Article: What’s New and Exciting About Sonoma West Hospital

[Peacetown Jonathan]

What’s New and Exciting About Sonoma West Hospital

By Jonathan Greenberg
For WaccoBB.net
May 25, 2015


https://www.youtube.com/watch?v=tgTT4_-xDq4Ray Hino, the warm-spirited, highly accomplished new CEO of the soon-to-open Sonoma West Medical Center (SWMC), seems to relish his new role as tour guide. Every Saturday for the past few months Hino, with his signature welcoming smile, light blue suit and tie, has graciously guided area residents through the innovative steps and spaces that will make Sonoma County’s only “no-wait emergency room” possible.

The tour begins in the renovated emergency room area. Visitors see a hospital waiting room that has been transformed into a staging area where patients will be seen almost immediately by a qualified medical professional. Hino next leads them through the hallway into some of the most thoughtfully designed patient recovery rooms ever seen in California.

"Our goal at the SWMC,” Hino explains, “is to perfect the patient-centric experience. Our goal is to have an average wait time of 5 minutes from door to bed, and in most cases, if possible, immediate bedding.”

The “patient-centric” experience is the key to what’s different, new, and exciting about Palm Drive. This approach of humanistic, quality local treatment is a welcome alternative to the institutional large city hospitals affiliated with multi-billion dollar bottom line-focused conglomerates (even non-profit ones) like the Kaiser and Sutter hospitals in Santa Rosa.

In an era in which health care is driven to consolidation for “greater efficiencies,” many consumers of health care are feeling that these “efficiencies” are diminishing care and reducing human beings into depersonalized numbers. Because our system has never evolved into a Medicare-for-All insurance system that will let us choose our doctors, we have been driven to ever larger private insurance conglomerates that actually limit our choice of doctors—especially local ones.


https://www.waccobb.net/forums/waccobb/keep90days/2015-05-25_13-21-00.png
Ray Hino, CEO of Sonoma West Medical Center

Nowadays, about the only provider choice that the vast majority of people with insurance can still make is which hospital we choose to go to when faced with a life-threatening emergency. That’s because insurers like Kaiser and Sutter and Blue Cross will always reimburse the hospital emergency rooms that save lives when treating things like heart attacks and sudden injuries.

“Small hospitals can be much better at personalized, high quality care close to home," says Dan Smith, board chair and lead philanthropist of the SWMC. “Having close-by emergency care makes all the difference in the world when you have a life-threatening illness. It’s not just how close the hospital is; it’s how close the doctor is. If you go to a hospital and wait 4 hours and you have a heart condition, that’s not a good situation. You really need to be able to see a specialist immediately. The fact that you’re in a small hospital can mean you’re getting better care. It’s very personal, people pay a lot of attention to you, and you have more access to physicians.”

Given the desire to “go local” for humanistic care, and the fact that the new SWMC will reopen with many of the same doctors who made Palm Drive the safest of more than 300 hospitals in the State of California (as rated by Consumer Reports), adding a no-wait emergency room and new patient-centric services make the reopening of the hospital the most important and exciting event in West County medical history.

“I believe the new hospital will be successful,” says John Moise, a health care consultant who has held executive positions within California’s Health and Human Services Agency for 10 years. “Doing what it takes to become the hospital of choice makes the hospital much more desirable than before. Sonoma West Medical Center will be offering excellent medical and nursing care in a high quality personalized environment. Most of the people I know in Sonoma County prefer a smaller more personalized experience when the quality is equal to are higher than other alternatives.”

“The North Bay’s patient-centric hospital of choice” might serve as the tagline for the Sonoma West Medical Center. Ray Hino observes that the SWMC is putting its money where its mouth is. “The premier in-hospital bed experience is going to include a private room with an exterior view,” Hino explains. “Most of our rooms have a view of a beautiful courtyard setting. In that private room there will be room for a guest chair. The guest chair can be folded out into a bed that guests will be able to sleep in, to allow them to be a comfort and a part of the healing process."

In addition, Hino notes, guests will have a personalized mini iPad at their bedside, to be used not only for charting by the medical team, but also for Skyping with family members. Or even watching movies from Netflix.

The dozens of hard working doctors, medical professionals and planners behind the SWMC have spent the past year thinking hard about what to keep from the Palm Drive tradition, and what needed improvement. The famous “pink ladies,” who have sadly been sidelined for a year, will certainly be back. They are retired local women who volunteer to connect with patients, on a personal and human level, during their time at the hospital. They will be augmented by new “patient navigator” personnel. These are trained professionals who will personally assist every patient through the complicated labyrinth of insurance billing and follow up care. Imagine such a helper presenting his or her card to you or a family member soon after arriving, with an email and phone number, saying, “Call me directly at this number so I can help you when you receive the bill.”

https://www.waccobb.net/forums/waccobb/keep90days/2015-05-25_13-26-37-2.pngThen there’s the food. The SWMC has hired Rob Hogencamp, the former lead chef of the CERES project, to run a cafeteria and restaurant that will offer patients and their guests organic, nutritious food from a menu carefully focused on health.

Says Hino, “We intend to have the finest menu available with choices that are not normally found in a hospital setting and the opportunity for guests to be able to have a glass of wine if they choose. That’s what patient-centric means to us. It will be a complete experience unlike any that you will find in any other hospital in our region, if not the entire state.”

The Sonoma West Medical center plans to open at the end of May. For most area residents who for the past year have had to go to Santa Rosa’s large city hospital emergency rooms, it will be a huge relief. “I’ve lived here for over 40 years, and for me, this is great,” said 88 year Rosie Bratton, a widow (and the neighbor of this reporter). Like thousands of seniors in the West County area, Bratton’s inconvenience and worry over accessing health care has increased significantly since Palm Drive closed. Recently, what had once been a simple request to a neighbor to drive five minutes and drop her off with the helpful “pink ladies” at Palm Drive Hopsital has become a major ordeal. Bratton recently needed to be driven more than 20 minutes to Kaiser, wait hours to be seen, then brought home to Sebastopol. It took her a half hour to find someone to help her: an 80-something retired friend who was able to commit the four hours that the trip and wait took for her.

Rosy Bratton is relieved, and delighted that the Sonoma West Medical Center is reopening West County’s small hospital. She says, “I’m excited because there will be an emergency room again!”

[Rustie]

What a glowing review of our new hospital. You paint a picture of paradise. Are these the tricks of the trade that will keep our ER open and service our extensive community? I have my doubts. For instance, I can't help but wonder about all of the “patient-centric” benefits cited; private rooms with beautiful views, chairs converting to beds for overnight guests, organic menu meal choices, mini iPad's for Skyping and Netflix, just to name a few. Absolutely a fantastic improvement over efficiency-based large facilities serving the masses. But will these delightful homey & healthy upgrades be insurance approved line items or do they fall under the category of private pay? I suspect that precious few will have insurance coverage that will negotiate a higher rate of reimbursement to SWMC to account for the additional costs associated with these perks. That having been noted will these patient-centric benefits actually be optional extras available for a price? Where does that leave the average working class stiff who has trouble enough paying their insurance premiums? I don't know about you but if I'm in need of hospitalization I'm not looking to pony up extra cash so that my hospital experience will resemble a vacation at a 5 star hotel.

Invoking the image of National Health Care you suggest that due to the continued refusal of a government funded “Medicare for All” system the only choices left to us regarding our health services are when we are in need of emergency care. This becomes an obvious segue demonstrating the value of SWMC's small but superior ER facility. While SWMC may in fact be the preferred ER destination the sad truth is that the limitations of our current health industry and the choices we have, or lack thereof, also apply to emergency treatment.

Your hospital of choice must accept your insurance plan and more importantly your insurance plan must accept the hospital. Insurers such as Kaiser and Sutter are very specific regarding hospital facilities that are covered under their plans. No hospital will turn you away in an emergency but the question remains – if it is not an emergency that is life threatening to transport a given distance, who will pay the ER bill? Broken bones, stitches, even a severed limb are often not life threatening, particuarly when stabilized by the EMTs in route. One's insurance coverage frequently will dictate which ER facility is chosen in an emergency. SWMC may well be the cream of the crop but considering the fact that Kaiser is the number one health insurance provider in CA it seems unlikely that the vast majority of our West County residents will ever experience the bucolic health care heaven offered here. Which begs the question – in the working class world how will this sheik tag line and these non-covered patient-centric services keep the beds filled and the doors open?

Currently the U.S. has an uninsured population of approximately 31 million, we pay double compared to any other industrialized nation for our healthcare and we are ranked number 37 in quality. Bottom line, I would have expected something with a little less of an aristocratic smell from this innovative conscientious community we are all so proud of belonging to and participating in. Rather than touting the added value puff products being offered why not note the high quality professional specialty medical services that will be available to everyone, regardless of economic means? Lacking any mention on this topic in your review of the facility and its services I went to SWMC's website. Unfortunately I could not find any information indicating whether or not this amazing team of assembled specialists will be accepting sliding scale and/or Medi-cal for all available services. Perhaps this is not a feature of SWMC. If so how sad for a community that gives so much lip-service to the concept of equality.

So far it looks to me like Dan and his cronies have done a great job in creating a high-end elitist medical facility catering to the wealthy. If you have the cash to pay for the frills you certainly can get them at SWMC. Time will tell if this model is viable for the long haul or merely a wet dream ending in service of a small select few. Perhaps Sebastopol is in fact the perfect place for just such an experiment.



What’s New and Exciting About
https://www.youtube.com/watch?v=tgTT4_-xDq4
Sonoma West Hospital

By Jonathan Greenberg
For WaccoBB.net
May 25, 2015

...

[jbox]

What a glowing review of our new hospital. ...

At least my tax dollars will benefit somebody, at least for a while.....Too bad I can't go there since I pay Kaiser $1587/mo.

[geomancer]

For god's sake lose the purple font if you want to be read.

Hurts my eyes it does.

Richard

What a glowing review of our new hospital. ...

[farmerdan]

What a glowing review of our new hospital. You paint a picture of paradise. Are these the tricks of the trade that will keep our ER open and service our extensive community? I have my doubts....Rustie,

We agree with everything you are saying about single payer and our #@%74# health system. It truly is a mess. Most doctors and hospitals spend tons of time and money trying to get paid instead of giving care.

For the record, we are strong supporters of single payer Medicare for all. While there are definite shortcomings with Medicare, it functions at a much lower management cost than insurance companies (about 3%.) We also think that Medicare should be means tested so that the wealthy, who can, have to pay for it. We also support taxing capital gains as Medicare earnings just like wages and eliminating the cap on Medicare wages so that high earners pay more.

"So far it looks to me like Dan and his cronies have done a great job in creating a high-end elitist medical facility catering to the wealthy. "

Actually, all patients at Sonoma Medical Center will receive the same level of care regardless of insurance or ability to pay. From our perspective, private rooms, family sleep overs, beautiful gardens and nutritious food are not luxuries but basic necessities. What's more, SWMC will not bill patients who have no insurance any more than an insurance company would pay. SWMC is being opened to serve our community not the elite. We expect to accept all regional insurance but Kaiser and Sutter who have closed systems. This is not our choice, but theirs. (We will treat everyone and anyone in the Emergency Room and both Kaiser and Sutter will pay for emergencies.)

"If you have the cash to pay for the frills you certainly can get them at SWMC."

You apparently equate better hospital services with serving the wealthy but in reality, providing better services can be more cost effective when serving the entire community, here's how:

a) It's easier to care for patients in private rooms. Patients can rest better when they have privacy and nurses can give them more individual attention, improving their transition to home.

b) Having a family member (or two) stay with patients improves outcomes and helps monitor patients when nurses are not in the room. Patients are much more relaxed when they have loved ones close by and family members can get educated about how to care for loved ones when they return home.

c) Providing great food costs a little more than the usual hospital crap but a lot of food goes to waste in hospitals because people aren't ready to eat at meal time or don't like what they get. So having patients order what they like is much more sensible.

d) Good nutrition is directly related to wellness and patients who have had a major surgery or illness need to eat healthy food to recover. Serving them mac and cheese with green Jello really doesn’t cut it.

e) Providing entertainment can also reduce stress and anxiety, conditions that trouble many patients when hospitalized. Next time you are ill, I highly recommend watching The Life of Brian, The Hitch Hikers Guide to the Galaxy or Charlie Chaplin flicks. It is hard to feel miserable when you are laughing.

f) Providing easy access to loved ones far away can also be helpful for patients with serious health challenges who otherwise feel cut off from family and friends.

One thing to be aware of is that hospitals are paid mostly based on the diagnosis, not how much care they provide. That means SWMC gets paid the same no matter who the patient is or how long they stay in the hospital. Hospitals are also penalized if patients are readmitted within 30 days (they don’t get paid for the readmission.) This means that helping people get well quickly and making sure they are ready to go home are important financial drivers for hospitals, not just something for the wealthy.

What you also might not realize is that compensation from Medicare in the future will be partially based on patient satisfaction and clinical outcomes. That means that hospitals that provide better care and have happier patients will get paid better by Medicare and insurers. So it makes financial sense to deliver the best care possible in a patient centric environment to get paid better.

All that being said, we do need to attract patients for elective surgery in order to support services like 24/7 ER. The best way to do this is to have great docs and excellent care both clinically and personally. So it makes sense to be the hospital of choice for the specialties that we can excel at.

