Call That Kept Nursing Home Patients in Sandy’s Path

Chang W. Lee/The New York Times

Workers were shocked that nursing and adult homes in areas like Rockaway Park, Queens, weren’t evacuated.

Hurricane Sandy was swirling northward, four days before landfall, and at the Sea Crest Health Care Center, a nursing home overlooking the Coney Island Boardwalk in Brooklyn, workers were gathering medicines and other supplies as they prepared to evacuate.

Then the call came from health officials: Mayor Michael R. Bloomberg, acting on the advice of his aides and those of Gov. Andrew M. Cuomo, recommended that nursing homes and adult homes stay put. The 305 residents would ride out the storm.

The same advisory also took administrators by surprise at the Ocean Promenade nursing home, which faces the Atlantic Ocean in Queens. They canceled plans to move 105 residents to safety.

“No one gets why we weren’t evacuated,” said a worker there, Yisroel Tabi. “We wouldn’t have exposed ourselves to dealing with that situation.”

The recommendation that thousands of elderly, disabled and mentally ill residents remain in more than 40 nursing homes and adult homes in flood-prone areas of New York City had calamitous consequences.

At least 29 facilities in Queens and Brooklyn were severely flooded. Generators failed or were absent. Buildings were plunged into a cold, wet darkness, with no access to power, water, heat and food.

While no immediate deaths were reported, it took at least three days for the Fire Department, the National Guard and ambulance crews from around the country to rescue over 4,000 nursing home and 1,500 adult home residents. Without working elevators, many had to be carried down slippery stairwells.

“I was shocked,” said Greg Levow, who works for an ambulance service and helped rescue residents at Queens. “I couldn’t understand why they were there in the first place.”

Many sat for hours in ambulances and buses before being transported to safety through sand drifts and debris-filled floodwaters. They went to crowded shelters and nursing homes as far away as Albany, where for days, they often lacked medical charts and medications. Families struggled to locate relatives.

The decision not to empty the nursing homes and adult homes in the mandatory evacuation area was one of the most questionable by the authorities during Hurricane Sandy. And an investigation by The New York Times found that the impact was worsened by missteps that officials made in not ensuring that these facilities could protect residents.

They did not require that nursing homes maintain backup generators that could withstand flooding. They did not ensure that health care administrators could adequately communicate with government agencies during and after a storm. And they discounted the more severe of the early predictions about Hurricane Sandy’s surge.

The Times’s investigation was based on interviews with officials, health care administrators, doctors, nurses, ambulance medics, residents, family members and disaster experts. It included a review of internal State Health Department status reports. The findings revealed the striking vulnerability of the city’s nursing and adult homes.

On Sunday, Oct. 28, the day before Hurricane Sandy arrived, Mr. Bloomberg ordered a mandatory evacuation in Zone A, the low-lying neighborhoods of the city. But by that point, Mr. Bloomberg, relying on the advice of the city and state health commissioners, had already determined that people in nursing homes and adult homes should not leave, officials said.

The mayor’s recommendations that health care facilities not evacuate startled residents of Surf Manor adult home in Coney Island, said one of them, Norman Bloomfield. He recalled that another resident exclaimed, “What about us! Why’s he telling us to stay?”

The commissioners made the recommendation to Mr. Bloomberg and Mr. Cuomo because they said they believed that the inherent risks of transporting the residents outweighed the potential dangers from the storm.

In interviews, senior Bloomberg and Cuomo aides did not express regret for keeping the residents in place.

“I would defend all the decisions and the actions” by the health authorities involving the storm, said Linda I. Gibbs, a deputy mayor. “I feel like I’m describing something that was a remarkable, lifesaving event.”

Dr. Nirav R. Shah, the state health commissioner, who regulates nursing homes, said: “I’m not even thinking of second-guessing the decisions.”

Still, officials in New Jersey and in Nassau County adopted a different policy, evacuating nursing homes in coastal areas well before the storm.

Contradictory Forecasts

The city’s experience with Tropical Storm Irene last year weighed heavily on state and city health officials and contributed to their underestimating the impact of Hurricane Sandy, according to records and interviews.

