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Clark Memorial/Norton Healthcare

Clark Memorial Norton hospital

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#21 Citizen5

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Posted 05 November 2014 - 12:41 PM

Rick,
 
You have been very open and active in your approach to relaying information to us, the citizens of the county.  It is appreciated.  I say this because one it is true, and two because I know you are not at fault for the culture of secrecy that grew in our county government for the past few decades.
 
This culture of secrecy is one of the reason I was involved, and gave my small part, in assisting some of our new members of  county government to elected to office.  One of the expectations is that this secrecy would be tossed and transparency installed.  
 
The information on, and details of, two of the biggest assets in our county, the hospital and the county landfill have been cloaked in secrecy for decades.  These are publicly held assets owned by the citizens of Clark County.  Yet during contract negotiations clauses are inserted to prevent relaying the financial and structural details of these assets to the very people who own them, the citizens of the county.  
 
I understand in isn't feasible to relay every little detail to the public during negotiations.  However this is why we elect people to represent us in these matters.  You, the other commissioners and our council members are those people.   In my opinion there is not an acceptable reason for any information related to county assets to be withheld or unavailable to the elected officials ultimately responsible  for managing those assets, namely the commissioners and the county council.
 
It is my understanding the hospital board has denied request from the county council to review the boards minutes of their meetings.  How can this be allowed?  How can you and the other elected members be denied information related to a county asset by a board that is appointed by those representing the citizens who own it?  Let me repeat, how can they deny the owners of the asset the detailed information needed to make decisions on managing the asset?
 
I know this issue is more complicated than just this.  However I have an easy solution to this small part.  Replace the members of the board.  The secrecy related to CMH has stretch back for decades, prior to the affiliation with Jewish Hospital.  Why it was ever allowed to be I can't answer and why it is tolerated now I can't answer either.  I can say it is not acceptable to me and I doubt that I am alone in my opinion.  If the members of the board do not wish to be transparent to the elected members of our county government they need to be replaced. 
 
I would like to see our representatives on the Board of Commissioners and the County Council take a stand and do what is necessary to stop this type of unacceptable behavior in the management of county assets.  You and the other members need the detailed information required to make the best decisions.  Regardless of outcome I can respect those decisions if they are made with all the details considered.  
 
Relying solely on the hospital boards and the hospital administrations recommendations without reviewing all the details yourselves, in my opinion, is not acceptable for assets of this size and importance.   I know every area can't be micro-managed, but this issue needs to at least be micro-reviewed by the people we elected to manage our county assets, The Commissioners and the County Council.  
 
May I remind you and all interested that the hospital board and the hospital administration made the decisions that lead to this.  Could they have prevented it or not is not my point.  The point is you and the other elected members of our county government are the ones responsible for the management of this asset, they are only people hired to assist.  If they are creating barriers to your access to the required information, I recommend firing them.  We the voters gave you and the other members that power, if you need it use it.
 
Get the information and make the best decision you and other members can.
 
Respectfully,
 
Citizen5 
 

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#22 Stirring the Pot

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Posted 05 November 2014 - 12:52 PM

The county doesn't already pay for inmate medical treatment at the hospital?

I'm a little confused. Is Norton's going to actually take over Clark, or is it going to be an "alliance" like Clark/Jewish?

#23 MyMan

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Posted 06 November 2014 - 10:53 AM

Chris, Google

 

'Clark Memorial CEO pitches Norton merger'

 

From that article:

 

'The hospital provides about $1 million in care for Clark County jail inmates, though it's not contractually obligated to do so.  Under the agreement, Norton would pick up the tab for inmate care for the next five years.  What happens after that was a concern for County Councilman Danny Yost.'

 

"That's almost a million dollars after five years we could be on the hook for," Yost said.

 

Rick would be able to provide more insight. 



#24 RStephenson

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Posted 06 November 2014 - 03:13 PM

I will find out more and post tonight. Sorry I missed last nightq

#25 IntegrityMatters

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Posted 06 November 2014 - 04:04 PM

Is that $1 million in care PER YEAR??? or what? Seems rather high to me.

#26 MyMan

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Posted 06 November 2014 - 04:16 PM

My guess is per year. I see a lot of Orange jumpsuits around here.

Look forward to your response Mr. Stephenson.

#27 Oldgoat

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Posted 08 November 2014 - 03:07 PM

If the county can get ANYONE to take over the hospital, they better jump at the chance. With Obamacare, health care providers are bleeding money all over the country.  I just heard yesterday that Kentucky One Health lost  $134 million in the last 9 months.


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#28 RStephenson

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Posted 08 November 2014 - 06:08 PM

Oldgoat,

I think all the players agree that the deal is a no brainer. My concerns are that the make up of the new board of directors does not include appointees from the County. As long as the County residents are on the hook for 50 million dollars in bonds they will have voice in the direction the hospital goes.

