Coast Hospital Suffers Another Relapse

The Mendocino Coast District Hospital (MCDH) is in turmoil. Sure, if you go in for a routine blood draw, you will get prompt, positive service, and you won't even notice the pinprick. However, the administration of the hospital is an entirely different matter.

Longstanding members of the Board of Directors don't know who the managers of individual departments are. The Finance Committee summoned department heads before the committee. The department heads refuse to be summoned. The relatively new CEO, Bob Edwards, appears to be in open opposition to two physicians on the Board of Directors. The brand new CFO contradicts one of those doctor's statistics at the most recent meeting of the hospital's Finance Committee on October 20th, and nobody outside hospital employees bothers to attend.

Admission is free to such events. Many of the MCDH Board of Directors and committee meetings possess more tension and angst than any reality show. Do the doctors, administrators, and other employees at MCDH need to race big rigs across frozen tundra while pulling each other’s hair out to get the attention of the public?

In August, supporters of Dr. Diane Harris filled the MCDH's Redwood Room when it seemed that their physician was going to be summarily dumped from her position at North Coast Family Health Center (NCFHC) after an insulting contract offer from CEO Edwards and NCFHC administrator Ilona Horton. In subsequent MCDH meetings, attendance by the general public has dwindled to almost nothing.

As good as the Board meetings have been, for entertainment purposes alone you can't beat the Finance Committee. You can almost count on Board of Directors chair Sean Hogan to show up, flaunt the Brown Act, and go on a ten minute rant concerning everything from agenda issues to his Irish ancestry. After completing his most recent red-faced ramble at the Finance Committee, Hogan ambled by my seat, leaned over and whispered, “Of course, this entire meeting is off the record.”

The retired attorney may have a poor grasp of civic meeting rules, but he still displays a self-deprecatory sense of humor. The problem is, as much as everyone loves a show, there's serious bid-ness at hand.

MCDH owes a boatload of money in bankruptcy payments; they will be making those payments for years to come. The Hospital has done very little, if any, planning toward building a new hospital physical plant (which it will be required to do in fourteen years time); and it is not breaking even many months of this year. In fact, MCDH's own figures show a net loss from operations in September, 2015, amounting to $187,121. At the end of that month the hospital's debt service ratio computed out at .86. In the words of the hospital's Chief Financial Officer (CFO) Wade Sturgeon, this is a number "no longer in compliance with the bond covenant ratio requirement of 1.25."

The debt service ratio is a requirement of Cal-Mortgage, chief amongst MCDH's bond insurers. A ratio of 1.0 would mean that the hospital had precisely enough money to cover operating costs and current debts. A ratio of 1.0 is more or less a bare minimum. Cal-Mortgage is asking/requiring that MCDH show a positive side, ongoing 1.25 ratio. Get the picture of what a .86 ratio means? It means that Cal-Mortgage would be within bounds to pull the plug on Mendocino Coast District Hospital.

Let's get back to the October 20th Finance Committee meeting where the most promising item on the agenda was the long promised appearance of MCDH's department managers.

First up, the Emergency Room (ER). CEO Bob Edwards stepped in for the ER Department manager, stating that she was refusing to appear before the committee. He added that other department managers at MCDH would take a similar stance. Several of these department managers were present in the back of the room. Most acted like they'd never attended a civic meeting before, though many have been seen, if not heard before. The managers interrupted the agendized proceedings of the Finance Committee, insisting they be heard from. When the committee finally relented NCFHC administrator Ilona Horton spoke first, essentially saying that she felt disrespected by the committee and potentially intimidated. Her sentiments were more or less repeated by a couple of other interruptive department managers.

Keep in mind that Horton was a party to the contract offer, or lack thereof, to Dr. Harris earlier this summer. She doesn't have a lot of respect ground to walk on. As for the other managers, no matter how disrespected or semi-innocent they might be, how can someone managing an entire department at a hospital that has just barely survived bankruptcy proceedings recently expect to appear even slightly reasonable while rejecting the request of that hospital's finance committee to hear specific details about their department? To this outside observer, these department managers appear as whiny, spoiled brats, whose body language at such meetings is somewhere on the ultra defensive side before the meetings even commence.

The doctors on the MCDH Board of Directors who are also chairing the Finance Committee are very assertive fellows, but that does not excuse each and every department, and their managers, from explaining as best they can what's going on. This hospital will not survive without a detailed accounting about what works in the terms of making money for the institution and what must be pared in order to continue. It's as simple as that. Anyone balking at participating in this practice should be deemed expendable.

That's probably what these defensive managers are afraid of, losing their jobs. But it's not the explaining of potential money losses in their departments that would or should cost them their jobs, it's the refusal to explain anything at all that is tantamount to insubordination. Taxpayer money provides a healthy chunk of these managers' salaries. (The Hospital is a special district with elected officers and a parcel tax increment is imposed on each property owner in the Hospital’s north-coast district.) This writer is a taxpayer who helps support MCDH. MCDH department managers, how dare you display such arrogance in refusing to tell the publicly elected officials of MCDH's Finance Committee what's going on in each and every one of your departments?

The problem here is that new MCDH CEO Bob Edwards sided with these managers at the Finance Committee meeting. Edwards is one of those smiley faced liars who cannot be trusted. He seems intent on some sort of power play battle with the two physician members of the MCDH Board, Dr. William Rohr and Dr. Peter Glusker.

Reportedly Edwards has continued to engage in public lies about the Dr. Harris scenario. A reliable source states that Edwards appeared before a local non-profit group recently, claiming that Dr. Harris had retired voluntarily before the whole contract kerfuffle hit the fan. Included in this tale as backup information, according to Edwards, was a "misstatement" (polite word for prevarication) that Harris had a retirement party before the contract brouhaha occurred. The opposite was true: Once Harris was unceremoniously refused a contract extension by Edwards, her supporters gave her a "retirement" party.

Dr. Harris has decided to move on to the Fort Bragg Rural Health Center (FBRHC), presumably taking a large percentage of her clientele with her. Readers of coastal weekly newspapers may have noticed the half page ad taken out by MCDH and North Coast Family Health Center (NCFHC) last week celebrating Dr. Pankaj Karan's practice at NCFHC. The problem is Dr. Karan is leaving to practice elsewhere. Currently, NCFHC is three physicians short. Reportedly, administration is requesting the remaining NCFHC physicians bear an ever increasing patient/work load.

The powers that be at MCDH seem to think the way out of their self-inflicted economic debacle is another attempt at a parcel tax. A previous attempt, approximately a decade ago, failed. What cognizant taxpayer would pony up more money to an organization whose physicians are abandoning ship, who have to outsource bill coding jobs at $71 per hour, and whose managers refuse to tell the public what's going on in their departments?