The Future of Healthcare in Our Region

The Future of Healthcare in Our Region

Today's guest editorial is written by Dr. Kevin Caldwell, a local Family Practice physician and frequent recipient of Del Norte County's "favorite physician" award. Before we get to Dr. Caldwell's article, I would like to thank everyone who responded to the request by the California Department of Public Health for community input regarding Sutter's decision to convert Sutter Coast Hospital into a Critical Access facility. In addition to the letters you sent separately, I forwarded 115 letters of opposition to Critical Access, written by residents of Del Norte and Curry Counties, to the Calif. Dept. of Public Health last week. Please forward this newsletter to anyone who may be interested, and post it on social media.  I also appreciate your emails with ideas on this issue, and how to improve transparency and affordability of healthcare. Gregory J. Duncan, M.D. drgjduncan@yahoo.com

Our Healthcare Decisions Must be Based on Fact  and Transparency by Kevin Caldwell, M.D.

As a current Del Norte Healthcare District Board member, three term former Chief of Staff and Board member of Sutter Coast Hospital ("SCH"), and local physician for the past 29 years, I would like to clarify some information published in last week's Del Norte Triplicate which may have left readers confused as to the ownership of SCH.  As you read articles on Sutter's plans for our community, please ask yourself if the information was written by someone who receives money from Sutter Health.  I have no financial ties of any kind with any Sutter corporations.

First, a definition of Regionalization:  a Sutter Health statewide policy to transfer ownership of community owned Sutter affiliated hospitals FROM local ownership TO regional ownership.  In our case, Regionalization would transfer ownership of Sutter Coast Hospital (which has always been owned and governed locally) FROM Del Norte County TO Sutter West Bay Region in San Francisco. 

Sutter Coast Hospital is currently owned by the corporation of Sutter Coast Hospital, and is governed by a Board of Directors, the majority of whom reside locally.  SCH is affiliated with, and managed by, Sutter Health.  How do I know this?

(1) The settlement agreement between Sutter Health and the Del Norte Healthcare District states, "Sutter Coast Hospital owns Sutter Coast Hospital."  In the first draft of the settlement agreement, Sutter attorneys inserted the statement, "Sutter Health owns Sutter Coast Hospital," but the Healthcare District made Sutter Health remove that statement, because it was false. Nevertheless, SCH CEO Linda Horn continued to spread the false claim that Sutter Health owns SCH.

(2)  Sutter West Bay Region President Mike Cohill, in a recorded meeting held in Del Norte County on 8/2/12, stated that Sutter Coast Hospital is owned by Sutter Coast Hospital.  

(3)  Sutter Coast Hospital currently has its own Board of Directors, bylaws, Articles of Incorporation, and tax I.D. number, all of which are dissolved with Regionalization.   

In last week's Del Norte Triplicate, editor Richard Wiens quotes the following from the Settlement Agreement between Sutter Health and the Del Norte Healthcare District: "Sutter Health has been the sole general member of Sutter Coast Hospital, with the right to exercise control over it, since its inception."  I suspect few readers understand the meaning of that statement.

The "General Member" is Sutter Health. In some corporations, the General Member is all-powerful.  In our case, the General Member is not--Sutter Coast has a number of powers over Sutter Health.  "Control," in the sense used here, is a legal term which means Sutter Health has the power to appoint the majority of the SCH Board.  "Control" does not mean Sutter Health can do whatever they want--their powers are limited by SCH bylaws, Sutter Health bylaws, Medicare regulations, Joint Commission standards of hospital accreditation, and California law.  Evidence of Sutter's repeated violations of these regulations, and California law, will be detailed in future articles.

According to Mike Cohill, Sutter Health and SCH are separate corporations, each with its own unique powers (which Mr. Cohill calls "reserve powers"), as defined in the bylaws of each corporation. One of SCH's reserve powers is the authority to approve and disapprove of mergers.  In other words, Sutter Health cannot transfer ownership of Sutter Coast out of Del Norte County (Regionalize) without the approval of the Board of Directors of SCH.

