Maintaining high-quality doctors in Haywood County emerged as a common theme in a public hearing last week on the future of MedWest-Haywood.
A public hearing on the future of Haywood Regional Medical Center will be held at 6 p.m. Thursday, Aug. 22, at the MedWest-Haywood Health & Fitness Center on the hospital campus.
Janie Sinacore-Jaberg has run a lot of hospitals — small hospitals, financially precarious hospitals, turf-war embattled hospitals, hospitals in the midst of a merger, even hospitals in the midst of hostile take over.
The former CEO of Haywood Regional Medical Center will get $150,000 from the hospital after settling a lawsuit claiming he was wrongfully fired.
David Rice was at the helm during a near meltdown of the hospital in 2008. At the time, Rice publicly said he resigned, but in a lawsuit filed two years later he claims he was forced out.
Settling the suit was a business decision, according to the current CEO Mike Poore.
“We felt that it was best not to spend any more money on attorneys and complete that chapter,” Poore said.
In his suit, Rice demanded 20 months of his salary, back pay for accrued vacation and sick time, bonuses he had been promised and lost benefits. While Rice’s salary was $199,000, benefits included a car and health insurance, extra bonuses and other perks.
Although Rice left in the spring of 2008, he claims the hospital board verbally promised him his salary and benefits through the end of 2009 when his contract expired. In exchange, they asked him to publicly announce that he resigned instead of labeling it a termination.
Rice claims he was tricked, however, and that the hospital board had no intention of keeping its verbal promise. Rice had been the CEO for 15 years.
Many in the community blamed Rice for the hospital crisis back in 2008. The hospital failed federal inspections causing it to lose its Medicare and Medicaid status, triggering an exodus of private insurers as well. The hospital essentially shut its doors for five months except for the most essential services.
Rice kept the brewing crisis a secret, attempting to quietly fix the underlying issues, but it eventually imploded. Observers believe that Rice’s failure to address the citations early on led inspectors to make an example out of Haywood, pointing to other hospitals with more egregious problems that didn’t get shut down.
Regardless, hospital board members and community leaders said they were blindsided and condemned Rice for failing to keep them in the loop.
The hospital leveled a countersuit against Rice. Even though the hospital maintained that Rice resigned, the countersuit claimed there was good cause to fire Rice had that not been the case.
The countersuit claims Rice failed to “communicate with the board, medical staff and administration in an effective and timely manner, or otherwise concealing and distorting material facts and circumstances concerning the operation and affairs of HRMC.”
In the countersuit, the hospital claimed Rice’s actions leading to decertification caused “significant loss of HRMCs patients and revenue placing the future operation of the hospital in jeopardy.”
The hospital shutdown had major economic consequences for the community. For starters, the hospital burned through more than $10 million in reserves it had built up over the years.
Doctors lost business when patients went elsewhere. Many of the nurses and staff were put on temporary unemployment. The county saw a substantial increase in ambulance costs for ferrying patients to hospitals in Asheville or Sylva. Patient numbers still have not fully returned to normal.
Last month, a group of emergency room doctors was awarded $1.6 million in a lawsuit against the hospital dating back to Rice’s reign. Haywood Emergency Physicians were wrongfully ousted by the hospital in 2006 and replaced with a corporate physician staffing company. Rice helped orchestrate HEP’s replacement because he saw them as a threat to his insular power structure, according to the doctors involved.
Settling the suit with Rice marks the final chapter in the saga, allowing the hospital to move forward with its mission, Poore said.
“We are moving forward and focusing on our hospital’s mission of providing compassionate, quality and cost-effective healthcare,” Poore said.
The two sides went to mediation in November. The only ones present were Poore, Rice and his wife, and their respective attorneys.
While out-of-court settlements are not publicly filed in the court record, Poore elected to share the information in the interest of transparency.
A group of emergency room doctors has been awarded $1.6 million in a lawsuit against Haywood Regional Medical Center.
Haywood Emergency Physicians was ousted by the hospital in 2006 and replaced with a corporate physician staffing outfit before the group’s contract had expired. The group sued for breech of contract, unfair and deceptive trade practices and conspiracy in restraint of trade.
The case was heard before a three-member panel of arbitrators in mid-January. Much like a judge’s ruling in court case, the decision was binding, meaning neither side had the option of accepting or rejecting the amount of the award.
At the hearing, the hospital failed to produce any evidence that it had a good reason for ousting the ER doctors. As a result, the hospital owed the ER doctors for 18-months of lost income, the arbitrators ruled. The award will come out of the hospital’s bottom line.
Attorney Bill Cannon, who represented the group of doctors, said they were pleased with the amount. The hospital offered to settle out of court two days before the arbitration hearing, but the physicians rejected the offer as too low.
Mark Jaben, one of the ER doctors with Haywood Emergency Physicians, said the reasons given by the hospital leadership for ousting the emergency doctors at the time were “smokescreens.”
“Why did he want us out? It is a really good question I think a lot of people would say it boiled down to wanting power and control,” Jaben said. “We were in the whistle blower position.”
The lawsuit dates back to 2006 when the hospital was under different leadership. The hospital has undergone a massive transition since then, including a nearly clean sweep of top leaders and the governing hospital board.
The hospital failed federal inspections in 2007, causing it to lose its Medicare and Medicaid status and triggering an exodus of private insurers as well. The hospital essentially shut its doors for five months except for the most basic services.
As a result, the hospital leaders who had ousted the ER doctors the previous year got ousted themselves. It became clear that many of the issues raised by the ousted ER doctors — issues hospital leadership tried to silence — were in fact true.
