Monday, October 26, 2015

Headline Article Debunks Sutter's Prior "Gloom and Doom" Forecast

October 18, 2015 
In This Issue
Headline Article Debunks Sutter's Prior "Gloom and Doom" Forecast

For those who missed the 10/1/15 headline article in The Del Norte Triplicate, and were unable to attend yesterday's Town Hall meeting, here is "the rest of the story" on Sutter's financial claims  . . . . 

Background:  In late 2013, Sutter executives told us that downsizing Sutter Coast Hospital to Critical Access status was necessary to stem Sutter Coast's financial losses. Former hospital CEO Linda Horn publicly announced the hospital had not had a positive operating margin since 2008. (Ms. Horn's statement is contradicted by Sutter's own data, which shows operating income of $7 million for years 2009 plus 2010.)

The Camden Group (a consulting firm paid by Sutter) and Linda Horn both projected heavy losses at Sutter Coast through 2018. Those dire predictions were used to justify removing half of the hospital's beds from service, which hospital officials conceded would necessitate an increase in mandatory patient transfers (due to the 25 acute care bed cap imposed by Critical Access).  But in the face of the projected losses, Critical Access would allow Sutter Coast to triple its payments from Medicare. (source: Linda Horn, NewsPlus," 1/17/14.)  Thus, the downsizing was portrayed as a necessary trade off in the face of predictions of steep losses ahead.
Fast forward to 2014:  The Del Norte Triplicate's headline article 10/1/15 reported Sutter Coast Hospital's profits were $10.8 million in 2014, and according to Sutter Coast CEO Mitch Hanna, expected to be roughly $11.9 million in 2015 (without Critical Access). (source:

Sutter's gloomy 2013 forecasts turned into huge profits the next year. These profits are not surprising--Sutter Health is nationally renowned for its high prices and profiteering--see the following New York Times article, which discusses Sutter Health:

Critical Access news for 2015:  The Sutter Coast Board of Directors, noting an influx of patients seeking treatment, voted to hold off converting Sutter Coast to Critical Access, but hospital officials "declined to share the census numbers for 2015 that prompted reconsideration of the Critical Access application." (source:

Hospital CEO Mitch Hanna later confirmed Sutter Coast's Critical Access application has not been withdrawn, so the hospital Board keeps open the option of Critical Access at Sutter Coast, behind the veil of secrecy of Sutter Coast's closed Board room.  

Why Is This Important to You?  Because if Sutter Coast downsizes to Critical Access, there will be 50% fewer available beds, more mandatory emergency patient transfers, plus, higher out of pocket costs and higher secondary insurance premiums for Medicare patients. (sources: Office of Inspector General Report Oct., 2014, and Kaiser Health News, 10/7/14)

How you can help address Sutter's high prices, conflicting statements, and closed Board rooms:

1. Write The Del Norte Triplicate, letters to the editor, 312 H. St., Crescent City, CA 95531, or by email at   Be sure to include your phone number, which is not published.

2. Contact me at if you would like more information, or if you have any information on hospital charges or patient transfers.

3. Join the 4,000 others who have signed the petition at my office, opposing Sutter's plans to move ownership of Sutter Coast Hospital out of our county.

4. Please read the editorial below, published 10/15/15 in The Del Norte Triplicate, also available at this link:

Thank you all for your continued support,
Gregory J. Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery
Sutter's Profiteers Cause for Dismissal
By Curtis Bower

October 15, 2015

(reprinted with permission from The Del Norte Triplicate and Curtis Boewer) 

In follow up to the excellent headline article regarding Sutter Coast Hospital's multimillion dollar profits, published Oct. 1 in the Del Norte Triplicate, please consider the following: 

Hospital finances: 

When it benefited Sutter Coast to show losses (as the hospital board attempted to convince our community that hospital downsizing was needed for financial reasons), Sutter Coast showed losses. When it benefitted Sutter Coast to show profits (as the healthcare district considers purchasing Sutter Coast through an eminent domain action), Sutter Coast shows profits. It seems Sutter can make its books show whatever Sutter wishes.