Here’s a few other points I’d like to make:


If you have no insurance and go to a hospital, you get a bill that is grossly inflated, not what an insurance company or Medicare would pay for the same service. Sometimes you are told that the hospital will discount the bill if you pay early, but usually they do not discount down to the level an insurer would pay. SWMCs policy will be to bill cash payers the same rate an insurer would pay. We call this truth in billing.
If you can’t pay your bill, most hospitals will sell your account to a collection agency, who will hassle you and ruin your credit. SWMC will not do this. We do not believe people should have their credit ruined because of illness or injury. SWMC will work with people to develop a payment plan or discount the bill. We call this humane.


Before you assume that we are elitists who wish to serve the wealthy, I invite you to spend your weekend with us painting walls, scrubbing floors and working in the hospital gardens, which Joan and I did today and have done every weekend in recent times. We will be at the hospital all day Saturday and Sunday and there is plenty of work, so come and join us!

Best Regards,

Dan and Joan

[kpage9]

With thanks to Rustie for putting it so well and so thoroughly. I wondered too, when I read about the new version of the hospital, HOW ON GOD'S (formerly) GREEN EARTH will this be paid for! It does seem like a most conspicuous absence--a web page that does not mention sliding scale or Medi-Cal.

I really hope this is an incorrect impression--the Sonoma Mission Inn of medical care, eagerly await further illumination.

Kathy

What a glowing review of our new hospital. You paint a picture of paradise. Are these the tricks of the trade that will keep our ER open and service our extensive community? I have my doubts. ...

[Rustie]

Hi Dan,

I appreciate your reply. Truthfully I would have preferred some direct responses to my questions and points rather than the abundance of information focused on selling the virtues of SWMC's healthy healing protocol, but thank you to take the time. For the sake of clarity I would like to readdress several points...

First I feel it is important to mention that there is a subtle but important misrepresentation in your statement that both Kaiser & Sutter will pay for emergencies. Without defining the terms of emergencies allowable for reimbursement by Kaiser & Sutter you are implying that anyone with either of those plans may come through SWMC's ER doors for treatment and can rest assured that their insurers will pick up the associated costs. This in fact is not so and I suspect you are well aware of the distinctions. To imply that all ER services will unequivocally be reimbursed by these two insurance providers is negligent. In short, Sutter will cover “legitimate” emergent or urgent care at an outside facility regardless of the distance to a preferred provider. Reimbursement of ER services by a Kaiser plan will be determined by the severity of the emergency. Additionally, with either plan, once stabilized, coverage of hospitalization if needed, may likely require transport to the insurers' preferred facility if the patient expects the resultant hospitalization to be covered by their plan. These are important distinctions that should not be carelessly glossed over.

On to overlooked questions. Will all services available at the medical center, hospital services as well as the “specialty institutes”, be accepting Medi-cal &/or sliding scale? You frequently mentioned Medicare but you neglected to address the direct question regarding Medi-cal and sliding scale. This of course is also relevant to your “truth in billing” policy.

Kudos by the way for the decision to bill uninsured patients at the “insurance rate”. But the question remains, which insurance rate? Medi-cal for instance pays a much lower rate than Blue Cross. Which of these rates would you apply to a cash paying patient? As you can see the unanswered sliding scale question resurfaces.

I agree with you, working with people to develop a payment plan or discount their bill is humane and I applaud you for the decision to include this in your billing policies. I do feel compelled however to point out that most hospitals have similar billing practices. When approached, hospitals would rather develop a payment plan than sell your account to a collection agency as you have suggested. Nonetheless this misleading comparison does not alter your humane, truth in billing intentions. One additional question on the subject, will these billing policies apply to all services and institutes at SWMC?

Your comment that hospitals are paid based on diagnosis rather than quantity of care provided is not exactly the whole picture. While it is true that the diagnosis will dictate the parameters of allowable treatment including the number of in-patient days permitted for recovery, each and every service provided is a line item that is adjusted by the contracted rate of reimbursement. I can say with confidence, costs for private rooms, organic meals and Netflix will not be covered.

That having been said it appears to me, after parsing through your eloquent promotional post, that you expect to take a loss on your “patient-centric” hospital and hope to make up the difference attracting wealthy elites to your “specialty institutes” for elective surgeries. If this is in fact your game plan I do not personally have a problem with this agenda. On the other hand I do have concerns regarding the viability over the long haul of this concept. Have you done a feasibility study and a budget analysis to determine if this model is sustainable beyond 3 to 5 years? As a taxpayer who will be funding this project to the collective tune of millions of dollars I think it fair that you provide us with your projected financial statements, the basis for your projections and all substantial data you have collected to demonstrate the soundness of your hospital plan as a long term model. I do see on the SWMC website the “business plan”. Unfortunately, in my opinion, it is primarily a talking points PR piece with several slick graphs on projections that appear to be pulled out of thin air.

Obviously at this point the hospital is a done deal. That was clear when the only person asking for a sound financial assesment and business plan was voted off the Palm Drive District board and replaced by two insiders from the then named Foundation, aka SWMC. Regardless, if this plan has been adequately vetted and stands the test of time then we will all be winners. Of course if this is a short lived pet project built in service of a small few the test of time might not have been a consideration in moving forward. Under those circumstances I would expect the architects of such an ill conceived venture utilizing public funds to be held accountable.

As an aside I find your attempt to remove yourself from association with “elitists who wish to serve the wealthy” as comical. Drawing attention to the fact that you and your wife have been scrubbing floors and painting walls at SWMC does not change the fact that you are one of Sonoma County's wealthier elites. Furthermore, the business plan for the facility that you are pridefully scrubbing and painting seems to be based primarily on revenues generated in service of the wealthy. What a shame that your hospital agenda is not as equally transparent.


Rustie,

We agree with everything you are saying about single payer and our #@%74# health system..............

[gypsey]

I really wish I could have read through this post, but the tiny font and pale purple color made it impossible. Please post in a normal size font and easy to read color, so that we can learn from your posts and respond.
Thank you.


Hi Dan,

I appreciate your reply. Truthfully I would have preferred some direct responses to my questions and points rather than ...

[farmerdan]

Rustie,

Some answers (as best I can) to your questions:

Will all services available at the medical center, hospital services as well as the “specialty institutes”, be accepting Medi-cal &/or sliding scale? You frequently mentioned Medicare but you neglected to address the direct question regarding Medi-cal and sliding scale. This of course is also relevant to your “truth in billing” policy.

The hospital will accept Medi-Cal for all services. At present, there is not a 'sliding scale' policy in place but as stated earlier a policy to discount to insurance rates. More on that below.

Kudos by the way for the decision to bill uninsured patients at the “insurance rate”. But the question remains, which insurance rate? Medi-cal for instance pays a much lower rate than Blue Cross. Which of these rates would you apply to a cash paying patient? As you can see the unanswered sliding scale question resurfaces.

The policy will be to discount to average insurance rates including Medi-Cal and Medicare. This will be close to Medicare.

One additional question on the subject, will these billing policies apply to all services and institutes at SWMC?

The policy will apply to all hospital services.The institute physicians will be setting their own policies for their services. (SWMC is providing offices and other services for a fee from physicians but they will be managing their own practices.)

I can say with confidence, costs for private rooms, organic meals and Netflix will not be covered.

You may be confident but you are wrong for all of the reasons I explained previously. These and other services will be part of basic service for all patients. We will have two rooms that are doubles but these will be for short term observation, not overnight under normal circumstances.

That having been said it appears to me, after parsing through your eloquent promotional post, that you expect to take a loss on your “patient-centric” hospital and hope to make up the difference attracting wealthy elites to your “specialty institutes” for elective surgeries.

I don't think I have used the term 'wealthy elites' in any context or even implied it in any way. What I said was that we will be providing elective surgery for people from a broader region than west county. Those patients will come with the same insurance (or lack thereof) as everybody else so there is not a bias toward wealthy patients, this is only your assumption.

As an aside I find your attempt to remove yourself from association with “elitists who wish to serve the wealthy” as comical.
Drawing attention to the fact that you and your wife have been scrubbing floors and painting walls at SWMC does not change the fact that you are one of Sonoma County's wealthier elites.

Glad to see you have a sense of humor. Your attempt to characterize us as 'elitists who wish to serve the wealthy' is one of the funniest things I have heard in a long time.

e·lit·ist noun
a person who believes that a system or society should be ruled or dominated by an elite.
synonyms: aristocrat, blue blood; snob

I have been called a lot of things, but this is the first time for being called an elitist. I suppose if I am I should buy a yacht instead of reopening our hospital, it would be much cheaper anyway. Or perhaps a villa on the Riviera, it must be very nice there this time of year.

Seems out of character to be scrubbing floors and painting walls now that you mention it. And funny wearing old worn out jeans and driving a 13 year old car and living in our funky little house we built in 1970 with savings from my $400 monthly paycheck. And, my God, we must be missing all those elite gatherings of the wealthy at the golf course or wherever they meet.

In the meantime, I would advise giving up on the mind reading, especially from a distance. I have never met anyone who was good at it and it does tend to distort your reality some. When you want to know someone's motivations, the best test I have found is to ask them and listen to the answer. It's not perfect but comes as close as you can get.

Best Regards

Dan

[Gail Raborn]

I really wish I could have read through this post, but the tiny font and pale purple color made it impossible. Please post in a normal size font and easy to read color, so that we can learn from your posts and respond.
Thank you.



Hi Rusty: you make a lot of good points - but - I also want to suggest LARGER FONT if not a darker ink. It is hard to read, truly; perhaps put out the same letter in a more legible way? Still - you're bringing up a lot of important concerns about money/insurance/etc. that I'm curious about, too.

But I am also curious why you insist that Dan Smith and Joan Marler are part of the local "elites"? what does that mean exactly? there are a lot of folks around here with money - is everyone who's well-to-do automatically part of some special "elite" group that's different than you and me? or you think, they think they are superior to us lesser mortals? Sounds like you don't know these two folks: if you ever got to know them and visited their home, you'd realize they live a rather simple life-style - no grandeur, nothing fancy, nothing outrageous...and their lives are very busy with their passions of a lovely restaurant, Dan's work with telemedicine, Joan's Phd studies with archeomythology, their gardens - and of course, helping create our new hospital! As people, other than both being two of the most kind, brilliant and selfless folks I've ever met, they're amazingly down to earth and not at all pretentious. So please drop the "elitist" bit. You don't know what you're talking about.

[Rustie]

Dan

Thank you for your response. It sounds like the specialty institutes will establish their own insurance acceptance parameters just as they will be setting their own billing policies - correct? Am I also accurately interpreting that the hospital discount rates for uninsured cash paying patients will be determined by averaging the different insurance reimbursement rates and billing that average to those uninsured cash payers? Will the cash discount be applied to uninsured patients who are also in need of a payment plan? And finally on this topic, why not just bill uninsured patients the Medi-Cal rate, which of course would be the least expensive?

I understood you the first time regarding basic service for all patients. It is clear that you intend to accept as payment in full, for all patient-centric hospital services, the allowable insurance reimbursement rate. My point is only that the additional costs to provide these services will not be accounted for in the insurers reimbursement to you. This brings us to the salient point, you expect to take a loss on these services, at least when provided in connection with insurance covered procedures, and make up the difference via the specialty institutes.

It appears that these specialty institutes will be independent renters whose patients provide no direct economic benefit to the hospital, except to the extent that they utilize hospital services. Under that arrangement it would seem that your intent to cover your expected hospital losses via these specialty services would be from full charge, full pay, non-insurance claimable services. You know the ones, those provided to all the non-elite folks without much money who will come from a broader region for elective surgeries that are usually very expensive and typically not covered by health insurance. Am I on track? You did say in your first post that “we do need to attract patients for elective surgery in order to support services like 24/7 ER.” So I ask you, would the above be an accurate interpretation of the workings of that plan or am I not framing it allusively enough for you?

Dan, you are obviously a very educated and intelligent person This elite issue has become absurd. To begin with, I never categorized you as an “elitist who wishes to serve the wealthy”. That was your quote in your first post. My first use of the word elitist was not ascribed to you, “looks to me like Dan and his cronies have done a great job in creating a high-end elitist medical facility catering to the wealthy.” In this context I have clearly used the word elitist in reference to the facility not you or your cronies. You misrepresented my use of the word elitist in ascribing it to yourself, a subtle but important distinction. In my second post, I was quoting you, as should have been understood by the use of quotation marks. It was evident that you had taken the leap from my comment about the facility and associated yourself with the term. Further it was evident that you were attempting to remove yourself from that self-ascribed association by letting us know that you scrub & paint. My comment that scrubbing & painting does not alter the fact that “you are one of Sonoma County's wealthier elites”, is the only reference I have made associating you as a person in a group or class of persons who enjoy superior intellectual, social or economic status, which is the definition of elite.

Personally I have no knowledge of your social status and I can only guess by your use of language and writing skills as to your intellectual status. Your economic status however is apparent. Considering the multimillion dollar investments you have made into the hospital, both past and present incarnations, the fact that you are the primary investor in E-Health Records International, your cloud-based medical records company marketing your HarmoniMD software, your 30 acre West County farm, your elegant high-end restaurant and your bio statement which references you as an angel investor, a group of people that comprise as little as 1% of the US population and maintain a net worth in excess of one million dollars, I think it fair to ascribe to you the term elite. I'm sorry if reality offends you.

