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A headline from today's PD: Palm Drive Health Care District seeks to sell Sonoma West Medical Center https://www.pressdemocrat.com/news/8329877-181/palm-drive-health-care-district.
The story brings back memories of one of the best discussions ever on WACCO - how many? years back with Dan Smith and Jim Horn as the two leading voices. . I wish I could find it.
Now that Palm Drive has been absolutely and convincingly shown to be a management and financial failure for the umteenth time (fraud, lawsuits, unpaid employees, me too, huge deficits every month, board of directors incompetence, etc.), I would like to see Jonathan Greenberg's opinion on the current state of affairs, since he was one of the leading cheerleaders of the latest resurrection.Quote:
Posted in reply to the post by luke32:
I believe the best use for this facility is as a homeless service center.
No one in this community wanted the hospital to open and succeed more than myself.
And now, as much as I hate to say it, the District selling the hospital is probably the best scenario.
However (and I know there will be fallout on THIS point) the Palm Drive Health Care District IS NOT Sonoma West Medical Center.
And there is no proven fraud in the current climate on either part NOR is there even a lawsuit.
It is a claim and a very common one at that. Neither of my two previous comments anticipate, judge or even speculate at the final outcome. Just setting the record straight as it stands right now.
MOST everyone (and I did say most) who cheerlead for the hospital genuinely wanted a operating hospital, health care facility for our families in our community.
Quote:
Posted in reply to the post by jbox:
The notion that the hospital has been mismanaged is a mean spirited deceptive narrative that insults the many, many hard working people who have done an amazing job reopening and staffing and working for the Sonoma West Hospital.
I want to remind everyone that that community hospitals are failing everywhere in the country because we have a messed up health insurance system that exists for the benefit of the multi billion dollar insurance and hospital conglomerates.
The "economies of scale" are such that it is virtually impossible to break even for a small hospital. It is the only business in the USA that cannot predict or measure reimbursement.
Nobody has done anything wrong, except the hospital haters who for some reason that few can understand continue to ply their lies and character assassination against hard working people and the VOLUNTEER board members who have broken their backs trying to do the impossible, while providing WE THE PEOPLE of West County with an open emergency room for more than two years!! And providing more than a hundred decent paying jobs to those in our community.
I continue to be shocked at those who denigrate this essential public service, as well as our elected officials who want to pretend that they need not do anything to help the only hospital in West Sonoma County stay open.
from Jonathan Greenberg
Quote:
Posted in reply to the post by GetReal145:
Well, "Peacetown", this is sure a mean spirited response. You're a much better apologist for failure than you are an "investigative journalist".
The hospital has not been mismanaged? But it can't keep staff, or pay them. People quit or get fired if they're not on board with the narrow minded and desperate management clique. And yes, lawsuits have been filed for improper termination and fraud. The ER was shut down due to unclean conditions.
It's OK for Sonoma West to fail because that's what happens to small hospitals? You now admit the economies of scale are insufficient for the hospital to make ends meet, even with the huge public subsidy for which the taxpayers will be on the hook for years, but it's OK because WE THE PEOPLE need it? Really?
Hospital haters? Lies? Character assassination? Oh, come on. If the hospital was able to exist without huge deficits every month, year after year, we would all be on board. Even the Russian River area, which has successfully detached with unanimous LAFCO endorsement, would support this facility if it was not such an abysmal financial failure.
Anthem has sued for reimbursement of over $13 million of fraudulent charges. Just because this hasn't gone to trial, you assert nothing has been proven. Oh, please! They dropped this bogus fraudulent drug test scheme like a hot potato as soon as the news broke.
Now the hospital is up for sale. If you want to do some good, Jonathan, then support the transition to a homeless service center, something that is really needed.
You paying for that?Quote:
Posted in reply to the post by jbox:
sure, that facility's probably got features that aren't needed for homeless services, that would be more efficiently used for something like, say, medical services.Quote:
Posted in reply to the post by ChefJayTay:
but the implication that providing services for the homeless is an expense that can be ignored is selfish and shortsighted. If you don't mean it that way, you should avoid things that ring of "make XXX great again". This response is a snow-clone, used a lot when someone advocates for necessary social spending by those who feel over-taxed and unwilling to accept their role in paying for a solution.
