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  1. TopTop #31
    cynctysings's Avatar
    cynctysings
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Dian, Because of your post, I, also, read Jim Horn's informative article. As always, there are many sides to this story. I am very grateful for Mr. Horn's reporting of facts on another side of the coin.

    This issue of re-opening an urgent care facility, however, remains to be solved. It is my fervent hope that the needs of this community will trump the needs of finger pointing and vitriol from any side of the discussions at hand and that the Board, the Foundation, and everyone else at the table are able to work together towards a solution.

    Quote Posted in reply to the post by Dian Hardy: View Post
    Having read this, my certainty is shaken. Along with everything else I didn't know is the Smith/Gude business connection...
    Last edited by Bella Stolz; 05-28-2014 at 01:17 PM.
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  3. TopTop #32
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    [First let me say that I have learned not to respond to attacks like Jim Horn’s because it only gives them more credibility than they deserve. But since I have been asked, I would offer the following:]

    I first met Dr. James Gude in 2007. I was desperate to get Palm Drive back on its feet. It was losing $500,000 from operations every month and I was having to write checks for $250,000 every two weeks to cover payroll. My first thought was to reopen the ICU since it had been closed a year earlier. The closure was reportedly going to save the hospital $1 million a year but actually cost it $3 million because the hospital could no longer do complex surgeries or handle higher acuity cases. I had heard that Jim was tired of running Sutter’s ICUs and was looking to create a telemedicine company.

    I went to visit him in his office, which was the old men’s room in the medical library wing of the 1930s Community Hospital. Jim had been told that he could have an office anywhere and chose to be with the books, his true love. The only office available was the old men’s bathroom so that is where he had settled many years before.

    I was a little taken aback to see this prestigious physician camped out with his dog and surrounded by books in the old wing of the hospital but our conversation was wonderful. I told him that I was aware that he wanted to start a telemedicine company serving rural hospital and offered that if he would come to Palm Drive and reopen the ICU under his management, I would help him build his telemedicine company (a promise I am still keeping to this day.) He also had to agree to set up an office in the hospital and be a mentor to the physicians and nurses.

    My instinct was that Jim would bring business to Palm Drive because of his reputation and collegial relationship with physicians all over the county. This turned out to true beyond my wildest dreams. After considering this proposal for only a few moments, Jim said ‘Yes.’ We shook hands and I told him to be ready for a moving truck on July 1. There was no contract, no terms or anything. I left elated because I could now see a possible path to getting Palm Drive to cash flow.

    My next stop was the hospital to get a budget together to remodel the ICU into a state of the art facility. It was being used as a storage room and looked awful so this was going to be a real challenge. The budget came back at $350,000. We had no money so I headed out to Kaiser where I declared that they should give me $300,000 or Palm Drive was going to close and all the indigent patients would end up in their ER. To my shock, Judy Coffee said yes. Once again, I was elated but I got a call later and Judy said she could only give us $100,000. Somehow, we scrounged up the rest of the money, I don’t actually remember where it came from.

    In fact, the Palm Drive ICU was remodeled and opened on July 2, 2007. By 11:00AM, there were 3 patients in the ICU, one of whom was flown by helicopter from Willits. Over the next 2 years, Palm Drive’s revenue went from $22 million to $28 million and the hospital had a profit for the first time in years in 2010. I attribute most of this to Jim’s presence. Jim created a certified stroke program, the first of its kind with Dr. Allan Bernstein, taught grand rounds every Wednesday, connected Oakland Children’s Center by telemedicine and provided the best ICU care in the area.

    So my work with Jim has taken on a number of forms. When I was still on the district board, I donated money to the foundation, which was loaned to Jim when his company was faltering because I knew that his loss would be terrible not only for Palm Drive but for Healdsburg, Fort Bragg and Willits. When I left the district board, I began helping Jim build his telemedicine company by finding some investors and providing business guidance so that he would stay at Palm Drive. I have been working for 2 years for $1/year.

    When Jim said he was going to rally the doctors to save Palm Drive in April, I told him he was crazy, that he had no idea how difficult this would be, how much money it would take and how much abuse would be dished out (as we see from Jim Horn.) I watched him march off as if he had never heard me. I had already decided that I was NOT going to get involved in Palm Drive’s demise which I had seen coming for over 2 years but was powerless to prevent since the district board had long ago decided that I was persona non grata.

    I should add here that I do have a conflict of interest: I consider Jim Gude to be the most amazing person I have ever met and someone I would do most anything for. At 74, he is full of energy, is kind to everyone and willing to work nights and weekends to provide care and comfort to patients. The nurses and doctors who work with him revere him. Just today, he announced that he is going to work one week a month at Clear Lake in person to help get their hospitalist program going. So I am not very interested in people who attack him.

    I was actually in the Philippines when the announcement was made and missed the first meeting. When I came home, I had NO INTENTION of getting involved. Even Jim did not get me to consider it. But then Joan called me on the phone one day crying and said ‘Dan, you’re not going to let them close the hospital without saying something are you?’ Unfortunately this leaves a guy with only two choices; be a schmuck and say ‘dear, I am going to sit by and watch it fail’ or be her hero and say ‘dear, I will do everything I can to keep the hospital open.’ You guys know the drill.

    So I turned to the best healthcare CPA I know, Glenn Minervini-Zick and asked him if he would look at the finances and see if there was the potential of getting operations to work. Only Glenn could do this because he was the CFO for a few years and has 30 years of healthcare experience for big CPA firms. He is also the best business forecaster I know and was willing to do this for free.

    Glenn came back with a way to keep the hospital going if we could raise $2-3 million, which we were able to find most of on pretty short notice so there was at least a hope of keeping the hospital alive. Glenn and I worked night and day to figure out the business strategy and recruited a bunch of new docs to fill out the business. We only had a week to put a plan together, but it was very good from my perspective. Of course some parts were not fully fleshed out, but that’s what you get in one week. Unfortunately, we did not get the opportunity to try it out as you know.

    I can’t see how you turn this into some nefarious plot by the evil Dan Smith, Dr Jekyll/Gude and Mr Scrooge/Minervini-Zick but it reminds me of 1999 when local people got together and bought the hospital as the 35 for Palm Drive. In the local paper there were all kinds of accusations about this nefarious group who were ‘running away with our hospital.’ There were even some political cartoons that cast the 35 for Palm Drive as robbers stealing the hospital. I was shocked because I knew that everyone was just trying to save the hospital. I have learned since then that people who give away money are often distrusted by people who can’t see themselves giving money away even if they had it.

    As for Jim Horn’s ‘report’, you should know that there were 4 reports about the foundation’s plan. Two of them rated the plan 95 out of 100 (Jim Maresca and John Moise.) Jim Horn rated it lower as did Sandra Bodley but even these ratings were not so low as to call off discussions, which the district board went forward with.

    As to the offer of free software, I put that in the proposal because I saw it as a possible way to capture the other federal meaningful use money for the hospital. Jim Horn’s fantasy that somehow we were trying to use the hospital as a guinea pig and we were going to somehow use Palm Drive to break into the US market is just that, his fantasy. We have no plans to do this and I always saw this as a transition until the hospital could get back on its feet and afford a US centric system.

    By this time in my life, I am pretty used to being attacked. Whenever you speak truth to power, the first response is usually character assassination, which I consider Jim Horn’s piece to be. This works with a lot of people because of our natural inclination to distrust people who do crazy stuff like donate lots of money, give their services for free, or just act out of their love of the human race. The odd part is these same people trust $520 per hour lawyers, $50,000 hospital shut down consultants, high priced financial consultants who don't do any more than tell them what is already on their financial statements and CFOs who are painting pretty pictures. Go figure!

    farmerdan
    Last edited by Barry; 05-28-2014 at 02:47 PM.
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  4. TopTop #33
    Peacetown Jonathan's Avatar
    Investigative Reporter

    Horn's "Conflict of Interest" Smokescreen Masks Wells Fargo Conflict of Interest Scheme

    It was five weeks ago, soon after I started investigating the Palm Drive closing, when I attended the April 23 hearing.

    That's when I first started hearing the allegations of "conflict of interest," being leveled by members of the Palm Drive Board toward Jim Gude and Dan Smith.

    I was already acquainted with both men. I knew enough about their background, and the fact that Smith was offering to DONATE $1.5 million, and Gude to work for next to nothing, to realize that the conflict of interest allegations rang hollow.

    It was then, and remains, a smokescreen to mask the antipathy that members of the Palm Drive Board feel for Smith. This antipathy, it seemed, spread to anyone (myself included) that criticized Palm Drives abysmal management--or anyone who tried to suggest that the hospital might stay open.

    Although it was not spelled out in the shutdown playbook that the Board signed off on, with the shadowy PR firm Young & Company on March 25, it seemed to me to be a basic strategic communications tactic called deflection.

