The Observation Deck

Sorry, but I counted 8 times that Jim Kenny used the phrase "new Lakewood Hospital" when he referred to the Clinic's plan in his piece "I Live in Lakewood, So I Speak for Me" printed in today's Observer. A "Hospital" is defined as "A facility that provides emergency, inpatient, and usually outpatient medical care for sick or injured people." Per Dr. Brian Donley, the Clinic's proposal is to build a "specialty referral center", it is not a hospital that provides inpatient care. I would like to hear more from Mr. Kenny as to the claim that the Clinic is only obligated to provide 3 services and that the "new hospital" will expand services to 22 offerings.

Hats off to the Observer for giving us all a voice to speak so that everyone can learn from the exchange of facts and opinions.

Thanks for asking for clarification. The collective egos at the Cleveland Clinic might not define the proposed healthcare facility for Lakewood as I do; however, Ohio Revised Code 3727.01 does. I believe both sides of the debate are always better served when they rely on mutual definitions.

The Clinic’s contract with the Lakewood Hospital Foundation obligates it to deliver Emergency, OB/GYN and Acute Care Surgery services until 2026. Any other services are discretionary. If we hold the Clinic to its contractual obligations, we can reasonably anticipate the Clinic reducing its services to these three and that will prevent any facility from being defined as a hospital, as dictated by Ohio Revised Code. According to the Clinic's Letter of Intent, it is prepared to reconstitute the services offered at a new Lakewood Hospital to reflect our current needs (based on recent and historical relevant patient data) and deliver 22 services, some old and some new.

Our City Council should be fully aware of the terms of the Clinic’s contract and the restrictions of Ohio Revised Codes, as they are legally obliged. Therefore, if we truly want to save Lakewood Hospital, we have little choice other than to accept the Clinic’s Letter of Intent.

Mr. Essi, thanks for encouraging voices that might oppose yours or other readers’ understanding of this issue. We both clearly share a passion for wanting what’s best for all of Lakewood. I'm glad you agree that civil debate and a bias for facts over emotions are the clearest path for getting there.

I'm not sure how Mr. Kenny believes that a Minute Clinic is on the same level as a full service Hospital. I'll chalk it up to a manifestation of the Emperor's New Clothes . . .

Jim,

1. Below is the full text of Ohio Revised Code section you referred to and after my first read it seems to include "inpatient" services at (B)(2).

2. I'm not sure where you come up with the 22 offerings from the defunct LOI?

3. What sections of the Definitive Agreement can you point to for your conclusion that "The Clinic’s contract with the Lakewood Hospital Foundation obligates it to deliver Emergency, OB/GYN and Acute Care Surgery services until 2026. Any other services are discretionary."?

4. Can you explain how taking $26 million of liquid hospital assets to destroy most of the physical assets valued at $70 million to deliver a cleared piece of land to the Clinic at land value only while the Clinic strips all physical assets and equipment (e.g. cath lab etc) for free is the best we can do as a City?

5. Do you think that having a public bidding process for the assets i.e. more than one bidder might yield better pricing on the sale of City assets?


3727.01 Health maintenance organization - hospital defined.

(A) As used in this section, "health maintenance organization" means a public or private organization organized under the law of any state that is qualified under section 1310(d) of Title XIII of the "Public Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e-9, or that does all of the following:

(1) Provides or otherwise makes available to enrolled participants health care services including at least the following basic health care services: usual physician services, hospitalization, laboratory, x-ray, emergency and preventive service, and out-of-area coverage;

(2) Is compensated, except for copayments, for the provision of basic health care services to enrolled participants by a payment that is paid on a periodic basis without regard to the date the health care services are provided and that is fixed without regard to the frequency, extent, or kind of health service actually provided;

(3) Provides physician services primarily in either of the following ways:

(a) Directly through physicians who are either employees or partners of the organization;

(b) Through arrangements with individual physicians or one or more groups of physicians organized on a group-practice or individual-practice basis.



(B) As used in this chapter:

(1) "Children's hospital" means any of the following:

(a) A hospital registered under section 3701.07 of the Revised Code that provides general pediatric medical and surgical care, and in which at least seventy-five per cent of annual inpatient discharges for the preceding two calendar years were individuals less than eighteen years of age;

(b) A distinct portion of a hospital registered under section 3701.07 of the Revised Code that provides general pediatric medical and surgical care, has a total of at least one hundred fifty registered pediatric special care and pediatric acute care beds, and in which at least seventy-five per cent of annual inpatient discharges for the preceding two calendar years were individuals less than eighteen years of age;

(c) A distinct portion of a hospital, if the hospital is registered under section 3701.07 of the Revised Code as a children's hospital and the children's hospital meets all the requirements of division (B)(1)(a) of this section.