Check the recent rant by the lawyer in the New York lunch room, where he quickly goes to the aggrieved claim that he's paying for some unspecified benefits for all those he deems to be 'illegals' who are working there. It's just a bad look. Not enough people read Dickens anymore.
From tomorrow's Sonoma West Times and News:
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Commentary: SWMC is failing; now what?
Jim Horn is one of five elected members of the governing board of Palm Drive Health Care District
- By Jim Horn
With the demise of its ill-fated drug testing scheme, Sonoma West Medical Center likely will fail by this fall because it can’t generate enough profit to pay its expenses and debts and sustain itself.
SWMC needs to pay its loyal vendors and give its dedicated employees 60 days notice that they will be laid off, as required by state law and common decency. The Palm Drive District needs to sell the hospital as a health care facility if possible, but for another use if necessary, so we can reduce our debts and pay our former employees and creditors. Then we can use our remaining parcel tax income to improve our community’s health in more cost-effective and sustainable ways.
The hospital’s failure is no surprise. From 1998 to 2014, Palm Drive Hospital suffered operating losses every year, totaling about $70 million. The district itself is in the fourth year of its second bankruptcy, still without an approved exit plan. Since reopening two and a half years ago as SWMC, the hospital has lost another $23 million, excluding temporary drug testing profits. According to the SWMC controller, assets likely will be exhausted within three months at the current operating loss rate of $800,000 per month.
In addition to its monthly expenses, SWMC owes more than $9 million to employees and vendors and to the government for payroll taxes. And that doesn’t include potential liabilities from Anthem’s $13.5 million claim for allegedly improper drug tests. Moreover, given the physical condition of our 40-year-old hospital, SWMC needs another $12.5 million over the next five years for maintenance and equipment.
Here's the bottom line: the hospital needs to generate nearly $400,000 profit per month, instead of an $800,000 monthly loss.
Does the $155 annual parcel tax help offset the hospital’s losses? Not anymore. The district owes $28 million for the bankruptcy and bonds it has sold to investors. Currently, nearly 70 percent of parcel tax collections go to repaying that old debt. Even the detached Russian River areas must continue to pay their share until the mid-2030s, at least. Another 20 percent of the parcel tax goes to running the district itself, leaving only about 10 percent to help pay for hospital maintenance. There’s nothing left to cover the hospital’s relentless losses.
As they have for the last 20 years, many hope that new services, more surgeries and better billing and collection will save the day. But no one has done the necessary market studies, business plans or cash flow projections to define and validate these services. And while billing and collection apparently have improved recently, they won’t be nearly enough to sustain the hospital over time.
In a belated effort to save the hospital by selling it, the district has issued an RFP seeking buyers for the hospital. I’ve asked for this since January 2017. Unfortunately, the current RFP limits prospective buyers to operating the building as either a hospital or an undefined “other health care facility.” However, both the district and SWMC admit they’ve been pursuing prospective hospital buyers and operators informally since 2016 without success. I proposed selling the property for other lawful uses as well, but the board majority declined.
Even if we find a buyer and successfully negotiate price and terms, a sale still requires district voter approval in an election that would take three additional months to schedule. A November 2018 vote is a dim possibility, but March 2019 is more likely.
Under any plausible scenario, and absent another Hail Mary, SWMC won’t last that long. If it follows past practice, it will try to stay open by cutting staff, deferring maintenance, delaying payments to frustrated vendors until they refuse to provide goods and services, then finally closing the hospital abruptly and laying off staff without the required 60-day WARN (federal Worker Adjustment and Retraining Notice). That happened in 2014 and nearly happened again in April 2017.
I hope it doesn’t end that way. Instead, SWMC could choose to close in an orderly fashion, using its remaining cash to pay its employees and vendors what it can. And the district can sell the hospital as a health care facility if possible, but for other uses if necessary, and move on to a more sustainable future. That could be the best ending possible for everyone.
