Roy Exum
There is no question in my mind that the Erlanger Hospital Board of Trustees – individually – are fine people. I know five of the 10 personally and have great respect for another two or three I’ve heard about. Yet we are told that sometime Thursday the hospital board will vote to award President and CEO Will Jackson a $50,000 bonus and I am convinced this is wrong. Understand, I have no dog in the hunt; I’m no more than an interested observer. But I am disappointed in myself in that I have become a vocal critic of Erlanger management, only because I am in a position to see what the other actual owners of the hospital obviously cannot.
Erlanger Hospital is Hamilton County’s greatest asset.
Nothing else comes close when it comes to public trust. What our Level 1 Trauma Center means not only to our city and county but - most importantly - to every human being within a 100-mile radius of 960 East Third St. is very nearly sacred. The hospital is owned by the people of Hamilton County. Sure, it works in close cooperation with both the state and federal government and, whether they have the courage to admit it, the Board of Trustees is appointed to be our stewards in providing premier health for easily more than one million people in the United States. Think of that … over 1 million people, most particularly as one citizen in our nation now dies every 60 seconds from the COVID virus.
I watched, very carefully and with great interest, when former CEO Kevin Spiegel was ousted in August of 2019 and Jackson was hired as his successor a month later. It was as messy and as despicable as a South American coup and the principles in the ruse would have made Fidel Castro laugh. To this day the lack of accountability to the public was unforgivable, equaled only by the careless empathy by our elected leaders and the unknowing public - the owners. Jackson had absolutely no experience in hospital administration whatsoever but had spread enough venom in the three years since his arrival to hasten Spiegel’s abrupt departure.
Who is this guy? Where did he come from? How did he get here? Did he ever see patients at Erlanger? If so, insiders say it was precious few. I believe not one member of the Erlanger Board of Trustees can point to one specific reason Will Jackson should be the hospital’s CEO. That’s right … it’s all smoke and mirrors … and down deep inside, the individual trustees haven’t the gumption to question what is now becoming something of a farce. Just study the timeline by using the skeletons in the closet - each has an actual name!
Jackson soon enchanted the weak members of the board, assured certain others that the lucrative contracts with physician groups would remain unsullied, and cultivated quite the promise of a Garden of Eden among the hospital’s ever-fickle medical staff. No problem, come right ahead, said the quick thinkers whose fiefdoms were secure and – bingo! – the 2019 Word-of-the-Year at the Tennessee Hospital Association and our Blue Cross-Blue Shield juggernaut was “Will Who?”
Trust me, I was teethed on Erlanger Hospital – my grandfather was the chairman of the Board at Erlanger for 38 years. While medicine and the Art of Healing has advanced astronomically, the tawdrier side of hospital politics has stayed just about the same. Human nature, greed, ego, vendettas, petty favoritism and the “boy-dog principle” (each wants to be the last to tinkle on the rose bush) has thrived at Erlanger. Quickly, get a list of the last 10 Erlanger CEOs, note the surprising brief tenures of each, and then sit around in a late-night setting with some of the greatest medical geniuses in the last 50 years our city has adored, and listen to “what really happened” to cause each one’s demise.
In September a year ago, Jackson was named as the CEO of Erlanger and in the very first paragraph of a story in the Chattanooga Times Free Press we read that he would be paid $625,000, “… and potentially another $50,000 if he meets three key goals: address physician relations, reorganize the hospital's management structure and reorganize the governance structure.”
Over the past couple of months Jackson has quite nearly become obsessed as he has clamored for the bonus. While he has apparently convinced trustee John Germ of his merit, I can safely say the majority of Erlanger’s doctors and nurses know better:
* -- ADDRESS PHYSICIAN RELATIONS: All the board needs to do is obtain a list of doctors who have left Erlanger in the last 12 months and let board member James Bolton, MD, who is also the Hospital’s chief of staff, stand as tall as he can, be given “The Oath” by board member and Judge Gerald Webb, and then tell the truth. Bring up the juicy names … Devlin, McCravey and his oncology group, Blake, the cardiologists now at Parkridge, and other quite notables.
