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vi CONTENTS

3 Freestanding Ambulatory Care 69

Rebecca B. Reynolds, EdD, RHIA, FAHIMA
Elizabeth D. Bowman, MPA, RHIA, FAHIMA

Introduction to Setting 70
Regulatory Issues 74
Documentation 81
Reimbursement 96
Information Management 99
Quality Improvement and Utilization Management 107
Risk Management and Legal Issues 109
Role of the Health Information Management Professional 111
Trends 113

4 Managed Care 118

Dorthy K. Young, PHD, MHSA
Cecile Favreau, MBA, CPC
Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

Introduction to Settings and Plans 119

Regulatory Issues 127
Revenue Generation 130
Information Management 135
Quality Improvement and Utilization Management 142
Risk Management and Legal Issues 145
Role of the Health Information Management Professional 147
Trends 149

5 Dialysis 154
Ann H. Peden, PhD, RHIA, CCS

Introduction to Setting 155

Regulatory Issues 159
Documentation 160
Reimbursement 166
Information Management 168
Quality Assessment, Performance Improvement, and Utilization
Management 175
Risk Management, Legal, and Ethical Issues 179
Role of the Health Information Management Professional 180

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 CONTENTS vii

6 Correctional Facilities 186

Carisa Nixon, RHIA
Nina Dozoretz, MA, RHIA, CCHP
Barbara Manny, MS, RHIA
Brianna McCloe Rogers, RHIA

Introduction to Setting 187

Regulatory Issues 199
Documentation 201
Reimbursement and Funding 206
Information Management 208
Quality Management, Performance Improvement, and Utilization
Management 212
Risk Management and Legal Issues 213
Role of the Health Information Management Professional 215
Trends 216

SECTION 3 Behavioral Health Care

7 Mental Health: Long-Term and Acute

Services 221
Mona Y. Calhoun, MS, MEd, RHIA, FAHIMA
C. Harrell Weathersby, PhD, MSW

Introduction to Setting 222

Regulatory Issues 235
Documentation 236
Reimbursement and Funding 247
Information Management 249
Quality Improvement and Utilization Management 258
Risk Management and Legal Issues 259
Role of the Health Information Management Professional 262
Trends 263

8 Substance Abuse 269

Melissa Newell, MPPA, RHIA, COPM
Frances Wickham Lee, DBA, RHIA
Kimberly D. Taylor, RHIA

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viii CONTENTS

Introduction to Setting 270

Regulatory Issues 280
Documentation 283
Reimbursement and Funding 293
Information Management 294
Quality Improvement and Utilization Management 299
Risk Management and Legal Issues 300
Role of the Health Information Management Professional 304
Trends 309

9 Facilities for Individuals with Intellectual

Disabilities 316
Nan R. Christian, MEd
Judy S. Westerfield, MEd
Elaine C. Jouette, MA, RHIA

Introduction to Setting 317

Regulatory Issues 322
Documentation 323
Reimbursement and Funding 328
Information Management 329
Quality Improvement and Utilization Management 344
Risk Management and Legal Issues 345
Role of the Health Information Management Professional 348
Trends 349

SECTION 4 Post-Acute Care

10 Long-Term Care 353

Barbara A. Gorenflo, RHIA
Kris King, MS, RHIA, CPHQ

Introduction to Setting 354

Regulatory Issues 362
Documentation 364
Reimbursement and Funding 373
Information Management 378
Quality Improvement and Utilization Management 387
Risk Management and Legal Issues 391

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 CONTENTS ix

Role of the Health Information Management Professional 391

Trends 396

11 Rehabilitation 400
Ann H. Peden, PhD, RHIA, CCS
Terry Winkler, MD

Introduction to Setting 401

Regulatory Issues 412
Documentation 417
Reimbursement and Funding 421
Information Management 430
Quality Improvement and Utilization Management 437
Risk Management and Legal Issues 438
Role of the Health Information Manager 440
Trends 441

12 Home Health Care 446

Pamela R. Dodd, RHIA
Ida Blevins, RHIA
Gwen D. Smith, RHIA
Kim A. Boyles, MS, RHIA

Introduction to Setting 447

Regulatory Issues 451
Documentation 454
Reimbursement and Funding 459
Information Management 463
Quality Improvement and Utilization Management 468
Risk Management and Legal Issues 470
Role of the Health Information Management Professional 473
Trends 474

13 Hospice 478
Teresa Sherfy, RHIT
Karen M. Staszel, RHIA

Introduction to Setting 479

Regulatory Issues 482
Documentation 488
Reimbursement and Funding 491

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x CONTENTS

Information Management 495

Quality Assessment/Performance Improvement and Utilization
Management 499
Risk Management and Legal Issues 502
Role of the Health Information Management Professional 503
Trends 504

SECTION 5 Other Specialized Care Settings

14 Dental Care Settings 508

Francis G. Serio, DMD, MS, MBA
Denise D. Krause, PhD
Cheryl L. Berthelsen, PhD, RHIA

Introduction to Care Settings 509

Regulatory Issues 521
Treatment Documentation 523
Reimbursement 531
Information Management 534
Quality Improvement and Utilization Management 540
Risk Management and Legal Issues 542
Role of the Health Information Management
Professional 543
Trends 545

15 Veterinary Settings 550

Valerie Ball, RHIA, CHIT-IS
Margaret L. Neterer, MM, RHIA

Introduction to Setting 551

Regulatory Issues 553
Documentation 555
Reimbursement 560
Information Management 561
Quality Improvement and Utilization Management 567
Risk Management and Legal Issues 567
Role of the Health Information Management
Professional 571
Trends 572

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 CONTENTS xi

SECTION 6 Other Health Care Related Settings

16 Consulting 576
Karen Wright, MHA, RHIA, RHIT
Scott Wright, MBA

Introduction to Setting 578

Regulatory Issues 580
Documentation 581
Reimbursement and Compliance 582
Role of the Health Information Management Professional 584
Trends 597

17 Cancer Registry 602

Deirdre B. Rogers, MS, CTR

Introduction to the Setting 603

Regulatory Issues 606
Documentation 611
Revenue Generation 615
Information Management 616
Quality Improvement and Utilization Management 623
Legal and Ethical Issues 625
Role of the Health Information Management Professional 626
Trends 628

Glossary 632
Index 658

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 About the Author
PREFACE

Health care is provided in a wide variety of settings, with regulatory, reimburse-

ment, and other health information management (HIM) issues that are unique
to each. Today’s health information managers are building challenging careers in
what were once considered nontraditional sites, and they need the most accurate,
up-to-date, and relevant information to master their respective positions and
maximize their influence and value. Comparative Health Information Manage-
ment, fourth edition, is written by an elite team of expert professionals from
both the educational and practice arenas, who were chosen for their particular
expertise in the different content areas.
Managing the information flow within and among differing care sites, espe-
cially in light of the technologies that make electronic health records possible, is
a challenge for today’s health information managers. Comparative Health Infor-
mation Management, fourth edition, was developed to assist health information
students meet this challenge. This text has 17 chapters, covering diverse set-
tings in which students of health information management may find employ-
ment upon graduation, ranging from hospital-based care to veterinary care to
consulting. Because many health information management professionals have
found careers in cancer registry settings, chapter 17 is new to this fourth edition.