I do not profess to be a mind reader nor do I attempt to practice the art form as you have suggested, I simply take note of the facts and connect the dots. For instance, your comment regarding distortion of reality, perhaps it's self reflective. Distortion is seemingly something you are familiar with as evidenced, in this thread, by your numerous misleading and misrepresented presentations of several key pieces of information. As a final observation I would recommend that when you are making suggestions about asking questions and listening as a method of ascertaining one's motivations, you consider answering questions when asked. I am still waiting to hear a response from you regarding the study and analysis used to determine the long term viability of your hospital plan. Is there a reason you have not addressed this point? I have brought it up on two separate occasions. Perhaps your idea of simply asking to obtain information is not as effective as you would like us to believe. But since you're appearing to be requesting direct questions, here's another one: What benefits can EHRI, OffSiteCare and yourself personally, expect to see by the first U.S. implementation of your HarmoniMD software in SWMC?



Rustie,

Some answers (as best I can) to your questions:

Will all services available at the medical center, hospital services as well as the “specialty institutes”, be accepting Medi-cal &/or sliding scale? You frequently mentioned Medicare but you neglected to address the direct question regarding Medi-cal and sliding scale. This of course is also relevant to your “truth in billing” policy.

The hospital will accept Medi-Cal for all services. At present, there is not a 'sliding scale' policy in place but as stated earlier a policy to discount to insurance rates. More on that below.

Kudos by the way for the decision to bill uninsured patients at the “insurance rate”. But the question remains, which insurance rate? Medi-cal for instance pays a much lower rate than Blue Cross. Which of these rates would you apply to a cash paying patient? As you can see the unanswered sliding scale question resurfaces.

The policy will be to discount to average insurance rates including Medi-Cal and Medicare. This will be close to Medicare.

One additional question on the subject, will these billing policies apply to all services and institutes at SWMC?

The policy will apply to all hospital services.The institute physicians will be setting their own policies for their services. (SWMC is providing offices and other services for a fee from physicians but they will be managing their own practices.)

I can say with confidence, costs for private rooms, organic meals and Netflix will not be covered.

You may be confident but you are wrong for all of the reasons I explained previously. These and other services will be part of basic service for all patients. We will have two rooms that are doubles but these will be for short term observation, not overnight under normal circumstances.

That having been said it appears to me, after parsing through your eloquent promotional post, that you expect to take a loss on your “patient-centric” hospital and hope to make up the difference attracting wealthy elites to your “specialty institutes” for elective surgeries.

I don't think I have used the term 'wealthy elites' in any context or even implied it in any way. What I said was that we will be providing elective surgery for people from a broader region than west county. Those patients will come with the same insurance (or lack thereof) as everybody else so there is not a bias toward wealthy patients, this is only your assumption.

As an aside I find your attempt to remove yourself from association with “elitists who wish to serve the wealthy” as comical.
Drawing attention to the fact that you and your wife have been scrubbing floors and painting walls at SWMC does not change the fact that you are one of Sonoma County's wealthier elites.

Glad to see you have a sense of humor. Your attempt to characterize us as 'elitists who wish to serve the wealthy' is one of the funniest things I have heard in a long time.

e·lit·ist noun
a person who believes that a system or society should be ruled or dominated by an elite.
synonyms: aristocrat, blue blood; snob

I have been called a lot of things, but this is the first time for being called an elitist. I suppose if I am I should buy a yacht instead of reopening our hospital, it would be much cheaper anyway. Or perhaps a villa on the Riviera, it must be very nice there this time of year.

Seems out of character to be scrubbing floors and painting walls now that you mention it. And funny wearing old worn out jeans and driving a 13 year old car and living in our funky little house we built in 1970 with savings from my $400 monthly paycheck. And, my God, we must be missing all those elite gatherings of the wealthy at the golf course or wherever they meet.

In the meantime, I would advise giving up on the mind reading, especially from a distance. I have never met anyone who was good at it and it does tend to distort your reality some. When you want to know someone's motivations, the best test I have found is to ask them and listen to the answer. It's not perfect but comes as close as you can get.

Best Regards

Dan

[farmerdan]

Rustie,

Rusty, I think you made clear that you wished Jim Horn got elected and the hospital stayed closed. You are certainly welcome to this opinion but at this point, it is not terribly relevant. Attacking me is a convenient method of trying to establish your position but we are not opening the Dan Smith Memorial Hospital, we are opening Sonoma West Medical Center, our community hospital with the help of hundreds of people from all walks of life, rich and poor, young and old. I am only a small part of the puzzle and becoming less important every day. What happens next is up to the doctors, nurses, the hospital board and the administration, not me.

Because it might be useful to others here are answers to some of your questions:


Thank you for your response. It sounds like the specialty institutes will establish their own insurance acceptance parameters just as they will be setting their own billing policies - correct? Am I also accurately interpreting that the hospital discount rates for uninsured cash paying patients will be determined by averaging the different insurance reimbursement rates and billing that average to those uninsured cash payers? Will the cash discount be applied to uninsured patients who are also in need of a payment plan? And finally on this topic, why not just bill uninsured patients the Medi-Cal rate, which of course would be the least expensive?
It is important to understand that Medi-Cal reimbursements in general do not cover the cost of care. The other thing to understand is that not all uninsured are poor and unable to pay for the cost of their care. Medicare rates come close to covering the cost of care and are therefore a more appropriate billing rate for the uninsured.


I understood you the first time regarding basic service for all patients. It is clear that you intend to accept as payment in full, for all patient-centric hospital services, the allowable insurance reimbursement rate. My point is only that the additional costs to provide these services will not be accounted for in the insurers reimbursement to you. This brings us to the salient point, you expect to take a loss on these services, at least when provided in connection with insurance covered procedures, and make up the difference via the specialty institutes.
We don't believe that the 'additional services' will add significant cost and their value will be in better care and a more pleasant patient experience, which will in turn create additional revenue.


It appears that these specialty institutes will be independent renters whose patients provide no direct economic benefit to the hospital, except to the extent that they utilize hospital services. Under that arrangement it would seem that your intent to cover your expected hospital losses via these specialty services would be from full charge, full pay, non-insurance claimable services. You know the ones, those provided to all the non-elite folks without much money who will come from a broader region for elective surgeries that are usually very expensive and typically not covered by health insurance. Am I on track? You did say in your first post that “we do need to attract patients for elective surgery in order to support services like 24/7 ER.” So I ask you, would the above be an accurate interpretation of the workings of that plan or am I not framing it allusively enough for you?
I can't answer this because I don't understand what "full charge, full pay, non-insurance claimable services" are.


Dan, you are obviously a very educated and intelligent person This elite issue has become absurd. To begin with, I never categorized you as an “elitist who wishes to serve the wealthy”. That was your quote in your first post. My first use of the word elitist was not ascribed to you, “looks to me like Dan and his cronies have done a great job in creating a high-end elitist medical facility catering to the wealthy.” In this context I have clearly used the word elitist in reference to the facility not you or your cronies. You misrepresented my use of the word elitist in ascribing it to yourself, a subtle but important distinction. In my second post, I was quoting you, as should have been understood by the use of quotation marks. It was evident that you had taken the leap from my comment about the facility and associated yourself with the term. Further it was evident that you were attempting to remove yourself from that self-ascribed association by letting us know that you scrub & paint. My comment that scrubbing & painting does not alter the fact that “you are one of Sonoma County's wealthier elites”, is the only reference I have made associating you as a person in a group or class of persons who enjoy superior intellectual, social or economic status, which is the definition of elite.

Personally I have no knowledge of your social status and I can only guess by your use of language and writing skills as to your intellectual status. Your economic status however is apparent. Considering the multimillion dollar investments you have made into the hospital, both past and present incarnations, the fact that you are the primary investor in E-Health Records International, your cloud-based medical records company marketing your HarmoniMD software, your 30 acre West County farm, your elegant high-end restaurant and your bio statement which references you as an angel investor, a group of people that comprise as little as 1% of the US population and maintain a net worth in excess of one million dollars, I think it fair to ascribe to you the term elite. I'm sorry if reality offends you.

I do not profess to be a mind reader nor do I attempt to practice the art form as you have suggested, I simply take note of the facts and connect the dots. For instance, your comment regarding distortion of reality, perhaps it's self reflective. Distortion is seemingly something you are familiar with as evidenced, in this thread, by your numerous misleading and misrepresented presentations of several key pieces of information. As a final observation I would recommend that when you are making suggestions about asking questions and listening as a method of ascertaining one's motivations, you consider answering questions when asked. I am still waiting to hear a response from you regarding the study and analysis used to determine the long term viability of your hospital plan. Is there a reason you have not addressed this point? I have brought it up on two separate occasions. Perhaps your idea of simply asking to obtain information is not as effective as you would like us to believe.

And your point is what?
Dan Smith is an imperfect being with money?
Not sure what this has to do with our hospital but I admit it!
I don't always jump when Rusty says jump? Also agree to that!
(I think the business plan speaks for itself so I saw no reason to respond to this.)
You want someone who is has no money leading the effort to reopen the hospital?
(Actually, there are LOTS of people involved in this effort, many who are volunteering their time, a resource more precious than money.)


But since you're appearing to be requesting direct questions, here's another one: What benefits can EHRI, OffSiteCare and yourself personally, expect to see by the first U.S. implementation of your HarmoniMD software in SWMC?

OffSiteCare, Dr. Gude's telemedicine company will be paid for providing medical services to SWMC. I don't know the details of this since I was not involved in the process, only Dr. Gude and the OffSiteCare CEO were . I receive no compensation from OffSiteCare, which has barely covered its cost of providing telemedicine services to rural hospitals in recent years.

I have no way of knowing whether EHRI will ever benefit from the implementation of HarmoniMD at SWMC or even how one would measure the benefit if one occurred. EHRI has been building the HarmoniMD system for years and is already working in a number of countries around the world so the business is not dependent on SWMC. As the CEO for EHRI, I receive a salary of $2 a year (up from $1 a year). I suppose the board might give me a raise to $3 a year if the SWMC implementation goes well but then I might get fired if it doesn't.

But for the sake of argument, let's assume that EHRI does benefit from implementing its software for free at SWMC in much the same way that companies all over the US benefit by supporting public radio and other charities. Would this be a problem or would it create more opportunity for capital for our hospital?

What I do know is that EHRI is providing a free service that normally costs well over $1M in startup and at least $100,000 a year in maintenance and other services and that SWMC simply does not have the money to pay for these services, at least at present. You can look at the Palm Drive financials to see that the McKesson implementation (which was basically a disaster) cost well over $2M and basically drove the hospital into the ground.

Another thing I know is that there is an incalculable benefit to the community to have a hospital both in dollars and lives and that many people and businesses are already benefitting from our efforts. We have already spent $2.5 million on preparing to open the hospital, much of it with local businesses and hiring local people. All of them have benefitted as have the many lunch places near the hospital, the local motels, and the city itself.

Best Regards,

Dan

[Peacetown Jonathan]

I appreciate Dan taking the time to provide a point by point response, and for his and Joan's generosity in sacrificing so much time and money to restore an emergency room for ALL of us in West County.

Rustie appears to have taken on the baton for the marathon vendetta to malign Dan Smith and his partner in philanthropy Joan Marler. I have written about this vendetta here on Wacco before (https://www.waccobb.net/forums/showthread.php?109236-Sonoma-West%92s-Relentless-Vendetta-to-Stop-Dan-Smith-from-Re-Opening-Palm-Drive-Hospital).

Rustie does a great qualifying round for the Jim Horn deception team with this dandy: My first use of the word elitist was not ascribed to you, “looks to me like Dan and his cronies have done a great job in creating a high-end elitist medical facility catering to the wealthy.” In this context I have clearly used the word elitist in reference to the facility not you or your cronies. You misrepresented my use of the word elitist in ascribing it to yourself, a subtle but important distinction.

A subtle but important distinction? Really?

There is nothing elitist about reopening an emergency room to serve the people of Sonoma County. What was elitist was the legally questionable closed door decision, without public debate as clearly required by the Brown Act, made by Nancy Dobbs and the past Palm Drive Board majority (Chris Dawson, Sandra Bodley and Marsha Sue Lustig), to close the emergency room. This decision was made without consulting a single doctor, community member, or business leader. Without a public meeting advising those of us whose tax dollars have paid for this hospital for years, and whose health and indeed very lives were jeopardized by this decision. As advised by a secretly selected cadre of out of town $4,000 dollar a day health industry consultants so elitist that they also never spoke to a hopspital employee, doctor, local hospital expert or member of the community. Along with a $500 an hour attorney whose law firm, though not disclosed to the public at the time, also conveniently represented bond trustee Wells Fargo Bank--as I reported here last year (https://www.waccobb.net/forums/showthread.php?105367-Article-Behind-Palm-Drive-Hospital%92s-Closing-Part-II-The-Shutdown-Playbook).

Rustie, it seems, has also chosen to pick up the tired "prove the plan works" bullshit, perhaps because the other "keep it closed" boosters in our community who have repeated it in the past have been so thoroughly discredited. As I have noted in the past, it is impossible to "prove" any plan, because by nature, all plans are hypothetical, about something that is planned for the future. Rustie writes that the plan, with its extensive and persuasive projections that took hospital finance experts months to complete,
"is primarily a talking points PR piece with several slick graphs on projections that appear to be pulled out of thin air."

On one hand, Rustie complains that the non-ER facilities might make money for the hospital, to help subsidize the emergency room, and then professes to worry how our tax dollars will be used (a worry she apparently did not have when those same tax dollars would have been used to NOT provide us with the emergency room and hospital they were created to fund).

Rustie trots out the absurd, hateful Dan Smith "conflict of interest" diatribe that I first heard Nancy Dobbs, then chair of the Palm Drive District Board, voice at the April, 2014 meeting in which she led a vote to close the hospital and reject a plan to keep it open. To continue to suggest that the person who, with his wife, is responsible for sacrificing thousands of hours of time and millions of dollars of cash to reopen OUR PUBLIC hospital, is doing it for personal financial gain is an insult to the intelligence of our community.