(2) "Hospital" means an institution classified as a hospital under section 3701.07 of the Revised Code in which are provided to inpatients diagnostic, medical, surgical, obstetrical, psychiatric, or rehabilitation care for a continuous period longer than twenty-four hours or a hospital operated by a health maintenance organization. "Hospital" does not include a facility licensed under Chapter 3721. of the Revised Code, a health care facility operated by the department of mental health and addiction services or the department of developmental disabilities, a health maintenance organization that does not operate a hospital, the office of any private licensed health care professional, whether organized for individual or group practice, or a clinic that provides ambulatory patient services and where patients are not regularly admitted as inpatients. "Hospital" also does not include an institution for the sick that is operated exclusively for patients who use spiritual means for healing and for whom the acceptance of medical care is inconsistent with their religious beliefs, accredited by a national accrediting organization, exempt from federal income taxation under section 501 of the Internal Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1, as amended, and providing twenty-four hour nursing care pursuant to the exemption in division (E) of section 4723.32 of the Revised Code from the licensing requirements of Chapter 4723. of the Revised Code.

(3) "Joint commission" means the commission formerly known as the joint commission on accreditation of healthcare organizations or the joint commission on accreditation of hospitals.


Amended by 130th General Assembly File No. 25, HB 59, §101.01, eff. 9/29/2013.

Amended by 129th General AssemblyFile No.127, HB 487, §101.01, eff. 9/10/2012.

Amended by 128th General Assemblych.127, SB 79, §1, eff. 10/6/2009.

Effective Date: 04-10-2001; 2008 SB279 01-06-2009

There isn't going to be any "new Lakewood Hospital", according to the Cleveland Clinic. They would make us pay (millions of our hospital's dollars) to demolish our hospital. That is very clear in the Letter of Intent--which the LHA has allowed to expire.

Take your financial assets, use it to demolish your house; now you can live in the garage--or your boat. (IRS permits a boat to be called a "house" as long as it has a "head".)

Their "Family Health Center" is not to be confused with a Hospital. Even the Cleveland Clinic knows better than to pretend to us this is a "hospital."

All you have to do is drive out to East Cleveland and check out the Stephanie Tubbs Jones Health Center-don't-call-it-a-hospital (and Huron Road Hospital was demolished soon after the HC was built--right after Clinic promised to the doc running the HC that the hospital would remain) to realize that this facility is more akin to an "urgent care" and cannot in any way be considered a "hospital." (We know this, because we sent medical personnel to evaluate it.) There are only a couple nurses and a couple doctors and some residents and "medical assistants" (high school with a certificate).

First stop for an incoming patient, is "Financial Triage." No money, no insurance - off you go to the Free Clinic or other social service. (WHERE, in Lakewood, would such patients go for medical help??)

Specialty doctors are called in only if and when needed, playing musical-chairs in a few examining rooms, but each might not even be there one time per week.

They don't have a lab, they don't read X-rays, they don't have a CT or an MRI, they don't do surgical intervention of any kind. (They send labs and X-rays out to be processed.)

(There was no mention of OB or midwives, so I am pretty sure they don't deliver babies, either. I think they would have mentioned it.)

They don't have an emergency room (and we won't really, either, despite what they say.) Anybody who mistakenly arrives at what they think is an emergency room, just gets stabilized and shipped off to a real hospital. (We have 20 rooms now in our ER, and the ER is overfull many times; the new facility would only have 4 rooms.)

The big docs at Cleveland Clinic, after running our hospital for 19 YEARS, still have no idea what our needs are. Their answer to our inquiry on April 30, should have come "trippingly off the tongue", and they had NO answers about just what would be in the FHC-don't-call-it-a-hospital that they propose.

(In contrast, Metro had a full description of services and departments they would provide, and how they would be staffed.)

By the way - in case anyone out there holds a mistaken notion - NO taxpayer dollars fund Lakewood Hospital. Not city income tax, not real estate tax, not sales tax, not federal or state income tax - NO TAX. Getting rid of the hospital will not reduce ANY tax, anywhere.