ABOUT THE FOURTH EDITION

The revised fourth edition opens with an introductory chapter that describes the
recent history of health care in the United States and the changes taking place in
the twenty-first century. Included are topics such as the effect of changes in pay-
ment systems on health care; an overview of regulatory and accreditation issues
affecting health care, including a section on the Health Insurance Portability and
Accountability Act (HIPAA); and the evolution of the electronic health record.
This fourth edition includes new federal initiatives and other changes affecting
health information services that have been brought about by federal action. Chap-
ter 1 explores how these changes affect the HIM professional and lays a foundation
of resources that can assist in meeting the challenges of the twenty-first century.
The remaining setting-based chapters follow a consistent template, facilitat-
ing a comparison of the different sites. Each chapter includes discussions of the
following: introduction to setting; regulatory issues; documentation; reimburse-
ment and funding; information management, including data flow, coding and
classification, electronic information systems, and data sets; quality improve-
ment and utilization management; risk management and legal issues; role of the
HIM professional; and trends. Although the chapters refer to and build on one
another, they can stand alone and may be used out of sequence or as modules.
Chapter 2 discusses HIM issues unique to hospital-based care and includes
both acute and ambulatory care in the hospital setting. Chapter 3 details a wide
xiii

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xiv PREFACE

variety of ambulatory health care settings and their information management

issues, including a discussion of meaningful use of electronic health records. Chap-
ter 4 provides fundamental information on the spectrum of managed care mod-
els with which health information managers interact today. Chapter 5 discusses
both dialysis providers and the regional networks that monitor them. Chapter 6
explains terms and issues related to health care for incarcerated persons. Chapter 7
discusses both community-based and inpatient mental health care issues. Chapter
8 explains health information issues affecting facilities offering treatment and reha-
bilitation for chemical dependencies. Chapter 9 describes the unique information
maintained in facilities offering care and training for individuals with intellectual
disabilities. Chapter 10 explains the increasingly sophisticated data management
needs of long-term-care settings, including information on quality reporting, as
well as changes in federal regulations and an introduction to the “culture change
movement” in long-term care. Chapter 11 is devoted to information manage-
ment issues in programs designed to improve the function of patients who have
suffered a debilitating illness or injury. This chapter also provides an introduction
to proposals to bundle payments for various types of post-acute care. Chapter 12
discusses home care information management issues, including the home health
prospective payment system and provides information on both federal regulations
and voluntary accreditation for home health services. Chapter 13 outlines require-
ments for entities providing health care and support for persons who are terminally
ill and their families. This chapter reflects the latest Conditions of Participation
for hospice as well as current trends in hospice care. Chapter 14 provides insight
into health information needs for maintaining and improving oral health. Dental
terminology is provided to help familiarize students with the specialized language
of dentistry. Chapter 15 describes the health information services in the veterinary
medicine setting. The chapter gives current information on health information
management in settings providing care for animals. Chapter 16 provides practical
advice to the health information practitioner considering working as a consultant
in any health care setting, including information on the impact of recent federal
legislation on the consultant’s practice. Chapter 17, a new addition to the book,
offers an introduction to health information management in cancer registries.

NEw TO THE FOURTH EDITION

●● Coverage of laws and regulations has been thoroughly updated to reflect
changes in regulations and legislation that readers must understand to work
effectively in each of the varied care settings.
●● Self Review. This new feature, sprinkled throughout each chapter, offers self-
review questions that engage the student in active learning and self-reflection.
Suggested responses can be found in the online Instructor Resource Center.
●● Professional Spotlight. This new element highlights individuals working in
health information management roles in various settings, to provide students
with a practical look at what it might be like to work in a given specialty area.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 preface xv

●● MindTap. MindTap is a fully online, interactive learning platform that

combines readings, multimedia activities, and assessments into a singular
learning path, elevating learning by providing real-world application to
better engage students. MindTap includes an interactive eBook with
highlighting and note-taking capability, self-quizzes, and learning exercises
such as matching activities, multiple choice questions, flash cards, and more.
MindTap can be accessed at http://www.cengagebrain.com.

features of the text

Each chapter of Comparative Health Information Management, fourth edition,
contains the following learning elements:
●● Learning Objectives. The learning objectives are outcome-based and
identify and organize learning expectations for more effective studying.
●● Introduction to Setting. This feature opens each chapter and gives learners

a quick snapshot of the specific setting under discussion, including common

names for the setting, a description, and synonyms.
●● Self-Review. This feature allows students to pause throughout their reading to

check their understanding of concepts presented in each section of the chapter.

Suggested responses can be found in the online Instructor Resource Center.
●● Professional Spotlight. These are accounts from real-life professionals who

work in the setting under discussion. The feature will help students envision
what it might be like to pursue a career in that specialized area of practice.
●● Summary. Each chapter includes a brief narrative review of the chapter

content, with a focus on key points the learner should retain.

●● Key Terms and Definitions. Unfamiliar or critical vocabulary words are

boldfaced and defined in the margins of each chapter, and also appear in the
master glossary at the back of the text.
●● Review Questions. A series of knowledge-based and critical thinking review

questions challenge readers to apply what they have learned. These may be
used for self-study or assigned for class discussion. The answers to the review
questions appear in the Instructor’s Manual.
●● Web Activity. These internet-based exercises challenge learners to explore

information beyond the book for each setting.

●● Case Study. Real-world case studies present actual situations a learner

might encounter in practice, and include a series of questions to guide

learners through the problem-solving process. Cases may be used for in-class
discussion or assigned for individual practice. Suggested answers to the cases
are included in the Instructor’s Manual.
●● References and Suggested Readings and Key Resources. Each chapter

includes a list of references for further self-guided exploration, and a separate

listing of organizations and associations pertinent to the chapter that will
lead the learner to additional information.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
xvi preface

Learning package for the Student

Mindtap
MindTap is the first of its kind in an entirely new category: the Personal Learning
Experience (PLE). This personalized program of digital products and services
uses interactivity and customization to engage students, while offering a range
of choice in content, platforms, devices, and learning tools. MindTap is device
agnostic, meaning that it will work with any platform or learning management
system and will be accessible anytime, anywhere: on desktops, laptops, tablets,
mobile phones, and other Internet-enabled devices. Comparative Health Infor-
mation Management, fourth edition, on MindTap includes:
●● An interactive eBook with highlighting, note-taking functions, and more
●● Drag-and-drop microbiology exercises
●● Flashcards for practicing chapter terms
●● Computer-graded activities and exercises

teaching package for the inStructor

instructor resources
The Instructor Companion Website to Accompany Comparative Health Information
Management, fourth edition, contains a variety of tools to help instructors success-
fully prepare lectures and teach within this subject area. This comprehensive pack-
age provides something for all instructors, from those teaching health information
management for the first time to seasoned instructors who want something new.
The following components in the website are free to adopters of the text:
●● A downloadable, customizable Instructor’s Manual containing lecture notes,
teaching strategies, class activities, answers to review questions, and more.
●● A Test Bank with several hundred questions and answers, for use in instructor-
created quizzes and tests.
●● Chapter slides created in PowerPoint® to use for in-class lecture material
and as handouts for students.

Mindtap
In the new Comparative Health Information Management, fourth edition, on
MindTap platform, instructors customize the learning path by selecting Cengage
Learning resources and adding their own content via apps that integrate into the
MindTap framework seamlessly with many learning management systems. The
guided learning path demonstrates the relevance of basic principles in health
information management through engagement activities, interactive exercises,
and animations, elevating the study by challenging students to apply concepts to
practice. To learn more, visit www.cengage.com/mindtap.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 ACkNOwLEDgMENTS

This book is the result of the efforts of numerous persons. Shirley Anderson had
the vision for Delmar (now Cengage) Learning’s HIM (Health Information
Management) series and first suggested this text to its editorial staff. In 1994,
the publisher assembled a focus group of HIM practitioners and educators to
plan the first edition. Accepting the role of editor for this text was much easier
given the groundwork that had been laid by the thoughtful contributions of my
HIM colleagues.
The author is very grateful for the work of the contributors to previous
editions, who created a superb body of work that the current contributors
were able to update, revise, and refine. The names of all contributors, both
previous and current, are listed following each chapter heading, although
some of the earlier contributors were not able to participate in the fourth edi-
tion. I would like to give the following individuals special recognition for their
groundbreaking work in the development of previous editions of this text:
Sonya Beard for the chapter on hospital care, Beth Bowman for the chapter on
freestanding ambulatory care, Lynn Kuehn and Cecile Favreau for the chap-
ter on managed care, Nina Dozoretz, Barbara Manny, and Brianna McCloe
Rogers for the correctional chapter, Harrell Weathersby for the mental health
chapter, Frances Wickham Lee and Kimberly Taylor for the substance abuse
chapter, Elaine C. Jouette and Judy S. Westerfield for the chapter on services
for individuals with intellectual and developmental disabilities, Ida Blevins,
Gwen D. Smith, and Kim Boyles for the home health chapter, Karen Staszel
for the hospice chapter, Cheryl Berthelsen for the dental chapter, and Mar-
garet Neterer for the chapter on veterinary health care. I also remember with
gratitude two individuals who are no longer physically present in this world,
though their contributions are very much alive—Kris King and Terry Winkler,
who wrote the original chapters on long-term care and rehabilitation, respec-
tively. I owe a tremendous debt of gratitude to all of these contributors for
developing the first three editions, thereby providing an excellent foundation
for the current volume.
The reviewers also played a major role in the development and refinement of
this book. Their insights kept us focused on the needs of the readers, and their
excellent suggestions have helped make the fourth edition “new and improved.”
The author and publisher would like to thank the following persons for their
role in shaping this text by serving as reviewers during the preparation of the
manuscript:

