Restricted Counties-Delta, Franklin, Red River, Hopkins, Bowie, Morris, Titus, Cass, Camp, Rains, Upshur, Marion, Van Zandt, Smith, Gregg, Harrison, Henderson, Anderson, Cherokee, Rusk, and Panola. Patient population includes total hip replacement, total abdominal hysterectomy, thyroidectomy, colectomy, sepsis, CHF, AFib RVR, CVA, ETOH withdrawal, and HTN crisis.