Former Palm Drive District Board Chair Dobbs and three other members of that Board endorsed Jim Horn's candidacy not because he would help reopen the hospital. But because they knew that he was committed to their misguided and irresponsible choice to close it, and to keep it closed.

Jim Horn stated at a public District Health Board meeting earlier in the year that he did not think the hospital should reopen until the bankruptcy had been fully paid off. Given that the hospital's license suspension expired after one year, this would have meant never. Even though under Chapter 9 federal bankruptcy law for municipalities, judges have no authority to force hospitals to close to pay creditors. Or to garnish tax revenues required to provide municipal services, like hospitals.

Unfortunately, neither Jim Horn, nor his political supporters (who, sadly, included all five of Sebastopol's current City Council members), had the integrity to share this "no reopening until the creditors are paid off" opinion with voters before the election. Rustie endorses Horn's excuses when she notes that "the only person asking for a sound financial assesment and business plan was voted off the Palm Drive District board," seeking to perpetuate the deception that Jim Horn was voted off the Board because he wanted to do the responsible thing--which, to Horn and Rustie, was to drain our tax dollars while refusing to reopen the emergency room.

Thankfully, We, the People of West Sonoma County, saw through this deception. And voted for the Doc and the Cop last November, to reopen our hospital.

[Gail Raborn]

Jonathan - thanks so much for your careful and thorough reply to Rustie's vendetta to discredit Dan, Joan and the new hospital that's a-birthing at this very moment in Sebastopol. You put together many vital points that show her as the horsefly that she is, wanting to cause pain, with no real desire to create true clarity for anyone concerned about payment options at SWMC.

Rustie just seems to want to sow more seeds of confusion, wrong info, and argument. I wonder about her motives: and how much her "elite envy" plays into this? for I know that when "The lady doth protest too much", it can be a cover for what that person desires for themself, but lack...hmmmm.....I wonder what is HER financial situation? and HER insurance coverage?

Or is she a landowner in the Russian River Corridor unhappy about her parcel taxes?

Whatever: I wish Rustie would drop the elite garbage and realize we're all just people trying to do the best we can to make the world a better place, regardless of income levels. We're incredibly fortunate in this area to have a few folks with the money to invest in saving lives through their donations of money, time, and energy to create a new hospital with a state-of-the-art emergency room! After all, someday the life that new hospital saves may be Rustie's own, her kids, family or friends....


Rustie appears to have taken on the baton for the marathon vendetta to malign Dan Smith and his partner in philanthropy Joan Marler. I have written about this vendetta here on Wacco before (https://www.waccobb.net/forums/showthread.php?109236-Sonoma-West%92s-Relentless-Vendetta-to-Stop-Dan-Smith-from-Re-Opening-Palm-Drive-Hospital). ...[/SIZE]

[Goat Rock Ukulele]

My brother Dan and his wife Joan elitist and building a hospital for their elite friends?

I've know Dan since the day I was born 62 years ago and Joan close to 40. Elitist they are not. Our parents where hard working working class people who lived in a tent for two years while building their own home because they couldn't afford a home any other way. You had to go into the closet to turn on my bedroom light when I was a kid, our mother did the wiring, at least the house didn't burn down. During the leanest times our mother scavenged discarded food behind the local market.

Our parents were involved in civil rights, keeping PGE from building a reactor at Bodega Head and many other community betterment issues. I see Dan and Joan as continuing that tradition of public involvement . They are certainly not elitist. I don't think either one of them could stand to be in the same room with the wealthy elite for more than five minutes unless they are trying to get them to pony up for the hospital. My brother Dan and Joan would likely consider it the height of vulgarity to lavish their wealth on themselves when it could be spent enriching the community, In this case a life saving hospital.

[rossmen]

you are shooting the messenger. lots of good well intentioned people disagree about a complicated effort. a sebastopol hospital supported by the current healthcare district is geographically elitist. nobody knows if the effort will succeed and history does not bode well. truth hurts when high on hope.


Jonathan - thanks so much for your careful and thorough reply to Rustie's vendetta to discredit Dan, Joan and the new hospital that's a-birthing at this very moment in Sebastopol. You put together many vital points that show her as the horsefly that she is, wanting to cause pain, with no real desire to create true clarity for anyone concerned about payment options at SWMC.

Rustie just seems to want to sow more seeds of confusion, wrong info, and argument. I wonder about her motives: and how much her "elite envy" plays into this? for I know that when "The lady doth protest too much", it can be a cover for what that person desires for themself, but lack...hmmmm.....I wonder what is HER financial situation? and HER insurance coverage?

Or is she a landowner in the Russian River Corridor unhappy about her parcel taxes?

Whatever: I wish Rustie would drop the elite garbage and realize we're all just people trying to do the best we can to make the world a better place, regardless of income levels. We're incredibly fortunate in this area to have a few folks with the money to invest in saving lives through their donations of money, time, and energy to create a new hospital with a state-of-the-art emergency room! After all, someday the life that new hospital saves may be Rustie's own, her kids, family or friends....

[Gail Raborn]

you are shooting the messenger. lots of good well intentioned people disagree about a complicated effort. a sebastopol hospital supported by the current healthcare district is geographically elitist. nobody knows if the effort will succeed and history does not bode well. truth hurts when high on hope.

When the messenger is insulting, makes personal attacks intended to cause pain, and gives distorted or simply wrong information, perhaps it's time for them to be shot. Or at the least, stood up to.

I fully support fair, polite discussion and argument about the hospital; I'm well aware of the dismal past history of the old Palm Drive Hospital. But this is a new endeavor with a very new approach, new leaders (there are many highly skilled people involved in the creation and management of SWMC than Dan Smith, though folks seem to forget this), new business plan - don't judge SWMC by the history of Palm Drive.

Sure, no one can guarantee success - but trying to destroy it without giving it a chance seems to me not only very negative, but silly. Why kill it before it's had a chance to prove itself? What can be possibly lost by supporting it? I'm a very pragmatic person: it's not blind hope that makes me an enthusiastic supporter of SWMC. It's my awareness of the outrageous talent and skills of the new medical staff (and amazingly talented old staff that have been rehired), plus the clear minded business leaders/organizers that will run the business part of the new hospital. Believe me, the folks putting all this together are VERY aware of the dangers of failure, and would be very blind not to have learned from the mistakes that caused Palm Drive to fall into bankruptcy twice. I trust the people I've talked to over the past year who are determined not to fail.

What I see, in truth, is a Phoenix rising from the ashes! And my gut intuition says it will fly, both well, and high. If you don't see the same, I'm very sad for you. Just don't try to kill it before it's even born.

[farmerdan]

When the messenger is insulting, makes personal attacks intended to cause pain, and gives distorted or simply wrong information, perhaps it's time for them to be shot. Or at the least, stood up to.

Gail,

Please no shooting!
I am a pacifist.

Dan

[Icssoma]

i think your post would be more readable if you just enforced the positive about someone's post, & the facts, or your opinions re specifics.
if you love the hospital & think its great talk about the specifics.
if you don't like how others are criticizing it, how about abstaining from the tactics you find offensive.
wouldn't it be better to be above the fray, & make the conversation a healthier one?
i have opted out from the hospital discussion as it seems full of campaigning, & attacks if one doesn't agree. would love to see constructive discussion.
have heard from a number of business people who are afraid to speak out against it.
does anyone really want to be a part of a diatribe, on either side? let's be "really west county", talk about the issues, agreements & disagreements.:heart:
i believe we can do so much better.:waccosun:



Jonathan - thanks so much for your careful and thorough reply to Rustie's vendetta to discredit Dan, Joan and the new hospital that's a-birthing at this very moment in Sebastopol. You put together many vital points that show her as the horsefly that she is, wanting to cause pain, with no real desire to create true clarity for anyone concerned about payment options at SWMC.

Rustie just seems to want to sow more seeds of confusion, wrong info, and argument. I wonder about her motives: and how much her "elite envy" plays into this? for I know that when "The lady doth protest too much", it can be a cover for what that person desires for themself, but lack...hmmmm.....I wonder what is HER financial situation? and HER insurance coverage?

Or is she a landowner in the Russian River Corridor unhappy about her parcel taxes?

Whatever: I wish Rustie would drop the elite garbage and realize we're all just people trying to do the best we can to make the world a better place, regardless of income levels. We're incredibly fortunate in this area to have a few folks with the money to invest in saving lives through their donations of money, time, and energy to create a new hospital with a state-of-the-art emergency room! After all, someday the life that new hospital saves may be Rustie's own, her kids, family or friends....

[Gail Raborn]

i think your post would be more readable if you just enforced the positive about someone's post, & the facts, or your opinions re specifics....

Thanks for your measured reply. I'd love to see more polite discourse/argument about SWMC. And I would agree with you normally - except - in my opinion, it's also important to give feedback to those who are unkind, dishonest, and/or distorting the truth (See Jonathan's very polite commentary to Rustie).

I can understand those committed to being "above the fray" that this may sound bad. But turning one's back on rude, cruel, demeaning or insulting behavior/speech, or information that's simply not true, once more in my opinion, only increases the likelihood of more.

And describing such words/behavior, and wondering about the origin of it, is not the same as being unkind oneself...having been walked on, verbally, far too many times in my life, at this time in my life I refuse to stand by and watch mean behavior go unchallenged anymore whether it's towards me - or someone/or something I admire. If more people stood up against such behavior in the kind of non-violent way I have, I think we'd have a better world...

[Goat Rock Ukulele]

I really like the idea of direct email to a patient and Netflix. There were times this year I had friends in the hospital that I wanted to support and get information to that when I went to see them were sleeping so I left rather them waking them. It would have been wonderful to be able to send them supportive messages and pass on information that they could access when they wanted. Netflix seems like a small thing, it certainly doesn't cost much. Watching an old movie like Guys and Dolls can really be a restful settling experience. I'm sure we all have movies like that.

I'm wondering since the patients room will have internet access if it could be worked out with the Sonoma County Library to access their online book library from patients rooms. They have thousands of books that can be downloaded if you have a library card. Sometimes it's easier to listen with eyes closed if you are wiped out. My family members who were in the hospital really benefited from audio books.

[Dorothy Friberg]

Well, not entirely elitist. Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive. In my opinion, this new/old hospital is "pouring money down a rat hole" and unfortunately it is OUR money. Who are the rats?


you are shooting the messenger. lots of good well intentioned people disagree about a complicated effort. a sebastopol hospital supported by the current healthcare district is geographically elitist. nobody knows if the effort will succeed and history does not bode well. truth hurts when high on hope.

[Shandi]

Could you tell us where the information is on imported prisoners from Marin County for unknown procedures? Seems like there should be details on this somewhere. And why we'd have to import prisoners when we have plenty right here in Sonoma County jail is a mystery to me.


Well, not entirely elitist. Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive. In my opinion, this new/old hospital is "pouring money down a rat hole" and unfortunately it is OUR money. Who are the rats?

[Shandi]

As a researcher, I was compelled to track the validity of your statement about "Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive". and am unable to find any reference to it. I'm a bloodhound by nature, but this one has me stumped! Hope you can clear up the mystery of where to find the reference.


Well, not entirely elitist. Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive. In my opinion, this new/old hospital is "pouring money down a rat hole" and unfortunately it is OUR money. Who are the rats?

[farmerdan]

As a researcher, I was compelled to track the validity of your statement about "Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive". and am unable to find any reference to it. I'm a bloodhound by nature, but this one has me stumped! Hope you can clear up the mystery of where to find the reference.

Shandi,

In the past, Palm Drive had a contract with San Quentin for certain diagnostic procedures. This contract lapsed well before the hospital closed and SWMC does not anticipate providing care to San Quentin inmates in the future. I believe that Marin General is now providing these services.

Having said this, almost all hospitals provide care to incarcerated patients at one time or another with security being provided by the jail and I believe that Sutter currently has a contract to serve Sonoma County jail inmates. Some hospitals even create special wards with higher security for this purpose when they are close to a major jail or prison.

I will add that to my knowledge, there was never a single incident with inmates in the hospital, which is not something we can say about the general public.

As with a lot of things, this rumor is based partly on fact and mostly on fiction.

Dan

[Shandi]

Thanks Dan, I really appreciate your response. It makes sense that prisoners would be seen in hospitals for things that their infirmary couldn't provide. My concern was that the prisoners might be "used" for procedures they hadn't given permission for. What is the "rumor" you speak of that's based partly on fact, but mostly fiction?


In the past, Palm Drive had a contract with San Quentin for certain diagnostic procedures. ...

[farmerdan]

... My concern was that the prisoners might be "used" for procedures they hadn't given permission for. What is the "rumor" you speak of that's based partly on fact, but mostly fiction?

I can assure you that no one would ever have been "used" for procedures they hadn't given permission for. I have heard from nurses that inmates were universally grateful for the care they received.

The rumor you responded to was that 'busloads' of prisoners were being treated. This was only an occasional event with a few inmates.

Dan

[rossmen]

my gut says it will fail again. logic also has powerful warnings. what we lose is more money. swmc has its chance thanks to a democratic process, and the fundraising seems to be slowing short of the initial goal. cheer lead all you want, i enjoy throwing pie in the face of fools, being the most foolish one of all ; )



...Sure, no one can guarantee success - but trying to destroy it without giving it a chance seems to me not only very negative, but silly. Why kill it before it's had a chance to prove itself?...

