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Jim Bullard, one of three Methodist Hospital officials present for the
regular board meeting, said their proposal is the same as a previous
offer that was withdrawn when the board opted to seek additional offers.
Under the management agreement, Methodist Hospital Systems would provide
an administrator approved by the board, and the board would retain
complete control of RCH.
"We see a good opportunity for everybody to have a good win-win
situation," Bullard said.
Board chairman Raul Garcia questioned an audit made previously by
Lubbock Methodist in which they found a number of problems they felt
should be corrected.
"Were you considering doing another audit, or is that what you are going
to work with?" Garcia asked.
Bullard said that audit would be used to develop a baseline, but "If the
board or staff desires, we would be glad to re-review that document and
bring you back a report as to some things I am sure have been done
differently."
Garcia said he agrees with some things in the audit report, but some he
doesn't.
"I think we should review this and see what we all need to get together
and do in the interest of getting this off on the right foot," he said.
"We agree," Bullard said. "I think that, in retrospect, we would
probably take a different approach. We need to take a more positive
approach to the document and to some of the issues we discussed."
Garcia also objected to some of the terms in a proposed contract
submitted with the proposal, and Bullock agreed to work out the
differences with Scott Johnson, the hospital's attorney.
In the interim, Bullard said he would submit a letter of intent to enter
into a contract so Methodist Hospital can go ahead with a transition
team to work with Quorum Health Resources until their management
contract expires in January.
Interim CEO Carolyn Riley has submitted her resignation as of Nov. 21,
and Quorum is to provide another interim, Garcia said.
Jeannette Alligood said that Riley's resignation puts the board in a
position to need help right away.
"It would be a very good time to start working and doing transition -
and more cost effective for the hospital," she said. "We have gone
through so many changes. The sooner we can get to a stable environment
the better it will be for everyone."
Bullard said they would invite input from the board on what type
administrator they want and provide candidates meeting that criteria.
"There is not a shortage of administrators," he said, noting that the
administrator will be employed by RCH and answer to the board.
"This is your hospital, your community," he said. "We will be happy
tomake recommendtions to you; share with you wht other folks are doing,
but your decisions will direct the hospital 100 percent. That's the one
distinctive part in our agreements we feel the best about, and why we
have a large network."
Alligood's motion to enter into a "letter of intent" with Lubbock
Melthodist for management and to negotiate a contractual agreement
received a second by Jesse Prieto and passed unanimously.
That decision made moot an agenda item to consider purchasing group
options, because Lubbock Methodist will provide the needed quantity
purchasing power to obtain discounts on supplies and pharmaceuticals.
Methodist Hospital Systems and Medical Center Hospital in Odessa had
submitted differing proposals.
"We have here apples and oranges; not two like we requested," said board
chairman Raul Garcia. "One is for management, and the other is for
affiliation with Odessa Medical Center. I don't believe that we have an
option from what to select. I would like to submit we reject all bids
and ask for re-submission from interested parties, to be reviewed two
weeks from today."
Garcia said the board could not make a choice from "just one submittal
that meets the standard of what we asked."
Jeannette Alligood said that people who wanted to respond did so and met
the terms of the board's request for proposals.
"It is not their fault nobody else did. To reject them because no one
else responded is not fair."
Methodist Hospital's response indicates they are concerned with the
board's wishes and know how to meet deadlines, Alligood said.
"The problem I have is consideration of this magnitude, we need a
choice," Garcia said. "We are not pressed for time. We have time to ask
for re-submission. If no one else is interested, then that will be
something we face when the time comes. We don't have to accept anything
from anyone. I would like for the board to have a choice."
"What happens if we reject and request again and only get one proposal
again?" Alligood asked.
"The time will come when we have to do something, but at this point we
don't have to do either one," Garcia said.
Marcella Lovett said that RFPs were sent to Odessa Medical Center,
Shannon Medical Center in San Angelo, Texas Tech, Midland Memorial
Hospital and Lubbock Methodist.
"Only two responded. Where would we go beyond five?" she asked.
"I don't know. A re-schedule would like anyone to respond to our needs,
and that's what we would do. Give anyone and everyone to come in an give
us a choice. If not, we will consider it when the time comes," Garcia
said.
He made the motion to reject all proposals and ask for re-submittal form
all interested parties. Chel Flores seconded.
"I think it is very unfair whenever they have had their opportunity and
don't submit," Lovett said. "I don't understand."
"That's what I think would be fair to the board to have an option from
where to choose," Garcia said.
Attorney Scott Johnson said the requests for proposal could be changed
slightly to give hospitals a wider latitude in making their proposals
and still have a basis for comparison between bids.
Alligood said it is unfair to those who have already submitted a
proposal because other hospitals have access to it. She suggested that
board members not discuss contents of the proposals.
