USACS Takes the L

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
EctopicFetus

EctopicFetus

Keeping it funky enough
20+ Year Member
Joined
May 3, 2004
Messages
12,941
Reaction score
3,815
Points
6,631
Location
Arizona
  1. Attending Physician
Advertisement - Members don't see this ad
Reports abound about USACS losing that ED contract in California. Thats a win for the little guy. Always happy to see USUCKS lose contracts. Cant wait to see them flounder when their debt is due.
 
Which contract?
 
It’ll only be a win if a non-CMG steps in but showing USACS the door is a good start.
 
thegenius said:
Santa Clara Valley Medical Center
Huge hospital just outside San Jose.

I've read the same reports, and I also read or heard the ER group is forming their own SDG.
Click to expand...

www.levernews.com

Out Of The ER, Into The Street

Enraged by Wall Street’s takeover of their profession, emergency physicians are rising up and speaking out.
www.levernews.com www.levernews.com
 
Know thy worth. Our SDG has been stable for decades. If for some unforeseen reason we are taken over by a CMG I would up my family and move. Some will say not a realistic solution. To me this job isn’t remotely sustainable unless you have control and are compensated appropriately. I’ve lived in a lot of places. I can live in one more.
 
Tenk said:
Careful they might do you a huge favor and blacklist you.
Click to expand...
Dude. I’m tops on their blacklist. Reportedly their regional medical director is a PA. What a USACS thing to do. Lol. Clown show over there.
 
Last edited:
Advertisement - Members don't see this ad
thegenius said:
I dunno how big that organization is, but there is sure a lot of apparent leadership bloat
Click to expand...
Yeah what a flat partnership. Those folks get fat $$ going to meetings and fluffing dom meanwhile poor docs don’t know any better and are working Saturday overnights in an understaffed Ed.
 
Each one of those special people is pulling down 400K for their "leadership roles". It certainly is physician-owned. In that a few physicians own and profit off of the work of hundreds of others.
 
ScepticSkeksis said:
Each one of those special people is pulling down 400K for their "leadership roles". It certainly is physician-owned. In that a few physicians own and profit off of the work of hundreds of others.
Click to expand...
A physicians reintroduction to capitalism.
 
ScepticSkeksis said:
Each one of those special people is pulling down 400K for their "leadership roles". It certainly is physician-owned. In that a few physicians own and profit off of the work of hundreds of others.
Click to expand...

I wonder what they make in their admin roles. It would be pretty chitty if they each made 400K without actually practicing. 50 docs x 400K = $20M of cash taken from EM docs working the pits. I kind of doubt that, but I wouldn't bet against it.
 
thegenius said:
I wonder what they make in their admin roles. It would be pretty chitty if they each made 400K without actually practicing. 50 docs x 400K = $20M of cash taken from EM docs working the pits. I kind of doubt that, but I wouldn't bet against it.
Click to expand...
Most admin think they are a net positive for the organization when, in fact, they aren't. Some admin roles would be better off going unfilled rather than having someone there that makes active decisions that make things worse. Remember during COVID when none of the admin came into the hospital for months (despite us all being 'in this together') and everything carried on? That's because many aren't needed although they'll like to think they kept everything running virtually.
 
JacobMcCandles said:
Most admin think they are a net positive for the organization when, in fact, they aren't. Some admin roles would be better off going unfilled rather than having someone there that makes active decisions that make things worse. Remember during COVID when none of the admin came into the hospital for months (despite us all being 'in this together') and everything carried on? That's because many aren't needed although they'll like to think they kept everything running virtually.
Click to expand...

Dude I hear ya. I just wonder in an organization like USUCKS how much money in made for being an admin. My understanding (I'm casually aware of one of the admins through a friend) that many make a stipend for doing admin work, but many of them still work in the pit. So maybe their monthly stipend is 10K and not 30K.
 
I don't know any of their actual salaries but I do know they all receive generous monthly stipends of 10K-50K so it would be easy to bring home well over 500K+ without doing shifts every month. I will add their current president owns a multimillion dollar mansion in Central Texas with this sweet custom made backyard lounge with an infinity pool that was featured on the show pool kings.
 