[nancypreb]

Dan, is there a place where the public can view the business plan, the proposed budget, projections, etc. This seems to be a battle between sales pitch vs. numbers. And lets not pretend that an American/western market for your software is not going to be an extremely lucrative return on your philanthropic investment, compared to a medical center in the Philippines. Just tell everyone that you're planning to make a sh*t ton of $$$ as a result of SCMC using your software as a beta test for the American marketplace. You've already made money on your software, but you stand to make a whole bunch more via SCMC. That's fair, so long as the business plan for SCMC works. It's not that you HAVE to, but what does it hurt to just fess up? Why is everyone dancing around this?! And you'll probably tell me I'm way off base and totally wrong, but that's what this all smells like to me- if nothing else, know that this is the perception that is standing in the way of your sales pitch....anyone else?!


my gut says it will fail again. logic also has powerful warnings. what we lose is more money. swmc has its chance thanks to a democratic process, and the fundraising seems to be slowing short of the initial goal. ...

[podfish]

Well, not entirely elitist. Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive. In my opinion, this new/old hospital is "pouring money down a rat hole" and unfortunately it is OUR money. Who are the rats?sorry, that's baffling. There are implications I just don't understand. I'm not sure what you're objecting to - secret experiments on prisoners? caring for the indigent? laundering money?

[farmerdan]

Nancy,

The business plan with financial projections is here:

https://sonomawesthealth.org/wp-content/uploads/2015/04/Our-Mission-1-20-15-with-edits_04_09_2015.pdf

Having two left feet, I have never been a good dancer (much to Joan's dismay) so I am not "dancing around the subject."

We determined long ago that the US market for Electronic Medical Records is dominated by a number of Billion Dollar companies and would take much more money than we have to break into. (Having one implementation does not get you into a market.) Think of it like starting a new car company, you don't get there by building one car no matter how cool the car is. (The fact that Tesla has survived is a miracle that took many hundreds of millions and Elan Musk to lead.)

I won't argue that there is no benefit to implementing at SWMC because we have already benefitted by getting to know the doctors requirements better and improving the software in some areas as a result. If we make 'a sh*t ton of $$$' will it be because of one implementation in the US, or all the work we have been doing around the world and the years of development? If SWMC fails, as some people believe it will, it will be a black eye for EHRI, not a big success so how does this work in our favor? I find it a bit humorous that the same people, who argue that SWMC can't possibly succeed, claim that EHRI will make a lot of money from the success.

As to whether SWMC will be successful over the long term, we can all argue the hypothetical until we are blue in the face but time will soon tell the real story. No one has ever pretended that reopening our hospital was going to be easy and I can honestly say it has been extremely challenging on many fronts but the many people who have been engaged are making it happen.

I heard there is a movie out with you as the star.
Where can we see it?

Dan

Dan, is there a place where the public can view the business plan, the proposed budget, projections, etc. This seems to be a battle between sales pitch vs. numbers. ...!

[Dianala]

I have been reading the latest critiques with a heavy sigh, as few people get to see what is happening at the hospital to insure that it will open with a different model for success. Everyone there has been working above and beyond normal (what is normal anyway?), and it is a very complex project just to get through the many pieces that are building related, software development, team development, new programs and integrating new health models.

I have been on the recruiting side of life at SWMC, and I tell candidates and new hires that we are dealing with a 5000 piece puzzle, not 500... During orientations, I say something like 'this is not for the faint of heart and it will take everyone's effort and commitment to open the hospital and keep it open'. The excitement from the new people hired, and soon to come, is strong and energizing. Aside from that, Dan has been there every day including weekends working tirelessly (sometimes I see the fatigue in his body, but his commitment remains strong).

The truth is that even if Dan did make tons of $$ from software sales? (see his recent reply), he would probably give quite a bit of it to worthy charitable projects and organizations.

Can we let this series of negative comments about the failure of the hospital rest for awhile? We need all the positive energy we can get to move through the final stages for opening the hospital. Come to a Board meeting if you want to know more. The schedule should be on the Web site: www.sonomawesthealth.org (https://www.sonomawesthealth.org). We know this has never been done before and there are many risks, and the rewards will become apparent over time.

[farmerdan]

Dianna,

The focus on me is just a distraction dreamed up by people who want to kill the hospital.
Next week, they will be attacking someone/something else.

Having said that, it creates an opportunity to dialogue with the community and provide useful information instead of rumors. Rusty, for example, had a lot of good questions about billing the uninsured that are complex, worthy of discussion and important for the community to know. The questions about up charges for private rooms and such are important to make clear as well. The questions about treating inmates were also important to address.

If you cast the world into good guys and bad guys, it is easy to think you are among the good guys and that all good guys will think like you do. If, on the other hand, we all look like the imperfect beings that we are, life is a lot more interesting and the opportunity for dialogue is much more present. I like to remind myself that Nixon dialogued with Mao, Churchill with Stalin, Mandela with De Klerk and Martin Luther King with Bull Conner (though without much success.) I figure that if these leaders could talk to their adversaries and create breakthroughs, certainly we should be able to do the same right here in Mudville.

I still believe that when the dust clears, we will all be working together...you may say that I'm a dreamer, but I'm not the only one. John Lennon said that. I'll let you be in my dream if I can be in yours...Bob Dylan said that. I have no intention of dying rich so the Infernal Revenue Service can fund more guns and bombs...I said that.

Dan

[nancypreb]

Thanks for the link, Dan. I think its very helpful for many of us who are interested and concerned but may not have the time to go to all the community and board meetings (busy being movie stars and all...:wink:). And I'd like to say that criticism and skepticism, "negativity" as it's called, is not necessarily a bad thing in my view. Much like your software development, it's the challenges that lead to better results, no?! Just like a positive attitude lends to good health, but false hope is never a good practice. Balance is everything- isn't that the "Sebastopol way?" So I hope that those with the abundance of optimism and energy can embrace the "negativity" so as to better our understanding and guide us all towards a realistic prognosis. (Alright, I'll get off my yoga mat now.)

As for the business of medical advancements, all I can say is that I have a little (and I truly mean, just a little) familiarity with how difficult it can be to get important and necessary procedures and advancements approved in the US. I know this because of one Dr. Ruben Quintero who had to perform his case studies in Venezuela in order to expedite approval for his innovative procedures here in the US; a procedure that benefited my family (the first ever to have been performed on identical triplets). It is through the veil of this experience that I, like others, don't buy the purely philanthropic motive, but rather a smart business opportunity. And that's totally fine. Make $$$, a sh^t ton, in fact. I wish I had the brain to develop such software. Kuddos to you!

It's just that when we're talking about motives, up against a history that involved in-fighting and strife over a perceived "conflict of interest," that's what a huge segment of the community sees; not a bleeding heart millionaire in blue jeans painting walls, but rather a software developer who's at the helm again, and who stands to make significant personal financial gain, even despite the success/failure of the hospital itself. Truly, no judgement, just putting it out there... this is part of the problem in the public perception which leads to the skepticism in the long-term viability of the plan for the hospital. I'm only being this frank because I know you can handle it.

And yes, it appears that I am in a movie, of which I guess you could call me the star. I think it's more accurate, though, to say I'm the star of my own life, about which a movie happens to have been made. Interestingly, in the first three minutes of the film, I talk about health care and how we didn't have it, and how significant that is for those of us who live in the rural outskirts of town. I know first hand how important this facility is for our rural community. I'll never forget driving my mother to Palm Drive as she was dying in the passenger seat of my truck. There was no point in calling 911. They weren't going to get to us any faster than I could get her into town. I can only imagine if I had to drive another 20 minutes to Santa Rosa. Instead of dropping off a dying woman with hope, I would have been dropping off a corpse in despair.

I, like EVERYBODY, wants this hospital to succeed, because it needs to. But you do lose me when you pitch rooms with a view, Netflix, and an organic menu. I just want to know that the numbers work and that the hospital is going to be there the next time I find a loved one writhing on the bathroom floor in pain. And whether you make another couple million doing it, or are taking the position of a philanthropic saint, I don't care; as long as it works for the long term.

And because you asked :thumbsup:... the film is called "On Her Own" and will be playing tomorrow at the Roxie in SF (part of SF Docfest), however it's sold out so they've scheduled an encore screening on July 2, then at the Arclight Theater in Hollywood on July 13th, then back here at the Rialto in August as part of the SCA's "Best of the Fest" series. We do have a distributor now, so probably in a year's time your patients will be able to watch it from the comfort of their hospital beds on Netflix.

Good luck to all of you who have worked so hard to reopen our hospital! Even by virtue of criticism, you have our support.


Nancy,
The business plan with financial projections is here:
https://sonomawesthealth.org/wp-content/uploads/2015/04/Our-Mission-1-20-15-with-edits_04_09_2015.pdf
...
I heard there is a movie out with you as the star.
Where can we see it?
Dan

[theindependenteye]

>>>my gut says it will fail again.<<<

I'd have that checked. You're probably okay, but you never know.
-Conrad

[Dianala]

I appreciate that you keep the dialogue going, I am affected by the tone more than the questions. Also, I just want to provide a different perspective in this thread...
Peace out,
Diana


...Having said that, it creates an opportunity to dialogue with the community and provide useful information instead of rumors. Rusty, for example, ...

[Shandi]

Thanks for questioning the "money down the rat hole" part. I got sidetracked with the "busloads of prisoners" part.
Good catch on the other mystery implication....



sorry, that's baffling. There are implications I just don't understand. I'm not sure what you're objecting to - secret experiments on prisoners? caring for the indigent? laundering money?

[farmerdan]

Nancy,

There are no guarantees of long term success with anything but the numbers look good and there is a bed shortage in the county now that we did not figure into the plan. If you want to stay out of hospitals I'd stay off that motorcycle. I gave up my 53 Indian Chief after too many near death experiences.

Dan

[Peacetown Jonathan]

Responding to Nancy's comment below:

A "huge segment" of our population does NOT see it this way.

This is how a very small number of politically powerful and manipulative people see it, and these are the malicious falsehoods they continue to spread. They seem to have the ear of some vocal members of the community, including you.

What is our collective reality is that this sacrifice of opening the SWMC, in dollars and time and effort, has earned and deserves a chance. And whether it succeeds or not, it will not cost taxpayers a single dime extra than if it was not attempted. Hence the mystery of why this vendetta against Dan Smith and the hospital continues. Someday, I hope, this will be revealed to the public, whose interest and support is clearly behind the hospital reopening.

What a "huge segment" of us truly see, Nancy, is a group of hard working people and a dedicated philanthropic couple sacrificing a great deal of time and money to save lives in our community by restoring an emergency room and hospital service that will again serve us, our families, and our neighbors.

And people like you complaining about it.


It's just that when we're talking about motives, up against a history that involved in-fighting and strife over a perceived "conflict of interest," that's what a huge segment of the community sees; not a bleeding heart millionaire in blue jeans painting walls, but rather a software developer who's at the helm again, and who stands to make significant personal financial gain, even despite the success/failure of the hospital itself. Truly, no judgement, just putting it out there.

[ywv]

As a researcher, I was compelled to track the validity of your statement about "Busloads of prisoners are imported from Marin county for procedures unknown to us. This was occurring at Palm Drive". and am unable to find any reference to it. I'm a bloodhound by nature, but this one has me stumped! Hope you can clear up the mystery of where to find the reference.

FYI - Palm Drive Hospital had a contract with San Quentin prison, to provide outpatient/day surgery procedures on inmates. This was a money generator for the hospital.

They would arrive on Thursday afternoon on bus vans with guards. I was at the hospital in the outpatient/day surgery rooms on Thursday's and would watch their arrival. It was a aged population. I was impressed by the respect and gentleness the guards treated them with.

[Tinkerbell]

I know from personal experience that inmates of San Quentin were regularly brought to Palm Drive Hospital for colonoscopies and various other procedures. My observation was that there were approximately 5 or 6 inmates at a time, and almost as many guards. These guards explained to me that San Quentin authorities brought inmates to different hospitals so that it could not be predicted where they were going to be transported, and therefore avoid a breakout. (I was a regular IV patient at Palm Drive, and on those days I was not permitted into the regular IV room by prison guards, who explained this procedure to me. On these occasions, I was sent to other, smaller rooms for my IV.

[jbox]

...And whether it succeeds or not, it will not cost taxpayers a single dime extra than if it was not attempted. ...
Jonathan,

While I resent paying for Palm Drive with my property taxes, and I will never use the facility, I sincerely hope this current incarnation will succeed. If, after the appropriate amount of time, it fails to succeed, will you run up the white flag and say OK, enough? The price of failure should be failure. How many times do we have to fail?

[nancypreb]

As a child, I grew up with a someone who had a pretty severe case of aphasia. As his translator, whether at family dinners or at the DMV, I learned very early on in life to not clench onto solitary words too hard, but rather listen for whole thoughts and meaning. It helped to expedite what was otherwise a rather difficult and exhausting process. Here on Wacco, however, I'm learning that it is a skill that is either under-appreciated or simply not shared as multiple people seems to gloss over whole thoughts for the sake of identifying and macerating one single solitary word; elite, huge, poor (that's from a different thread).

