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World Trade Organization says global trade could slide this year because of Trump’s tariff policies

GENEVA (AP) — The says the volume of in goods is likely to decrease by 0.2% this year due to U.S. President Donald ‘s shifting tariff policies and a standoff with , but it would take a more severe hit if Trump carries through on his toughest “reciprocal” .

The decline in trade will be particularly steep in North America even without the stiffest tariffs, the global trade forum said Wednesday, with exports there this year expected to fall by 12.6% and imports by 9.6%.

The WTO based its report on the tariff situation as of Monday. Initially, 2025 and 2026 were expected to have continued of world trade, but Trump’s trade war forced WTO economists to substantially downgrade their forecast, the forum said.

Trade in goods worldwide would slump by 1.5% if Trump follows through on his stiffest tariffs on most nations, due to the uncertainty unsettling businesses.

Trump suspended the toughest set of tariffs for 90 days earlier this month so more than 70 countries have a chance to address U.S. trade concerns. Meanwhile, he is increasing taxes on Chinese imports to 145% and engaging in a lengthy back and forth with Canada and Mexico about tariffs on their goods.

Despite the 90-day pause, “the enduring uncertainty threatens to act as a brake on global growth, with severe negative consequences for the world, the most vulnerable economies in particular,” WTO Director-General Ngozi Okonjo-Iweala said in a statement.

“Our simulations show that trade policy uncertainty has a significant dampening effect on trade flows, reducing exports and weakening economic activity,” WTO chief economist Ralph Ossa said in the statement. “Moreover, tariffs are a policy lever with wide-ranging and often unintended consequences. In a world of growing trade tensions, a clear-eyed view of those trade-offs is more important than ever.”

California will sue to stop Trump from imposing sweeping tariffs

SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom sued the administration on Wednesday, challenging the president’s authority to impose sweeping that have set off a global war.

The argues that ‘s use of the International Emergency Economic Powers Act to impose tariffs on Mexico, Canada and or a 10% tariff on all imports is unlawful. The act enables a president to freeze and block transactions in response to foreign threats but doesn’t allow the president to adopt tariffs, the suit says.

The lawsuit, which was filed in the U.S. District Court for the Northern District of California, also argues that enacting such tariffs requires approval from Congress.

Trump has offered many justifications for increasing tariffs, including that they are designed to spur U.S. and stop the flow of illicit fentanyl into the country. California’s move follows rapidly changing tariff plans by the Trump administration.

A White House official slammed the lawsuit and defended the tariff plan.

“Instead of focusing on California’s rampant crime, homelessness, and unaffordability, Gavin Newsom is spending his time trying to block President Trump’s historic efforts to finally address the national emergency of our country’s persistent goods trade deficits,” White House spokesperson Kush Desai said. “The entire Trump administration remains committed to addressing this national emergency that’s decimating America’s industries and leaving our workers behind with every tool at our disposal, from tariffs to negotiations.”

Newsom, a Democrat, said the tariffs have essentially resulted in inflated costs and could bring billions of dollars in damage to California, which has the largest economy and is the largest importer among U.S. states. Many businesses have told state officials they will start passing the cost of tariffs to consumers. The state budget could take a major hit with the tumbling market because California disproportionately relies on income tax revenues from capital gains — mostly money made from investments and stocks — from its wealthiest taxpayers. The additional costs from tariffs could also hamstring the state’s ability to plan for the future and pay for services, the suit states.

“No state is poised to lose more than the state of California,” Newsom said Wednesday at a press conference.

California has filed more than a dozen lawsuits challenging Trump’s policies this year. But the tariffs lawsuit marks the first time this year that Newsom, who is already considered a top 2028 presidential prospect, has been a plaintiff. The Democratic governor scaled back his anti-Trump rhetoric after January’s deadly Los Angeles fires as the state sought federal support.

Newsom discussed the lawsuit at an orchard in the farm-rich Central Valley, highlighting California’s status as a farming powerhouse. Many of the nuts, fruits and vegetables grown in the state are destined for other countries.

Christine Gemperle, a second-generation almond farmer in the Central Valley, said her farm has survived three droughts and the COVID-19 pandemic over the decades, but she’s uncertain how to the family business would make it through the ongoing trade war. Farmers in California grow roughly 76% of the world’s almonds, and they rely on the global markets for materials to build farming equipment and irrigation systems.