The SCH Board did vote to Regionalize on 11/3/11, over my objection. I advised my fellow hospital Board members that we should not vote on something we did not understand.  The Board had not read the Regional bylaws before voting to Regionalize, although three hospital Board members falsely stated they had read the Regional bylaws in advance of the Regionalization vote.  I know this because the Regional bylaws were not distributed to the SCH Board until 11/8/11, five days after the vote to Regionalize. So, the hospital Board voted on a policy they had no way of understanding.  Does a Board have a responsibility to cast an informed vote?

In 2011, Sutter Regional executive Larry Dempsey, Esq., re-wrote the bylaws of SCH, weakening many of the hospital's reserve powers over Sutter Health.  Mr. Dempsey did not explain this fact to the SCH Board, which had no independent legal counsel. On 2/3/11, following minimal discussion, Mr. Dempsey's 1300 changes to the SCH bylaws were approved by the SCH Board. 

The California State Bar is the agency which oversees attorney conduct.  It is a Bar rule that one attorney cannot represent two parties without the written informed consent of both parties. Sutter Health  attorneys never obtained consent from SCH before re-writing the SCH bylaws or asking the SCH Board to dissolve themselves and transfer hospital ownership to San Francisco.  Dr. Duncan and I filed a complaint regarding two Sutter Health attorneys to the State Bar, which is currently under review.   

The fact is, despite overwhelming community opposition to Sutter's plans for this region, Sutter refuses to budge.  Sutter Health is determined to end their 28 year relationship of managing a locally owned, Acute Care hospital in Del Norte County. The SCH Board refused to rescind their Regionalization vote. Regionalization remains SCH Board policy.  Sutter will not release any Board meeting minutes. Last May, SCH CEO Linda Horn announced in a televised meeting that "Critical Access is not being discussed," even though the SCH Board had just approved a $170,000 study on the hospital which mandated an analysis of Critical Access.  In December, the SCH Board voted for Critical Access. Last month, they filed the application.

The SCH Board refuses to discuss community letters of concern in the Board room, which remains closed to the public.  Sutter Coast's ongoing secrecy and high prices have compelled many in our community to seek care at distant hospitals, resulting in a steady decline in our hospital census over the past year.

During our 1/28/14 meeting, the Del Norte Healthcare District voted unanimously to oppose Critical Access and Regionalization.  The Triplicate did not report on that resolution, so the District ran the announcement as a paid advertisement.  We believe our community deserves options for their healthcare. Three other healthcare systems have offered to provide capital to develop an affiliation with our hospital.   Please share your thoughts with me and my fellow  Board members at: The Del Norte Healthcare District, 550 E. Washington Blvd., Crescent City, CA  95531.  We want to hear from you.

Kevin J. Caldwell, M.D.

Redwood Family Practice

Crescent City, CA

How to stop Sutter from downsizing our hospital

Working together, we can stop Sutter Health from implementing their corporate plan for our healthcare

Yesterday, I was contacted by the California Department of Public Health (CDPH) regarding Critical Access Designation at Sutter Coast Hospital.  CDPH is seeking input from local residents.  They want to know if local residents approve of downsizing the hospital, and how it will affect you and your loved ones.  They asked where we will be transferring patients when the hospital is full due to the 25 bed cap imposed by Critical Access.  (Answer:  Wherever a bed is available between Portland and San Francisco).    At the end of this guest editorial, please read how you can help stop Sutter Health from downsizing our region's only hospital.