I don't know if you noticed Jonathan, but Dan and I actually have a very easy and respectable repartee, even in the face of dissent, because we know each other. We've been on the same and opposite sides of the table together. Both of us have been the subjects of villainization as much as we have been touted as pillars within our community; for very different reasons, but framed by public opinion, both good and bad, none-the-less. I admire your cheerleading for Dan, but it does seem to cloud your ability to listen beyond words and glean sensibility and valuable meaning. At least Dan has the capacity to validate concerns, interpretations, and general community feedback, even if he may disagree with it. You, however, appear to want to get into a quantitative pissing match over "who's huge is huger?!" If your finger was on the pulse of such a huge "huge," I'd like to think you'd be sitting on our city council right now. But maybe you're right, Jonathan. Maybe your huge is indeed that much bigger than my huge, so I'll go ahead and downgrade to "significant." Now, if my "huge" wasn't at least "significant," why there'd be no reason for you to have your speedos in a bunch, now would there?!

You can't ask for community feedback, but then dismiss people as mere mouthpieces for a small faction of politically powerful mastermind manipulators. At the very least (especially considering all the cheerleading you seem to be doing), afford others autonomy over their own opinions and perceptions- right, wrong, aligned or misaligned. As someone who sought the role of community leadership, take these opportunities to provide clarity and understanding.

You act like its a mystery why people are skeptical. I was simply pointing out that it's no mystery. Take a millionaire, add a software program, divide by a multi-million dollar investment in the field to which his software applies, subtract the philanthropic angle, and multiply by a history of conflict based on a "conflict of interest," and now you have the recipe for skepticism. Mystery is solved! Dan already knows this, so does a "significant" segment of this community. I just haven't seen it articulated in no-uncertain terms, so I just thought I'd go ahead and do the nasty myself. Dan can at least pick up the baton and give jovial advice on how to maintain a sound and healthy body. You on the other hand....

And this idea that in order to be supportive you can't scrutinize or be critical is how we got here in the first place....and then AGAIN! It's like saying, just trust your government- the Congress only wants what's best for the people, there's no special interests....and everything would be just fine if only you'd people stop being so damn judgmental and critical. But now, in that context, it doesn't ring quite right to the liberal ear, now does it?!


R...A "huge segment" of our population does NOT see it this way.

This is how a very small number of politically powerful and manipulative people see it, ...

What a "huge segment" of us truly see, Nancy, is a group of hard working people and a dedicated philanthropic couple sacrificing a great deal of time and money to save lives in our community ...

[Rustie]

Hey Dan,

I've been busy but I wanted to respond. You are correct to conclude that I wish Jim Horn had been elected to one of the two openings on the district board. Requesting a sound financial assessment and business plan in my opinion was very reasonable while running two insiders from the Foundation struck me as stacking the deck. That having been said how do you conclude that I wish the hospital had stayed closed? Is it the fact that I question the merits of your plan and that means I want the hospital closed? This is irrational. Further I don't understand why you think anyone would actually want the hospital to stay closed, what would be the point?

We have both traversed the road of sarcasm in this thread. When coming from you I did not interpret it as a personal attack. Was I wrong, were you attacking me? To establish my position it is not necessary to attack you, my observations are clear and valid. If the language of truth is disturbing to you then I am sorry.

There are many who still question the viability, the motives and the wisdom of this hospital plan as it has been presented. In the spirit of community I would think that the architects of the plan would want to do all they can to lay those concerns to rest.

I appreciate your answering my questions and more importantly your doing so because it might be helpful to others. The truth is that is exactly why I have been asking these questions and presenting these various areas of concern, because I think the information is valuable to our community.

Thank you for the explanation regarding the applicable rate that will be used for uninsured patients. That sounds reasonable and fair and is an important gesture in helping those in need.

With respect to the “additional services”, I'm not following the logic.

1) How do you expect to provide organic meals at no significant added cost? I can not go to a grocery store and buy any organic edibles without seeing a significant added cost over commercially grown food.

2) Private rooms vs dual occupancy rooms - doesn't that reduce your potential revenues by half thereby indirectly adding a significant cost?

3) Additional revenues generated through better care and patient experience, in theory, is a good strategy but it does not account for the obvious fly in the ointment – Kaiser, the number one insurer in the state. This single factor, Kaiser and its highly competitive edge, has been a huge player in the closure of many small community hospitals. How does SWMC expect to overcome this obstacle?

Regarding all the chatter on the elite hot button issue – I was not the one who turned the single passing comment, ("creating a high-end elitist medical facility catering to the wealthy") into the focal point and ultimately a distraction from the objective of this thread, the hospital. You picked this up, incorrectly, as a personal swipe at you and from there the avalanche began.

I have allowed myself to be taken down this rat hole only in an attempt to clarify to all of those who don't understand the concept, that you are in fact self-evidently an elite – period. You and your family and friends are the ones who have attached a negative, insulting connotation to that undeniable reality.

You ask what does your superior wealth have to do with the hospital? That too is obvious and undeniable. It is in fact your elite position in this community that affords you the ability to influence, as you have, the reopening of our hospital. Would I want someone who has no money leading the effort? In my opinion that is the wrong question. Some people with no money have accomplished huge social change and community betterment. I think transparency and zero conflict of interest are more important than money.

And while we're on the subject of transparency and conflict of interest I think it fair to address a few points that you have been reluctant to talk about. You said that you have “no way of knowing whether EHRI will ever benefit from the implementation of HarmoniMD at SWMC”. You are a smart businessman Dan and your words, taken literally to the letter are true. You certainly can't know for a fact what will or will not happen in the future, but you can surmise and project, and I suspect you did. Isn't that how the hospital plan was developed, by conjecture and projection?

Your HarmoniMD software was federally certified in 2011 with OffSiteCare listed as the vendor. It appears that over 3 years later you still have not placed your product into one single U.S. medical facility. It's not uncommon or unscrupulous for a company to offer a give-away as a means to achieve market visibility and/or credibility, especially in a highly competitive industry. When viewed in this light the potential benefit to all HarmoniMD associated entities and persons is apparent.

As per your assessment, start up costs of this system are well over one million dollars with ongoing maintenance and other services running at around $100,000 per year. There are currently over 5,000 hospitals in the U.S., I'm sure you've done the math. If several years down the road you captured only 1% of the market as a result of SWMC's testimony this would prove to have been a very effective and worthwhile R&D expenditure with or without the long term success of the hospital. Sure it's a tough nut to crack but well worth any and all efforts.

So, is there a problem with this? Only if the success of the hospital was a secondary consideration behind the success of your private enterprise – that my friend is conflict of interest. We may never know for certain but it is your lack of transparency and obscurantism that is alarming to me and perhaps others as well. I realize that the hospital is a done deal and as the old saying goes, time will tell.

If in the end we find ourselves once again without a hospital and functionally having subsidized your multimillion dollar private enterprise I hope that at the very least we as a community will be more discerning the next time a fast moving train mesmerizes us in its headlights. I for one will be keeping a close watch on the story that unfolds. I sincerely hope my concerns are unfounded.


Rustie,

Rusty, I think you made clear that you wished Jim Horn got elected and the hospital stayed closed. ... Attacking me is a convenient method of trying to establish your position ...

...We don't believe that the 'additional services' will add significant cost and their value will be in better care and a more pleasant patient experience, which will in turn create additional revenue. ...

OffSiteCare, Dr. Gude's telemedicine company will be paid for providing medical services to SWMC. ...

I have no way of knowing whether EHRI will ever benefit from the implementation of HarmoniMD at SWMC ...

[Rustie]

Gail,

To begin with I would like you to point out exactly where and when I was dishonest, distorting the truth, providing wrong information or sowing seeds of confusion. These are rather slanderous accusations you have made and I expect you to be able to back them up with hard facts.

Secondly, what gives you the insight to determine that I have “no real desire to create true clarity for anyone concerned about payment options at SWMC”? Did it come from the same wisdom you tapped into when you dredged up the concept of “elite envy”?

Regarding your comments that I was “rude, cruel, demeaning or insulting”, that's your opinion, you're entitled to it. If you have the stones to attempt to back your opinion up with some examples I would be interested in hearing what you have to say. In the meantime I suggest you get a dictionary and look up the word elite – there's nothing inherently evil or demeaning about it. You might also want to look up the word vendetta.


Jonathan - thanks so much for your careful and thorough reply to Rustie's vendetta to discredit Dan, Joan and the new hospital ...show her as the horsefly that she is, wanting to cause pain, with no real desire to create true clarity ...

Rustie just seems to want to sow more seeds of confusion, wrong info, and argument. I wonder about her motives: and how much her "elite envy" plays into this? ...


... it's also important to give feedback to those who are unkind, dishonest, and/or distorting the truth (....
...I can understand those committed to being "above the fray" that this may sound bad. But turning one's back on rude, cruel, demeaning or insulting behavior/speech, or information that's simply not true, once more in my opinion, only increases the likelihood of more....

[farmerdan]

Apologies to poets everywhere...

A Salute to the Impossible.

It would be easy to call it impossible.
The pundits say so and the politicians hope it.
(The former hate the tax and the latter grope for it.)

The engineer has studied and declared it true.
The consultants who closed it reported it too.
How can they be wrong with all of their writs?

The bureaucrats have given their blessing.
To just let it die without even messing.
It doesn’t hurt them so why would they care?

It would be easier to let someone else do it.
Giving up is clearly the most pleasant place to sit.
We could sip chardonnay and dine on steak rare.

And think of the money we’d all save.
Enough for a yacht, or a villa in Cave.
Quitting now is most fiscally sound.

And then there are those who question our motive.
We must be up to something bad they are sure.
While declaring theirs purer than pure.

And think of how happy they would all be if we quit.
‘We told you so! It never could work one bit!’
(Quitting now is the most accommodating thing.)

It failed twice before they all claim.
Aren’t the past and the future always the same?
‘Certainly nothing changes ever’ we’ll sing.

But wait just a moment, now how would we cope.
When our neighbor collapsed or suffered a stroke.
When the child next door died en route.

When our doctor left town.
Or closed her practice down.
Or simply gave up after so many years.

When we quit before even starting.
When we could have, and should have, but didn’t.
Just because of our fears.

There really are things much worse than a failure.
Not trying, not giving, not fighting for right.
Giving up too soon and taking flight.

We have to remember that everything good.
Starts with intention, momentum and work.
Nothing comes easy to something that’s new.

Anything important will attract the detractors.
So Something Wonderful can only be born.
With effort and perseverance beyond the norm.

So let’s do something new.
That’s never been done.
Certainly, we won’t be the only one.

Let’s invent penicillin, sulfa and airplanes.
And radio, radar, light bulbs and more.
Let’s build a computer and a polio cure.

Let’s climb El Capitan by the hardest route.
And sail round the world in a tiny boat.
Or dive to the bottom of every ocean.

Let’s do the impossible while we still can.
We’ll do it together, each woman and man.
It won’t be easy, and it won’t happen fast.

But maybe with effort.
We can build something to last.
Something to serve and care for us all.

Something much better than all of our fears.
Something that’s taller than previous years.
For everyone living, let’s open our hospital!

[Serendipity]

It's so weird how when someone wants to do good tries and gets a backlash of energy in reply. I mean, how hard is it to try to understand and be tolerant?
A: Very hard if it rubs you in the wrong way.

I think it's a worthy endeavor even if it's not my thing.


Responding to Nancy's comment below:...

[Rustie]

Jonathan,

I think it would be a good idea if you get your reading and language chops a little better honed. Whether you like it or not there is a clear distinction between elite and elitist. You can twist and turn all you want but the fact remains, as is evidenced in writing, that I did not refer to Dan, his cronies, or their efforts to reopen the hospital as elitist. I suggest you refer to your dictionary and understand what it is you are attempting to write about.

I'm guessing that truth in journalism is not your forte. You state, “Then she complains that the non-ER facilities might make money for the hospital and doctors, to help subsidize the emergency room.” First of all you will find NO mention of doctors in any context in any of my posts on this thread. Secondly, I clearly stated that I have NO problem picking up the hospital losses via elective surgeries. My concern was questioning the viability of this as a successful long term business plan. Here's my quote: “it appears to me, after parsing through your eloquent promotional post, that you expect to take a loss on your “patient-centric” hospital and hope to make up the difference attracting wealthy elites to your “specialty institutes” for elective surgeries. If this is in fact your game plan I do not personally have a problem with this agenda. On the other hand I do have concerns regarding the viability over the long haul of this concept.” What is it that makes you incapable of getting the facts straight?

Please Jonathan show me where I suggested that the new hospital will “squander our tax dollars”. What I said was that as one of many taxpayers who will be contributing to the funding of this project I think it fair that Dan provide us with his projected financial statements as well as the basis for those projections in an effort to demonstrate the soundness of the hospital plan as a long term model. How the hell do you get squandering our tax dollars out of that?

Apparently in your world “prove the plan works” is a “bullshit” concept. I'm guessing you've been sold many bridges in your lifetime. For the sake of clarity no one can prove anything that has yet to happen. That having been said it is not unreasonable or bullshit to request basic documentation demonstrating how a plan was derived. I expect intelligent people to ask questions and request validation of claims made. More importantly however I never made a request to 'prove the plan works'. My concerns have been specifically focused on the long term vs short term objectives of the hospital. What study and analysis, if any, has been done to respond to the question of long term sustainability?

I take particular offense at your conflict of interest perspective. According to you noticing a conflict of interest is “absurd and hateful”. Or is that your characterization only when applied to people you know? For instance if I were to point out the conflict of interest issue when Obama appointed a Monsanto executive as the FDA Deputy Commissioner for Foods would you slam me for being absurd and hateful? Conflict of interest is something that you can draw a clear and direct line to. If I'm in a position to exercise power &/or authority, and my primary interest may be influenced by my secondary interest, then that is a conflict of interest. The presence of a conflict of interest is independent of any occurrence of impropriety. Your disregard for the obvious presence of a conflict of interest in regards to Dan and the shaping of SWMC is no less negligent than it would be in the Monsanto/FDA example. If we allow ourselves to become indifferent and inattentive when conflicts of interest are present we undermine our ability to maintain our common interest as the primary motivating force over personal gain. The result, greater corruption and inequality.


