enjoyed my first day in my new job. Nice place and nice people 🙂
Am starting my new job today. Looking forward to it, a bit anxious, but excited too. Have sat about long enough and have been bored. I just don't know how people can stay at home all day for years on end. Different when your kids are young, always busy then. But there is only so much housework you can do. Wish me luck.
I have no idea what I am doing 😦


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Michonne's "M" necklace, worn on The Walking Dead, has been googled and searched for since it was first spotted on Danai Gurira. Well, search no more. Grab your initial necklace, made by the very same designer that made Michonne's necklace. The initial is available in 14K yellow gold or 14K rose gold, and hangs on a sterling silver chain. Michonne's initial "M" is 14K rose gold. The pretty script font is eye-catching.
There has been a lot of speculation on where the initial necklace originated. A simple "M" necklace, given by Mike - symbolizing Mike and Michonne. A promise that he would always be with her. Just one "M" - Michonne and Mike.
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Corey, me and dave took a drive to FG creek. none of us had fished it before but heard good things about it. we fished the upper section closer to the lake but the fish were quite small so we ended up driving to the lowest point we could and hiked downstream 2-3 miles and fished our way up. we think the storms in the last couple of days had affected the fishing cause the fishing was not near what he had expected. the water was extremely fishy and although we did catch a few decent fish, it did not hold up to it's reputation. next time we plan on hiking down 6 miles or so. we hope that hiking farther from any civilization that the fishing will be worthy of the hike.
Walk The Land Day – Join The McKenzie River Trust for a Day at Green Island - All day on June 24th – Here is a link to the days events, maps, and details. – http://www.mckenzieriver.org/events/walk-the-land/
1 day ago