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Warning about UMDNJ-New Jersey Medical School

Discussion in 'Pre-Medical - MD' started by raph91, Dec 21, 2005.

  1. raph91

    raph91 Member
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    Hi,

    Just a warning for everybody:

    The US attorney general put into effect an ultimatum for UMDNJ which means either:

    the school's financial proceedings fall fully under a federally appointed independent counsel

    or

    the school faces criminal prosecution which shuts down the University Hospital based in Newark since it is dependent on Medicaid and Medicare

    Don't know what this means for the school though
     
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  3. medhacker

    medhacker We can end world poverty!
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    where you got this from?
     
  4. That's very disturbing.
     
  5. ASDIC

    ASDIC The 9th Flotilla
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    you probably didnt read the article clearly:

    "By agreeing to the federal takeover of its finances, UMDNJ avoids a federal prosecution that effectively would shut its teaching facility, University Hospital in Newark. An indictment would trigger a cutoff of Medicaid and Medicare reimbursements to the hospital; hospitals cannot survive without federal reimbursement funds."

    I dont think its that serious as it sounds. The school has a history of scandals, now is the time they are cleaning up.
     
  6. doctorFred

    doctorFred intensive carer
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    i understand that (assuming from your location) as a UMDNJ student you'd like to downplay this a bit, but it sounds like a serious matter to me. when the u.s. attorney general steps in and tells you to either comply with the federal monitor request or he will (effectively) shut down the school and the hospital, that counts as serious.
     
  7. raph91

    raph91 Member
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    Alright,

    The state newspaper also had an article about it:

    If you want to say part of the truth it's easy ... (key points in bold)

    "The U.S. attorney delivered an ultimatum to the troubled University of Medicine and Dentistry of New Jersey yesterday -- telling its governing board to accept a federal takeover of the school's financial operations or face a criminal prosecution that could shut it down.

    In a stunning, surprise visit, Christopher Christie walked into the trustees' monthly meeting and, in a closed-door session, told them he had lost faith the state university could correct the recurring troubles that have sparked an investigation into alleged Medicare and Medicaid fraud going back six years.

    Christie told the board he wants a federal monitor in place by Jan. 11 to oversee financial operations of the university, according to board members who were in the room. He gave the board members 36 hours to appoint an outside attorney who would work with his office to get the details of monitorship rolling.

    The U.S. attorney laid out a litany of federal criminal charges he was prepared to bring against the school and certain of its officers -- including Medicaid fraud -- if he did not get the school's full cooperation, board members said.

    Board members said Christie was particularly upset by the recent destruction of documents under federal subpoena, and the theft of dozens of critical files in several break-ins at the university's administration building this year.

    "This place is a public embarrassment," members of the board recalled Christie saying in the closed session held at the school's administration building in Newark. Board members said they had basically accepted the federal offer, though details had not been officially worked out.

    "He made this offer in the spirit of cooperation, and we've agreed," recounted board member Alexander J. Menza, a retired Superior Court judge.

    "He wants an agreement (on details of monitoring) by Jan. 11," Menza said.

    According to Menza, the monitor wouldn't pre-empt the powers of the current school president, John Petillo, but rather would oversee the situation. He said the academic business of the university would not be affected.

    Christie would say little about the meeting. He emerged looking grim, with two aides on either side.

    "I met with the board and discussed the investigation. Beyond that, I have nothing to say," he said as he got on an elevator.

    The U.S. attorney's offer is called deferred prosecution, a tool federal authorities are using increasingly to bring businesses into compliance. But law enforcement and higher education experts could not recall it ever being used against a university.

    UMDNJ has been under federal investigation for months. The probe focuses largely on improper Medicaid and Medicare billing dating back years. The investigation also is looking at millions in no-bid contracts awarded to consultants with political ties and other alleged sweetheart deals.

