HCAs trauma center expansion makes superior care available to more patients, providing lifesaving clinical services while treating all critically injured patients, said company spokesperson Harlow Sumerford. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate pricing for the services provided. You can cancel at any time. HCAs stock has doubled in three years. She has explained to me that if I leave, I might have to pay back the retention bonus. HCA runs trauma centers really well, said Winchell, who runs the Level I trauma center at NewYork-Presbyterian Weill Cornell Medical Center. By splitting a limited number of cases, a competing, cross-town trauma center could set the stage for subpar results at both hospitals, goes the argument. VCU has run the regions only Level I facility for decades. These rewards include competitive salaries and benefits, leadership development programs, education assistance, paid family leave benefits and much more. HCA Virginia Health System makes no guarantees regarding the accuracy of the pricing information provided herein. By splitting a limited number of cases, a competing, cross-town trauma center could set the stage for subpar results at both hospitals, goes the argument. We focus on keeping benefits fair, smart and competitive with a full package of rewards that support your health, life, career and future. Last year, 85% of Med-Trans flights for Virginia patients with health insurance were in-network, said a company spokesperson. Since 1972, Chippenham Hospital has been committed to providing a wide range of services to the residents of Central Virginia. Theyre driven by the motive to keep the stock price high.. Online Payment; Careers; Contact Us; CJW Medical Center - Chippenham Hospital. (Julia Rendleman for KHN). I am mid treatment and I don't feel any better. Hourly Rate: $20 - $45. That strategy in turn feeds surgical growth. We hope that through our online financial resources, you can make more informed healthcare choices and better understand your potential financial obligations when visiting our facility. The pay scale is poor and there is a lot of turnovers. Researchers call it the practice makes perfect effect. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures and non-hospital related charges, any of which may increase the ultimate pricing for the services provided. MyHealthONE is our secure online patient portal where you can manage your health and the health of your loved ones. Eleven Virginia lobbyists are registered with the state to advocate on HCAs behalf. 1401 Johnston Willis Dr, Richmond, VA 23235. The biggest U.S. hospital operator along with the Department of Veterans Affairs, HCA has opened trauma centers in more than half its 179 hospitals and says it runs 1 of every 20 such facilities in the country. After cutting his arm in a fall from a ladder, Ed Knight, 71, was taken to HCA Healthcares Chippenham Hospital in South Richmond. You can even set up automatic, recurring payments. That strategy in turn feeds surgical growth. Our model gets smarter over time as more people share salaries on Glassdoor. Chippenham Hospital met the requirements to become a Level I center, he said. Does anyone currently work at Molina or have in the past? Find answers to many of your billing questions by reading our frequently asked questions. In a process shielded from public view in Virginia, Chippenham recently applied for and won the highest trauma center designation, Level I, providing the most sophisticated care and putting it squarely in competition with nearby VCU Health. News headlines called it trauma drama. Hospitals with existing centers repeatedly filed legal challenges to stop the expansion, with little effect. Instead of letting a drive for profits dictate trauma center expansion, health authorities need objective and transparent metrics to guide the designation of trauma centers, Winchell recently wrote in the Journal of the American College of Surgeons. I am having a difficult time working due to SOB and chronic fatigue. We know your time is valuable, so we offer convenient online registration for services such as surgical procedures, mammograms and diagnostic tests and treatments. To discuss options for financial assistance or payment for participating Atrium Health locations, please call our Patient Customer Service department at 704-512-7171 or 1-844-440-6563. Chippenham Emergency Department - Adults: Chippenham Emergency Department- Pediatrics: Chippenham Health Information Management: Chippenham Patient Rooms: (804) 483-4 + room number. Learn about the most common type of poisoning and what to do if you or someone else has been exposed to a poisonous substance. Blunt-trauma patients are generally victims of car accidents and falls and tend to have good insurance, analysts say. Copyright 1999-2022 C-HCA, Inc.; All rights reserved. Chippenham Hospital welcomes your questions, calls and emails. Given his minor injury, the $17,000 trauma activation fee is not necessary, said Dr. Ira Weintraub, WellRithms chief medical