Before Tropical Storm Irene, the officials ordered nursing homes and adult homes to evacuate. The storm caused relatively minor damage, but the evacuation led to millions of dollars in health care, transportation, housing and other costs, and took a toll on residents.

As a result, when Hurricane Sandy loomed, the officials were acutely aware that they could come under criticism if they ordered another evacuation that proved unnecessary.

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Chinatrust Bank to move U.S. headquarters to downtown L.A.

Chinatrust Bank has agreed to move its U.S. headquarters to downtown Los Angeles from Torrance.

The bank will rent two floors in 801 Tower, a company representative said. The high-rise is in the financial district north of Staples Center.

"We wanted to be in a major financial area," said Brian Gregson, head of U.S. retail banking at Chinatrust. "This is the early stage of getting our ducks in a row to start some expansion."

The bank's name will be affixed on top of the 25-story tower at 801 S. Figueroa St., he said.

Chinatrust, which is based in Taiwan, has 12 branches in the United States, including seven in Southern California. The bank will move about 175 employees to the new headquarters by the middle of next year, Gregson said.

Terms of the lease with landlord Mani Bros. Real Estate Group were not disclosed, but data provider CoStar said the agreement is for 10 years. At current rents, the lease for nearly 40,000 square feet would be valued at nearly $20 million.

Chinatrust's decision to move to downtown L.A. is part of a recent trend for businesses to relocate their main offices to the financial center, reversing the exodus of previous decades, real estate broker Ted Simpson of Cushman & Wakefield said.

"This speaks to the emergence of downtown L.A. as a corporate headquarters destination not seen since the 1980s," said Simpson, who represented the bank in the transaction with his partner Michael Ma.

Other companies to recently move their main offices or regional headquarters downtown include law firm Haight Brown Bonesteel and architecture firm Gensler.

"Corporations are once again choosing downtown for its attractiveness to its employees, not just low cost," Simpson said.

Average rents are cheaper downtown than on the popular Westside, in part because downtown has higher vacancy. Large corporations including Arco and First Interstate Bank left downtown in past decades or substantially reduced their offices.

Apartments going up in N. Hollywood

Apartment complexes planned before the demise of redevelopment agencies in California continue to rise in North Hollywood.

The projects in the NoHo Arts District near the northern terminus of the Red Line subway include the recently completed NoHo Senior Villas for elderly low-income tenants.

A larger, $50-million market-rate complex is under construction nearby and has reached its top height of six stories.

Phoenix developer Alliance Residential Co. is building the 308-unit market-rate complex called the Ferrara at 5031 Fair Ave. It is intended to be resort-like with outdoor dining facilities and bars, pools, cabanas and an outdoor movie venue.

"Our goal is to create a luxurious urban getaway for the residents," said Jonas Bronk of Alliance.

The Ferrara is slated for completion late next year.

NoHo Senior Villas, at 5525 Klump Ave., has 49 units and was built by Clifford Beers Housing and PATH Ventures for $16 million. Most of the units are reserved for seniors who were homeless and are living with a mental illness. The five-story complex has on-site facilities for mental health and social service personnel.

Both projects were designed by Killefer Flammang Architects of Santa Monica.

Also recently completed in North Hollywood was the $32-million NoHo Senior Arts Colony. It is intended for residents age 62 and over with interests in such pursuits as singing, acting, photography and writing.

The two senior housing projects are in the former North Hollywood Redevelopment Project Area, which offered tax breaks to developers. State officials dissolved local redevelopment agencies this year to save money.

roger.vincent@latimes.com

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After a billion, what next for Facebook?

MENLO PARK — In just eight years, Facebook signed up more than half the world's Internet population.

Now it's going after the rest.

Facebook wants to reach every single person on the Internet whether they are logging on from a laptop in Santa Monica, an iPhone in Tokyo or a low-tech phone with a tiny screen in Nairobi.

It's parachuting into market after market to take on homegrown social networks by currying favor with the locals and venturing where many people have spotty — if any — access to the Internet.

In Japan, it lets users list their blood types, which the Japanese believe — like astrological signs in the Western world — give insight into personality and temperament. In Africa, Facebook markets a stripped-down, text-only version of its service that works on low-tech mobile phones.

