Jay Carson wrote:I see a lot of criticism of the report based on the fact that the City paid for it. But I have not seen anything to indicate that the facts reported in it are incorrect. The findings state that the rooms are smaller than more modern hospitals and not set up private rooms. There are no showers in the rooms. Elevators from the 1930s; asbestos from that same era. Do any of those claiming that they want to "save" the Hospital have a plan how to fix these things?
Lastly, the Huron report was commissioned at the insistence of the those claiming that the hospital is economically viable as an inpatient facility--because they didn't believe the conclusions of the first report. Who did you think would pay for it?
Jay,
No worries---the hospital is viable.
I spoke for 2 hours last week with the Huron consultant who wrote the report and here are my takeaways:
1. Huron was not hired to look back at how we got here--they did not look at how we lost the business and service lines--i.e. how they were stolen by CCF: i.e. they did not address the accountability, leadership and change issues the City faces---Without good leadership there is no accountability and, therefore, there can be no change. So the Huron Report does not address the fundamental issue of CHANGE.
2. The hospital was not marketed properly---Subsidium and LHA did not get a release from CCF last year or ever, i.e. CCF did not sign off or agree that if a buyer was found CCF would leave---so LHA and Subsidium were hopelessly compromised i.e. the hospital has never been marketed for sale in any meaningful manner.
3. Huron did not obtain a legal opinion on whether CCF would be liable for under the Definitive Agreement operating losses through 2026 per the cash to debt ratio obligation of the CCF--Neither did Subsidium---so now LHA and the City have together spent $600K without a core issue being addressed by either consultant--not Huron's fault--it was not in the scope of their engagement. FYI the Clinic is liable--they are stuck!
As to the minor issues of showers, room sizes and money needed, these are the easiest solutions---LHA and LHF currently have $80 million in cash and investments. CCF is on the hook for more than that--I've heard that the Plaintiff's now have evidence of fraud and intentional wrongdoing--that means punitive damages--but "hold the phone"---they are only in the first few months of discovery so it can only get better for the City's case (that the new mayor will get behind in January).
So the Clinic has to pay one way or the other--the longer they drag it out, the more they will pay---and they will likely lose market share too.
I have yet to read the Huron Report, but below are some points prepared by one of the smartest leaders working on positive solutions on behalf of the City:
Three Key Points from Huron Report:
· Lakewood can support an acute inpatient Hospital (Pages 38, 40 and 71).
· City Council needs to do more "Due Diligence" (Pages 17-18).
· Subsidium's Partner Search was flawed (Pages 43-44).
Lakewood can support an acute inpatient Hospital:
· Lakewood's population can support a hospital: The Huron Reports states: "A population the size of Lakewood has the ability to support an acute care hospital if the outmigration of healthcare services is significantly reduced." (Pages 38 and 71)
· Status Quo is Viable: Huron believe status quo "may be a viable option if LHA and the City prefer to delay a decision on the Hospital, during which time the City would continue to receive payments under the lease." Use additional time "to develop a strategy to address facility issues, develop a supportive physician network; and pursue negotiations with potential partners." (Pages 40, and 71)
· Additional study needed. Huron states additional study is needed with regards to maintaining the status quo. (Page 71)
· Right Size Hospital: Reduction of Beds - Huron believes this is "a viable option if there is sufficient capital for facility renovations and an ability to expand the physician network and capture additional community support for the Hospital." (Page 40)
· Physician Recruitment: Huron states that the newly formed Ohio Independent Collaborative "could aid the situation [i.e., difficulty in recruiting independent physicians] if they are successful in their missions." (Page 22)
City Council needs to do more "Due Diligence
· Additional Study needs to been done to explore status quo. (Page 71)
· Other considerations for City Council: Huron states that before Council decides to close the hospital, it should consider:
1. What are wait time for ERs in area?
2. Will closure cause wait times to deteriorate
3. Will emergency responders transport to family health center?
4. Risk to patients with critical care issues?
5. Will general health of community improve?
6. With no hospital, ability to recruit physicians?
(Page 18)
· Quality of Care Issues must be examined: "Huron has not taken a position on the anticipated impact on quality of care for the residents of Lakewood if the Hospital is closed and replaced with a family health center." (Page 18)
Subsidium's Partner Search was flawed
The Huron Business Advisory identified the multiples way in which the Hospital Partner search conducted by Subsidium was flawed:
· Process should have included a "licensed investment bank (broker-dealer). (Page 43)
· No release obtained from Cleveland Clinic regarding potential tortious interference claims in marketing of the Hospital. (Page 43)
· Difference in RFPs - some to operate as an acute care hospital - one for an outpatient facility - may have limited buyer interest. (Page 43)
· Not marketed to potential buyers that have a history of acquiring distressed hospitals. (Page 43)
· Not marketed to faith-based systems. (Page 44)
· Huron states "does not factor in the inconvenience to Lakewood residents or potential impact on public health (especially for high-risk condition such as stroke and cardiac arrest) resulting from increased transit times to other hospitals if Lakwood Hospital is closed." (Page 17)
·
Patients go to Avon - Subsidium concludes that CCF with move 80% of current volume to the new Avon facility - Huron states "this is a pessimistic assumption given the ability of patients to choose their facility." (Page 49)
Premier Physicians - Huron makes an erroneous statement that Premier group "has already declined to affiliate with the Hospital." Premier Physicians never backed out and they are still interested--in fact their patients account for about 40% of hospital admissions.
So Jay, there is no need to worry---the City has can keep a hospital by backing the right leaders who are positive and critical thinkers. I believe that Lakewood will make the right choice in November---less than 3 months from now.
