Mendocino Coast District Hospital's (MCDH) Board of Directors has canceled its monthly Planning Committee meeting for May. It strikes this observer as odd to cancel a chance to express a clear vision of future planning for a hospital in the final month before that hospital is asking the public to approve a parcel tax. It's a bit like a candidate not showing up at a forum to handle questions from the voters in the weeks leading to an election. It does not engender confidence.
A look back at the April Planning Committee get-together offers further insight into how the leadership team at the hospital views and treats the public, even their own handpicked members of the public. The hospital leaders I am writing about are Bob Edwards, Chief Executive Officer (CEO), and Steve Lund, President of the Board of Directors. These two essentially run the Planning Committee.
The main agenda item at the April planning meeting was labeled, “Strategic Initiatives.” CEO Edwards passed around a seven page handout to those in attendance. As usual, his strategic initiatives are not available online. Edwards described his six most important initiatives as “pillars.” They were titled, in order of Edwards' preference: 1) “Quality/Delivery of Care;” 2) “Physical Plant/Facilities;” 3) “Financial/Fiscal Solvency;” 4) “People/Physician, Nursing and Support Staffing;” 5) “Community Engagement/Involvement;” 6) “Governance.”
Pretty mundane, run of the mill headings. If you want to watch your own eyeballs roll back out of sight, stand in front of a mirror and get a load of what is written underneath the “Quality/Delivery of Care” heading:
Joint Commission, 2nd or 3rd quarter 2018
ACR, 2021
BETA, Annual, May 19
Prime, Annual, Oct 18
CMS, Ongoing, Unannounced
ACHD, April 18, April 19
NRC Health (HCAHPS) Quarterly
Yes, acronym city. They are all abbreviations for entities that review part or all of the hospital's workings. A member of the public who was part of a subcommittee to put together these strategic initiatives wrote this: “If for public use... Include a glossary of acronyms: Acronyms that aren't familiar don't educate, they keep the reader at a distance, which goes against goals for transparency and educating.”
That same member of the public also stated, “The audience for this document is unclear. As is, it doesn't speak to the community outside the hospital. Public buy-in going forward means addressing people in everyday language and out in their arena. This is not just a planning exercise. Everything done from now on is critical to the future of the bond measure and keeping patients here. Anything that distracts or distances the public, the voters, or drives patients over-the-hill unnecessarily can negatively impact the hospital's future.”
As that member of the public most likely figured out by the time Edwards was done shambling through this mess of acronyms and abbreviations, the document was not truly meant to see the light of full public airing, but merely as something to show bureaucratic auditors, inspectors, and regulatory review teams. As part of this hoodwink, the CEO and Board President needed to create the appearance of public participation in the process of strategic planning for the hospital.
The member of the public quoted above described how the process worked for her: “Four public members were asked by Steve Lund to be part of a Planning subcommittee on a strategic planning effort. We met twice for one hour each time. For the second meeting the Draft information was arranged into a more traditional format a member suggested. Despite other, sometimes extensive comments, questions, and suggestions by the public members, none were addressed at our second and last meeting. There was no real discussion of our comments, nor clarification of anything in the Draft, nor an answer to the question of what was expected from our participation. We expressed concerns for the lack of public engagement focus in the draft — an emphasis when inviting us onto the subcommittee. We also gave assurances, if done properly, a public planning process could be successful. The virtually unchanged document has moved on a fast track to the [MCDH] Planning Committee. The missed opportunity is [for] those who were invited to the table (and others in the public) [who] have expertise and success at planning and management including in a major hospital. In short we've earned our stripes.”
Not much more need be said. It is clear that Mendocino Coast District Hospital's Chief Executive Officer and its Board President see the public, even their own hand-picked part of the public, as mere tools, and abbrev. ones at that.
Some real planning for MCDH's future should look more like what Dr. Peter Barg sketched out in a recent letter to the editor opposing the hospital's parcel tax ballot measure. “[A] reasonable concept moving forward might be for the District to oversee expanded outpatient care that would provide rapid access to providers at all levels; routine, urgent and emergent. (The Emergency Department is exactly the same size it was 48 years ago when the Hospital opened.) A triage system would be put in place to establish the level of care needed and direct people accordingly. In addition we would need an expanded transportation system including shuttles, ground and air emergency by contracting with various existing agencies to get patients to the right place for the best care in the most expeditious fashion. Finally, there should be an overnight holding unit for stabilization or prior to transfer and for people undergoing scheduled outpatient procedures.”
Peter Barg made good sense for the future planing of MCDH. This parcel tax will not save the hospital, they are too much in debt and the building is in major need of renovation.