I appreciate Dan taking the time to provide a point by point response, and for his and Joan's generosity in sacrificing so much time and money to restore an emergency room for ALL of us in West County.

Rustie appears to have taken on the baton for the marathon vendetta to malign Dan Smith ...

[nancypreb]

Really?! Seriously?!

I'm glad you prefaced this with an apology. But whatever happened to "Think of it like starting a new car company, you don't get there by building one car no matter how cool the car is."

Fine. I concede. Let's all hold hands now...."Kum ba yah, my lord, kum ba yah. Kum ba yah, my lord, kum ba yah...." Oh yeah, there it is.... I'm starting to feel the magic!!

Namaste :meditate:


Apologies to poets everywhere...

A Salute to the Impossible....

[Peacetown Jonathan]

Rustie,

Please spare us your absurd twists and turns to weasel out of speaking of "Dan and his cronies," and the "elite" new hospital and the tired rationales that we have heard for a year now about why the hospital should not be reopened.

As you have a hard time understanding why people might object to terms like "cronies," then I would suggest that it is your "language chops" that need to get "a little better honed."

I know quite a bit about journalism, and conflicts of interest. You can link to the JonathanGreenberg.com website (https://jonathangreenberg.com/) with some of the articles and references to the books that I have published during my 35 year career as a professional journalist, Rustie. Please share with us a hyperlink to the work that you have published and let the public compare our public records on who has more experience reporting facts.

Comparing Dan Smith to Monsanto's FDA appointee is ridiculous. As ridiculous as this charade that Dan Smith is doing this to make money. The argument that Dan Smith has any real conflict of interest is a central part of the deflective strategy started more than a year ago to make the reopening effort about Dan, and not about the urgent need to keep an emergency room in our community.

To suggest that Dan's intention and motivation for writing checks for millions of dollars and spending thousands of hours of uncompensated time and neglecting his software business because he is planning to make money from reopening the hospital is ridiculous.

It is an insult to a courageous community leader who has worked insanely hard to his neighbors have the emergency room and hospital that has served us for 70 years. And an insult to the scores of people who have volunteered time and energy and money to the Herculean effort of reopening this hospital.

The second ridiculous charade that you perpetuate, echoing Jim Horn and the past Palm Drive Board members hell bent on keeping our hospital closed, is that the plan is incomplete. Or that it is flawed. Or that it in irresponsible. Or that it is too short on details. Or that it is a sketch of a plan. Or...or...whatever it takes to argue that it ought not be tried.

Hundreds, and perhaps thousands of hours, have gone into preparing this plan and revising it many times. There have been negotiations and meetings with the public, and the elected members of our District, and revisions based upon comments and input made during that deliberative process. The license for the hospital had a one year suspension on it, which has been extended for a little longer recently due only to the imminent opening. Without approving of and proceeding with this plan, the hospital would never have reopened. This argument, that "of course we support reopening the hospital but the plan is flawed" was the strategy used by Jim Horn and the political bosses of our community to close the hospital and oppose its reopening. As I mentioned earlier, Jim Horn recently told the Board that he did not think the hospital should be reopened until the bankruptcy was fully repaid. Given the suspended licensing timing, this would have meant never. Thanks to hundreds of us who campaigned to reopen the hospital, the voting public saw through this deceptive rhetoric ("prove the plan works"), and voted for a change in the Board majority.

Then there is the issue of your concern for how your tax dollars will be spent. Where was your concern a year ago, when the purpose this tax was created for was locked up and the emergency room that served 60,000 of us was closed down? Where was your concern for the suffering of the seniors and sick and injured people forced to wait hours at Santa Rosa's overcrowded emergency rooms? Where was your concern about the lives of our neighbors that will inevitably be lost if this hospital remains shuttered?

No, Rustie, your concern, and Nancy's, is that Dan Smith's software is untested. It's that the plan failed to convince Jim Horn and you that reopening the hospital could be proven viable. That the hospital might actually reopen and our emergency room might be restored and thousands of members of our community might be served by it and then, and then, and then what Rustie?

What exactly are you and Nancy concerned with, anyway?

Because despite the personal attacks on me, or Dan, or whomever you perceive to be your enemies for daring to want to see this hospital reopened, despite the ridiculous excuses that have been trotted out and discredited again and again during the past year, few of us understand why the prospect of reopening a new hospital with a life saving emergency room is something that well-meaning people would fight against.

What makes you oppose this effort?

Nobody is asking you to do anything, to work on the reopening, or to spend a single additional tax dollar on this beyond what you, like all of us, would be spending anyway for a closed hospital. The worst case scenario is that the emergency room and hospital reopens and it serves people for some time and then runs out of money and we are back where we started from.

While the best case scenario, which many informed folks like me believe more likely, is that it does succeed. That lives are saved, that humanistic care returns for us, our families, and our neighbors, and that the most innovative, caring, safest small hospital in our country is built in our hometown. :heart:


Jonathan,

I think it would be a good idea if you get your reading and language chops a little better honed. ...

[Sara S]

Thank you, Jonathan....


Rustie,

Please spare us your absurd twists and turns ...

[Shandi]

Rustie,

This response and others that you've made seem to show intelligent and rational thinking. Even those who don't agree on some levels, have to see the wisdom in your questions and requests. To me, it represents the kind of thinking that any substantial business would do, and as a local business, these findings/reports would be obviously available to the community that's supporting it. It's not brain surgery...


Jonathan,

I think it would be a good idea if you get your reading and language chops a little better honed. ...

[nancypreb]

The other person I grew up with was a grandmother who'd smack you up side the back of the head for talking stupid! Then she'd hollar "DO YOU NEED YOUR HEAD CHECKED?!" Quickly followed by "BECAUSE I THINK YOU GOT A SCREW LOOSE!" You obviously did not grow up with someone of that influence, Jonathan. Thank god the hospital is opening because an MRI might be in order. :dunno:

Nobody on this thread is opposed to opening the hospital. Nobody has advocated for keeping it closed. It's very difficult to take you seriously, Jonathan, despite your self-proclamated intelligence, when you ask ridiculous rhetorical questions, only to answer them yourself with the actual response.

"The worst case scenario is that the emergency room and hospital reopens and it serves people for some time and then runs out of money and we are back where we started from."

THIS!!! THIS IS WHAT WE'RE OPPOSE TO!!!! Not success, not Herculean effort, not good-will, not the presence of a hospital or an emergency room that's going to serves 60,000 people, not any of the other ridiculousness you blather on about. And I won't speak on behalf of all the Wacco's who are PMing me saying "THANK YOU, NANCY! We're exhausted by the Jonathan and the Dan, and while I don't always agree with you... on this one, I totally do!!" No, I'll only speak for myself.... I'm opposed to the carte blanche pass you seem to advocate for; no scrutiny, no criticism, no skepticism, no inquiry. You ask questions and I'll dance (albeit, poorly) in circles and tell you just to think positive! I'm oppose to the "Who knows what the future holds? Here, here's a poem!" kind of responses. I'm oppose to "I'm smarter than you! Don't believe me?! Here's my curriculum vitae!" kind of journalism.

Opening the hospital is the easy part, Jonathan.... keeping it open has proven to be the challenge. I support the opening of SWMC 1,000%!! The problem for me is not in the WHAT, but in the HOW. I'm guessing that's other people's objection too. I'm very excited to see the hospital open!! But God help you, Jonathan, should we indeed run out of money, and Dan fails to pull out his check book, and we're back where we started. And if I'm still here 40 years from now, still wasting my time on Wacco, I will gladly....GLADLY.... advocate for a bronze bust of you and Dan to be set in the lobby. I promise.

Is it clear now, Jonathan? Have I made myself PERFECTLY clear?! Now, from here on out, can we please just have normal, measured responses to the skepticism, criticism, inquiries, and the like?! Because doubt is normal....VERY NORMAL! If this is new news to you, check with your doctors who deal with fear and doubt from their patients every day, and YET still manage to maintain better bed-side manners than what you are displaying. You're role, Jonathan/Dan, is to ease those fears, have answers for the questions, not propagate dissent. And acknowledge that it is only the fool-hearty that will permit you to lead blindly.


Rustie,

...why the hospital should not be reopened... the past Palm Drive Board members hell bent on keeping our hospital closed...

No, Rustie, your concern, and Nancy's, is that Dan Smith's software is untested. It's that the plan failed to convince Jim Horn and you that reopening the hospital could be proven viable. That the hospital might actually reopen and our emergency room might be restored and thousands of members of our community might be served by it and then, and then, and then what Rustie?

What exactly are you and Nancy concerned with, anyway?

... despite the personal attacks on me, or Dan, or whomever you perceive to be your enemies for daring to want to see this hospital reopened, despite the ridiculous excuses that have been trotted out and discredited again and again during the past year, few of us understand why the prospect of reopening a new hospital with a life saving emergency room is something that well-meaning people would fight against....

What makes you oppose this effort?

The worst case scenario is that the emergency room and hospital reopens and it serves people for some time and then runs out of money and we are back where we started from.

[Rustie]

Once again Jonathan get out your dictionary – Crony: a long time close friend or companion.

[Edit: Although Rustie's definition above matches the definition at Dictionary.com (https://dictionary.reference.com/browse/crony), Mirriam-Webster (https://www.merriam-webster.com/dictionary/crony) defines it as: " a close friend of someone; especially : a friend of someone powerful (such as a politician) who is unfairly given special treatment or favors". If we can't even get the dictionaries to agree, no wonder these two are fussing so much! :waccosun: Barry]

Additionally, I have never suggested that the hospital should not be reopened. I don't believe I read that sentiment in anything that Nancy wrote either.

Why do you keep positing the same accusations and asking the same questions that have already been addressed? One more time Jonathan, the facts, not that you seem to care much about those, are simply that I have questioned the long term viability of the current plan as it has been presented. I have also been very clear as to what I see the primary problem is – Kaiser. I didn't just make this up. In case you hadn't noticed this place actually exists and is the number one insurer in CA, number two in the nation. It appeared to me, by simply reading Nancy's posts, that her concern was also regarding the long haul. This reasonable question is complicated by the obvious conflict of interest that you and others seem to be blind to.

You can yell, rant and rave all you want Jonathan but it doesn't change the fact; Dan has a conflict of interest, and by the way, so does Dr. Gude. Here's how this works:

1) Dan & Dr. Gude were both on the Foundation Board and are currently on SWMC board.

2) They were both architects of the hospital plan, inclusive of decisions regarding equipment and services that will be used at the facility.

3) They both have companies that will be providing equipment and services to SWMC which in turn will provide them personal gain.

Without a doubt this is a relationship where their secondary interest may influence their primary interest – period. Break out that dictionary Jonathan, this is a classic “conflict of interest” example.

Like it or not there is in fact a very “real” conflict of interest here. Remember what I explained in my previous post to you: “the presence of a conflict of interest is independent of any occurrence of impropriety”? So as I see it there are a few areas of possible impropriety.

1) if the software in question is inappropriate or inadequate – I don't believe anyone has raised this issue.

2) if the hospital plan was short-sited thereby not providing the intended public service – hence our questioning of the long term model.

Truth is if it weren't for this glaring conflict of interest and continued lack of transparency I would be more likely to “quietly” wait and see. That's what you want isn't it Jonathan – for that “substantial” faction of our community who has doubts to just be quiet? Problem is, as Nancy so eloquently put it, that's how we got here in the first place.

You can scream as loud as you want Jonathan but that doesn't make your distortions of the facts suddenly become reality. I don't recall suggesting that Dan's sole purpose to reopen the hospital was to sell his software. That's your distortion. I personally believe that he genuinely wants to help his community and make wise investments of his time and money in the process. Is there a problem with that? No, the problem is lack of transparency. Dan is no fool, he sees the entire picture before you even get out of bed in the morning. Perhaps the outcome of all this contention is that Dan will realize that he might well garner the support of that “significant” faction as well if he were more transparent in his future ventures.

I don't need a link to a website with my published works – I have never claimed to be a journalist or a published writer. The question here is not how much experience you have had reporting facts but rather how accurately you report them? When called upon to substantiate your inaccurate reporting and/or misuse of language you merely repeat your same diatribe with all the same inaccurate commentary, ramped up with more venom. Here are a few rules about ethical journalism:

1) Respond quickly to questions about accuracy, clarity and fairness

2) Acknowledge mistakes and correct them promptly and prominently.

3) Avoid stereotyping, journalists should examine the ways their values and experiences may shape their reporting.

4) Be vigilant and courageous about holding those with power accountable. Give voice to the voiceless.

5) Support the open and civil exchange of views, even views they find repugnant.


Rustie,

Please spare us your absurd twists and turns to weasel out of speaking of "Dan and his cronies," ...

[Shandi]

Nancy, you're another intelligent woman with rational statements. You and Rustie say things that need to be said. So, I appreciate your insights to help us see what's not being said in "what's wrong with this picture?".