“Will we be able to access what we need to grow our crops, and if so, will we even be able to afford it?” Gemperle said Wednesday.

The state will ask the court to immediately block the tariffs.

The announcement comes days after Newsom asked countries to exempt California exports from retaliatory tariffs. No deals have yet been announced. He also launched a tourism campaign to entice Canadian visitors to California this week.

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Austin is a corps member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Austin on X: @sophieadanna

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Reporters Trân Nguyễn in Sacramento, Calif., and Joshua Boak in Washington, D.C. contributed.

 

Notes: Eds: UPDATES: Adds reaction of a California farmer to lawsuit, quote. Links additional photos from Newsom’s announcement. With AP Photos.

Tech shares fall after Nvidia says new US controls on exports of AI chip will cost it $5.5 billion

BANGKOK (AP) — Shares in computer chip makers slumped early Wednesday after said tighter U.S. government controls on exports of computer chips used for artificial intelligence will cost it an extra $5.5 billion.

The company, which announced Monday that it will produce its artificial intelligence super computers in the United States for the first time, said the government told it that its H20 integrated circuits and others of a similar bandwidth would be subject to the licensing requirements for the “indefinite future.”

In a regulatory filing, it said the government said the controls addressed risks that the products “may be used in or diverted to, a supercomputer in .”

Nvidia’s shares fell 5.8% in pre-market . Shares in rival chip maker AMD dropped 6.5%.

Asian technology giants also saw big declines. Testing equipment maker Advantest’s shares fell 6.7% in Tokyo, Disco Corp. lost 7.6% and Taiwan’s TSMC dropped 2.4%.

The news of the new controls came after Sen. Elizabeth Warren urged Commerce Secretary Howard Lutnick to impose restrictions on exports of Nvidia’s H20 and other advanced AI chips to China.

“I write with great concern regarding reports that the Commerce Department has paused its plan to restrict the export of powerful advanced AI chips like Nvidia’s H20 to the People’s Republic of China (PRC),” Warren wrote in a letter posted on the website of the U.S. Senate’s Committee on , Housing and Urban Affairs.

It said former President Joe Biden had not included the H20 chips in controls his administration placed on exports of advanced AI chips.

The emergence of China’s DeepSeek AI chatbot in January renewed concerns over how China might use the advanced chips to help develop its own AI capabilities.

Commerce Department officials were not immediately available for comment early Wednesday.

Nvidia said Monday it has commissioned more than one million square feet of space to build and test its specialized Blackwell chips in Arizona and AI supercomputers in Texas — part of an investment the company said will produce up to half a trillion dollars of AI infrastructure in the next four years.

The announcement came after President Donald and other officials said tariff exemptions on electronics like smartphones and laptops were only a temporary reprieve until officials develop a new tariff approach specific to the semiconductor industry.

Trump claimed Nvidia’s decision as a victory for his effort to expand manufacturing in the U.S.

US stocks tumble as Nvidia slides and the fog of Trump’s trade war thickens

NEW YORK (AP) — U.S. stocks are tumbling Wednesday after  warned new U.S. restrictions on exports to will chisel billions of dollars off its results, while companies around the world said ‘s war is clouding forecasts for how they or the economy will do this year.

The S&P 500 was 3% lower in late trading, an amount that would have vied for one of its worst losses in years before its historic, chaotic swings of recent weeks.

The Dow Jones Industrial Average was down 843 points, or 2.1%, with an hour remaining in trading, and the composite was down a market-leading 4.1%.

Losses accelerated after the head of the Federal Reserve said again that ‘s appear to be bigger than it expected, which in turn could slow the economy and raise inflation more than it had earlier thought. But Jerome Powell also said the Fed will need more time before deciding whether to lower interest rates, which could help the economy but also make inflation worse, or to do the opposite.

“All of this is highly uncertain,” Powell said. “We’re thinking now, really before the tariffs have their effects, (about) how they might affect the economy. That’s why we’re waiting really to see what the policies ultimately are, and then we can make a better assessment of what the economic effects will be.”

Some companies say they’re already seeing effects from the higher barriers to trade Washington is implementing.

Nvidia dropped 9.9% after it said the U.S. government is restricting exports of its H20 chips to China, citing worries that they could be used to build a supercomputer. The restrictions could mean a hit of $5.5 billion to Nvidia’s results for the first quarter, covering charges related to inventory and purchase commitments.

