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3 Attachment(s)
Hospital Sale - Measure A
March 5 is the deadline for voting on Measure A in the special election is bringing us closer to resolving the political turbulence swirling around the fate of our West County hospital.
A YES vote on Measure A is the only way to preserve an acute care hospital west of Hwy 101 while reducing future tax liabilities.
A NO vote could result in the loss of hospital services in West County forever while increasing the tax burden by millions of dollars with no benefit whatsoever to the community.
More information is attached.
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Hospital Sale
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Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt
Your description of the consequences of voting are not accurate. Probably has a lot to do with your deep involvement in efforts to keep a hospital in seebasstoepull. Selling the property to a private for profit company only guarantees that the public loses control. Yes, while we haven't managed it well in the past, and you have done more than your share, that doesn't mean giving up public ownership is automatically a good thing. Perhaps the old hospital property is the place to build affordable housing rather than downtown parking lots? I know you have donated millions to local health care, I appreciate that.
Quote:
Posted in reply to the post by jmarler:
...A YES vote on Measure A is the only way to preserve an acute care hospital west of Hwy 101 while reducing future tax liabilities.
A NO vote could result in the loss of hospital services in West County forever while increasing the tax burden by millions of dollars with no benefit whatsoever to the community.
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Re: Hospital Sale
Urgent Care Now Open in Sebastopol. Join us for a Grand Opening Reception Today! Wednesday, February 13th 4PM - 7PM in the conference room at Sonoma Specialty Hospital, 501 Petaluma Avenue in Sebastopol.
In keeping with this time of expressing and providing care for those near and dear to us, young and old, our family, friends and neighbors Sonoma Specialty Hospital is very proud to announce the grand opening of Progressive Urgent Care now open 7 days a week, 9AM to 9PM.
Sonoma Specialty Hospital and Progressive invite you to join us in celebrating our Urgent Care facility which is now open, offering the same compassionate, personal, no-wait patient service the County’s only acute care hospital west of HWY 101 has long been known for.
Urgent Care will handle about 90% of past Emergency Room visits and accepts most insurance. A visit to this Urgent Care facility is much less expensive than a visit to an Emergency Room.
Progressive Urgent Care is enhanced by its access to traditional services offered by Sonoma Specialty’s acute care facility including:
- Radiology
- Laboratory
- 3-D Mammography
- ICU
- Out-patient services
- Operating Room (out-patient surgeries resuming soon)
- Hospital admission when referred by a doctor
- Continued participation in the County Emergency Management Services program.
Many competitive-paying jobs for medical professionals
Sonoma Specialty plans to open the first ever Long Term Acute Care in Sonoma County (one of only 5 in Northern California) once the certification is complete later this Spring.
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Re: Hospital Sale
The December 2018 deferred maintenance study assigned no value to the building and $1.3 million in demolition cost. Why, then, would the appraisal two months earlier give a $3.7 million value of the building?
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Posted in reply to the post by Barry:
Board nails down terms of hospital lease/sale
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Re: Hospital Sale
I believe that is at least part of the reason behind Jim Horn's NO vote on the lease and sale to AAMG - and a reason to vote NO on Measure A.
Quote:
Posted in reply to the post by MFlute:
The December 2018 deferred maintenance study assigned no value to the building and $1.3 million in demolition cost. Why, then, would the appraisal two months earlier give a $3.7 million value of the building?
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Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt
Quote:
Posted in reply to the post by rossmen:
... Perhaps the old hospital property is the place to build affordable housing rather than downtown parking lots? I know you have donated millions to local health care, I appreciate that.
It seems crazy to tear down the hospital and rip out the parking lots to build apartments. What a waste that would be.
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Re: Hospital Sale - Measure A
from:
https://www.waccobb.net/forums/wacco...4_17-48-38.png
What you should know about Measure A
Who owns the hospital?
The Palm Drive Health Care District (or in other words, the people) owns the hospital building and the property it sits on. The district is primarily funded through an annual $155 per parcel tax. American Advanced Management Group (AAMG) took over hospital management in September after Sonoma West Medical Center could no longer fulfill their contractual obligations. AAMG renamed the hospital Sonoma Specialty Hospital, which is now operating as a long-term acute care facility with an urgent care center.
Why do they need a special election?
By law, voter approval is required in order for the district to sell the hospital building and the property.
If Measure A passes, what are the terms of the lease/sale agreement?
The approved terms between the district and AAMG include a $275,000 annual lease agreement with an option to purchase within the first two years for $5.2 million. The purchase price includes a $4 million cash down payment and a $1.2 million promissory note to be carried through a 10-year period.
If AAMG operates the hospital as a long-term or short-term acute care hospital with an urgent care facility for 10 years, the $1.2 million will be forgiven. A Deed of Trust secures the promissory note.
What happens if Measure A doesn’t pass?
AAMG is under a 10-year contract with the district to manage Sonoma Specialty Hospital, formerly Sonoma West Medical Center. When the management agreement was made, it included an exclusive option for AAMG to purchase the hospital. If Measure A does not pass, AAMG will still be under contract to manage the hospital.
What about the district’s debt?
If AAMG purchases the hospital, a $4 million cash payment is required right away. That money will be used to pay off the district’s general obligation bond, which will be triggered by the sale and be due in full. The other two bonds the district is paying off will need to be refinanced as taxable instead of nontaxable.
The sale of the hospital would in no way impact the district’s bankruptcy plan. The district’s most recent financial statement reflects a $1.3 million reserve for bankruptcy pay out.
Will the district be dissolved if the hospital is sold?
The district can be dissolved after the hospital is sold, but only by voter approval.
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Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt
Quote:
Posted in reply to the post by Goat Rock Ukulele:
It seems crazy to tear down the hospital and rip out the parking lots to build apartments. What a waste that would be.
How about converting the existing structure into small affordable living units?:2cents:
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Re: Hospital Sale - Measure A
I have been trying to follow this thread..but I do think that the need of walkable downtown mixed age affordable housing is something so important to the growth of Sebastopol that I don't know if I could put a $ sign on it. The hospital is very valuable. I t does not need to be demo'd just re-purposed. ..Why not sell flats like in Europe? The resident puts all kitchen.appliances,flooring in and when they leave they take it all! Folks use some imagination and start thinking just a little outside the box.. Has anyone put a pencil to cash flow to having the units rented or purchased? I say keep it and create..If you sell you will be sorry because it gives nothing back to the community., Our community needs housing! Less cars and more walkability
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Re: Hospital Sale - Measure A
I've been reading all the information trying to understand the two options we have. I'm hoping someone can offer an answer to a few questions:
1. If the measure passes, what assurance do we have that AAMG will actually operate the hospital for the long term? What will keep them from exercising their option to buy within the first two years, then close the hospital and either sell or develop the property for a profit? I see a financial incentive to operate for ten years, but nothing about limiting the sale before or after that.
2. If I understand the Sonoma West Times article quoted below, the District currently has a 10 year agreement with AAMG to operate the hospital. I found it on the District website. That seems like our best chance for having an operating hospital for the next ten years. Other than debt accruing, what is the downside of letting that agreement continue?
3. If the District's debt grows, does that just mean that the parcel tax ($155/year) goes on for a longer period of time? If that's the case, I'm not sure I care. I figured that was a permanent thing when I voted for it years ago.
Quote:
Posted in reply to the post by Barry:
from:
What happens if Measure A doesn’t pass?
AAMG is under a 10-year contract with the district to manage Sonoma Specialty Hospital, formerly Sonoma West Medical Center. When the management agreement was made, it included an exclusive option for AAMG to purchase the hospital. If Measure A does not pass, AAMG will still be under contract to manage the hospital.