The ER physicians enjoyed an outpouring of community support as well from those urging hospital administration not to get rid of them. But a few who believed the accusations against the group espoused by Rice apologized after the unraveling of his administration.
“People said ‘You were telling the truth and we are sorry we didn’t listen to you,’” Jaben said.
Jaben said it is a shame the community had to go through such a cataclysmic event to realize there were problems at the top.
“The full cost is enormous, well more than just the amount of the award in this one case. We trust that this final action will free the hospital of any remaining vestiges of the old guard and conclude this sad tale,” Jaben wrote in a group statement from the doctors.
Jaben said the hospital board at the time was led down the wrong path by Rice.
“I think boards have a responsibility to verify their information, to verify that things are happening the way they are being told,” Jaben said. “Clearly did not do that.”
While the medical community overwhelmingly rallied to the ER doctors’ defense, the hospital board and administration summarily dismissed their impassioned pleas. The physician community came to the sinking realization of just how little they were valued by hospital administration, Jaben said.
“The physician community had been systematically cut out of the process over the course of many years,” Jaben said.
Jaben said the new CEO Mike Poore has embraced the medical community.
“If you listen to Mike Poore’s language, he understands quite well that there has to be collaboration and cooperation with the medical staff,” Jaben said.
If Jaben could go back and do anything differently, he would have worked harder to achieve that.
“Your success lies in collaboration. At the time we did as best as we could trying to help that happen, but I think there are yet other ways we could have done a better job,” Jaben said.
Yet the records show that Rice’s administration was trying to get rid of the ER doctors prior to their firing. During the course of the lawsuit, Cannon got copies of emails between the hospital and the corporate physician staffing outfit months before the hospital pulled the trigger on firing Jaben’s group. Other evidence shows Rice had the group in his sights long before that, including a phone call from him to one of the ER doctors pledging to get even after the doctors shared a report outlining areas where the hospital needed improvement.
Rice did not return a message seeking comment prior to press deadline.
Poore said the hospital is glad to have this issue behind them.
“We understand that good relationships with all of our 230 physicians are critical in providing the world-class health care our communities deserve, and we’re happy to close this chapter,” said Poore.
Haywood Regional Medical Center is now part of MedWest, an affiliation with the hospitals in Jackson and Swain counties, and has a partnership with Carolinas Medical System out of Charlotte.
Jaben said the team of 10 ER doctors had loved living and working in Haywood County.
“This has been gut wrenching for many of them,” Jaben said. Only four have remained in Western North Carolina. The rest had to move to find work. Even those who stayed are not on the permanent ER staff of a hospital, but either went into another field of medicine or travel for work.
Haywood Regional Medical Center Hospice and Palliative Care has submitted a quilt square to be included on the Haywood County Arts Council’s Quilt Trails project.
The Haywood County Arts Council has joined other existing quilt trails in Ashe, Avery, Madison, Yancey, Mitchell and Watauga counties. The concept is based on similar projects in neighboring states, where quilt squares are painted on wooden squares from 2 to 8 feet in size and installed on barns, public buildings, shops and other appropriate buildings around the community.
The quilt squares represent a much-loved symbol of comfort, family, heritage, and community, and will provide new splashes of color alongside major roads and in the rural countryside for a free driving trail, according to Kay Miller, executive director of the Haywood County Arts Council.
Miller was joined by Sylva Mayor Maurice Moody and Dave Riggs, executive director of the Community Development Clubs of Haywood County, as judges for six quilt designs entered by HRMC Hospice and Palliative Care staff and volunteers Oct. 7.
Life’s Path, created by Hospice Team Assistant Mary Anne Yurko, was chosen as the design to represent HRMC Hospice and Palliative Care. The design features a sun illustrating the beginning of life, a flowing river with the ups and downs of life, and hospice providing the end of life comfort and care.
Second place went to the Rally Round design created by Hospice Volunteer Coordinator Linda Nichols. Rally Round is what folks in Western North Carolina do when a family member, friend or loved one is ill, Nichols explained.
Third place went to the Mountain Star design created by Linda Clark, noting that hospice staff and volunteers are true stars in helping patients and families deal with end of life situations. The other entries were Country Roads, Right Hand of Friendship and Kaleidoscope. The designs were submitted by hospice staff and volunteers.
Western North Carolina has the highest concentration of quilt trails in the state, Miller said.
The engineering, grounds and Behavioral Health Unit at Haywood Regional Medical worked together to brighten the hospital community by planting a rose garden.
Research has shown that hospital patients whose windows looked out at landscape scenery recovered from surgery quicker than those who faced a brick wall.
Marty Murray and the hospital’s engineering team prepared planting beds at the front entrance to the Haywood hospital. With the help and hard work of patients and staff of the Behavioral Health Unit, the team then transformed the space into a rose garden that will bloom throughout most of the year.
An article that appeared in The Smoky Mountain News opinion section two weeks ago based on an anonymous interview with several nurses from the Haywood Regional Medical Center Emergency department prompted a rebuttal from hospital employees last week.
All three Haywood Regional Medical Center board members were reappointed this week for another three years by the Haywood County commissioners.
By Michael Rey
I would like to offer some words of support for those Emergency Department Nurses at Haywood Regional Medical Center who were brave enough to contribute to the debate over recent changes there (I am referring to the article that appeared in The Smoky Mountain News on April 24). Even speaking anonymously, they have all put their jobs on the line.