Insight blames agency’s hurdles and barriers for closure

An Insight spokesman announced the action Wednesday in an email. The move was in response to Ohio Department of Health’s notice on Monday that it would revoke Insight Hospital and Medical Center Trumbull’s license in mid-December if it did not address violations reported Nov. 17 by its inspectors. “The tumultuous Steward bankruptcy significantly affected health care in Trumbull County,” an Insight spokesman wrote. “In those difficult circumstances, Insight has done its best with a non-profit approach to resurrect the hospital.” The state health department, Insight charged, placed “many regulatory hurdles and barriers” in the Warren hospital’s path. “In fact, the department’s roadblocks affected the (Centers for Medicare and Medicaid Services) certification, and then, after affirming compliance with the state hospital license on Oct. 14 prior to reopening, it took additional adverse actions against the hospital,” according to the statement. “We strongly disagree with the Ohio Department of Health’s assessment, insinuations and actions to publicly revoke the hospital license as the clinical and facility care has been outstanding.” Insight charged that ODH’s “inaccurate accusations” have set back the Warren hospital’s re-opening process. “The hospital is not able to function in a sustainable manner,” the Insight email said. “Therefore, hospital operations are suspended and new patients will no longer be admitted until Insight is provided with a clear determination from the Ohio Department of Health as to whether or not there is full permission and support in operating the hospital.” Insight said it had submitted a response to the department’s notice. “Once all issues are resolved, we will be in a position to chart the best plan forward,” it stated. Warren Mayor Doug Franklin said Wednesday that he has maintained contact with Insight officials while monitoring the work done at Insight Trumbull. “I do know that they’re committed to putting the proper investments in the facility, particularly at this front end phase of emergency care that has taken place,” Franklin said. “I know that to be a fact. Once these regulatory issues are cleared up, they’ll be able to function properly. “I do understand without the CMS certification in hand and those regulatory questions why they made a decision, even though I don’t like it.” Insight first suspended operations at 3 p. m. March 27 at all of its county locations, including Insight Rehabilitation Hospital Hillside, Howland. As part of its reopening plan, Insight pursued certification through CMS, a federal agency that provides coverage reimbursement to facilities serving Medicare and Medicaid patients. A phone call took place the morning of Oct. 14 in which U. S. Sen. Bernie Moreno spoke to ODH Director Dr. Bruce Vanderhoff about the hospital’s status, an ODH spokesman said in an email. At 9: 30 a. m. the state agency gave Insight permission to reopen. Moreno also talked to Dr. Mehmet Oz, head of CMS, about Insight’s federal licensing. The narrative provided to the media was that Medicare and Medicaid certification had been obtained. In fact, CMS terminated ties with Insight Trumbull and Insight Hillside on Oct. 10, according to documents obtained through a public records request. An Insight legal representative discussed the matter July 5. “Insight has received its Medicare license, which paves the way for us to apply through the Ohio Department of Medicaid,” the attorney said. Insight CEO Dr. Jawad Shah spoke with federal, state and local officials Aug. 5 and pledged to reopen Insight Trumbull “within weeks.” Shah said at the gathering Insight had to complete a few steps before opening its East Market Street facility. He said CMS had acknowledged its change of ownership from the now-defunct Steward Health Care and that Insight was waiting to hear from the Ohio Department of Health and the Joint Commission. In an email dated Sept. 24, an Insight representative said that the health system was in communication with CMS. “We’re assessing the pathways they require to allow reopening,” the spokesman said. Trumbull County Commissioner Rick Hernandez called Insight’s announcement disheartening. “We worked very diligently with Insight, spent a lot of time with the Senator, Mayor and other commissioners,” he said. “We were very optimistic after that meeting with Bernie Moreno and Dr. Oz when they reinitiated those licenses. At least, that’s what we heard that day. “We’re hoping that maybe they find a way to reopen.” Tom Connelly, AFSCME Local 2026 president, said the closing didn’t surprise him, but its timing did. “I’m just surprised that it comes about when all my people are planning for the holidays,” he said. “I mean they just announced we’re open now and then we’re going to be closed. I just drove by the hospital, and it’s boarded up tight. “So I don’t know what’s to become of us here.” AFSCME Local 2026 represents more than 200 nurses who worked at Insight Trumbull before being laid off at the end of March. He said that at the time of Wednesday’s announcement 24 nurses had returned to work. “I just don’t know how you can work with people who lie,” Connelly said of Insight’s management. “They said that our Medicare and Medicaid was all solid now. And it was just a big falsity. “I don’t know how they think that helped anybody, because it didn’t. Even if the truth is bad, we would much rather deal with the truth.” The Ohio Nurses Association, representing Insight Hillside workers, said the closure is “a grievous blow to the residents of Warren, Trumbull County and surrounding communities. “This is more than mismanagement it is a reckless gamble with the health and well-being of patients, especially those who depend on local hospital services for emergency, acute, and rehabilitative care.” The association directed its ire at Insight leadership. “This is the direct result of Dr. Shah’s decisions and Insight’s inability or unwillingness to operate these hospitals with even the minimum level of competence or responsibility that patients, nurses, and health professionals deserve,” a union spokeswoman said. Rick Lucas, association president, said that lives are at risk without functioning hospitals. “We cannot allow corporate failures to turn this region into a health care desert. Hillside must be reopened, Trumbull Regional Medical Center must be reopened, and they must be operated by a responsible, competent health care organization that actually cares about its mission to provide safe, high-quality patient care.”.
https://www.tribtoday.com/news/local-news/2025/11/insight-blames-agencys-hurdles-and-barriers-for-closure/