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Re: Hospital Sale - Measure A
What’s unclear to me is:
if the sale goes through and the voters vote to dissolve the district does the parcel tax end?
and
There was a high appraisal which included giving the building value and a low appraisal calling for demolition of the building. The low appraisal value was used for the sale price. However, the building is not being demolished. It’s being used by the purchaser. So why use the lower appraisal value as the price?
and also
why the language on the ballot that says the property can be bought at appraised value when it appears to me that the value has been already determined and the writer of the proposition seems to just be avoiding saying what it actually is, and that it is based on the lower of two appraisals. I am either in the dark about the full picture or the wording of the ballot measure seems misleading to me.
i humbly invite a response from someone more informed than myself.
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Re: Hospital Sale - Measure A
I believe the questions are part and parcel of the reason Jim Horn, a member of the PDHCD board, voted no on the lease and sale. Your "no" vote would agree with him..
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Re: Hospital Sale - Measure A
After reading through this whole thread, unless I missed something or misunderstood something, I still don't know, should the sale go through, if the parcel tax goes away or not. Can anyone answer this with a yes or no?
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by photolite:
...should the sale go through, if the parcel tax goes away or not. Can anyone answer this with a yes or no?
No
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by luke32:
No
To elaborate on that, the Hospital District went into debt that is backed by the parcel tax, so the parcel tax will continue until the debt is paid off. I've always assumed that we'll be paying the parcel tax forever.
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Re: Hospital Sale - Measure A
Barry,
In response to your request, I'm not sure what questions you are trying to clarify but here are some answers to a few of the posts on this thread:
1) Converting the hospital to most other uses is not practical because of the special nature of the construction and mechanical systems and the high cost of renovation. Wright construction estimated the cost of conversion to an office at $10M, much more than the value of the building or cost of tearing it down (Estimated at $1.5M by the appraiser.)
2) The confusion with the appraisal(s) is due to the fact that the initial appraisal did not have the cost of deferred maintenance and was based on a revenue stream generated by 90% occupancy. Once the appraiser received estimates of necessary uprades, they re-appraised the property at $5.2M. (This was the same appraiser, not a different company.) AAMG's bank also did an appraisal that was $4M. The proposed sale price is $5.2M, the higher of the two.
3) The problem with thinking that the hospital can continue operations under the district is that someone needs to invest heavily in the property to bring it up to more current standards. The district does not have the money to do this and AAMG will have a hard time raising this capital if they can't use the property as collateral. For this reason, I would not expect AAMG to stay around if a sale does not happen.
4) While AAMG has a 10 year agreement with the district, it does not preclude them from leaving if they are not able to purchase the property and there is no reason to think that they won't since financing the improvements will likely not be possible. It also does not preclude the hospital from closing because necessary upgrades are not made,
5) There is no guarantee that AAMG will continue to operate a hospital over the long run other than they will have to pay the full appraised price for the property if they quit within 10 years. (They will pay $5.2M instead of the $4M they are initially to pay.)
6) While this may not be a deal that everyone likes, it is the best deal the district has and no other players came to the table during a very lengthy RFP process by the district.
7) Taxes will not go away until all bonds are repaid. They will be lowered by the payment of the original GO bonds once the property is sold and they could be lowered further if the district is disbanded after a sale by reducing the overhead of the district but will continue until bonds are repaid.
The people who are advocating a No vote think that they know more than two appraisers, four of the five board members, and those of us who have been involved over the last 20 years. Most of them are no longer in the district as they have recently stated themsleves and don't care if there is a hospital in Sebastopol or not. The others, like Jim Horn beleive they can get more money out of a turnip but badly underestimate the mess that will be caused.
Best Regards,
Dan Smith
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Re: Hospital Sale - Measure A
Several points should be made.
One, those who would vote yes tend to want a "hospital" at all costs, any kind of hospital, whether it offers emergency room services or not. They conflate the reason the Palm Drive Health Care District and the parcel tax were established - to establish hospital emergency room services - and "hospital". See Joan Marler's original post on this topic, above, particularly where she laments " the loss of hospital services in West County". And from Dan's post "The people ... who are advocating a No vote don't care if there is a hospital in Sebastopol or not." Its emergency room care that people care about.
Two, Jim Horn was correct how many years ago when he said the proposed Sonoma West Medical Center would not succeed financially. Dan Smith was wrong. So while the issue now is not financial feasibility, whose judgement do you go with this time on the appraisal? Jim Horn or Dan and the others? Where would the bond debt be now if we had funneled the parcel tax into bond payments instead of Sonoma West Medical Center these past X years?
To me its sort of like going with Hilary again because maybe this time she will get it right.
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by luke32:
...To me its sort of like going with Hilary again because maybe this time she will get it right.
Luke,
If you think Hillary would have made a worse president than Donald Trump, I am not sure you have been paying attention.
Quote:
...Two, Jim Horn was correct how many years ago when he said the proposed Sonoma West Medical Center would not succeed financially. Dan Smith was wrong. So while the issue now is not financial feasibility, whose judgement do you go with this time on the appraisal? Jim Horn or Dan and the others? Where would the bond debt be now if we had funneled the parcel tax into bond payments instead of Sonoma West Medical Center these past X years?
It is true that I underestimated the challenge of reopening the hospital, however your assumption that the district supported the hospital over the last few years is mostly false, since SWMC bore almost all of the financial costs. You might ask why Jim is a minority of one in opposing the sale (that he voted to put on the ballot.)
Please don't take my word for anything, but you might want to listen to Richard Power, who Jim recruited to run for the board and now supports this sale. So if Jim doesn't want to see the hospital sold, why did he vote to put the initiate on the ballot, just so we can waste a lot of money and time?
Dan Smith
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Re: Hospital Sale - Measure A
Dan -
I voted for Hilary. I think she would have made a very good president. She ran a poor campaign and Its nominating her again that I think would be a very bad idea.
With regard to PDHCD support of SWMC, I don't know what portion of the total annual tax receipts (@$155/parcel) went to SWMC during its lifetime. My point was that whatever tax money went to SWMC could better have gone to pay down the bonds.
Could you 'ballpark' the amount of PDHCD tax money that went to Sonoma West MC over the years - just so we know whether we're talking about small change or to paraphrase Senator Everett Dirksen, "...a million here, a million there, and pretty soon we're talking about real money".
I am aware of your very generous support of SWMC and commend you for that.
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Posted in reply to the post by farmerdan:
... however your assumption that the district supported the hospital over the last few years is mostly false, since SWMC bore almost all of the financial costs...
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by luke32:
...Could you 'ballpark' the amount of PDHCD tax money that went to Sonoma West MC over the years ...
Luke,
I believe the number would be about $1.5M that the district provided to SWMC but $600K of that was for equipment that SWMC transferred to the district. Jim may have a more accurate number.
That does not take into account that SWMC spent about $8M upgrading the building and purchasing equipment and supplies that all now belong to the district. In total, SWMC spent over $15M in donations getting the hospital going. So, the district got a lot more than it paid for even if you just consider all of the improvements. Unfortunately, this does not make the hospital more valuable because there is still a lot of deferred maintenance but it did allow AAMG to take over an ongoing business that was relatively well equipped and supplied and they may be able to run a profitable business.
I hope it is obvious that I would not do it again (and certainly do not have the capital), but it was a gallant effort that saved some lives and now, perhaps will transition to something beneficial for the community going forward. It had long been my belief that the hospital needed to be managed by a system and that restarting it might attract Memorial or the Adventists and in fact, the Adventists showed a good deal of interest at one point. (They manage 7 hospitals north of here but finally decided ours did not fit because they could not run the clinics in the area like they do in the north.)
