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Hospital defers celebration for Cancer Center

STORY BY MEG LAUGHLIN (Week of November 7, 2013)

A celebration of progress toward a Cancer Center at Indian River Medical Center has been postponed by major donors eager to be certain hospital finances and operations are on track before proceeding.

The Nov. 20 celebration is likely to be held after Jan. 1 if the hospital has a break-even budget and patient care has improved. But those eager to begin construction worry that millions in pledged money could be reclaimed by donors.  

Several Hospital District trustees thus are urging the majority, who favor waiting until more progress is made on the financial turn-around plan, to quickly reschedule the cocktail party for foundation donors to celebrate the progress of the Cancer Center.

“I think the time has come to move ahead with the Cancer Center. We need to honor the efforts of the foundation ... and the donors,” said District trustee Alma Lee Loy, who along with District Trustees Eugene Feinour and Harris Webber now favor immediate construction of the $48 million Cancer Center.

But at last Wednesday’s Hospital District meeting, the majority of trustees made it clear that they were not yet ready to make that happen.

The four District Trustees who are hesitant stressed that they honor the foundation and donors and support the Cancer Center, but want hospital finances and operations to be sound before proceeding. Their hesitation, they say, comes from wanting to see that the hospital’s financial turn-around plan and patient-care improvements are working, rather than accepting the prediction that they will work.

One example for their concern comes from projected admissions numbers for October, 2013, when 161 inpatient surgeries were projected but only 141 were actually performed.

Only 113 of the projected outpatient surgeries actually happened, all of which will translate into financial shortfalls.

“The hospital is taking on too much with the Emergency Room contract and the low morale, the turn-around program, the computer system, the unpredictability of the Affordable Care Act, the Wellness Center and now the purchase of Vero Radiology. I am hearing a groundswell of concern,” said District Trustee Trevor Smith.

“It makes more sense to wait six months and see where we are, doesn’t it?”

District Trustee Burton Lee agreed: “I can’t be in favor until I see things are in better hands,” said Lee.

The change of heart of the three trustees who now favor moving ahead came on the heels of a hospital board meeting two weeks ago when new hospital CFO Greg Gardner said hospital finances were “rock solid.”

Also, the week before, the hospital’s chief medical officer presented numbers that said patient care was improving.

But deficiencies still exist: This year the hospital has a budget shortfall of about $4 million and according to evaluators of hospital finances, the hospital’s current cash on hand of $36 million is precariously low. And, while some patient care statistics show the hospital is improving, others show the opposite.

Yet, the majority of hospital board members seem satisfied with the status quo, leaving the hard questions to the Hospital District, which owns the hospital buildings and land on behalf of county taxpayers.

The two hospital board members who have been most critical of the hospital’s prresentations of different sets of numbers, Hugh McCrystal and Paul Nezi, attended the trustees’ emergency meeting and were asked by District Chairman Tom Spackman why they couldn’t get the rest of their board colleagues “to ask questions and stare management in the face?” 

“I think the hospital board of directors has concerns,” said McCrystal.

But Nezi was more pessimistic about the chances of the hospital’s own board getting tough.

“I’ve been asking, but I feel most would rather I not, which is pretty sad,” he said.

At Wednesday’s meeting, Spackman also questioned whether hospital management could take out a $20 million loan for the purchase of Vero Radiology without Hospital District approval. Jennifer Peshke, attorney for the hospital district, said she’d look into it.

Spackman said hospital CEO Susi asked the Hospital District to move up its Nov. 21 monthly meeting to have it before a cocktail party for foundation donors to celebrate progress for the Cancer Center.

Apparently, in the next two weeks, Susi hopes to convince at least one more district trustee to switch sides and get a majority vote to proceed with the Cancer Center, so that the party is a true celebration.