The Battle to Demand a Better Hospital

Every year, the Henry Mayo Medical Staff has a duty to elect physicians to their Medical Executive Committee (MEC). This election took place in early December and was the most contentious battle in my 23 years on Staff.
Unsubstantiated and unwritten allegations of previous voting impropriety were made by CEO, Roger Seaver, in an apparent attempt by Administration to affect the outcome of this election. Even the hospital Board of Directors, which was handpicked by Mr. Seaver, passed a “resolution” to appoint a retired Judge to oversee the election proceedings.
The Henry Mayo Medical Staff, as at any hospital in California, is an autonomous organization which has legal, ethical, and fiduciary responsibility to the citizens of this Valley. Our role is to maintain and enhance the healthcare at Henry Mayo Hospital without outside influence. Knowing the MEC might be the last bastion against special interest, 93% of the voting physicians turned out to cast their ballot and overwhelmingly defeated Mr. Seaver’s attempted takeover.
Unsettled and angry, Mr. Seaver lashed out at the Medical Staff after the voting stating members were “not honorable”. This was witnessed by a Judge and captured on videotape. Accusations like this against doctors have been presented in the past to the Board of Directors, hospital Foundation, and public in order to manipulate and create bias against the MEC and the Medical Staff.
Borne out of this, an outside physician consultant was asked earlier this year to assist and improve communication amongst doctors and hospital staff. As these meetings progressed, I continually asked why the Administration’s role in lack of communication was not delineated. To no ones surprise, it became apparent in the consultant’s final assessment that blame was to be made solely against members of the MEC, disregarding any role of the Administration. So, who paid the consultant?
A Chief Medical Officer (CMO) was hired and immediately, not only were accusations made about elections, but false “Code of Conduct” allegations were being made against physicians. Recently I queried hospital nurses and they told me they were appalled when asked by Administration to report doctors for “anything” (and would testify to this in Court). So, who pays the CMO?
Finally, the Board of Directors has passed multiple “Resolutions” against the Medical Staff and the MEC. So, who pays the Board of Directors? They aren’t paid...but please read on.
As a 501(c)3 non-profit hospital, Henry Mayo Hospital must file a 990 form to the IRS concerning financial conflict of interest from Board members. Anyone can ask for this document and obtain it. Not reported on their form is the millions of dollars Henry Mayo has in the Bank of Santa Clarita where James Hicken is the President & Chief Executive Officer and Elizabeth Hopp is the Senior Vice President/Director of Client Services...both of whom are on the Board of Directors of Henry Mayo Hospital. Were any other Board members left off the form that might have financial conflict of interest? Certainly, their exclusion from this 990 form must be known to the accountants and attorneys of Bank of Santa Clarita and Henry Mayo Hospital, but what does the IRS and the California Attorney General think about this? (Please see: Is the Henry Mayo Newhall Hospital board too cozy?)
Even with the Medical Staff and MEC under a barrage of deprecating allegations, they are fiercely defending their role in protecting patient care at our hospital. Apparently questionable and threatening decision making by Roger Seaver and the Board of Directors jeopardizes the viability of Henry Mayo Hospital.
As alluded to previously on this site, the hospital knowingly has appointed a CMO whose duties and responsibilities are not listed nor defined by Henry Mayo governing documents, making us liable for sanctions from The Joint Commission (TJC) and Centers for Medicare & Medicaid Services (CMS). Not addressing recent sanctions by TJC puts the hospital at further risk, as do violation of HIPAA, “sentinel events”, and the above mentioned financial conflict of interest.
The Medical Staff, some of whom are your physicians, and the MEC need your support in their efforts to maintain quality and high standards at our hospital. We must demand honesty and transparency from Henry Mayo Hospital, and not the defaming and demeaning rhetoric we’ve seen from them in the past. Should the physicians and the public not have their demands met by Roger Seaver and Board of Directors, then maybe we will get justice from the IRS, California Attorney General, CMS, and TMJ.
As contentious as this battle is, it is one we cannot afford to lose.
Gene Dorio, M.D.
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 or those of the West Ranch Beacon.

Commentary: Is the Henry Mayo Newhall Hospital board too cozy?