The exorbitant cost of rented employees in all departments, is a huge financial burden. Why do we not have trained local professional candidates right here? Years ago when I was an R.N. at the hospital local employees made up the majority of the employees from the top to the bottom. We have a college right here in town, why are they not interested in classes that could benefit the hospital? It may be the cost of living here is so high no one wants to live and work here.
Amen!
Dr. Barg wrote it out brilliantly.
Come on, people. It’s time to stop listening to the garbled bs and stop making decisions by our emotions.
It is a sunk ship with no direction up.
Not to forget all the hidden corruption. Closing our eyes does not make it non existent.
I noticed Measure C, the coast hospital tax initiative, has no published ‘against’ statement.
Any suggestions where to go to find such a perspective, or who to talk to?
Thanks,
Cob
Look in the AVA archives under everything MM has written on the MCDH. MM is the only reporter to have attended MCDH board meetings on a continuing basis. Also, the Peter Barg letter appeared in the AVA in early May, and was published in both the Beacon and Advocate.
What Peter Barg is saying seems pretty obvious. The MCDH needs to evolve to address the changed needs of the community it serves, and it needs to be very good at doing this.
Yes George I agree that what Barg suggested is a wise path.
Another problem with Measure C is that it is an assessor parcel tax. An appropriate tax would be based on legal habitations, or something along those lines. An assessor parcel tax is based on parcels long established by the County Assessor. Those parcels have little practical meaning, beyond the Assessor’s Office. So an apartment complex on one assessor parcel pays $144 year. A person like myself, with one habitation, who has multiple assessor parcels pays much more. Doesn’t make any sense. If the tax passes, which I doubt it will, there will be a mad dash to the Assessor’s Office to consolidate assessor parcels. That should be fun. When the MCDH Board decides to go for a new property tax, once things are going in the right direction, the parcel tax idea needs to be scrapped. There are better options.
What we need to see first is broad support for services being provided, by our hospital district. With broad support, a tax will be supported.
Among others, Peter Barg, Margaret Paul, Malcolm Macdonald, Marianne McGee, Louise Mariana and Dr. Richard Miller have all publicly brought up salient issues with the parcel tax, the healthcare district board, and the administration. And they have shared some great ideas on how to remedy some of the problems and how to at least improve others. But with thebCEO is deaf to, and has disdain for, the public. The board has recently improved their attitude a little, probably because of the upcoming vote on the parcel tax.
I also recommend watching the board and committee meetings where you can gain your own perspective from the facts. The meetings can be long and tedious but you can listen while engaged in other activities.
Mendocinotv.com is where you will find videos of all of the meetings. It’s where you’ll hear from the board president that the parcel tax revenue will not cover the deficit, that the hospital will not close if the parcel tax measure fails, the board and CEO have not prepared an official Strategic Plan (and strategic initiatives are not the same as a strategis plan), the CEO and board hired consultants and completely ignored their recommendations (one of whom was the target of an unprofessional long rant by the CEO, during a recent board meeting and he should have been stopped by the board president), the board renewed the CEO’s contract, at well over $300,000 per year, for an astonishing 4 additional years…and on and on. Due to his lack of respectful leadership, he is also named in a lawsuit that the hospital will likely lose. But the hospital does now have an anti-bullying policy in reaction to the treatment of employees by him and Mr. Sturgeon and a board member.
You will also learn that the board continues to ignore the necessary planning that must occur to bring the hospital up to seismic standards by 2030, a mere 12 years from now. In 2002 a property tax measure was passed and the first line on the ballot was that the hospital needed to be brought up to the, then new, seismic standards. Although they have been continuously collecting money from property owners in the district since then, the seismic work is not completed, let alone planned or discussed beyond board members and the CEO saying that the job will be difficult and is looming – an amazing way to deal with the biggest issue facing the hospital.
This vote is about whether to throw good money after bad. From the commentary in the Fort Bragg Advocate yesterday, we learn all of the collected taxes for a year will not make up the shortfall due to mismanagement, including not collecting from insurance companies what is owed.
The hospital is broken. There is no way to fix it with this tax. Let it fail so a new group of people will step in and provide care appropriate to the needs of this community
How much does the hospital pay individual doctors on contract?
If they get a lot and they are on the board, is that an inherent conflict of interest that should require them to abstain from votes concerning the financial condition of the hospital? For instance, one of the doctors stated at a board meeting that he got in excess of 850K a year.
850K a year is a conflict of interest.
The $850,000 (plus) physician is Dr. John Kermen. He sits at the dais at MCDH Board meetings along with the Chief of Nursing, but is no longer a (voting) board member, though he once was.