Guest Editorial by Leah Eidam, Crescent City, CA

On 12/5/13, Sutter Health executives and the Sutter Coast Hospital Board voted to downsize Sutter Coast to a Critical Access Hospital.  In response, the Del Norte Healthcare District, a local government body elected to promote health services for county residents, voted unanimously to oppose Sutter's plans. The Healthcare District resolved to "explore all alternatives to maintain local ownership and shared governance of our hospital." Sutter wants you to think they cannot be stopped.  They are wrong.  Let's support the Healthcare District and tell Sutter it is NOT over.   The State of California and the Federal Government will decide whether Critical Access will be granted to Sutter Health.  That means YOU not Sutter Health will make the decision.  Voice YOUR opinion. What YOU need to know: 1) Sutter Health is a tax-exempt public benefit charity funded by billions of dollars in tax-exempt bonds.   Their purpose for existing is to help YOU.  This is very important to remember as you read further. 2) A Sutter Executive has said that Crescent City "was not sophisticated enough" to understand Regionalization.  Was he talking about YOU? 3) Sutter Hospital rates are roughly 60% higher than other hospitals in California.  Does that hurt YOU? 4) The steady decline in privately insured patients at Sutter Coast is due, in large part, to patients from Crescent City travelling to other hospitals in California and Oregon, where the same care costs 60% less than at our local hospital.  Do YOU have to travel for your healthcare? NOW THE REASONS WHY: 1) Between 2007 and 2012 many Sutter Health executives doubled their own compensation. 2) Sutter Health CEO Pat Fry's compensation increased from $2,287,763 in 2007 to $6,393,883 in 2012.  That's a $4,106,120 increase--almost triple. 3) In 2012, the top 10 Sutter Health executives were paid a total of $27,644,426.  That's millions, folks. 4) Their salaries are paid from YOUR hospital bills.  Remember the 60% more YOU pay at Sutter Coast. 5) Every year from 1985, when Sutter took over the hospital, until 2010 the hospital was profitable.  The only time the hospital reported losses was after they got rid of the Chief Financial Officer.  6) There has been no independent audit of the Hospital finances since 2007.  If all of this seems very unfair, YOUR help is needed.  Remember YOUR hospital is a tax-exempt public benefit charity.   There are avenues available to BLOCK conversion to Critical Access. In addition to Sutter's plan to downsize our hospital to Critical Access, do YOU want to continue to support and pay exorbitant salaries to executives in San Francisco by paying 60% more for your health care?  If the answer is no, please read on to learn how to stop Sutter Health . . .

WHAT YOU CAN DO TO STOP SUTTER HEALTH

Take a few minutes to write a letter.  Three sentences is enough.  Here are some facts for letters:

• Critical Access was funded in order to improve healthcare access by subsidizing tiny hospitals.  By cutting beds to qualify, Sutter is using the program to reduce access to care in order to increase their payments from Medicare. 

• At Sutter Lakeside Hospital, where Sutter cut beds to qualify for Critical Access designation in 2008, emergency patient transfers out of Lakeside quadrupled, and Sutter Lakeside became the number one recipient of Medicare funds among the nation's 1300 Critical Access hospitals.

• Critical Access at Sutter Coast will result in patients being airlifted to outside hospitals--at the patients' expense, separated from their family, friends, and local doctor, and responsible for their return trip home. 

The California agency which oversees hospitals converting to Critical Access states the program is intended to preserve access and improve quality of healthcare services to rural Californians.  If you believe downsizing the hospital does not fit that goal, write letters to:

(1)  Dana Forney, California Department of Public Health, Licensing and Certification, 2170 Northpoint Parkway, Santa Rosa, CA  95407  

(2)  Alex Garza, CAPT, USPHS, Centers for Medicare and Medicaid Services, Division of Survey and Certification, 90 7th St, Suite 5-300 (5W), San Francisco, CA 94103-6707  (Mr. Garza's email is alex.garza@cms.hhs.gov)

(3) The Del Norte Triplicate, 312 H. St., P.O. Box 277, Crescent City, CA  95531.  Include your city and phone number at the bottom of the letter.  Phone numbers are not published but allow the paper to contact individuals submitting letters.