    UMDNJ is the largest public university for health sciences in the country, with five regional campuses, more than 4,500 students, and a $1.6 billion annual budget. A takeover of the school -- even through the offices of a special monitor -- could have ripple effects throughout the university -- possibly affecting millions in federal research grants, the accreditation of its schools and enrollment.

    Christie left the board with few options. An indictment of the institution would result in the cutoff of all Medicaid and Medicare reimbursement to UMDNJ's University Hospital in Newark, closing it down. No hospital can exist without federal reimbursement funds.

    UMDNJ's board itself is already in disarray. Two trustees resigned Monday, in response to an executive order banning any conflicts of interest among board members at New Jersey public colleges and universities. The executive order by acting Gov. Richard Codey came after The Star-Ledger reported in August that five of the nine voting members on the board had apparent conflicts because they worked for companies or agencies that did business with UMDNJ.

    Interim UMDNJ chairwoman Sonia Delgado and board member Christopher Paladino both submitted their resignations to Codey, effective today. A third trustee, UMDNJ board secretary John Ferguson, the president and CEO of Hackensack University Hospital -- an affiliated teaching hospital -- told the board yesterday he was resigning, effective immediately.

    Separately, several senior UMDNJ executives have been leaving as well. Yesterday, Christy Davis Jackson, UMDNJ's vice president for government affairs, resigned from her $156,000 job. While records related to her office also have been subpoenaed by a federal grand jury, she said that had nothing to do with her decision to leave.

    "I'm going to be a stay-at-home mom," said Davis Jackson. "I was blessed to give birth to my son in July, and I was torn when I came back to work. I cannot re-create these times in his life."

    James Lawler, the chief financial officer of UMDNJ's University Hospital, abruptly quit last Thursday after refusing to sign federal documents certifying the accuracy of the medical center's Medicare and Medicaid bills. He said he was cooperating with federal authorities."

    It goes on from there for a while. But if you don't think this is serious, you seriously have no clue what's going on.
     
  8. kauai

    kauai Member
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    There is no question that these types of matters are always serious. However, there are many university hospitals affiliated with medical schools that have faced billing fraud charges, which were settled to avoid prosecution (e.g. University of Washington). The unique aspect of this situation is the appointment of a federal monitor to superintend the settlement/compliance process. This type of procedure has been applied to corporations who have faced prosecution by the U.S. Attoneys Office for fraud etc. (e.g. Bristol Myers Squibb). It has never been applied to a University hospital before --it is actually an excellent idea to ensure compliance and an opportunity for UMDNJ to avoid prosecution and to fix the issues that are a problem and get back to the business of taking care of indigent patients in the community that they serve, as well as, continue to serve as an excellent clinical training ground for NJMS.
     
  9. BOBODR

    BOBODR Senior Member
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    In about 5 seconds DrGuy22 is gonna lay the smack down the OP and have a canary.....
     
  10. doctorFred

    doctorFred intensive carer
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    have a canary?

    might you mean.. have a coronary? because having a small, yellow bird utilized by miners to detect trace amounts of deadly gasses doesn't make sense to me.
     
  11. beponychick

    beponychick SDN Angel
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    yikes... this is serious stuff!!! :eek: :eek: :eek:

    does this affect RWJ as well? they keep referring to UMDNJ, but RWJ is under the UMDNJ system.
     
  12. raph91

    raph91 Member
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    I don't think this will have serious repercussions in terms of the school necessarily. BUT it IS a reflection on the school and its administration.

    The truth is that UMDNJ made MANY big mistakes. You don't shred documents. You don't put the state into a position where your main administrative building has to be covered by independent state police because the state no longer trusts the internal administration due to multiple robberies of subpoenaed documents. I don't CARE that they've avoided a major problem. THEY did not avoid it. The US attorney general GAVE them a way out.

    Also, NJMS, with all of this, has gone through major issues. They got rid of the dean of student affairs and the dean of the school within the same year and now have interim people in place.

    I think the issue here is mainly with NJMS simply because the MAJOR issue is coming out of the main administrative groups in Newark. Also, the hospital that is experincing major problems is University Hospital, which is the main teaching hospital for NJMS. You have the possibility of rotations in other hospitals but the student run clinic and the main teaching comes out of this hospital.