International growth is crucial to maintain its dominance as the world's largest social network. The company's scorching pace of growth has cooled especially in the United States. Facebook must coax users to sign up — and make sure it remains popular with the users it already has — or risk being knocked from its lofty perch.

"We're not a company that is just trying to add more people," said Chris Cox, Facebook's vice president of product. "What we are trying to do is build a service that everyone in the world can use."

But overseas growth that once seemed to come so easily is slower now. Facebook has already saturated most major markets around the globe. Eight out of 10 Facebook users are outside of the U.S.

"I don't think that Facebook has a chance of attracting another billion users," Wedbush Securities analyst Michael Pachter said.

Inside Facebook's Menlo Park, Calif., headquarters is a small army out to prove naysayers wrong. Above their desks they have hung flags from around the world that represent their nationalities. They obsessively scan screens that track user growth around the world.

They cheered and popped open champagne in September when the number of active Facebook users crossed 1 billion. But the moment of jubilation quickly passed as they redoubled their efforts to spread Facebook around the globe.

Naomi Gleit is the soft-spoken, headstrong 29-year-old product manager in charge of growth at Facebook. She says Facebook's future is on mobile devices, the medium by which most people will experience the Web in coming years. Facebook now works on more than 2,500 different phones, helping it gain a foothold in emerging markets. And it is forging relationships with mobile phone operators around the world.

Gleit's 150-member team has boots on the ground in far-flung places armed with low-tech phones and cheap data plans. Even team members here carry Nokia phones alongside their iPhones to update their status or check their News Feed.

"We originally built a product for ourselves," Gleit said. "This is different. Now we need to understand the experience of users who are not like us."

Analysts say Facebook already has established an impressive track record of uprooting entrenched competitors. In Britain, it displaced the dominant social network Bebo, forcing AOL to sell it at a huge loss. In Germany, Facebook overtook the homegrown StudiVZ. Facebook even broke Google social network Orkut's stranglehold on Brazil and India.

In 2009, it launched a clever tool to help Facebook users find their Orkut friends on Facebook and instantly send them friend requests. Two years later it swiped Google's top executive in Latin America, Alexandre Hohagen. Facebook sprinted ahead of Orkut one year ago, and now has 61 million active users in Latin America's largest country.

Facebook is treating India as a test lab for how it can spread in other emerging markets such as Indonesia. Facebook, which has offices in Hyderabad, India, has grown from 8 million users in 2010 to 65 million users today. It is aggressively targeting India's youth. A few hundred young Indian programmers recently jammed a Facebook hackathon at a Bangalore convention center to chug chai and brainstorm new apps that would appeal to their friends.

But Facebook has its eyes on a much bigger prize beyond the country's 100 million Internet users: the 900 million-plus Indians on mobile phones. Some analysts predict India will have more Facebook users than any other country including the United States by 2015.

The company also faces significant challenges in India. It must make the service captivating on low-tech mobile phones with unreliable Internet connections and it must gingerly navigate demands from the Indian government to remove objectionable content without alienating users.

Facebook is making some of its biggest moves in Russia, South Korea and Japan, the only major markets where it operates but has penetration of less than 50%, according to research firm ComScore.

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Microsoft updates Android Xbox SmartGlass app for 7-inch tablets

While Nintendo (NTDOY) has chosen to create second-screen experiences with the new Wii U GamePad, Microsoft’s (MSFT) strategy for the Xbox 360 involves bringing your own devices (BYOD) with the Xbox SmartGlass app for Android, iOS, Windows Phone 8 and Windows 8. One of the more frustrating things initially about the Xbox SmartGlass app was that it wasn’t natively compatible with 7-inch Android tablets such as Google’s (GOOG) excellent Nexus 7, but Microsoft’s gone ahead and updated the app to take advantage of 7-inch Android tablets while squashing a batch of bugs at the same time. While still in its infancy, Xbox SmartGlass is a glimpse at the future of smartphones and tablet and how they connect to the TV. 

Last month, we said: “SmartGlass isn’t just a fancy touchscreen remote control app for the Xbox 360 — it’s much more than that. With the app, users can start a movie on any mobile device and resume on the Xbox 360 (and vice versa), monitor real-time sports stats, bios and highlights on a secondary display, navigate the newly added Internet Explorer with multitouch gestures such as pinch-to-zoom and enhance gameplay with new gameplay options.”