officer. The status allows a cascade of lucrative reimbursement, including activation fees billed on top of regular charges for medical care. We have more Level I, Level II trauma centers today than we have ever had in the company history, HCAs then-CEO, Milton Johnson, told stock analysts in 2016. One lobbyist spent more than $5,000 from December 2019 through February 2020 treating public officials to reception spreads and meals at posh Richmond restaurants such as L'Opossum and Mortons the Steakhouse, lobbying records submitted to Virginias Conflict of Interest and Ethics Advisory Council show. Please subscribe to keep reading. VCU has run the regions only Level I facility for decades. Any prospective patient should understand that a final bill for services rendered at HCA Virginia Health System may differ substantially from the information provided by this website. You have permission to edit this article. What makes the Justices so elite? How to support someone with an eating disorderkeyboard_arrow_right, The most common type of poisoning and when to go to the ERkeyboard_arrow_right, 5 St. Patrick's Day recipes to try this yearkeyboard_arrow_right, Managing chronic foot pain with simple lifestyle changeskeyboard_arrow_right. We strive to celebrate cultural and other differences and consider them strengths of the organization.We are committed to: Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, gender, national origin, citizenship, age, disability, sexual orientation, genetic information, gender identity, protected veteran status, or any other legally protected category in accordance to applicable federal, state, or local laws. The gash wasnt life-threatening and required about 30 stitches, but his injury activated an emergency team in the Level I trauma center and the bill came to $52,238. Providing an inclusive work environment where everyone is treated with fairness, dignity and respect. The Virginia Department of Health rejected KHNs request to review HCAs Chippenham trauma center application and related documents. There is no standard accounting for trauma-related costs incurred by hospitals. Salary information comes from 12 data points collected . Data collected by the state of Florida, analyzed by KHN, shows that regional trauma cases and expensive trauma bills rise sharply after HCA opens such centers, suggesting that many patients classified as trauma victims would have previously been treated less expensively in a regular emergency room. Has anyone here ever had latent TB? After launching Level II centers across the state, HCA officials urged Florida regulators not to adopt CDC guidelines recommending severely injured patients be treated at the highest level of trauma care in a region Level I, if available. I need to get out from this toxic work environment. One method involves multiplying hourly pay for members of the trauma team by the potential hours worked. HCA's substantially higher charges didn't necessarily result from patients with especially severe injuries, public university research found. Access your health information. John Marshall boys basketball reclaims No. (Julia Rendleman for KHN), Ed Knight was taken to Chippenham Hospital after cutting his arm in a fall from a ladder. After falling from a ladder and cutting his arm, Ed Knight said he found himself at Richmonds Chippenham Hospital surrounded by nearly a dozen doctors, nurses and technicians its crack trauma team charged with saving the most badly hurt victims of accidents and assaults. About Us 7101 Jahnke Rd, Richmond, VA 23225 (804) 483 - 0000 Average ER wait as of 12:14pm PST 7 mins Our top priority is always you. The pricing information provided by this website is strictly an estimate of prices, and HCA Virginia Health System cannot guarantee the accuracy of any estimates. More than half the companys revenue in 2020 came from private insurers, regulatory filings show. Chippenham Birthing Centre Appointments Line: 01249 456467 (Monday - Friday, 9.00am - 1.00pm/Closed weekends and bank holidays) Midwife Office: 01249 456434 Opening Times (Daily) 8.00am - 8.00pm (please note you can access the Birthing Centre 24/7 by calling the Midwife Office number) HCAs expansion into trauma centers alarms health policy analysts who suggest its motive is more about chasing profit than improving patient care. Hospitals, in general, collect a little more than a third of their revenue from private insurers, according to the U.S. Department of Health and Human Services. The bills for all this reaching into tens of thousands of dollars go to private insurers, Medicare or Medicaid, or to patients themselves. This data is based on 16 survey responses. Whats going on with HCA is the Wall Street model theyre following, said Pracht, who provided KHN with additional Florida Department of Health data showing soaring trauma cases. Intensive inpatient treatment and long patient recoveries add to the income. At Chippenham, in south Richmond, trauma cases are 90% blunt trauma, according to the hospital's online job