    Deflect attention from the facts by attacking the messenger of those facts.

    Then, use friendly media to parrot your talking points.

    Sonoma West, whose publisher Rollie Atkinsons' actions seem to indicate a strong personal loyalty to one or more members of the Palm Drive Board, was all too willing to play the parrot. As mentioned in my post above, Atkinson’s 'Palm Drive is Dead" May 1 editorial hit all the playbook talking points like a stenographer taking dictation. Jim Horn's "conflict of interest" editorial, which we are talking about in Farmer Dan's post above, ran one week later. Ironically, while engaging in his mythical conflict of interest character assassination of Smith and Gude (two men who have worked hardest, through the years, to make the hospital the beloved institution it is in our community),

    Jim Horn also used his commentary to condemn the "vicious attacks" on management and the board that many, many community critics had made at public meetings. Many have called on the Board members to resign of they do not believe that our Hospital District, created specifically to provide emergency room services, should provide these services any longer. And let representatives serve our community who believe that this service is part of their job. I am
    hopeful that the elected Board members can change their adamant positions in this matter,as they learn the facts behind the manipulative advice they received.

    But calls for the resignation of Board members are not "vicious attacks.: They are grassroots, democratic responses of members of a community who are unwilling to go quietly into the night of the "new normal" of no hospital for 40,000 of us. "Vicious attacks" would be allegations of corrupt intentions. This is what Horn himself engaged in with this editorial.


    Horn also reported that he had analyzed the plan on behalf of the Palm Drive District Board, and that it "does not solve the hospital's basic money problems." It had "basic competency questions that could not be answered" and was full of the dreaded "conflict of interest."

    Political supporters of the Palm Drive Board have been using Horn's piece as "evidence," to reporters like myself, that the Foundation plan was unworthy of support (despite the fact that it would have resulted in an emergency room that would be open as I write this).

    On May 12, Council Member John Eder, who is married to District Board Member Marsha Sue Lustig, emailed me a link to Horn's editorial, with the note, For a concise and balanced critique of the Foundation's proposal, I suggest that you read "Palm Drive Foundation proposal not the answer", by Jim Horn, a Sebastopol engineer who was on the proposal review committee. After reading and analyzing the 70+ page document, he shares many of the same conclusions and concerns as the Palm Drive Board of Directors."

    It was not until I investigated further into the Board assessment of the Gude/Foundation Plan that I learned what has been mysteriously absent from the Sonoma West's editorial page. Or John Eder's email.

    This is that Jim Horn's report was one of FOUR assessments made of Dr. Gude's Foundation Plan for the Palm Drive Board on April 23. That two other reports, by Board Member Jim Maresca, and health care expert John Moise, had no problem with the viability of the plan and suggested the Board accept the takeover plan and keep Palm Drive Hospital open.

    Moreover, Maresca and Mosie were by far the more experienced analysts of the financial structure of the plan. Neither Horn, who is an engineer, nor Sandra Bouley, a nurse on the Board have any hospital finance experience. Both Maresca and Moise do.

    I was disappointed to learn that Council Member Eder neglected to mention that there were other assessments. And that Jm Horn did not mention in his piece that his was one of four assessments, and that two of the others believes the Gude/Foundation should have been accepted.

    It does not surprise me that John Eder is defensive about, and wants to support, his wife's challenging and difficult judgments.

    What is surprising is that while Board members were angrily accusing Dan Smith and Jim Gude of conflicts of interest, they were having $520 an hour bankruptcy attorney Michael Sweet lecture them, and the public, about the Board's "fiduciary responsibility" to turn down the Foundation plan because it "squandered" tax revenue that a bankruptcy court would require be reserved for creditors.

    This advice was misleading and false, as documented in my original post above.

    And it was being disseminated by an attorney for the law firm of Fox Rothschild, a firm whose largest banking client is Wells Fargo Bank. Wells Fargo Bank, as I have reported, is the trustee of the largest hospital creditor, its $22.9 million bond holders. The Board, and Palm Drive CEO Tom Harlan, had been advised of a conflict of interest waiver that had been signed so that Mr. Sweet could represent them.

    Yet during five public meetings, and to this day, this humongous conflict of interest, the conflict of interest that seems to have induced an attorney to deceive the Board and public to benefit the bond holders at the expense of the taxpaying citizens of the hospital district, was never disclosed by the Board members. Or Palm Drive's CEO. Or Jim Horn.

    Why was there no disclosure of the true conflict of interest that determined the rejection of the keep-it-open doctor plan during the April 23 public hearing?

    So, when we talk about conflict of interest in the struggle to understand why Palm Drive closed, let's stop deflecting from the facts to scapegoat hard-working volunteer solution creators Dan Smith, or Dr. Jim Gude.

    Let's stop talking about a smokescreen.

    Let's discuss the conflict of interest that matters.

    And what We, the People of West County need to do now to get the Palm Drive District Board to fire Fox Rothschild, and hire a bankruptcy lawyer who will represent us.

    Not Wells Fargo Bank.
    Last edited by Peacetown Jonathan; 05-28-2014 at 04:40 PM.
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  5. TopTop #34
    Gus diZerega's Avatar
    Gus diZerega
     

    Re: Horn's "Conflict of Interest" Smokescreen Masks Wells Fargo Conflict of Interest Schem

    Thank you Jonathan and Dan. When I first read the editorial something about it smelled- lots of charges and personal attacks and absolutely no details. The attacks on Dan, who probably more than anyone in the county has historically kept Palm Drive open, called out for details and the lack of them made the author's case suspect.

    But I do not know the details so I stayed quiet and hoping for a reply from Dan and Jonathan, which they have given in spades.

    Speaking as a political scientist, the editorial was an attempt at Karl Rove-style attacking the opposition by questioning their strengths (MANY YEARS of demonstrated commitment to the community) and changing the subject from the misdeeds of the Board and its lawyer (who it seems to me should be disbarred) to sliming the personal motives of their critics. Further, the editorial projected the sins they are committing (secret agendas) onto others. This is standard operating procedure for those who are powerful and whose actions cannot be justified on their own merits.

    Their attempt has backfired by providing more information I had not encountered or had not noticed - the two positive reports - that underline any conceivable excuse for the reckless disregard for public well being on the Board's part.Given the division in the reports wy refuse mediation? There is no honorable excuse.

    However this episode does suggest that Sonoma West is as bad at reporting on this issue as some have suggested.

    If this is what the allies of the Board can bring forth it proves the weakness of their position and the need for the people of Sebastopol to no longer have them in any position of authority over the hospital.

    I admit I am "piling on." But it seems to me nothing short of piling on will work given the obduracy of the Board and its increasingly impossible to defend position.

    Quote Posted in reply to the post by Peacetown Jonathan: View Post
    It was five weeks ago, soon after I started investigating the Palm Drive closing, when I attended the April 23 hearing.

    That's when I first started hearing the allegations of "conflict of interest," being leveled by members of the Palm Drive Board toward Jim Gude and Dan Smith....
    Last edited by Bella Stolz; 05-28-2014 at 01:25 PM.
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  7. TopTop #35
    Dianala's Avatar
    Dianala
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    I do not trust the news media much these days and that is why I pointed out the headline about the judge "refusing" mediation, when in fact he recommended it.

    The hidden agenda and conflict of interest issues are on the District Board's back, not Dan and Dr. Gude's. I agree that there is a lot of deflection going on to get the heat off of them and the lawyer.

    The fact that some members of the District Board is making this about Dan Smith (and possibly Dr. Gude) is wrong thinking, and some community members are buying it without paying attention. I remember several Foundation Board members speaking at the last meeting in support of Dr. Gude's plan and the desire to continue negotiations. They were open to flushing out their plan since they only had 10 days to put it together.

    It is important to keep an open mind on the Foundation's plan because it is the closest to keeping the local doctors and staff in place and providing the community with the services we want.

    Quote Posted in reply to the post by farmerdan: View Post
    [First let me say that I have learned not to respond to attacks like Jim Horn’s because it only gives them more credibility than they deserve. But since I have been asked, I would offer the following:

    I first met Dr. James Gude in 2007. I was desperate to get Palm Drive back on its feet...
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  8. TopTop #36
    John Eder's Avatar
    John Eder
    Former Seb City Council Member

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    My name is John Eder. I am a member of the Sebastopol City Council, and the Council liaison to Palm Drive Hospital. Palm Drive Boardmember Marsha Sue Lustig and I are partners of over a decade. We have both been patients at the Palm Drive Hospital Emergency Room.

    The recent closing of the hospital has been a tragedy for our entire community. I have refrained, until now, from commenting on this situation, as efforts are undertaken to understand the forces that have restrained the success of Palm Drive Hospital in the past and craft solutions that will lead to its reopening and future viability.