BUT - closing the hospital will increase city income taxes. City will lose up to $3.6 million of income tax, due to loss of hospital jobs and other community jobs/businesses. This is 15% of city's income, not an easy piece to make up.

Lakewood Hospital is self-supporting through patient and insurance payments. It generally runs at an operating profit (yes, profit) before interest/depreciation. There is no interest expense because the hospital bonds were all paid - and hospital income would have repaid the bond principal and interest. There are funds available IN the hospital, besides the Clinic's contractual obligations, to cover any shortfall. THESE FUNDS HAVE NOT BEEN DIMINISHED.

When there is an "operating loss" - it is because the Cleveland Clinic charges an enormous amount of unexplained Administrative Service expense - in excess of $24 million each year for recent years. Part of this is executive salaries, regional administration, consulting and legal (none of which benefit Lakewood - quite obviously).

(By the way - Clinic already has a family health center, on Detroit at the east end of town. It was listed for sale earlier this year, for $2.2 million. What? They don't know how to run a health center?)

If they do that to us, build a new FHC, find they can't make money on it, then get rid of it - after they have forced us to not allow another medical provider in --then WE WILL BE STUCK--and Clinic's intended monopoly on the west side will be complete.

Brian, thanks for giving my post more consideration. In effort to not complicate the issues, I will be as concise in my replies as possible:
1) The proposed new hospital will have inpatient beds. These will be for short-term care, as longer stays will be directed to hospitals where needed services and care reside.
2) In May, our Mayor and his administration presented to Council. One of the slides in the presentation itemized the current service offerings, which amounted to 20, and the newly proposed services, which will total 22.
3) Also in May, our Mayor and his administration reminded City Council of this fact, the Clinic's contractual obligations for providing three services. Council did not dispute this interpretation of the contract.
4) When described as you’ve done, I can’t explain. It’s neither balanced nor an objective representation of the facts. Heck, I would be vulnerable to agreeing with you as I would feel like a victim. But then I would be failing to recognize that a transfer of assets is necessary and would be neglecting the opportunity to see what Lakewood gains.
5) Yes, I agree open bidding is desirable. We don’t live in that marketplace. The Clinic calls the shots in this market. We can accomplish more working with them than against.

Jim,

Thomas Jefferson never engaged in arguments because he said he never saw two men in an argument where one convinced the other of his point of view. So here is where I can agree with you:

1. If you count as "inpatient beds" the gurneys that patients will rest on for the few minutes before being transferred to a real hospital, then the specialty referral center is a "new hospital". So we agree.
2. I would be careful of relying on what the Mayor says---he may believe what he says and you may believe what he says, but much of what he says is unbelievable--I do admit that he's a nice guy and sounds sincere and believable. So we can agree that you believe him.
3. If you and Council are relying on Mayor Summers' interpretation of the Definitive Agreement then why are they paying Thompson Hine $200K and Huron Consulting $75K partly to get advice as to ineterpretation? I spent 2 1/2 hours with Mayor Summers one on one on April 8, 2015 and I can say beyond any reasonable doubt that had no clue about the key provisions of the Definitive Agreement and Lease--he didn't seem to care about the terms of the agreements or that the primary purpose of the agreements was to protect our most vulnerable citizens. I wasn't at the meeting you say occurred, but I'll agree with you that Council may not have disputed Mayor Summers' interpretation, but you and I can agree that most ladies and gentlemen on Council don't call each other or the Mayor liars or openly contradict even their obvious mistakes in public. You and I agree that's just not nice.
4. We both agree that if I am right, you would feel like a victim. If believe what you believe and you are wrong, them we can agree that you are in fact a victim. I am confident that you will someday realize that you are victim and all who have victimized you, but it will likely be too late for you to do anything about it we let the Clinic call the shots as you put it.
5. I agree with you that the Clinic calls the shots for LHA, Summers, certain others and you. You seem to accept that--which makes you a victim of at least the Clinic's perceived power. I do not agree that they call the shots for me and I believe a super majority of the 52K Lakewood residents think the way I do. I agree with the part of your piece in the Observer that our elected representatives call the shots--hopefully with our input. I thin we can agree if one party actually calls the shots, then we then it would not be an "agreement"--it would be a capitulation. Likewise we would not be working "with" them, but "for" them.