posting last year for a trauma medical director. Get up-to-the-minute news sent straight to your device. VCU Health charges up to $13,455 for trauma activation, according to its charge list. But Med-Trans is out of network for Virginia members of Aetna and UnitedHealthcare, two of the states biggest carriers, said spokespeople for those companies. Over three years ending in 2014, Florida patients with sprains, mild cuts and other non-life-threatening injuries were significantly more likely to be admitted under trauma alerts at HCA hospitals and other for-profit hospitals than at nonprofit hospitals, according to research by University of South Florida economist Etienne Pracht and colleagues. MyHealthONE is your secure, online health portal to find your most recent imaging results, view hospital lab results, pay your hospital bills and more. I am a physician interested in HCA employment opportunities. The number of VCUs admitted adult trauma patients decreased from nearly 3,600 in 2014, before Chippenham attained Level II status, to 3,200 in 2019, VCU officials said. After launching Level II centers across the state, HCA officials urged Florida regulators not to adopt Centers for Disease Control and Prevention guidelines recommending severely injured patients be treated at the highest level of trauma care in a region Level I, if available. Chippenhams air ambulance partner, private equity-owned Med-Trans, has been the subject of numerous media reports of patients saddled with tens of thousands of dollars in out-of-network surprise bills. Chippenham Hospital 7101 Jahnke Rd Richmond, VA 23225 Tel: (804) 323-8820 Visit Website Accepting New Patients: No Medicare Accepted: No Medicaid Accepted: No Physicians at this location. HCA Virginia Health System is committed to providing useful information to our patients so you can understand the financial side of your healthcare needs. HCA Virginia Health System makes no guarantees regarding the accuracy of the pricing information provided herein. It is ACS-verified as a Level II center and, Caldwell said, is seeking Level I status with ACS. Patients at HCAs largely suburban hospitals are more likely than those at an average hospital to carry private insurance, which pays much more than Medicare and Medicaid. Reasonable charges for Knights total bill would have been $3,537, not $52,238, according to the analysis by WellRithms, a claims consulting firm that examined his medical records and Chippenhams costs filed with Medicare. Chippenham Hospital Employee Directory. Charges for trauma activations, also known as trauma alerts, for HCAs Florida hospitals averaged $26,890 for inpatients in 2019 while the same fees averaged $9,916 for non-HCA Florida hospitals, the data shows. To learn more about MyHealthONE, visit us at MyHealthONE.com. 1 ranking in country. Any suggestions? Chippenham & Johnston-Willis Hospitals are members of the HCA Healthcare network. Theyre driven by the motive to keep the stock price high.. It was clear that their trauma activation fees were five or six times larger than ours.. Basically, it was just a gash on my arm, said Knight, 71. The average Chippenham Hospital hourly pay ranges from approximately $19 per hour for, Chippenham Hospital employees attributed a compensation and benefits rating of 3.5/5 stars to their company. Med-Trans is part of Anthem Blue Cross Blue Shields network, an Anthem spokesperson said. Any prospective patient should understand that a final bill for services rendered at HCA Virginia Health System may differ substantially from the information provided by this website. Avg. Such charges have made trauma centers, once operated mainly by established teaching hospitals, a key part of the companys growth and profit-generating strategy, corporate officials have said. Request an estimated payment amount for our most commonly scheduled services. A Mechanicsville man charged by Texas authorities in January with soliciting underage girls online now faces charges of possessing child porno, Richmond police detectives are investigating reports that a towing company may have committed widespread fraud, including unauthorized towing . Hospitals dont reveal calculations, but the wide variation in fees suggests they are often set with an eye on revenue rather than true costs, say industry analysts. HCAs EMS liaisons are expected to develop a business plan, driving service line growth, according to its employment ads. Pay your bill online in full or make partial payments with a credit card, checking account or savings account. One method involves multiplying hourly pay for members of the trauma team by the potential hours worked. I live in Houston, TX. Richmonds population is booming, said Chippenham spokesperson Jeffrey Caldwell. After cutting his arm in a fall from a ladder, Ed Knight, 71, was taken to HCA Healthcare's Chippenham Hospital in South Richmond. Sunrise Hospital & Medical Center (Las Vegas . For St. Patrick's Day, this article will highlight recipes that can be made to celebrate the holiday. Once a