Then ask the hospital’s physicians expert Meridith O’Keefe (vice president for Physician Relations) to explain preying on staff doctors who failed to meet contractual quotas in a COVID situation and present a list of those penalized at what amounts after admissions were down 14 percent and ER visits declined 23 percent. Who penalizes the hospital for missing projections? This is always a jolly moment for a board that represents the true owners of the hospital.
Then let’s get the guy who has given his life to Erlanger, board member Phil Burns, to be sworn in and present a candid and stark analysis of his fellow MD friends, past and present. I’m saying if you charged $5 a ticket to Burns' presentation, you could clear $25 grand (including TV rights) from the Hamilton County medical community alone because they already know but want to fling rotten vegetables, if you get my drift. To punish your own doctors is abhorrent.
* -- REORGANIZE THE HOSPITAL MANAGEMENT STRUCTURE: First, we’d have to borrow a lot of microscopes from UT’s College of Medicine to see anything because the short answer is: Nothing. Nada. No way. But wait, there was that Friday when about a hundred mid-management positions were axed (with no anesthesia, mind you), and “Quality Control” disappeared, and some key people like Pam Gordon, who had one of the best reputations in the hospital, said, in July, "no longer in good faith and good conscience can I remain in my role ... this has caused me health issues and many sleepless nights.” Then there was the startling discovery of abuse and mistreatment to the nurses that wiped away Gestapo leadership … Trust me, if you can only read in Braille you’d know management is at a low peak dating back to World War I. Governance? An outside group of neonatologists actually wrote and signed a letter this summer that Erlanger’s neo-ICU numbers were among the worst for a hospital of its size in the entire United States. Demand a list of state and federal inquires and investigations in the past year. Please, let’s discuss these revelations.
* -- LET’S ADD A FOURTH … A $50,000 BONUS IS ABOUT MONEY: According to a profoundly knowledgeable source: “Only the board can give the CEO a bonus. This is why they must have a board meeting to discuss it. But the CEO can give anyone a bonus. So, it will be interesting to see if Jackson has given bonuses to his senior management team. Either way, the idea of giving the CEO a bonus before you give all the employees a bonus is not only very unfair, it is simply stupid.” That’s a bit profound, is it not? Or how about this: “If you look at Note N on page 42 of the 2020 audit (which you have), you will see Erlanger received about $70M from the feds, but they only recorded about $56M of it. A bit further down it is noted the hospital received another $10M but they simply did not record it. This is perfectly legal since they use an accounting system called "Enterprise Fund" accounting.” Whew, that’s over my IQ, but graduate school professors understand it with the explanation: “This means that they have $24M of cash they received in 2020 that they can count as revenue in 2021. Now do this: If you look at the first quarter numbers, you will see that even though admissions are down 14 percent and ER visits are down 23 percent, they are showing a $15M improvement over the corresponding periods. That is, of course, absolutely impossible.”
Man, oh man! Does County Mayor Jim Coppinger know this stuff? What about our state legislators? Delegation? Patsy Hazlewood, who is leading our delegation, knows Erlanger’s immense value to Hamilton County but, for the life of me, a $50,000 bonus to a guy who has caused serious hurt and financial woe to Erlanger in the last 14 months deserves a subpoena rather than a bonus.
Here's a prediction from my Swami that the Board, in the true interest of stewardship, needs to recognize: “I am thinking what Erlanger management may have done was to use some, if not all, of that $24M to show a huge profit in the first quarter. Remember, the hospital did not receive any federal funding after June 30, so the idea that they could generate a profit like this is bizarre.”
But there is this: “Keep in mind that from an accounting point of view, they may in fact have done nothing wrong, but sending these numbers out and leading people to believe that they are doing great is, at best, misleading. They will very quickly use up that $24M if they have not, in fact, done so by now. And that means the next quarter(s) will be a disaster.”
So, the question confronting the board as they meet on Thursday becomes, why would the Board of Trustees deliberately mislead the good and faithful and trusting owners of our hospital? It’s plain to see some big gorilla is going to jump out at the end … but that’s okay … by then Will Jackson will have cashed his bonus.
Do you think he’ll give it back?
royexum@aol.com