When you take on impossible tasks sometimes you lose and this was one of those times for me. But I do not regret trying and I certainly think the district was not harmed by it since there is a possibility now on the table that would otherwise not exist. I think it will be a shame if the hospital is torn down but it is really up to the voters, not me.
We can argue till we are blue in the face about who is to blame for our predicament but the reality is that healthcare is now the property of corporations, insurance companies, and big pharma and that is the real reason. The age of the family doc and the community hospital is gone and won't return. Perhaps we tried too hard to keep an emergency room in our town with local doctors and for that, I certainly share blame. But the fountains of vitriol that continue to pour forth against board members and others do not reflect well on us as a community.
I agree about Hillary. The reality is that she was too easy a target for the Russians and the Trumps.
We live in ugly political times unfortunately and I fear for us all that the nastiest win and the most thoughtful lose.
Dan Smith
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by 1104GT:
I've been reading all the information trying to understand the two options we have. I'm hoping someone can offer an answer to a few questions:
1. If the measure passes, what assurance do we have that AAMG will actually operate the hospital for the long term? What will keep them from exercising their option to buy within the first two years, then close the hospital and either sell or develop the property for a profit? I see a financial incentive to operate for ten years, but nothing about limiting the sale before or after that.
2. If I understand the Sonoma West Times article quoted below, the District currently has a 10 year agreement with AAMG to operate the hospital. I found it on the District website. That seems like our best chance for having an operating hospital for the next ten years. Other than debt accruing, what is the downside of letting that agreement continue?
It is my understanding that there no longer is, nor will there be a hospital open to the public at the Palm Drive location. The “hospital” that now exists is currently a short term acute care facility, in the process of applying for long term status. Short or long term, the facility will only serve folks rehabbing from severe acute illness or surgery. In function this is similar to, if not the same as the Apple Valley Post Acute Rehab off of Hwy 116 just on the edge of town. These facilities are meant to be an in between stop following a hospital stay before returning home. This is not a general hospital that will serve you if you think you're having a stroke or heart attack. That kind of hospital care is no longer available in Sebastopol. In my opinion, this is an important distinction when we are talking about AAMG operating “the hospital”. So whether it's a 10 year contract at $100,000/mo that we pay to AAMG or a lease option for them to buy the facility at below market value, either way there is no general hospital.
AAMG is a Modesto based company with a business model that appears to be one of managing, leasing and buying small failing rural hospitals and converting them to some form of specialty care facility. Don't know if that's good news or bad news, guess it depends on what you're wanting. It does however seem to lend credibility to the idea that they are in business to stay rather than just turn the property for a profit. That having been said there is a possible twist.
The word in the medical community regarding these acute care facilities is that Medicare is seriously considering not covering the costs. Should these facilities get dropped from Medicare covered services it's likely these specialty hospitals will have a bleak future. If the acute care rehab center goes under, I wonder if we would also lose our new urgent care facility. But at least for now we have an urgent care facility, something I believe Jim Horn was suggesting we consider way back in the save our hospital campaign days...
While I'm on the subject, I believe we've come full circle to Mr. Horn's assessments of the hospital's transitions. Starting with his measured opinion that SWMC's plan was not financially feasible and concluding with the suggestion that instead of trying desperately to preserve the hospital and ER, we might consider a transition to an urgent care and outpatient services facility. Less than 5 years later and I don't know how many millions of dollars spent, here we are, right where we could have started, serving the majority of our community with Urgent Care and Outpatient Services. Subtle difference, we're paying an outside management company $100,000/mo to run the operation. Now the same people who convinced us to save our hospital are urging us to sell our hospital because once again, the hospital is bankrupt. And who do we get to sell our only assets to? The lowest bidder of course, the for profit Modesto based corporation. I think this would be a good time to notice that Jim was right on the money, as the old phrase goes, and to say thank you Jim for your thoughtful and accurate insights and continued efforts to guide our community through our hospital's perils.
And now as I understand it, Jim is once again the sole dissenting voice. His opinion is that the sale, as it has been negotiated, is a bad deal for us. His reasons are sound, but then again there are some valid arguments in favor of this deal, it's a tough call. Once you've hit damage control the choices are never optimum. But one salient point that I consider important for all of us to realize, which ever way the vote goes, is that there is no hospital, as we typically think of when we discuss “our hospital”, to save.
The Measure A literature implies that a yes vote will preserve “the hospital” for years to come. I perceive that language as subtly misleading, which leaves me a bit skeptical of the yes vote proponents. Perhaps it's simply a matter of semantics but let's be clear, this is what we have: an Urgent Care Center which handles non-life threatening conditions, Outpatient Services providing labs, x-rays, etc and an Acute Care Facility which rehabs people after severe acute illness or surgery. There is not now, nor will there be in the future a hospital serving the general population regardless of how the vote goes.
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Re: Hospital Sale - Measure A
My explanation of the appraisals is the same as Dan Smith's but with a little more in the weeds.
The higher value by the same appraiser preceded the Wright Contracting estimates of $28M in deferred maintenance. Of this, $9M was estimated by Wright, and utilized by the appraisers for immediate requirements to make the building commercially viable. One can argue with these numbers and the necessity of each line item, but I heard no one from the board (or anyone else for that matter) arguing that. Wright is relatively well known with a good reputation in the commercial field and predates me (but not Norbert).
The appraisers were asked to revise their value opinion given this new information. You can't utilize the higher value if there's new facts that tend to disprove the old. Appraisers aren't qualified to inspect roofs, heating equipment, etc. and generally assume they're OK unless otherwise known or observed.
It's standard appraisal practice to determine whether the value of the building and land, as it's currently utilized or can be feasibly utilized for some other purpose, is worth more than the land, as if vacant.
This is a hard concept for most people to grasp but we've seen it recently with the former lumber yard/tractor supply (now approved for a hotel) and the former auto dealership (now a CVS). Both improvements were demolished. The buyer was paying for the land (less demolition costs) and not for the buildings which were obsolete.
So, the question becomes: What's the value of the land, as if vacant and less demolition costs, and what's the value of the building plus land as utilized for a hospital. All the approaches to value by the appraiser showed a value of less than $600K as improved and $5.2M for the land less demolition.The higher of the two is the "highest and best use", i.e. the market value.
Jim Horn's only real opposition that I heard at the hearing I was at was his objection to the rent credit AAMG is getting for any deferred maintenance money they spend. I agree with Jim. The value and the rent are both based on land only and so unless they're spending more than $9M on the improvements, it ain't going to benefit us, the owner.
On the other hand, the rent is only $275K per year for a maximum of six years, including extensions. This is a small price to pay given that the district is $20M+ in the hole, has had multiple bankruptcies, losing close to $1M per month and doesn't seem to be viable to any other entity given the lack of response to the District's RFP.
I've voted for every hospital parcel tax and would have supported many more, but will be voting Yes on Measure A. I hope AAMG can make a go of it.
Howard
Quote:
Posted in reply to the post by Norbu:
...There was a high appraisal which included giving the building value and a low appraisal calling for demolition of the building. The low appraisal value was used for the sale price. However, the building is not being demolished. It’s being used by the purchaser. So why use the lower appraisal value as the price?
and also
why the language on the ballot that says the property can be bought at appraised value when it appears to me that the value has been already determined and the writer of the proposition seems to just be avoiding saying what it actually is, and that it is based on the lower of two appraisals. I am either in the dark about the full picture or the wording of the ballot measure seems misleading to me.
i humbly invite a response from someone more informed than myself.
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Re: Hospital Sale - Measure A
Howard,
Well said!