Do the hospital employee salary reductions Mr. Hanna oversaw apply to him? IRS filings show his 2013 compensation was $645,399, plus other income described as "deferred in prior form 990." Was Mr. Hanna's salary reduced in 2014? Hopefully, he will fulfill his promise made earlier this year to return to a town hall meeting and discuss hospital finances.

Hospital utilization:

Mr. Hanna repeats the claims of the last two CEOs - the number of patients using Sutter Coast is declining. Let's think about reasons why fewer people would be going to Sutter Hospital. Could it be the hospital's reputation, its high charges for care or the fact that in the past two years a Sutter surgeon general, a Sutter orthopedic surgeon and a Sutter family practice doctor have left our area to work elsewhere? Dr. Duncan and Dr. Davis offer surgery at Mad River Hospital, where charges to patients are much lower. It seems Sutter administrators are responsible for the fact fewer patients are choosing to receive care locally.

Hospital profits:

Our community should know that the profits taken in by Sutter Coast are transferred every two weeks to Sutter Health in Sacramento, where Sutter executives decide where to spend the money. This may explain why Sutter Health CEO Pat Fry saw his own salary increase from $2.4 million in 2007 to $6.4 million in 2012. I prefer those profits stay locally - for more staff and better wages for the hard working employees at Sutter Coast.

Finally, I ask two questions: 

Is Sutter Health trustworthy?

Which is a higher priority for Sutter Health executives - our health care or their salaries?

As a former hospital administrator, I support the Del Norte Healthcare District's effort to expand and improve local health care.

Curtis Boewer

Curtis Boewer of Crescent City, is a consultant, former administrator of Good Samaritan Foundation, vice president of Good Samaritan Hospital, both in San Jose, and a former administrator of Marion Medical Center in Santa Maria.

Gregory J. Duncan, M.D. | | | 1200 Marshall St.
Crescent City, CA 95531

Saturday, April 25, 2015

Sutter Health Does Not Play Nicely in Sandbox

Sutter Health Does Not Play Nicely in Sandbox

by Roger Gitlin, Del Norte County Supervisor
Originally published in The Del Norte Triplicate, available online at (search "Sutter Health" for this article and related information).

"Who's going to protect the people of Del Norte County?"

Those words of Kevin Caldwell, M.D., reverberate loudly. It was Dr. Caldwell who first dared to stand up to the multi-billion dollar goliath Sutter Health by opposing Sutter's decision to move hospital ownership out of Del Norte County to the Bay Area and lower the 49-bed Acute Care hospital to a 25 bed Critical Access facility.

Dr. Caldwell was the first local physician to see Sutter's malfeasance. As hospital chief of staff, he identified Sutter's repeated implementation of patient care policies without physician input. Sutter Health was telling doctors how to practice medicine, in violation of California law. With great effort, Dr. Caldwell was able to unwind Sutter's illegal policies. Later, after Sutter Health executives advised the local hospital Board to dissolve itself and transfer hospital ownership to the Bay Area, Dr. Caldwell asked the hospital board chair for a guarantee Sutter would not close the obstetrics service. Dr. Caldwell could not get that guarantee. He stood alone in defense of our community.

Dr. Caldwell joins medical colleagues Mark Davis, M.D., Manfred Ritter, M.D., and Gregory Duncan, M.D., all of whom have experienced the pain of a revengeful, insatiable bully, Sutter Health Corporation. Sutter Health, parent of Sutter Coast Hospital, does not play nicely in the Del Norte sandbox. 

Do you recall hospital CEO Mitch Hanna's announcement this year that Sutter had suspended its application for Critical Access designation? Not true. According to a letter sent to me by Dana Forney, regional manager of the California Department of Public Health, as of April 3, no changes to Sutter Coast's Critical Access application have been reported to CDPH. Was Mr. Hanna's big announcement just more public relations designed to quiet the growing concern with Sutter's decisions? 