xvii

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
xviii ACkNOwLEDgMENTS

Mona Calhoun, MS, RHIA Melissa H. Edenburn, RHIA

Chair, Health Information Associate Professor, Health
Management Program Information Technology
Coppin State University McLennan Community College
Baltimore, Maryland Waco, Texas
Monica L Carmichael, BS, MHSA, Robert Haralson, RHIT, CCS
MHRM, CPC Instructor
Allied Health Program Director Ozarks Technical Community
Miller-Motte Technical College College
Charleston, South Carolina (online Springfield, Missouri
division)
Kerry Heinecke, MS, RHIA
Crystal A. Clack, MS, RHIA, CCS Biomedical Informatics Technician
AHIMA Approved ICD-10-CM/ Program Director
PCS Trainer Mid-State Technical College
Adjunct Faculty Marshfield, Wisconsin
Lane Community College
Lorraine Kane, MS, RHIA
Eugene, Oregon
Associate Professor
Stephanie A. Donovan, MBA, RHIA SUNY Institute of Technology
Faculty Chair Health Programs Utica, New York
Peirce College
Philadelphia, Pennsylvania

The chapter authors also are grateful for expert assistance and advice pro-
vided to them by others. For Chapter 5: Brenda Dyson and the staff of Network
8 for sharing their knowledge of the ESRD networks and dialysis facilities (Fre-
senius). For Chapter 6: Nina Dozoretz for reviewing the chapter and suggesting
updates. For Chapter 7: Tessie Smith, Ellen Crawford, Ted Lutterman, Barbara
Carpenter, and Mary Crossman. For Chapter 11: Mary Montana of Methodist
Rehabilitation Center, Jackson, Mississippi, for her careful review and sugges-
tions for updates. For Chapter 15: Various members of the American Veterinary
Health Information Management Association (AVHIMA) for providing editorial
support, especially Kathleen Ellis, RHIT, RN, BS, and Roberta Schmidt, RHIA,
health information management professionals for the colleges of veterinary med-
icine at the University of Illinois and Ohio State University, respectively.
I would like to thank the editorial staff of Cengage Learning for their work
on the project and the many ways that they supported and enhanced my efforts,
including thanks to Jadin Babin-Kavanaugh and Beth Williams for their patience
and resourcefulness. Finally, I would like to thank my co-author, Jody Smith for
stepping in to help wrap-up the project.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 ACkNOwLEDgMENTS xix

I am very grateful for the support and encouragement I have received from
my colleagues at the University of Mississippi Medical Center. I want to thank my
dean, Dr. Jessica Bailey, for creating an environment conducive to professional
growth and the acceptance of professional challenges. I also thank my fellow
faculty members for giving their best to our students and for their support and
encouragement, including their service as contributors to this edition. I thank
the many professionals who have shared their knowledge of health information
management in traditional and nontraditional settings with my students and with
me. I want to thank Doris Austin for the many ways she helps me to “stay on top
of things,” especially when faced with time constraints. I also thank Casey Bell
and Hope Peden Vandersteen for their assistance with some of the new features
of the book.
I thank my family, especially my husband, Sam, my children, Eric, Jericho,
and Hope, and their spouses, my mother and father, my mother-in-law, and also
my church family for their encouragement and their prayers. And I thank the
One who hears and answers prayer, His Son, who “always lives to make interces-
sion,” and His Spirit, who “also helps in our weaknesses.”

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 About THE
ABOUT the AUTHOR
Author

Ann H. Peden, PHd, RHIA, CCS, is professor of health informatics and information
management in the School of Health Related Professions at the University of
Mississippi Medical Center in Jackson, Mississippi. She has her PhD in Clinical
Health Sciences from the University of Mississippi and her MBA from Loui-
siana Tech University, where she also previously taught. Before teaching, she
served as director of medical records at St. Francis Medical Center in Monroe,
Louisiana. She completed her undergraduate education at the University of
Mississippi.
Dr. Peden’s awards include the American Health Information Management
Association’s “Professional Achievement Award” and the Mississippi Health Infor-
mation Management Association’s “Distinguished Member Award” and “Legacy
Award.” She has been honored as “Teacher of the Year” for the University of
Mississippi’s School of Health Related Professions and was also named to the uni-
versity’s Nelson Order in recognition of teaching excellence. Her service to the
profession of health information management includes serving as a member of
the board of directors of the Commission on Accreditation of Health Informatics
and Information Management Education and terms as president of the Louisiana
Medical Record Association and the Mississippi Health Information Management
Association. She has also served as a member of the nominating committee of
the American Health Information Management Association (AHIMA), and as the
chair of AHIMA’s Coding Policy and Strategy Committee.

K. Jody SmItH, PHd, RHIA, FAHImA, is professor emeritus of health informatics

and information management in the Doisy College of Health Sciences at Saint
Louis University in St. Louis, Missouri. She has her PhD in Higher Educa-
tion Administration from Saint Louis University and her MS from Maryville
University in St. Louis. Prior to retiring in 2014, Dr. Smith chaired the depart-
ment of health informatics and informatics at Saint Louis University. Before
teaching, she served as director of medical records at Memorial Medical Cen-
ter in Springfield, Illinois and the University Hospital in St. Louis, Missouri.
She completed her undergraduate education at Illinois State University in
Normal, Illinois.
Dr. Smith’s awards include the Missouri Health Information Management
Association’s “Distinguished Member Service Award” and “Outstanding Health
Information Management Educator”. She was named “Distinguished Alumnus”
for the College of Applied Science and Technology at Illinois State University.
Dr. Smith received the “Faculty Excellent Award” from the Student Government
Association at Saint Louis University and the “Faculty Excellence in Advising
and Mentoring” awarded by the Doisy College of Health Sciences at Saint Louis

xxi

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
xxii About the Author

University. Her service to the profession of health information management includes

serving as chair of the scholarship committee for the American Health Information
Management Association (AHIMA), the editorial review board for Perspectives in
Health Information Management (AHIMA), and member of the Council on Cer-
tification (AHIMA). She served terms as president of the Illinois Medical Record
Association and the Missouri Health Information Management Association.

About the Contributors

VALERIE E. BALL, RHIA, CHIT-IS, currently serves as the manager for the health
information management department at the North Carolina State Veterinary
Hospital, Raleigh, NC. She has been employed in this capacity for twenty four
(24) years and also served in a similar capacity at the Virginia Tech College of
Veterinary Medicine for almost nine (9) years. She graduated from Virginia Com-
monwealth University-Medical College of Virginia with a Bachelor of Science in
Health Information Management. She also completed graduate coursework in edu-
cational administration at Viginia Tech and counseling education at North Carolina
State University. Throughout her career she has been involved with various profes-
sional and community organizations in various leadership capacities. She contin-
ues to serve as a preceptor and placement site for several community college HIM
programs.

MonA Y. CALHoun, MS, MEd, RHIA, FAHIMA, is the Chairperson for the Health Informa-
tion Management Baccalaureate Program at Coppin State University in Baltimore,
Maryland. She is a graduate of Texas Woman’s University in Denton, Texas with a
B.S. in Medical Records Administration and M.S. degree in Healthcare Administra-
tion. She obtained a second M.S. degree in Rehabilitation Counseling from Coppin
State University. Mrs. Calhoun has close to 30 years of extensive professional experi-
ence in the Health Information Management profession in a variety of healthcare
settings, including behavioral health, rehabilitation and acute care settings. She has
also provided consultative services to outpatient clinics and home health care agen-
cies. The last nine years of her career has been in education.

nAn R. CHRISTIAn, MS, LCIddT, LCMHT, is Director of Education/Quality Service

Manager at Hudspeth Regional Center. She is a graduate of the University of
Mississippi with a B.A. in Communicative Disorders and received her M.S. degree
in Speech and Hearing Services from the University of Southern Mississippi.
She obtained post-graduate work from the University of Southern Mississippi in
School Supervision and Administration and School Psychometry. Ms. Christian
has over 42 years of professional experience in special education, administration,
and speech pathology. She has been recognized by Cambridge Who’s Who as
“Professional of the Year” representing Special education administration for the
2009–2010 year.