Advertisement - Members don't see this ad
thegenius said:
I wonder what they make in their admin roles. It would be pretty chitty if they each made 400K without actually practicing. 50 docs x 400K = $20M of cash taken from EM docs working the pits. I kind of doubt that, but I wouldn't bet against it.
Click to expand...
The regionals vps for envision made 450k+ in 2015. These people are making over 400k guaranteed.
 
alpinism said:
I don't know any of their actual salaries but I do know they all receive generous monthly stipends of 10K-50K so it would be easy to bring home well over 500K+ without doing shifts every month. I will add their current president owns a multimillion dollar mansion in Central Texas with this sweet custom made backyard lounge with an infinity pool that was featured on the show pool kings.
Click to expand...
Them usucks dollas spend like all other dollas. Can’t wait to see them collapse. It’s coming and it is gonna be glorious. Reports that a bunch of other California contracts of theirs are at risk.
 
thegenius said:
I dunno how big that organization is, but there is sure a lot of apparent leadership bloat
Click to expand...
Not carrying water for USACS, but how many executive level national positions do you think it takes to run a corporation? In a business as complex as healthcare?

I have no knowledge of USACS command structure other than briefly perusing that link, but I did get to see Team's structure up close. They had a two tiered leadership structure, with tier I being the leaders of large groups that sold out to Team and tier II being internal Team docs that rose through the ranks. Tier I were generally given either make-work speaking/consulting positions or were made regional leaders if they still wanted to be in the game. They rarely if ever worked clinically and their pay was essentially just an annuity that resulted from the sale of their former group. Tier II docs were overachievers that were still working at least half-time clinically and had a full-time corporate job on top of that. They'd make a little bit more than their purely clinical counterparts, but weren't billing anywhere near ED rates for their non-clinical time.

From looking at a selection of the bios, USACS seems to be mostly Tier II types. And most of the titles seem reasonable from a corporate standpoint.

With that being said, good on the Cali docs for dumping them and I hope that becomes a major trend.
 
Recent email from USACS asking us to "reach out" to our "non-USACS colleagues" to recruit them by telling them how great their clinical decision making tools are...or something.

Same email had a survey asking us to prioritize a 16 item list of things that are important to us "clinician owners". Items like gym memberships/tai chi/etc, child care, advanced degrees, mentoring, etc.

Higher pay and adequate staffing was curiously missing from the list of things they wanted input on.
 
Mount Asclepius said:
And yet you still work for USACS. Answer the survey with your feet.
Click to expand...
I mostly have.

I still work there a shift or two a month because it is a great team there, and working there makes me better. The medical director is a great guy, and a friend, who I would do about anything for.

But when they bought out previous big group (who pretty much left us alone), and then cut our pay 20%, I moved on to another primary gig.

Then they cut the MLP staffing by 40%.

I'm hoping the hospital cuts USACS and we either form a SDG or are direct employed. I think with the cuts in hours the metrics are going to tank, opening that possibility up.
 
EctopicFetus said:
Them usucks dollas spend like all other dollas. Can’t wait to see them collapse. It’s coming and it is gonna be glorious. Reports that a bunch of other California contracts of theirs are at risk.
Click to expand...
Pudortu said:
Is that with or without clinical shifts?
Click to expand...
0 clinical shifts.
 
Looking at that list of leaders for USACS it’s an impressive collection of brain power. Many of them are very talented and capable leaders. It’s a shame it’s going to waste for this company.
 
Advertisement - Members don't see this ad
Boatswain2PA said:
Recent email from USACS asking us to "reach out" to our "non-USACS colleagues" to recruit them by telling them how great their clinical decision making tools are...or something.

Same email had a survey asking us to prioritize a 16 item list of things that are important to us "clinician owners". Items like gym memberships/tai chi/etc, child care, advanced degrees, mentoring, etc.

Higher pay and adequate staffing was curiously missing from the list of things they wanted input on.
Click to expand...
They know what they need to do to help make their physicians truly happier, however, those things cost a lot of money. What they really want to know is “how can we trick you into liking us more (or at all) by spending the least amount of money as possible”.

Gym memberships would cost a minimal amount. Childcare would be more expensive but I could see someone taking a job strictly because of available/flexible childcare. Mentoring would be free because they’d try to tug on the heart and moral strings of seasoned docs to ‘help’ the newer docs. I’m sure they’d get several docs willing to help out.

I know where USACS is headed (and they do, too). Their admin is just trying to ride the gravy train until they’re unemployed.
 