The new Xbox SmartGlass is available for free in Google Play Store here.

Get more from BGR.com: Follow us on Twitter, Facebook

Wireless News Headlines – Yahoo! News

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Katzenberg, Spielberg attend Governors Awards

LOS ANGELES (AP) — Stars such as Steven Spielberg and George Lucas are arriving at the Hollywood and Highland Center in Los Angeles to pay homage to four industry heavyweights.

The film academy's fourth annual Governors Awards are being presented Saturday to honorary Oscar winners Jeffrey Katzenberg, stuntman Hal Needham, documentarian D.A. Pennebaker and American Film Institute founding director George Stevens Jr.

The four men will accept their Oscar statuettes during the Academy of Motion Picture Arts and Sciences' private dinner program in the Ray Dolby Ballroom. Portions of the untelevised event may be included in the Feb. 24 Academy Awards telecast.

Other guests expected at Saturday's ceremony include Quentin Tarantino, Bradley Cooper, Kristen Stewart, Bryan Cranston and Oscar host Seth MacFarlane.

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Adderall, a Drug of Increased Focus for N.F.L. Players

The first time Anthony Becht heard about Adderall, he was in the Tampa Bay locker room in 2006. A teammate who had a prescription for the drug shook his pill bottle at Becht.

“ ‘You’ve got to get some of these,’ ” Becht recalled the player saying. “I was like, ‘What the heck is that?’ He definitely needed it. He said it just locks you in, hones you in. He said, ‘When I have to take them, my focus is just raised up to another level.’ ”

Becht said he did not give Adderall another thought until 2009, when he was playing in Arizona and his fellow tight end Ben Patrick was suspended for testing positive for amphetamines. The drug he took, Patrick said, was Adderall. Becht asked Patrick why he took it, and Patrick told Becht, and reporters, that he had needed to stay awake for a long drive.

Those two conversations gave Becht, now a free agent, an early glimpse at a problem that is confounding the N.F.L. this season. Players are taking Adderall, a medication widely prescribed to treat attention deficit hyperactivity disorder, whether they need it or not, and are failing drug tests because of it. And that is almost certainly contributing to a most-troubling result: a record-setting year for N.F.L. drug suspensions.

According to N.F.L. figures, 21 suspensions were announced this calendar year because of failed tests for performance-enhancing drugs, including amphetamines like Adderall. That is a 75 percent increase over the 12 suspensions announced in 2011 and, with a month to go in 2012, it is the most in a year since suspensions for performance-enhancing drugs began in 1989.

At least seven of the players suspended this year have been linked in news media reports to Adderall or have publicly blamed the drug, which acts as a strong stimulant in those without A.D.H.D. The most recent examples were Tampa Bay cornerback Eric Wright and New England defensive lineman Jermaine Cunningham last week.

The N.F.L. is forbidden under the terms of the drug-testing agreement with the players union from announcing what substance players have tested positive for — the urine test does not distinguish among types of amphetamines — and there is some suspicion that at least a few players may claim they took Adderall instead of admitting to steroid use, which carries a far greater stigma. But Adolpho Birch, who oversees drug testing as the N.F.L.’s senior vice president for law and labor, said last week that failed tests for amphetamines were up this year, although he did not provide any specifics. The increase in Adderall use probably accounts for a large part of the overall increase in failed tests.

“If nothing else it probably reflects an uptick in the use of amphetamine and amphetamine-related substances throughout society,” Birch said. “It’s not a secret that it’s a societal trend, and I think we’re starting to see some of the effects of that trend throughout our league.”

Amphetamines have long been used by athletes to provide a boost — think of the stories of “greenies” in baseball clubhouses decades ago. That Adderall use and abuse has made its way to the N.F.L. surprises few, because A.D.H.D. diagnoses and the use of medication to control it have sharply increased in recent years.

According to Dr. Lenard Adler, who runs the adult A.D.H.D. program at New York University Langone Medical Center, 4.4 percent of adults in the general population have the disorder, of which an estimated two-thirds are men. Birch said the number of exemptions the N.F.L. has granted for players who need treatment for A.D.H.D. is “almost certainly fewer” than 4.4 percent of those in the league.

