At a November, 2017, Mendocino Coast District Hospital (MCDH) Board meeting, the Medical Staff Manager made a statement that included the claim that the hospital's physicians “are 100% board certified.” A few moments later he forcefully repeated the assertion.
This is a matter that requires distinction. The Medical Board of California recognizes the licenses of all the doctors practicing at MCDH. All of those physicians appear to be practicing legally, but they are not all board certified by the Medical Board of California, the governing body for such recognition. For example, board member Dr. Kevin Miller is, as one would expect, board certified by the American Board of Medicine (or ABM) in Ophthalmology; fellow board member, Dr. Lucas Campos is board certified by ABM in Pain Medicine as well as Anesthesiology.
But this is not true of the entire staff. This writer examined the Medical Board of California documents for other physicians who work at MCDH. For at least one MCDH doctor the paperwork lists the expected areas of practice, but next to the category “Board Certifications,” the following word is: none.
So when the Medical Staff Manager stated, more than once, in front of an audience at a MCDH Board meeting, as well as those who watched on Mendocino TV, that all MCDH's physicians are “Board Certified,” that declaration was something akin to false advertising. This sort of false advertisement is not allowed under California's Business and Professional Code, Section 651, paragraphs (h)(5)(A) and (B).
Bob Edwards, the Chief Executive Officer (CEO) of MCDH has just as forcefully backed up the claim of total board certification for the hospital's doctors. This article is not intended as a knock on any one physician's capabilities, it simply highlights one more in a series of false claims made by the head of administration at the hospital, evidenced by the federal lawsuit which cites as defendants: Edwards, the institution's former Chief Financial Officer (CFO), the President of the Board of Directors, and the hospital itself.
John Kermen, the head of the hospital's Medical Executive Committee (MEC) has noted publicly that all of the hospital's active physicians have been approved by MEC; however, the MEC standards are not as stringent as the Medical Board of California. Thus the term “board certified” when used in reference to a doctor in this state means that a physician has attained that designation through the Medical Board of California. Furthermore, the MEC, manager, and the CEO know what the term “board certified” means in California. When that “100% board certified” claim was made in November neither Kermen nor Edwards made any effort to clarify the comment. Nor did board president Steve Lund do anything to correct the statement. To the best of my knowledge the only MCDH Board member to address the November claim in a questioning manner was Dr. Peter Glusker.
At the hospital's finance committee meeting, held on January 23, interim CFO John Parigi told a small audience that it would take three to four years to turn MCDH's economic situation around. Plant Services Manager Nancy Schmid detailed ongoing capital maintenance projects that will cost the hospital about $1.8 million. Most of the money to pay for these mandatory updates will come from a $1.5 million dollar loan from the state's HELP II program (essentially the last ditch loan an institution can get from public coffers).
Readers, no doubt, did the math and noted the $300,000 still remaining to pay off this bunch of capital maintenance projects (There are more on the horizon). Keep in mind MCDH is already paying penalties for not having an up to date electronic health record (EHR) system in place. The total cost for the EHR implementation could exceed $4 million. Because money is dear at MCDH, the hospital is most likely going to go forward with month by month payments on a lease program for EHR equipment, avoiding a lump sum payment.
Back to leadership problems: At that last finance committee meeting, the chair of the committee, Dr. Campos, returned to a faulty practice he had adopted early in 2017, but seemed to have stopped by last summer. That faulty practice concerned the Finance chair's forbidding public input on “Action” items during the committee's meetings.
Late last spring the MCDH Board received a reminder about California's Brown Act, in particular Government Code 54954.3(a), which states, “Every agenda for regular meetings shall provide an opportunity for members of the public to directly address the legislative body on any item of interest to the public, before or during the legislative body's consideration of the item…”
After that Dr. Campos seemed to have taken notice of the law and he did allow the public to comment, at the appropriate times, during “Action” agenda items. However, once the calendar flipped to 2018, Campos reverted to a belief that the public only speaks during the “Public Comment” section after all the “Action” items on the agenda have been voted on and concluded. Simple common sense would dictate that a committee chair would welcome input from the public whenever possible.
Given that Dr. Campos, as Finance Chair, has repeatedly flouted the Brown Act, it would not seem far-fetched to ask for his removal from chairing the committee, but he is scheduled to attend a Brown Act training seminar in February, so one can hope he will return from that with a renewed appreciation for public input. Why he wasn't directed toward Brown Act training a year ago is another question seemingly left unanswered by MCDH's top administration and its Board's leader.