hospital has a trauma designation, it can charge thousands of dollars in activation fees for the same care seen in the same emergency room, said Stacie Sasso, executive director of the Health Services Coalition, made up of unions and employers fighting trauma center expansion by HCA and others in Nevada. Last year, 85% of Med-Trans flights for Virginia patients with health insurance were in-network, said a company spokesperson. HCA has basically taken a position that all of their hospitals should be trauma centers, said Dr. Robert Winchell, describing conversations he had with HCA officials. What patients actually pay for their hospital care has more to do with their insurance plan than the total charges, he said. HCAs share of statewide trauma cases jumped from 4% to 24%, the data shows. The average Chippenham Hospital salary ranges from approximately $46,649 per year for Nurse to $82,000 per year for Program Director. We make paying your hospital bill quick and easy with our online bill pay system. You can find all jobs here. 0. At HCA-owned Chippenham Hospital and others patients pay thousands more at for-profit trauma centers. Copyright 2008-2023, Glassdoor, Inc. "Glassdoor" and logo are registered trademarks of Glassdoor, Inc. The findings are similar to those reported by the Tampa Bay Times in 2014, early in HCAs trauma center expansion. I already put in my 2 weeks notice to my work place, my supervisor was mad at me because since I just received retention bonus that will expire for a year, shes saying I cant leave. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures and non-hospital related charges, any of which may increase the ultimate pricing for the services provided. Basically, it was just a gash on my arm, said Knight, 71. Find multiple options to make payments, arrange payment plans and get help when you need it. 69-year-old suffers stroke in his N.C. home; Realtor showing house leaves him there. What makes the Justices so elite? HCAs trauma cases can fit the same profile. HCAs political action committee donated $160,000 to state candidates last year, according to the records. Industry: Health Care Services & Hospitals. HCAs substantially higher charges didnt necessarily result from patients with especially severe injuries, public university research found. .css-r1m4lw{background-color:#20262e;border-radius:50%;}.css-r1m4lw > svg > path{fill:#fff;}Add your salary. But there are clearly areas of oversupply for trauma centers generally, he said. As HCA added trauma centers, trauma-activation billings and the number of trauma cases spiked, according to Florida Department of Health data analyzed by KHN. Nowhere has HCA added trauma centers more aggressively or the fight over trauma center growth been more acrimonious than in Florida. They do provide good benefit package. Location Details 7101 Jahnke Road, Richmond, VA 23225 Phone: (804) 483-0000 chippenhammed.com bookmark_border Save Facility RN and LPN Scholarships We care like family. VCU and other urban hospitals, on the other hand, treat a higher share of patients with gun and knife injuries penetrating trauma who are more often uninsured or covered by Medicaid. About 75% of VCUs trauma cases are classified as blunt trauma, hospital officials said. Flexibility to pay online means it's easier to focus on what matters most: your health and wellness. Im currently responsible social determinants of health at my place of work and want to stay in that area or something close to it. Treating trauma patients in the ER is only the beginning of the revenue stream. For technical questions on an application to HCA or an HCA Affiliate only, call (844) 422-5627, then press Option 1. Total average charges, including medical care, were $282,600 per case in 2019 for inpatient trauma cases at HCA hospitals, but $139,000 for non-HCA hospitals. That strategy in turn feeds neurosciences growth, it feeds rehab growth. Trauma centers attract a certain cadre of high-value patients, Dr. Jonathan Perlin, HCAs chief medical officer, told analysts at a 2017 conference. How much do Chippenham Hospital employees make? Emergency Department Technician salaries - 1 salaries reported. Just like a family, we pull together to care for, support and celebrate with each other. But to open or upgrade a trauma center, all thats needed is the approval of the health commissioner after a confidential qualification procedure. johnston-willis hospital. Fired RPS employee sues school district, alleges misuse of federal funds, Farmville native caught with 42 lbs of cocaine, $862K in drug money gets 17 years, Ashland dairy farm announces Farmview Creamery to help modernize business, Diablo Doughnuts dishes up Unicorn Farts and more yeast doughnuts in Glen Allen, Norment, long among the most powerful in the Capitol, is retiring, Bezos 'ban' may speed up Commanders sale as league meeting looms, Mechanicsville man charged with 10 child porn counts, Hundreds may be victims of illegal Richmond towing operation, police say, New biotech can 3D print living cells inside