Richard Ray Casseday, Sr.

Richard Ray Casseday, Sr., 87, of Morgantown, passed away peacefully Monday, November 24, 2025, in Sundale Nursing Home in Morgantown. He was born February 5, 1938, in Masontown, a son of the late Roy Casseday and Josephine Molissee Casseday. Richard was a devoted outdoorsman, who found joy in hunting and spending time in nature. He loved to sing and took great pride in building and creating with his hands. Above all, Richard treasured time spent with his family, and those moments brought him his greatest happiness. He is survived by his loving wife, Carolyn Burns Casseday; five daughters, Heather Rossetti and husband James, Hope Gage and husband Geoffrey, Dorothy Knight and husband Jay, Sara Dennison and husband Tim, and Martha Casseday; daughter-in- law, Marcie Casseday; 11 grandchildren, Tricia, Crystal, Alex, Richie, Tyler, Nathan, Maxwell, Brooks, Jillian, Vincent, and Lucia; many great- grandchildren; two brothers, Phil Casseday and Bob Casseday; two sisters-in-law, Diane Casseday and Iva Casseday; and several nieces and nephews. In addition to his parents, Richard was preceded in death by his first wife, Vinnie Casseday; one son, Richard Casseday, Jr.; six brothers, Junior Casseday and wife Betty, Fred Casseday, Lynn Casseday and wife Kathleen, Jim Casseday, Dale Casseday; and Daniel Casseday, and three sisters, Eva Shaffer and husband Albert, Arlene Molissee and husband Dave, and Doylene Davis and husband Bob. The family would like to extend its gratitude to Sundale Rehabilitation and Long-Term Care for the compassionate and extraordinary care of Richard over the last three years. To honor the families wishes, there will be private services and burial. The Field Funeral Home in Masontown is honored to be assisting Richard’s family. In lieu of flowers, donations, in Richard’s memory, may be made to Sundale Rehabilitation and Long-Term Care, 800 J. D. Anderson Drive, Morgantown, WV 26505; or to the Alzheimer’s Association at www. alz. org Condolences may be extended to the family at www. fieldfuneralhome. com.
https://www.dominionpost.com/2025/11/26/richard-ray-casseday-sr/

5 clear signals that will prove if the Bitcoin bull run is still alive

Crypto Twitter is filled with claims that “everyone is buying Bitcoin,” from Michael Saylor and BlackRock to entire countries and even banks. Yet despite these accumulation narratives, Bitcoin’s price has slipped sharply, breaking below key levels as ETF flows turned negative.

This contradiction between bullish headlines and falling prices emphasizes a crucial point: in markets driven by liquidity and marginal flow, who’s actually buying, and when, matters far more than who says they are.