The recently-exited Manfred Ritter, M.D., FACS, a superb surgeon who was recruited to Sutter in 2010, saw the writing on the wall and has taken his skills to Seaside, Ore. His recruitment was initiated and endorsed by Sutter Pacific Medical Foundation. After Dr. Ritter opposed Sutter Health corporate policy, his contract came up for renewal - with Sutter slashing his income guarantee by 50 percent. Sutter sent a clear message to a medical professional who had zero complaints levied against him and a rating of "superior" from over 98 percent of his patients.

Likewise, Dr. Davis suddenly finds his 22-year urology practice in Del Norte County in peril. Sutter Health has recently hired another urologist, whose income will be subsidized with Sutter's tax-exempt war chest, to compete with Dr. Davis. One might say, "What's the matter with a little friendly competition? That's good for the economy." To the contrary - the now-famous Camden Report, commissioned by Sutter, identified numerous health care needs, including cardiology, nephrology, oncology and mental health. Likewise, Sutter's Community Health Needs Assessment identified many unmet health care needs in our county. But neither study identified a need for a second urologist. Other than driving Dr. Davis out of town on a rail, what could be the reason Sutter Health has hired another urologist?

Dr. Greg Duncan's experience follows the pattern. After he opposed Sutter's plans to downgrade the hospital, Dr. Duncan found himself the subject of multiple investigations by Sutter Health and Sutter Coast Hospital. Dr. Duncan was forced to spend thousands of dollars and countless hours to defend himself from Sutter's baseless allegations. In the end, it was Sutter who was cited for misbehavior by the Joint Commission (which evaluates hospitals nationwide) and the California Department of Public Health (which regulates hospitals in California).

When Sutter's Exclusive Provider Organization was rolled out this past winter, none of the local independent doctors were invited into the network. CEO Hanna said they are part of the Sutter network, yet to date, Sutter has failed to send local doctors the appropriate paperwork to join, and those doctors are not part of the Sutter network. Drs. Caldwell, Davis, Ritter and Duncan each share a public opposition to Sutter Health's quest to lower hospital status and move all decision-making out of Del Norte County.

I would think a nonprofit "charity" would be obligated to maintain the very highest level of medical services. Sutter does not play nicely in the sandbox. It should come as no surprise that local doctors who have worked in our community for decades now find themselves with a fistful of sand granules tossed in their eyes.
Roger Gitlin is District 1 Del Norte County Supervisor.

Quick Links...
Past newsletters available at
See additional stories online at
How You Can Help
If you support expanded, affordable healthcare in our region, please join the thousands of citizens who have signed the petition opposing Sutter's plans, available at my office on 1200 Marshall St., Crescent City, CA  95531 or reply to this email with your thoughts.  Thank you all for your help and support!

Gregory J. Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery

Thursday, February 19, 2015



by Kevin Caldwell, M.D. and Donna Sund, D.O.

Many readers are aware of the new local EPO Health Plan being offered by Sutter Health, Anthem, and CalPERS.  You may or may not be aware that Redwood Medical Offices and several other local offices are not currently listed on the provider panel.  Here's why:

The new EPO plan is an "Exclusive Provider Organization."  This means that in order for you to be treated, you have to go to an approved provider and an approved hospital.  None of the local independent (non-Sutter affiliated) providers we contacted were offered an opportunity to join the provider panel before the initial plan roll-out on January 8.  We learned of the plan in the middle of January, when patients approached our office with letters from Sutter Health/Anthem Blue Cross/CalPERS, offering them a new health plan in our area.  We knew nothing of the plan until patients brought us these subscriber letters, and our patients obviously had many questions and concerns.

In the past, when a new health plan was made available, especially to large local employers, the plan administrator would contact us before the roll-out to offer us an opportunity to be on the provider panel.  However, this time the list of participating doctors included only Sutter-affiliated providers (two of whom have already left the area). The only hospital on the approved list is Sutter Coast Hospital. For 30 years, Redwood Medical has always been offered participation in local health plans, and we have been providers for CalPERS/ Anthem since its onset.  In fact, we provide a significant amount of the local primary care to these many employees and their families, and have done so for decades.