    The fact is that this can have repercussions in RWJ but it will experience the side effects of the central issues, due to federal control of institutional finances, etc. If this doesn't work out properly, the school that experiences the most immediate and direct negative effects is NJMS, period, because clinical duties are based at University Hospital for most people at NJMS.
     
  13. tigress

    tigress queen of the jungle
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    you can find dirt on any school
     
  14. doctorFred

    doctorFred intensive carer
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    frankly, this qualifies as a bit more than "dirt."
     
  15. raph91

    raph91 Member
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    Ah, dirt. Sigh. The dirt these US Attorney Generals drum up! When will they stop fooling around??

    This isn't me bashing the school. It's relaying information. I'm sorry but I don't like unethical people, and I find the theft and summary destruction of federally subpoenaed documents to be unethical, no matter who it's done by. And for the same office where these documents are housed to be "robbed" THREE times during the FBI investigation is quite frankly both ******ed and unethical. Unless some Newark thug has a fetish for documents out of this specific room, which is POSSIBLE I suppose.

    For a US Attorney General to call an institution of higher learning a "public disgrace" is big, no matter which way you turn it. You show me one other institution that has been publically referred to by the US government as a public disgrace and I'll say sorry and eat my own words.
     
  16. drguy22

    drguy22 1K Member
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    Message from Dr. John J. Petillo
    Undoubtedly by now you have heard the reports concerning the United States Attorney’s meeting with the UMDNJ Board of Trustees that occurred on Tuesday afternoon. Contrary to reports, his visit was scheduled, not a “surprise” to our trustees and administration.

    Clearly, while this proposal to have a federal monitor involved with our financial operations may be unprecedented, I view the presence of this external reviewer as a positive way to effect the changes I have proposed for this great university. The U.S. Attorney has recognized the tremendous value of UMDNJ to the State, and we deeply appreciate his sensitivity to our role in higher education. There are so many wonderful things going on at this university, yet there are also many things that must and will change. Having an outside presence will allow me to further drive down reform to the very foundation of this institution. We have been and will continue to work with the United States Attorney in these efforts, for we are all after the same thing – a university above reproach,a university in which all faculty, students, staff and alumni can take pride.

    In May of this year I announced a series of reforms, all of which have been implemented. Ranging from the tightening of executive perquisites on travel, the enforcement of waivers and bidding processes, and the end of political contributions from the organization, these reforms were a first, but important, step to righting the ship. Additionally we anticipate delivery of the report on purchasing and procurement practices from Justice Gary Stein in three to four weeks. His preliminary findings were positive, but we have already implemented a number of his interim recommendations along the way.

    During the course of these recent investigations, actions and decisions made by some members of the previous administrations have come to light. These decisions are now, unfortunately for us all, dragging down the reputation of the thousands of conscientious, hard working members of the UMDNJ family. Please hear me say this – any current or past UMDNJ employee involved with wrongdoing will be held accountable for their actions.

    With regard to the federal monitor, the obvious question you are undoubtedly asking is “what does it mean to me each day?” The answer for the vast majority of you is nothing. We anticipate no impact on how we teach students, how care is delivered to the 2 million lives we touch annually and in what research we engage. Students will continue to be guided by our expert faculty as they prepare for careers in the health sciences, faculty will continue to teach and advance the cause of science through their research, and caregivers will still dispense care to those most in need with compassion and skill.

    The involvement of an outside monitor is fully consistent with my commitment to reforming our great institution. I anticipate and expect continued full cooperation with these efforts from each of you.. Please stay the course and join with me as we work to better this institution as we serve our students and all residents of New Jersey.

    In conclusion let me say that I have a vision for what this university can become – what our rightful place in higher education should be nationally; clearly we are not there yet. But with your continued support and vigilance, I am confident that we will weather this storm and emerge on the other side, a stronger, more focused and truly remarkable institution.