    Like most complex situations, the closure of Palm Drive Hospital is not easily analyzed in terms of black and white. One of the major faults that I find with the Palm Drive Health Care District's Board of Directors is their failure to adequately address the orchestrated campaign of manufactured perceptions being espoused by some members of our community as the only existing version of reality. This attempt to simplify (spin) matters into a "good guys/bad guys" model provides no benefit to our community, and only exploits the lack of understanding and fear possessed by many of our citizens.

    By this time in my life, I am pretty used to being attacked.”- Mr. Smith

    For the purposes of responding to this thread, I would like to address the impression being put forth that a failure to agree with one’s position now constitutes an “attack”, as relates to a recent article in Sonoma West (“Palm Drive Foundation proposal not the answer”- see above). It was clear public knowledge that a committee of four individuals, two board members and two citizens, was convened to evaluate the “Foundation’s Proposal” to reopen Palm Drive Hospital. Mr. Horn’s participation in this committee is acknowledged at the bottom of his article. Anyone that was actually following this matter closely and paying attention at the time would have known that. To suggest that there was an attempt to conceal the existence of the other three evaluations is a fabrication and, frankly, laughable- kind of like, “…you didn’t tell me about the other eleven eggs in the carton.”

    In his May 7, 2014 Sonoma West editorial, Mr. Horn, who is now being “counterattacked” for his candor, clearly admits to a personal conflict-of-interest; his wife had been a nurse at Palm Drive Hospital for six years. Are we to conclude that Mr. Horn intentionally sought to obstruct the reopening of Palm Drive and prevent the reemployment of his wife by pointing out his concerns with this proposal?

    “I can’t see how you turn this into some nefarious plot by the evil Dan Smith, Dr Jekyll/Gude and Mr Scrooge/Minervini-Zick…”- Mr. Smith

    One of the main points in Mr. Horn’s article was a concern over conflicts of interest. Dr. James Gude was originally selected as the CEO-designate for the “Foundation’s Proposal”. At the time of Palm Drive Hospital’s closure, he had established contracts valued at many thousands of dollars per month with the hospital. Unlike private businesses, public agencies are highly regulated in the matter of conflicts of interest. Dr. Gude’s contractual relationships with the hospital presented a clear conflict.

    But it doesn’t stop there. As pointed out by Mr. Horn, a series of interwoven interests exists between Palm Drive Hospital, Dr. Gude, Mr. Dan Smith and the Palm Drive Health Care Foundation. Mr. Smith owns E-Health Records International (EHRI) in Sebastopol, a developer of EHR (electronic health record) software. Dr. Gude is the founder of Offsite Care (OSC), a Sebastopol-based provider of telemedicine services. According to EHRI’s website (https://ehrinternational.com/about/who-we-are/staff/), Dr. Gude is the Chief Medical Officer on their staff. He is also listed as the Medical Director for OSC (https://www.offsitecare.com/personne...tive-personnel). Mr. Smith is shown as the Chairman and CEO of EHRI, and as a member of the Board of Directors for OSC. Ms. Tabitha Bonetti-Asker, the Operations Manager for EHRI is shown as working for OSC as well. In his posting shown above, Mr. Smith states, “So I turned to the best healthcare CPA I know, Glenn Minervini-Zick and asked him if he would look at the finances and see if there was the potential of getting operations to work. Only Glenn could do this because he was the CFO for a few years and has 30 years of healthcare experience for big CPA firms. He is also the best business forecaster I know and was willing to do this for free.” Not mentioned is that Mr. Minervini-Zick is the Chief Financial Officer (CFO) for OSC, which Mr. Horn pointed out in his “attack”. Mr. Mark Lancaster is another employee shared by both EHRI and OSC. He was the Chief Executive Officer (CEO) of the Palm Drive Health Care Foundation in 2010.

    “Whenever you speak truth to power, the first response is usually character assassination, which I consider Jim Horn’s piece to be.”- Mr. Smith

    In his posting critical of Mr. Horn’s analysis of the “Foundation’s Proposal”, Mr. Smith continues; “As to the offer of free software, I put that in the proposal because I saw it as a possible way to capture the other federal meaningful use money for the hospital. Jim Horn’s fantasy that somehow we were trying to use the hospital as a guinea pig and we were going to somehow use Palm Drive to break into the US market is just that, his fantasy. We have no plans to do this and I always saw this as a transition until the hospital could get back on its feet and afford a US centric system.” There is a problem with this seemingly magnanimous offer. As Mr. Horn reported in his “attack”, this software is currently uncertified in the United States, and, as a result, prevents Palm Drive Hospital from receiving any “federal meaningful use money”. To confirm this fact, I contacted the Center for Medicare and Medicaid Services (CMS) and searched their 2014 Edition Certified Health IT Product List database under “Vendor Name” (E-Health Records International and Offsite Care Resources, Inc.) and “Product Name” (HarmoniMD). In both cases, I received the message: “Your Search Results: No Products Found”.

    You can do this yourself at https://oncchpl.force.com/ehrcert/ehrproductsearch. Still wanting to confirm that I was correct, I called the Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, EHR Information Center, who confirmed that E-Health Records International, Off Site Care Resources, Inc. and HarmoniMD are not in their current certified EHR product database. They further confirmed to me that the use of an uncertified product would disqualify a hospital from qualifying for full CMS EHR Incentive Payments. These are reimbursements to hospitals, “…as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology”. Please see: (https://www.healthit.gov/policy-rese...duct-list-chpl).

    I was surprised to see a certificate on EHRI’s website, dated November 2011, that indicated that HarmoniMD EHR software (now shown as a product of OSC) was “Certified by the US Department of Health and Human Services for Meaningful Use Stage 1” by a company called InfoGard. See: https://ehrinternational.com/products/. So I went to Info Gard’s website (https://www.infogard.com/healthcare_..._certification) in attempt to understand this seeming discrepancy. The Info Gard site states “Once InfoGard has certified an EHR system in accordance with applicable standards and certification criteria, InfoGard will submit the information to the ONC for posting on the ONC Certified Health IT Product List (CHPL) website.” This is the same website referred to above that displays “Your Search Results: No Products Found”. So, the complimentary software offered to Palm Drive Hospital does show up on the 2011 list, but is absent from the 2014 list. I concede that I am not an EHR expert, so any clarification on this matter from either Mr. Smith or Dr. Gude would be very helpful. Based upon available data, EHRI’s primary markets to date appear to be in Africa and Southeast Asia. I have been unable to identify any U.S.-based hospitals that have deployed the Smith/Gude software.

    It should be noted that the Palm Drive Health Care Foundation loaned money to Dr. Gude/OSC in 2011, which allowed them to attain their existing certification. In return, OSC committed three years ago to providing the HarmoniMD software to Palm Drive at no cost. See:
    https://pdhcf.org/2011/11/02/electro...-emr-software/

    This never occurred. At the time of closure, Palm Drive hospital was utilizing EHR software developed by McKesson, which was also used by Palm Drive’s strategic partners, Marin General Hospital and Sonoma Valley Hospital, as a way to share and reduce implementation costs. See:
    https://www.northbaybusinessjournal....dical-records/

    After CEO-designate Dr. Gude stepped down due to his conflicts of interest, the Palm Drive Foundation introduced a new CEO-designate for their proposal, Dr. Robert Stebbins. As a physician with “extensive hospital administration experience”, according to the Foundation, he appeared to be a great match for their requirements. He was impressive in person- well dressed, articulate and very professional in deportment. He approached my partner after the meeting at which he was introduced, thanking her for her questions regarding the Foundation’s proposal and assuring her that he wanted those concerns to be addressed as well. It was felt that there may be a new positive direction being established with the selection of Dr. Stebbins. You can imagine my dismay when I uncovered, after mere minutes of checking on the web, that he had voluntarily surrendered his medical license in 1997 due to professional/sexual misconduct with two female patients. Please see: https://w3.health.state.ny.us/opmc/f...E/lc113155.pdf . Thus, he has not been a licensed, practicing physician for seventeen years, a fact borne out by his otherwise impressive resume, which lists no “hospital administration experience”. See: www.worky.com/robertdeanstebbins.It should be noted that both of these documents were provided to Mr. Jonathan Greenberg by me via email on May 12, 2014. He subsequently thanked me for providing this information to him.