If you need help with letters, have information to share, or would like to write an article for this newsletter, please call me at 707-465-1126 or email to drgjduncan@yahoo.com  Join the more than 3,000 local residents who oppose Sutter's plans by signing the petition at my office on 1200 Marshall St., Crescent City.

  

Sincerely,

Greg Duncan, M.D.

The facts behind Sutter Health's media blitz in Crescent City

Subject: The future of hospital care in our region Sutter Health's Media Blitz is Oncoming October 31, 2013 Dear Fellow Residents of Del Norte and Curry Counties: This coming week, Sutter Health will release its long awaited "independent" study on Sutter Coast Hospital.  This newsletter will provide some balance and background to Sutter's public relations campaign. I am writing this update on the future of Sutter Coast Hospital because the hospital Board of Directors, of which my husband Dr. Greg Duncan is a member, voted to censure Greg for allegedly releasing confidential information outside the Board room.  Sutter Health and the hospital Board refuse to provide any written specific charges or evidence to support their allegations, so until we understand the implications of the censure, I will be writing newsletters.   Sutter Health is now beginning its final push to take ownership of Sutter Coast Hospital.  As Sutter's public relations blitz begins, please remember these facts:  (1) Sutter Coast Hospital is now owned and governed locally.  Regionalization is a change in ownership and governance.  If we Regionalize, local ownership and governance will be lost, and all future hospital decisions will be made by a Sutter-appointed board in San Francisco.    (2) Under Critical Access Hospital designation, 24 of our 49 inpatient beds would be closed.  If Critical Access is implemented here, people will be transferred elsewhere as a result of the restriction in hospital bed count.  People who have conditions that could be treated locally will be transferred to distant hospitals.  (3) The Healthcare District lawsuit had nothing to do with hospital ownership--it was an effort to hold Sutter Health accountable to its promises to provide expanded care and maintain a local hospital Board, in exchange for the monopoly privilege of operating the only hospital in the county. The lawsuit was settled when the cost became prohibitive for the District's small budget. What the settlement did prove is which side had more money. But the lawsuit bought our community precious time to become educated on these issues. The statement in today's newspaper that Sutter Coast Hospital is the rightful property of Sutter Health is meaningless.  Sutter Coast Hospital has always been locally owned and governed. Regionalization is a change in ownership--if Sutter Health already owned the hospital, they would not have needed to ask the the local Board to vote for Regionalization. During a recorded meeting on 8/2/12, Sutter Health Sr. Vice President Mike Cohill stated to our hospital Board and Medical Staff that Sutter Coast Hospital owns Sutter Coast Hospital.  In 2006, Sutter Health Vice President Brian Hunter declared to the Alameda County Superior Court, "Sutter Health does not own any hospitals," adding, "Sutter Health's function is to provide support to the affiliated hospitals.  Absent a specific grant of authority from a hospital corporation, Sutter Health is not authorized to act on behalf of the hospitals..." [Case no. RG05221764] As you review the results of the hospital study, please consider the following: (1) The soon to be released "independent" study on the future of the hospital was coordinated and funded by Sutter. (2) The independent funding for the study withdrew their support over concerns that the study results had been predetermined in favor of Sutter Health. (3) The local "Steering Committee" was chosen not by the hospital Board, nor by an open invitation for community participation, but by an undisclosed process controlled by Sutter Health. (4) The study consultants performed no independent financial analysis, but instead relied on financial data provided by Sutter Health. (5) Sutter required local residents on the Steering Committee to sign a confidentiality agreement.  Greg will not sign an agreement which prevents him from sharing information on the future of the hospital with the public. Now, let's review a point of agreement with Sutter Health:  our local hospital has been in decline.  The decline is understandable, given the fact that Sutter Health has shifted its focus to healthcare delivery in urban areas. Does it make sense to transfer hospital ownership to San Francisco, or should we engage partners who specialize in rural healthcare and operate in our region?     Fortunately, three other hospital corporations are interested in serving our community.   Asante Health system (which operates Rogue Regional Medical Center in Medford, Three Rivers Hospital in Grants Pass, and Ashland Community Hospital) has a proven track record of profitability and patient care excellence.  Asante would like to partner with this community.   As you review Sutter Health's upcoming presentation and public relations efforts, please remember our community has three options: (1) Continued local ownership and governance, with management by Sutter Health. (2) "Regionalization"--change of ownership and governance to a San Francisco based Sutter Corporation. (3) Affiliation with a new partner, such as Asante, which has publicly expressed an interest in a closer affiliation, specializes and excels in rural healthcare, and is in our region. If you have questions, ideas, or would like to receive future newsletters, please email me at drgjduncan@yahoo.com Please feel free to post this email on social media, forward it to anyone you wish, or stop by our office on 1200 Marshall St. to add your name to the 3200 residents who have signed the petition opposing Regionalization.  We also need more volunteers in Crescent City and Brookings to help distribute newsletters to those without internet access!  Thank you all for your help and support. Sincerely, Anne Marie Duncan, M.D.   Read more at www.crescentcityhospital.blogspot.com   Forward this email This email was sent to drgjduncan@yahoo.com by drgjduncan@yahoo.com |   Update Profile/Email Address | Instant removal with SafeUnsubscribe™ | Privacy Policy. Gregory J. Duncan, M.D. | 1200 Marshall St. | Crescent City | CA | 95531