When we realized our office was not on the EPO provider list, we immediately contacted Anthem to learn why not. This was the reply from Anthem Senior Managing Consultant Mark Johnson:  "Sutter is taking the lead on adding additional Del Norte County physicians into their EPO plan network providers."  Mr. Johnson added that he would forward our concern and request to be listed on the provider panel to Sutter, but we never heard back from Sutter or Anthem until later that month.

On January 27, Sutter Coast Hospital CEO Mitch Hanna told the hospital Medical Staff that he understood providers who are on Anthem's PPO list of providers were eligible to be on the EPO provider list.  He invited Medical Staff members to call him if they were interested in joining the plan. So we contacted Mr. Hanna's office the following day, indicating our interest in joining the provider list and asking for more details.  But our inquiry to Mr. Hanna about the plan's terms and restrictions has gone unanswered.  Now, halfway through the patient sign-up period, we are still not on the panel, and have not received any further information from Sutter or Anthem about the plan.

Some of our unanswered concerns about the EPO include:

(1) According to the letter sent to plan subscribers, the plan offers "no charge for inpatient or outpatient" hospitalization (as long as you go to Sutter Coast Hospital).  But according to the actual EPO Disclosure Form, there is a $250 co-pay charge for endoscopy, cataract surgery, and spinal injection, and $50 co-pay for an emergency room visit.   

 (2) According to letters from Sutter Health/CalPERS/Anthem sent out on Jan. 8 and Jan. 19, "members do not need to select a primary care physician."  Those same letters also state that the "EPO Plan is specifically designed to not require a primary care physician." But according to an email sent to a local doctor by Nora Nunn Powers, Anthem Regional Director of Provider Contracting, "the structure of the product requires that any request for referrals outside of the established/approved EPO panel need to be directed back to the primary care physician for referrals to other specialists."

 (3)  If patients present emergently to Sutter Coast Hospital and require transfer, either due to specialized needs, such as a heart attack, or because our local hospital is "full"and unable to admit more patients, can these patients be transferred, as has been traditionally done, to the closest available facility (most often Rogue Valley Medical Center), or will they be transferred to a Sutter facility at a much further distance in order to stay within the Sutter network of providers?  In addition, many patients are referred from our office to specialists in southern Oregon or Humboldt County.  Will the new EPO make it impossible for patients to see these usual specialists?

As of today, Redwood Medical Offices is still not on the EPO provider list.  We have made several attempts to learn the details of the EPO plan, but we continue to wait for answers from both Sutter and Anthem.  We hope these answers will be forthcoming, and that we will be able to continue to provide our many long-time patients with the excellent health care they deserve.


Kevin Caldwell, M.D.                                                        Donna Sund, D.O.
                                      Redwood Medical Offices
                                           1240 Marshall St.
                                      Crescent City, CA  95531

Highlights of Town Hall with hospital CEO Mitch Hanna

For those who missed last night's Town Hall debate with me and Sutter Coast Hospital ("SCH") CEO Mitch Hanna, this newsletter has the highlights. Although the hospital Board of Directors have still held no public meetings since they voted to downsize SCH to Critical Access and transfer hospital ownership out of Del Norte County, I appreciate Mr. Hanna's willingness to attend last night's event.  

Prior hospital articles available at
Past newsletters available at
More information available at
Summary of Opening Statement by Greg Duncan, M.D.

Sutter Health and Sutter Coast Hospital both tax-exempt charities.  Sutter Health claims to "act openly and truthfully in everything we do."  As you evaluate both sides of the Sutter Health conflict, please consider three questions:

(1) Does Sutter act openly in everything they do? 

Fact:  Despite multiple requests from our elected leaders for Sutter Coast Hospital to release its Board meeting minutes and financial documents, Sutter has refused to comply with those requests.  SCH holds closed Board meetings.  Last night, SCH CEO Mitch Hanna once again refused to release Board meeting minutes.  Mr. Hanna said he would release some financial data, adding that Critical Access designation is expected to bring Sutter an additional $5 million in Medicare payments. 

(2) Does Sutter act truthfully in everything they do?