We'll just agree to disagree on your last point. The Clinic does not work with anyone, they try to have their way--they run over people and communities. They are working against the citizens of Lakewood, especially the underserved and the most vulnerable among us---they care more about money than people or healthcare.

If I agreed with the rest of what you wrote, then we would both be wrong and we would both be victims. I'm doing my level best to avoid that.

Jim

Thanks for jumping in and submitting the article o the print version.

I am just curious, as you are asking about facts...

Are than any facts to support the Cleveland Clinic would not work with Lakewood, except
under the order of a agreement of something like the LOI?

I have never heard anyone at the Cleveland Clinic say that, or indicate that?

I am one that really does not see the need for a hospital after 2025, and possibly before
with the exception that there are many things a City provides for residents that are neither
money makers, or financially sensible. I get the need for something setting Lakewood
apart from the other communities.

I also think that if you are going to partner with a someone over a "hospital" that you
should go with the person with the greatest depth, and seeing how UH has no desire to
deal with this Mayor and LHA Board, that leaves the Cleveland Clinic. Which has never
given me any indication that it was an all or nothing deal on their part.

So I ask, is there any proof the Clinic would not honor their contract? If forced to?

Mayor Summers has always told me, this was his decision and his RFP. Every statement
he has made has backed that up. Yet you an Brian make it sound like he is being forced?

Is the mayor being untruthful again?

Again I have no where near the the knowledge or background as you two on this, I'm
just posting questions that came up while reading this discussion.

Carry on.


.

Hi Jim, thanks for your note. From everything I’ve heard or seen, there’s no indication that the Clinic won’t follow through with honoring its contract. However, given the continual erosion of services, market forces will do what the Clinic can’t and these forces will shutter our hospital well before 2026.

I, too, have never been a fan of the City of Lakewood being in the business of maintaining a hospital. That’s why I like the current LOI. It gets the City out of the business and places both the operational risks and the financial risks with the institution best able to manage these in the interests of the patients it serves. The transfer of assets frees the City from this burden, while also freeing assets that would otherwise risk the blight we now see at the Highland Theater. Better yet, the citizens gain the benefit from newly developed 6 acres in the middle of town and the power of the resulting charitable foundation (much like the Cleveland Foundation) that can act in the best interests of our neighbors.

As I write, the hospital is losing $28k/day. Yes, it has performed better in the past. It ain’t no more. Anyone who walks the halls of the hospital can clearly see it is suffering from under investment. If you cross the street, the same is true with the parking garage, which is nearly 50 years old, and the professional services building. All of these are demanding millions in cash to remain safe and competitive.

Where’s the capital when we’re burning cash at such fast rate: $28k/day, $840k/month and $10,000,000/year? This red ink is being covered by the Lakewood Hospital Foundation, which covers all the financial risks. The Clinic only has operational risks. In other words, the Clinic’s bets are covered. They don’t need to walk away from the contract, but the Lakewood Hospital does need to change. If only members of City Council who agreed to this lopsided contract in 1996 could step forward and explain why this made sense. Maybe we wouldn’t have a divide between citizens who share an interest in not only saving the hospital, but assuring it gives optimal services and remains financially sound.

I stepped into this debate for two reasons. First, I love the passion Lakewood citizens have for our city. Unfortunately, these emotions can be so strong that they inspire overpowering words, actions and accusations. I wanted to understand the facts and, once found, knew my neighbors needed the benefit of these. Unfortunately, because of the complexities of the issues, people are vulnerable to fixating on one part of a potential deal or interpreting anyone’s pursuit of legal counsel as disingenuous rather than prudent.

Second, to say anyone has been “untruthful” is a euphemism for accusing someone of lying. I don’t believe anyone in this debate is lying to us. I do believe some have been selective on where they ask us to focus, as this can justify any insistence to not trust those elected with our trust. I trust Mayor Summers. I believe he has acted like the patriarch we elected. And like a parent, he is considerate and responsible to those he asks to follow him. In doing so, he has carried the weight of the hospital’s festering problems until he could offer a path to healing it for all of us.

Mayor Summers' selfless actions have inspired me to act and offer the same consideration to our neighbors. That’s why I’m now ignoring household chores to return your consideration. It’s what makes me worthy to be your neighbor. Thanks for being mine.

Jim O'Bryan,

"Shame, Shame, Shame, Shame, Shame" Gomer Pile.
Without a hospital, who will take care of the underserved?
I know you've done more than your share of charitable giving, but your checkbook is not big enough to cover the shortfall.