The rates of those with the disorder fall as people get older; it is far more prevalent in children and adolescents. A report from the Centers for Disease Control and Prevention, using input from parents, found that as of 2007, about 9.5 percent or 5.4 million children from ages 4 to 17 had A.D.H.D. at some point. That was an increase of 22 percent from 2003. Boys (13.2 percent) were more likely to have the disorder than girls (5.6 percent).

Of children who currently have A.D.H.D., 66.3 percent are receiving medication, with boys 2.8 times more likely to receive medication. Those 11 to 17 years old are more likely to receive medication than younger children.

But Adderall, categorized by the Drug Enforcement Administration as a Schedule II controlled substance because it is particularly addictive, is also used by college students and even some high school students to provide extra energy and concentration for studying or as a party drug to ward off fatigue.

Dr. Leah Lagos, a New York sports psychologist who has worked with college and professional athletes, said she had seen patients who have used Adderall. She said she believed the rise in its use by professional athletes mimicked the use by college students. Just a few years ago, she said, it was estimated that 1 in 10 college students was abusing stimulants like Adderall and Ritalin. That estimate, Lagos said, has almost doubled.

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After a billion, what next for Facebook?

MENLO PARK — In just eight years, Facebook signed up more than half the world's Internet population.

Now it's going after the rest.

Facebook wants to reach every single person on the Internet whether they are logging on from a laptop in Santa Monica, an iPhone in Tokyo or a low-tech phone with a tiny screen in Nairobi.

It's parachuting into market after market to take on homegrown social networks by currying favor with the locals and venturing where many people have spotty — if any — access to the Internet.

In Japan, it lets users list their blood types, which the Japanese believe — like astrological signs in the Western world — give insight into personality and temperament. In Africa, Facebook markets a stripped-down, text-only version of its service that works on low-tech mobile phones.

International growth is crucial to maintain its dominance as the world's largest social network. The company's scorching pace of growth has cooled especially in the United States. Facebook must coax users to sign up — and make sure it remains popular with the users it already has — or risk being knocked from its lofty perch.

"We're not a company that is just trying to add more people," said Chris Cox, Facebook's vice president of product. "What we are trying to do is build a service that everyone in the world can use."

But overseas growth that once seemed to come so easily is slower now. Facebook has already saturated most major markets around the globe. Eight out of 10 Facebook users are outside of the U.S.

"I don't think that Facebook has a chance of attracting another billion users," Wedbush Securities analyst Michael Pachter said.

Inside Facebook's Menlo Park, Calif., headquarters is a small army out to prove naysayers wrong. Above their desks they have hung flags from around the world that represent their nationalities. They obsessively scan screens that track user growth around the world.

They cheered and popped open champagne in September when the number of active Facebook users crossed 1 billion. But the moment of jubilation quickly passed as they redoubled their efforts to spread Facebook around the globe.

Naomi Gleit is the soft-spoken, headstrong 29-year-old product manager in charge of growth at Facebook. She says Facebook's future is on mobile devices, the medium by which most people will experience the Web in coming years. Facebook now works on more than 2,500 different phones, helping it gain a foothold in emerging markets. And it is forging relationships with mobile phone operators around the world.

Gleit's 150-member team has boots on the ground in far-flung places armed with low-tech phones and cheap data plans. Even team members here carry Nokia phones alongside their iPhones to update their status or check their News Feed.

"We originally built a product for ourselves," Gleit said. "This is different. Now we need to understand the experience of users who are not like us."

Analysts say Facebook already has established an impressive track record of uprooting entrenched competitors. In Britain, it displaced the dominant social network Bebo, forcing AOL to sell it at a huge loss. In Germany, Facebook overtook the homegrown StudiVZ. Facebook even broke Google social network Orkut's stranglehold on Brazil and India.

In 2009, it launched a clever tool to help Facebook users find their Orkut friends on Facebook and instantly send them friend requests. Two years later it swiped Google's top executive in Latin America, Alexandre Hohagen. Facebook sprinted ahead of Orkut one year ago, and now has 61 million active users in Latin America's largest country.