the human body, Ukraine will join NATO but in 'long- term', says NATO chief Stoltenberg, Finland begins building fence along Russia border. The findings are similar to those reported by the Tampa Bay Times in 2014, early in HCAs trauma center expansion. Unlike regular emergency departments, Level I and Level II trauma centers make trauma surgeons, neurosurgeons and special equipment available around the clock. The 90% figure is not accurate today, Caldwell said. Regions only Level I trauma center expansion health care services & amp ; hospitals just a gash my... The records salaries on Glassdoor has hca added trauma centers really well, said Chippenham spokesperson Caldwell!, the $ 17,000 trauma activation fee is not accurate today, Caldwell.. Or savings account explained to me that if I leave, I might have to online! I am having a difficult time working due to SOB and chronic fatigue retention bonus salary ranges from $! Hca healthcare network services & amp ; hospitals Julia Rendleman for KHN ), Ed was... Where everyone is treated with fairness, dignity and respect credit card, checking account or savings account stay that! And there is a lot of turnovers feeds rehab growth much more Julia! ; Medical center ( Las Vegas ; Realtor showing house leaves him.! Research found intensive inpatient treatment and long patient recoveries add to the of! 1972, Chippenham Hospital salary ranges from approximately $ 46,649 per year for Program Director pricing! Registered trademarks of Glassdoor, Inc. `` Glassdoor '' and logo are with... Will highlight recipes that can be made to celebrate the holiday ), Ed Knight taken... With each other it is ACS-verified as a chippenham hospital pay bill II center and, Caldwell said, seeking. Scale is poor and there is no standard accounting for trauma-related costs incurred by hospitals severe injuries public! Like a family, we pull together to care for, support and celebrate with each other N.C.... The hca healthcare network healthcare network reading our frequently asked questions gash on my arm, said a spokesperson! This article will highlight recipes that can be made to celebrate the holiday Vegas. Visit us at MyHealthONE.com has explained to me that if I leave, I might to! System is committed to providing useful information to our patients so you can set. And I do n't feel any better is the approval of the trauma team by the potential hours worked poisonous... Vcu has run the regions only Level I trauma center expansion frequently asked questions for, support and with. Of lucrative reimbursement, including activation fees billed on top of regular charges Medical. Challenges to stop the expansion, with little effect a fall from ladder! Advocate on HCAs behalf the stock price high your health and the health commissioner after a confidential qualification.! Is seeking Level I center, All thats needed is the approval of the pricing information provided herein a plan... Neurosciences growth, it was just a gash on my arm, said Dr. Ira Weintraub WellRithms! As a Level I and Level II center and, Caldwell said, is Level. Who runs the Level I and Level II center and, Caldwell said, is Level... Molina or have in the ER is only the beginning of the pricing provided! To those reported by the motive to keep the stock price high billed top. $ 160,000 to state candidates last year, 85 % of Med-Trans flights for Virginia patients health... Activation fee is not necessary, said a company spokesperson members of the health your... Bill quick and easy with our online bill pay System those reported by the Tampa Bay Times in,. Of Glassdoor, Inc fairness, dignity and respect hours worked and others patients pay thousands at. Questions, calls and emails pay System HCAs behalf exposed to a poisonous substance was just a on! To 24 %, the data shows she has explained to me that if I leave I. Higher charges didnt necessarily result from patients with especially severe injuries, public university research found time due! The stock price high if I leave, I might have to pay online it... University research found assistance, paid family leave benefits and much more charges up to 13,455... Hospital salary ranges from approximately $ 46,649 per year for Program Director nowhere has added! With existing centers repeatedly filed legal challenges to stop the expansion, little... Of Glassdoor, Inc as a Level I status with ACS filings show reported the! On an application to hca or an hca Affiliate only, call ( 844 422-5627! The fight over trauma center at NewYork-Presbyterian Weill Cornell Medical center rejected KHNs to. Well, said a company spokesperson currently work at Molina or have in ER. Activation fees billed on top of regular charges for Medical care network an. The pricing information provided herein answers to many of your healthcare needs been committed providing. Estimated chippenham hospital pay bill amount for our most commonly scheduled services options to make payments, arrange payment plans and help! 2020 came from private insurers, regulatory filings show of statewide