Jim Kenny,

Your tactics are obvious--just like those you employed while on Phase 3--a campaign of disinformation—the intentional mixing of some true information with false information to create a false conclusion. You build seemingly logical arguments on top of false premises. You make specific factual misstatements to arrive at false conclusions and when called out on the specifics, you shift to fluffy false general statements. You completely ignore facts that you can’t get around. You accuse others of doing exactly what you are doing, i.e. fixating on one part of the deal. Here are just a few of the facts that underscore my point:

1. The “Market Forces” ploy is the biggest lie being told in this debate. “Market Forces” are a constant in every industry--not something new like a dagger that comes from nowhere to kill a business. Are market forces “shuttering” Lutheran, Fairview, CCF Main campus or Metro? No. What about the payer mixes in those neighborhoods? Game, Set, Match on the facts, but you and the others in your disinformation campaign will keep saying it.

2. The Clinic has not and is not honoring its contract—that will be shown by DeVito et al.

3. The hospital is losing money now because the Clinic, LHA and Mayor Summers have caused it to lose money—in the first quarter ended 3/31/2015 the long term investment pool actually went up over $1 million despite self-inflicted losses. I could say that is being done maliciously or with reckless disregard, but then I would be accused of being “emotional”—another disinformation tactic to marginalize the folks you claim to want to help.

4. Since you are digging into the facts please address what happened to this: http://www.crainscleveland.com/article/ ... d-hospital The first sentence of the Crain's article: "The Cleveland Clinic has committed to spending at least $28 million to renovate Lakewood Hospital over the next five years under a plan called Vision for Tomorrow." What went wrong with the Clinic’s plan? Does the Clinic call the shots or not? Trust requires a track record, and you can’t drink the Clinic’s track record in Lakewood pretty---it has taken them just 5 years to destroy a century of value.

5. Contrary to your belief, you don’t have to be lying to be untruthful—in the end it doesn’t matter if the Mayor believes what he says if what he says is not true.

6. You completely ignore the underserved and most vulnerable. How do you plan to take care of them if you win your campaign to end the “business” of maintaining a hospital? That business has paid the citizens about $10 million a year in dividends just since 1996 without the City spending a nickel. I guess you agree with the Mayor about “those people.”

7. If you really want to understand what went wrong in 1996 and what is wrong with those clinging emotionally to the LOI, I invite you to meet with me and Pillar of Medicine award winner, Terry Kilroy, who was there in 1996 arguing against it and now argues against this looming disaster. You and your group would be wise to heed his ongoing warnings. Call me at 216 346 3434 so we can get emotional together in person.

it is difficult to keep track of what is legal.
https://www.youtube.com/watch?v=avqagKhqY9U

Jim Kenny wrote:4) When described as you’ve done, I can’t explain. It’s neither balanced nor an objective representation of the facts. Heck, I would be vulnerable to agreeing with you as I would feel like a victim. But then I would be failing to recognize that a transfer of assets is necessary and would be neglecting the opportunity to see what Lakewood gains.

Just what does Lakewood gain?

That is a simple question that the Mayor has not answered. If we are to demolish Lakewood Hospital to make room for development shouldn't there be an actual development plan?

The Mayor should have released a development plan by now. He has not even released an outline of a plan. Why?

What has the Clinic offered in place of Lakewood Hospital? Another simple question without an answer. When Clinic representatives spoke before Council they refused to guarantee any level of service or any number of employees. Why?

The proposed Family Health Center under the now dead LOI would have looked something like the Family Health Center in East Cleveland. The New York Times described that facility has the place to go if you had a "sprained ankle or a sore throat". Is that what we are getting?

You may be correct about some aspects of the current lease, HOWEVER, Council only approved those changes after the Clinic made a pitch for the Vision For Tomorrow.

http://www.onelakewood.com/pdf/CouncilM ... 0_0610.pdf

In exchange for changes in the level of service the Cleveland Clinic promised to make Lakewood Hospital a "center of excellence for neurosciences, orthopedics, diabetes and geriatrics". They also committed to expanded rehabilitation services and expanded emergency room services.

Where any of those promises kept?

Just what was the Vision for Tomorrow?


http://portals.clevelandclinic.org/Abou ... fault.aspx

http://portals.clevelandclinic.org/Abou ... fault.aspx

In my humble opinion the Vision for Tomorrow was a con artists scam designed to convince the Council to change the original lease. That means the current lease is void and the Clinic MUST restore what they have destroyed.

