Roy Exum: Erlanger Leaders Are Sick

Saturday, January 26, 2013 - by Roy Exum
Roy Exum
Roy Exum

The Hamilton County delegation of the Tennessee Legislature has recently written two letters to the Erlanger Hospital Board of Trustees, asking the group to slow down in hiring a new chief executive, but now frantic hospital leaders are clamoring for the politicians to do the exact same thing.

The legislators are poised to introduce a bill early next week that would alter the governance structure but as word of the proposed bill became public Friday, key hospital leaders fought pseudo-symptoms ranging from hypertension to nausea.

Erlanger, which lost $10.5 million in the last fiscal year and has lost another $2.5 million at the midway point of this year, desperately needs a better business model but what the area legislators are now proposing offers scant changes and will do little more than replace the current board of trustees with a new cast of characters.

What is clear is that the area’s Level One Trauma Center and Chattanooga’s top health provider needs a 501(c)(3) corporate structure but the legislators’ pending action calls for “just another” governing board of nine people, with just seven allowed to vote, that could -- quite literally -- vote to sell the hospital and its campuses – get this -- if just four members felt that way.

Currently there are 12 trustees but after millions in losses and a myriad of other vexing problems, concern for the hospital and the thousands of patients who are treated there each year has grown to epic proportions.  The legislature, hoping to stop a politically-driven board that has proven to be inadequate, wants out of the nominations business and hopes to ask Hamilton County Mayor Jim Coppinger to pick a new nine-person team with two unable to vote.

That way the hospital would function just as it has and vocal insiders predict the consequences would be dire. Under the proposed bill, the Sunshine Law would still be in effect and there are ominous undertones that a “takeover” by the University of Tennessee, a private corporation, or another hospital could soon take place with just four votes, or a majority, needed to succeed. In short, the proposed bill is abysmal.

Seriously, the pending bill as outlined makes no sense to anyone who is familiar with the hospital and, sadly, most of the present trustees said Friday they have not spoken to, nor met with, the Hamilton County legislators. That fact leads to the presumption by some on the board, as well as other hospital leaders, that something may be “fishy” in the hurried actions by the politicians.

Why there hasn’t been a joint meeting between the legislators and the entire board is curious. Some of the hospital group already feel the delegation has been steered in a wrongful way that hardly reflects the true wishes of the trustees, the community and hospital leaders.  Ever since Board Chairman Ron Loving actively campaigned for embattled Charlesetta Woodard-Thompson to remain as CEO there has been distrust within the hospital leadership and, with change now eminent, tensions are high.

The trustees, most shocked by the legislators’ toothless bill, are poised to name a new CEO after interviewing the final three candidates, who are each well acquainted with what has happened at Erlanger in recent years. And the proposed legislation does call for the new board to rotate, the members selecting incoming candidates as individual terms expire. That’s a good move.

If, indeed, County Mayor Coppinger selects the first nine members – and who would ever want to serve on a board with the liability but not be allowed to vote? – Mayor Coppinger would be well-advised to pick some of the current board members because not only are some very solid and qualified, they already know the inner-workings of an $800 million business better than any outsider ever will.

It is clear the legislators have little knowledge of Erlanger’s problems or such a flimsy bill would have never been brought into being. The “Sunshine Law” stifles competition and the highly-successful business model that many other 501(c)(3) hospitals across the country enjoy. Then again, the puzzling lack of mid-management, the void in capital spending, the horrible out-sourcing, and the poor decision-making are almost too much for any one mortal to comprehend.

Believe this; until the legislators meet with the full board of trustees and carefully listen, any rush to push a bill through at the state level will hurt much more than it will help. As one put it so succinctly, “these (politicians) have a chance to be heroes but are becoming the villains. This opportunity isn’t going to come around again.”

So, yes, the need to move quickly is obvious but to make the wrong move – by just changing from one cast to another in the same dreadful play – is ridiculous and may the Lord help us all if our representatives in Nashville can’t recognize the urgent need for a total and complete reorganization at our region’s most important health facility.

Not only does Erlanger deserve better, the citizens of our region do too.

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