JacobMcCandles said:
They know what they need to do to help make their physicians truly happier, however, those things cost a lot of money. What they really want to know is “how can we trick you into liking us more (or at all) by spending the least amount of money as possible”.

Gym memberships would cost a minimal amount. Childcare would be more expensive but I could see someone taking a job strictly because of available/flexible childcare. Mentoring would be free because they’d try to tug on the heart and moral strings of seasoned docs to ‘help’ the newer docs. I’m sure they’d get several docs willing to help out.

I know where USACS is headed (and they do, too). Their admin is just trying to ride the gravy train until they’re unemployed.
Click to expand...

Yup at the end of the day making 50-75 more / hr goes a long way towards doc happiness. Gym memberships are super cheap. $150/month? LOL.
 
emergentmd said:
Knowing what I know about insurance reimbursement, USACS and other CMGs are going to face some tough realities soon.
Click to expand...
Yep and the insurers are not playing around. Unsure how many saw the recent edpma posts.

For those who don’t know edpma is essentially the business arm of cmgs. All their leadership are either rcm companies or cmg folks. They are totally spooked and rightfully so. It’s harming the sdgs as well but billions in debt isn’t easy to manage in this environment.
 
thegenius said:
Yup at the end of the day making 50-75 more / hr goes a long way towards doc happiness. Gym memberships are super cheap. $150/month? LOL.
Click to expand...

Planet fitness is like $150 / year. 🙂
 
EctopicFetus said:
Yep and the insurers are not playing around. Unsure how many saw the recent edpma posts.

For those who don’t know edpma is essentially the business arm of cmgs. All their leadership are either rcm companies or cmg folks. They are totally spooked and rightfully so. It’s harming the sdgs as well but billions in debt isn’t easy to manage in this environment.
Click to expand...
More details / links to said posts?
 
EctopicFetus said:
Yep and the insurers are not playing around. Unsure how many saw the recent edpma posts.

For those who don’t know edpma is essentially the business arm of cmgs. All their leadership are either rcm companies or cmg folks. They are totally spooked and rightfully so. It’s harming the sdgs as well but billions in debt isn’t easy to manage in this environment.
Click to expand...
The big problem is the insurance issue will prevent many SDGs from taking over and then what are the real options.
 
I think the insurance issues are still a bigger hit to CMGs than SDGs. SDGs will likely have some lean years but they can weather them much better than any CMG can at this point.
 
emergentmd said:
The big problem is the insurance issue will prevent many SDGs from taking over and then what are the real options.
Click to expand...
I don’t have a crystal ball but what I’m seeing is that the insurers are going oon with all their contracts where they are above the qpa. The hits the cmgs. Keep in mind the cmgs are both heavily leveraged AND have substantial overhead.

The insurers are squeezing them hard. They aren’t even paying the arbitration cases they are losing. This is a ploy to make more money but also to cripple the cmgs. It’s working.
 
Advertisement - Members don't see this ad
EctopicFetus said:
I don’t have a crystal ball but what I’m seeing is that the insurers are going oon with all their contracts where they are above the qpa. The hits the cmgs. Keep in mind the cmgs are both heavily leveraged AND have substantial overhead.

The insurers are squeezing them hard. They aren’t even paying the arbitration cases they are losing. This is a ploy to make more money but also to cripple the cmgs. It’s working.
Click to expand...
You know what’s funny, Tony Briningstool, APP CEO sent out a system wide email saying there are all sorts of rumors about our finances, but I assure we are on solid financial ground prepared for challenges blah blah etc..

If you have to send out emails like this, you know the company is already in trouble…
 
bravotwozero said:
You know what’s funny, Tony Briningstool, APP CEO sent out a system wide email saying there are all sorts of rumors about our finances, but I assure we are on solid financial ground prepared for challenges blah blah etc..

If you have to send out emails like this, you know the company is already in trouble…
Click to expand...