One issue that I see is that closing the hospital was very expensive in 2014 and was one of the major reasons the district did not have a good way to exit bankruptcy. If the district has to close it again, this could easily add to the cost of selling the property and the delays with having to go back to voters to sell will also continue the costs for the district.
Any developer who was going to buy the property would want to do so contingent on the city approving a project. We all know what a crapshoot this can be and it can take years.
Dan
Quote:
Posted in reply to the post by Howard:
My explanation of the appraisals is the same as Dan Smith's but with a little more in the weeds....
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Re: Hospital Sale - Measure A
I am one of those that support the sale of the hospital to AAMG. In addition to being convinced this is the best deal we will get for the property (as enumerated in the thread), it is the only option that will retain the hospital beds in Sonoma County. Sonoma County is aging and the demand for hospital beds continues to increase with the aging of the population.
There are many times a year, mostly in the winter months, where our local hospitals are full and unable to accept new admissions. This results in a search for any hospital bed outside of Sonoma County and the person is transferred to the hospital with an available bed. If no bed is available the only alternative is to wait in the Emergency Department for a bed to become available, which can take many many hours and at times a day or more.
If I am in a hospital it is important to me to have family and friends close, and to be in the same area as my primary care physician. In my experience, care is better when a family member or friend is present as a visitor as much as possible. This becomes difficult or impossible for many of us when the hospital is far away from Sonoma County.
With AAMG offering hospital services in Sebastopol, the total number of hospital beds in Sonoma County is 37 more than if the hospital is no longer there. That to me is something that will someday be crucial for at least some of you reading this thread.
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personal experience with Urgent Care last Friday, February 22, 2019
Last Friday, on our way to a restaurant in Petaluma, my wife slipped and fell as she crossed the street. Bracing herself against the fall, she hurt her wrist badly. In the restaurant, we asked for a bag of ice and drove home trying to decide what to do. She thought she might have broken a bone.
It was about 6:30, and we decided to pull into what we still think of as Palm Drive Hospital, not knowing what kind of reception we'd get. We thought we might be turned away because it might be considered an "emergency" and Palm Drive no longer has an ER.
My wife gave the receptionist her Medicare card and Anthem/Blue Cross supplement ID, filled out the usual clipboard form of medical history, and a nurse came out and explained that if we needed x-rays, we might get billed for a co-pay.
Dr. Holmes took us back to an examination room, examined the wrist and arm, and said he'd see us again after he read the x-rays. A few minutes later, the three x-rays came back: there was no fracture.
We left about an hour later with my wife's wrist in a flexible splint after Dr. Holmes offered a pain medication, explained what we could expect recovery to be, what self-treatment she should do, and what possible complications we should look out for.
So that's what Urgent Care was for us last Friday night.
We're voting for Measure A.
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Re: personal experience with Urgent Care last Friday, February 22, 2019
Kevin,
My wife also went to the urgent care and got excellent treatment by Dr. Flowers.
But what was more important is that Dr. Flowers saved a woman's life the day before.
Most urgent care facilities are no where near as well equipped as Sonoma Specialty Hospital.
She will be very glad to hear your story.
Dan Smith
Quote:
Posted in reply to the post by Kevind:
Last Friday, on our way to a restaurant in Petaluma, my wife slipped and fell ...
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Re: personal experience with Urgent Care last Friday, February 22, 2019
LAFCO
Susan attended and spoke out at the January LAFCO (Local Agency Formation Committee) meeting where proponents of detachment from the river joined forces with people in Bodega Bay to gather enough signatures to consider detachment. Unfortunately, it has been hard to share clarifying information to Bodega Bay residents who receive regular emails to which outsiders have no access. Incorrect information has been circulating and signatures gathered on that basis, such as “The hospital has remained closed.” So, it has been important for there to be voices of clarification and support for our hospital at the LAFCO meetings to set the record straight at that level. LAFCO's next meeting is scheduled for March 6 at 2:00. LAFCO meetings are held at 575 Administration Drive, Santa Rosa. It is very helpful to have supporters of the hospital and District present at meetings of the Local Agency Formation Committee, who makes decisions about our Health Care District.
Urgent Care is Open!
We are delighted that Urgent Care is open 7 days a week, from 9 am to 9 pm and receiving grateful patients. The soft opening was early in February, and the Grand Opening Celebration was held Wednesday before Valentine’s Day. Despite a steady downpour, about 75 or more people attended the opening and toured the facility. Even the first week, Urgent Care was saving lives. Earlier that opening day a patient was presented to Urgent Care in a grave condition with breathing difficulties. Our doctors and medical staff were able to immediately stabilize her and sent her to Santa Rosa in an ambulance. Without their intervening care the woman would probably not have survived the additional 30 minute trip. The Progressive Urgent Care doctors Pankaj Malhotra and Dr. Libby Flower have been kept busy each day.
Our Urgent Care accepts most insurance plans plus Medicare. We are delighted that they can cover about 90% of the cases presented at our former ER and that West County now has a drop-in, no-wait option for those with non-life or limb-threatening medical needs. Unlike other Urgent Care facilities, Sebastopol’s has access to the acute care hospital facilities for radiology, lab work and other services for which most Urgent Care doctors have to send patients elsewhere. Several of our foundation community have used Urgent Care and give it glowing reviews.
Election Update:
On December 3rd the District Board voted 5-0 to sell the hospital and to pursue negotiations to determine the terms for the lease/sale. Ballots for Measure A were received around the 6th of February. On February 5th, with negotiations complete, the Board voted 4-1 to accept the terms (Directors Dennis Colthurst and attorney Richard Power represented the Board in these negotiations), with Mr. Horn voting No because of his “gut feeling” that we could get a better deal. The District had five Town Hall discussions scattered throughout West County and one League of Women Voter’s Debate to discuss issues and concerns. There are relevant articles at www.sonomaindependent.org that address questions about the hospital and our managing company AAMG, the issues and that answer many of the questions raised at the various meetings. (By the way, Kudos to Sebastopol’s own Jonathan Greenberg, editor of Sonoma Independent, for his recent Washington Post article which can be read in full at: www.sfgate.com - “Opinion: The 6 essential cons that define Trumps success”).
A recent Press Democrat editorial addressed the daunting labyrinth one must negotiate for campaign compliance. We’ve experienced this maze for ourselves and are finally on track to finish the required reporting after filing a few days late. Fortunately, the IRS has clarified that a “non-profit” like ours can indeed sponsor and contribute to campaigns around specific issues. A Sonoma West Times article this week quotes criticized the postcard/flyer demonstrating the lively debate about the fate of our hospital throughout West County. Contrary to what opponents appear to be saying, the information on the card is accurate since no claims were made about contractual terms, just likely outcomes depending upon the vote. Please check out www.sonomaindependent.org and remember to mail in your Yes Vote by March 5.
The terms of the negotiated deal are posted on the Palm Drive Health Care District web site (https://www.pdhcd.com/), if you are curious.<
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Re: personal experience with Urgent Care last Friday, February 22, 2019
is walk-in urgent care going to be part of the plan going forward?
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Re: Hospital Sale - Measure A
AAMG is running walk-in urgent care now 7 days a week from 9:00AM to 9:00PM open to the public.
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Re: Hospital Sale - Measure A
The Urgent Care is proving itself very useful. My friend Ronnie passed out. She tried to get into her MD but no luck. She went to the Urgent Care at the hospital and received some of the best medical care she has had she says.
A few more days of rain and we would have all been trapped in West County. The Urgent Care could easily been turned into a 24 hour facility in an emergency. Extreme weather could very well be in our future and we may need to make it on our own here in West County for days or a week at a time.