Lately I have been thinking about boards of directors and corporate executive pay because for the last several years it has been increasingly in the news. Corporate executives being arrested for stock option backdating or swindling of funds; boards of directors asleep at the wheel or just rubberstamping whatever the Chief Executive Officer wants, and more.
It’s interesting to see that Warren Buffet, one of the richest men in the world, gets paid by his company Berkshire Hathaway about $100,000 a year plus some perks. Or how about Steve Jobs the CEO of Apple getting a dollar a year. Obviously both men are billionaires and don’t need the money but it is an example of responsible corporate leadership.
There are plenty of other examples where corporate chiefs get a base salary and their bonuses are tied to performance. If the company does well and the owners (shareholders) are happy with the returns on their investment, then the CEO is rewarded and if the company doesn’t do well then that is reflected in the compensation too.
Good corporate boards should be made of individuals that bring some expertise or experience to the table and are active in the governance of the company. These are professionals that should not have conflicts of interest either by doing business with that company or have relatives working for the company.
That’s one of the reasons why it’s rather odd to me to see the Henry Mayo Newhall Memorial Hospital (HMNMH) board of directors appear to be so cozy. Especially with all the controversy that has surrounded the hospital over the years it would seem prudent to have a board of directors that are as independent as possible.
The HMNMH Board Chair is James Hicken, President & Chief Executive Officer of Bank of Santa Clarita and Elizabeth Hopp, Sr. Vice President/Director of Client Services for Bank of Santa Clarita, is also on the hospital Board of Directors. What’s interesting about this is that the hospital apparently has millions of dollars in the Bank of Santa Clarita. That makes me ponder if these board members are looking out for the best interests of the hospital or of the bank? If the hospital decided to put its’ money in another bank would these board members still invest their time on the hospital board?
I also wondered why several doctors that are on the HMNMH board apparently have million dollar contracts with the hospital? Wouldn’t it be better to have medical doctors or experts on the hospital Board of Directors that don’t have any monetary affiliation with the facility; doesn’t that make them more objective and impartial?
There is an awful lot of construction going on at the hospital campus with more to come over the next few years and one of the owners of a construction company that appears to have a multi-million dollar contract with the hospital is on the board of directors. I would think having a construction expert on your board during a major facilities expansion and upgrade is a great idea but it would seem more sensible to have an independent expert, one with no business connection, on the board to add to the checks and balances of overseeing the construction work at the hospital. Wouldn’t that seem better?
The other thing that I thought was peculiar is that Roger Seaver the President/CEO of Henry Mayo Newhall Memorial Hospital getting a total compensation package of $631,540.00. Gee, that’s more than six times what Warren Buffett makes and more than 50% higher then the $400,000 that President Obama makes. It might be better to have a more performance based compensation structure in place, one that rewards for significant improvements in health care to patients.
Now let’s face it, the hospital can pay what it wants and have whomever it wants on its board of directors. But it does raise eyebrows when you do see some of the activity described above going on and continually hear about quality of care issues. Those quality issues have been around for a long time and it may mean that the hospital facility has to go above and beyond to shake that negative stigma. Even starting at the board level with having more transparency and less perceived conflicts.
I discussed it with a few folks and one of them said to me; “That’s just how they do things in the Santa Clarita Valley; there is a lot of back slapping going on, that’s just the way it is.” But that doesn’t make it right or appropriate, does it?
It’s not hard to get the impression from some of this information that quite possibly there may be more interest in business and “back slapping” then in the administering of quality health care. That is certainly the view of some local doctors and former hospital patients.
Dave Bossert- Commentary
Dave Bossert is a community volunteer who serves on a number of boards and councils. His commentaries represent his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.

From “OUR” Hospital to “THEIR” Hospital

Your loved one is ill and has been hospitalized for several days. Typically, the physician decides on a treatment plan and when they can return home. Would it bother you if the hospital CEO made these decisions based on bottomline finances instead of educated and reliable medical reasoning? This scenario is occurring across the country, and presently entangles our Henry Mayo Hospital.

Let’s face it, big business has taken over Wall Street and the banks, and little business and people like us have been hurt. A decade ago, plans were launched to take over hospitals...why?...because that’s where the money is! According to an article in one of our medical journals, the hospital industry is “out to decimate the independence of medical staffs and take away physicians’ rights. Their objective is clear: they want to place unfettered power and economic control over doctors in the hands of hospital administrators.”