Advanced Micro Devices sank 9.4% after it said U.S. limits on exports to China for its own chips may mean a hit of up to $800 million for inventory and other charges.

In Amsterdam, ASML’s sank 5.2%. The Dutch company, whose machinery makes chips, said demand for artificial-intelligence technology is continuing to drive growth. “However, the recent tariff announcements have increased uncertainty in the macro environment and the situation will remain dynamic for a while,” CEO Christophe Fouquet said.

The uncertainty around Trump’s trade war has been scrambling plans for companies across industries and around the world. It’s so dynamic that United Airlines gave two different financial forecasts for how it may perform this year, one if there’s a recession and one if not.

The airline said it made the unusual move to give twin forecasts because it believes it’s “impossible to predict this year with any degree of confidence.”

United’s stock fell 1.2% even though it reported a stronger profit for the latest quarter than analysts expected.

Many investors along Wall Street are bracing for a possible recession because of Trump’s tariffs, which he has said he hopes will bring jobs back to the United States and trim how much more it imports from other countries than it exports. A survey of global fund managers by Bank of America found expectations for recession are at the fourth-highest level in the last 20 years.

The  said Wednesday it expects tariffs to cause a 0.2% decline in the volume of world merchandise trade for 2025. That’s if the tariff situation remains as it was on Monday. Trade could shrink by 1.5% this year if conditions worsen, the WTO said.

The “enduring uncertainty threatens to act as a brake on global growth, with severe negative consequences for the world, the most vulnerable economies in particular,” Director-General Ngozi Okonjo-Iweala said.

One U.S. company that moves freight, J.B. Hunt Transport Services, tumbled 8.5% for one of Wall Street’s sharper losses even though it reported slightly stronger profit for the latest quarter than analysts expected.

Tariffs could also drive up inflation, at least temporarily, by pushing U.S. importers to pass along the higher costs to their customers.

Fears about such price rises drove a spending binge last month, and sales at U.S. retailers accelerated by more than economists expected. Growth surged to 1.4% in March from February, up from 0.2% the prior month. Economists said much of that was likely because U.S. shoppers rushed to buy automobiles, electronics and other items before their prices could rise due to possible tariffs.

Recent surveys have shown U.S. households are feeling more pessimistic about the economy because of tariffs, and a fear is that it could lead them to pull back on their spending eventually, which could cause a recession by itself.

Treasury yields eased in the bond market, taking a leg lower following the comments from the Fed’s chair. The yield on the 10-year Treasury fell to 4.27% from 4.35% late Tuesday and from 4.48% at the end of last week.

It’s another sharp move for the bond market, and somewhat of a return to form after an unusual rise in yields last week rattled investors and Trump himself. Treasury yields typically fall when investors are worried about the economy, and last week’s rise suggested the trade war may be causing investors to doubt the reputation of U.S. government bonds as one of the world’s safest possible investments.

In stock markets abroad, indexes fell across much of Asia and were mixed in Europe.

Stocks dropped 1.9% in Hong Kong, 1% in Tokyo, 1.2% in Seoul and 0.1% in Paris.

The FTSE 100 rose 0.3% in London after the government said inflation in the U.K. fell for the second month running in March, largely as a result of lower gas prices.

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AP Business Writers Matt Ott and Elaine Kurtenbach contributed.

Notes: Eds: UPDATES: trading, headline, media.

Developer withdraws unpopular Pittsylvania data centers proposal

After months of residents and business owners speaking against an $8.85 billion campus and proposed for land along Chalk Level Road, the developer announced Monday that it has withdrawn its rezoning application

“The company is now evaluating alternative development options for the property in addition to the previously proposed campus,” , a Herndon development company, stated in a news release. The company didn’t respond to requests for additional comment.

Among the alternatives Balico is considering for the property is a residential subdivision project in partnership with a national builder. The property’s current agricultural zoning designation permits development of up to two dwelling units per acre, according to Balico.

“While a residential development is not the ideal use we had envisioned for this property, it represents a viable alternative that could still deliver value to our stakeholders, particularly if the data
center campus does not proceed,” a Balico spokesperson stated in the news release. “We are exploring several options that align with existing zoning parameters while meeting market demands.”

