County commissioners and members of the public called for an independent audit of the financial records of Weems Memorial Hospital at a workshop held Tuesday afternoon.
Commissioners also told Weems CEO Mike Cooper they wanted a series of hefty raises given last fall to six top administrative employees to be reconsidered.
About 30 people attended the workshop to discuss the future of Weems. Any votes to be taken on matters must be done at a regular or special meeting.
Hospital administrators and hospital board members called a recent letter from Tallahassee Memorial Hospital (TMH) CEO Mark O’Bryant a positive note for hospital operations, but commissioners and several members of the audience who spoke out expressed a lack of confidence in hospital leadership.
The O’Bryant letter said that TMH and Weems had identified a potential risk partner for Weems, but “if we are unsuccessful with this party, we will search out another potential partner.
“Please know that the agreement that mitigates financial risk for Franklin County and transfers it to other parties would need to include the continued support of the sales tax subsidies and the immediate commitment to the building program,” he wrote.
The meeting began with a presentation to the board of the sort that normally takes place during the regular county meeting. It centered on the financial state of the hospital as of June.
Weems CFO Robert Graham said that the hospital had at that time about three days of cash on hand, but that after several expected reimbursements, this figure would rise to 23 days in October. He said Weems will have $120,000 in the bank after the next payroll but added that the hospital is “playing catch up” on some bills.
Graham said collection time is down to 66 days which “is an improvement over the last several months.”
After the financial report, Jim Bachrach, chair of the hospital advisory board, addressed the workshop.
Referring to a more detailed financial packet presented to commissioners, also dated June 2016, Bachrach said that after breaking down profit and loss among the two Weems clinics in Carrabelle and Apalachicola; the hospital itself and the ambulance service, only the hospital showed a profit.
According to the report Weems East in Carrabelle was $78,000 in the red in June. Weems West showed a $300,000 deficit.
Bachrach said one of the most critical lines in the report is the share of costs from operating the clinics that is absorbed by the hospital - $114,000.
“The hospital is doing quite well,” he said. “Now we have to deal with this clinic issue.”
Cooper said the clinics are losing money because they weren’t properly structured when they were first opened. “I can’t imagine why they thought they could keep two physicians busy enough to (have a doctor on duty full time at each one),” he said.
Cooper said the average Medicaid reimbursement at the clinics is now $35 per patient, but could increase to as much as $90 per patient if the clinics were restructured as rural health clinics. He said the hospital administration began working on changing the clinic status about two years ago, and has filed for the change four times, but each time has been forced to alter their paperwork.
Commissioner Smokey Parrish asked why Cooper had not come to the board for help with the problem. “We can contact our senators and representatives. At times the board can help if we know,” Parrish said.
Cooper said he had contacted Congresswoman Gwen Graham’s office.
Parrish asked why deficits at Weems Clinic West were higher than those at the clinic in Carrabelle.
Cooper said Weems East has a higher volume of patients, about 14 daily than Weems West which serves on the average about 11 patients a day. He said this is at least in part because patients in Apalachicola can visit the emergency room without an appointment and since they will not be paying for treatment, the higher cost of the ER is not a consideration.
Bachrach said collections at the hospital are trending up while revenue is trending down.
Cooper defends salary hikes
According to the information presented in the packet, salaries as a percentage of revenue are higher at Weems than at other comparable hospitals.
Cooper said the hospital is not grossly overpaying employees, but due to the small size of the staff is forced to keep many staff members on site to provide services like radiology, even when they are not working. because they could be needed unexpectedly.
“I see you gave some substantial raises,” Commissioner Noah Lockley said. “Why are we paying on the same scale as other hospitals if we are so small?
Cooper said many members of the administrative staff “wear multiple hats” and deserve to be paid well. He said administrative staff members work more than 60 hours a week.
Commissioner William Massey asked how work hours for the administrative staff were documented, and suggested a time clock could be used.
Lockley asked why Cooper was the first Weems CEO in recent memory who felt it necessary to radically increase the wages of the administrative staff.