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 ABOUT THE AUTHOR xxiii

PAmeLA R. dodd, RHIA, is the Corporate Health Information Manager and Pri-
vacy Officer for Alacare Home Health and Hospice located in Birmingham, AL.
She holds a BS degree, cum laude, in Medical Record Administration from the
University of Alabama at Birmingham. She has worked in health care for 24 years
with over 18 years in home health care. She has served as preceptor for over
10 years to local community colleges and Universities. She serves as an Advisory
Committee member at Wallace State Community College and has received their
Outstanding Clinical Education Award. She authored two other publications
in 2001. She has presented at annual and local health information management
meetings as other long-term care association meetings.

BARBARA A. GoRenFLo, RHIA, is the Administrator of Blocher Homes, the Assisted

Living Facility of Beechwood Continuing Care in Williamsville, New York.
Before her current position, she was the Assistant Administrator of the Skilled
Nursing Facility and prior to that the Director of Health Information Manage-
ment at Beechwood. She has a BS degree in Medical Record Administration
from Daemen College, Amherst, New York. She has served as Clinical Instructor
for Health Information Technology students at Trocaire and Erie Community
Colleges. Mrs. Gorenflo contracts with several long-term care facilities and renal
dialysis centers for medical record consulting services. She is a presenter on medi-
cal record documentation issues as well as on HIPAA compliance.

denISe d. KRAuSe, PHd, is an associate professor of preventive medicine at the

University of Mississippi Medical Center and associate director of technology
and research with the Office of Mississippi Physician Workforce. She is a gradu-
ate of the University of Kansas and has Masters’ degrees in International Policy
and Russian from the Monterey Institute of International Studies in California,
and Master’s and PhD degrees in Preventive Medicine with a emphasis in epide-
miology from the University of Mississippi Medical Center. She has completed
extensive professional technical training in networking and other aspects of infor-
mation technology. Dr. Krause is managing numerous technology projects to
support research and education, and to inform policy, especially on topics related
to improving access to health care and services.

AnGeLA moRey, mSm, RHIA, is an assistant professor in the Health Informatics and
Information Management Department at the University of Mississippi Medical
Center. She is a graduate of the Health Information Management program at the
Medical College of Georgia and has a Master of Science in Management degree
with a concentration in Organizational Behavior and Development from Georgia
State University. Ms. Morey has extensive experience in teaching health infor-
mation practices in acute settings as well as medical terminology, performance
improvement, organizational management, healthcare statistics and legal aspects
of health information management.

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Another Random Document on
Scribd Without Any Related Topics
 Long since that illumination had been discontinued. Dave had
paused with due caution as he approached its cause. He had lurked
behind a big rock fronting the shelf of stone.
No other sound or presence was indicated, and after a spell of
watchfulness Dave decided to approach closer. It was as he peered
around the edge of a cavelike opening fronting the ravine that he
uttered the words:
"Well, this is queer."
The cave extended back into the hill a long way. Dave could
decide this by the shadows cast by a light that burned about fifteen
feet from its opening. A rude earthen pot of native construction was
filled with some kind of oil. A wick, made out of some fibrous plant,
burned within it.
This light illuminated a long broad piece of matting laid across
the floor of the cave. As Dave examined the various articles spread
out on this mat, he was filled with amazement.
There were all kinds of dishes, such as Dave had seen in the
homes of the Windjammers. These were made of thin bark and
decorated with figures of flowers and birds outlined in berry stains.
"The wonder of it all, though," said Dave; "food, and such food-
-all kinds."
In the dishes were berries and other fruits, a kind of tapioca
bread also. Then there were meats, all cooked and cold, and some
fish the same. There were also two quite tastefully made bowls filled
with a clear white liquid that Dave took to be cocoanut milk.
Dave watched for a long time. The display tempted his appetite
prodigiously.
 "Of course there's a proprietor for all this elegant layout," said
Dave. "What's the occasion of it? Where is he?"
Dave sent a piece of stone rattling noisily into the cave, then a
second. He waited and listened.
"I don't believe there is anyone in there," he decided. "I can't
resist it. I don't know who this feast is spread for, but I want a share
of it."
Dave stepped forward boldly now. His audacity was increased as
he made out a spear standing against a rock. Dave took the
precaution to arm himself with this. Then he came still nearer to the
food.
Whoever had prepared the feast was, in Dave's estimation, a
most admirable cook. The various articles he sampled tasted most
appetizing.
"Fine as home cooking," said Dave, with satisfaction, stepping
back from the mat. "One man wouldn't have all that stuff for
breakfast, though. Is it some native ceremonial like Stoodles has told
me about? Or does the man expect friends? That's it," Dave
reasoned it out. "Maybe he has gone to meet them. I had better
make myself scarce."
Dave was now satisfied that he was really on the Windjammers'
Island. The articles in the cave were in a measure familiar to him.
Then, too, a glance from the cliffs as he had ascended them had
shown a distant coastline, suggesting precisely the spot where
Captain Broadbeam, himself, and the others had been marooned.
Dave resolved to appropriate the weapon he had taken up. He
started to leave the cave and retrace his steps to the beach. At the
entrance he paused abruptly and started back.
 "Too late," he exclaimed; "someone is coming."
Dave had almost run out upon two men. A curious circumstance
prevented them seeing him. They were approaching from the
direction opposite to that from which he himself had come in
reaching the cave.
Both were natives. The minute Dave saw them he instantly
recognized them as belonging to the Windjammers' tribe of which
his friend Pat Stoodles had once been king.
One of them was a thin, mean-looking fellow, scrawny and wild-
eyed. He was creeping on hands and knees along the path. His pose
and manner suggested the utmost humility.
The other was a man gayly decked out. He wore a richly
embroidered skin across his shoulders and a necklace of gaudy
shells. He had a kind of mace in his hand. The lordly manner in
which he carried his head indicated extreme pride and importance.
"Why," said Dave, backing into the gloomy depths of the cave,
"that is the same dress the man wore who was the great priest of
the tribe when I was on the Windjammers' Island the first time."
There seemed to be no doubt but that Dave was back on the
old stamping-ground of Pat Stoodles. He was not at all sorry for this.
It was the destination of the Swallow. Perhaps the steamer had
already reached it.
"Things are working easier for me than I had any right to
expect," reflected Dave, "only I must keep out of the clutches of any
of the natives till I locate my friends."
Dave got behind an obscure rock. From there he peered intently
at the two men who now entered the cave; the one crawling on his
hands and knees, the other maintaining still his lofty bearing of
superiority.
Reaching the mat, the guide arose to his feet. He showed the
greatest humility and respect in all that he did.
He made a gesture to have his visitor sit down to the feast. The
latter shook his head in great disdain.
Then the evident resident of the cave groaned and wept and
rolled all over on the ground as if in the deepest despair. In a
mournful sing-song voice he seemed to make an appeal to his
august visitor to grant some prayer.
The priest finally stamped his foot and spoke some quick words.
The other arose. The priest, fixing a menacing eye upon him,
advanced, and putting out a hand, tried to pull aside the garment
which the man wore on the upper part of his body.
The poor wretch seemed frantic. He clung close to the garment,
seeming especially anxious not to expose his back or shoulders.
The priest, however, managed to tear the front of the garment
open. Then Dave half understood the situation from something he
remembered to have heard Stoodles tell about on a previous
occasion.
A peculiar mark, a circle inclosing a cross, was visible on the
chest of the suppliant.
"I know what that means," mused Dave. "They brand their
criminals, drive them away, and if they ever approach the tribe
again, they burn them alive. That is the outcast brand. Stoodles told
me so when he was on this island with me."
The refugee cowered with shame. Then he kicked aside some of
the dishes of the feast which his august visitor had spurned.
 "I'm glad of that," thought Dave. "Now he won't be likely to
notice that I have been trespassing."
The outcast went to a sort of shelf in the cave. He came back,
poising a small earthen crock in his hand.
He began a quick talk to the priest in a louder, more assured
tone. The latter suddenly changed his manner. His eyes sparkled. He
looked eager and excited.
The outcast seemed to be giving a most glowing description of
the contents of the little crock. Dave tried to follow his meaning.
"He is saying," translated Dave to himself, "that he has great
quantities of whatever the crock contains--lots of it, heaps of it--I
see. Now he has interested the priest. He is offering to buy his
citizenship back into the tribe, that looks sure. Ah, he is showing
what he has in the crock. Gracious!"
Dave forgot all prudence. He was so interested that he slipped
out from hiding to gaze at the contents of the crock, now poured out
rapidly by the outcast upon the food mat.
Fortunately the two men were equally engrossed. What the
outcast had poured out of the crock were half a hundred or more
pure gold coins!