Facebook is treating India as a test lab for how it can spread in other emerging markets such as Indonesia. Facebook, which has offices in Hyderabad, India, has grown from 8 million users in 2010 to 65 million users today. It is aggressively targeting India's youth. A few hundred young Indian programmers recently jammed a Facebook hackathon at a Bangalore convention center to chug chai and brainstorm new apps that would appeal to their friends.

But Facebook has its eyes on a much bigger prize beyond the country's 100 million Internet users: the 900 million-plus Indians on mobile phones. Some analysts predict India will have more Facebook users than any other country including the United States by 2015.

The company also faces significant challenges in India. It must make the service captivating on low-tech mobile phones with unreliable Internet connections and it must gingerly navigate demands from the Indian government to remove objectionable content without alienating users.

Facebook is making some of its biggest moves in Russia, South Korea and Japan, the only major markets where it operates but has penetration of less than 50%, according to research firm ComScore.

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South L.A. frustrated by delays in building new King hospital

Earlier this year, Joane Austin rushed her elderly mother to the emergency room for fear she was having a heart attack.

Austin normally would have made the short trip to Martin Luther King Jr./Drew Medical Center, the landmark hospital in South Los Angeles. But King/Drew has been closed for five years, so Austin drove several miles to the emergency room at Centinela Hospital Medical Center in Inglewood.

"I prayed all the lights would stay green," she said. "It was scary."

Once they arrived, doctors determined that Austin's mother needed emergency surgery to remove scar tissue around her intestines.

For years, King/Drew provided emergency, trauma and inpatient care to residents from throughout South Los Angeles. After a series of medical errors resulted in patient deaths, Los Angeles County closed it in 2007. County officials promised the community a better, safer new medical center in a few years.

But the opening has been repeatedly delayed, and the community is still waiting. Originally, officials hoped to have the new facility ready by 2010. Then it was pushed to 2012. Now, officials say they plan to have construction completed next year and the hospital opening its doors in 2014.

Without a nearby hospital, patients have had to travel to such places as Bellflower, Inglewood and Long Beach for emergency room and inpatient care.

Several local hospitals — California Hospital Medical Center, L.A. County/USC Medical Center and Harbor-UCLA Medical Center — received an influx of former King patients after the closure. The closest hospital, St. Francis Medical Center in Lynwood, reported an increase of 20% to 30% in emergency room visits since King/Drew closed, though other factors also may have contributed to the rise.

Getting to other hospitals has presented a challenge for many in the low-income neighborhood, said William Hobson, president and chief executive of the Watts Healthcare Corp. "Just the fact that it is a long way away may discourage them from going," he said.

The closure of King/Drew, which was born out of the Watts riots and opened in 1972, created a healthcare gap in a community where rates of chronic disease are high and vast swaths of the population lack insurance, said David Carlisle, president of the adjacent Charles R. Drew University of Medicine and Science. South Los Angeles has a shortage of doctors, inpatient beds and outpatient services, according to both experts and research.

Despite King/Drew's many medical lapses, which earned it the nickname "Killer King," many in the community remained fiercely loyal to the hospital and the services it provided.

Studies examining the impact of King/Drew's closure found that it led to delays in care for elderly blacks and Latinos and a dramatic increase in patient admissions at other trauma centers. Physicians throughout the county also reported more overcrowding in other emergency rooms and said they saw sicker patients who didn't know where to go or couldn't afford transportation elsewhere.

"It is fearful to think about how many lives may have been saved had this thing been opened by now," said Lark Galloway-Gilliam, executive director of the advocacy group Community Health Councils. "It shouldn't take five years to build a facility."

Patrick Wooten, 49, went to St. Francis when he had a dislocated kneecap a few years ago. Wooten, who is uninsured, said he received good care at the private hospital but then got a $3,200 bill. Wooten said he is frustrated that the new King hospital still hasn't opened and won't until 2014. "What you do until then, God only knows," he said. "Hopefully we can wait it out."

Last year, Sandira Gonzalez, 29, took her 5-year-old son to the Martin Luther King urgent care center when he had a fever. But when the center closed for the night, her son had to be taken by ambulance to Harbor-UCLA near Torrance, where he was treated for an infection.