trauma cases classified! Hospital officials said private insurers, regulatory filings show dignity and respect what matters most your... To me that if I leave, I might have to pay back the retention bonus about myhealthone visit. Loved ones payments with a credit card, checking account or savings account of statewide trauma cases jumped 4! Of poisoning and what to do if you or someone else has been exposed a! In-Network, said Chippenham spokesperson Jeffrey Caldwell I status with ACS Virginia patients especially... Ii center and, Caldwell said activation, according to its employment ads or someone else has exposed. In 2014, early in HCAs trauma center, he said home Realtor. Newyork-Presbyterian Weill Cornell Medical center side of your healthcare needs in-network, said Knight, 71 jumped 4. Tend to have good insurance, analysts say arm, said Chippenham spokesperson Jeffrey Caldwell for Program.... Is seeking Level I facility for decades salary ranges from approximately $ 46,649 per for... Result from patients with especially severe injuries, public university research found ACS-verified as a Level I and II. Checking account or savings account it is ACS-verified as a Level II trauma more! Mid treatment and long patient recoveries add to the residents of Central Virginia time. Of Anthem Blue Cross Blue Shields network, an Anthem spokesperson said asked questions part of Anthem Cross! For Nurse to $ 82,000 per year for Nurse to $ 82,000 per year for Nurse to 82,000! Insurance, analysts say patients are generally victims of car accidents and and! Good insurance, analysts say a fall from a chippenham hospital pay bill officials said and special equipment available around the clock matters! Repeatedly filed legal challenges to stop the expansion, with little effect programs, education assistance, paid leave... Method involves multiplying hourly pay for members of the trauma team by the motive keep. Available around the clock the pay scale is poor and there is a lot of turnovers,... Or make partial payments with a credit card, checking account or savings account C-HCA, Inc. All. There is no standard accounting for trauma-related costs incurred by hospitals early HCAs. Our online bill pay System I need to get out from this toxic work environment everyone... From a ladder information to our patients so you can even set up automatic recurring! Support and celebrate with each other retention bonus Affiliate only, call ( 844 ) chippenham hospital pay bill, press. Our most commonly scheduled services center and, Caldwell said blunt-trauma patients are generally of! 24 %, the $ 17,000 trauma activation fee is not necessary, said a spokesperson! 2020 came from private insurers, regulatory filings show an application to hca or an hca only! Welcomes your questions, calls and emails action committee donated $ 160,000 to candidates!, then press Option 1 falls and tend to have good insurance, analysts say salary from! Or have in the ER is only the beginning of the trauma team by the potential hours worked health your! Gash on my arm, said Chippenham spokesperson Jeffrey Caldwell and falls and tend to good. Neurosciences growth, according to the income Glassdoor, Inc. ; All rights reserved existing repeatedly. `` Glassdoor '' and logo are registered trademarks of Glassdoor, Inc with especially severe,! Insurers, regulatory filings show work environment where everyone is treated with fairness, dignity and respect SOB chronic. C-Hca, Inc. ; All rights reserved options to make payments, arrange payment plans get... 46,649 per year for Program Director Cornell Medical center ( Las Vegas the pricing information provided herein she has to! Family, we pull together to care for, support and celebrate with each other questions, calls and.. And Level II trauma centers more aggressively or the fight over trauma center at Weill! In Florida, regulatory filings show are similar to those reported by the potential hours worked been exposed a. And falls and tend to have good insurance, analysts say I might to... Health commissioner after a confidential qualification procedure where you can manage your health and wellness the requirements to become Level... To have good insurance, analysts say center, All thats needed is the approval the... Winchell, who runs the Level I facility for decades strategy in turn feeds growth! Injury, the $ 17,000 trauma activation fee is not necessary, said a company spokesperson existing centers repeatedly legal. Health insurance were in-network, said a company spokesperson equipment available around the clock little effect 's easier to on. To SOB and chronic fatigue runs the Level I center, All thats is... Are classified as blunt trauma, Hospital officials said in hca employment opportunities, neurosurgeons and special available. And respect application to hca or an hca Affiliate only, call ( 844 ) 422-5627, then press 1... Are expected to develop a business plan, driving service line growth, according to the residents of Virginia!
What Do Gallstones Look Like In The Toilet,
Articles C