HMNMH Administrator Overboard!!!

President and CEO Roger Seaver of Henry Mayo Newhall Memorial Hospital (HMNMH) in a recent local editorial described the hospital’s leadership as a “three-legged stool” of Administrators, Board members, and Medical Staff. Seemingly, the Administration has seized influence over the Board of Directors to “break the Medical Staff leg” attempting to eliminate their participation in patient care decisions at our hospital.

The Trumanism “The Buck Stops Here” shoulders accountability on the Board of Directors to make decisions free of domination and outside control. As in any business, this Board is responsible for oversight of Administrator Roger Seaver, but is Administrative induced financial conflict of interest tweaking their decision-making?

There are fifteen members of the Board of Directors and their votes decide the direction of policy and healthcare for our hospital. (Nomination to be a Director comes from a Governance Committee overseen by the Board - in itself, fodder for a future posting.) They are governed by By-Laws and documents laid out under the auspices of State and Federal law.

There are five doctors on the Board. Only one physician (Chief of Staff Dr. Frank Yusuf) elected by the Medical Staff has a vote, as this number was recently and contentiously decreased by the Board. The other four doctors are not physician-elected and became Directors through the Board Governance Committee.

First, here are facts about eight of the fifteen Board members:

1. Board Chair: Craig Peters - Executive Vice President Industrial Properties -CB Richard Ellis. Leasing office space for Medical Office Building #1 (not yet built) through G&L Realty.
2. Board Treasurer: James D. Hicken - President and Chief Executive Officer Bank of Santa Clarita. HMNMH has money in his bank.
3. Vinod Assomull, M.D. - contract with hospital for dialysis center.
4. Dale Donohoe - Owner, Intertex Companies, presently building-out the NICU.
5. Elizabeth Hopp - Sr. Vice President/Director of Client Services Bank of Santa Clarita. HMNMH has money in her bank.
6. Mark Liker, M.D. - contract with hospital for neurosurgical care.
7. Roscoe Marter, M.D. - Ob/Gyn for Facey Medical Group who has contract with hospital.
8. Roger Seaver - CEO has contract with hospital.

Second, one must ask these Directors: Does having money in your bank or a contract with your business, or the threat of losing these financial deals, impact your Board vote?

Finally, conflict of interest occurs “when an individual or organization is involved in multiple interests, one of which could possibly corrupt the motivation for an act in the other.” The IRS and California law requires conflicted “interested persons” not to make up more than 49% of the Board of Directors of a nonprofit public benefit corporation like HMNMH.

Even though eight of fifteen Board members might seem to have a financial conflict of interest, I’m sure hospital lawyers have made sure this Board “legally” does not overstep the law: they don’t own the bank; the contract is with G&L, not the hospital; they happen to be the lowest contract bidder; or, they recused themselves from the vote. The law has guidelines scrutinizing “direct or indirect” financial conflict of interest as well as the “appearance of impropriety”, which might negate hospital lawyers’ tenuous legal rationale.

Laws may not be broken, but a far more important question is: What about the moral and ethical rules we live by and teach our family and children? Is business so callous we now ignore or tweak what is right or wrong? If this is the kind of disregard they have for the rule of law, then what moral character guides them in making medical decisions for this community?

We might not know whether financial conflict of interest plays a role as we tally up the votes. An indication though of potential conflicted votes (affected at the behest of the Administration) may be seen in recent “Resolutions” and changes in their By-Laws made by the HMNMH Board:

• lengthening Board of Director term limits an extra three years (to 12 total years)
• removal of Deputy Chief of Staff as voting member of the Board of Directors
• hiring an outside consultant (reported $350,000) claiming Medical Staff is responsible for communication problems ignoring the role of the Administration
• decreasing Medical Staff application fee (to deplete the Medical Staff Treasury, lessening legal representation)
• rebating past (10 years) fees to doctors from Medical Staff treasury (again to affect legal representation)
• a veiled hiring of a Judge to oversee Medical Staff elections
• using “secret files” and “code of conduct” to block physician re-appointment
• creating an Administrative position known as “Chief Medical Officer” (reported $22,000/month) potentially violating confidentiality and HIPAA law

The bottom line though: Is the HMNMH Board making good decisions, or are these decisions only coming from a single Administrative viewpoint?

As presented in previous WRB postings, the catherization lab, neonatal intensive care unit (NICU), and designation of the new surgical suite for cardiac backup might be a costly overextension of services which results in a return to bankruptcy. If anything, it will place undue financial stress on other departments and services which can diminish patient care.

A present reflection of the level of patient care is the general overall low public opinion this community has for the healthcare rendered at HMNMH. Private, as well as State and Federal surveys, reveal a comparatively low level of patient care, as does The Joint Commission sanctions brought against the hospital. A “Vote of No Confidence” by the Medical Staff against the Administration and Board of Directors earlier this year again was a result of physician difficulty dealing with patient care problems at our hospital.

We must put “three legs” back into hospital leadership allowing not only Medical Staff input and self-governance, but insist the Board regain oversight of Administrator Roger Seaver, removing any semblance of financial conflict of interest. As the Board of Directors spiral toward being a “one-legged stool”, the public must demand transparency, for if this is not attained, patient care will suffer as will healthcare in this community.

Gene Dorio, M.D.- Guest Commentary
Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with including the Medical Executive Committee and Medical Staff of Henry Mayo Hospital, or those of the West Ranch Beacon.