I once had a job where reading standards documents was my bread and butter.
SHOULD is not a requirement. It is a recommendation. For requirements they use SHALL.
My team was writing code that was safety related. Bad bugs could mean lives lost. We happily ignored a lot of SHOULDs and were open about it. We did it not because we had a good reason, but because it was convenient. We never justified it. Before our code could be released, everything was audited by a 3rd party auditor.
It's totally fine to ignore SHOULD.
> SHOULD This word, or the adjective "RECOMMENDED", mean that there may exist valid reasons in particular circumstances to ignore a particular item, but the full implications must be understood and carefully weighed before choosing a different course.
To validly disregard a SHOULD, you need to (a) fully understand the implications, and (b) accept them.
Any time someone disregards a SHOULD and then complains about the result, they are necessarily in the wrong. Either they didn’t fully understand the implications, or they don’t actually accept them.
You're forgetting about synonyms. The common adage that English has the largest vocabulary stems from the fact that it often has multiple words for the same thing. Sofa, couch. Autumn, fall. Etc etc. Other languages generally don't do this. I've never heard anyone suggest that English has words for more concepts.
Which "finding", presumably, being that PE owned hospitals have substandard metrics.
My question is natural given the context of a discussion that's literally titled:
"Death rates rose in hospital ERs after private equity firms took over"
It's literally the entire subject of the discussion. Why would anyone think it's irrelevant?
Do you have a hypothesis as to why CON requirements are driving inferior outcomes and increased cost metrics at PE owned hospitals? (A hypothesis that accounts for the fact that PE owned hospitals underperform even in the absence of CON requirements.)
Serious question. I'm trying to get my head around this.
You respond questioning how that could explain why PE operated hospitals have worse outcomes. I agree, this doesn’t seem to have an explanatory power for why PE operated hospitals have worse outcomes, but how does that relate?
Which is understandable after the monumental pain and damage oxy caused to families everywhere.