Admittedly, doctors are not good business people, and they tend to have quirks of arrogance and self-righteousness that continually divide them. Taking advantage of these faults, big business swooped in and used physician medical licenses to make big profits. Yes, we’ve heard of some mismanaged hospitals going bankrupt, but most are now doing exceptionally well. Certainly, it would be generous if these hospital business people were interested in streamlining the system, saving money, and improving healthcare. But the massive profits are instead deceitfully funneled into huge administrative salaries, bonuses, pensions, and golden parachutes. Sound familiar?

A game plan by well-financed hospital business associations have lobbied many states to allow hospitals to “corporately practice medicine.” California does not. Because of this, there is an attempt to circumvent State law, which ultimately will be tested in California courts. Prime example is The City of Hope Medical Staff trying to thwart efforts by the hospital to use the position of Chief Medical Officer (CMO) and a foundation to hire outside physicians. (Please refer to my October 12, 2010, commentary on this blog surrounding the controversial appointment of a CMO at Henry Mayo. Are they “setting the table”?)

These physicians are paid and under the authority of the hospital, who therefore dictates the degree and extent of care hospitalized patients receive. I’d love to cry “What about the Hippocratic Oath?!” these physicians have taken. Doctors are intelligent, and a rare breed, but sadly some are not so principled to bite the hand that feeds them.

As I’ve discussed previously in the West Ranch Beacon, Henry Mayo Hospital is governed by three entities: Medical Executive Committee (MEC), Administration, and Board of Directors. The MEC is elected by the physicians of the Medical Staff and follows By-Laws, and Rules & Regulations in maintaining State-law protected self-governance, which separates authority between doctors and the Administration. This is why physicians currently make all decisions about care of our hospitalized patients.

What if though the MEC is “majorilized” by physicians who vote to change the By-Laws, and Rules & Regulations in favor of the hospital Administration? Will patient control and decision making then be in the hands of the Administration? Of course. There are some physicians paid by Henry Mayo Hospital because they have contracts and directorships, and we have seen them financially coerced into speaking for the hospital (City Council Hospital Master Plan meetings). I wonder how they will vote if they are a member of the MEC? Conversely, physicians presently on the MEC who have attempted to maintain autonomy and self-governance have been bullied, degraded, defamed, and threatened by the Administration.

One truly needs to ask a critical question: Where is Henry Mayo’s Board of Directors in all of this? Unfortunately, they have already laid their cards on the table by passing multiple “Resolutions” condemning the MEC efforts to protect themselves. One can only look at the role the Administration plays in this influence and wonder when the public will ask for a conflict of interest investigation of certain Board members.

There is an attempt to make the MEC and Medical Staff at Henry Mayo Hospital be the “bad guys” as this has been propagated and propagandized to the Board of Directors, Foundation, hospital medical personnel, and even to the Medical Staff. As an involved Medical Staff member and not on the MEC, my view of these problems are clear and precise: the problem does not lie with the MEC nor Medical Staff; this bullying and hostility comes directly from the Administration, in conjunction with their plan to take over all financial control and influence of our hospital.

In life, we have only a few intimate relationships: with our spouse, our clergyperson, and our physician. Once thought to be sacred ground, the relationship with our doctor is in jeopardy and threatened. Preservation of this sacrosanct relationship is critical, and from this my hope is “our” hospital will never be called “their” hospital.

Gene Dorio, M.D.

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 or those of the West Ranch Beacon.