    Perhaps even more troubling was that a number of the Palm Drive Foundation members knew of these past concerns regarding Dr. Stebbins, saw them as inconsequential to his selection, and withheld them from the public and their colleagues. I am unclear if Mr. Greenberg concurs with this assessment, as his posting of May 20, 2014 stated, “The Foundation’s doctor-led plan wanted to bring in a sharp new CEO,…” I understand that retired Sebastopol Police Officer Dennis Colthurst, a current member of the Foundation, was extremely dismayed after learning of these concerns after the fact. At a recent City Council meeting, Mr. Colthurst, in apologizing to me for the vitriol surrounding the closure of Palm Drive Hospital, indicated that the Foundation recognized that they “…had lost the ability to control Dan Smith.” He concurred with me when I stated that, in his maniacal quest to wrest control of Palm Drive, Dan Smith was willing to not only take down the hospital, but would “blow up your show (the Foundation) as well.”

    “I have learned since then that people who give away money are often distrusted by people who can’t see themselves giving money away even if they had it.”- Mr. Smith

    One of the major tasks facing anyone undertaking the reopening of Palm Drive Hospital is the need to acquire a substantial amount of capital- millions of dollars. The current administration of Palm Drive recently estimated that $20,000,000.00 will be required in the near term just for infrastructure repair and replacement in the aging facility- not operating costs.

    After years of a somewhat adversarial relationship, the Palm Drive Health Care District's Board of Directors determined in January 2014 that a new Foundation was required, one operating under the direction of the hospital and focused on fund-raising. As a result, the District formed a new foundation, independent of the existing one. See: https://www.sonomawest.com/sonoma_we...9bb2963f4.html

    It is my understanding the Palm Drive Foundation, which is advocating for the "Foundation's Proposal", has set a current fundraising goal of $6,000.000.00 to facilitate the hospital’s reopening. This is a daunting goal, given that the Foundation raised approximately $3,000,000.00 between 2002 and 2012, while providing Palm Drive Hospital with approximately $1,200,000.00 in the past 12 years, as reported in Sonoma West on September 11, 2013. See: https://www.sonomawest.com/sonoma_we...a4bcf887a.html

    Per their IRS Form 990, for the 2012 fiscal year, the Foundation had $142,172.00 in revenue, and $217,242.00 in expenses, for a one year loss of $75,070.00. Of these amounts, $63,284.00 was paid out as “Other salaries and wages”. During this fiscal year, the Foundation contributed $102,750.00 to Palm Drive Hospital. See: https://www.guidestar.org/FinDocumen...09c62937-9.pdf

    Per their IRS Form 990, for the 2011 fiscal year, the Foundation had $281,402.00 in revenue, and $416,362.00 in expenses, for a one year loss of $134,960.00. Of these amounts, $184,615.00 was paid out as “Other salaries and wages”. During this fiscal year, the Foundation contributed $88,294.00 to Palm Drive Hospital. An amount of $39,000.00 was contributed to five other organizations, including Santa Rosa Memorial Hospital ($10,000.00). See: https://www.guidestar.org/FinDocumen...089bbf1b-9.pdf

    Per their IRS Form 990, for the 2010 fiscal year, the Foundation had $512,561.00 in revenue, and $377,771.00 in expenses, for one year net revenue of $134,790.00. Of these amounts, $130,835.00 was paid out as “Other salaries and wages”. During this fiscal year, the Foundation contributed $81,684.00 to Palm Drive Hospital. Two other organizations received a total of $10,000.00 See:
    https://www.guidestar.org/FinDocumen...07ad4d72-9.pdf

    It need be noted that, despite their losses, the Foundation is not insolvent, and still controls more than $500,000.00 in assets.

    By comparison, the Healthcare Foundation Northern Sonoma County, based in Healdsburg, recently concluded a $14.5 million capital campaign to benefit Healdsburg District Hospital. See:
    https://www.healdsburgdistricthospit...itiatives.html

    In a January 22, 2014 Sonoma West article, it was noted that “The Foundation was not set up to launch a capital campaign for the hospital, said Foundation Board President Ed Bauman, in a letter to Sonoma West Times & News.” It continued: A capital campaign “is not the mission of PDHCF,” Bauman wrote. The Foundation’s mission is “to aggregate smaller gifts in order to make new equipment purchases and improvements that are then paid out to the hospital.”

    This self-perception on the part of some members of the current Palm Drive Foundation was clearly spelled out in a September 2013 report, commissioned by the Palm Drive Board of Directors, titled: “Leadership Survey on Fundraising for Palm Drive Hospital Final Report of Findings, Observations and Recommendations”. The members of the Board, Foundation and Administration were interviewed. All individual replies were held in confidence. The candid responses were telling- there was a widely-held feeling that the interviewees were not trained for or experienced in fundraising for the hospital, and, in some cases, not that motivated to do so. I have attached a copy of that document to this post.

    I anticipate that charges of “Deflection” will be leveled at me as a result of this post-

    Deflect attention from the facts by attacking the messenger of those facts.”- Mr. Greenberg

    I also anticipate that I will be accused of “cherry picking” information to put a “spin” on it. I have attempted to assemble information, citing public source materials, which substantiates the observations made by Mr. Horn in his Sonoma West article. I do not see this information as an “attack” or a “character assassination.” I have, I believe, done this without resorting to name-calling, bullying or ridiculing any members of our community. I apologize for the length of this piece, but I hope that it has provided you with important additional facts.

    There are many more aspects to this complex situation that need to be looked at, and they will be forthcoming in the near future.

    Thank you for your time and interest.
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  10. TopTop #37
    JimHorn's Avatar
    JimHorn
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Thanks for your thoughtful and thorough post, John. For the record, you and I spoke briefly on the phone yesterday; before then, I didn't know you from a hole in the wall...

    When I have time, I hope to respond to some of the comments on my SonomaWest article as well as Mr. Greenberg's articles.

    Thanks again...

    Jim Horn, PE, LEED AP
    Horn Engineers
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  12. TopTop #38
    Dustyg's Avatar
    Dustyg
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    I'm glad that you've stopped making jokes about this serious situation that we are in.

    Quote Posted in reply to the post by John Eder: View Post
    My name is John Eder. I am a member of the Sebastopol City Council, and the Council liaison to Palm Drive Hospital. Palm Drive Boardmember Marsha Sue Lustig and I are partners of over a decade. We have both been patients at the Palm Drive Hospital Emergency Room....
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  13. TopTop #39
    Barry's Avatar
    Barry
    Founder & Moderator

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Quote Posted in reply to the post by Dustyg: View Post
    I'm glad that you've stopped making jokes about this serious situation that we are in.
    I, for one, have appreciated John's lighthearted comments.



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  15. TopTop #40
    Dustyg's Avatar
    Dustyg
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    I have a great sense of humor and love to laugh, but perhaps you're not one of the people, as I am and many others, whose life was saved in the ER at Palm Drive. This is no laughing matter.

    Quote Posted in reply to the post by Barry: View Post
    I, for one, have appreciated John's lighthearted comments...
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  17. TopTop #41
    Peacetown Jonathan's Avatar
    Investigative Reporter

    Thank you John Eder for the constructive information

    I was very pleased to see Council Member John Eder's response earlier today. If we are going to come together as a community to heal the personal and political divisions that have been caused by strong differences of opinions that go back years, we are going to need to communicate openly and clearly, with the the facts that we use to arrive at our opinions.

    These differences arise from different perspectives on some enormous, challenging questions: Why did our beloved Palm Drive Hospital close? And, moving from there, whether we can re-open the emergency room and acute care facility that has been an integral part of it for so many years, and saved so many lives? And what this will take? I think that we can. I will continue to advocate, and work for, a re-opening of the hospital with an emergency room.

    As part of this collective, democratic process, the presentation of information, like John's important introduction to this public discussion about how much money the physical plant of the building requires, and how much money the Foundation might need to raise, is very helpful. I think that the Foundation team is in the process of reviewing the evolving financial picture of the hospital, and preparing a financial road forward that they believe can be sustainable and successful--with an emergency room. I see the willingness of John, and Jim Horn (from his post above) to engage with the public about their views on this subject as yet another important step forward in the collaboration that will be necessary in the challenging months ahead.

    In this spirit of informed public debate in a civil manner, John asks whether the "sharp new CEO" I referred to in my post referred to Dr. Stebbins.

    No, it was not. Dr. Stebbins was brought in on the spur of the moment by Dr. Gude when Dr. Gude was challenged to not be part of administration. The moment the Foundation learned of Dr. Stebbins record, they dropped him from consideration. This was many weeks ago, at a meeting between the Foundation and Board. I am referring to the Foundation plan to find a CEO with a lot of business, hospital administrative and marketing experience. By its nature, this "who will be the new CEO" is a chicken and egg dilemna , because someone like this is probably working elsewhere right now--and a re-opened Palm Drive is not ready to start paying this person.

    I look forward to John and Jim sharing their insights with our community. And working together the many diverse people in our community who are going to need to come together to re-open Palm Drive Hospital.