Latest Information on the Future of Sutter Coast Hospital

Latest Information on the Future of Sutter Coast Hospital

learn more at www.crescentcityhospital.blogspot.com

August 10, 2013  In This Issue Board of Supervisors' record request and higher costs at Critical Access Hospitals

SUPERVISORS REQUEST INFORMATION, SUTTER HEALTH SAYS NO

First, I write to thank the Board of Supervisors for sending another excellent letter to Sutter Health, reiterating the Supervisors' ongoing opposition to Sutter Health's plans to dissolve our local hospital Board of Directors, and transfer ownership and governance of Sutter Coast Hospital to a San Francisco based Board appointed by Sutter Health.  The latest letter, addressed to Sutter Health CEO Patrick Fry and Sutter Coast CEO Linda Horn, repeated the Supervisors' concerns with Critical Access, including the facts that "the program would eliminate 50% of our hospital beds, necessitating hundreds of emergency patient transfers every year to distant hospitals, at the patients' risk and expense, and without their family or local doctor at the receiving hospital."  The Supervisors also noted that Critical Access would precipitate significant layoffs at Sutter Coast.

Sutter Health's response to the Supervisors' latest request for records was blunt.  During last week's hospital Board meeting, Sutter Health Regional President Mike Cohill stated, "we will not be releasing our meeting minutes to the Board of Supervisors or anybody else."

I understand Sutter Health is not legally obligated to release our hospital meeting minutes, but I certainly agree with several Supervisors who requested Sutter Health release the data and meeting minutes.  I fully agree with Supervisor Finigan, who advised in open session, "If you really want an open discussion, then release the data."   

Together with the Board of Supervisors and the Healthcare District, I will continue to work to preserve a full service, locally owned hospital, and prevent downsizing to a Critical Access facility.

Second, we have identified another problem with Critical Access--it will increase costs to patients, and not just costs of transports to distant hospitals.  In order to reduce the number of emergency patient transfers imposed by the Critical Access bed limit, Sutter's consultant wrote the following:  "the Hospital [Sutter Coast] can aggressively use observation bed services; however, this may not be sufficient to allow the Hospital to eliminate the transfer of patients outside the community." 