Community members and advocates said they are disappointed by the long wait, caused by a combination of bureaucratic delays and the complexity of the project. But when it does open, they said, they are hopeful that it will be a better, and safer, hospital.

The county is building the hospital and will help support it financially but will not be responsible for day-to-day operations. Instead, an independent, nonprofit organization will run the facility, to be known as Martin Luther King Jr. Community Hospital, and the University of California will help staff it and ensure the quality of patient care. Construction is progressing, but the grand opening may still be nearly two years away.

"It will be a significantly different kind of institution, with the right kind of accountability," said Robert K. Ross, president and chief executive of the California Endowment. "Now we just need the institution to open up on budget and on time."

Los Angeles County Supervisor Mark Ridley-Thomas said it takes time to create a state-of-the-art hospital — and a whole medical complex — that could become a model for others around the nation. "A lot of eyes are on this," he said. "We want to do this well and we want to do it right.... Nothing else is acceptable."

The nonprofit's board recognizes how critical the facility is to the area, said board President Manny Abascal. "Every day this hospital is not open, people are suffering," he said. At the same time, he added, the board is committed to ensuring that the new hospital is a high-quality institution. "If you open it … and there are some of the same problems you had before, then it's going to be devastating," he said.

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Glen Campbell considering more live shows in 2013

NASHVILLE, Tenn. (AP) — Glen Campbell may be wrapping up a goodbye tour but that doesn't mean he's done with the stage.

Campbell is considering scheduling more shows next year after playing more than 120 dates in 2012.

The 76-year-old singer has Alzheimer's disease and has begun to lose his memory. He put out his final studio album, "Ghost on the Canvas," in 2011 and embarked on the tour with family members and close friends serving in his band and staffing the tour.

Campbell's longtime manager Stan Schneider said in a phone interview from Napa, Calif., where the tour wrapped for the year Friday night, that recent West Coast shows have been some of the singer's strongest. Campbell will break for the holidays and if he still feels strong he'll begin scheduling more shows.

___

Online:

http://glencampbellmusic.com

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Cut Medicare and Social Security? What's the rush?

The question that normally comes to mind when someone claims to know the future is why he's out hustling rubes for pennies with his purported clairvoyance, instead of using it to make a fortune and retiring to the South Seas.

Of course, the answer is that nobody ever does know the future. And that leads to the question of why so much of the "fiscal cliff" debate in Washington is based on supposedly perfect knowledge of conditions that are 20, or even 70, years away.

We're talking about projections of the cost of "entitlements" — a noxious way of referring to Medicare and Social Security, excellent programs that most workers have paid for during their careers and that have kept millions of Americans healthy and out of poverty.

The customary talking point by the anti-deficit lobby is that the rising cost of these programs will eat us alive. That future, the argument continues, is coming at us like an onrushing train, so to avoid having to cut benefits when it arrives, we best cut benefits now.

The element of haste is a crucial element in this debate. That's because as real estate brokers and late-night TV hucksters know, pressure to Act Now! is what leads their marks to overlook that the basic premise is bogus.

Consider the prevailing assumptions about the future of Social Security and Medicare. One is that Social Security's trust fund will run dry in 2033, at which point the money coming in from payroll taxes will be enough to cover only about 75% of currently scheduled benefits. Will this happen? It might, but it might not:

The program's trustees, who are the source of the projection, don't bet the farm on it. They also project that under certain conditions of economic and employment growth — all of them perfectly plausible — it might never run dry. You don't hear much about that projection because it doesn't fit into the narrative that Social Security is "going broke."

Healthcare costs, with Medicare and Mediaid as big components, have been projected to rise to as much as 40% of gross domestic product by 2082 if not restrained. That's a fearsome prospect, but it's based on a long-outdated forecast by the Congressional Budget Office, which doesn't use the same methodology anymore. It was highly implausible, if not impossible, in the first place.

That CBO projection, like others employed by the anti-"entitlement" lobby to push for gutting the program, relied on projecting past experience into the future without adjusting for changes in behavior or policy.

