Build Lakewood Whistles a Happy Tune

[Dan Alaimo]

Jenn Pae's answer to the tax question, despite its inadequacies and vagaries, is a not-bad response to the question about the tax impact of the hospital deal. It raises one more big question for me: what took them so long to produce in a way that was broadly promulgated?

Of course there are so many other questions that leave me with the conclusion that the deal, and council's support for it, are inexplicable.

To me a central question remains: why such a narrow focus on the Cleveland Clinic to the detriment of the City? If they could have/would have answered that one adequately and much earlier, it would have changed the dynamics of the debate and saved a lot of grief.

[Lori Allen _]

Jenn Pae's answer to the tax question, despite its inadequacies and vagaries, is a not-bad response to the question about the tax impact of the hospital deal. It raises one more big question for me: what took them so long to produce in a way that was broadly promulgated?

Of course there are so many other questions that leave me with the conclusion that the deal, and council's support for it, are inexplicable.

To me a central question remains: why such a narrow focus on the Cleveland Clinic to the detriment of the City? If they could have/would have answered that one adequately and much earlier, it would have changed the dynamics of the debate and saved a lot of grief.

In my opinion, there are far too many coincidences and too much cronyism to suggest anything other than some kind of reward or benefit. Evidence has been posted here and elsewhere to suggest (although not definitely prove) this. This question has been beaten to death. I believe that anyone that still believes that this deal was done with absolutely zero impropriety should re-examine the aforementioned and other evidence.

FWIW.

[tom monahan]

Lori:

Apparently you did not understand my comments about Mike Summers first being a Republican and then becoming a Democrat.

Back in the May Primary of 2006, Mike Summers, then a Republican, took out a Democratic ballot to vote for a friend, That automatically made him a Democrat. I am not blaming Lakewood Republicans for anything. In fact, many of them are my best friends.

[Stan Austin]

The affinity for a political party or philosophy can transcend the technicalities of registration.

[Lori Allen _]

Summers is A Democrat. That is the truth. I know it is hard for you to believe it.

[Dan Alaimo]

Jenn Pae's answer to the tax question, despite its inadequacies and vagaries, is a not-bad response to the question about the tax impact of the hospital deal. It raises one more big question for me: what took them so long to produce in a way that was broadly promulgated?

Of course there are so many other questions that leave me with the conclusion that the deal, and council's support for it, are inexplicable.

To me a central question remains: why such a narrow focus on the Cleveland Clinic to the detriment of the City? If they could have/would have answered that one adequately and much earlier, it would have changed the dynamics of the debate and saved a lot of grief.

In my opinion, there are far too many coincidences and too much cronyism to suggest anything other than some kind of reward or benefit. Evidence has been posted here and elsewhere to suggest (although not definitely prove) this. This question has been beaten to death. I believe that anyone that still believes that this deal was done with absolutely zero impropriety should re-examine the aforementioned and other evidence.

FWIW.

There are too many people involved for this impropriety to not have come to light, although maybe it will as time goes on. All the Council members, all the LHA members, executives at CCF, doctors and nurses with CCF, the Build people, hospital executives and employees, other City Hall employees, various citizens who have been clued in - they may be sympathetic to the deal, but sooner or later one of them with knowledge of the improprieties - if they exist - is going to get pissed off and spill the beans. Perhaps we need a dedicated investigator, journalistic or otherwise, to bring this to light. In the absence of this hard evidence, I conclude that there is some convincing information that has not been shared with the public, a lack of transparency which in itself is damning. To me, the sudden "conversion" of the three Council members is evidence of this. Without personal knowledge of this, I remain solidly opposed to the deal.

[Lori Allen _]

Perhaps we need a dedicated investigator, journalistic or otherwise, to bring this to light.

I would concur. Perhaps a private investigator would have been beneficial.

[Jim Kenny]

Dan, are you telling us that the players in the hospital deal are guilty until proven innocent?

[Dan Alaimo]

Dan, are you telling us that the players in the hospital deal are guilty until proven innocent?

Jim,
I'm not sure how to answer this as I don't think I was ascribing guilt, rather the opposite, I was countering a post that cited impropriety in the hospital deal. But there's so much written here, even by me, it's hard to keep track. Here are two statements I made in this thread:
1) "In the absence of this hard evidence, I conclude that there is some convincing information that has not been shared with the public, a lack of transparency which in itself is damning. To me, the sudden "conversion" of the three Council members is evidence of this. Without personal knowledge of this, I remain solidly opposed to the deal."
In short, after 12 months and counting, I still don't get it. The word I keep using to describe the deal is 'inexplicable.' I'm thinking there's some convincing information that has not been shared widely, but it should be. Go ahead. Convince me. Take a shot. I'm not unreasonable; I can be won over like the three council members. But I've heard all the old arguments from your side, as you have heard all the old arguments from my side.
2) "To me a central question remains: why such a narrow focus on the Cleveland Clinic to the detriment of the City? If they could have/would have answered that one adequately and much earlier, it would have changed the dynamics of the debate and saved a lot of grief."
That's the heart of the matter. Throughout the entire process it seems to me the Cleveland Clinic has had the inside track, and I have grave doubts about the effectiveness of the RPF process. Again, take a shot at convincing me, but please tell me something new.