Much better to use the hospital as a medical facility than turn it into condos or apartments.
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Re: Hospital Sale - Measure A
Mike,
The Urgent Care stayed open until 2:00Am during the flood.
Not sure how many people used it but it was there...
Dan
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Re: Hospital Sale - Measure A
It is my opinion that if we vote yes, as I did, on Prop. A we will be saving lives, perhaps even yours or those of beloved ones. Balancing the life-saving qualities of this hospital with the minimal amount of taxes will help improve the health of many and literally save lives. When I drive by the parking lot, it is already often close to being full, so people are using the Sebastopol Specialty Hospital. This new operation is also serving as a school with the many excellent, free presentations on health related issues, given mainly by M.D's.
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Re: Hospital Sale - Measure A
Having the hospital be an (enhanced) urgent care center is clearly the right answer.
However, what does that mean for how to vote on Measure A??
I'd love to hear from Jim Horn or others about why they think we should disapprove of this proposed arrangement and what would happen if it is disapproved.
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Re: Hospital Sale - Measure A
Thanks Barry for putting that question out there. I too would love to hear from Jim, I think some clarity would be very valuable. As I read what folks are saying on various discussion sites I get the impression that many believe the hospital is a facility available to the general public. My understanding is that it is not – it is an acute care facility. Only the portion of the hospital that was the ER is now the Urgent Care Center. The labs, x-ray & imaging services are still at the hospital and available as needed to folks coming in to the Urgent Care Center or via doctors' order requests. Who owns that equipment? Who owns and operates that business entity? I don't know but I would like to.
The Urgent Care Center is owned and operated by AAMG. That would or should mean that AAMG is leasing that portion of the property from the District. But I don't know, is that true? What is the arrangement regarding that situation?
Sonoma Specialty Hospital is managed by AAMG but they do not own the business. I'm guessing they are still operating on the 10 year $100,000/mo agreement that was made with the District to transition the hospital to a long-term acute care facility and manage it. If that's correct does that necessarily mean that if they can't buy it from us they will walk on the 10 year management agreement? Part of that agreement is that we have 5 years at 5% interest to reimburse AAMG for their investment. Some portion of the $100,000/mo is advance payment on some of those costs. I think it would be beneficial to know what portion of that $100,000/mo is capital investment vs management fees?
In early September 2018 the shingle went up changing the name as well as the function from SWMC to Sonoma Specialty Hospital. Unlike the Urgent Care Center AAMG does not own the Acute Care portion of the hospital, they are merely managing it. At least this is my understanding. However, Sonoma Specialty Hospital is an LLC that was filed with the state of CA in early August of 2018. The member/manager is Gurpreet Singh, the doctor that owns AAMG. So who actually owns the acute care business that is being operated in our hospital? And why incorporate if you're not planning on sticking around?
Dr Singh has made a business of buying small rural failing hospitals on the cheap and turning them into profitable specialty facilities. Each time he appears to file a new limited liability corporation with the state. Don't know if these are single member LLC's or if each time he is in partnership with some of the facilities' original owners, doctors, investors, etc. That might be a worthwhile question to get some answers to.
As I see it there are three different business operating out of the old hospital facility: Outpatient Services, an Urgent Care Center and a Long-Term Acute Care Facility. Currently the entire hospital property is owned by the district. So what are the current arrangements with each of these business entities? Why are so many assuming that if the sale is not approved we will lose it all? Is the sale of the hospital property an issue that can be readdressed at a later date with either a different or similar negotiation?
I think, as apparently Barry does, that we might want to ask at least a few more questions.
Quote:
Posted in reply to the post by Barry:
Having the hospital be an (enhanced) urgent care center is clearly the right answer.
However, what does that mean for how to vote on Measure A??
I'd love to hear from Jim Horn or others about why they think we should disapprove of this proposed arrangement and what would happen if it is disapproved.
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Re: Hospital Sale - Measure A
Rustie,
I can answer some but not all of your questions:
Paragraph 1: The district owns all of the equipment and the operation at present with the possible exception of the operations of urgent care. While SWMC bought much of the equipment, the contract it had called for all equipment to be transferred to the district if SWMC quit managing for the district. AAMG is a contract manager for the district.
Paragraph 2: I am not aware of the arrangement between the district and the Urgent Care but think it is likely that the urgent care is operating as a separate entity since the district did not have a license to operate urgent care.
Paragraph 3: I am not clear on this. Someone from the district will need to answer.
Paragraph 4: Please understand that 'acute care' simply means 'hospital'. Both an LTAC (Long Term Acute Care) and any other hospital are licensed as 'acute care' facilities. AAMG's plan is to focus on LTAC, which requires additional certification and does not allow full emergency room services, but the license would continue to be 'actute care'. Acute care includes inpatient and outpatient services, surgery, etc.
AAMG is planning to stick around but the big issue is that millions of dollars are needed in building improvements. As a manager, AAMG does not have access to this capital, as an owner, they do. It is common to create separate LLCs to insulate the business from losses with other entities and visa versa.
Paragraph 5: Don't know Dr. Singh's other business relationships but one has to asume that he has capital partners for each of his projects since they take many millions of dollars to get off the ground.
Paragraph 6: There is only one hospital business, not two. As I said above, it is likely that the urgent care is a separate business since the district did not have a license to operate urgent care. (Dr. Singh had to obtain one. This is why there was a gap between closing the ER and opening urgent care.)
As I stated earlier, the issue with not making a sale at this time is that someone needs to come up with many millions of dollars to ugrade the building. The district can't do this and Singh can't as the manager but he can borrow the money if he owns the property and the business. There are many upgrades that have to be made now and cannot be put off. Also, the business will likely not be profitable for years, which means that the district has to take the risk for these losses unless the business is transferred to Singh.
Please be aware that a lease to Singh would also have to go to vote and would not necessarily provide the security a lender will want to provide capital to upgrade the facility.
For these reasons, we should expect that if we vote no, the hospital will be closed and sold for development because these upgrades cannot be made and the hospital will not be able to operate without them. I believe that this is exactly what Jim and his friends want since he is well aware of all of these issues and feels 'in his gut' that the district will get more money selling to investors than the appraisers do.
But let's hear from him.....
Dan
Quote:
Posted in reply to the post by Rustie:
Thanks Barry for putting that question out there. I too would love to hear from Jim, I think some clarity would be very valuable. ...
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Re: Hospital Sale - Measure A
Thanks Dan for that info, much appreciated. A couple of salient points that you've shared. AAMG is planning to stick around. I would think so, they've been establishing their business at our hospital supposedly before any sale negotiations have been in place. That indicates to me that we can vote no to the sale and the entire facility will not necessarily shut down.
The problem, as you see it, is acquiring capital to make the necessary improvements. Supposedly the capital needed would only be available to AAMG by selling the property to them. If I've understood you correctly, it is your opinion that indirectly, the closure of the entire facility is inevitable if we don't vote to approve the sale. Yet it appears that six months ago, September 2018, when the facility officially became Sonoma Specialty Hospital, Dr Singh took ownership of all the business operations. Or is it that his corporation, SSH, owns only the Urgent Care Center and his other business AAMG is managing the rest of the facility for the District?
As we know, Dr Singh, the owner of AAMG is also the owner of Sonoma Specialty Hospital, which was formed early August. This means that two months before the board had an appraisal of the property, and seven months before an option to purchase was presented, Dr Singh moved forward with his new corporation. He opened and invested in his new business on the assumption that he would undoubtedly purchase the property. A purchase of property that, in your scenario, would be necessary for his business to be viable. A purchase that had not yet been negotiated, a property that had not yet been appraised and a sale that had not yet been presented as an idea to the voters let alone approved. I think Dr Singh is a smarter business man than that – this is not his first rodeo.