CHAPTER XVIII
THE OUTCAST'S SECRET

The young ocean diver had a right to be astonished and interested.

The first moment his eyes landed on the coins the outcast had
exhibited, he felt sure they were part of the ocean treasure.
They were similar in size to the bulk of the pieces brought up
from the ocean bed in the diving bell. They looked the same at a
distance. Besides, where on this rarely visited island would the
native get such a hoard except from the treasure heap?
The priest gathered up a lot of the coins. They manifestly
pleased him. He laughed with glee and clinked them musically
together in his hands.
Then he seemed to ask the outcast a great many questions. He
stamped his feet as the latter appeared to evade direct answers.
"It's plain," said the anxiously watchful Dave, "those coins came
from our stolen store. This native knows where it is."
Dave thought this a great discovery. From the way the outcast
pointed Dave decided the bulk of the treasure was at a distance
somewhere.
"I don't believe he has told the priest where," Dave surmised.
"He seems bargaining to have the outcast edict removed, then he
will pay a much greater amount. That's the way all this jabbering
looks. Ah, they have come to an agreement."
The priest had become very gracious now. He pointed, too, in
his rapid talk as if agreeing to return to the royal village and acted as
if some proposal was to be made to the native king.
"I hope I can get out of here before they bring any more
people," thought Dave. "I can't do it just now, though, that is sure."
The priest went away. The outcast began to array himself in
new apparel. He grinned and chuckled and acted as if delighted.
Dave figured out that he had bought his pardon.
 Clearing the mat the native sat down in its center, first
surrounding himself with a variety of native weapons.
"He is going to receive his company in state," decided Dare. "I
simply couldn't get past him without being seen. He is heavily
armed, too. Well, I'll have to wait patiently and watch out for my
chance to escape."
One hour went by, two hours. Dave did not dare to stir from the
covert in the cave where he crouched. Once the idea was suggested
to his mind of overcoming the native who possessed a secret of such
importance to him. The next moment, however, he saw how foolish
this would be. Even if he succeeded, what could he do with the man,
on his hands alone, not knowing the whereabouts of his friends, and
his captive speaking a language he could not understand?
Dave was thinking over all these things when there came a
sudden climax to the situation.
Without warning a dozen armed natives dashed past him with
echoing yells.
It was patent to Dave that these men, apprized by the priest,
had been instructed to steal into the cave by another entrance than
the front one known to them and seize the outcast.
It looked as if the law of the island would not allow the king to
treat on any terms whatever with an outcast. All the poor fellow's
negotiations, therefore, seemed to have gone for naught. He must
have realized treachery. He must have guessed that he would now
be taken to the king as a captive, his secret tortured out of him, and
the voice of the populace might demand that he be burned alive.
At all events he acted with acute alarm. He was on his feet in an
instant. Dave saw him clear the entrance to the cave in a flash. The
men who had burst so quickly upon the scene dashed out after him.
Dave could not help running to the entrance of the cave to see
how things turned out. The fugitive had gone west away from the
coast. Dave saw him far outdistance his pursuers. Darts and spears
were hurled after him, but they all missed him. He finally
disappeared into a grove, and distance shut out his pursuers as well.
Dave seized his spear and started promptly in the direction of
the sea. In his brief survey from the heights he had made out the
high plateau which he and Stoodles and Bob Vilett had once crossed
in joining their friends on the other side of the island.
"It's due north, and it looks to be only about ten miles distant,"
calculated Dave. "I know that from the plateau we could see all over
the island. If I could reach it, and the Swallow has arrived, I
certainly could make her out. Yes, I must try to get to the plateau."
Dave used due haste in descending the cliff by the route he had
come. He had the idea in his mind of trying to mend up the yawl on
the beach. Then he would wait for dark and skirt the coast in the
direction of the plateau.
He was glad when he got down to the shore bluffs. He planned
how he would fix the hole in the side of the yawl and make some
oars.
"I will make an inspection of the boat," he thought, going
towards it across the beach. "I did not notice it particularly, and
maybe it isn't much damaged."
The yawl lay keel upwards, as it had landed with him and as he
had left it earlier in the morning.
As he got nearer he saw that several boards were badly sprung.
They were, however, all above the waterline.
 "I think I can manage to make it seaworthy for a little cruise,"
said Dave. "Wonder if she is damaged inside."
Dave stooped, put his hand under the side of the yawl, and
gave the boat a tremendous lift and a push.
Over she went, but to disclose a fact that gave Dave a decided
shock.
Three natives had lain in hiding under the yawl. They arose
simultaneously. Three spears were leveled at Dave, and he knew he
was a prisoner.

