While there was some hopeful activity at the Mendocino Coast District Hospital (MCDH) Finance Committee, committee members and the public are still not getting the information they are requesting.
Committee Chair Dr. Lucas Campos did allow for more public input and discussion, which was a positive sign. It was also encouraging to see Tom Birdsell confront CFO Wade Sturgeon regarding information that has been requested for years. Dr. Peter Glusker also reminded the Committee that Kay Handley was previously shut down by Sturgeon when she also asked pointed questions regarding the financials. Ms. Handley has stopped attending meetings, although it isn’t clear if she has resigned from the group or not. Other members of the Committee and the public asked for clarifications from CFO Sturgeon.
Over a year ago staff was directed to purchase software that would enable the kinds of financial information that will give people more direct information about what revenues and expenses are attributed to various departments and services. While the software was purchased, no new information from it appears to be forthcoming.
Hospital finances are complicated, although it is easy for staff to track the revenue and expenses for Obstetrics (OB). Given that OB is not a required service and has lower reimbursements, it has been a target for elimination for the last 18 months. Although public outcry kept it alive again this summer, President Lund added a trailer to the motion which said as long as it is “financially feasible”, which meant it could go back on the chopping block again. Additionally, the survey MCDH conducted last August revealed that the community demands OB and Emergency Room services as their two top priorities.FY2018_Graphics_7_17a
It was ironic to hear CFO Sturgeon lecture the crowd about how rural hospitals are not in the business of making a profit; they exist to provide the services the community demands, as he was defending the costs of providing 24 hour orthopedic coverage. That is exactly why the public has shown up in force to demand OB be kept open at any cost.
The other complication is that so much of the fiscal information is confined to closed sessions as it involves salaries and contracts, including those of medical professionals also serving on the Board of Directors. Added to the confusion are the unique methods used by insurance companies and the government to reimburse for services. One major factor impacting the budget is that visits, particularly inpatient procedures, are severely declining, while costs continue to rise.
Additionally, new survey associated with new taxes needs to address what services people want. For example, if most people are leaving the community for orthopedic care, do we need 24/7 very expensive coverage? Can this community support two orthopedic surgeons when MCDH is also covering all the costs associated with their practice, including malpractice insurance, office expenses, support staffing etc.
It is hopeful to hear members of the MCDH committees, the community and the press begins to engage in actual communications, although there is a long distance to travel before we experience actual transparency. As MCDH Board and staff prepare to engage the community as they seek out new funding, they need to stop the defensive tactics we have observed. People in the community have many concerns and issues that need to be addressed in real terms and are not going to provide new funding without answers to old questions.