Douglas’ healthcare future discussed at joint meeting

By Trisha Maldonado
Douglas Dispatch
Published/Last Modified on Friday, December 7, 2012 9:38 AM MST


On Nov. 19 Douglas Mayor Danny Ortega Jr. and members of the City Council meet with representatives from Southeast Arizona Medical Center (SAMC) in a joint work session at the Douglas Visitor’s Center.


Both entities spoke of the impact of closing the hospital would have on the Douglas community and the fiscal impact it would have on the city.

At the Sept. 12 city council meeting then Chief Executive Officer for Southeast Arizona Medical Center Brian Bickel gave a presentation to mayor and council on the Safety Net Care Pool (SNCP.

SNCP was established in 2011and was approved by Arizona Health Care Cost Containment System (AHCCCS) in 2012, to reimburse participating hospitals for uncompensated care cost provided to AHCCS members and the uninsured.

Eligible hospitals must receive disproportionate share payments and have a local governmental entity sponsor.

SAMC is asked the City of Douglas to be that governmental entity sponsor and also provide them with $300,000. The funds are to be paid directly to AHCCCS then matched by the federal government and distributed to the hospital quarterly. SAMC had until Sept. 30 to have this agreement signed and returned to AHCCCS for processing if they wanted to take part in the SNCP.

The CEO also approached the county with the same proposal. The county felt they were in a better position to sign into this agreement; the request was signed and submitted to the state on Oct. 2.

“The county approved the IGA with AHCCCS for this money for the Douglas hospital,” Douglas City Manager Carlos De La Torre said. “(The County representatives) they said we are only going to execute that agreement if the city participates in providing some funding for that IGA.”

County representatives proposed to participate in a one to one match. In order for the city to participate in this one to one match they would have to inter into an IGA with the county.

As of Nov. 27 AHCCCS has not yet approved or denied SAMC’s agreement.

At the Nov. 19 meeting SAMC’s currently CEO Annie Benson presented how closing the hospital would impact Douglas and surrounding communities.

All agreed that Douglas needs a health care facility that is close to provide care.

SAMC has made some small changes to the hospital to save funds. But both Mayor Ortega and De La Torre feel that there hasn’t been any long term plans made by the hospital for subtlety.

“We have to be supportive to the hospital, but at the same time we cannot just sit back and see what they are going to do,” De La Torre said. “There are other health care providers that have approached the city that said we are ready to move in there and build a facility in Douglas.”

“The council wants to support SAMC but at the same time does not want to leave Douglas without health care,” De La Torre added. “If someone else wants to come in and provide that all we really care is that Douglas has the best care from with “A” provider or “B” provider. It comes down to be a business decisions at that time.”

Comments

    DC wrote on Dec 13, 2012 10:46 AM:

    " Armundo you are wrong, we don't need a smaller hospital we need a bigger and more modern one. The city, the county the state and the federal government need to fully fund this hospital and give us more doctors. The hard working poor people deserve better then what we have. There are places in Mexico that have a better hospital then we got and those people are poorer then us. Our government leaders need to step up and give us a better hospital. "

    Armundo wrote on Dec 12, 2012 6:59 PM:

    " By reading all the childish posts on this article it is no wonder that our hospital and much of our community is failing. Everybody just want to complain and make stupid comments.

    I strongly feel that the current hospital should be closed and the buildings and real estate be liquidated. I new, smaller and leaner hospital should be relocated in town where the people of Douglas could have better access. A smaller streamline medical facility using inovative ways of managment could actually be viable here in Douglas.