Henry Mayo Hospital on the Edge of Viability

Henry Mayo Newhall Memorial Hospital (HMNMH) is a nonprofit, 501(c)3 facility required to follow governing documents for recognition of compliance, and for allowing legal accreditation. When found not to be compliant, the hospital faces sanctions that must be rectified in a timely fashion. Such has been the recent case of persistent communication problems between the Administration and Medical Executive Committee (MEC). This problem has now come full circle in a convoluted epic of power and brinksmanship, creating potential liability and putting our hospital in its greatest jeopardy since bankruptcy.
The Joint Commission (TJC) is a government agency delegated with the responsibility of assuring hospitals throughout the United States maintain consistent standards of patient care. To comply with a recent TJC sanction reciting communication problems, the hospital Administration and MEC jointly agreed to hire a Mediator who would mitigate the conflict and write a report to TJC, thus removing the hospital sanction.
Within weeks, HMNMH oddly announced creation of a new position and hiring of a hospital administrator called Chief Medical Officer (CMO), and to the surprise of the medical staff and MEC, it was the Mediator! Still with me?
Day-to-day hospital operation and function rely on committees under the auspices of the MEC, Administration, and Board of Directors. Committee members follow rules related to HIPAA and Peer Review to maintain patient confidentiality according to By-Laws, Rules & Regulations, and Hospital-Wide Policy and Procedures. The CMO position, duties, and responsibilities, are not mentioned nor defined in these HMNMH governing documents.
The hospital has demanded the CMO be allowed to sit in hospital committee meetings and peruse patient charts. The MEC has objected and feel this is a breach of HIPAA and Peer Review confidentiality. With that, every committee the CMO has attempted to attend has resulted in this objection and cancellation of the meeting, stalling hospital function and compromising patient care.
It is ironic the person hired as Mediator to improve communication has now become the source of “discommunication.”
Because I attend many HMNMH committees, I discussed this matter with my malpractice insurance Risk Management attorney. My attorney agreed that indeed, because the position of Chief Medical Officer is not defined by the hospital governing documents, physicians, Administrators, and the hospital are at risk should there be HIPAA/Peer Review litigation brought against the hospital. Additionally, governmental agencies such as TJC might sanction the hospital and jeopardize accreditation. Hospital attorneys might not agree, but I wonder what is their legal precedence?
The position of Chief Medical Officer is not new in a hospital setting, but ground work must be laid in governing hospital documents in order for the position to legally exist. This has not been done and hence the hospital may be judged to be libel.
Ultimately, the Board of Directors are responsible for this legal matter, as they voted to create the CMO position. Viability of our community hospital is at stake, so I truly hope communication is better between the Board of Directors and hospital attorneys than between Administration and the MEC.
Gene Dorio, M.D.- 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 or those of the West Ranch Beacon.

Guest Commentary: Dissecting Henry Mayo Newhall Memorial Hospital

The West Ranch Beacon’s mantra “Sometimes controversial, always thought provoking” can describe Henry Mayo Newhall Memorial Hospital. Most emergency and critical medical care in the Santa Clarita Valley is rendered there, yet most have no understanding of how our hospital functions.
I have been on the Medical Staff at Henry Mayo 23 years, and have a private practice specializing in geriatric medicine. As an educator, I cohost “The Senior Hour” on KHTS, wrote a column in The Signal “Profiles in Medicine”, and have had a television show entitled “House Call for Seniors” on Channel 20. For those who read this blog and are involved in City Council politics, you know that I fought to keep our Transitional Care Unit (TCU) open for our elderly, and questioned the recent hospital expansion through their Master Plan. As a primary care physician for seniors in this community, I consider myself to be on the frontline in healthcare, and therefore hope I can briefly present to you…without the medical jargon…how Henry Mayo functions.
The hospital is established as a nonprofit 501(c)3 which means it doesn’t have to pay taxes, but because of this status, is obligated to follow certain legal guidelines. Federal and state legislation maintains constant vigil over patient care to protect the public. Periodic unannounced inspections by The Joint Commission, California Health Department, and other agencies must be passed for the hospital to remain “accredited.”
Having practiced at Henry Mayo for over two decades, there have been tremendous strides in technology adapted by our hospital. It is much easier for physicians to now give state-of-the-art medical care to those critically ill patients. There is no doubt also that my colleagues and I have the best trained nurses, pharmacist, laboratory, x-ray, and other personnel (many of whom also live in this community) working with us at Henry Mayo Hospital.
The Medical Staff are physicians, most in private practice, some in groups, and others solo, like myself. We are bound and guided by “Rules & Regulations” and “Bylaws” that must be adhered to. There are some groups that have contracts with the hospital to give specialized care to patients such as emergency, trauma, anesthesia, radiology, dialysis, and pathology. Most of the physicians though are not contracted, nor are they paid or employed by the hospital. Payments for hospitalized patients are made to us from Medicare, MediCal, and third party payers (Anthem Blue Cross, Aetna, Blue Shield, etc.). The Medical Staff duly elects members to a Medical Executive Committee (MEC) that represents physicians as a part of the governing body.
There are three interactive governing bodies at Henry Mayo…somewhat similar to the Executive, Legislative, and Judicial branches of our government where there are checks and balances: The above mentioned MEC; the Administration; and final decision maker Board of Directors.
The Administration hierarchy is headed by Chief Executive Officer, Roger Seaver. Immediately under him are the Chief Financial Officer, Bob Hudson, Chief Operational Officer, John Schlief, and Chief Nursing Officer, Larry Kidd, RN. There are a myriad of department heads all of whom must follow highly regulated policies and procedures again laid down by federal and state agencies.
Finally, the Board of Directors are volunteer members who live or work in this community. They are the ones that must juggle all the financial and medical information to come up with the best decisions for the hospital and the residents of the Santa Clarita Valley.
Some physicians serve on the Board of Directors, some Board of Directors serve on Administration Committees, while some Administrators come to the MEC meetings. All the governing bodies therefore have links to enhance communication.
Painting this picture of functionality makes it seem all the necessary ingredients are in place for our well-oiled hospital to run smoothly. But do the Executive, Legislative, and Judicial branches of our government run smoothly?
Mistakes have been made, but we are legally mandated to rectify these mistakes and learn from them.
Differences arise from personality, financial, and political conflicts with a recent surge in dysfunction between the MEC and Administration. Divisive issues and divisive rhetoric are emblematic of this ongoing drama. The Joint Commission sanctioned Henry Mayo for this lack of communication, and the hospital has been given a deadline to rectify this problem or it will jeopardize our accreditation.
Fortunately, this problem does not have any direct effect on patient care…yet. As I shrug my shoulders and raise my hands into the air, I think Henry Mayo’s mantra should really be: “Sometimes thought provoking, always controversial.
Gene Dorio, M.D., -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 or those of the West Ranch Beacon.