As it appears to me Dr Singh is either the manager of the hospital on behalf of the District or he is the owner/operator of the businesses housed in the district's facility. Be it manager for the district or new owner of the business, why have we not approved this before it happened? Is our approval not necessary for the transition that has taken place? Perhaps not if AAMG is the manager for the District, but then what are the terms of that agreement? Is this the $100,000/mo management contract that we've been talking about? If so, why have we changed the name to SSH? My understanding was that when Palm Drive became SWMC, a board decision that did not require voter approval, the District was not paying SWMC to manage the hospital. So if we are paying AAMG $100,000/mo to manage our facility why did we change the name to SSH, a separate and legal entity owned by the same person who owns AAMG?
And what about the Urgent Care Center which is a business entity owned by SSH, also managed by AAMG? If that portion of the facility is a privately owned business operating on District property did that arrangement also not need voter approval? Assuming it didn't, isn't some rental or lease agreement necessary? Or are we just letting Dr Singh run his business on our property rent free? And if there is a lease agreement for the Urgent Care Center what is it? The lease agreement pending our vote on Measure A covers the entire facility but that is not yet in place. Does this mean that since September the Urgent Care Center has been operating without any agreement? It would seem careless on the part of our District if they entered into a business arrangement like this without any legal documents.
On February 01, 2019 the lease agreement between Sonoma Specialty Hospital, LLC, (SSH) as the lessee and the Palm Drive Health Care District (PDHCD) as the lessor was drafted. Short version of the lease; in exchange for rent SSH will perform $275,000 each year in deferred maintenance. Among other items in the lease, SSH has the right to execute Leasehold Mortgages, which would provide a means of obtaining the needed capital for improvements. The lease agreement also includes the option to buy the property as per the terms we all now know.
Dr Singh incorporated in August. The transition to SSH took place in September. The lease with option to buy agreement was drafted in February. The vote to approve all of this is March 05. What am I missing? We seem to be voting retroactively on much that has already been done. Why has this been presented to us on such short notice? Dr Singh apparently had some idea of his intentions back in August when he incorporated Sonoma Specialty Hospital, LLC. Why are we expected to fall in line at the last minute to save the hospital or lose all? I suspect there's more to the story and more possibilities than we are being told.
Quote:
Posted in reply to the post by farmerdan:
Rustie,
I can answer some but not all of your questions:
Paragraph 1: ...
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Re: Hospital Sale - Measure A
Rustie,
- Just a few points: AAMG is currently managing the hospital for the district. They do not own the business, the equipment, the building, or the inventory. (Other than perhaps the urgent care.) I'm not sure what leads you to believe they took title to the business but that is not true.
- There is an agreement to lease to AAMG in the future but this has to be approved by voters before it can come into effect. That is what the election is for. It is not legal for the district to lease or sell more than 50% of its assets without voter approval.
- The district did not need voter approval to rent space for the urgent care as this represents less than 50% of the assets.
- If there is a no vote, the district is still at risk for the operations (as required by law) until another vote could be approved and cannot by law lease the hospital to AAMG. The only other option is closing the hospital.
- In the meantime, with no lease and no purchase, AAMG will not be able to raise capital to finance improvements, which will most likely mean the closure of the hospital in the near future. As I said before, this appears to be exactly what Jim Horn has wanted for a long time. I have not seen him refute this.
- I have not seen any refutation of these basic facts anywhere.
Dan
Quote:
Posted in reply to the post by Rustie:
Thanks Dan for that info, much appreciated. ...
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Re: Hospital Sale - Measure A
In addition to the potential closing of the Sebastopol hospital, which will cause loss of life and other medical problems, the following article in today's NY Times documents how rural nursing homes are also closing. This means that some older folks will have to move away. Following is a link to that article and its first few paragraphs:
https://www.nytimes.com/2019/03/04/u...s-closure.html
By Jack Healy, March 4, 2019
MOBRIDGE, S.D. — Harold Labrensz spent much of his 89-year life farming and ranching the rolling Dakota plains along the Missouri River. His family figured he would die there, too.
But late last year, the nursing home in Mobridge, S.D., that cared for Mr. Labrensz announced that it was shutting down after a rocky history of corporate buyouts, unpaid bills and financial ruin. It had become one of the many nursing homes across the country that have gone out of business in recent years as beds go empty, money troubles mount and more Americans seek to age in their own homes.
For Mr. Labrensz, though, the closure amounted to an eviction order from his hometown. His wife, Ramona, said she could not find any nursing home nearby to take him, and she could not help him if he took a fall at home. So one morning in late January, as a snowstorm whited out the prairie, Mr. Labrensz was loaded into the back of a small bus and sent off on a 220-mile road trip to a nursing home in North Dakota.
“He didn’t want to go,” said Mrs. Labrensz, 76, who made the trip with her husband. “When we stopped for gas, he said, ‘Turn this thing around.’ ”
More than 440 rural nursing homes have closed or merged over the last decade, according to the Cowles Research Group, which tracks long-term care, and each closure scattered patients like seeds in the wind. Instead of finding new care in their homes and communities, many end up at different nursing homes far from their families.....
(the article continues)
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Re: Hospital Sale - Measure A
Shepherd,
Healthcare in the US is a slow rolling disaster.
The Canadians have it much better figured out.
Dan
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Re: Hospital Sale - Measure A
Hey Dan,
Thanks to continue the dialog on this issue. I don't believe I said nor did I intend to convey that title on any property had changed. Sorry for any misunderstanding. What I did say is that the name of the facility changed. My question is, did the ownership of the business change with the name change? I understand that AAMG is the contract operations manager, as apparently SWMC was when that name change took place. However the facility name change has been to a third entity, Sonoma Specialty Hospital. On the surface one might think that since AAMG and SSH are both owned by the same person, Dr Singh, it's all the same. Not really true. AAMG and SSH are two very separate legal entities each individually incorporated with the state of CA. This leads me to question who owns the business of the hospital? Which is not the same question as who owns the real property, equipment etc.
The unveiling of Sonoma Specialty Hospital seven months before there was any public discussion regarding the imminent lease/option deal, in my opinion, is suspect at best.
Thank you to explain that under the current management contract with AAMG the District is still at risk for all operations. Apparently this is not the same situation that was contracted with SWMC. Nonetheless, you suggest that it is the nature of the current contract with AAMG that renders the lease/option deal a necessity if we want to maintain any version of a hospital. If true it looks to me like our District backed us into a corner. They agreed to a management contract that was not sustainable. They understood that the terms of that contract included a future lease with option to buy. They knew a lease or sale would require voter approval. They approved and moved forward with the hospital's name change to that of the future potential buyer. And seven months later they present us with sketchy details and an urgency to vote yes on a deal that we have barely had time to digest. Why?
Some of your points 1 – 3 and part of 4 are important facts and not to be refuted. The remainder of your assertions; the only other option is to close the hospital, AAMG will not be able to raise the capital needed for improvements and Jim Horn has wanted the hospital closed for a long time, are all speculation. I see no facts presented that substantiate these claims. Why are you and others trying so hard to push us into a yes vote that you are willing to present speculative opinions as facts?
I'm not of the opinion that the deal is necessarily bad for us. Nor am I convinced of the premise that a no vote would result in the hospital being closed and the property being sold off to developers. Much of that discourse sounds like a lot of scare tactics to push us into a deal that we haven't been given adequate time to study. At this point my primary question is why.......?