### Bitcoin Price Breaks Key Levels Amid Negative ETF Flows

Bitcoin fell through $106,400 as spot ETF flows turned negative over four consecutive sessions. The shift came as BlackRock’s IBIT logged redemptions totaling $714.8 million over the last four days, removing a significant source of daily demand right as a widely watched cycle pivot gave way.

According to Farside Investors, the outflows of $88.1 million, $290.9 million, $149.3 million, and $186.5 million coincided with this breakdown. These redemptions forced selling by authorized participants who redeemed shares for underlying Bitcoin and offloaded them into the market, flipping the net flow.

When creations slow and redemptions rise across the U.S. spot ETF complex, the daily bid that helped absorb volatility turns into a source of supply.

### Fund Flows and Market Impact

Mid-October saw stretches of net outflows across digital asset funds as Bitcoin struggled to stay above $106,400. While there were brief inflow days late in the month, the recent trend has tilted back into the red—a pattern aligning with IBIT’s data.

The mechanical impact matters because ETF flow translates into spot buys or sells. The timing overlaps with a break of a key level many traders use to distinguish a late-cycle pullback from a trend resumption.

### Derivatives and Macro Factors Add Pressure

Derivatives added further pressure on Bitcoin’s price. The CME three-month futures premium cooled to roughly 4-5% annualized over the back half of the year, curbing carry-trade incentives that typically pull institutional basis demand into rallies.

Simultaneously, funding on perpetual swaps softened or turned negative at points, accelerating down moves when longs de-risk and liquidations cluster.

In this climate, slow, scheduled spot accumulation by corporates or sovereign entities does not offset forced liquidations on leverage or redemptions on regulated products that directly translate to spot selling.

### Macroeconomic Headwinds

Macro factors have not eased the path. The U.S. Dollar Index rebounded toward the 98-100 range in November after a weak first half, while the U.S. 10-year yield remains near 4.1%, keeping real rates restrictive.

A firmer dollar and tight real yields tend to compress global liquidity and weigh on long-duration risk assets. Bitcoin continues to respond to these impulses at tactical horizons. When flows are roughly flat, the dollar often determines whether a bounce holds or fades.

### Supply Overhang and Miner Selling

Supply narratives also persist. The Mt. Gox rehabilitation timeline was extended to October 31, 2026, following partial distributions earlier this year, maintaining a recurring overhang even if actual sales are staggered. Periodic trustee updates and wallet movements repeatedly tighten risk tolerance on rebounds.

Miners remain another pressure valve. Post-halving economics have left hashprice near cycle lows relative to the spring spike, creating ongoing incentives for treasury monetization on stress days. This can compound selling pressure, especially when funding softens procyclically.

### Cycle Context: The Bull-Bear Pivot Lost

Cycle framing helps tie these pieces together. Recently, $126,000 was called the cycle high and $106,400 the bull-bear pivot. The price just lost that pivot as ETF bids turned into net selling, while basis stayed subdued and funding cooled.

Interestingly, common on-chain and cycle monitors—such as the 2-Year MA Multiplier, Pi Cycle Top, and RHODL—have failed to reach euphoria this cycle, even near the highs. Metrics are already slipping toward distribution and mean reversion as flow support fades.

This could mean the bull run will be extended this cycle or represent diminishing returns compared to prior transitions. These tools are not standalone timing devices. However, when they align with daily flow inflection and macro stiffness, traders tend to withdraw liquidity, amplifying the impact of incremental sells.

### Why Is the Price Falling If Big Players Are Buying?

Why is the price falling if BlackRock, corporates, or countries are buying? The flow math provides a direct answer.

– Nation-state purchases are episodic and small compared to daily turnover.
– Corporate treasuries operate on idiosyncratic schedules.
– Banks often facilitate client activity rather than deploying balance sheet risk daily.

None of these actors offset a week where issuers that normally create shares instead redeemed, funding drifted toward or below zero, and the dollar firmed. In this mix, the marginal seller rules the tape.

### What’s Next for Bitcoin’s Near-Term Path?

The near-term path depends on whether spot creations reappear and the basis expands.