Balico withdrew its application following the Saturday release of an analysis on the proposed data center and power plant by the Southern Environmental Center. The report concluded that “Balico’s proposal would significantly increase the concentration of [fine particulate matter] in Pittsylvania County communities and cause adverse health impacts with real economic costs to county residents and the broader region.”

Balico did not respond to a request for an interview.

In November, Balico withdrew an initial rezoning application for a data center campus in the same area that would have included up to 84 buildings and a power plant on 2,233 acres. That proposal drew heavy public opposition and a statement by Robert Tucker Jr., now chair of the county’s board of supervisors, that Balico lacked the local political support to get the rezoning passed.

In January, Pittsylvania County’s Planning Commission heard a scaled-back proposal from Balico involving building 12 data center buildings on about 763 acres. As with the initial proposal, the plan included a 3,500-megawatt natural gas power plant. The commission members unanimously voted against recommending the proposal to the Board of Supervisors, citing concerns about proffers and transparency.

In both February and March, Balico asked to postpone the board’s public hearing on the proposed data center. On April 7, according to Balico’s news release, it asked the county to withdraw its application for rezoning.

Tucker said that he planned to leave the rezoning public hearing on the agenda for Tuesday’s meeting, which had to be moved to Chatham High School to accommodate an anticipated large crowd. He wants the matter to be settled and for county officials and staff to be able to move on to new projects and issues.

“We have been more than gracious with Balico,” he said. “In my mind, it really doesn’t make sense to tie up the resources of the county. We have other things going on.”

Va. casinos report $85M+ in March revenues

March revenues from Virginia’s three casinos totaled $85.19 million, according to an April 15 report from the . March’s statewide gaming revenues were up $10.02 million from February’s $75.17 million.

Last month, Hard Rock casino reported about $21.33 million in adjusted gaming revenues (wagers minus winnings), of which about $17.35 million came from its 1,444 slots and about $3.98 million came from its 73 table games. (The Virginia Lottery Board approved HR Bristol’s casino license in April 2022, and the Bristol casino’s temporary facility opened in July 2022, making it the first operating casino in Virginia. The permanent opened in November 2024.)

Rivers Casino , which opened as Virginia’s first permanent casino in January 2023, generated about $19.9 million in March from its 1423 slots and nearly $7.98 million from its 84 table games, for a total AGR of about $27.88 million.

The state’s newest permanent casino, the resort in , reported almost $35.99 million in AGR, with about $26.02 million coming from its 1,479 slots and more than $9.96 million coming from the casino’s 100 table games. The $800 million Caesars Virginia opened in December 2024, replacing a temporary casino that opened in May 2023.

Virginia law assesses a graduated tax on a casino’s adjusted gaming revenue. For the month of March, taxes from casino AGRs totaled roughly $15.33 million.

Under Virginia law, 6% of a casino operator’s AGR goes to its host locality until the operator passes $200 million in AGR for the year, at which point the host locality’s tax rate rises to 7%. If an operator passes $400 million in AGR in the calendar year, that rises to 8%.

For March, Portsmouth received 6% of the ‘s AGR, getting about $1.67 million. Danville received 6 % of the Caesars Virginia casino’s adjusted gaming revenue, amounting to roughly $2.16 million. For the Bristol casino, 6% of its adjusted gaming revenue — about $1.28 million last month — goes to the Regional Improvement Commission, which the General Assembly established to distribute Bristol casino tax funds throughout Southwest Virginia.

The Problem Treatment and Support Fund receives 0.8% of total taxes — about $122,676 last month. The Family and Children’s Trust Fund, which funds family violence prevention and treatment programs, receives 0.2% of the monthly total, which was approximately $30,669 in March.

Two more casinos are on the horizon in Virginia.

Construction began on the long-awaited $750 million Norfolk casino in February. The Pamunkey Indian Tribe remains a partner, but Boyd Gaming replaced Tennessee investor Jon Yarbrough. The entities have scrapped the name HeadWaters Resort & Casino. A temporary casino is expected to be completed by the end of the year. Developers named Ron Bailey as vice president and general manager for the forthcoming casino, earlier this month.

In November 2024, more than 80% of Petersburg voters said yes to the city’s casino referendum. Baltimore-based The Cordish Cos. and Virginia Beach developer Bruce Smith Enterprise broke ground on the much-anticipated $1.4 billion casino in March.

