Disputing reports that a division exists in their ranks, members of the Coalition to Save Bayonne Medical Center held a consensus vote on Jan. 2 reaffirming their support to have Dr. Barry Elkind and Dr. Tobi Ippolito appointed to the medical center’s board of directors.
Although the Coalition voted for the two doctors on Dec. 11, reports from several people close the coalition seemed to indicate a divided opinion on the doctors.
According to Caryl van Baaren, the coalition voted at a meeting in the Bayonne Community Mental Health Center on Jan. 2 to reaffirm support toward Elkin and Ippolito for their appointment to the hospital board of directors.
Discussions between the Coalition and the hospital board have centered on expanding the board to include two new doctors.
While Coalition members claim Board President Hermann Brockman rejected the deal that would allow Elkin and Ippolito a place on the board, a city official said Brockman was not responsible for the rejection and placed blame on factions within the coalition. Van Baaren, however, said Coalition members have indicated their support for the two doctors.
“The Coalition is firmly behind Dr. Elkin and Dr. Ippolito,” van Baaren said.
Jeanne Otersen, another Coalition member, said the board has yet to respond to the requests
“We still haven’t received a response from the BMC board and have had no indication in writing that they intend to expand the board, only a verbal commitment,” she said.
The Coalition was formed last August after a series of changes at the hospital, including the temporary closing of maternity operations. While hospital officials claimed the cutbacks were necessary in order to keep the facility fiscally solvent, Coalition members have been seeking a full accounting of the finances.
Elkin said the coalition is looking for the hospital to open its books for public scrutiny to prove that what is being said to justify the department closures is true.
Otersen stated that one of the key pieces to resolving the conflict is the condition of an independent financial review of the hospital.
“We have an expert we have found and Mayor (Joseph) Doria is helping us. A review would take about 30 days,” she said.
Related to this is the union concession the hospital has asked for.
“The hospital is asking for concessions in order to save money,” Otersen said. “The union response is that the employees will do what is financially viable, it we get some commitments from the board. This includes transparency by opening up the books.”
Otersen said the Coalition wants the hospital to admit there is a problem, but that the board is aloof.
While hospital officials have indicated that a recent review showed a $12 million shortfall in revenue for 2006, Elkin, Otersen and other Coalition members are seeking full accountability.
Otersen said the Coalition and Unions do understand the difficulties hospitals face throughout the area, and people would be willing to help, but that the hospital must present the public with a realistic plan of action that has been reviewed by the community.
Elkin, Otersen and others believe the board of directors has failed to oversee the finances of the hospital property, allowing former CEO and President Robert Evans to make investments without significant investigation.
Coalition members claim the board has not provided enough oversight over how money is expended or investments made. This is why many in the coalition want the board expanded with Elkin and Ippolito added to the roster.
“How can the board make critical decisions without examining the finances closely?” Otersen said. “The Board can redeem itself by adding these two doctors.”
“The board needs to ask questions,” Elkin said. “We have to look at the book to make sure the audits are done properly.”
Elkin said the board has relied to heavily on Evans to supply them with information when they should have been seeking out the information themselves.
“The question is, why won’t they open their books?” he asked. “The hospital is bankrupt, and the town could lose this hospital.”
Paul Swibinski, spokesperson for BMC disputed this assumption.
“The hospital is not bankrupt, it has not missed any payrolls or loan payments,” Swibinski said. “To my knowledge, it is still the only Hudson County hospital that can make this statement over the past six years. However, it is true that BMC faces significant financial pressure to address accumulated debt issues and also achieve a balanced budget for 2007. “We will probably have more to day about this over the next few days.”
St. Vincent’s Hospital purchase lit the fuse of protest
The purchase of St. Vincent’s Hospital in Staten Island has taken on symbolic meaning because it comes at the same time employees in Bayonne are losing their jobs.
While Swibinski said the two factors are not connected, that the purchase may save BMC some money, the operations are separate.
But Coalition members say the matters are connected since the same people who have failed to oversee the finances of BMC are in charge of the purchase of the new hospital.