CHAPTER XIX
A DAY OF ADVENTURES

The three spears held Dave in a circle. The spearsmen advanced

them nearer and nearer till they hemmed Dave in dangerously. He
had placed his own weapon on the ground while attending to the
boat, so he was entirely unarmed.
Dave could do nothing but quietly await the further action of his
captors. They regarded him fiercely. Then there was a confab among
them.
Two of them finally dropped their spears, leaving their
companion to guard Dave. They went to the nearest bushes and
secured some stringy vines of great strength.
They tied Dave's arms behind him. One of the men pointed
west, in which direction the priest had gone. It seemed that the
native village was located west.
 A second of the trio dissented from the proposition made. He
pointed down the shore a bit and talked volubly. Then the two went
away, giving some directions to Dave's guard.
The latter, prodding Dave with the spear, made him go towards
the shore bluffs. He forced him up an incline. There he secured a
thick flexible vine, passed it through Dave's arms, and tied the other
end around a tree.
He then threw himself on the ground and reclined there lazily.
From where he was Dave could look down the beach. He
comprehended that the savages had come across the yawl and had
probably seen his footmarks. They had calculated he would return
and had hidden under the boat. Now, judging from the actions of
the two natives down the beach, they were hunting for other
footmarks.
At least it looked so to Dave. They seemed to locate some
disturbance in the sand like a trail. They followed it up this course,
which took them finally out of view of Dave.
Dave's guard reclined at the edge of the bluff, looking out at the
sea. His spear lay beside him.
"I wish he would go to sleep," thought Dave. "With time given
I'd bargain to get free from these flimsy bonds, if I had to gnaw
through this big vine with my teeth."
The native, however, had no idea of going to sleep. He turned
regularly about every two minutes to look at his captive.
Suddenly Dave saw the man start to rise up as if in great alarm.
A look of horror was in his gleaming eyes. With a yell he toppled
backwards. The amazed Dave saw him roll down the bluff incline.
The native turned over and over, his head struck a great rock in the
way with a fearful click. The blood flew from the wound and deluged
the native's face and he lay like one dead, his body suspended over
a bent sapling.
"Why," exclaimed the startled Dave, "what made him do that?
Mercy!"
A lithe, sinuous form cut the air, coming from the thick
shrubbery just back of Dave. It landed where the native had sat.
Dave understood now. It was a panther.
His blood ran cold as the animal, disappointed of its expected
prey, turned quickly, facing him. From former experiences on the
island Dave knew that he confronted a foe dangerous and
bloodthirsty in the extreme.
The native panther was feared by the natives greatly. It was a
small animal, but ferocious to a degree and enormously strong in
forefeet and teeth.
Dave, bound, unarmed, felt himself completely at the mercy of
the animal. He shrank back, naturally, as it began to describe a
semicircle. It crept low to the ground, uttering a harsh, hissing snarl.
Its eyes were fixed intently on its intended victim.
Dave watched the fatal circle narrow. The panther came to a
pause, a crouch. It shot up from the ground.
Dave had prepared for this first onset. He realized, however,
that, helpless as he was, his agility could not eventually save him.
The youth made a leap as the panther sprang at him. Through a
remarkable circumstance Dave's rush drew the big vine out. The
panther met it coming up, was caught across the breast, and was
sent hurtling back violently.
 It fell to the ground, Dave ran at it. He ventured boldly, for the
chances of escape were desperate. Dave delivered one kick at the
prostrate animal. His foot partly landed in its gaping mouth.
"It's incredible!" cried Dave.
He was lost in wonderment. That resolute kick had worked
marvels. As Dave looked at the ground he saw several teeth there
and a trail of blood. Their owner had rolled back and had gone over
the bluff as the native Had gone, uttering several frightful snarls.
"Will it come back again?" panted Dave. "A surprising
adventure--I can hardly realize it. Yes, it is returning--no, human
voices. Men, mates!" shouted Dave, "this way, this way!"
With anxious heart elate Dave had caught the voice of more
than one person. Then a word in English, and he recognized the
voice of Daley.
"Hello, where are you?" responded Daley's tones, their owner
beating his way through the dense foliage.
"Young Fearless! We've found him," he cried, staring hard.
"Turned up again, eh, lad?"
"I'm mighty glad you have," said Dave rapidly. "What, the three
of you, and safe and sound?" he added, as two others joined their
leader.
"We were looking for you," announced Daley. "Here, one of you
has a pocket knife. Cut the lad loose."
"You were looking for me?" repeated Dave wonderingly.
"To be sure," nodded Daley. "We washed ashore last night all
safe and trim, as you see."
"Yes, but not near here, for I looked for a trace of you," said
Dave.
 "No, it must have been a good ten miles to the south, lad. We
made this way, and saw those natives get under that boat. We were
unarmed and hid. When those two up the beach left you in charge
of the fellow here, we rounded into the bluffs and searched for you.
Where is the fellow, anyhow?"
Dave narrated what had taken place. Daley looked pretty
serious.
"We're in a nest of them, it seems," he remarked, taking up the
spear belonging to Dave's guard. "Come on, mates; let's make a
tight run for it while the coast is still clear of them."
Daley's plan was a simple one and Dave allowed it to prevail. It
was to get north as fast and far as they could before they were
discovered by more natives.
"They're thick back of the coast, just hereabouts," said Daley.
"We heard their yells several times in our jaunt down shore, and saw
several of them. Keep in the cover of the bluff, and let us try to
round that cape yonder. From what I remember here before, the
cyclone pretty well cleaned out the north end of the island."
"That is true," said Dave, "and the natives probably shun it on
that account."
Their progress was very satisfactory. The cape that Daley had
alluded to was reached about two hours later.
It presented a sheer high wall to the sea and gave a fine view
of the island for miles around. It was wooded to within about fifty
feet of the edge.
They were all terribly tired out and badly torn with thorns and
brambles. As they came out into clear space, Daley and his
companions threw themselves down on the ground, nearly
exhausted.
Dave, starting to follow their example, paused, uttered a great
shout, and ran to the sheer edge of the cliff.
"Hello, there--what's doing, mate?" challenged Daley, in some
wonder.
"See! see! see!" cried Dave, pointing down at the sea with
shining eyes--"the Swallow!"

CHAPTER XX
ON BOARD THE "SWALLOW"

"Captain Broadbeam, come here, please."

"Why, lad, what's the matter?"
Bob Vilett had spoken in a way that might well have excited the
surprise of the commander of the steamer.
For over ten minutes Bob had stood at the side, gazing through
a spyglass landwards. Now of a sudden the glass dropped in his
nerveless hand. Bob began to tremble, and he had called to the
friendly captain like one in distress.
"Those natives up to some more high jinks?" said Broadbeam,
coming up to Bob.
"No, no, captain! Look--look! Quick, captain!"
"Toplights and gaffsails, what's this now?" demanded
Broadbeam, as Bob extended the glass, looking pale and agitated.
 "Look at the high cape cliff, captain," urged Bob. "See if I'm
mistaken."
"Dave Fearless!" fairly roared the old sea veteran the minute he
put the glass to his eyes.
"You are sure, captain?" cried Bob, in great excitement.
The captain had been staggered at his surprising first view
through the spyglass. Now he looked again.
"Dave! Ah, a glad sight," he went on. "Some men with him--look
like sailors. Fearless! Amos Fearless! Where is he? Old friend, your
son is alive!"
Those of the crew in sight and hearing stared quite wonderingly
at their captain. They had rarely seen him so moved as when he ran
towards the cabin, shouting the name of his friend.
"What is that?" said the old diver, coming up the cabin stairs.
"Dave is alive."
"My son alive," cried Amos Fearless, turning white, and in a
momentary weakness holding to a rail for support.
"Yes, he is--ashore there."
"Oh, are you sure?"
"Go look for yourself. Hurrah!"
Captain Broadbeam was beside himself with genuine gladness.
He clamped his big paw of a hand across his old friend's arm
and fairly dragged him across the deck.
"Yes, it's Dave," cried the happy father, taking a look through
the spyglass. Then he handed it back to Bob Vilett. The old diver
turned his face away. It was wet with tears of thankfulness and joy.
Captain Broadbeam moved about the deck too excited to stand
still.
 "I felt it in my bones! Didn't I say it all along?" he spoke. "Didn't
I stick to it that a lad born to the sea would find a way out of it?
Below there, Adams," he hailed to the engineer, "how's she
working?"
"Bad, sir; mortal bad," reported the engineer.
There was something serious the matter with the Swallow.
There had been since the night previous.
Dave Fearless had not been missed from the ship until that
morning. Then they had searched everywhere for him. It became
patent after an investigation that he had been swept overboard.
There was little chance to look for him. The storm that had
given Dave and his refugee friends, Daley and the others, such a
terrible experience, had dealt the stanch little steamer a severe
blow.
There had been times during the tempest when the Swallow
was thrown about like an eggshell in the grasp of a giant. She was
cast on her beam-ends more than once.
The steamer outrode the storm just in time. She could not have
stood another hour of that terrible tossing about and wrenching.
With a grave face Adams had called Captain Broadbeam down
into the engine room to see the damage that had been done.
The engine was fairly out of commission. One driving rod was
bent badly, some of the minor mechanism was clear out of gear.
"It's land and a quiet harbor mighty quick, sir," reported the
experienced engineer, "or trouble if another storm strikes us on the
open sea."
"You are right, Adams," said the captain, after due investigation.
"We must make land somehow, somewhere. The Swallow is badly
crippled."
"You see, sir," observed Adams, "I have rigged up a temporary
makeshift for a driving rod. It may give out at any moment under
strain. If we can work our way easy like and crawl to harborage, in a
few days with some blacksmithing we might forge or rig up some
new parts."
It was just after this that land was discovered, and Stoodles
came into a general consultation as an authority that they were
surely approaching the Windjammers' Island.
Their former experience in these same waters was of value now.
Adams advised that they get close to the shore and line it, looking
for a temporary harbor.
Bob Vilett had a valuable suggestion to make. He was in a
pretty gloomy mood over the unknown fate of his chum, for whom
they had spent two hours with all the small boats out.
Bob, however, had to stick to his duty. It nearly broke his heart
to witness the prostration of the old diver, but as he thought of
something, he went to the captain.
"When we were here before, captain," he said, "you remember
the natural harbor where we found the old derelict vessel?"
"Why," said Broadbeam, "the very thing. Thanks for the
suggestion, lad. If we can reach that spot we are safe from any
bother from the natives here and from any storm that may come up.
Tell Adams."
The Swallow had been discovered by the natives about an hour
later. These came to the beach in several places. They made a great
ado. Whole processions came into view. At one place they brought
down a covered platform borne by four men. Upon this platform was
a great earthen pot filled with some smoking material.
"What are they up to, Pat?" the captain asked Stoodles.
"Begorra, it's the ould magic spell of their high-priests to send
us bad luck," answered the Irishman.
The various incantations of the natives went on nearly under
the eyes of those on board of the Swallow for some time. Then the
visitations to the beach ceased. It was now about half an hour later
that Bob Vilett had discovered Dave Fearless on the cape cliff where
the young diver and his three companions had just arrived.
While Mr. Fearless was gazing anxiously ashore and Bob was
tracing every movement of his distant chum through the spyglass,
Captain Broadbeam was giving quick orders to his men.
A boat was to go ashore at once and a signal given from the
deck of the Swallow that Dave would understand.
"Don't delay, my friends," the excited Stoodles kept urging the
sailors. "Let us get into action before my former subjects come into
sight again."
All was ready, boat, men, and weapons, to start to the succor of
Dave, when Bob Vilett uttered a shout of dismay.
"Oh, captain," he cried, running up to the commander of the
Swallow, "it's too late."
"How's this? What do you mean?" demanded the captain.
He snatched the glass from Bob's hand and took a look himself.
Then he uttered a hollow groan.
Dave and the others were still visible on the cliff, but over a
hundred natives had suddenly swarmed about them.
 As he looked, the captain saw these surround Dave and the
others. They were seized, bound, and carried off into the forest
before his very eyes.