    Quote Posted in reply to the post by John Eder: View Post
    My name is John Eder. I am a member of the Sebastopol City Council, and the Council liaison to Palm Drive Hospital. Palm Drive Boardmember Marsha Sue Lustig and I are partners of over a decade. We have both been patients at the Palm Drive Hospital Emergency Room.

    The recent closing of the hospital has been a tragedy for our entire community. I have refrained, until now, from commenting on this situation, ...
    .
    Last edited by Barry; 05-29-2014 at 08:56 PM.
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  19. TopTop #42
    Dianala's Avatar
    Dianala
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    You have provided a great deal of information about Palm Drive Foundation and it's operations, current approach and differences, Dr. Gude and Dan Smith, fundraising abilities, etc.

    What is your knowledge of the current conflict of interest issues between the District Board and with the Wells Fargo trustee relationship, their current attorney and PR consultant? If you are the City's liaison, I expect you to offer complete information so the community can receive a well rounded set of facts.

    Deflection is a one-sided approach, and I do hope you are willing to approach this very complex set of circumstances from the best set of facts available to you, and what you can continue to uncover based on the community's questions and concerns about the sudden closure, hidden agendas and conflict of interest issues related to the District Board. Many of us feel duped and have lost a great deal of confidence in the current elected officials.

    Quote Posted in reply to the post by John Eder: View Post
    My name is John Eder. I am a member of the Sebastopol City Council, and the Council liaison to Palm Drive Hospital. Palm Drive Boardmember Marsha Sue Lustig and I are partners of over a decade. We have both been patients at the Palm Drive Hospital Emergency Room.

    The recent closing of the hospital has been a tragedy for our entire community. I have refrained, until now, from commenting on this situation, ...
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  21. TopTop #43
    theindependenteye's Avatar
    theindependenteye
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Like Jonathan Greenburg, I’m encouraged to see responses about Palm Drive from people who have at least some tangential connection with the situation. That’s been sorely lacking. If some critics have been personally harsh, it’s quite possibly due to what I’ve perceived (as a mere citizen) as an exasperating stone-walling on the matter. I would imagine the District Board members have had legal advice not to discuss the matter: intelligent advice from a legal standpoint, outrageously stupid in terms of relations with the people who elected them.

    What I haven’t heard from Mr. Horn or from Mr. Eder is any response to these questions:

    • What plan does the District Board have to restore these health care services to the region? What process are they in for developing such a plan? Who’s involved? What’s the timetable? Is the District Board actually drafting such a plan or simply seeking to mollify the bondholders?

    • Any response to the far more questionable “conflict of interest” suggested by Jonathan Greenburg in relation to Wells Fargo Bank and the active attorney?

    • Mr. Horn states his opinion that the Foundation proposal is fatally flawed and not worth further consideration. But he states no specifics. Instead, he and Mr. Eder go into excruciating detail on hypothetical collusions, software licenses, etc., which, as far as I can tell, are pretty much beside the point. So what’s lacking in the Foundation’s proposal, and what can be done to improve it?

    • Why has the District Board proceeded in a manner wherein they seem to assume that their electoral mandate is to make all decisions on the fate of Palm Drive with virtually no input or notice to their constituency? Is there some way for those people to move out of this bunker mentality?

    I realize this last point seems to be Attack Mode, and I’m sorry for that. I’ve been close a number of nonprofit boards in crisis mode (in the arts arena), and the pressure can make very bright, dedicated people act in magnificently stumble-bum ways -- especially when “fiduciary liability” snarls from the depths. I can see how District Board members would feel they’re under personal attack, but I fear that they can’t see the utter frustration -- from their failure to communicate forthrightly -- that induces it.

    I’m hoping, in posting this, not to intensify the polarization but to bring the discussion around to dealing with the questions that, I think, are in the minds of a number of people in this forum.

    Respectfully—
    Conrad Bishop
    Last edited by Bella Stolz; 05-30-2014 at 01:10 PM.
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  22. TopTop #44
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    John,

    Rather than refuting anything you have said, I offer the following:

    Editor: On May 22, at a special Board of Directors meeting of the Palm Drive Health Care District, dealing with closure of Palm Drive Hospital, an important issue, related to the health and well-being of our community, was not addressed: acute stroke. Nobody considered the time factor going from the West County to Santa Rosa with a stroke. A 30-minute trip will “cost” about 6 billion brain cells. And that assumes that the receiving hospital in Santa Rosa is anywhere near as good as Palm Drive has been in rapid evaluation and treatment of acute strokes. Sutter doesn’t have a stroke program, Memorial gives trauma first priority and Kaiser, while good, is further away. Every paramedic and every 911 operator knows “time is brain” and will direct you to the closest facility that “knows how.” Palm Drive Hospital served that critical role in the County. We “know how.” We did not merely stabilize for transfer. We provided the definitive treatment, faster than any facility, including the university hospitals in San Francisco. We were in the top 6 percent of hospitals nationally in stroke treatment. We had a grant from the NIH for stroke research, the smallest hospital in the country to get one. We were up there with UCSF, Mayo Clinic, Duke and Harvard. We were that good. It really hurt me to have to inform the NIH that someone pulled the plug on the hospital “that could,” and that I would have to withdraw Palm Drive from the research program. Ask some of the people from the Grove who needed stroke care during their encampments. Their houses are bigger than our hospital, and their names are on the buildings of major medical centers. Our stroke care was better. It needs to be reestablished.

    Allan L Bernstein MD
    Medical Director of stroke programs,
    Palm Drive Hospital and Healdsburg District Hospital

    I now know it is inevitable that the hospital will reopen with full Emergency Room and Acute care. This is what we are paying taxes for, it's what the community needs to be safe and secure, and the will, intellectual capital and financial capital is here to do it. The sooner we stop talking about WHO did what in the past that pissed us off or WHO might have a conflict of interest or WHO will operate it and start talking about HOW we will work together and HOW we will reopen Palm Drive, the sooner it will happen.

    I hope you and Marsha will join this effort and firmly believe that you will.
    I would be pleased to work with you.

    farmerdan
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  23. TopTop #45
    Dianala's Avatar
    Dianala
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Thanks, Dan. Working together is the ideal goal for sure. Has the District Board stated they will make sure an ER will be included in the plan?

    Also, just an FYI, Kaiser Santa Rosa is a certified Stroke center (it is the top level of certification), but that doesn't help non-Kaiser patients, or Kaiser patients with acute stroke and heart attacks that require the most immediate response. Also, with Sutter moving to the north end of Santa Rosa, that puts another ER further out from the Hwy. 12 corridor. It will be closer to the River residents, in reality.

    Let's keep the faith that this will resolve with a way to support an ER and acute care facility.

    Quote Posted in reply to the post by farmerdan: View Post
    John,

    Rather than refuting anything you have said, I offer the following:...
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  25. TopTop #46
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Dianna,

    The district board voted 4-0 to continue discussions to reopen services.

    That being said, it is somewhat unclear what this means or if the district board has any plans for specific services like ER. We have learned that the foundation is the only organization proposing ER and acute Care.

    Another way to think about this is that there is a hospital sitting there (closed) with an acute care license and mostly all the equipment in place. You don't have to build one like Sutter and Willits are doing. You don't have to go through licensing. You also have $2 million in tax money to support the operations, capital improvements, and major medical equipment. You have a fabulous team of doctors like Allan Bernstein, Jim Gude, Dr. Powers, Mike Bollinger, Dr Gonzales, Dr. Crane, Dr. Betz and many others and the best nurses in the county just waiting for you to reopen. You have overwhelming community support. You have a 70 year history of excellence.

    Given all this, can you create a business model for a small acute care hospital that works?
    Yes we can. Yes we will. It is only a question of when.

    farmerdan
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  27. TopTop #47
    twodogs's Avatar
    twodogs
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Just ask winery owner Mike Martini how grateful he is for Palm Drive's quick intervention saved him from a paralyzing stroke.
    Quote Posted in reply to the post by farmerdan: View Post
    John,

    Rather than refuting anything you have said, I offer the following:
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  28. TopTop #48
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Quote Posted in reply to the post by twodogs: View Post
    Just ask winery owner Mike Martini how grateful he is for Palm Drive's quick intervention saved him from a paralyzing stroke.
    Thanks for bringing this up. Mike is only one of many. My neighbor would be in a wheel chair right now but is out in her yard gardening instead.

    We can reopen Palm Drive and we will.
    It is only a question of when and how.
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  30. TopTop #49
    Barry's Avatar
    Barry
    Founder & Moderator

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    In addition to the unusually conciliatory posts here recently , there's another positive development in the Palm Drive Hospital saga... From the PD yesterday (May 30th):

    Palm Drive Hospital debt relief bill heads to Gov. Brown's desk

    A state bill that would allow the shuttered Palm Drive Hospital to save millions of dollars in bond debt was approved by the California Legislature Thursday and is now before Gov. Jerry Brown.