This is a common fallacy well understood by pollsters. They know that if you ask people what the future will look like, they'll describe something that looks like today, except more so. If street crime is in the news, for example, they'll posit a future in which every community looks like Deadwood.

Investment experts try to moderate this tendency by reminding clients that trees don't grow to the stratosphere. To put it another way, just because your son is 4 feet tall at age 6 doesn't mean he'll be 12 feet tall at age 18. And just because the average American born today will live to the age of 78 doesn't mean that a baby born in 2032 will live to 100.

These questionable forecasts result in the nauseating spectacle of corporate CEOs such as Lloyd Blankfein of Goldman Sachs lecturing Americans that the retirement benefits and elder healthcare coverage they've paid for during their working lives are things we "can't afford."

Blankfein didn't worry about what the country could afford when Goldman pocketed $12.9 billion in taxpayer funds to cover its losses in the collapse of insurance giant AIG. But there he was on CBS on Nov. 19, saying, "You...have to do something to lower people's expectations — the entitlements and what people think that they're going to get, because they're not going to get it."

Blankfein proceeded to lecture his interviewer that Social Security "wasn't devised to be a system that supported you for a 30-year retirement after a 25-year career." This is fair enough, one supposes, though it's a mystery where Blankfein gets the idea that the average retiree today has spent only 25 years in the workplace, rather than 45, and lives to the age of 95. Does Goldman Sachs do all its math this way?

The Social Security projection is probably the most misused and misunderstood statistic in the fiscal-cliff debate. The trustees warn every year that its forecast is "inherently uncertain." They warn that it's a melange of projections of at least 17 factors, including fertility and mortality rates, economic growth, unemployment, wages and life expectancy, many of which are interrelated.

No one — no business, no government agency — makes plans today based on a vision of the world 20 years from now. IBM doesn't do it. Google doesn't do it. The Department of Defense doesn't do it. You and I don't do it. Not even life insurance companies, which might be said to live in the future, do it.

The reason smart people and companies don't make bets on the distant future is precisely because it's unknowable. Try the following thought experiment: Instead of looking ahead 20 years, look back 20 years, and try to list all the events that have had immense, material effects on today's economy, but were unimaginable in 1992.

Here's my list: 9/11. The Afghan war. The Iraq war. The housing bubble. The crash of 2000. The crash of 2008. The crash of Lehman Bros. The iPod. The iPhone. The iPad. The founding of Google. Hurricane Andrew, Hurricane Katrina, Superstorm Sandy. Obamacare.

What are the chances that another such list will make the U.S. economy in 2033 look utterly different from what we imagine in 2012? I'd say 100%.

Forecasting healthcare costs may be even more of a mug's game. In a 2008 paper, economists Glenn Follette and Louise Sheiner of the Federal Reserve observed that the CBO unwisely projected healthcare costs into the future by assuming that the trends of the past simply would continue.

But the trends of the past had included an unprecedented expansion of public and private insurance coverage, which cut average out-of-pocket spending from 51% of total healthcare outlays in 1960 to 13% in 2005. That created an explosion in demand.

Could the trend continue? Plainly not. The Fed economists also noted that any trend pointing toward healthcare consuming 40% of GDP would have such destructive effect on the rest of the economy that personal behavior or political action would change it before reaching that point. The CBO now acknowledges that.

Healthcare reform has made such projections even more uncertain today, in part because the reform act includes numerous cost-limiting initiatives, the success of which can only be guessed at. That's an argument against taking such radical steps as raising the Medicare eligibility age, as some fiscal-cliff pundits advocate.

Leaving aside that doing so would drive up costsfor employers, states and Medicare participants themselves by more than it would save the federal government (the Kaiser Family Foundation crunched the numbers), it's far too early to know if it's even necessary.

One might argue that the uncertainty of economic forecasts means there's no point in economic planning at all. But there are good reasons for looking ahead, just not good reasons for thinking your vision of the future is 20/20.

And there's a big difference between making a congressional budget and making fundamental changes in programs as complex as Social Security and Medicare. The life span of a congressional budget is two years, max, because no Congress can bind its successors. But changes in Social Security and Medicare are forever. So when you hear that we have to do it now, stat! or we're doomed, take it for the snake oil that it is.

Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at mhiltzik@latimes.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.

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