    If the people of Douglas continue with the status quo, the hospital will be lost and we will have no medical facility here. But maybe that is what the people want and/or deserve. "

    Douglas Native wrote on Dec 11, 2012 11:00 AM:

    " This continues to get more interesting. Mr. Malusky uses confidential information that was illegally leaked to him, to bad mouth everyone who ever questioned him. I am quite sure that his personal use of the hospital backhoe, at his home,for free, did nothing to help the hospital financially. This took place under Bickel's watch. Bickel did the same thing. I have many friends in Douglas, & not one of them has a good word to say about little John. Remember John, that respect is earned. You are pathetic. "

    SAMC wrote on Dec 11, 2012 5:43 AM:

    " John how is it that you know so much about the finances? Do your wife share personal information? I think its time to get rid of the other Malusky, shes the mole to his knowing all personal finances. "

    Julie wrote on Dec 11, 2012 5:15 AM:

    " Wow John, for having so many degrees your grammar is pretty pathetic. I would have at least had someone proof read it before making myself look like an idiot. John why are you so full of anger? you claim you have friends here in Douglas REALLY?? WHO? You have destroyed the lab, and the staff that's left your respect in which you NEVER gained from this community. You have shared information about other staff wadges when in fact you should never even know what SAMC employees make, but wait, as your statement was, "HOW DO YOU THINK I KNOW? I ONLY SLEEP WITH THE PERSON WHO DOES PAYROLL EVERY NIGHT" SO IN FACT YOUR WIFE IS DISCLOSING PERSONAL INFORMATION. That is illegal!!!

    You go on about Mary Fernandez, do you even know her, her back ground? I believe its just jealousy because you weren't given the CFO position, or CEO position. Look at yourself John your so unhappy with yourself and life you try and make everyone else life miserable, thankfully you have left this facility to go destroy another. I only pray to god that hospital in Mississippi reads you like the nasty, horrible book you are! If feel sorry for you and you will be in my prayers. I will pray you find happiness within your black heart. I pray you start getting help like seeking professional help going to AA meeting all that vodka and cranberry you drink daily is really affecting you. I pray you don't have an extra marital affairs over there remember you left one behind, I pray for you!!

    Annie if I were you i would be speaking to the hospitals attorney this man needs a rude wake up call, and remove his wife from that facility, another Malusky MEANS trouble "

    anonymous nickname wrote on Dec 11, 2012 2:38 AM:

    " It doesn't take "half a PhD", or a certified scientist to recognize that Lucia Spikes is worthless, but thanks for bringing that to our attention. We'll give you that much, Mr. Malusky.

    John, aren't you the one who wanted his mother to be taken care of in SEAMC's acute care by our careless nursing staff?

    Good luck at YOUR new facility. "

    Douglas Native wrote on Dec 10, 2012 4:31 PM:

    " In regard to John Malusky. He was exposed as a liar & a coward many times over. If him & Brian Bickel did such a great job, why did the hospital go broke under their watch? He could have spoke up at anytime before he left, but being the coward he is, he waited until he is long gone to spew his venomous remarks.Mary Fernandez has not been over billing for over a year as he stated, & she was put in place when the wonderful Bickel sold out to SV. Your remarks about Annie Benson are wrong & the only reason you are pouring out your hatred is because she got the job of cleaning up the total disaster you & Brian left. Good riddance. "

    former douglassan wrote on Dec 10, 2012 1:38 PM:

    " I am hoping and praying that the family I have in Douglas never, ever needs medical attention from SEAMC. After reading the letter from the former lab director, who gave quite a description of the staff activities (or inactivities) and laboratory at the time of his arrival at SEAMC (I cannot believe how many infractions that lab had prior to this!!)I certainly hope that the leadership of Douglas will seriously consider letting another hospital entity come in and open up a new facility. (With the promise that they will not hire any of the SEAMC employees that this lab director wrote about). "

    John M wrote on Dec 7, 2012 1:39 PM:

    " To the friends I have made and the fine people of Douglas it is time to set the record straight. Unlike the libelous cowards that hide behind anonymous nicknames, I am John Malusky and I would like to set the record straight about SEAMC.
    With regards to the malicious and derogatory comments made in reference to me by the unnamed only demonstrates a lack of business knowledge and a lack of understanding of the highly regulated environment of the laboratory, The laboratory for over 20 years has been forced by federal and state regulations to operate with a very narrow margin of latitude. When I assumed directorship of SEAMC’s laboratory there were 30 employees with the majority working 3rd shift, a shift with minimal workload but a substantial shift differential. If I had been an inspector, with what I had discovered, SEAMS would not have a laboratory today. A brief and by no means all encompassing synopsis of the staff follows My first night, I walked into the lab on a Sunday night and found a tech working bare foot in shorts, blood on the walls and counters and urine spilled on the microscope This same tech, had his girlfriend, another lab tech shacked up with him in the bunk room. That same week, I found the night shift phlebotomist wrapped in a blanket head on a pillow in the break room sound asleep as we paid him premium dollar. Over the next 90 days, it was discovered that the techs working there had falsified QC data, patient information, failed to perform maintenance and preformed in an unprofessional manner that compromised patient care. As if this was not enough, the recent Joint Commission inspection that was held while Deb managed the lab had resulted in 66 pages of periodic performance review (deficiencies and concerns) that needed to be addressed. It took almost two months to address the issues. It pleases me to say that under my direction and with the professional staff that has been developed, the inspection in 2011 resulted in zero deficiencies and concerns.
    There were poorly negotiated contracts by the prior administration that had resulted n an annual expense of over $500 thousand dollars. The selected analyzers functioned poorly, had numerous breakdowns and resulted in long delays of questionable results frequently. Although it took a little more than a year, the equipment was replaced with state of the art analyzers that allow SEAMC’s lab to operate comparable to the QUEST and LabCorp reference labs while saving the hospital over $2.5 million dollars over a 5 year period. So to the comment of me not knowing how to run a lab, all of my labs are operated above the law, by a highly trained professional staff, providing the highest quality results, is an extremely efficient low cost environment. Although the nurses at the hospital despised the fact the laboratory was operated with structure, discipline and within the confines of the law, in the weeks prior to announcing my resignation, 6 prior employees had called the lab asking if they could have their job back. Like one commentator said, there is a reason they are ex employees”
    To qualify the following statements, my background is a BS in Medical Science. I am a certified scientist; I have a Masters in Hospital Administration and half of a PhD in Business with a concentration in hospital Administration. I will be talking the fellowship exam with the American College of Healthcare Executives next month, To demonstrate how prestigious this designator is, there is only one other FACHE in the county.
    The problem with SEAMC is not the laboratory, Brian Bickel or me. There are three driving factors that will result in the demise of the hospital.
    First and foremost is the Board of Directors. The self perpetuating Board operates far outside of their scope of duties. Driven by Lucia Spikes, who thinks that she is the reincarnate of her late husband George, is unaware that she is not nor will ever be as smart or savvy a businessman as her late husband. Her tyrannical style of governance has left more than one administrator in tears. The Boards daily interference with daily operation, finance and human resources undermines the CEO and other C level administrators. The decision to move administration into the main hospital to save on electricity was sheer genius. If the hospital was profitable from this day forward the paltry monthly savings would take 528 THOUSAND years to cover their current debt. The board needs to stay out of operations and finance. If you do not believe me, you are reading this and obviously have internet, Google Board of Directors governance not for profit hospitals and you will see their sole purpose is long range strategic planning and the interviewing and hiring of a CEO. But one of the biggest thorns in many of our sides is the fact that some of your board members consider their family and friends are better than you and I and we should treat them differently. They are VIP patients and deserve preferential treatment and bypass the same route you and I take to receive care.