    AB 582, by Assemblyman Marc Levine, D-San Rafael, would allow the Palm Drive Health Care District to refinance $20 million of its existing bond debt, resulting in lower interest rates that would save the district $6.5 million, according to Levine's office.

    The refinancing would also free up to $3 million in security funds.

    Continues here


    There's also a Palm Drive Health Care District Board of Directors Meeting this Monday, June 2nd at 6pm at the Sebastopol Center for the Arts on High Street. Lot's more info about that here.



    And the Palm Drive Health Care Foundation is having a meeting the following Monday, June 9th, at the Community Church. More info is here.

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  32. TopTop #50
    Barry's Avatar
    Barry
    Founder & Moderator

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Did anybody out there go to this Palm Drive Health Care District Board Meeting last night (Monday)?

    If so, can you share anything about it with us??

    Barry

    Quote Posted in reply to the post by Barry: View Post
    PALM DRIVE HEALTH CARE DISTRICT
    BOARD OF DIRECTORS MEETING

    MONDAY, JUNE 2, 2014

    (Full Packet with lots of info is here)

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  34. TopTop #51
    Sara S's Avatar
    Sara S
    Auntie Wacco

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    It was rescheduled.... [No! See below -Barry ]
    Last edited by Barry; 06-04-2014 at 04:03 PM.
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  36. TopTop #52
    scamperwillow's Avatar
    scamperwillow
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Nope - not rescheduled. I was there at the very end so can't really report, but it was way more polite and sedate than the last one.

    Quote Posted in reply to the post by Sara S: View Post
    It was rescheduled....
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  38. TopTop #53
    Peacetown Jonathan's Avatar
    Investigative Reporter

    The Bridge to Somewhere: Reopening Palm Drive

    I was not at Monday's Palm Drive District Board Meeting, but I have spoken to three people who were. It was indeed polite. It ended with departing CEO Tom Harlan holding up an Open Our Hospital button, and saying, 'I want to open the hospital too."

    I just saw Tom outside the hospital. He shook my hand and repeated his desire to find a way to reopen, while expressing sincere sadness that the hospital is closed. He said that this has been one of the most difficult experiences of his life.

    It think there is a growing consensus in the community that we need to reopen with an emergency room, and that we are going to need to work together to make this happen. I have been impressed with the progress and new thinking that the Board effort, led by Jim Maresca, has started to make with the Foundation. As well as the big picture strategic thinking that the Foundation effort has embarked upon.

    The public will have a chance to hear about this at the Town Hall meeting at the Community Church of Sebastopol (1000 Gravenstein) next Monday, June 9, at 7 pm

    I am by nature more of an optimist, and a solution-seeker, than a critic.

    Nonetheless, during the past month, I have worked to provide factual, strong criticism, and the transparency and accountability that reporting new information brings, to an issue that is vital to our public interest.

    I think something has been, and continue to be, achieved in this reporting and discussion process here at WaccoBB.net, a 21st century forum for community dialog and disclosure.

    At this stage, I am shifting most of my focus, and time, to working on the challenging road ahead, to helping the collaboration underway to develop and express a solution to our closed hospital.

    It feels to me that re-opening Palm Drive as a financially sustainable hospital, with a life-saving emergency room and acute care facility, is not only likely, but inevitable.

    Provided that our community works together to make this our reality.

    I feel this bridge to somewhere is being built right now.

    I am committed to being part of it. And hope that you are, too.
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  39. TopTop #54
    Dianala's Avatar
    Dianala
     

    Re: The Bridge to Somewhere: Reopening Palm Drive

    This is great to hear as I have been very concerned as well that we are without an ER for a district with over 60,000 residents. On Sunday I stopped to speak with an ambulance driver who was on duty and waiting for a call and I asked him what the impact has been from his point of view. He stated that it was very sad that the ER is closed and he said... "You won't believe how many more miles this ambulance has put on the road this past month or so, and how much more time is spent on the road instead of at the ER." He wholeheartedly hopes that the community can come together and open the ER again soon.

    I think we are getting past the "shock" period and getting down to business on a solution. That is much needed for this to work and I certainly hope the District Board members are sincere about opening the hospital again as well.


    Quote Posted in reply to the post by Peacetown Jonathan: View Post
    I was not at Monday's Palm Drive District Board Meeting, but I have spoken to three people who were. ...

    I feel this bridge to somewhere is being built right now.

    I am committed to being part of it. And hope that you are, too.
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  41. TopTop #55
    arthunter's Avatar
    arthunter
     

    Re: The Bridge to Somewhere: Reopening Palm Drive

    the website:

    https://openourhospital.com/
    Quote Posted in reply to the post by Peacetown Jonathan: View Post
    I was not at Monday's Palm Drive District Board Meeting, but I have spoken to three people who were. It was indeed polite. It ended with departing CEO Tom Harlan holding up an Open Our Hospital button, and saying, 'I want to open the hospital too."

    I just saw Tom outside the hospital. He shook my hand and repeated his desire to find a way to reopen, while expressing sincere sadness that the hospital is closed. He said that this has been one of the most difficult experiences of his life.

    It think there is a growing consensus in the community that we need to reopen with an emergency room, and that we are going to need to work together to make this happen. I have been impressed with the progress and new thinking that the Board effort, led by Jim Maresca, has started to make with the Foundation. As well as the big picture strategic thinking that the Foundation effort has embarked upon.

    The public will have a chance to hear about this at the Town Hall meeting at the Community Church of Sebastopol (1000 Gravenstein) next Monday, June 9, at 7 pm

    I am by nature more of an optimist, and a solution-seeker, than a critic.

    Nonetheless, during the past month, I have worked to provide factual, strong criticism, and the transparency and accountability that reporting new information brings, to an issue that is vital to our public interest.

    I think something has been, and continue to be, achieved in this reporting and discussion process here at WaccoBB.net, a 21st century forum for community dialog and disclosure.

    At this stage, I am shifting most of my focus, and time, to working on the challenging road ahead, to helping the collaboration underway to develop and express a solution to our closed hospital.

    It feels to me that re-opening Palm Drive as a financially sustainable hospital, with a life-saving emergency room and acute care facility, is not only likely, but inevitable.

    Provided that our community works together to make this our reality.

    I feel this bridge to somewhere is being built right now.

    I am committed to being part of it. And hope that you are, too.
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  42. TopTop #56
    JimHorn's Avatar
    JimHorn
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Thanks, Barry.

    About a month ago I wrote this commentary about Palm Drive Hospital for Sonoma West that can be found here.

    In that commentary, I discussed some of my concerns with the Palm Drive Health Care Foundation’s proposal to run the Hospital. Within 12 hours of your posting, responses appeared on your site from Jonathan Greenberg and Dan Smith, among others, accusing me of conspiring with the Palm Drive District Board of Directors, Sonoma West, and other dark forces to shut down the Hospital.

    Conspiring to shut down the Hospital? Really? My wife has worked at the Hospital as a staff nurse for the last six years, so its closure has meant the loss of her job and our health insurance. I must be the dumbest co-conspirator ever….

    And my relationship with the Board? Back in 2010, when I ran against Nancy Dobbs and Chris Dawson for one of their seats, I was soundly thrashed. Hardly the start of a beautiful friendship…

    Did I collaborate with the Board to close the Hospital? Not even close...

    When the topic of closure was first presented at the Board meeting on April 1 of this year, I suggested from the audience that the Board postpone its decision to allow more time to explore alternatives. The Board eventually agreed.

    After that meeting, I filed a California Public Records Act request with the District for the “Alvarez” reports (confidential financial studies prepared for the Board about ways to keep the Hospital operating). The District complied. Once obtained, I emailed the Alvarez reports to everyone on the Board’s agenda distribution list, so folks could review them before the next meeting.

    In my email disseminating the Alvarez reports, and in my Sonoma West commentary, I stated my belief that discussion of major restructuring and closure of the Hospital should have occurred in open rather than closed session. The potential bankruptcy, on the other hand, clearly was a legitimate topic for closed session.

    I suspect that the closure and the bankruptcy were intimately related in Board members’ minds, and they may have received legal advice that they could not discuss the one in open session without compromising the other. Regardless, I’m certain that the Hospital and the community would have benefitted from an open discussion of potential closure much earlier than April 1.

    So why did I write the article in Sonoma West? After thoroughly reviewing the Foundation’s proposal as a member of the evaluation committee, I felt that there were significant problems with its management and financial plan as well as potential conflicts of interest with the proposed Hospital CEO and CFO. Unless those problems could be resolved, I didn’t believe it was prudent for the Board to turn over Hospital management to the Foundation.

