Will Voters Be the Cure?
By Richard Riehl / The Riehl World
Tri-City Medical Center. Photo credit: Google
According to a 2011/2012 San Diego Grand Jury Report, Tri-City Healthcare District Continuing Issues, May 30, 2012, “The Grand Jury believes the coming election to be an excellent opportunity for the electorate to remake the current Tri-City Hospital Board of Directors into a less distracting and more professional body.”
So, how did that go? In the four years since the 2012 election, the “remade” board fired its CEO, hired and fired his replacement, and hired another to take his place.
A series of failed lawsuits cost the hospital over $30 million in settlements, attorneys fees, and lost revenue resulting from bogus allegations related to the purchase of a medical office building that remains vacant to this day on the hospital’s campus.
Yesterday, Tri-City attorneys filed a motion in Superior Court to avoid having to make a payment on the settlement of its most recent failed lawsuit. Chief Financial Officer Ray Rivas explained that the $12.1 million judgment could trigger a default on a line of credit that funds payroll, accounts payable and all other hospital expenses.
Is Tri-City on the brink of bankruptcy?
Two months ago I suggested the hospital start firing attorneys, rather than CEOs, (Tri-City’s Fired CEO Cleared Again of Wrongdoing). But Irwin Schenker, an Oceanside resident with 35 years of experience in healthcare management, gave me an insider’s view of Tri-City’s Board of Directors. Flipping CEOs, it seems, is just the tip of the iceberg.
Schenker served from 2009 to 2013 as a citizen volunteer, appointed to the hospital’s Finance, Operations and Planning Committee. The retired healthcare administrator told me that nothing in his long career had prepared him for the “series of sad circus events that passed for the Tri-City experience.”
In the first Board of Directors meeting he attended, a discussion of how to terminate CEO Larry Anderson, about a year after he’d been hired, topped the agenda. He survived that first attempt, managing to hang on for nearly four more years.
Schenker told me the story of one board member who was so out of control with tirades, insinuations and insults the individual had to be excluded from attending meetings in person. Arrangements had to be made for the disruptive board member to sit in another room, fitted with electronic communications, to allow for limited participation.
The 2010 election brought another individual to the board whose behavior, according to Schenker, was even more bizarre. As well as disrupting meetings, on more than one occasion the new board member took a position on the hospital’s front lawn to display signs warning visitors to go elsewhere for treatment, declaring Tri-City was unsafe for patients.
At one meeting, Schenker recalled, a board member challenged an audience member to a fistfight.
After two board members were replaced because of city residency requirements, the reconstituted board included two individuals who, it became apparent to Schenker, had a “hidden agenda” to fire Larry Anderson.
After Anderson was ousted, Schenker met with a couple of board members to question them about allegations of his dishonesty. They assured him the truth would shortly be made public. That “proof” never materialized.
After Schenker’s four-year committee member term limit expired, he continued to attend board meetings open to the public. Here are some of his observations:
* Talented personnel have been terminated because of imagined loyalty to Anderson or lack of subservience to the board.
* “Fear and uncertainty have permeated the staff” because of continual changes in executive leadership.
* Financial reports are no longer as available to the public at meetings as they had been. Instead, an abbreviated financial report is briefly flashed on a screen. Cost items, such as legal expenses, part of comprehensive financial reports in the past, are no longer included.
* Opposing views are dealt with in a “mean-spirited manner,” either by dismissal or, as was the case of one dissenting board member, an intimidating and expensive lawsuit.
San Diego County’s Local Agency Formation Commission, (LAFCO), is a regulatory agency that provides information to guide the development of healthcare districts. In its May 5, 2015 report, LAFCO cited grand jury recommendations to “consider several governance alternatives for Tri-City, including merging the district with the neighboring Palomar Health HD, turning over hospital operations to an outside party, or selling Tri-City Medical Center to another health system.”
On November 8 another four-member majority will be elected from the nine declared candidates. The incumbents: Larry Shallock, Julie Nygaard, Ramona Finnila and RoseMarie Reno were all there during the hospital’s last four years of costly chaos.
Nygaard and Finnila are the most politically well-connected, having served a combined total of 26 years on the Carlsbad City Council.
In 2013 Reno was named Trustee of the Year by Modern Healthcare for her long years of service to Tri-City. Reno’s board colleagues were apparently unimpressed. She was maliciously accused of a conflict of interest in the hospital’s lawsuit related to the purchase of a medical office building, a case which collapsed in court. Reno was cleared of all charges of wrongdoing.
Among the five other candidates are Frank Gould, a retired Superior Court judge; Donna Rencsak, a psychotherapist; Leigh Anne Grass, a registered nurse; Marggie Castellano, a film/TV producer; and Dan Hughes, a business owner.
Combine any three of these five with the steady hand of RoseMarie Reno, and voters could get a new majority, free of the baggage of the last four years, bringing new hope for Tri-City’s future. Given the legal issues bungled by the board, I’m hoping the retired judge will be among them.