Bank of America ordered to pay $540 million in long-running lawsuit from the FDIC

NEW YORK (AP) — A federal judge has ordered Bank of America to pay more than $540 million to resolve long-running litigation from a U.S. regulator that alleged the company underpaid mandatory assessments for deposit insurance.

The order, reached March 31 and published publicly on Monday, arrives over eight years after the Federal Deposit Insurance Corporation sued Bank of America in 2017.

“We are pleased the judge has ruled and have reserves reflecting the decision,” Bank of America said in a statement to The Associated Press. The FDIC declined to comment when reached Tuesday.

Back in 2017, the FDIC accused Bank of America of refusing to pay over $500 million in assessments — a figure it later expanded to $1.12 billion — alleging that the giant failed to honor a 2011 regulatory rule and “unjustly enriched itself” at the FDIC’s expense.

The Bank of America later filed a motion to dismiss in part, strongly denying it acted with an intent to evade such payments. It also argued that some of quarters the FDIC targeted for assessments fell outside the statue of limitations.

After a yearslong battle, U.S. District Judge Loren L. AliKhan in Washington, D.C. partially granted and denied motions for both Bank of America and the FDIC. She said that the nearly $540.3 million payment from Bank of America would cover its underpaid assessments spanning from the second quarter of 2013 through the end of 2014’s fiscal year, plus interest — but ruled that the FDIC waited too long to sue over earlier claims.

Formed in 1933 during the Great Depression, the FDIC is one of several banking system regulators today. The agency is best known for running the nation’s deposit insurance program, which insures Americans’ deposits up to $250,000 in case their bank fails.

Bank of America, headquartered in Charlotte, North Carolina, is the second-largest bank by assets in the U.S. On Tuesday, the company reported a first-quarter profit of $7.4 billion and $27.37 billion in revenue net of interest expense, topping expectations.

Nasdaq holds off delisting Primis Financial until May decision

Nasdaq will wait for the results of a May hearing before -based bank holding company , the company said Monday.

Primis Bank announced last week that it had received notice from the exchange April 3 that the company was out of compliance with one of ‘s rules that requires listed companies to file all periodic reports with the U.S. Securities and Exchange Commission on a timely basis. Primis acknowledged it had not yet filed its Form 10-K for the period ending Dec. 31, 2024.

On April 9, the company requested an appeal of Nasdaq’s decision, requesting a hearing before a panel and postponing delisting from the exchange on April 14, meaning that Primis’ stock could not be traded after April 11. However, Nasdaq agreed to give Primis an extension on being delisted, and the panel hearing is set May 15. Nasdaq will decide whether to delist Primis once the panel issues a final written decision, and in the meantime, the bank will continue to its common stock on the exchange.

The company says it plans to file the Form 10-K “as promptly as practicable” and expects to do so before the hearing. At that point, Primis says the company will be in compliance with the Nasdaq listing rules.

Headquartered in McLean, Primis Financial is the parent company of Primis Bank. As of Dec. 31, 2024, Primis had $3.7 billion in total assets, $2.9 billion in total loans held for investment and $3.2 billion in total deposits.

Integer to expand operations in Salem, adding 83 jobs

Gov. Glenn announced Tuesday that global medical contract developer and company Holdings is expanding its operations in , creating 83 jobs.

A news release from the governor says the company plans to make a “significant investment” over the next five years to expand its operations at 200 S. Yorkshire St., but did not specify the cost. Integer plans to lease an additional manufacturing facility to increase production of catheter components for its growing cardio and vascular business segment.

The company has operated for Salem in 30 years, where it manufactures components for medical devices like catheters, guidewires, stents and pacemakers.

“Integer’s decision to expand in Salem demonstrates Virginia’s ability to compete and win in the advanced manufacturing sector,” Youngkin said in a statement. “For three decades, Integer has found success in the commonwealth, and this significant investment further strengthens Virginia’s growing medical device manufacturing industry. The company’s showcases how Virginia’s world-class workforce and strong business environment enable manufacturers to thrive and grow.”

According to the release, the new 13,000-square-foot facility will allow Integer to expand production capacity while also creating space for additional investment and jobs at its existing Salem locations.