There are many other questions, like the financial ones Brian Essi raises elsewhere today, but I leave that for another thread.
Dan

[Jim Kenny]

Dan: Thanks for the response. Yes, I’ve heard the old arguments too. I doubt I can share anything you haven’t heard. The best I can do is remind you of some facts. Such as:

Locally, the only other true alternatives were UH and MetroHealth. We know UH wasn’t interested as it walked away in 1996 from Lakewood Hospital.

Yes, MetroHealth flirted with the idea, yet never offered a true proposal. Furthermore, as Jenn Pae reported here at the Deck and elsewhere, once the vetting process began Lakewood got to peek into MetroHealth’s financials only to discover it was over leveraged. This revealed it wouldn’t have the cash needed in the near future and raised the concern it might be making a cash grab, only to leave us with a white elephant in short time. News reports in Q3/4 of 2015 confirmed MetroHealth’s finances are suffering.

I understand why you might not get excited about the deal with the Clinic as its true value isn’t on any negotiation sheet. The value is it opens a door to delivering healthcare in ways like never before. The Clinic is telling the nation that its investments beyond facilities in Lakewood will make our city a model for community health. These are processes, systems and a culture of keeping people healthy. We don’t need inpatient beds when that happens. We also need less of an ER. The good news, however, is we’re not getting less, we’re getting more. We’ll have a facility staffed with professionals who can treat serious illnesses. Those requiring more than immediate attention can then be transferred to the center of excellence that can deliver it and where they’ll experience a level of quality that improves outcomes.

More so, the terms of this deal don’t directly point to the savings. Our community now gets to avoid robbing city services, roads and other infrastructure of +$90 million dollars that would need to be directed to the hospital for capital improvements – improvements that can only be recouped by inpatient stays that are decreasing from healthier populations and the 3::1 over saturation of beds in our market.

Lastly, the hospital’s capital demands were also a threat to the City’s bond rating. Once the threat would be realized, the cost of bonds would rise, making less capital available and more costly to pay off.

In other words, this deal is keeping us from going over a cliff. I can defend that.

[Michael Deneen]

I understand why you might not get excited about the deal with the Clinic as its true value isn’t on any negotiation sheet.

Whenever someone tells you that you're trading tangible assets for intangible assets (which is what Jim's partners over at BL claim on their FB page), that's a big red flag that you are being conned.
City Hall wants to trade the cow for magic beans....so hold on to your wallet!

We don’t need inpatient beds when that happens.

Avon sure seems to need inpatient beds. That's why they want our hospital.

The Clinic is telling the nation that its investments beyond facilities in Lakewood will make our city a model for community health. These are processes, systems and a culture of keeping people healthy.

After countless broken promises by the Clinic, who is gullible enough to believe ANYTHING they say?
As for "keeping people healthy"...how does Dru Siley's "bar and restaurant economy" fit into the "healthiness" plan?

[Bridget Conant]

Several untrue statements are in Mr Kenny's response.

First, the Metrohealth proposal WAS A SERIOUS PROPOSAL. Tell me one major hospital system that would take the time and expense it requires to prepare a
detailed offer like Metro did as a joke. Do you think they did it as a joke? Do these people have time to play games?

The fact is, the only entity playing a game was Lakewood - they never SERIOUSLY considered Metro's proposal.

The offer can be found in its entirety here:

http://savelakewoodhospital.org/metrohe ... -released/

Secondly, while Ms Pae is a talented individual, she is not qualified to make an assessment of Metrohealth's financial stability, nor judge the seriousness of their proposal. Her pronouncements are uninformed and carry no weight. Additionally, Mr Kenny's assertion that Metrohealth's finances are "suffering" do not seem to be accurate. Can you point me to your source as to the contention that they performed poorly this year?

According to Moody's and others, Metrohealth has not only improved their financial stability, they are poised to continue on into 2018 in good financial condition as their debt was front loaded and will be decreasing. Their outlook is positive and continuing to improve.

See these reports:

http://finance.yahoo.com/news/fitch-aff ... NlYwNzcg--

http://www.beckershospitalreview.com/fi ... ating.html

http://www.metrohealth.org/News/MoodysA ... A3-Outlook

So, Mr Kenny, you can repeat misinformation as many times as you care, but it is still MISINFORMATION. Metrohealth is in NO WAY FINANCIALLY STRAPPED or in any sort of difficulty and Ms Pae's "assessment" was merely wishful thinking.

This is the MO of the Build Lakewood group - repeat and continue to repeat misinformation. It will never make it true.