As I pointed out in my previous post, this deal was eminent seven/eight months ago when Dr Singh incorporated his business, SSH, and hung his shingle on our hospital door. Why are we only now, under the threat of losing all, learning about the details of a business arrangement that requires our approval? Why has the District not been forthcoming with us since August, when this deal began to brew? Why do they continue to tell us that this will save our general hospital when in fact the OR is closed and there is no requirement in the lease/option deal to reopen it?
Quote:
Posted in reply to the post by farmerdan:
Rustie,...Dan
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Re: Hospital Sale - Measure A
My question is, did the ownership of the business change with the name change? No, the district still owns the business.
The unveiling of Sonoma Specialty Hospital seven months before there was any public discussion regarding the imminent lease/option deal, in my opinion, is suspect at best.There have been many public meetings, not sure what you consider suspect.
Thank you to explain that under the current management contract with AAMG the District is still at risk for all operations. Apparently this is not the same situation that was contracted with SWMC. This is true, the district had to retake full control to be compliant with their bonds. At the time SWMC Inc. took over, this was not understood.
They approved and moved forward with the hospital's name change to that of the future potential buyer. And seven months later they present us with sketchy details and an urgency to vote yes on a deal that we have barely had time to digest. Why?
As stated above there have been lots of public meetings. The name change was necessary to differentiate the purpose of the hospital as a specialty hospital focused on LTAC.
Some of your points 1 – 3 and part of 4 are important facts and not to be refuted. The remainder of your assertions; the only other option is to close the hospital, AAMG will not be able to raise the capital needed for improvements and Jim Horn has wanted the hospital closed for a long time, are all speculation. I see no facts presented that substantiate these claims. Why are you and others trying so hard to push us into a yes vote that you are willing to present speculative opinions as facts?
There is nothing speculative about the need for considerable captial ($29M) and AAMG has stated very clearly that they will not be able to continue operations without it. They have also made clear that they can't raise capital without a long term lease or ownership, both of which require voter approval.
While Jim Horn has not said in so many words that he wants to see the hospital closed, all of his actions indicate this and he has not stated that he wants to see it remain open (to my knowledge). If this is speculation, Jim can easily refute it. Please ask him to do so.
To your other statements, I can only add that there have been many public meetings that were reported on by the local press. There have also been town halls. Any belief that the hospital will continue without a sale is pure speculation that has no basis in fact.
Dan
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Re: Hospital Sale - Measure A
Be sure to VOTE!!! Tuesday, March 5 is Election Day!
:vote1: :vote: :vote1:
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Re: Hospital Sale - Measure A
Dan,
You seem to take issue with many of my comments. My reference to the lack of public discussion regarding the imminent sale as “suspect” seems to disturb you. You point to the many public meetings and question what I consider suspect. The many public meetings I am aware of began February 05, 2019. That was just one month before the vote deadline. What, when and where were the public meetings well in advance of this special election? The destination at which we have now arrived was known many months ago. Why was this issue not presented and brought to our attention for discussion back in August when the lease/sale option was on the table? In my opinion many public meetings one month before the election is to little to late, hence, suspect.
I appreciate the information that the hospital name change was necessary to differentiate the purpose as a specialty hospital, but changing the name is not what I take issue with. It's the choice of name. Why was the name of the potential new owner chosen? On the surface it would appear that the board was/is expecting the sale to be approved by us. This of course could explain, what I consider, the heavy handed push to vote yes. This is another reason why I personally view much of how this has gone down as suspect. Then again Dr Singh's corporate name might have been chosen because he intends to move forward and stay on board regardless of how the vote goes. This scenario would lend support to the suggestion that a no vote is not necessarily the end of the hospital. It's difficult to know, and that's part of the problem. I don't think it should be difficult to know, I think it should be crystal clear.
I don't understand the point of your comment “There is nothing speculative about the need for considerable capital....” I have never stated or alluded to the idea that your comments regarding the need for considerable capital were speculative. I listed the three points that I considered speculative, that was not one of them.
Additionally you assert that “AAMG has stated very clearly that they will not be able to continue operations without it”. Obviously I have no idea where or when AAMG has stated to you, or anyone else for that matter, that they will not be able to continue operations without the passage of Measure A. What I am aware of however, is AAMG's comment in the Sonoma County Gazette’s article of February 01, 2019 where they are on record for indicating that if the lease/sale is rejected they will continue to manage the facility as per the terms of the 10-year management agreement.
You also suggest that “they have also made clear that they can't raise capital without a long term lease or ownership, ...”. Again, I have no idea where or when AAMG made that clear to you or anyone else. I have no knowledge as to weather or not they are able to raise the capital. I know, per the same Gazette article cited above, that they have stated to the press that they will do the upgrades if the measure passes and there was no comment regarding their intentions if it doesn't pass. To conclude from this that they won't is speculative. That having been said, neither of these comments have anything to do with their ability to raise the capital. What's your source for that information?
I admit that I take issue with your comment “Any belief that the hospital will continue without a sale is pure speculation that has no basis in fact.” While there are many beliefs that are purely speculative with no basis in fact I feel confident that I have shared many facts in support of my speculative opinions. Forinstance the fact that AAMG is under a 10-year contract with the District to operate and manage the facility. The fact that AAMG is on record as having stated their intention is to fulfill their contract with the District if this sale negotiation is not approved. The fact that Dr Singh incorporated Sonoma Specialty Hospital in August. The fact that the hospital name has been changed to the name of Dr Singh's corporation. The fact that the 10-year management agreement includes language that requires the District and AAMG to develop a new lease/sale contract to be presented to the voters in November if it is not passed in this special election. In my opinion all of these facts suggest the possibly that there's more to the picture than is being shared with us. Certainly the management contract requiring a new lease/sale agreement to be voted on in November, should this one not pass, indicates that there is a contingency plan in place other than shutting it all down. This is just a small sampling of the facts that I have used to come to my conclusion that a no vote this time around is not necessarily the kiss of death, as you would have us believe.
I've said this before and I will say it again. From my perspective, for what it's worth, which in the scheme of things is not much, you and many others have been pushing forward opinions as facts and I consider that disingenuous at best. Your comments about Jim Horn continue to reflect this. I understand that you believe that Jim wants the hospital to close for no reason other than he doesn't want a hospital. Your assertion that this is a fact because he doesn't step forward and refute your accusation is just as speculative as your primary accusation. Just because someone chooses not to refute accusations & assertions does not validate those accusations & assertions as facts. A small point you might want to consider. I have read on multiple occasions, from commentary expressed by Jim regarding the hospital in the SWMC days that his objections were based on his examination of the business plan. He looked at the numbers and thought it was not financially feasible. As it turned out he was correct. Now he simply states, once again from the numbers, that he doesn't think this is the best deal we can get. Why do you continue to disparage Jim with this idea that he just doesn't want a hospital?
By now I would hope that most everyone has voted. For clarity, I have not been lobbying for a no vote. If I've been lobbying for anything it's for an informed vote. One that comes from examining all of the facts, using our critical thinking skills, checking our fears at the door and being as clear as possible that the dice we roll are not loaded.
By tomorrow morning the votes will be in and I suspect the measure will pass. Good news, bad news, who's to say, only time will tell.
Quote:
Posted in reply to the post by farmerdan:
My question is, did the ownership of the business change with the name change? No, the district still owns the business....
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Re: Hospital Sale - Measure A
Election Summary Report
Special Election
Palm Drive Health Care District
March 5, 2019
Precincts Reported: 40 of 40
Registered Voters: 24,746
Total Votes: 6,946
YES: 5,345 (76.51%)
NO: 1,641 (23.49%)
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Re: Hospital Sale - Measure A
More about this is in today's Press Democrat. This is an overwhelming victory, which shows the wisdom of the majority of Sebastopudlians.