Observation patients are short term patients, who are not counted as part of the patient limit imposed by Critical Access.  Observation patients may not be commingled with patients on the inpatient nursing units in Critical Access Hospitals, and are subject to higher charges than standard patients admitted to the hospital.  Here is quote taken from the 2012 Sutter Coast Hospital Critical Access study:  "The beneficiary may not be aware that observation stays fall under [Medicare] Part B and require coinsurance and possibly other CAH charges."  According to Medicare regulations, "the beneficiary in an observation status will be liable for a coinsurance charge equal to 20% of the CAH's customary charges for the services."

(Regulation 485.620(a), 6/7/13)  

 

One should also know unless the hospital elects to place their observation patients in some of the 25 available hospital beds, they will need to occupy a stretcher.  Only 25 hospital type beds are allowed in Critical Access Hospitals.  Of course, on busy days like June 28, when there were 36 inpatients plus two observation patients in Sutter Coast Hospital, it will be necessary for many patients to be transferred elsewhere, due to the 25 bed limit.  Our patient numbers are typically lowest during the summer months.  What will happen during the busier winter months, when respiratory illnesses are common?

The hospital Board also held a discussion on Critical Access during our 8/1/13 meeting, which Sutter Health executive Mike Cohill concluded by stating he believed the Critical Access program would inevitably be implemented here in Crescent City, while acknowledging he had not spoken to Asante or any other potential management firms.  

If you have ideas or comments you would like to share, please send them to me at the email address below, or stop by my office on 1200 Marshall St. to learn more or add your name to the more than 3,000 local residents who have signed a petition opposing Regionalization and Critical Access designation for Sutter Coast Hospital.  To join our email newsletter, just send me an email at drgjduncan@yahoo.com

Next issue: The story behind the resignation of Sutter Coast's excellent former Chief Financial Officer, and the ensuing reports of financial losses for the first time in the hospital's history.

Sincerely,

Greg

Gregory Duncan, M.D.

Chief of Staff

Sutter Coast Hospital

Sutter Coast Hospital Never Reports Annual Loss Until They Fire the CFO

August 18, 2013 

Sutter Coast Hospital Never Reports Annual Loss Until They Fire the CFO

The next time you hear that Sutter Coast Hospital (SCH) needs to downsize to a Critical Access facility because the hospital is losing money, please remember the following story:

After 24 consecutive years of profitability, SCH first reported a yearly loss in 2011.  It was also in 2011 that former Sutter Coast CEO Eugene Suksi fired the hospital's Chief Financial Officer (CFO), following which Mr. Suksi took responsibility for the hospital finances.  SCH bylaws specifically state the CFO cannot be the same person as the CEO.

The California Corporations Code requires Sutter Coast employ its own CFO, yet SCH has been operating without a CFO for over two years.   

After the hospital Board expressed increasing concern over the absence of a CFO, Mr. Suksi confirmed the appointment of Sutter Regional CFO John Gates as CFO for Sutter Coast in two emails, sent 5/29/12 and 9/14/12, both of which list Mr. Gates as a recipient. 

I remained concerned with the absence of a CFO because hospital bylaws stipulate the CFO perform specific duties, such as reporting to the hospital Board and working with the Chair of the Finance and Planning Committee.  The CFO is the financial professional charged with providing the Board reliable data at Board meetings, but these bylaws-mandated duties were not being fulfilled. 

Ultimately, I brought my concerns to auditors from Ernst and Young earlier this year, who confirmed to the hospital Board that SCH does not have a CFO.  After that announcement, interim hospital CEO Linda Horn notified the physicians that the position of CFO at Sutter Coast remains unfilled since July 2011.

Last week, Mr. Gates stated during a recorded meeting of physicians and hospital Board members that he was unable to answer the question of whether he was CFO for SCH.  

Sutter Health will not release any of this information to the public, but if anyone reading this sits on the hospital steering committee, the membership of which is being held confidential by Sutter Health, please ask if Sutter Health will allow you to view these emails, and I will send you copies. You may also wish to ask for the meeting minutes where the Finance and Planning voiced their concern that a CFO should be hired, and raised the question of whether the absence of a CFO could be a factor in Sutter Coast's revenue cycle issues.  With Sutter's permission, I will send you that information also.