I'm working with an new organization that plans to get funding for a group home for the disadvantaged. The first item on their agenda is to get a realtor to check out land/properties that might be suitable. When I heard this, I had to force myself to remain calm, and not re-act. Instead, I did what I've done with clients when I had a business, and it was necessary to bridge the gap between their fantasy and reality. So, I said "O.K. let's say I'm a realtor, and I've just found an ideal spot for your project." What's the next step? That's all it took to get the message across, that some vital things were missing, like funds!, and a business plan for the group home. From what I understand, many realtors won't even show properties unless potential buyers are qualified. What was shocking is that the people who are involved in this are educated and intelligent, but have never been in business, or written a grant proposal. Their next step is to approach a bank for "seed money". I'm watching to see how far this gets without a well researched plan to detail expenses.

Getting seed money for a local hospital may not need a well researched, and public business plan to get resident support, but it seems like a reasonable request from those who know the importance of it.


The other person I grew up with was a grandmother who'd smack you up side the back ...

[Dustyg]

I can't help but ask, is the hospital going to open or not? dustyg

[Dorothy Friberg]

Well, perhaps you aren't paying $300/year in property taxes to support this fantasy.


It's so weird how when someone wants to do good tries and gets a backlash of energy in reply. I mean, how hard is it to try to understand and be tolerant?
A: Very hard if it rubs you in the wrong way.

I think it's a worthy endeavor even if it's not my thing.

[Dorothy Friberg]

The object of language is communication, not semantics.


Jonathan,

I think it would be a good idea if you get your reading and language chops a little better honed. ...

[Barry]

The object of language is communication, not semantics.

And the object of this thread is to discuss the re-opening of the hospital and the various considerations, which Rustie's questions and Dan's answers have been helpful to explore.

Let's leave the various personal attacks and defenses go and return to the discussion of the hospital, including what was asked on another thread that I have merged into this one: What's the current thinking about when it will open? I heard a rumor of sometime in July...

[geomancer]

Last I looked, the hospital tax was $155.00 per parcel.

Richard


Well, perhaps you aren't paying $300/year in property taxes to support this fantasy.

[Sara S]

My letter to the Press Democrat (June 6) and Sonoma West Times and News:

I've been reading about the folks who don't want to pay a parcel tax to support Palm Drive Hospital (now Sonoma West Medical Center), and I'd like to comment. From 1975, I lived way out west of Cazadero, and Palm Drive was my hospital for everything: ruptured appendix, broken wrist-- a long list.

When I heard that Palm Drive was financial straits, I had a bake sale in downtown Cazadero. I baked for three days, sold everything, and made $85 for the hospital (always a bit naive about money).

When the parcel tax was on the ballot, I came in to Sebastopol for a couple of days to work on phoning voters. I couldn't even vote for it because I wasn't in their district, but I would have. My feeling is this: Even if I were poor again, the thought that my contribution might save one person's life (any person's) would make me happy to do it.


Well, perhaps you aren't paying $300/year in property taxes to support this fantasy.

[farmerdan]

Last I looked, the hospital tax was $155.00 per parcel.

Richard

Seems people are worried about how their tax dollars are being spent.

To date, the district has spent about $100,000 toward reopening.
(They spent millions to close it.)
To date, SWMC has spent about $3.5 million, all from donations.
SWMC will spend about $8 million (all donated) and the district will spend about $1 million by the end of the first year (though this is still subject to the bankruptcy settlement.)
As tax payers, it seems like we are getting a pretty good deal for the small amount (25% of the tax money the district receives) from our taxes by getting 8 times as much from people who want to support the hospital.

It is hard to imagine how our tax dollars could be better spent.

Dan

[Rustie]

Hey Dan,

I remember reading in a PD article early in the year that the hospital was scheduled to receive $2 million from parcel tax revenues in the first year plus another $2 million transfer from the bond reserve fund. That to me looks like $4 million from the tax payers in the first year not $1 million as you have indicated. The article also noted that in subsequent years the district will contribute $1.5 million per year from tax revenues not $1 million. How do you account for the discrepancies in these figures?

I'm also curious about the additional $8 million in donations that you mentioned will be spent in the first year. Has that figure been met in pledged donations? If not how much of that needed $8 million has actually been received?

Thanks


Seems people are worried about how their tax dollars are being spent.

To date, the district has spent about $100,000 toward reopening.
(They spent millions to close it.)
To date, SWMC has spent about $3.5 million, all from donations.
SWMC will spend about $8 million (all donated) and the district will spend about $1 million by the end of the first year (though this is still subject to the bankruptcy settlement.)
As tax payers, it seems like we are getting a pretty good deal for the small amount (25% of the tax money the district receives) from our taxes by getting 8 times as much from people who want to support the hospital.

It is hard to imagine how our tax dollars could be better spent.

Dan

[Dustyg]

Just wondering, amidst all of this talk, is the hospital going to open or not? When?

[farmerdan]

Hey Rustie,

Can't believe everything you read in the paper (or even on WACCO!)

Actually, the article was correct at the time, we were hoping for the district to be able to make these funds available for reopening the hospital. As time went on, it became more apparent that the district would not be able to do this and settle their bankruptcy at the same time. We therefore changed the plan to depend much more heavily on philanthropy for the startup and the yearly funding from the district was reduced to $1M.

This should allow the district to use bond withhold funds and other tax income to make a reasonable settlement with creditors and former employees, something that is important for everyone.

Of the $8M, roughly $5M+ has been received in cash, another $500K+- is in escrow and $2M will become available after July 1. This does not count the district commitment of $1M. There are also other pledges that will come in over time.

Dan


I remember reading in a PD article ...

[farmerdan]

Dustyg,

Yes the hospital is going to open.
We are not able to publish a date because of state regulations but quite soon.

Dan


Just wondering, amidst all of this talk, is the hospital going to open or not? When?

[rossmen]

i heard from one source that almost half the parcels paying this tax are along the river road corridor. and someone else told me that this area contains less than 15% of the registered voters for the healthcare district. both of these could be true given the nature of voter registration and history of property development. if so then a case of taxation without representation, a highly regressive tax...


Last I looked, the hospital tax was $155.00 per parcel.

Richard

[farmerdan]

Rossmen,

These numbers are greatly exaggerated but it is true that more river corridor parcels are owned by people who live outside of the area and either rent their property or use it for vacation than for other areas in the district. (I have heard that one family that has been in the forefront of opposing the hospital owns over 100 parcels along the river.)

In the case of rental properties, the tenants can vote. I suppose one could argue that absentee owners get taxation without representation, but it is hard to shed too many tears for them since they are earning income from their properties and are not likely to pass tax savings on to their tenants or are using their property as a second home and getting the value of local services when they sell. It should be remembered that contiguous parcels and low value (unbuildable) parcels are exempt from the tax so if people have them, they should apply for the exemption.

I will try to get the real numbers for you or maybe someone else has them?

Dan


i heard from one source that almost half the parcels paying this tax are along the river road corridor. and someone else told me that this area contains less than 15% of the registered voters for the healthcare district. both of these could be true given the nature of voter registration and history of property development. if so then a case of taxation without representation, a highly regressive tax...

[Goat Rock Ukulele]

How much do you want to bet the family with 100 properties has owned them since before June 6 1978 the date proposition 13 was passed and pays 60% less in property taxes than the young couple who just bought a like property next door? Not all taxes are perfectly fair. But if my paying the health care district tax helps the child who is going into anaphylactic shock from a bee sting or the 55 year old father of three who had a stroke get back home with his brain intact I do it gladly. I pay it three times over.

[rossmen]

thanks dan! while i disagree with you on opening a hospital in sebastopol, i only admire your hard work, dedication, intelligence, and financial support for this project. i believe without you it would not happen. if successful i will contribute to the bronze bust in your likeness, and lay flowers on the pedestal every time i go to swmc : )

[Dorothy Friberg]

Oh yeah. I had the experience of calling a friend and in speaking to her knew by her speech that she had had a stroke. I rushed her to Palm Drive and told them proper information. They 'observed' her for over and hour and then sent her home. Even though she was having difficulty walking (they finally issued her an aluminum walker upon my request) and sent her home without treatment. The next day she tried to drive, ended up in a ditch, also with a broken hip. Never having fully recovered she died a few years later in a nursing home. So much for emergency care in small town hospitals. I'd rather my tax money go to schools or the roads and leave medical care in the hands of competents.


.... But if my paying the health care district tax helps the child who is going into anaphylactic shock from a bee sting or the 55 year old father of three who had a stroke get back home with his brain intact I do it gladly. I pay it three times over.

[Dustyg]

And then there are those of us, and plenty of us, whose lives were saved at Palm Drive Hospital, and who would not have made it to another hospital in a farther town. I am one of those.


Oh yeah. I had the experience ...

[Glia]

It sounds like the emergency room, like the rest of the hospital, will be much improved with the new incarnation. Awareness of the need for speedy, effective treatment of stroke is higher than it was even a few years ago.


Oh yeah. I had the experience of calling a friend and in speaking to her knew by her speech that she had had a stroke. I rushed her to Palm Drive ....

[Gail Raborn]

You're right! SWMC will not be a duplicate of Palm Drive, but promises to bring even more advanced medical care, methods, and treatments of every sort. Can't wait till it's open!


It sounds like the emergency room, like the rest of the hospital, will be much improved with the new incarnation. Awareness of the need for speedy, effective treatment of stroke is higher than it was even a few years ago.

[Rustie]

What state regulations prevent you from publishing an expected date of opening?

Did you not publish the original anticipated opening date of late April? Why did these state regulations not prevent that public announcement?

What has been the delay/problem in opening?

Thank you for all of your responses to all of our questions.


Dustyg,

Yes the hospital is going to open.
We are not able to publish a date because of state regulations but quite soon.

Dan

[Shandi]

Rustie, I love the way nothing gets past you! It's one way to keep people honest, and more careful about what they say. Knowing that someone is watching, can help us think before we speak. Thanks!


What state regulations prevent you from publishing an expected date of opening? ...

[gypsey]

Actually Shandi and Rustie, this information is available online with a little research.


Rustie, I love the way nothing gets past you! It's one way to keep people honest, and more careful about what they say. Knowing that someone is watching, can help us think before we speak. Thanks!

[farmerdan]

Rustie,

Answers below:


What state regulations prevent you from publishing an expected date of opening?
We were informed that the state does not allow an opening date to be announced until they have done a survey and approved the hospital license for opening. This makes sense to us since you would not want people showing up for care before the hospital is certified by licensing.


Did you not publish the original anticipated opening date of late April? Why did these state regulations not prevent that public announcement?

After we published a projected opening date, we were informed by the state that it was against their policy, we were not aware of the regulations prior to this.


What has been the delay/problem in opening?
Primarily the lengthy process of completing construction projects along with added work we decided to do to the building in order to avoid having to make upgrades after the hospital is operational. This work is almost all complete and we are anticipating final approval of construction projects next week. After that, we will have a state title 22 survey by the state and then an accreditation survey after being open for a while. Opening a closed hospital is an extremely complex process and we were overly optimistic in setting the earlier date. Having said this, we have used the time to complete a lot more refurbishing work than we originally planned and we believe that we are within weeks of being ready to open.


Thank you for all of your responses to all of our questions.

You're welcome.

Dan

[Serendipity]

After occasionally seeing SOME of the commentary on the hospital, and not overly much so as to avoid wasting my time, I want to chime in on how Rusty communicates- a clearly unfriendly tone and I am not impressed by the incessant determination that is sounds like she/he has to reveal Dan as the most evil liar in the world. Frankly, though I've said hello to the man twice, I barely know him and if I've said hello to Rusty, it was without any introduction.

C'mon! You want to know why he can't give a date? Do you even try to conceptualize anything about how big an endeavor it is to put all the parts of an organic system together in combination with the bureaucracy that it required by the state? If you have the capacity to imagine that there are things happening behind the scenes, why not try to imagine, WITH Empathy, that there are dozens of people focused on a goal, who are all still learning who does what and how each individual's work is inter-dependent on the other, and yet, all of that has to be learned- which of course, TAKES TIME! One cannot know fully how his/her position will be affected by the other until a circumstance occurs that requires the individuals to meet or to work together to solve a problem or to communicate and clarify a process or procedures.

Perhaps you might consider reading something about organizational development or about large systems. I am from a large family so I realize I have a different point of view, usually very different from the child born in a family where there is only one, two, or three children. That's my excuse for having some compassion here and my reason for saying CHILL OUT Rustie. And seriously, if you have this much passion and energy, please, for humanity's sake, charge it towards SB277 or Monsanto or Fluoride in our water. Your energy and passion is incredible but let a man work and give us readers a little break, please.
(I seriously need to get off this thread! Sorry others who are on it. I mean not to be a downer or to criticize too hard.)

And for the record, I barely read the conversation on which I'm commenting. LOL- it was more like I scanned over a couple of sentences so if I sound like I missed something, that's why. please forgive.)

PS So glad all I had to do was uncheck a box! Peace OUT!

What state regulations prevent you from publishing an expected date of opening?

[Rustie]

Hey Dan,

Thanks a lot - Great information - Much appreciated!

[Rustie]

Actually Gypsey I doubt that we could have found the site specific information that Dan provided had we done a little online research. If you have access to a link or two that provides the particular details answering all of the questions then I invite you to share them with us. Short of that I fail to see your point....



Actually Shandi and Rustie, this information is available online with a little research.

[Shandi]

My sentiments exactly! Why state that information can be found with a little online research, and not provide the source? Isn't sharing resources the best part about WaccoBB? Maybe sometimes there's an underlying reason for not giving the link for the source of information, and I can only speculate as to what that might be.


Actually Gypsey I doubt that we could have found the site specific information that Dan provided had we done a little online research. If you have access to a link or two that provides the particular details answering all of the questions then I invite you to share them with us. Short of that I fail to see your point....