The following statement is found in the 12/6/13 issue of "NewsPlus," written by former SCH CEO Linda Horn:  "CY [calendar year] 2008 was the last year in which the hospital generated a positive operating margin."  The Camden Group stated the same--that 2008 was the last positive year, and that "Sutter Coast is expected to operate at a loss through Fiscal Year ("FY") 2018."

Those are dire statements.  They were used to justify downsizing SCH to Critical Access. But are they true?

Fact: Sutter Regional CFO John Gates reported that SCH had positive operating margins in 2009 and 2010.  In addition, earnings for both those years exceeded $5 million for each year.

What about the prediction of losses through 2018?

Fact:  Last month, Mr. Hanna reported SCH was profitable in 2014.

Finally, here is a quote by Linda Horn in her 4/10/14 NewsPlus:  "There has been considerable concern and misinformation expressed about limiting our in-use beds to 25."  "To change our bed capacity to 25 is "right sizing" the hospital. These beds are empty every day--and have been for years."  (emphasis added)

Fact:  Hospital census data shows 62 days during the period 1/1/12-6/30/13 where the number of hospitalized patients exceeded 25.  That's 62 days where people would have been flown out, at their expense, without their family or local doctor. 

(3)  When you hear information about the hospital, does the person providing it have financial ties to Sutter?

Although I am hospital Chief of Surgery and past Chief of Staff, I have taken no money from Sutter for those positions.  Dr. Caldwell accepted no money from Sutter when he was Chief of Staff.  (Note: public records indicate Mr. Hanna's 2012 salary was $729,754.  Sutter Health CEO Pat Fry's 2012 salary was $6.4 million). 

I present this information not to embarrass Sutter executives or question Sutter Health's integrity.  I do so because LIFE and DEATH decisions for this community are being made in closed Board rooms with false information.  I have more than 50 written or recorded false statements by Sutter Health executives.

I think our community deserves better. 

Highlights of Statements by Mitch Hanna, Sutter Coast Hospital CEO

  • 800 patients were transferred out of Sutter Coast Hospital in 2014 (note: 271 patients were transferred from Sutter Coast to other hospitals in 2006.  If nursing home transfers are included, a total of 368 patients were transferred out of SCH in 2006)
  • Due to the increase in the hospital census, Sutter is re-thinking its decision to implement Critical Access and is holding up the transition
  • When an audience member asked if the Critical Access application had been withdrawn, Mr. Hanna responded, "No."
  • The reason local independent doctors have not received contracts to participate in the Sutter Health/Anthem/CalPERS EPO is because Anthem, not Sutter is in charge of the contracts  (note: this contrasts with an email from Anthem senior consultant Mark Johnson stating, "Sutter is taking the lead on additional Del Norte County physicians" and "Sutter is entirely in charge of these discussions." 
  • Mr. Hanna confirmed earlier statements that SCH was profitable in 2014 (note: this is without Critical Access designation or transferring hospital ownership out of the county)
How You Can Help

If you believe healthcare decisions should be based on factual information in open meetings, please join our effort.

To add your name to the more than 4,000 residents who have signed the petition opposing Sutter's corporate plans, stop by my office on 1200 Marshall St.  Forward this information to your friends and post on social media.  Volunteers are needed to distribute newsletters to residents without internet access.

Most of all, please consider writing a letter to the California Attorney General, asking for an investigation of Sutter Health's activities in our region.  Our County Board of Supervisors, Del Norte Healthcare District, and City Council of Crescent City have already asked Kamala Harris to investigate Sutter.  Please consider repeating that request in a letter, asking the Attorney General to exercise her authority to open up Sutter's closed books and investigate Sutter's conflicting statements.

Please contact me if you would like to see more facts or have any ideas to share.

Here is the contact information for the California Attorney General:

The Honorable Kamala Harris
California Attorney General
Office of the Attorney General
1300 "I" Street
Sacramento, CA 95814-2919

Nathan Barankin, Esq.
Chief Deputy Attorney General 
Office of the Attorney General
1300 "I" Street
Sacramento, CA 95814-2919