Discerning Fact from Fiction​

​
Tony Briningstool, MD, FACEP, Chief Medical Officer​
Some of you may remember the old “telephone game” we used to play as children, where you whisper a phrase in the first person’s ear, and they keep whispering it on down the line through multiple people. By the time you reach the last person in line, what that person heard was often vastly different than the original message. This reminds me of how stories can be taken out of context when they pass through the media or are posted on social media sites with comments. In light of the recent attention we have received in the media, I thought this would be a good opportunity to share an update with all of our physicians and advanced practice clinicians of what makes APP special, what we stand for, and provide reassurance to our team amidst these misrepresentations so you are able to discern fact from fiction should you read or hear about APP in the media, social media, or even discussions with colleagues. Our goal is that you are well informed so you can feel proud to work with APP and and also correct misinformation as you come across it.

We built APP to be a specialized management company, intentionally designed to deliver a level of engagement, expertise, and partnership that allows us to differentiate ourselves as an industry leader in quality in the patient care experience and provide an environment that allows our providers to practice at a high level within a winning team environment enhancing their professional satisfaction. Our focus is simply on exceeding the expectations for all those we serve.

As I have shared in other recent articles, the field of Emergency Medicine—and all practice types within the specialty—are facing several headwinds right now which must be navigated well:
  • Medicare reimbursement declines from sequestration and COVID relief starting in Q2 2023
  • Volatile patient volumes, with an overall net loss of more than 800,000 ED visits across our company from our pre-COVID volumes
  • Rising labor costs as physicians, APCs, and nurses leave the job market and companies must rely on more temporary staffing resources
  • Reimbursement volatility secondary to disruption from No Surprise Billing legislation
  • Our hospitals expecting their outsourced partners to share in the financial challenges they are experiencing from reimbursement declines

Despite these headwinds, we are confident we will successfully navigate these situational challenges together. With the strong support from each of our financial partners who are committed to facilitating our success, we will continue to be recognized as an industry leader and to serve in new markets as we grow. It is our collective responsibility as good stewards of our resources to manage our practices thoughtfully and adjust accordingly to any volume and reimbursement changes we experience. Know that we stand steadfast together on our commitment to exceed expectations for our patients, providers, and hospital partners, and to fulfil our mission to deliver safe, compassionate, and efficient care to every patient, every time.

While all of us in healthcare right now are working hard to provide exceptional patient care in a challenging environment, I truly believe that APP is well-positioned for a strong future, and the foundation we are laying today leads to enhanced operational security, access to more best practice resources, and ongoing educational deliverables to further support our clinical care teams. I want to take an opportunity to again “Thank You” for being a part of our journey to excellence.

As always, should you have any questions regarding anything I shared here or other questions about APP’s future, please EMAIL ME, call me at xxx-xxx-xxxx or click the “Ask Tony” button below that appears on every Clinical Update issue.​
 
bravotwozero said:
​

Discerning Fact from Fiction​

Tony Briningstool, MD, FACEP, Chief Medical Officer​
Some of you may remember the old “telephone game” we used to play as children, where you whisper a phrase in the first person’s ear, and they keep whispering it on down the line through multiple people. By the time you reach the last person in line, what that person heard was often vastly different than the original message. This reminds me of how stories can be taken out of context when they pass through the media or are posted on social media sites with comments. In light of the recent attention we have received in the media, I thought this would be a good opportunity to share an update with all of our physicians and advanced practice clinicians of what makes APP special, what we stand for, and provide reassurance to our team amidst these misrepresentations so you are able to discern fact from fiction should you read or hear about APP in the media, social media, or even discussions with colleagues. Our goal is that you are well informed so you can feel proud to work with APP and and also correct misinformation as you come across it.

We built APP to be a specialized management company, intentionally designed to deliver a level of engagement, expertise, and partnership that allows us to differentiate ourselves as an industry leader in quality in the patient care experience and provide an environment that allows our providers to practice at a high level within a winning team environment enhancing their professional satisfaction. Our focus is simply on exceeding the expectations for all those we serve.

As I have shared in other recent articles, the field of Emergency Medicine—and all practice types within the specialty—are facing several headwinds right now which must be navigated well:​
  • Medicare reimbursement declines from sequestration and COVID relief starting in Q2 2023
  • Volatile patient volumes, with an overall net loss of more than 800,000 ED visits across our company from our pre-COVID volumes
  • Rising labor costs as physicians, APCs, and nurses leave the job market and companies must rely on more temporary staffing resources
  • Reimbursement volatility secondary to disruption from No Surprise Billing legislation
  • Our hospitals expecting their outsourced partners to share in the financial challenges they are experiencing from reimbursement declines


Despite these headwinds, we are confident we will successfully navigate these situational challenges together. With the strong support from each of our financial partners who are committed to facilitating our success, we will continue to be recognized as an industry leader and to serve in new markets as we grow. It is our collective responsibility as good stewards of our resources to manage our practices thoughtfully and adjust accordingly to any volume and reimbursement changes we experience. Know that we stand steadfast together on our commitment to exceed expectations for our patients, providers, and hospital partners, and to fulfil our mission to deliver safe, compassionate, and efficient care to every patient, every time.