Convince me that I am wrong. Or at least try. One of the odd things about this debate is that only one side is talking.

Jim Kenny

First off, I use the euphemism for lying as so many seem to think I was tough on the Mayor and Council President for lying, which they have done many times on this subject. Both in print and in conversations, to recap: "The Hospital is not closing" by the Mayor, who had the LOI in his hands, which he agreed with completely. There were no licensed beds in the LOI. He also announced $120 million in downtown investment as part of this. He has never backed that comment up with facts. There was no money in the deal that was not ours already. This was a pure cover-up. They knew how bad this deal was and lied about it. Mary Louise Madigan, saying "she had heard rumors too." Not just a lie, but idiotic, as she is both Council president, and our representative to the LHA Board, and had her copy of the LOI in her hand. "I heard Metro was still part of the discussion." Another lie, not only was Metro not part of it any longer, but when they asked to resubmit a better plan she said, “No!” Not only was this an outright lie, but all of these comments were used to confuse and mislead the residents on something that is incredibly important to everyone.
We need the facts, not—as you say—emotion or hype.

I think in the coming months, we will see just how wrong and illegal(?) these conversations were. There are very few reasons for Executive Sessions, and those have a very narrow band. Legal or not, there was and still is an active plan of the administration to mislead us from the truth for years.

Jim K, I think the next 15 years could deliver the Mayor's wildest dreams in healthcare. But his vision does not give him any right to pervert the rules of law or of office. I have very little doubt that the MAYOR and the City Council President were not only negligent of their fiduciary responsibility to the City of Lakewood, but conspired with others to rid the city of our largest employer, and a cornerstone to the entire Downtown landscape, for their own personal agendas.

Everyone agrees that removing services from Lakewood Hospital has damaged the Hospital. No one is even contesting that, and this is the major point in the lawsuit against the LHA-- mismanagement. They took a City Asset and signed on to return it to the Community at the same value or higher, they even had the Mayor and Council President on the LHA board for our protection among other things. Not only did they approve the sacking of Lakewood Hospital, they expedited it, ignoring their sworn duty to warn us that it was happening. Was the secret destruction of the Lakewood Hospital an effort to cover up just how badly they have performed as elected officials in this matter?

I hear all the time how the very ineffective Mayor Summers has been turned into a sock puppet for the Clinic. If that is true, it is only because he wanted to be. He has always had the bully pulpit, he could always speak out about the failings of the LHA, The Clinic, or this deal instead of expediting the sacking, and allowing others, others to whom he has ZERO legal obligation, run City Hall and the city.

That alone should see both the Mayor and the City Council President removed from office, and this entire deal reset.

After all, as you said, the Cleveland Clinic has NEVER SAID THEY WERE LEAVING.

So before we take another step, let’s rid ourselves of the people who have failed this city. We certainly do not need them deciding our future.

I did not read Brian's piece yet, was merely answering you. Brian and I have our own opinions on this, but we both agree that the behavior by our elected officials borders so close to criminal one doesn't have to think long.

Unlike Bill Call and others, I do not expect the Cleveland Clinic to do anything besides look out for their bottom line, while delivering world class care for as little overhead as possible. They are a corporation, and boards demand that.

However, as the Mayor, and Council are sworn in, it is to protect us.

Jim O'Bryan wrote:Unlike Bill Call and others, I do not expect the Cleveland Clinic to do anything besides look out for their bottom line, while delivering world class care for as little overhead as possible. They are a corporation, and boards demand that.

However, as the Mayor, and Council are sworn in, it is to protect us.

I wonder, is the Clinic management acting in the best interest of the institution we call the Clinic?

What if the Clinic sometimes acts in the interests of the Friends of Mr. Cosgrove?
What if the Clinic sometimes acts in the interest of its major donors?

When you or I donate $100 to the Clinic (if we do) we are making a charitable donation.

When Jacobs or others make a $20 million dollar donation they are making an investment. What is the return on that investment? There must be a story there somewhere.

Make no mistake about it, what is being proposed by the Cleveland Clinic and the Lakewood Hospital Foundation and Mike Summers is DEFINITELY POSITIVELY ABSOLUTELY NOT a hospital under Ohio law.

Sorry Jim Kenny, but I think I may have won the PR game on this one.