    Second, Annie Benson and the other C level executives. Although Annie received many accolades and the hopes and wishes that she returns the hospital to “the way it was”, remember it is the way it was and the business of past that drove the facility to bankruptcy. Annie, who starts her meetings (and I have sat through many of her meetings) with “I don’t know” doesn’t realize how true a statement she recites. Running a hospital is like being the captain of a ship and you must make sound decisions and keep your wits together at all times. Annie is merely Lucia’s puppet and she jumps as Lucia pulls the strings. Some decisions made since Annie took office demonstrate a lack of good judgment and how she operates the hospital for personal benefit for her and her “friends” For months, the cafeteria has come under fire for high expenses with little revenue generated. It took months for their lead executive to follow the direction of Bickel to reduce volumes and selections, basically trim costs. The cafeteria actually charges less than cost to provide meals and only recently has some of the expense been trimmed. Annie, because she does not like to leave work and have to prepare dinner, has expanded the cafeteria selections to satisfy her and another C level that doesn’t not like to or wish to cook. I see a significant problem with this since the cost runs about $5000 a month to generate $900 dollars a month. Keep in mind, the lab has been on credit hold for months and we would have to delay testing so Annie could take dinner home instead of cooking. Another one of Annie’s stellar decision to release payroll checks to a select few individuals 3 days early resulted in NSF and overdraft fees. I guess it does come down to who you know. My prior staff informed me of the latest hospital fundraiser which netted the hospital a 10% of total sales. The idea of inviting Dillard’s down to put on a special sale for the employees that included payroll deduction netted a whopping $600 was absolutely ridiculous. What’s next a Horchata stand out front or maybe a bake sale? Annie insists that a saving piece of the puzzle is the start up of a hydro therapy program at the city pool and the implementation of a fast track in ER. Neither program has enough patients to be supported and the fast track concept has already cost tens of thousands of dollars and not even open.
    Brian and I have had many candid conversations regarding operations and the direction of SEAMC. For those that welcome Mary Fernandez as the new CFO and savior of the business department, there are two things to keep in mind 1st Mary and her staff at Sierra Vista has been over SEAMC collections for over a year and we are worse off now than before her group took over billing. 2nd She is a Sierra Vista employee that was placed there by Sierra Vista to protect their interest in the 1.1 million dollar loan they provided SEAMC. By no stretch of the imagination is Mary even slightly qualified for the position of hospital CFO
    The third piece of the puzzle is the nursing staff. Talk to your neighbors and friends, talk to your medics or maybe it has happened to you. Your brought to the hospital and basically ignored by your nursing staff. They are too busy playing on facebook or texting on their phones to worry about patient needs. You’re laying in a hospital bed that has someone else’s blood on the bedrails, or your bedside commode is not emptied and cleaned for 3 days. There are nurses that refuse to take patients or carry a normal patient load. While other seasoned nurses feel they are providing quality care while committing CMS fraud. Nurses that do not know the law or care about the law and the exposure to risk that they place the hospital in on a daily basis eventually this practice will catch up with them and the penalties for the hospital are severe.
    I saw the business plan submitted to the city. I read and reread the proposal and had to laugh at the repetitive pipedreams that will never culminate. It is a shame that the cash strapped city has thrown good money after bad. The facility operated with unbelievably high expenses in the neighborhood of $800,000 dollars a month while taking in an anemic $400,000.I don’t care how fuzzy the math is, the numbers do not add up to any type of profit. Roughly 3.8 million dollars in the hole, vendors that have not been paid in months, some 8 to 10 months, but Annie takes her dinner home. Efficiency experts say even at our lowest staff levels, the hospital was still overstaffed and Annie is hiring more staff without the census to support the increase.
    As much as I did not want to leave and as painful as it was to leave a wonderful staff behind, I have a family to think about and witnessing the sheer incompetence of the new regime did not leave me feeling secure when payday rolled around..
    You, the people of Douglas deserve better than what you are and will get. You deserve to know your health needs will be taken care of now and in the future. You should demand better than what you are receiving. Nearly 3 years from day one, I leave you a highly professional, well trained staff operating state of the art equipment providing you the highest quality test results. I can only wish I had the opportunity to do for SEAMC what I have done for the lab and will do in an expanded role at my new facility.
    In parting I wish you all the very best and I will keep you in my thoughts and prayers. "

    Armudo wrote on Dec 7, 2012 10:29 AM:

    " Maybe it is time to close the hospital and rebuild it to fit our needs. Trying to keep an old, outdated facility just doesn't work. It is just a band-aid approach to the problem. If the new hospital need to be smaller, then so be it. If the people of Douglas can't or won't pay, then they shouldn't have one. The days of governments giving us everything we want is over. All governments, Federal, Sate, County and Cities are broke. Don't rely on government, rather rely on yourself and get help from your family and church. "

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