“How can they buy another hospital – investing $100 million – when they weren’t even aware of the problems at the Medical Center here in Bayonne,” Otersen asked. “The board has a legal and moral obligation to open its books. And the coalition is demanding all information and the evaluation of an independent expert.”
Otersen and others in the Coalition claim management has been looking for a quick fix to a fundamental problem. Instead of solving the problems, BMC – under Evans – has jumped from one medical fad to another.
“It is not enough to chase fads in healthcare as the medical center has been doing under Rob Evans,” Otersen said. “Most of them haven’t worked.”
Otersen said if a review of the hospital finances shows that the board has done the right things, the coalition will accept it.
“If we’re wrong, we’ll be happy to say we’re wrong,” she said. “But we have more than 1,000 jobs at risk. We want everything to be fine. But we’re afraid things are worse than we thought.”
The Coalition was scheduled to hold a rally on Jan. 9 to call once more for the finical review. With them will be James Lawler, of JPL Healthcare Consulting, who has agreed to review a proposal for conducting an independent assessment of BMC finances.
The review is expected to take 30 days, and will include an assessment of the hospital’s current financial status, opportunities for improving revenues and how the purchase of St. Vincent’s will affect the future of BMC. Mayor Doria is expected to request a meeting with Lawler and BMC the board chairman within the next few days to begin the review.
“Transparency is crucial to moving forward and improving the working relationship between the hospital board, employees and the community,” said Mary Jane Desmond of the Coalition “We in the Bayonne community have the right to expect our board to be open and responsive to the community’s needs. With the Mayor’s involvement and information we can trust, we can make the right decisions for our hospital. The board members are stewards of our health care – but the hospital belongs to the community.”
New programs may be largest part of increased costs
While current financial records are not available, a review of tax records from the last three available years appears to support some of the Coalition’s claims.
Despite cutbacks in basic services, a review of the of BMC financial tax reports for the years 2002 through 2004 shows that new programs appear to be the largest new expense.
Total revenue rose over the last few years from about $122 million in 2002 to about $132 million in 2004. Government support rose from about $80,000 in 2002 to about $100,000 to 2004.
Indirect contributions to the hospital – listed as various contributions – jumped from zero in 2002 to nearly $750,000 in 2004. BMC also receives about $4 million from the State of New Jersey to cover charity care.
But expenses also rose during that period from $119 million in 2002 to about $131 million in 2004.
While BMC cut more than 130 jobs in 2006 in order to maintain operating expenses, salary and wages (which is the hospital’s largest expense), however, only rose about $3 million over the two-year period from 2002-2004. Supplies – which usually accounts for more than 30% of a hospital expenditures dropped from $30 million in 2002 to just over $18 million in 2004. Coalition members have claimed vendors have gone unpaid.
Some of the key increases in cost to the medical center appear to be related to new programs and not basic services which the hospital has been cutting back.
Coalition members claim that basic services have taken a hard hit at the medical center with severe reductions in the telemetry and psychiatric departments and with services closed in obstetrics, outpatient gynecological, sleep center, senior citizen day care, outpatient psychical therapy, and pediatrics. The coalition also claims that patients who have no insurance have been sent to area clinics where services are much reduced.
Tax records from 2002 to 2004 show a sharp increase in hospital expenditures for the uninsured.
While coverage for debts more than doubled during the two year period from about $5 million in 2002 to $11.5 million in 2004 (in 2003, this cost the hospital $12.5 million), most of the other increases appear to be related to new high profile programs or outside services contracted to replace services done previously in-house.
Investment fees jumped from $122,000 in 2002 to $2.3 million – covering some of the new programs the hospital put into place.
Consultant fees – which apparently were related to the new programs – cost $1.5 million in 2004 up from about $1 million in 2003. None were listed at all in the 2002 audit.
Purchased services – which did not exist in 2002 – cost the medical center $1.8 million in 2003 and $5.3 million 2004, indicating that hospital had contracted for outside services that did not exist prior to 2003.
Additional physician fees- which appear to be connected to some of the new programs and not listed in the 2002 audit – cost the hospital $3.8 million in 2003 and $2.3 million in 2004.