    You can read my full committee evaluation here:

    Unfortunately, many people took the Foundation’s proposal as Gospel without really studying it, and they ascribed ulterior motives to the Board (and anyone else) for not immediately accepting it. Greenberg, for example, has written two articles that accept without question the Foundation’s plan. Unfortunately, he’s saving an actual review of the Proposal for a future article! Isn’t that a bit backwards?

    Please note that my original evaluation didn’t dismiss the Proposal outright. It began like this:

    The Palm Drive Health Care Foundation Proposal is well-written, well-organized and provides substantially all information requested in the District’s RFP. I recommend that it be considered carefully by the Board. However, I do not believe it makes a convincing case for the Hospital’s long-term financial viability under Foundation management.

    The Hospital’s administrators also presented an evaluation of the Proposal that can be found here:

    As Greenberg and Smith pointed out, two of the committee evaluators (Jim Maresca and John Moise) scored the Proposal higher than the other two (Sandra Bodley and me). However, much of the difference resulted from our differing approaches: the higher evaluators gave full points for the existence of various components in the Proposal (“financial plan, check; CEO listed, check…”), while the two lower evaluators deducted points if those components, while present, appeared problematic.

    Of course, according to Greenberg, I wasn’t really qualified to evaluate the Foundation’s proposal in the first place because I’m just an engineer (and Bodley just a nurse…). I disagree.

    Since graduating from Caltech, I’ve been a mechanical engineer in California for 33 years, the last 28 as head of my own firm. Prior to the Great Recession, I had 14 employees and worked on projects throughout California. I have extensive experience owning and managing a business.

    During my career, I’ve helped design dozens of health care projects, including construction at Kaiser, Sutter, Ukiah Valley, Sonoma Valley and Mendocino Coast hospitals. I’m familiar with many of the intricate and expanding regulations and restrictions that hospitals face, even the smallest hospitals like Palm Drive. I also understand the enormous maintenance and facilities challenges at Palm Drive. (One reason the Foundation’s proposal to save money by laying off the entire maintenance staff made no sense to me!)

    In addition, I’ve been a board member in the Gravenstein public school district for 12 years, serving seven years as board president. I’m familiar with public contracting and conflict of interest regulations, financial statements, and government codes and regulations. I know how a successful, multi-million dollar public enterprise is run. (And unlike Mr. Smith, I firmly believe that a public district that uses public funds, whether for education or health care, requires a publicly-elected board to oversee its operations.)

    Last but not least, my wife Susan has been a registered nurse for 35 years, including six years at Palm Drive. For my money, if you want to know how a hospital really works, ask a staff nurse, not a doctor. My wife has helped me understand how the medical-surgical wing—the heart of our “famously caring” Hospital—operates. (That’s why the Foundation’s plan to slash the med-surg unit to three beds made no sense, when the average daily census was about nine patients and it often served 10 patients or more on the busiest surgery days.)

    But instead of trying to rebut my specific concerns, Greenberg and Smith attempted to “deflect attention from the facts by attacking the messenger of those facts.” They accused me of “character assassination” and making “allegations of corrupt intentions.” Unfortunately, they both appear to misunderstand what a “conflict of interest” means with respect to public officials in California. This confusion is curious for an experienced journalist like Greenberg and remarkable for Smith, who was forced to resign from the Palm Drive board of directors less than three years ago over the same conflict.

    Please understand: conflict of interest laws have nothing to do with a public official’s honesty or integrity. Rather, they have everything to do with the official’s position. The purpose of these laws is to help public officials avoid situations where their decisions “will have an important impact” on their economic interests.

    In the Foundation’s original proposal, both Dr. Gude, the proposed CEO (who is a wonderful doctor, according to my wife), and Glenn Minervini-Zick, the proposed CFO (who is a good guy, according to a friend), would have had obvious and unavoidable conflicts of interest in those positions. Gude’s company, Offsite Care, contracted with Palm Drive to provide medical services. As a result, both Gude and Minervini-Zick, Offsite’s CFO, would be precluded from holding management positions with our public hospital.

    These conflict of interest restrictions apply to “individuals who make or participate in making governmental decisions that could affect their personal economic interests.” They apply equally to Board members--as Smith, an investor in Offiste, learned three years ago when forced to resign--and to key administrators like CEO’s and CFO’s. You can visit the Fair Political Practices Commission’s website for more information.

    To his credit, Dr. Gude quickly acknowledged his potential conflict at the April 23 Board meeting and publicly removed himself from consideration for the future CEO position. Unfortunately, both Greenberg and Smith apparently missed that memo, instead claiming indignantly that my original concerns “rang hollow” and constituted “abuse” of poor Dr. Gude. Sadly, Gude’s suggested replacement as CEO proved unsuitable for different reasons, as John Eder has detailed elsewhere.

    Crucially, neither Gude nor his ill-fated successor possess the “minimum of 5 years of successful management of a small hospital as a CEO” that the Foundation sought in a want ad posted on Craigslist about three weeks ago.

    Perhaps the Foundation lifted these criteria from an unanswered question I posed in item #6 of my original evaluation?:

    1. What recent, relevant experience (especially in the last five years) do members of the proposed team have at their proposed positions in managing an acute care hospital in California?
    I’d also like to offer few comments on some of Greenberg’s biggest bogeymen. First, let’s examine the alleged conflict of interest of the Board’s bankruptcy attorney, Michael Sweet. His firm apparently represents both the Palm Drive District and Wells Fargo Bank (which serves as trustee for payments to some of Palm Drive’s bondholders). I’m not an attorney, but I have been a party in cases where my attorney also represented another related party. In those cases, assuming the parties deemed the conflict inconsequential, both signed waivers that recognized the joint representation, and the potential conflict was removed. Greenberg quotes Sweet that such waivers are in place in this case and doesn’t offer anything to dispute that statement.

    So where’s the beef? Greenberg maintains that the Board conspired with Sweet and Wells Fargo (using its secret “shutdown playbook”) to close the Hospital while maintaining the parcel tax that’s used to pay back the bondholders. But this alleged tactic makes absolutely no sense. In fact, the Hospital’s closure is the single biggest threat to maintaining the parcel tax and keeping the bondholders happy. Already, Smith has promised a campaign to repeal the tax if the Hospital isn’t reopened soon, presumably under the Foundation’s control. The surest way for the Board to maintain the parcel tax in place and keep the bondholders happy was to keep the Hospital open--even if it meant giving the Foundation a crack at running it with a flawed plan. If anything, Wells Fargo would be pushing to keep the Hospital open, not closed.

    Also, those threatening to repeal the tax need to remember that a parcel tax takes a 2/3 majority vote to pass but only a simple majority to repeal. Given all of Palm Drive’s challenges--two bankruptcies, the current acrimony, the growing Kaiser enrollment, the new Sutter opening, etc.--anyone who wants the Hospital to reopen in the future and have that tax money available, regardless of who runs it, should be very cautious about pushing to repeal the tax now.

    Greenberg and Smith also have accused attorney Sweet of lying to the Board and the public about proper uses for pre-bankruptcy accounts receivable. I’m not a bankruptcy attorney; of course, neither are Greenberg and Smith. But I do know that the Palm Drive District uses an “accrual” rather than a “cash” basis for its accounting. This means that Income, such a patient’s bill, is counted as soon as it’s earned and not later, when it’s actually collected. The same goes for Expenses, which count when first charged and not later, when actually paid for.

    No one disputes that income the District earns after the bankruptcy filing can be used for any legitimate business purpose the Board chooses, including running the Hospital. The dispute is over income that was earned before the bankruptcy but not collected until after. Obviously, were I a creditor of the Hospital (as are many local business and many former Hospital employees), I probably would want that pre-bankruptcy money to be used first to pay what is already owed to me. Sweet says that spending the pre-bankruptcy money must be approved by the judge as part of the bankruptcy plan to repay creditors. I suspect that he’s correct.

    Greenberg disputes that position, primarily by quoting David Heaslett, the attorney who handled Palm Drive’s previous bankruptcy. But read Mr. Heaslett’s quote carefully: “In all the cases that I have done, we have used some of the future revenue to operate the hospital.” In fact, Heaslett does not contradict Sweet’s position on “past” revenue at all. Greenberg offers no other evidence to support his claim that I can see.

    This leads to my final comment about Greenberg’s articles—his relentlessly partisan tone. In his writings and commentary on this issue, the world is divided into two camps: heroes and villains. Greenberg always ensures that we know which is which. Attorney Sweet, a villain, is repeatedly described as “slick,” a “shark,” ”sharply dressed” (an attorney’s customary uniform, isn’t it?), and “San Francisco based” (as was the Foundation’s attorney, who presumably was also sharply dressed?).