CHAPTER XXI
THE ISLAND HARBOR

The great joy that the friends of Dave Fearless had experienced, at
discovering him almost in reach, now gave way to great anxiety as
he seemed lost to them again.
Bob Vilett was summoned to the engine room by his superior.
Amos Fearless went back to the cabin, looking dejected and sad.
Captain Broadbeam fumed secretly. He paced the deck rapidly,
going through considerable mental perturbation.
Pat Stoodles saw the expedition ashore abandoned.
He knew the captain's fiery moods and kept out of the way for a
spell. When the Swallow turned her head directly north he
approached Broadbeam.
"It's on your way you'd be going, captain dear?" mildly observed
Stoodles.
"Don't you see I am?" challenged Broadbeam petulantly.
"It's disturbed ye are, I see," said the plausible Irishman.
"Ochone, ye may well be. Wirra-wirra! that fine broth of a boy, Dave
Fearless, abandoned to his fate. Deserted by his friends."
"Who's abandoning him, who's deserting him?" flamed out the
captain.
 "That's it. I was asking your honor," said Stoodles innocently.
"Of course ye have plans to assist the lad. I know the island. Wasn't
I their king once on a time? Make me your confidant, captain dear.
What's your plans?"
"I'll show those bloodthirsty villains soon," declared Broadbeam,
shaking his ponderous fist at the island. "I'm going around to anchor
in the cove at the northwest end of the island."
"I see," nodded Stoodles thoughtfully. "A foine spot. And then,
captain?"
"Every man aboard armed to the teeth, and let those savages
look out. My duty is first to my ship. When I have her safe at
anchorage it's Dave Fearless, first, last, and all the time."
"Captain," observed Stoodles enthusiastically, "you're a jewel!"
Stoodles went apart by himself, smiling and apparently intensely
satisfied. He seemed planning something all the rest of the time it
took to go about one-third around the island.
The sheltered cove into which the Swallow finally ran was
located at a remote and unfrequented part of the island.
It was here that on a former occasion a derelict had lain shut in,
undiscovered for a long time, by great forests and guarded by steep
cliffs towards the sea.
The ravages of a great cyclone were visible here and there as
the Swallow neared its port. The steamer ran under a network of
vines that hung like a curtain across the front of this singular cove.
The first thing done, once a permanent mooring was made, was
to carry a portable forge ashore. Adams, the engineer, selected two
of the crew who had some knowledge of blacksmithing.
 "We'll have the Swallow in taut trim inside of three days,
captain," Adams promised.
"Good," nodded the commander. "I leave it to you. Now then, to
adopt some plan to reach Dave Fearless."
The boatswain came up and touched his cap respectfully.
"What is it, Drake?" inquired Broadbeam.
"That man, Gerstein."
"Well, what about him?"
"Uneasy, sir. I've been watching him closely. I found a package
of food and a knife and a pistol hidden under his bunk this morning."
"You did, eh?" muttered the captain thoughtfully. "Preparing to
bolt, you think?"
"I know it."
"Won't do," advised Broadbeam tersely. "Lock him up."
"In irons, captain?"
"No, the hold storeroom is safe and sound. Put him there. We
mustn't let the man escape until we know what he knows."
Captain Broadbeam had a long talk with Amos Fearless. He
decided that early the next morning they would make up a strong
party, well armed, and march on the native town of the
Windjammers.
"Come in here, my friends," said the captain to Pat Stoodles and
Bob Vilett, at the end of his talk with Mr. Fearless.
He then told them of his decision. Stoodles did not say much.
Bob was pleased and eager to start on the foray.
"I hope we shall be in time," sighed Dave's father anxiously.
"Those natives may even now have killed their captives."
 "You're wrong there, Mr. Fearless," declared Stoodles, with
confidence. "Listen, sir. Wasn't I once king of that fine lot of natives?
Don't I know their ways? Very well, my friends, if you will look at the
moon to-night you will find it on the lasht quarther. The
Windjammers never kill a prisoner except from a new moon up to a
full moon."
"Is that true, Pat?" asked Captain Broadbeam.
"True to the letther, sir--who knows betther than I, who have
had experience? Yes, sir, they won't harm the lad or his comrades for
over a week at the least, unless in a fight or an accident. Those
natives who came out on the big rock had come there to cast
another spell on the ship. Dave couldn't get away seawards without
dropping into the sea. He couldn't fight half the tribe. He's given in
quietly, as we saw, sir. They'll shut him up; that's all for the present.
We'll get him out; that's all for the future. Now, captain dear, I've got
something of a favor to ask of you."
"All right, Pat, what is it?"
"Don't march down on the Windjammers. I've said nothing
against your plans until the right moment."
"Well?" asked Broadbeam.
"I've a betther plan than your own to offer. Listen, sir--the most
you can muster is half a dozen able men."
"A dozen, fully."
"And leave the ship unguarded? All right, captain, call it a
dozen. What then? You march on a thousand natives. No, no, sir,"
said Stoodles, shaking his head solemnly, "they would wipe you off
the face of the earth, first move. Don't be foolish, sir. Let me thry."
"Try what?"
 "To rescue me young friend, Dave Fearless. Captain, you
remember how I hocused them and came it over them when you
were here before?"
"Yes, Pat, I have a very vivid memory of some of your whimsical
doings," answered the captain, smiling.
"Then one favor, captain: loan me Bob Vilett and a few traps I
need. Give me two days to bring back Dave Fearless."
Amos Fearless looked anxious, the captain undecided.
"Do it, captain," urged Bob Vilett eagerly. "I have great faith in
Mr. Stoodles."
The captain reflected seriously for a moment or two. He glanced
at the old diver. The latter nodded. Anything that might affect his
son's welfare appealed to him strongly.
"Do it, then," said Captain Broadbeam, "only, remember, you
two take your own risks."