While all of us in healthcare right now are working hard to provide exceptional patient care in a challenging environment, I truly believe that APP is well-positioned for a strong future, and the foundation we are laying today leads to enhanced operational security, access to more best practice resources, and ongoing educational deliverables to further support our clinical care teams. I want to take an opportunity to again “Thank You” for being a part of our journey to excellence.

As always, should you have any questions regarding anything I shared here or other questions about APP’s future, please EMAIL ME, call me at xxx-xxx-xxxx or click the “Ask Tony” button below that appears on every Clinical Update issue.​
Click to expand...
This means trouble is on the very near horizon. Very interesting.
 
bravotwozero said:
​

Discerning Fact from Fiction​

Tony Briningstool, MD, FACEP, Chief Medical Officer​
Some of you may remember the old “telephone game” we used to play as children, where you whisper a phrase in the first person’s ear, and they keep whispering it on down the line through multiple people. By the time you reach the last person in line, what that person heard was often vastly different than the original message. This reminds me of how stories can be taken out of context when they pass through the media or are posted on social media sites with comments. In light of the recent attention we have received in the media, I thought this would be a good opportunity to share an update with all of our physicians and advanced practice clinicians of what makes APP special, what we stand for, and provide reassurance to our team amidst these misrepresentations so you are able to discern fact from fiction should you read or hear about APP in the media, social media, or even discussions with colleagues. Our goal is that you are well informed so you can feel proud to work with APP and and also correct misinformation as you come across it.

We built APP to be a specialized management company, intentionally designed to deliver a level of engagement, expertise, and partnership that allows us to differentiate ourselves as an industry leader in quality in the patient care experience and provide an environment that allows our providers to practice at a high level within a winning team environment enhancing their professional satisfaction. Our focus is simply on exceeding the expectations for all those we serve.

As I have shared in other recent articles, the field of Emergency Medicine—and all practice types within the specialty—are facing several headwinds right now which must be navigated well:​
  • Medicare reimbursement declines from sequestration and COVID relief starting in Q2 2023
  • Volatile patient volumes, with an overall net loss of more than 800,000 ED visits across our company from our pre-COVID volumes
  • Rising labor costs as physicians, APCs, and nurses leave the job market and companies must rely on more temporary staffing resources
  • Reimbursement volatility secondary to disruption from No Surprise Billing legislation
  • Our hospitals expecting their outsourced partners to share in the financial challenges they are experiencing from reimbursement declines


Despite these headwinds, we are confident we will successfully navigate these situational challenges together. With the strong support from each of our financial partners who are committed to facilitating our success, we will continue to be recognized as an industry leader and to serve in new markets as we grow. It is our collective responsibility as good stewards of our resources to manage our practices thoughtfully and adjust accordingly to any volume and reimbursement changes we experience. Know that we stand steadfast together on our commitment to exceed expectations for our patients, providers, and hospital partners, and to fulfil our mission to deliver safe, compassionate, and efficient care to every patient, every time.

While all of us in healthcare right now are working hard to provide exceptional patient care in a challenging environment, I truly believe that APP is well-positioned for a strong future, and the foundation we are laying today leads to enhanced operational security, access to more best practice resources, and ongoing educational deliverables to further support our clinical care teams. I want to take an opportunity to again “Thank You” for being a part of our journey to excellence.

As always, should you have any questions regarding anything I shared here or other questions about APP’s future, please EMAIL ME, call me at xxx-xxx-xxxx or click the “Ask Tony” button below that appears on every Clinical Update issue.​
Click to expand...
www.spglobal.com

American Physician Partners rating cut to CCC-, withdrawn by S&P Global Ratings

Ratings considers the company's near-term default risk as
www.spglobal.com www.spglobal.com

I don't think that email can counteract the fact that their credit rating is basically in junk category and you're considered to have a "high" default risk.
 