    Attorney Heaslett, a hero, is called “independent” and ”a small town attorney”—twice. (I assume Heaslett dresses like a slob and avoids San Francisco like the plague, but Greenberg doesn’t say for sure...)

    Greenberg hyperventilates about a “secret shutdown playbook” that was “mysteriously” prepared by a PR firm called Young + Company—obviously another villain. According to Greenberg, the firm “suspiciously” has no website, business address or phone number. Oddly enough, although I am merely an engineer and not a “professional investigative journalist,” it took me about thirty seconds to find the firm’s website (which lists Dry Creek Inn and Sonoma Valley Inn as clients) and a Facebook page with entries dating back to September 2013. Both sites list a phone number. Neither site lists a physical address, but then neither does Greenberg’s own--not particularly mysterious in this Internet age…. (to see Young’s mysterious web sites, visit here and here.

    The “shutdown playbook” (a phrase Greenberg uses 11 times in the article, just so we don’t forget it) is actually a Proposal for PR services to help the District manage its bankruptcy and the Hospital’s shutdown. It was dated March 23 and signed on March 25, 2014—less than a week before the District publicly announced its bankruptcy and closure plans. Since the potential bankruptcy had not yet been announced, the “mysterious” phase “Privileged and Confidential / Prepared at Request of Counsel” is not mysterious at all—as noted earlier, potential bankruptcy is a legitimate topic for closed Board meetings and confidential documents.

    None of the PR firm’s proposed services is particularly earth-shattering either—“lay the foundation for a bright future for Palm Drive” and “protect the parcel tax income,” for example. I’ve already discussed the importance of the parcel tax for anyone who wants the Hospital to succeed. I think we all hope for a bright future for Palm Drive.

    Now, your readers might ask, “This is all in the past, isn’t it? The Foundation is preparing a new “better than ever” Proposal (per the Foundation’s Gail Thomas), so why do we care about the old Proposal?”

    Why? Because the Foundation and some of its supporters (including Greenberg) have maintained loudly and relentlessly that the Board had no legitimate reason to balk at the Foundation’s original proposal. Board members have been called lazy, incompetent, criminally negligent, murderers… take your pick. As discussed above, I believe there were significant problems and concerns with the Foundation’s original Proposal, and the Board was prudent to tread carefully.

    And if the Board doesn’t immediately accept the next Proposal, I suspect the same charges will be leveled against Board members. But those who truly want the Hospital to succeed over the long run should examine the next Proposal just as closely as the last.
    Last edited by Bella Stolz; 06-09-2014 at 01:05 PM.
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  44. TopTop #57
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Jim,

    Your continual insistence that there are conflict's of interest in the physician/foundation plan are absurd. You ran for the district board when your wife worked at Palm Drive. You didn't think this was a conflict when half of your family income was being paid by the hospital? Wow! Amazing!

    But let's get real: People are DYING and being PERMANENTLY DISABLED because Palm Drive is closed. Our police and fire departments are unable to handle having to get in line in Santa Rosa hospitals. People are having 10 hour waits in the Santa Rosa ERs just to get seen! As Dr. Bernstein pointed out, 30 minutes is 6 billion brain cells (6,000,000,000) when you have a stroke. If you have sepsis and are not treated within a few hours, YOU DIE as recently happened to a Bodega resident. If you have a severe heart attack, a ruptured tubal pregnancy, a dissected aorta, a bleeding ulcer, a stroke, or any of hundreds of other conditions, you will NOT MAKE IT TO SANTA ROSA.

    If you have a better plan to reopen Palm Drive, let's hear it now! We will be happy to support it with money, time and IT services! The foundation has made VERY clear that they will support ANY PLAN that reopens Emergency Services, Acute Care, and Medical Services for the community's benefit. The word is ANY!

    Given that the district has closed the hospital, lost the MediCare billing and shows NO SIGN of putting forth a plan to reopen, the foundation is working to develop a sustainable business plan. This is not something that can be done in one week or one month and will require a lot of work. Unless and until a better plan emerges, we will continue to support this effort, which, by the way is being led by the Palm Drive DOCTORS and the FOUNDATION, not Dan Smith or Jonathan Greenberg.

    farmerdan
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  46. TopTop #58
    JimHorn's Avatar
    JimHorn
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Dan -

    My comments on potential conflicts of interest in the Foundation's original plan were and are valid. As I've said repeatedly, a potential conflict doesn't make you a bad person--it just means that you can't hold a particular position under California law. Dr. Gude has already recognized his potential conflict; why can't you?

    As far as my unsuccessful run for the Palm Drive Board four years ago, I remember your accusations about my "conflict of interest" at the time. You were wrong then, and you're still wrong now. Please read Government Code 1091 (1091.5(a)(6) to be exact, linked here). This is what it says:

    1091.5. (a) An officer or employee shall not be deemed to be interested in a contract if his or her interest is any of the following:

    (6) That of a spouse of an officer or employee of a public agency in his or her spouse's employment or officeholding if his or her spouse's employment or officeholding has existed for at least one year prior to his or her election or appointment.

    My wife had worked at the Hospital for more than a year when I first applied for a Board position--so no conflict. This situation isn't uncommon for school boards in small communities, for example, where the school district may be the area's biggest employer. Had I joined the Board, I would have had to recuse myself from voting on anything that affected my wife as an individual like a promotion or disciplinary action. But I could have legally and ethically served with that restriction.

    So, please, no more distractions.

    As detailed in my committee evaluation and subsequent articles (which neither you, nor Mr. Greenberg, nor anyone else have addressed), I don't believe the original Foundation proposal was a viable plan to keep the Hospital open and solvent. That doesn't make me a bad person--just a cautious one (a necessary survival skill for an engineer).

    I hope tonight's reboot is "better than ever" per Gail Thomas, and if it makes sense for the entire District, I will support it.

    But I don't have a plan myself. That doesn't mean I lose my right to engage in a public discussion on the issue. Given all of the challenges faced by a small acute care hospital in our area, I don't know if such a plan is even possible. You, and many others, are supremely confident that it can be done. Unfortunately, supreme confidence isn't a business plan...

    See you tonight...

    Quote Posted in reply to the post by farmerdan: View Post
    Jim,

    Your continual insistence that there are conflict's of interest in the physician/foundation plan are absurd. You ran for the district board when your wife worked at Palm Drive. You didn't think this was a conflict when half of your family income was being paid by the hospital? Wow! Amazing!

    But let's get real: People are DYING and being PERMANENTLY DISABLED because Palm Drive is closed. Our police and fire departments are unable to handle having to get in line in Santa Rosa hospitals. People are having 10 hour waits in the Santa Rosa ERs just to get seen! As Dr. Bernstein pointed out, 30 minutes is 6 billion brain cells (6,000,000,000) when you have a stroke. If you have sepsis and are not treated within a few hours, YOU DIE as recently happened to a Bodega resident. If you have a severe heart attack, a ruptured tubal pregnancy, a dissected aorta, a bleeding ulcer, a stroke, or any of hundreds of other conditions, you will NOT MAKE IT TO SANTA ROSA.

    If you have a better plan to reopen Palm Drive, let's hear it now! We will be happy to support it with money, time and IT services! The foundation has made VERY clear that they will support ANY PLAN that reopens Emergency Services, Acute Care, and Medical Services for the community's benefit. The word is ANY!

    Given that the district has closed the hospital, lost the MediCare billing and shows NO SIGN of putting forth a plan to reopen, the foundation is working to develop a sustainable business plan. This is not something that can be done in one week or one month and will require a lot of work. Unless and until a better plan emerges, we will continue to support this effort, which, by the way is being led by the Palm Drive DOCTORS and the FOUNDATION, not Dan Smith or Jonathan Greenberg.

    farmerdan
    Last edited by Bella Stolz; 06-10-2014 at 09:23 AM.
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  48. TopTop #59
    farmerdan's Avatar
    farmerdan
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    Jim,

    I quote you: "Dr. Gude has already recognized his potential conflict; why can't you?"

    I am not an officer of the district nor a board member of the foundation nor do I intend to be either. I am a major donor and volunteer. Please explain how this creates a conflict of interest. I am still baffled by how you can come up with this logic.

    Dan
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  49. TopTop #60
    JimHorn's Avatar
    JimHorn
     

    Re: Behind Palm Drive Hospital’s Closing Part II: Wells Fargo Bank & the Shutdown Playbook

    I guess I should have written "why can't you recognize his conflict of interest?" Sorry, I thought the last five words were understood.

    Quote Posted in reply to the post by farmerdan: View Post
    Jim,

    I quote you: "Dr. Gude has already recognized his potential conflict; why can't you?"

    I am not an officer of the district nor a board member of the foundation nor do I intend to be either. I am a major donor and volunteer. Please explain how this creates a conflict of interest. I am still baffled by how you can come up with this logic.

    Dan
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