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Hospital District fed up with how Medical Center being run

STORY BY MEG LAUGHLIN (Week of February 13, 2014)

The Indian River County Hospital District, made up of seven trustees who direct $8 million a year in local tax dollars to Indian River Medical Center for indigent care, is fed up with how IRMC is being run and is considering rejecting reimbursement requests for amounts beyond what has been budgeted.

That was the repeated message Monday morning at the District office, where six trustees sat at a conference table and, by turns, complained – some more vocally than others – about how poor management at the hospital affects patient care and increases the financial burden on the Hospital District and county taxpayers.

“This hospital is sinking downhill to a dangerous level, but most of the hospital board rarely question anything,” said trustee Burton Lee, one of the first to speak.

“Tom Segura (IRMC board chairman) has said nothing will happen to (CEO) Jeff Susi on his watch. Segura wants to keep the volume low and the pressure off, but that should not be the role of the supervisory body,” said Lee.

Trustee Trevor Smith said hospital CEO Susi has repeatedly expressed concern that criticism of the hospital by the District board has “caused terrible problems” (because it hurts fundraising).

But Smith, who related horror story after horror story about subpar emergency room care, said very little at the hospital seemed to be improving.

As for Susi’s desire for less public discussion of hospital problems, Smith said: “If I shot myself in the foot, I wouldn’t blame the gun.” 

Hospital District executive director Ann Marie Suriano said she met with CEO Susi a few weeks ago and asked if IRMC could supply the Hospital District with monthly reports.

Susi’s response, according to Suriano Monday, was ‘No.’ The owner of the building housing the Hospital District office doesn’t require monthly reports from the District, Susi was quoted as saying, and the District, which is landlord of the hospital, had no right to monthly reports either.

Hospital District trustee Harris Webber bristled at Susi’s reaction: “That’s ludicrous. Information is required. Susi is off-the-wall with that.”

Hospital District attorney Jennifer Peshke cited a clause in the bylaws that said the Hospital District was “not off-base with the request,” and had a right to monthly information from IRMC.

The Hospital District is facing a $1 million dip into reserve funds at the end of the year because of growing reimbursement bills submitted by the hospital, which include a $2.4 million request from the prenatal program Partners.  Partners serves the indigent population, as well as those who pay.

At Monday’s meeting, District trustees questioned whether the bill for Partners covered more than indigent care. 

“I think the question is: Has anyone looked carefully at Partners over the years? We can’t keep spending, spending, spending....Where is hospital management in reviewing this?” asked District trustee Webber.    

District trustee Gene Feinour listed other problems affecting finances: “Surgeries are down and paying clients are going north and south (to other hospitals) because of the situation with the Emergency Department.”

The questions continued: When would the Emergency Department be fixed? Could the Hospital District afford the $535,000 budget overage just requested by the hospital? Why was Partners costing more and more when the volume wasn’t increasing proportionately?

Finally, the big question in the back of everyone’s mind, was posed by Hospital District Chairman Tom Spackman: “Do we need to increase the millage rate (charged to property owners in the county) in order to break even?”

Smith estimated the increase that would be needed from county taxpayers would be between 12 to 13 percent next year, and said he believed that the Hospital District should say no to the hospital’s funding requests beyond what was budgeted.

Spackman agreed that it would be better to say no to the hospital than go to the taxpayers for more money. 

During the two-hour meeting Monday morning, all of the District trustees expressed concern over the Hospital District’s relationship with the hospital and the District’s growing position as the hospital’s bottomless purse.

“We are supposed to be the payor of last resort,” Suriano reminded trustees, after District trustee Alma Lee Loy questioned whether hospital management was making enough of an effort to get Medicaid reimbursement.

 “Our reserves will be perilously low if we spend what’s being requested by the hospital,” warned Smith, the District treasurer.