I believe the hospital Board should delay our decision on Critical Access until Sutter Coast comes into compliance with California law, adheres to our bylaws and recruits a CFO, and has the opportunity to analyze reliable financial trends.  Anything less seems contrary to our responsibility to this community. 

If you also believe the County's only hospital should not downsize to a Critical Access facility and cut 50% of our beds, please write Calif. State Sen. Jim Nielsen, Assemblyman Wes Chesbro, U.S. Congressman Jared Huffman, and Attorney General Kamala Harris. Send me an email or stop by my office if you need contact information, or would like to add your name to the petition opposing Sutter Health's plans to take ownership and downsize our locally owned hospital. Or, send me your thoughts at drgjduncan@yahoo.com and I will forward your comments to our elected representatives.

Thank you again for your support and encouragement.

Sincerely,

Greg

Gregory J. Duncan, M.D.

Chief of Staff

Sutter Coast Hospital

drgjduncan@yahoo.com

 

(Please forward this email to anyone who may be interested).

Please attend meeting Wed., July 17th, 3:30 p.m. at 9th and H Streets

Please attend meeting Wed., July 17th, 3:30 p.m. at 9th and H Streets

In This Issue Meeting between County Supervisors and Healthcare District

Opportunity for input on future of Sutter Coast Hospital I just learned that County Supervisors Mike Sullivan and Martha McClure will be meeting with Healthcare District Board members Clarke Moore and Kevin Caldwell, and Sutter Coast CEO Linda Horn, regarding the possible transfer of ownership and downsizing of Sutter Coast Hospital.  The meeting will take place Wed., July 17th, at the Flynn Center on 9th and H Streets in Crescent City.  Dr. Caldwell is the former Sutter Coast Hospital Chief of Staff who voted against the transfer of hospital ownership, and is opposed to hospital downsizing.   I know Dr. Caldwell would appreciate your input at this meeting.  Public input will be allowed. Please help spread the word by forwarding this message and posting on Facebook Please try to attend this meeting.  I am sorry for the late notice, but I was not invited to the meeting.  I just learned last night that the meeting was scheduled by the Supervisors.  I am unable to attend, but I was told Sutter Coast CEO Linda Horn was invited, and is expected to attend.  A good turnout would help our elected officials understand the importance of this issue and give you a chance for input. Meeting date:  Wednesday, July 17th, at 3:30 p.m. Location:  Flynn Center, 9th and H Streets, Crescent City Room:  Suite 200 (may be moved to the first floor auditorium if turnout is high). Please try to attend this meeting.   Sincerely, Greg  Greg Duncan, M.D. Chief of Staff Sutter Coast Hospital

Gregory J. Duncan, M.D. | | drgjduncan@yahoo.com | 1200 Marshall St.
Crescent City, CA 95531