Readers can see a June 21, 2017 AVA article for more on the attitude of Dr. Campos toward public input.
Speaking of false advertising… look at the public web page for MCDH. Look how many times it states “All Insurance accepted” then know MCDH and it’s clinics will not accept workmans comp insurance. This was publicly noted to the BOD last year. I would think the MCDH would want to have the right to claim actual care for the people whom the so seek to add further tax burden to…
Board certified is a meaningless term anyway. The Medical Board takes in over 100,000 consumer complaints every single year from harmed patients…many of those are about “board certified” doctors.
I recently had abdominal hernia surgery in 2015. That surgery failed 6 months later and the same surgeon went back in and redid the surgery in 2016. Literally right after my surgery, she hopped on a plane to fly back to Florida to get her “certification.” and bragged about it at our next appointment. 6 months later, that surgery failed , too. I’ve now had a third surgery by a different surgeon who had to go in and remove all the damage she created. Turns out, she had sewn my stomach to itself instead of to my esophagus (a procedure called a fundoplication).
So much for her now being “board certified.” Now I have to file a medical board complaint for her incompetence.
Hmmm. Not too hard to figure out who that might be since there are only three surgeons formally affiliated with Coast Hospital.
https://health.usnews.com/doctors/linda-james-396574
In general, when I think surgery, particularly major surgery, I don’t think Mendo.
I am the Former Asst. Chief Financial Officer at Healdsburg District Hospital and had the misfortune of working with Mr. Parigi (Interim CFO) and Ms. Schmid (CEO). I want to share my letter I submitted the Northern Sonoma County District Hospital Board of Directors before resigning. This will give you a real accurate picture of what Mendocino Coast has just allowed in their front door. I can assure you Parigi and Schmid have a history of raping financially struggling hospitals of their money then leaving them to repair the destruction in their wake. See below..
Directors,
I have made
the choice to leave Healdsburg District Hospital for several reasons that I
think you should be aware of but first it is necessary to understand what kind
of leader and what type of person I am. I am and have always been a
professional with the highest level of integrity and a sound ethical base. When
I make a mistake I own it and am not afraid to let others know that I am not
perfect. I treat staff, managers and senior leadership as people “first” and
afford them the common respect and kindness that should go along with that. I
am a motivator, a mentor, a collaborator and a team member.
The reason
I wanted you to understand what kind of person and leader I am is because it will
help you understand my choice to leave Healdsburg District Hospital after only
4 months time.
Reason #1: You all are being misled regarding the $1.5M
Medicare “take-back”. In early December 2014 Vivian, Executive Assistant,
e-mailed me about our fiscal intermediary’s, Noridian, attempt to contact both
John Parigi, Interim CFO, and Nancy Schmid, CEO about an interim cost report
and asked if I would follow-up…so I did. I called Noridian and the
representative informed me that they had tried to get ahold of John and Nancy
since July 2014 regarding the interim cost report and the deadline for
submission was 12/31/2014.
I immediately notified Mr. Parigi and Chad Klewer,
McGladrey, of my conversation with Noridian. Both told me not to worry about it
that it was due to John’s request for an interim cost report but it was no
longer necessary. I told them that perhaps they should at least give Noridian a
call and let them know rather than ignoring their calls. My suggestion fell on
deaf ears.
Either the first or second week of January 2015 we received
notification from Noridian that they were assessing a $1.5M pay back along with
reducing future reimbursements 10%. John, Chad and I scheduled a call with
Noridian shortly after. The Noridian representative told us that the $1.5M pay back
and 10% reimbursement reduction was due to the fact that we failed to submit
the 2014 Interim Cost Report as requested. John and Chad both informed the
Noridian representative that they no longer needed the Interim Cost Report they
requested to which the Noridian representative quickly responded that the
Interim Cost Report they were referring to was the Interim Cost Report Noridian
asked for. The Noridian representative informed us that periodically requesting
Interim Cost Reports is part of Noridian’s process.
Had John, Chad and even Nancy responded to Noridian’s e-mail
or even bothered to return their call this would have been avoided. If John and
Chad had checked my call with Noridian out we could have gotten the Interim Cost
Report out before 12/31/2014.
This is Mr. Parigi’s and Nancy’s fault…nobody else’s. It
greatly disturbs me to listen to John and Nancy blame Noridian for “coming
after them” or put the blame on others when I know the truth and I know
this was avoidable.