– **Continued net outflow days** from the largest U.S. spot ETFs, especially IBIT and FBTC, combined with CME basis near or below 5% annualized and flat to negative funding, would keep the market in a distribution phase. Under this setup, failing to reclaim $106,400 leaves $100,000 as a battleground and opens mid to high $90,000s on further red sessions, particularly if macro conditions stay tight.

– A **more neutral outcome** with oscillating smaller flows, basis stabilizing in the 5-7% zone, and a range-bound dollar around 97-100 suggests digestion between $100,000 and $106,000 while liquidity rebuilds.

– The **upside case** requires a return of multi-day net creations in the $300 to $800 million range across the complex, pushing basis above 8-10% annualized, and a softer dollar. This scenario could trigger a retest of $110,000 to $115,000 and reopen debate around the cycle top if flows persist.

### How to Tell If the Bitcoin Bull Run Is Still Going

Monitoring several indicators helps gauge the health of the current bull run:

– **ETF Flows (Farside data):** Sustained multi-day creations from major issuers like BlackRock’s IBIT or Fidelity’s FBTC signal renewed demand. Continued redemptions or flat prints confirm the bid turned into supply.

– **Fund Flows (CoinShares report):** Broad inflows across digital asset funds, especially led by Bitcoin, indicate institutional rotation back into risk. Persistent outflows or concentration in defensive altcoins point to capital retreat.

– **Leverage Conditions (CME basis and funding):** A rising basis (above ~7-8% annualized) and positive, stable funding suggest appetite for directional risk, typical in bull phases. Flat or negative setups imply deleveraging and distribution.

– **Macro Liquidity (DXY and 10-year yield):** A weaker dollar (DXY below 97) and easing yields open liquidity channels that historically underpin bullish momentum. Strength in either metric tightens liquidity, pressuring crypto beta.

– **Mining Supply Pressure (Hashprice trends):** Rising hashprice and stable or falling miner selling hint that the market is comfortably absorbing new supply, a bullish signal. Collapsing hashprice or spikes in miner transfers to exchanges often mark stress within uptrends.

### Recent Spot-ETF Flows Summary (BlackRock’s IBIT)

| Date | Net Flow (USD millions) |
|———|————————-|
| Oct 29 | -88.1 |
| Oct 30 | -290.9 |
| Oct 31 | -149.3 |
| Nov 03 | -186.5 |
| **Total** | **-714.8** |

The last four trading days flipped the spot-ETF bid into a sustained net seller, exactly as Bitcoin lost its pivot. With CME basis subdued and funding soft, the marginal price was driven by de-risking rather than dip-buying. A firmer USD and sticky real yields rounded out a flow-led break—not a referendum on long-term adoption.

Until daily creations return and $106,400 is reclaimed, this remains a distribution and digest phase within the broader cycle.

### Looking Ahead: The Cycle Pattern and Long-Term Outlook

Unless the historic Bitcoin cycle pattern has been disrupted by corporate treasuries and ETF flows, Father Time has already spoken. If Bitcoin were to reach a new all-time high by the end of this year or in 2026, it would mark the latest cycle high ever recorded.

For now, staying focused on daily issuer-level flows, derivatives positioning, and macroeconomic factors remains critical for understanding Bitcoin’s trajectory.

*Stay tuned for updates as market dynamics evolve.*
https://bitcoinethereumnews.com/bitcoin/5-clear-signals-that-will-prove-if-the-bitcoin-bull-run-is-still-alive/

Mt. Gox Delays Creditor Repayment to October 2026

Defunct crypto exchange Mt. Gox announced on Monday that it has extended the creditor repayment deadline by one year, moving it from October 31, 2025, to October 31, 2026.

The announcement stated, “As it is desirable to make the repayments to such rehabilitation creditors to the extent reasonably practicable, the Rehabilitation Trustee, with the permission of the court, has changed the deadline for the repayments from October 31, 2025 to October 31, 2026.”

Aside from a few specific types of repayments, the trustee has largely completed the main repayment phases. These include the Base Repayment, Early Lump-Sum Repayment, and Intermediate Repayment, which have been paid to creditors who completed the required steps and encountered no issues during the process.

As of writing, Bitcoin (BTC) was trading at $111,540, according to CoinDesk data.
https://www.coindesk.com/markets/2025/10/27/mt-gox-delays-creditor-repayment-to-october-2026