    John Petillo, PhD
    President
     
  17. drguy22

    drguy22 1K Member
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    FYI...just because NJMS is in Newark doesnt mean its the only one to blame...RWJ and SOM as well as the other schools are part of the UMDNJ family and share equal responsibilities....
     
  18. drguy22

    drguy22 1K Member
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    The University of Washington Medical School Fraud Case
    Published on 06 August 2005 | Author PARKER, Janet Louise, D.V.M.,B.S.


    The full story of the University of Washington Medicare-fraud case has not been told, says the whistle-blower, Swannee Rivers. She alleges that clerks were ordered to forge doctor signatures and re-create old records. She states that the fear of being fired, kept everyone quiet.

    There has been well-publicized four and one - half year Federal billing investigation of University of Washington School of Medicine that has resulted in criminal felony convictions of two nationally prominent physicians, a $35 million settlement and the expenditure of $27 million for legal and other costs. Two prominent faculty members, Dr. Richard Winn, Chair of the Department of Neurological Surgery and Dr. William Couser of the Nephrology Division, pled guilty to criminal charges (obstruction of justice and fraud).



    The Federal government arrived at a figure of approximately $70 million in over billings to Medicaid and Medicare. Given the treble damages allowed, the government’s total figure was approximately $210 million. The government’s investigation concentrated on the Department of Neurological Surgery, the Division of Nephrology and the Interventional Radiology Section. Although only two doctors pled guilty, there was broad systemic problems at UW involving no less than three dozen physicians from at least eight departments and no less than seven administrators who could easily have found themselves facing criminal charges.

    They were actually prosecuted and found guilty...
     
  19. drguy22

    drguy22 1K Member
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    On March 19, 1998, in the Western District of Pennsylvania, eighteen physician clinical practice plans associated with the University of Pittsburgh School of Medicine, the University of Pittsburgh Medical Center Health System, and the University of Pittsburgh agreed to pay $14 million for false or improper billings to the Medicare program, and $3 million for false or improper billings to the Pennsylvania State Medicaid Program. The settlement resolves allegations that the Clinical Practice Plans submitted claims in violation of established Medicare and Medicaid rules governing payment for physician services provided in the teaching setting. Attending physician's services which are furnished to beneficiaries in a teaching setting are covered under Medicare Part B and payment may be made only if the physician assumes and fulfills the same responsibilities for this patient as for other paying patients.

    These responsibilities include the attending physician's personal examination of the patient. Pursuant to established HCFA regulations, and directives from HCFA's contractors, the services of residents cannot be billed separately as services under Part B of Medicare. Services of residents and interns in approved teaching physician programs are explicitly excluded from the definition of "physician's services" and are not payable as such. These services are covered as hospital services under Medicare. Services provided by a resident or intern under the attending physician's personal and direct supervision, however, may be reimbursable under Medicare Part B. The Pennsylvania Medicaid rules allow payment only for services actually rendered by a provider.

    The Clinical Practice Plans conducted an audit at their own expense. The audit found faulty or inaccurate billing practices where physicians billed for services actually rendered by residents, and some billing for evaluation and management services where the code levels selected were not supported by sufficient documentation in the medical records (upcoding.) The terms of the settlement also require specific compliance measures by the Clinical Practice Plans through a Corporate Integrity Agreement.

    On September 8, 1998, in the District of Connecticut, a $5.6 million settlement involving Yale University School of Medicine was reached regarding the school's maintenance, use and write-off of credit balances. A portion of the settlement calls for the school to pay the United States $1,200,289 to settle a qui tam action. The rest of the settlement requires the school to pay $1,888,525 to private insurance companies and $2,511,298 to the State of Connecticut treasurer, pursuant to unclaimed property laws. The school did not match specific medical charges and posted them in their records as unidentified credit balances. Such credit balances represented amounts owed by the school to patients, health benefits program's and/or clinical departments within the school for the period January 1997 through September 1998. The government contended that the school improperly handled a significant number of credit balances. In the settlement, the school acknowledged that it failed to adequately manage and supervise the handling of certain credit balances. As part of a 4-year Corrective Action Plan, the school will establish a credit balance department, conduct biannual instruction programs for all individuals involved in the resolution of credit balances, and submit to annual audits.