“I know the rumors you’ve heard but I’m here to tell you that things are actually much worse. Please be aware that the c-suite is doing everything we can to salvage something for ourselves.”

Tony from APP
 
bravotwozero said:

Discerning Fact from Fiction​

​
Tony Briningstool, MD, FACEP, Chief Medical Officer​
Some of you may remember the old “telephone game” we used to play as children, where you whisper a phrase in the first person’s ear, and they keep whispering it on down the line through multiple people. By the time you reach the last person in line, what that person heard was often vastly different than the original message. This reminds me of how stories can be taken out of context when they pass through the media or are posted on social media sites with comments. In light of the recent attention we have received in the media, I thought this would be a good opportunity to share an update with all of our physicians and advanced practice clinicians of what makes APP special, what we stand for, and provide reassurance to our team amidst these misrepresentations so you are able to discern fact from fiction should you read or hear about APP in the media, social media, or even discussions with colleagues. Our goal is that you are well informed so you can feel proud to work with APP and and also correct misinformation as you come across it.

We built APP to be a specialized management company, intentionally designed to deliver a level of engagement, expertise, and partnership that allows us to differentiate ourselves as an industry leader in quality in the patient care experience and provide an environment that allows our providers to practice at a high level within a winning team environment enhancing their professional satisfaction. Our focus is simply on exceeding the expectations for all those we serve.

As I have shared in other recent articles, the field of Emergency Medicine—and all practice types within the specialty—are facing several headwinds right now which must be navigated well:
  • Medicare reimbursement declines from sequestration and COVID relief starting in Q2 2023
  • Volatile patient volumes, with an overall net loss of more than 800,000 ED visits across our company from our pre-COVID volumes
  • Rising labor costs as physicians, APCs, and nurses leave the job market and companies must rely on more temporary staffing resources
  • Reimbursement volatility secondary to disruption from No Surprise Billing legislation
  • Our hospitals expecting their outsourced partners to share in the financial challenges they are experiencing from reimbursement declines

Despite these headwinds, we are confident we will successfully navigate these situational challenges together. With the strong support from each of our financial partners who are committed to facilitating our success, we will continue to be recognized as an industry leader and to serve in new markets as we grow. It is our collective responsibility as good stewards of our resources to manage our practices thoughtfully and adjust accordingly to any volume and reimbursement changes we experience. Know that we stand steadfast together on our commitment to exceed expectations for our patients, providers, and hospital partners, and to fulfil our mission to deliver safe, compassionate, and efficient care to every patient, every time.

While all of us in healthcare right now are working hard to provide exceptional patient care in a challenging environment, I truly believe that APP is well-positioned for a strong future, and the foundation we are laying today leads to enhanced operational security, access to more best practice resources, and ongoing educational deliverables to further support our clinical care teams. I want to take an opportunity to again “Thank You” for being a part of our journey to excellence.

As always, should you have any questions regarding anything I shared here or other questions about APP’s future, please EMAIL ME, call me at xxx-xxx-xxxx or click the “Ask Tony” button below that appears on every Clinical Update issue.​
Click to expand...

giphy.gif
 
Okay, so one little guy formed a group. How can more of us do the same?
 
scummie said:
Okay, so one little guy formed a group. How can more of us do the same?
Click to expand...
Engage in hospital politics locally. Set up meeting with hospital CEOs but be targeted. Makes less sense speaking to an HCA or CHS ceo since those decisions often come from above the local CEO level. However local hospitals or regional systems make a lot more sense. Engage, use resources including AAEM or even the ACEP independent course which I heard good things about even though my disdain for ACEP is high. AAEM can hold your hand thru the process.
 
Advertisement - Members don't see this ad
You must log in or register to reply here.

Similar threads

alpinism
USACS is about to screw over their California docs
Replies
23
Views
3K
ERMudPhud
E
FlaminHotER
US Senator Investigating USACS
Replies
1
Views
2K
FlaminHotER
FlaminHotER
W
U Maryland USACS takeover
Replies
16
Views
5K
EctopicFetus
EctopicFetus
EctopicFetus
Usacs leader arrested for ……
Replies
20
Views
6K
Birdstrike
Birdstrike
BoardingDoc
USACS Shenanigans
Replies
19
Views
6K
Fpg1245
F
Top Bottom