“I tried to even it all up,” Cooper replied. “We are all paid equally less than what we ought to be paid.”
Speaking later in the meeting St. George Island resident Donna Butterfield said administrative employees at Weems are being overpaid based on salaries published on the internet at payscale.com, a website that allows prospective employees of medical facilities to compare salaries at comparable health facilities.
She said the median annual salary for human resource directors in Florida is $50,000 and the highest paid receives $67,000, but Weems’ Human Resource Director Ginny Griner now receives almost $78,000.
Butterfield said Plant Manager Craig Gibson, who received a $25,000 raise in October had performed poorly during recent safety inspections of the hospital.
“I am shocked by the attitude Mr. Cooper has taken,” Butterfield said referring to his refusal to reconsider the raises. “Aren’t you his boss.? His attitude about you and what you think is insulting,” she told county commissioners.
Massey pressed Cooper that “You have already spent more money this year than you have in next year’s budget. Where will the money come from?”
Cooper said some of the raises would be offset because professional certification earned by some staff members allowed Weems to keep services in-house that were formerly performed by outside contractors.
Lockley asked if the hospital board knew of and approved the raises for administrative staff. Cooper said the board knew the total of the raises to be given but did not know the details of who would receive what amount.
“We didn’t want to know,” said Bachrach, who said a “grouping in the hospital” spent hours researching the salaries.
Allen Feifer, president of Concerned Citizens of Franklin County, said he attended every hospital board meeting but one last year, and never heard the matter of raises discussed or voted on. He said he could find no record of a vote on pay raises in the minutes, and had spoken to three hospital board members who said they had no recollection of the vote.
He called financial data presented to commissioners by Weems staff unreliable and misleading.
Eastpoint’s Hank Kozlowsky, a retired labor attorney and the most recently appointed member of hospital board, argued in support of the salary increases. “You have to pay money to keep people,” he said. “Weems has a definite place in this county. You have an obligation to ensure health and safety of residents.
“Of all the people who have voiced an opinion, who is the one with greatest knowledge and experience?” Kozlowsky said. “Mark O’Bryant (TMH CEO) said in writing he sees a future for Weems.”
Cooper said in giving raises he had to consider the knowledge and skill sets of employees and the difficulty of replacing them. “The people making $8 to $10 an hour can be replaced,” he said.
Cooper said the administrators who received raises, who included him, did not need to work and “came here to retire.”
Massey replied that “they aren’t going anywhere. The only alternative is the oyster bar.”
County Commissioner Cheryl Sanders said “the numbers we have been given today concern me. Since October we have spent $3,957,000 on salaries. That’s a lot of money. We need to rectify this and not the (county commission) but the hospital board and Mr. Cooper.”
She said she disagreed with some of the figures in the Weems report and called for an independent audit.
Former hospital board chair Gayle Dodds said the “backbone of the hospital staff has been mentally abused since 1981” and called the 25-cent an hour raises given to most of the hospital staff disgraceful.
She said raises to administrative staff were unreasonable. “This is not New York or Miami,” Dodds said. She pointed out that the salary increases bring the annual pay for the top six administrators to $600,000.
“There aren’t that many hats,” Dodds said. “That hospital is imploding. Putting money into a new hospital is just not going to work.”
Commissioner Rick Watson said he wanted to build up contingency funding before starting construction of a new facility. He reminded Cooper that the hospital has borrowed substantial funds from the health care trust and said he wanted to see the loan repaid before the beginning of the next fiscal year.
“We’ve been looking in rearview mirror all day long. Most concerns are how are you going to pay for (a new hospital). Look to the future,” ,” said Bachrach.
“Mr. Cooper, what I asked today is what people are asking me,” Lockley told the hospital CEO. “I want to see this hospital work. I’ve been on it since day one. It’s not going to work if all the money is going out and none is coming back in. The bucket will be empty one day. We’re in better shape than a whole lot of counties. I don’t want to see (Weems) go down when it doesn’t have to.
“The money you spent on raises I would have like to seen that spent on an MRI machine,” he said. “I don’t believe people would have fussed over that.”