If and when Norton's pays or refinances the bond they can have total say as to how the hospital is ran. Clark Co residents will not be left hanging with the bond payment. Double period!

Edited by RStephenson, 08 November 2014 - 06:09 PM.

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#29 Stirring the Pot

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Posted 08 November 2014 - 06:22 PM

I can see where Danny Yost's concerns come from. We sent inmates on outside hospital trips all the time when I worked in corrections; we'd have close to a dozen in the hospital at times. Some weeks we probably spent close to $500,000, and that's just on medical expenses. That doesn't account for manpower, fuel if we had to take a state car or transport them in the institutional ambulance (yep, we had one of those--three, actually, but I think one's broke down since I left), stuff like that. It's probably a good thing the county's not on the hook for that, it racks up real quick.



#30 MyMan

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Posted 08 November 2014 - 06:28 PM

Rick,

If Clark Memorial goes belly up, who's responsible for the bonds? Are the county citizens on the hook?

Is Norton's agreeing to pay the loans? Please correct me, but the only way the county would be on the hook is if Norton's also goes belly up.

Seems like the county should fear the deal NOT going thru versus Norton refusing to refinance the current bonds since Norton's is in better financial shape.

Please provide your input Mr. Stephenson.
I don't want to spread misinformation.

Edited by MyMan, 08 November 2014 - 06:59 PM.


#31 MyMan

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Posted 08 November 2014 - 06:35 PM

So the struggling hospital should swallow that cost Chris?

#32 Stirring the Pot

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Posted 08 November 2014 - 07:23 PM

@MyMan-->Not at all. It probably ought to be a county responsibility; ergo, if the hospital was gracious enough to provide the services "pro bono", then the county probably never had to face the financial reality of paying for inmate medical care, at least not in a while, which means there isn't an easy solution. I don't see the state paying for it, and they'd face a lawsuit real quick if they tried to make inmates pay for their own care.

 

My experience comes from working in a Kentucky prison; since we had a more "permanent" population, we had to deal more with surgeries, chemo, things like that. Nothing elective, at least not to my knowledge. I'm not exactly sure how medical runs in a county jail so I don't really know if they have those things to deal with on a routine basis or not.



#33 MyMan

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Posted 10 November 2014 - 06:13 PM

Will there be another vote on the CMH/NHC merger before years end? Or will the commissioners not vote until the bonds are refinanced? Is the county working with both hospitals the deal happens?

#34 MyMan

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Posted 18 November 2014 - 03:38 PM

http://www.newsandtr...c7b7565dde.html

 

So, it appears that a merger won't take place before years end. 

 

With all due respect, why wasn't this information requested last fall?

 

We've been in a holding pattern since 2013 when the county decided to review the hospitals assets.  Why now was the decision made to have an independent audit? 

 

Pieces are missing here from both sides...  help us understand the process. 



#35 RStephenson

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Posted 18 November 2014 - 09:16 PM

MyMan, I do apologize for not getting back to you all sooner. Answer to your question is simple, if the hospital goes under everyone in Clark Co will pay.

In late 2013 when this administration became aware of all the negotiations that had been going on for a couple of years. We only knew one thing, we knew absolutely nothing about hospital mergers.

First thing we did was contract with a firm to appraise the hospitals assets. We have to know what it is worth before we go any further.

After several meetings with hospital management it was quite evident of the dire situation they were in. Not because of mismanagement of the hospital, but to national trends which the had no control over.

The hospital management contracted to find the best possible solution to the problem. The firm they contracted can to the conclusion that a merger with Norton's was the best fit for the mission of our hospital.

The merger with a larger enity as Norton's gives us the power and flexibility with not only purchasing but also with the dealings with the federal government. A 2 Billion corporation with multiple hospitals can better negotiate than one lowly county hospital.

My main concern is not for the hospital mgt or the Drs. I only care about the employees of the hospital and the citizens of Clark County. Unless the bond is guaranteed by Norton's I would not support the merger. I have been assured that language will be in the merger agreement between Norton's and the County.

You have heard that Clark Memorial's management has not furnished requested information from the Council. I have seen the information and if you know what you are looking at you have the information. Nothing is being hidden.

There will always be conspiracy theorists seeing shadows behind every corner. The commissioners have gone as far as to retain a law firm that has extensive experience with hospital mergers to represent the best interest of the citizens of Clark Co.

The information the Commissioners are relying on is from our attorneys. Not Nortons, not Clark Memorials, just your attorneys.

I promise I will not allow any risk to fall on the citizens of Clark Co. I also will only support this merger if it will improve all medical services for our citizens. I believe with the information we have gathered by all sources the the Norton's merger will better serve all of us.
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#36 MyMan

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Posted 18 November 2014 - 09:35 PM

Great response Rick. I appreciate that you took time to respond.