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Re: Hospital Sale - Measure A
I just want to say a BIG 'thank you' to all who asked questions and all who responded... it helped
me get clearer about the very complex issues involved and what my vote would mean....
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Re: Hospital Sale - Measure A
I agree that a HUGE THANKS is owed to those who asked excellent questions and those who provided very detailed and helpful responses and research. This was a very confusing issue, so your inquiry and input was immensely valuable.
Ted
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Re: Hospital Sale - Measure A
Sorry to disillusion you Shepherd but this was not a Sebastopol only vote. Palm Drive Health District includes about 15 other towns in addition to Sebastopol.
The story these numbers tell me is that this special election had only a 28% voter turnout. The “overwhelming” victory was by less than one fourth of the District. That leaves me to wonder if the other 72% of registered voters in the district just didn't care or weren't well enough informed about the issue...
Quote:
Posted in reply to the post by Shepherd:
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Re: Hospital Sale - Measure A
This was a complex issue and one that took extra effort to understand so it is no surprise that lots of people did not cast a ballot. This is typical of single item special elections. When presented with items I don't understand, I take a pass and let the people who have done the research decide as I suspect many did here
Quote:
Posted in reply to the post by Rustie:
...The story these numbers tell me is that this special election had only a 28% voter turnout. The “overwhelming” victory was by less than one fourth of the District. That leaves me to wonder if the other 72% of registered voters in the district just didn't care or weren't well enough informed about the issue...
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by farmerdan:
...no surprise that lots of people did not cast a ballot. This is typical of single item special elections. When presented with items I don't understand, I take a pass and let the people who have done the research decide as I suspect many did here
That's one way to look at it. Another way is how Rustie described it, as something that was clearly negotiated last summer, if not before, but many of us learned about it just a few weeks ago. (Btw, Rustie should get a plaque from the citizenry for all the detailed analysis & excellent questions & observations.)
Now that the deed is done, one assumes the PDHCD directors have two remaining jobs: Acting as landlords & managing the huge debt that has been run up in the last 19 years. If farmerdan is right, that first duty will go away before too long and we'll be down to a debt management problem. One wonders if paying off the debt will addressed with all the expertise & foresight that was brought to management of the district in the past.
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Re: Hospital Sale - Measure A
Some Forestville folks didn't even know there was an election happening, and those who did thought only Sebastopol got to vote. Those I've spoken to never received advanced mail-in ballots, myself included. A friend in Sebastopol said she only got her mail-in ballot the week before the election. I only learned of the issue from the discussions on Wacco. I don't use that hospital, and felt that those who do should actually vote on what to do with it, so I didn't vote. Also, I didn't vote because I was unclear which would be better, even after all the informative discussions on Wacco.
Quote:
Posted in reply to the post by Rustie:
...The story these numbers tell me is that this special election had only a 28% voter turnout. The “overwhelming” victory was by less than one fourth of the District. That leaves me to wonder if the other 72% of registered voters in the district just didn't care or weren't well enough informed about the issue...
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Re: Hospital Sale - Measure A
I hope the true believers and optimists about small government decision making are right. My bet is on the 'smart' money taking over the no-longer-a-hospital to wring out what they can at the lowest cost to them and leave us brilliant Sebastopudlians wondering what happened.
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Re: Hospital Sale - Measure A
I don't know any 'true believers and optimists' involved in this situation, just people trying to find the best path from the hand they have been dealt by the failing healthcare system in the US.
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Posted in reply to the post by doghairnancy:
I hope the true believers and optimists about small government decision making are right. My bet is on the 'smart' money taking over the no-longer-a-hospital to wring out what they can at the lowest cost to them and leave us brilliant Sebastopudlians wondering what happened.
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Re: Hospital Sale - Measure A
Thank you Dan, you've just made my case. It was a complex issue. Why did the board wait seven months to share the information with the public? Perhaps because they had already decided for us...
When you keep the majority in the dark you get governance by the minority. Sounds like you're OK with that.....
Quote:
Posted in reply to the post by farmerdan:
This was a complex issue and one that took extra effort to understand so it is no surprise that lots of people did not cast a ballot. This is typical of single item special elections. When presented with items I don't understand, I take a pass and let the people who have done the research decide as I suspect many did here
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Re: Hospital Sale - Measure A
Another 'me too' issue. I didn't get a ballot and I don't want to pay another dollar of my taxes for any of it.
Quote:
Posted in reply to the post by cw707:
Some Forestville folks didn't even know there was an election happening, and those who did thought only Sebastopol got to vote. Those I've spoken to never received advanced mail-in ballots, myself included. A friend in Sebastopol said she only got her mail-in ballot the week before the election. I only learned of the issue from the discussions on Wacco. I don't use that hospital, and felt that those who do should actually vote on what to do with it, so I didn't vote. Also, I didn't vote because I was unclear which would be better, even after all the informative discussions on Wacco.
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Re: Hospital Sale - Measure A
I think its pretty clear that people in West County who are in the health care district and can vote want a health care option in Sebastopol. They voted for a District Board majority who share that commitment and just voted overwhelmingly to support the Board in selling the hospital.
Yes the health care system is riddled with problems, but we rely on it and it makes sense to do the best we can to have local options available when we and our neighbors need medical care.
I for one have never seen a special election issue with more information about a Measure (community meetings, press articles, and an election pamphlet that went to all eligible voters. In terms of who got ballots, they were sent out from the Sonoma County Election office. Its important to understand that not everyone in West County is part of the Health Care District and eligible to vote.
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Posted in reply to the post by farmerdan:
I don't know any 'true believers and optimists' involved in this situation, just people trying to find the best path from the hand they have been dealt by the failing healthcare system in the US.
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Re: Hospital Sale - Measure A
How much $ did this county just waste determining the fate of a maybe 5 million dollar property? THIS is why democratic socialism sucks. No one even cared to show up for the vote.
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Re: Hospital Sale - Measure A
We should prefer fascist capitalism?
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Posted in reply to the post by ChefJayTay:
How much $ did this county just waste determining the fate of a maybe 5 million dollar property? THIS is why democratic socialism sucks. No one even cared to show up for the vote.
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Re: Hospital Sale - Measure A
Quote:
Posted in reply to the post by farmerdan:
We should prefer fascist capitalism?
Did I say that? No. Disagreeing with one thing doesn't make one an advocate for the exact extreme opposite.
Though capitalism wouldn't have required the county pay for several hundred people to hold a vote on it. They even paid to fly out technicians from LA. Such a waste of money.
That hospital never should have been public money in the first place.
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Re: Hospital Sale - Measure A
Agreed.
The hospital should be sold and the district dissolved.
(I say that as the guy that founded it but now realizes that government entities can't run businesses.)
Quote:
Posted in reply to the post by ChefJayTay:
...That hospital never should have been public money in the first place.
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Re: Hospital Sale - Measure A
This is moving into another big....but much more clear issue....how we vote. I worked the polls this year to gather more info. The county must spend $1MM per election on staffing, 'volunteers', training sessions, moving posters/binders/supplies/booths/equipment to cover every possible eventuality. A massive carbon bomb as well as a waste of money. And all that for ONE measure. The precinct I worked had 4 people from 6 a.a. till 9 p.m. and we had EIGHT (!) voters show up.
So, if you want to actually help solve one problem with a simple solution, PLEASE PLEASE PLEASE write to your state representatives to go to Vote-By-Mail-Only, as Oregon does. They will tell you they're 'studying it' but don't accept that. About 80% of our voters use mail already so the transition would be simple and cost effective. That money could be much better used for schools, roads, fire, almost anything else.