California law will not allow a healthcare district to abandon an elected governing board. Thatmeans the only way to save Tri-City is at the polls.
Shortly after my wife and I arrived in Carlsbad 20 years ago, a Tri-City surgeon saved Karen’s life. On November 8 we’ll vote to save the hospital.
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What can account for the tendency of pretty places like Carlsbad to elect the mean and greedy?
Tri-City Healthcare District recently affiliated with UCSD Medical Center. Perhaps this relationship will help the hospital get back on track. Changing the current board won’t fix the institutional maladies.
A toxic culture permeates the entire organization. The attorneys have built the Berlin Wall of secrecy. The quality of care is abysmal. The finances are on life support. I strongly recommend that everyone who is sick go to any hospital except Tri-City.
I’m not so hopeful about UCSD’s affiliation with Tri-City. It apparently will have no impact on the hospital’s management. Here’s an excerpt from the Oct. 14, 2015 Paul Sisson UT article that explains the relationship.
“Patty Maysent, the university health system’s interim chief executive, said the agreement is designed to be a partnership rather than a management pact.
“We don’t feel the need to manage or control them in any way. They were very clear on the front end that they wanted to stay self-governed, and we were fine with that. We can partner without having control,”
The problem, Randy, is a long history of dysfunctional board behavior. That won’t change without new faces who recognize and do something about that.
Richard, I agree that there is a long history of dysfunctional board behavior. However, there is also recent history of new faces. The 2010 board majority was replaced by 2013. Yet the institutional dysfunction remains. The best long-term solution would be for an outside entity with a proven track record to assume management and control of the day-to-day operations. This is how Grossmont Hospital District runs. Its elected board decides only one issue: which charities receive a portion of the district’s property taxes.
Can you refer me to your source for that claim?
The Grossmont Healthcare District website makes no mention of an “outside entity” managing and controlling its day-to- day operations. The elected board hires a CEO to do that, exactly the way Tri-City does. Contracting with an organization to govern its operations,according to LAFCO, is against state law for Healthcare Districts. Click on the following for Grossmont’s Board By-laws. Doesn’t appear they only choose charities. http://grossmonthealthcare.org/g-h-d/wp-content/uploads/2015/01/Bylaws-Revisions-ADOPTED-February-21-2014.pdf
If you google Grossmont Hospital, you get Sharp Grossmont Hospital. The hospital is managed and operated by Sharp. There is a management contract between Sharp and the hospital district. The contract is such that the elected board of directors has delegated the operation and management of the hospital to Sharp. I believe the initial contract was for 15 years.
Yes, but the only way Tri-City could pull that off is for the Board of Directors to agree to establish that relationship in a vote by the board. Hence, the importance of electing a new board. (And Grossmont HD didn’t “delegate” management. It leased the hospital to Sharp.)
Yes, the Tri-City Hospital board could lease the hospital to whomever they please by a vote. But NONE of either the current board members or the candidates will vote to do so. In the election 2 years ago, the current board was demonized by the union backed candidates with the spurious allegation that the current board was trying to turn the hospital over to another entity to operate and manage. Even though it is the best solution, it will never happen. The hospital will go bankrupt first.
Call me a cockeyed optimist, but I think when there are new board members, who are not not dragging the baggage of the last four years, there’s always hope.
Actually, I think some some of the new board members who have been put into place over the last four years that have been able to make changes that have benefited the community. Based on what I have witnessed and experienced, it is board members who have been there for years that have contributed and created the dysfunction. People in the community know that Tri-City has had a terrible reputation for decades. Check it out, there are members of the board that have been there for quite some time. Don’t be fooled into lumping all the incumbents into one pile. Because the elections are staggered we have to make incremental changes. Ramona Finalla has been the best thing that has happened to Tri-City in a long time. She has the wisdom and insight to identify and respond to the corruption and moral issues that have plagued the hospital. BTW – isn’t the author of this blog known to be friends of fired CEO Larry Anderson, and the retired judge, Frank Gould, who is running for election?
Some of the people running for election are friends of the fired CEO Anderson. There are also people currently on the board who contributed to the “dysfunction”. I do believe that the voters should take note of that and be sure they are voted out of office. On the other hand, I strongly believe that we have been in better hands since Ramona Finnila has been on the board. Julie Nygaard frequently works with Finnila and provides support. I have been following Tri-City hospital very closely after my husband suffered abuse and neglect. Mr. Horton mentions the institutional dysfunction that exists, and I assure you that it is real. Finnila and Nygaard are relatively new to the board, and Finnila has certainly established herself as reliable and ethical in her attempts to help the hospital make a turnaround. I urge you to support Finnila and Nygaard in their attempt to be reelected. It is the long term board members that should be booted out if the hospital and its patients want what is best.