Mr. Parigi continues to tell the F & B Committee and the
Board that once the 2014 Cost Report is complete that we are going to get all
of the $1.5M back. We may get a good portion of that money back, but we will
not get the 10% reduction we’ve realized since which could add up to hundreds
of thousands of missed revenue.
Reason #2: John Parigi and Nancy Schmid are placing all of the
blame for the troubles we’ve had regarding the 2013 audit on McGladrey.
Although they do shoulder some of the blame for not sending the most qualified
accountants I believe the vast majority of the frustrations sit with Mr.
Parigi.
I came on board November 17, 2014. Since coming on board I
have seen McGladrey auditors constantly come to Mr. Parigi for answers to their
questions only to be told he was “too busy” and for them to come back later.
The District even brought John Steging, consultant, on to help get information
that ended up being either incomplete or wrong. I know because I had to
re-accomplish much of his work. John would constantly talk about how
unqualified the accountants were and berate them to me when they left…which was
extremely unprofessional in my opinion.
At some point McGladrey brought Christy Dimson, auditor, in
to assist with the audit because of the timing issue with our insurance.
Christy was a more senior auditor and certainly had more experience. From the
day Christy came on board Mr. Parigi began behaving inappropriately. He would
ask her personal questions that had nothing to do with the audit at hand. He
asked about her husband, her marriage and other person questions completely
unrelated to the audit. I could tell that Christy was becoming uncomfortable as
well. One morning John actually came in and told me that he thought Christy
“liked” me to which I immediately responded, “I’m married and love my wife. I
would never even consider going outside my marriage”.
I reported this to Kristina Holloway, CHRO, the week of March
16th. I’m not sure if my report went anywhere.
Reason #3: Mr Parigi is constantly on the phone conducting
personal business and charging the hospital for it. I hear him talking to
vacation planners for a cruise; business associates about his next consulting
“gig”, investment broker about his portfolio…etc. This District is paying Mr. Parigi
a whole lot of money and I assume it’s not for those purposes.
Since coming on-board here Mr. Parigi has basically turned
over all of his tasks to me to include: putting the monthly financials
together, insuring all financial reporting is complete and submitted, supervising
the Finance department (which should be mine because I am the Controller),
managing cash flow and others. This has left John time to conduct other
business to be sure, but it has also left him to “lolly gag”, in my opinion. A
lot of the work I’m currently doing I’ve had to learn on my own because either
processes were not shared or I’ve had to develop on the fly.
I also despise rumors and gossip, but all I hear from John
is how incompetent people here are or things he may know about their personal
lives…again inappropriate. My first week here I was asked to dinner with John,
Nancy, Pam McFarland and the Lab Manager (I forget her name). All I heard was
how this hospital needed them and how employees are lazy and incompetent.
Inappropriate for senior leadership for sure.
Final Reason: I was offered the Asst. CFO/Controller position
with the understanding that I would be the “lead” candidate for the CFO
position in 3 – 6 months. I left a good position with Modoc Medical Center in
Alturas, CA as CFO because I had the chance to work at a higher level Critical
Access Hospital as a CFO. Over the last month John informed me that he told
Nancy that in his opinion I was not ready to take over the CFO position. The
fact of the matter is that John didn’t have another consulting “gig” lined up
and he and his partner’s plan to acquire hospitals in Texas fell through so he
needed a steady long-term income…hello Healdsburg!
Since Nancy and John are personal friends outside of
business my guess is that Nancy did John a favor and extended his contract so
he would have steady income. I also find it a bit odd that an RFP never
occurred for the consultant. Nancy merely slotted John and his team in.
I cannot wait a year to “maybe” become the CFO here at
Healdsburg. It would be a career-killer for a 5-year CFO.
In closing I hope you all take this to heart. The
consultants served their purpose, but should have been gone by now. Mr. Parigi
is poisonous. He is going to get the hospital in trouble either by sexually
harassing an employee, failing to submit another required report or by acting
inappropriately. He can’t help it. It’s who he is. He’s shared stories with me where
he’s been accused of many of the things I’m warning the board about now.
I leave with mixed emotions. On one-hand I know I could have
made a HUGE difference in employee morale, financial performance and overall
organizational excellence and I feel like I’m leaving unfinished business. On
the other hand I know my opportunity is out there waiting for me and whatever
organization lands me is going to get the most talented, ethical CFO who can
not only take them to the next level, but also help drive that success.