CHAPTER XXII
THE HOUSE OF TEARS

"Hooray!" said Pat Stoodles, as soon as they were out of the

presence of Captain Broadbeam and the diver.
"All right now, eh?" insinuated Bob curiously.
"Shure I am. Now, my friend, I've done you the honor of
selecting you to go with me. You're willing?"
"Try me," cried Bob stanchly.
"The first thing," said Stoodles, "is to see Doctor Barrell."
 "What! You're not thinking of taking him with us?" cried Bob.
"Not at all," responded Stoodles, "but I do want to take with me
something he has got."
"And what's that, Pat?" asked Bob.
"His phonnygraph."
"Aha, I see," cried Bob, grinning. "The time you visited your
subjects before you worked on their superstitious fears by rubbing
phosphorus on your face. This time----"
"I'm reckoning on giving them a spaach, lad. Lave that end to
me. What I want you to do is to make another of those paper
balloons you sent up into the air the Fourth of July out at sea."
"Sure," said Bob; "a dozen, if you like."
"No, make two, for one might get disabled. Have you any of the
fireworks left?"
"No, but I can make almost any kind of a sizzer with powder
and fuses the purser will let me have."
"All right," approved Stoodles. "I may want to send up a balloon
at the proper moment. If I do, I want it to send out lots of sparks
when it gets aloft."
"You leave all that to me, Mr. Stoodles," said Bob. "I'll guarantee
a perfect job."
"It's all for Dave's sake, lad, so I know you will," declared
Stoodles.
The eccentric but loyal Irishman now went to the stateroom
occupied by Doctor Barrell.
"Docther," he said, entering the presence of the old scientist,
"I'd be telling you something."
 Doctor Barrell was very busy examining some seaweed
specimens he had fished up in the cove, but he graciously received
the visitor, who was quite a favorite with him.
"Speak right out, Mr. Stoodles," he said.
Pat narrated his plans in behalf of Dave Fearless. Doctor Barrell
was interested.
"And how can I help you?" he inquired, when Stoodles had
finished talking.
"Docther dear, it's the loan of your phonnygraph I'd be
wanting."
Doctor Barrell looked serious. He had a remarkably fine
phonograph outfit, receiver and transmitter attachments, and all up
to date.
This he greatly valued, for he was accustomed to talk his
scientific deductions into a receiver, preserving the records for future
reference when he got back to the United States.
"Tell me about what you want to reach, Mr. Stoodles," said the
kindly old fellow, "and I'll see if I can fix you out properly."
Stoodles explained his scheme. After that he was shut up with
the doctor for several hours. When he rejoined Bob his face was
beaming.
"It's all right, lad," he reported. "Ah, but a wise old fellow is
Docther Barrell. It'll be amazing what we are going to do to the
natives."
It was just before dusk that evening when Stoodles and Bob left
the Swallow. They each carried a good-sized parcel. The captain had
seen to it that they were furnished with small-arms.
 The ship's yawl took them out of the cove and landed them
about five miles down shore, the boatswain in charge.
"It's understood, then," said Drake, "that we be here again with
the boat at six, twelve, and six to-morrow?"
"If we're alive and well," answered Stoodles, "you'll find us on
hand on one of those three occasions."
"That has saved us a long, hard tramp," said Bob, shouldering
his load as they started inland.
"Two-thirds of the journey, lad, if the native town is where I
think it is," answered Stoodles. "Now, everything depends on getting
to the town and into it without being seen."
"Yes," assented Bob, "and it may prove a hard task."
"Not if you do exactly as I say," declared Stoodles. "Just follow
me. I know all the short cuts."
The journey was not a pleasant one. There was no beaten path
to follow. They had to breast their way at places through whole
acres of thorny bushes. At other places they had some steep rocks
to climb.
They rested frequently. It was about two hours later when
Stoodles pressed through the last canes of a great brake with an
expression of intense satisfaction.
"The hardest part of our tramp is over and done with, lad," he
announced.
"That's good news," said Bob, who was pretty tired.
"Now you rest here till I get up into a tree and take a peep in a
certain direction."
Stoodles selected a high, lonely tree near at hand, and was
soon up among its loftiest branches. He came down speedily.
 "It's all right, Bob," he stated. "A mile more and we will be at
the edge of the town."
"The new town?" asked Bob. "The old one was destroyed by the
cyclone, you know."
"Yes, the new town. It's not far away. I can tell by the lights."
It was now, as they reached a moderately level plateau, that
they found paths evidently used regularly by the natives.
One of these lay right through a large field of flowers that
resembled poppies. These appeared to be under cultivation.
"What's the flower garden for?" asked Bob.
"These are the royal flowers, lad," explained the Irishman.
"They use them for royal celebrations and funerals. Bad cess to it! If
we should be found here by the natives."
"Why?" inquired Bob.
"Taboo. No one is allowed here except the women who give
their life to tending to the flowers, unless by direct permission of the
native king."
"Well," observed Bob quizzically, "you had ought to be able to
get a free pass, seeing that you was king once."
Stoodles chuckled as if some pleasant idea was suggested to his
mind.
"I'll be king again," he observed. "I've got to be. 'Tis only for an
hour maybe, but Dave Fearless and I want to make that ten
thousand dollars."
"What ten thousand dollars?" asked Bob eagerly, as Stoodles
paused in some confusion.
"You'd better ask Dave that," suggested Stoodles.
 "Oh, I know what you are hinting at," said Bob. "It's some
schemes concerning those two boxes Dave got at Minotaur Island."
"Ah, is it now?" said Stoodles, with an expression of vacancy on
his face.
"I am sure it is," persisted Bob, "and I know what is in those
boxes."
"Hear him! Well, well!" commented Stoodles.
"It's a little printing outfit. Pat, what are you and Dave going to
mix up these natives with a printing outfit for? Won't you tell me?"
"Lad," pronounced Stoodles solemnly, "that is a dark and deadly
saycret for the present."
Bob had to be satisfied with this. He followed his guide in
silence. Stoodles halted.
"Do you see that old building yonder?" he asked of his
companion.
"Yes," nodded Bob, curiously regarding a rude broad hut
occupying an elevated space just beyond the flower field.
"Well, take my bundle. That's it. Now don't sthir till I come out.
Crouch down among these bushes. I've got to get into that building
to make my plans good."
"What is it, anyhow?" inquired Bob.
"They call it the House of Tears," was the rather singular reply
of Stoodles.

CHAPTER XXIII
READY FOR ACTION
"I wonder what he has gone in there for?" thought Bob Vilett, as
Stoodles disappeared in the direction of the House of Tears.
Bob had not long to wait. Stoodles came back as silently as he
had gone.
"Aisy, lad!" he warned. "There's people about."
"I don't see any."
"In the pagoda yonder. There's a dozen or more mourners, all
widows."
"Oh, I understand why it is called the House of Tears now," said
Bob.
"I was in on them with a stumble. By good luck the lights were
low for one thing, and they were all given up to their groaning and
mourning. Well, I got these two, anyhow."
"Two what?" interrogated Bob. "Oh, I see," he added, as he
made out two curious garments in the hands of his companion.
Spreading one out at a time, Stoodles showed Bob what they
were.
"Any royal mourner," he explained, "wears one of these
constantly for a full month after the death of a relative. They are
taboo all that time. They must not be hindered. They are free to go
where they choose."
"Good," commented Bob, "they'll help us out, then, won't they?"
"Yes. Get into this one, lad; it's the shortest," said Stoodles.
The garment was of one piece, covering a person from head to
foot. Its top was a cap with holes for the eyes only.
When the two friends were arrayed in the garments they
presented queer figures. Each carried his bundle under its ample
folds.
 The next half-hour was an interesting one for Bob. He simply
followed Stoodles. Somehow he could not help but have confidence
in the whimsical old fellow. For one thing, Stoodles certainly knew
his ground well from experience. Besides that, he had been
successful in carrying his point when he had before visited the native
town when they were marooned on the island by the Raven crowd.
It was now past midnight. As they progressed Bob could see
that they were nearing a lot of habitations.
For the most part the native village made up of squalid-looking
huts.
Here and there, however, were some more pretentious
structures. So far they had not met a single person.
"The palace, the home of the king, that same," said Stoodles, as
they paused near the largest building they had yet seen.
"What's the programme?" asked Bob.
"You see that little pagoda attached behind?"
Bob nodded affirmatively.
"That is the council temple. I must get in there."
"It looks easy," said Bob. "Those sides of matting are not hard
to break through."
"No, but the place is guarded day and night by as many as six
natives," explained Stoodles. "They sleep all around the curtained
daïs that holds the royal throne. Lad, I must get to that throne."
"All right," said Bob. "And what am I to do?"
"Listen very carefully. You see that big rock in the center of the
square yonder?"
"With a great bowl-like thing at the top of it?" asked Bob.
 "Yes. That is the public tribune, or place where the king's
messengers make announcements to the people. That big bowl is
filled with a perfumed water once a year, and the people pass under
it while the high priest of the tribe throws a few drops over each of
them."
"Go ahead," said Bob, "this is kind of interesting."
"Now then," pursued Stoodles, "I have planned out just what I
want to have you do. Don't make any miss, lad."
"I'll make no miss--you just instruct me," said Bob.
"You are to climb up into that bowl. It's perfectly dry now. It's
deep enough to hold you and all your traps. In just an hour you fire
off a revolver, its full round of charges. Get your balloon ready. I'll
hand you up the phonnygraph. Start it up--that's all."
"But what's going to come of it all?"
"You will soon see that."
"And what am I to do when the performance is over?"
demanded Bob.
"I'll see that you are properly taken care of," declared Stoodles.
"All right," said Bob. "I suppose you know what you are about,
but it's a pretty elaborate programme you are laying out."
"Oh, I know how to hocus these superstitious people, that's all,"
said Stoodles lightly. "I've done it before, you know."
Stoodles took Bob over to the public tribune. Everybody in the
village seemed to be asleep. They were apparently unnoticed and
undisturbed as they got the bundles up into the great bowl.
Bob climbed in after. Stoodles gave him a few last words of
direction. Then he started off to carry out his own part of the
programme.
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