[Dan Alaimo]

Dan: Thanks for the response. Yes, I’ve heard the old arguments too. I doubt I can share anything you haven’t heard. The best I can do is remind you of some facts. Such as:

Locally, the only other true alternatives were UH and MetroHealth. We know UH wasn’t interested as it walked away in 1996 from Lakewood Hospital.

Yes, MetroHealth flirted with the idea, yet never offered a true proposal. Furthermore, as Jenn Pae reported here at the Deck and elsewhere, once the vetting process began Lakewood got to peek into MetroHealth’s financials only to discover it was over leveraged. This revealed it wouldn’t have the cash needed in the near future and raised the concern it might be making a cash grab, only to leave us with a white elephant in short time. News reports in Q3/4 of 2015 confirmed MetroHealth’s finances are suffering.

I understand why you might not get excited about the deal with the Clinic as its true value isn’t on any negotiation sheet. The value is it opens a door to delivering healthcare in ways like never before. The Clinic is telling the nation that its investments beyond facilities in Lakewood will make our city a model for community health. These are processes, systems and a culture of keeping people healthy. We don’t need inpatient beds when that happens. We also need less of an ER. The good news, however, is we’re not getting less, we’re getting more. We’ll have a facility staffed with professionals who can treat serious illnesses. Those requiring more than immediate attention can then be transferred to the center of excellence that can deliver it and where they’ll experience a level of quality that improves outcomes.

More so, the terms of this deal don’t directly point to the savings. Our community now gets to avoid robbing city services, roads and other infrastructure of +$90 million dollars that would need to be directed to the hospital for capital improvements – improvements that can only be recouped by inpatient stays that are decreasing from healthier populations and the 3::1 over saturation of beds in our market.

Lastly, the hospital’s capital demands were also a threat to the City’s bond rating. Once the threat would be realized, the cost of bonds would rise, making less capital available and more costly to pay off.

In other words, this deal is keeping us from going over a cliff. I can defend that.

Jim,
Thank you for a civil and informative response. You said some things I hadn't heard before. While I can't say I'm convinced - I'm not ready to put down my clipboard yet - I will say that I feel better about the deal than before.
Others have raised some questions, and I hope you will answer them in the tone I hope we can set here, and I hope they can follow up in the same manner.

Meanwhile, I have two questions of my own, both pertaining to the two hospital systems you mentioned.
1) On UH, you did not mention any recent conversations. As has been said, health care is changing rapidly and 20 years is like a century. What did UH say last year when contacted?
2) On MetroHealth, I see a lot of acquisition/expansion going on. I'm not an expert but it speaks to me of financial health. I recently heard of another major deal that is coming: HealthSpan. Until the end of the year I had HealthSpan and went to see a specialist at the very large Parma outpatient facility the last week in December for a follow up and a referral for the future. He told me that by the time I needed to see him again, he would probably be Metro. Are they really in bad financial shape?
(I just Googled it and the news broke this morning: http://www.cleveland.com/healthfit/inde ... iring.html)
Thanks again,
Dan

[Jim Kenny]

Ms. Conant: Please understand the MetroHealth PowerPoint that you are referencing was not a formal proposal. It served as a guide for a discussion in May 2014 on what MetroHealth might propose – which it never produced and formally declined to propose after Mayor Summers extended a specific request.

Please know, too, that the links you selectively provided speak of the bonding rate MetroHealth receives as a part of Cuyahoga County government. This rating is biased by the County’s financials and not the performance of MetroHealth.

The good news for MetroHealth is its finances rebounded in 2015, as compared to 2014 when Jenn Pae evaluated these before drawing any conclusions on the institution’s solvency. The link below is just one of many that cites its improved financial performance. More so, it also details MetroHealth’s intentions to invest $1 billion in its campus and the severe challenges it faces when financing this project. In other words, when the parent eats most of the food, the children suffer. I’m sure glad that Lakewood Hospital is not seated at the MetroHealth table.

http://www.crainscleveland.com/article/ ... althy-move

[Bridget Conant]

Standard and Poors assessed METROHEALTH's financial stability, not Cuyhoga County's. http://www.researchandmarkets.com/repor ... stem#pos-1

The affirmation reflects Standard & Poor's assessment of MetroHealth's strong enterprise profile and adequate financial profile.

The ratings are based on the performance of the hospital system, not the county. By virtually every assessment, Metrohealth is performing well, better than in the past, and has a promising and strong future.

That is a FACT,

As for the proposal not being a proposal, talk to Metrohealth chief Boutros, who stated to the PD

"MetroHealth has spent considerable time and effort in response to the [request for proposals] and has set a deadline of October 1 for conclusion," Boutrous wrote Oct. 3. "Since this date has passed, please accept this as confirmation of our withdrawal from the selection process."

So you still want to tell me that the proposal wasn't a proposal?