County commissioners are questioning how Weems Memorial Hospital can justify awarding more than $75,000 in salary increases last October to its top six administrators as part of hospital-wide pay hikes to staffers.

At Tuesday morning’s county meeting, Weems CEO Mike Cooper promised improved hospital finances and declined to reconsider the raises given to staff, saying they were based on sound financial analysis.

Cooper, who missed his regular appearance at the first August meeting, said he had more information to offer commissioners this week than would have been available two weeks earlier. He said Weems CFO John Graham had been unable to prepare a detailed financial report for the county because of glitches resulting from the installation of new software.

Cooper painted a rosy picture of progress in reviewing plans for renovation of the county hospital but said Culpepper Construction, the company chosen to administer the project, still has not provided him with a guaranteed maximum price (GMP) and may not be prepared to do so by Sept. 6 when a public hearing on the hospital is planned for 3 p.m.

He told commissioners that “meaningful use” money from Medicare amounting to $300,000 should be received next week and he predicted delayed low-income pool funding through Medicaid would arrive in October and would include retroactive payments back to July. He also said he believes the hospital can make payroll through October without further loans from the Healthcare Trust Fund.

“Cash collections from patient accounts are back to historical levels,” he said.” August should achieve about $500,000. In the dark times we were down to $250,000 (a month).”

Commissioner Noah Lockley expressed dissatisfaction with the report. “It’s taking us a long time to get numbers about how much the hospital will cost,” he said.

Cooper said Culpepper only received the finalized plans last week and would have to consult with subcontractors for precise figures. “It’s a very tight budget,” Cooper said.

Commissioner Cheryl Sanders confronted Cooper.

“I’ve prayed about this issue. The underlying thing is you need more money. I’ve looked at the figures and you still have only seven days cash on hand. You only have 1.6 patients a day. Over the last year you took $890,000 out of capital outlay on top of $1.5 million in funds from the health care tax and then you gave arbitrary raises to the upper echelon. The nurses and workers are the backbone of this hospital.”

Cooper replied that “there is a misconception regarding hospital finances. If it were possible, I would like to have 25 people in those beds. I’d like to have five or six swing bed patients because we really get paid well on those. But if there are 25 or none, it doesn’t matter. It doesn’t factor in to what that hospital gets paid. I’ve tried to explain this; I know just enough to be dangerous.”

Sanders stressed her continued support for county healthcare. “I want to make myself clear. I’m for a new facility. I’m for these clinics that are struggling to make it. I don’t see how you can sit up here and justify a 25-bed facility. How you can justify giving the top five or six $75,000 and then come in here and borrow money to make payroll? The capital outlay fund is not an open ended checkbook.

“We’ve got a sinking ship out there. How can you explain your operating cost of $1.6 million this year?” she said. “I’m for the hospital and employees. I’m not for management giving themselves raises. The employees only received 25 cents an hour.”

The audience burst into applause.

“Don’t smile,” Sanders told Cooper. “This is a serious thing. I am one of the principle people who wrote the language for this healthcare tax and this is not the meaning of it. I can’t sit here and say everything’s fine any more.”

According to documentation provided by the hospital to commissioners, the salary hikes referred to during the debate, and awarded in October 2015, were given to Cooper, who received about $15,000 and now earns $165,000 annually; Graham who received $10,962 more and now makes $121,000; Director of Nursing and Licensed Health Risk Manager Becky Gibson who received $13,416 and now makes $90,126; Human Resources Director Ginny Griner who received $10,379 and now earns $77,334; Director of Revenue Cycle Management Jordan Fulkerson who received $1,310 and now makes $76,315; and Director of Plant Operations Craig Gibson was received an increase of $25,376 and now earns $71,739.

Cooper said the raises were not random but the result of a detailed cost analysis. Commissioner William Massey said he is a Carrabelle city employee and hasn’t had a raise in 12 years.

“We were underpaying the staff by $500,000 compared to comparable small county hospitals,” Cooper replied. “You live here and you aren’t going anywhere but those nurses can go somewhere else and get a job.”

Massey countered that “I didn’t see any big raises for nurses.”

Commissioner Noah Lockley said that “When you are in business and money is down, you don’t give out raises. You cut back.”

Cooper told the commissioners the raises “were my decision and I stand behind it. We are running at a 15 percent turnover rate because of raises and benefits.”

Commissioner Smokey Parrish said “We want to understand. Is it a billing issue? If the federal government and state can’t provide free healthcare, little Franklin County can’t either. We can provide assistance. We need to be more efficient.”

Commissioners told Cooper to come to the hospital workshop on Sept. 6 with a breakdown of finances between the hospital, ambulance service and clinics. Cooper left and was followed to the podium by Kristen Bell, a nurse at Weems.

Bell thanked Sanders, saying “I could kiss you. I finally feel that we have a voice.”

She said she was appearing alone because other Weems employees feared reprisals. Weems nurses currently have no benefits, retirement or holiday pay Bell said.

“We work 12-hour shifts and don’t get relieved for lunch,” she said, noting that her main complaint was about security in the hospital.

“Weems has little or no security. (The nurses) think it’s normal to be spat on and verbally abused (by patients who cannot get a prescription filled),” Bell said. “The camera at reception in the ER doesn’t even record. I don’t think we even have a security system.”

She said that on Sunday, July 19, a member of the nutritional staff was assaulted in the Weems parking lot by a mentally disturbed patient and only escaped unharmed because she was armed with a Taser. Bell asked that the hospital supply nurses with panic buttons to alert police and other staff members if they are attacked.

Sanders asked Bell if she had gone to Cooper with her requests and concerns.

Bell said Cooper told her he could not afford to pay for security guards to “make a couple of nurses feel safe at night.” She said he told her he had ordered additional lighting for the hospital but failed to explain when it would arrive and where it would be installed.

Commissioners instructed County Coordinator Michael Morón to ask Cooper what could be done to beef up security until the lighting arrived.