    http://www.usdoj.gov/dag/pubdoc/health98.htm#cases
     
  20. Donkeykiss

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    well alot hasnt changed in 5 years

    umdnj students bailout state/city/healthcare through education facility only bond and tuition hikes, they tell us its state tuition cut

    http://www.umdnj.edu/about/board/pdf/1_27_09_BOT_res.pdf

    it appears like the bond from njefa that says on site for education only building, student related, pays for bonds and loans owed by:

    Child health institute, just clinical, in new brunswick
    george st redevelopment assoc, new brunswick city certificate of obligation bond?
    university behavioral health building
    International center for public health development, 2000 EDA bond, newark research center for vaccines
    2 bonds for general operating expenses of umdnj
    1989 cops bond, general umdnj obligation?

    COPSs are less fiscal burden than bonds backed with state funds and student revenue

    as well as state medicaid debt, and that $8 mill fraud charge in there, is forgiven for doing this

    our education related revenue then pays, as it always did for other umdnj hospital debts, but state funds for tuition used as collateral and now it looks like city government debts are paid by our tuition/fees as well from this

    i think other public schools here and other states are bailing out healthcare/state/city governments in a similar manner. All very manipulated by the low treasury rate set by fed since 2008 and the economic downfall

    state aid has nothing to do with tuition rises, as we are giving them the aid
     
  21. Donkeykiss

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    all in all very poor fiscal decisions for students education, fraudulent, and only seek to aid other branches of umdnj as well as bailout hospital which saves the state $30 mill a year
     
  22. theWUbear

    theWUbear EM PGY1
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    inb4 100 people read this not initially realizing its 6 years old. so the state of nj is in a poor state financially, qq moar donkeykiss. the medicare billing fraud scandal is far in the past for umdnj at this point
     
  23. Donkeykiss

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    uh its not as that doc shows half was forgiven, rest in 2013-2028, for taking an njefa bond to pay for debts the state usually pays for UH cause its a safety net hospital, as well as COPs which may have let newark/new brunswick off the hook from debt. A COP isnt required to be backed by revenue now as a bond it is. All bad fiscal decisions for the students,but hey that wasnt the obvious reason for an NJ EDUCATIONAL FACILITY AGENCY bond. It paid research centers bonds, housing COPs that may have been linked to joint newark plans that received HUD money. And $46 mill of state medicaid debt, $23 still owed

    these bonds will be paying 7.47% interest on $260 mill for 30 something years, $215 mill more is still approved. This interest is paid from tuition fees with few other revenue sources UMDNJ has. UH isnt actually breaking even this bond and the medicare forgiveness and deferment fixed. All state funds including state school aid is held in bank till bond interest paid. 70% of their bond portfolio has this. Its called less available working capital and a reason for tuition hikes

    This bond crap goes on at UC and other public schools you rube
     
  24. theWUbear

    theWUbear EM PGY1
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    I am far from a rube and your financial analysis is hardly relevant to the end user medical student save for increased tuition rates - which we are all aware of. It's also very hard to understand your broken English. Spare us your wasted effort
     
  25. Donkeykiss

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    nj investigators published concerns in 2007 about NJEFA and misuse, this in 2005, but the economic budget crisis in 2007-2008 for all pushed aside. Thats why I cant find individual school annual reports after that

    Yea tuition and student debt isnt an issue anymore right? UMDNJ tuition up 33% since then at njms/njds/rwj. And increased enrollment at umdnj further increases tuition revenue at the same time, 2007 saw a 9% hike 14% increased enrollment and a net increase in tuition revenue of 11%, same as 2009 vs 2010. Only a sheep believes state aid cut explains
     