Another view point in today's Sonoma West
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A better story ending
May 23, 2018
- By Rollie Atkinson, publisher
Miracles actually do happen in medicine and healthcare almost every day. Lives are saved and diseases get cured. For 77 years, up to this very week, doctors and nurses at the original Palm Drive Hospital, now called Sonoma West Medical Center (SWMC), have been healing pains, restoring well-being and performing unsung heroic work.
But last week the directors of the Palm Drive Health Care District voted to seek proposals to sell the hospital property. Board president Dennis Colthurst said, “we want a fully operating hospital with an E.R. and on solid ground.”
That’s a big miracle to ask for. Since it converted to a community-owned hospital in 1999, the hospital has lost almost $100 million and has suffered from low and declining patient use. Taxpayers have pumped more than $66 million into its coffers.
Palm Drive doctors and nurses have won awards for patient satisfaction and safety. A vigorous and hopeful community-wide campaign successfully reopened the hospital in October 2015 after a bankruptcy closing in April 2014. Sebastopol regained one of its largest employers. The county’s only emergency room west of Highway 101 was saved.
For decades, one business plan after the other was touted as a “turnaround” or “something wonderful.” A succession of management firms and more than a dozen CEOs have come and gone. Three times, west county voters overwhelmingly supported new bonds or increased taxes. (That long-term bond debt now totals $22 million.)
Alas, this “little hospital that could” may finally be out of miracles for itself. It’s a story that did not have to end this way.
In early 2014, a previous district board searched for any and all alternatives to keep Palm Drive open. In-patient use was down to 4-5 per day. Two national consulting firms concluded the hospital was too small to support acute care and an emergency room.
The consultants endorsed scaling back the hospital to an “urgent care” model with only on-call or emergency transfer coverage. Tom Harlen, the hospital’s CEO, made a passionate plea to “reimagine” Palm Drive to become a very different kind of “medical home.”
A potential strategic partnership with St. Joseph’s and Santa Rosa’s Memorial Hospital was explored. At the same time the Sonoma West Medical Foundation offered a plan to take over Palm Drive operations and save the emergency room.
Large and angry public meetings were held as district directors considered the options to downsize, lease or close the hospital. Debates were ugly. At one meeting the healthcare directors were called “murderers” for considering a bankruptcy closing. St. Joseph’s withdrew their offer of a strategic partnership, citing too much community rancor.
Harlen’s call for “reimagining” never happened.
The SWMC plan for a “new small hospital concept for the 21st Century,” never happened either. Instead of fulfilling a vision with a “no-wait” ER, wine country “destination medicine,” specialty institutes, a patient education center and “major gifts” from 28 prominent west county families, the current SWMC team has barely survived day-to-day cash flows.
SWMC’s current business plan has defaulted to the old Palm Drive plan that led to two bankruptcies, including the current one still in the courts.
When SWMC opened on Oct. 30, 2015, foundation chair Gail Thomas called it a “leap of faith,” where “everything must go right.” Despite the strong wills of leaders like Thomas and Colthurst, Dan Smith’s philanthropy, the loyalty of veteran physicians like Richard Powers and James Gude and other contributions, it is obvious not everything has gone right, to say the least.
More daily patients, restored strategic partnerships with St. Joseph’s or others, more extensive community outreach — and some of Harlen’s “reimagination” might have led us to a different story ending today.
We do not choose to give up hope on searching or finding a new miracle for Palm Drive. But sometimes the best miracles are found in compromises or reduced expectations. Maybe an urgent care center with an open door to west county’s fertile imagination is all we should hope for.
I have had occasion, for the last two Aprils, to use the services of the Sonoma West Medical Center Emergency Room. In both cases, the care I received was excellent. Dr. Kimbro and her staff treated me both times in a way that both inspired my confidence and made me feel they truly cared about helping me.
About eight months after the first visit, I realized I never got a bill. It took two phone calls and two visits to Billing to finally get a bill, almost one year after the treatment. That, obviously, is no way to run a business and, make no mistake about it, a hospital is a business. I wonder if my experience was a fluke or the norm? If the norm, management should be replaced or the taxpayers that have supported the hospital should take over the property in an effort to recoup their tax dollars.
Old GrandDad
PS.
Already got my bill for this April's visit and payed it. Seems like things are looking up as far as billing goes!
Old Granddad