“For more than three decades, our team in Salem has provided incredible talent to help Integer become our customers’ partner of choice for delivering innovation that enhances the lives of patients around the world,” Integer President and CEO Joseph Dziedzic said in a statement. “Our planned investment in this new facility is a testament to the great work the local team is doing, which is creating increased customer demand in growing markets that are addressing unmet patient needs. We look forward to our continued growth in Virginia.”

Salem Mayor Renée Turk said in a statement that the investment would boost the local . The Virginia Economic Development Partnership worked with Salem and the Regional Partnership to secure the project for Virginia, and Youngkin approved a $350,000 grant from the commonwealth’s opportunity fund to assist the city with the project. The governor also approved a performance-based grant of $500,000 from the Virginia Investment Performance Grant Program.

Integer did not immediately return requests for comment inquiring about the timeline of the expansion or the cost of the investment.

The company is headquartered in Plano, Texas, and reported revenues of $1.17 billion in 2024.

Roanoke jury finds ER doc wasn’t fired for whistleblowing

A jury decided Friday that a Valley emergency room doctor was not fired for complaining that ‘s emphasis on short wait times at and its Cave Spring ER had a negative impact on patient safety.

Dr. Thomas Bolton sought $20 million in his against his former employer, Lake Spring Emergency Group, a Glen Allen staffing and management services company that provides physician staffing for LewisGale Medical Center in and the freestanding LewisGale Cave Spring ER in Roanoke County.

The case is believed to be the first brought to trial under Virginia’s relatively new .

On Friday, the Roanoke County Circuit Court jury ruled that Bolton believed he was reporting a violation of federal or state law or regulations to a supervisor. However, jurors were not convinced that’s why Bolton lost his job.

In Bolton’s initial lawsuit, filed in 2023, LewisGale Medical Center, LewisGale Hospital and HCA Management Services were also listed as defendant, but Roanoke County Circuit Court Judge James R. Swanson dismissed parties other than Lake Spring Emergency Group from the suit. One of the nation’s largest for-profit hospital chains, Tennessee-based HCA Healthcare owns and operates about 2,400 hospitals and clinics, including the LewisGale facilities in the Roanoke area.

HCA Healthcare, Bolton’s attorneys and the attorneys representing Lake Spring Emergency Group did not respond to  requests for comment.

In Bolton’s 2023 complaint, he stated that doctors at the two LewisGale facilities receive alerts when management feels ER wait times are too long. Both facilities also have large digital signs that display the average length of time patients can anticipate waiting before being seen by emergency medical staff .

Bolton, who was hired by Lake Spring Emergency Group in 2018 to work at the LewisGale facilities in Salem and Cave Spring, repeatedly complained to management about the alerts and their impact on patient care. He also reported other concerns to management, including that patients who needed to be admitted to the hospital were being left in the emergency room and that there were slow responses for transporting critically ill patients in need of “emergent surgical intervention,” as well as inadequate numbers of medical staff.

Lake Spring Emergency Group denied the allegations in court documents.

In August 2021, management placed Bolton on a performance improvement plan. Bolton considered the PIP retaliatory, according to his complaint. Lake Spring Emergency Group, however, stated in court documents that the performance plan was implemented due to “among other things, clinical efficiency, timely communication and punctuality.”

In January 2023, Bolton complained to management that an 800-pound man had been at LewisGale Medical Center’s emergency room for 45 hours without any lab work being ordered. Bolton called an administrator at night to stress that the patient needed to be admitted to the hospital.

A month later, Bolton learned his physician agreement had been terminated and he would not be scheduled to work at either LewisGale facility beyond May 2, 2023.

Over the course of the four-day trial, numerous emails and texts were presented as evidence. Several of the emails are from employees of SCP Health, an Atlanta-based solutions company. Lake Spring Emergency Group shares a principal address with SCP Health in a Virginia State Corporation Commission filing.

In a May 2021 email presented in court, a SCP employee noted Bolton “consistently remains about 60 charts behind.” In a June 4, 2021, response, Bolton wrote that he took “complete ownership” of “charting delinquencies,” adding that his charts were “very thorough and detailed.”

In an Oct. 24, 2022, email, Bolton wrote to Puneet Chopra, regional medical officer for SCP Health, about concerns regarding patient care, writing, “I do not have trust in you, SCP and HCA administration that the concerns below won’t be disregarded due to chart delinquencies or other targeted issues and [I] do feel, have felt and I strongly believe that … in general none of the parties above ‘have my back.’”