  26. Donkeykiss

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    yea you are aware of like you are aware of other crap you dont know reasons for

    see in cali
    http://keepcaliforniaspromise.org/404/they-pledged-your-tuition-to-wall-street-summary/comment-page-1

    explanation of an education bond
    http://www.bondsonline.com/Todays_Market/Credit_Rating_News_.php?DA=view&RID=2977

    state agency that sells and required to list like all states
    http://www.njefa.com/njefa/activity/recent/2009/
     
  27. Donkeykiss

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    And sorry to waste your time on a nj topic in thread titled after umdnj-njms

    state and city budget problems are only an nj problem too I forgot, let alone a federal one

    they only made effort to distribute student loans at the same time. collecting from the treasury at 2.8% and giving to you at 6.8%. The treasury only sets the 0.1-0.25% Treasury fund rate that hasnt budged after they dropped it in 2008

    4% is nominal yearly fee, for the life of the loan, from a revenue stream of $110 billion dollars a year.

    so keep being aware why tuition rises with no stopping
     
  28. TTigers70

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    Whenever there is talk about UMDNJ's shortfalls whether it be corruption or other financial maladies, I feel as though NJMS is always at the end of the sentence. As UMDNJ is the umbrella organization, is there any discussion about RWJ or the DO school down south? Similarly, what about the school of public health, nursing, biomedical sciences, etc? Is the problem more local to NJMS?
     
  29. Donkeykiss

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    not at all UMDNJ is the corporate structure that houses all schools, research centers, clinics and hospital.

    the tuition rose the same for njms/njds/rwj/DO and their tuition revenue is used the same as all others

    The First DO dean went to jail for bribing a state senator with a salaried position there, he accepted

    its just njms is in newark where UH hospital that is broke cause of the payor mix and they had the medicaid scandal, haha as well as no show jobs to cardiologists

    only reason njms gets more attention

    Gov christie is trying to split off RWJ and the public health school in new brunswick and obviously UMDNJ is resisting as this cuts off a huge positive cash flow source, which they need not just for their own operation but to furnish the interest on these bonds, offset UH losses and whatever else they lose in their grips

    taking them out doesnt change anything, as other schools will see a tuition hike to offset. But maybe UMDNJ will bellyup and then its shown how their hospitals and clinics are operating fiscally.
     
  30. Donkeykiss

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    I'm not wasting my effort like WU said as I have this stuff pulled and worked at UH too so I know the issues. And if you are gonna be docs you should know how these hospital administration, government, and healthcare issues work

    http://www.theuniversityhospital.com/about/minutes/UHBODminutes_4_28_10.pdf


    Come on, 2009 is the year UH breaks even after they get hit with $9 million medicaid fine and in 2001-2008 they avg a deficit of $22 mill.

    And 2 days after this meeting that $260 million njefa education bond was listed, where as part of deal $23 mill of their medicaid debt was forgiven and the other $23 mill put off till 2013-2018

    They sound optimistic too saying 2010 should be even and 2011 positive cash flow

    and now as then they lost alot of hospitals in newark further putting a fiscal strain on UH with newarks mix of payors

    and student tuition and the fiscal health of the schools were all compromised by this bond and will continue to be. The state bails UH out of that deficit every year, theyd never let it shut down as it would be a catastrophe as a safetynet hospital

    And this education bond, that takes on other debt, was the reason the state absolved $23 mill of medicaid debt and student tuition/state aid/fees will pay off the horrible 7.47% interest on it

    The end gain for the state is that this bond, frees up UH and other UMDNJ money to attempt to make UH truly break even or positive cash flow in 2013 so the state gets that money and doesnt have to pay the UH 30 mill yearly deficit again

    Tuition is raised 18%, enrollment increases, and they take on direct role in st georges 3/4th education at rotation sites they were already hosted at.

    All generating revenue to pay bond, even with the 15% state aid cut, and we get another one next year despite a budget that shows same aid to UMDNJ as last year
     

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