Latest News on the Future of Sutter Coast Hospital

Latest News on the Future of Sutter Coast Hospital

July 15, 3013

I write to separate facts from rhetoric concerning Sutter Health and Sutter Coast Hospital (SCH).  Currently, SCH remains locally owned, and governed by a local Board.  In 2011, the hospital Board voted to "Regionalize" SCH, which will dissolve themselves as the governing body, and transfer hospital ownership and governance to a Sutter Board in San Francisco.  Under Regionalization, decisions which are currently made locally will be made in the Bay Area. Why is Sutter Health fighting so hard to own Sutter Coast? Sutter Health originally told our hospital Board that Regionalization was needed to increase efficiency in an era of decreasing payments.  However, former hospital CEO Eugene Suksi  later reported that Sutter's strategies for improved efficiency, such as outsourcing local jobs and purchasing supplies in bulk, are already in place and do not require Regionalization.  The main force behind Regionalization appears to be control.  Now, our hospital Board has the right to negotiate with companies other than Sutter Health to manage the hospital. Under Regionalization, we lose ownership of SCH, and management will be decided by a Sutter appointed Board, which meets 350 miles away and controls 11 hospitals in the Region.  What would "Critical Access" designation mean for us? The first major decision facing SCH is whether to downsize the hospital by 50% to qualify for increased Medicare payments under the federal Critical Access program.  Sutter Health's 2012 study on Critical Access concluded with the following statement:  "we believe the Hospital should pursue the Critical Access Hospital program."  The same study estimated that under Critical Access designation, 247 patients would have required emergency transfers from Crescent City to outside hospitals in 2011. At Sutter Lakeside, a hospital of similar size to SCH, Regionalization and Critical Access designation were followed by massive job losses, closure of two clinics, and a 150% increase in emergency patient transfers. Why does a charity operate in secret? When the local hospital Board voted to dissolve themselves, they did so without looking at options, such as affiliation with Asante Health System, which operates three hospitals in southern Oregon.  Asante has publicly expressed an interest in our hospital, but to my knowledge no one on the hospital Board other than me has approached Asante.  Now, after intense public criticism of their secrecy, SCH is paying a consulting firm $170,000 to evaluate strategies, including Critical Access.  However, Sutter Health controls the study, after refusing outside funding from three charitable foundations.  The consulting firm is not permitted to audit the hospital financial records or make any recommendations--they are allowed only to list options for the hospital Board, which already voted to Regionalize SCH.   The most disturbing aspect of this process is the hospital Board's refusal to include the public, beginning with their 2011 vote to Regionalize SCH, cast in a closed Board room at the deliberate exclusion of interested parties.  Hospital Chief of Staff Kevin Caldwell, M.D. objected to the Board's Regionalization vote, noted that they did not understand the transfer of ownership, and asked for more time to study the issue.  Nevertheless, the Board voted to Regionalize over his objection.  The hospital Board meeting minutes, hospital financial data, and even the membership and discussions of the current "steering committee" on the hospital study, all remain secret.  The hospital Board has not held a single public forum since their decision 20 months ago to transfer SCH ownership to Sutter Health.   Last month, the hospital CEO and Board Chair abruptly withdrew from a Town Hall event they had committed to attend.  No observers are permitted to attend Board meetings.  The Board Chair will not allow community letters of concern to be discussed in the Board room. Last week, The Joint Commission, a national accreditation agency which certifies hospitals, validated physician concerns that the SCH Board had inappropriately excluded physicians from hospital policies, in violation of our bylaws.  SCH leadership received four Joint Commission citations for failing to address physician concerns regarding Regionalization. SCH is a locally owned public benefit charity, with a monopoly over local hospital care and the privilege of tax exemption.  Sutter Health, and the SCH Board, are making decisions which will affect the lives of 41,000 people within the hospital's service area. Given the level of public concern, is it not appropriate for Sutter to release the documents the public needs to understand this issue?  Why does Sutter continue to operate behind closed doors, hold secret meetings, and withhold critical information this community needs for our long term planning?  I applaud the County Supervisors for asking Sutter to release this information.  Let's end the secrecy.  With Sutter Health's approval, I will make all the documents available on our website at www.crescentcityhospital.blogspot.com, including a link to the audio recording where Sutter Health Regional President Mike Cohill discusses Sutter's program to outsource jobs, and confirms that SCH is still a locally owned corporation.   Printed information, and a petition opposing Sutter's plans, are available at my office on 1200 Marshall St.  To receive future newsletters, please send me an email at drgjduncan@yahoo.com. I deeply appreciate the support from everyone who has joined our effort to stop Sutter Health, and preserve a locally owned, full service hospital.   Sincerely, Greg   Gregory Duncan, M.D. Chief of Staff Sutter Coast Hospital drgjduncan@yahoo.com

Gregory J. Duncan, M.D. | | drgjduncan@yahoo.com | 1200 Marshall St.
Crescent City, CA 95531