Good experience; no problems with pain management

I had surgery for uterine cancer a few months ago at Henry Mayo, and I have absolutely no complaints about the care I received. I had no problems with pain management; the nursing staff responded very quickly to my calls. Problems can occur at any hospital: Cedars-Sinai, UCLA Medical Center, St. Joseph’s Hospital are all well-regarded, and yet all have had their share of bad publicity for alleged medical errors and poor patient care. I am sorry your experience at Henry Mayo Newhall Hospital was a traumatic one for you and your family. In my personal experience, with my own medical care and with that of other members of my family, Henry Mayo Newhall Memorial Hospital rates very highly in professionalism, compassion, and patient care.

The hospital could not handle premature birth

(From Larry) My grandfather was in there after a bout with pneumonia. He was also suffering from dementia.
He ended up being placed in transitional care at the hospital. I was horrified when I went by to see him and he was feeding himself. While this is not a problem for most people, he could barely lift his hands. He had food all over himself. I talked to the nursing supervisor about this and was told they were short staffed and would do their best.
The next day, the same thing happened. We ended up having to hire our own nurse to go over there to feed him.
When he left, he was bed-ridden since the pneumonia had left him so weak. We found he was covered in bed sores and had raw areas on his skin. It was so bad that we documented it and my grandmother filed complaints with the state.
My sons were also born here. One of them was premature. The hospital could not handle this. They had to bring in specialists from Northridge Hospital for the delivery and transport. These guys knew their stuff and saved my sons life.
Unless I am dying, I drive to Holy Cross.
My grandfather was in there after a bout with pneumonia. He was also suffering from dementia.
He ended up being placed in transitional care at the hospital. I was horrified when I went by to see him and he was feeding himself. While this is not a problem for most people, he could barely lift his hands. He had food all over himself. I talked to the nursing supervisor about this and was told they were short staffed and would do their best.
The next day, the same thing happened. We ended up having to hire our own nurse to go over there to feed him.
When he left, he was bed-ridden since the pneumonia had left him so weak. We found he was covered in bed sores and had raw areas on his skin. It was so bad that we documented it and my grandmother filed complaints with the state.
My sons were also born here. One of them was premature. The hospital could not handle this. They had to bring in specialists from Northridge Hospital for the delivery and transport. These guys knew their stuff and saved my sons life.
Unless I am dying, I drive to Holy Cross.