If I understand correctly, the information the council needs regarding the audit HAS been provided by CMH?

Or will the process of hiring an independent firm to dig thru the audits move forward?

When you speak regarding the bonds and the language in the merger agreement, are you saying that Norton's will assume the bonds our something similar?

I realize I should quit asking questions while I'm ahead, I understand if you can't divulge more detail.

I'm just a dude that wants to see CMH survive. I've been here for many years, and owe this place a lot.

Edited by MyMan, 18 November 2014 - 09:45 PM.


#37 RStephenson

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Posted 18 November 2014 - 10:46 PM

MyMan,

Never stop asking questions, it is your right and I do work for you. If I can not divulge sensitive information I will say there is more information that I can not say.

Yes the information requested from CMH has been furnished. They are very detailed and complicated reports.

I see no reason to prolong the process by hiring another independent audit of the financial records of the hospital. The State Board Of Accounts does this every year. We do not need to waste taxpayer money by doing something that has already been completed.

Nortons will not assume the bonds at this time but are totally responsible for paying the payments on the bonds until maturity. Nortons own bond rating will be tied to the bond. They are responsible for all payments to the bond.

This merger will ensure that Clark Memorial Hospital will not only survive but will thrive under the new structure.

Again, I will not agree to the merger unless such language is in the final agree.

Edited by RStephenson, 18 November 2014 - 10:49 PM.

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#38 IntegrityMatters

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Posted 18 November 2014 - 11:00 PM

Another independent audit would be very costly and not accomplish anything.  If the county hires anyone, they should hire a firm with expertise in hospital management to review the agreement between Nortons & CMH.  However, if Ron Barnes is still on the CMH board (and I think he is), I believe he has very high qualifications and standards. I cannot vouch for the other board members, but Mr. Barnes definitely has the knowledge to understand the financials and know whether the proposed agreement is beneficial to the county or not.  If the merger goes through and the county can appoint anyone to the new Board, my recommendation would be Mr. Barnes.

By the way, both Mr. Padgett and his CFO are CPAs and were formerly with Ernst and Young before pursuing careers in the health care/hospital industry.  I think they are both highly qualified men who hopefully could stay onboard at least during the transition.

Mr. Stephenson, did CMH give you and the council members the board meeting minutes that were asked for?



#39 RStephenson

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Posted 18 November 2014 - 11:14 PM

MyMan, I do apologize for not getting back to you sooner. The answer to your question is quite simple, if the hospital goes under everyone in Clark County will pay.

In late 2013,this administration became aware of negotiations that had been ongoing for a couple of years. One thing we knew was that we know absolutely nothing about hospital mergers. The first thing we did was to contract with a firm that would appraise the hospitals assets. We had to know what it was worth before we could go any further.

After several meetings with hospital management,it was evident that the hospital was in a dire situation. The situation was not due to mismanagement, but to national trends which were in opposition to locally owned and small private hospitals.

Prior to this administration's involvement, the hospital management team contracted with an independent firm that specializes in evaluating and offerring financial solutions for hospitals.They recommended that Clark Memorial merge with Norton Healthcare. Merging with a larger enity such as Norton's, will give power and flexibility not only in purchasing, but also with federal reimbursement plans.

My main concern is not for hospital management or it's doctors, but for the employees of Clark Memorial hospital and the citizens of Clark County. Understand, that unless the bond is guaranteed by Norton Healthcare, I will not support the merger. I have been assured that language of the guarantee will be included in the merger contract.

It was reported that Clark Memorial's management team has not furnished information requested from an individual council person. The requested information has been furnished. I have personally seen the documents. Transparency is not an issue. There will always be conspiracy theorists seeing shadows behind every corner.
In addition, the present commissioners have retained an outside law firm with extensive experience in hospital mergers. We are relying on their expertise to recommend the best plan for our citizens.


I promise I will not allow any financial risk to fall on the shoulders of Clark County residents. I stated earlier that the contract will include verbage pertaining to the bond issue. In addition to financials, I will only support the merger if it will improve all medical services for our citizens.

I believe, given all the extensive information gathered from all sources, the Clark Memorial Hospital's merger with Norton Healthcare will prove to better serve our community. Please feel free to ask questions about this issue. Your voice is heard and will be taken into account when the commissioners vote their final decision.

Edited by RStephenson, 18 November 2014 - 11:16 PM.


#40 MyMan

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Posted 19 November 2014 - 08:26 AM

Since at least one member of the council has asked for additional information regarding the audit, how will this transpire?  Can the commissioners deny this request? 

 

I'm still in the dark about the "final vote" works?  Does the merger have to pass the council first, and then the commissioners vote?  Since the council seems to have issues that aren't shared with the commissioners, what happens next?






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