Johnson said the proposals are public record. "To the extent that the
law allows us to protect these bids, we can sure try to do it," he said.
Garcia called for a vote on the motion, and Flores and Jesse Prieto
voted "yes," with Alligood and Lovett voting "no." Garcia broke the tie
by voting "yes."
"This is the most unusual proceeding we have ever been involved in,"
said Jim Bullard for Methodist Hospital.
"We have gone to a lot of time, energy and work. We came here tonight to
make a presentation. We are greatly concerned that we are now not on a
level playing field. It is obvious all the energy we put into this is
available to all people. Maybe it was even structured that way.
"Based upon that, we are withdrawing our proposal to manage your
hospital. We have no desire to participate or to be parties to things
that we think...We still beleive in the West Texas spirit where we do
things on handshakes, up front and fair. We don't see it this way,"
Bullard said.
He offered to share their proposal with anyone else making a bid.
"They can't live up to what we can do. We have a lot of hospitals,"
Bullard said. "I don't see these proceedings as being on a level playing
field to us. We will decide later if we want to re-submit. I won't tell
you now whether we will choose to respond or not. It is something we
will take very seriously."
Garcia said he had checked to ensure that the board's action is within
the law.
"I'm not saying it is against the law," Bullard said. "But we withdraw
our offer to work with you."
Bullard and four associates then left the meeting, taking video and
computer equipment they had set up for their presentation.
Bullard said this morning that he was disappointed they were not allowed
to make the presentation after being invited by Garcia to do so.
"We are tremendously disappointed," Bullard said. "The board had
expressed to us a desire to make this a quick decision. We are quite
disappointed they chose to change their approach."
He said the decision has not yet been made whether to re-submit the bid.
The proposal was the best they could make, and it would be difficult to
change it, he said.
"Our cards are played already, and it is not a level playing field," he
said.
Methodist Hospital charges nothing for the services they offer, but asks
for reimbursement for the salary of an administrator, whom they provide.
An affiliated hospital then becomes part of a 28-hospital network with
access to any of the other members.
Although Lubbock Methodist provides a high level of health care beyond
the local hospital, it is not a requirement that patients be referred
there, Bullard said.
"It is something we believe we have to earn. Our facility is one of
quality care, and we could earn that."
RCH previously was affiliated in a non-management relationship with
Methodist, and some of the benefits included administrator meetings,
board retreats and education seminars and personnel training.
Ray Mason, community liaison, said RCH used their training for neo-natal
intensive care for Dr. Eunice Anderson, and several nurses trained in
obstetrical care - all free of charge.
Local training was also provided by Methodist staff, he said.
"Some facilities utilize them greatly, and some don't, but they are
there for the asking," Mason said.
Methodist also provides air ambulance service through AeroCare. RCH has
utilized that for the past three years.
The county's original offer was $36,300, and the board asked the
Pecos-Bartow-Toyah ISD for a quote. That offer of a fee not to exceed
$30,000 was not discussed.
"We have the opportunity here to save taxpayers $5,400 if that's what we
desire to do," said chairman Raul Garcia. "That's been the bottom line
up to now. Some people want to stretch the tax dollar as far as it will
go by saving on these costs, and here we have the opportunity to do
exactly that."
Chel Flores made the motion to accept the county's offer, and Garcia
seconded.
Marcella Lovett said that the county has collected the hospital
district's taxes "quite nicely in the past."
Looking at the offer from a business standpoint, she said, "we are
facing having two options presented to us. Time seems to be of the
essence with our financial situation at this point. I am concerned we
have had so many political situations to come in here and I hate it that
all taxing entities have been having to scrabble here lately."
Noting that the school is getting new equipment to handle the extra load
and the staff is not familiar with the hospital's tax roll, she agreed
to continue with the county.
Jesse Prieto cast the only negative vote.
"My only concern is, how do we know the same tax collector will be there
next year? Eletion time is just around the corner, and just anyone can
come in there and file for that position," he said.
Lovett said she understood that tax assessor-collector Elfida Zuniga has
three more years to go on her term, since she was elected in the general
election
last year.
However, Zuniga was elected to serve for the unexpired term, which
expires Dec. 31, 1996. That office will be on the primary ballot in
March, said county clerk deputy Virginia Palomino.
Garcia said that all taxing entities will eventually be consolidated.
"I don't know which way we are going to go, but I agree that we should;
probably it will be next year. I am sure we will find ourselves
compelled to comply," he said.
Prieto said that if the hospital district does have a problem with tax
collections, they should work it out with the tax collector and "not
bother anyone else. Let's not go and ask the school for any help."
Jeannette Alligood said the groundwork was laid at last week's meeting
of the four major taxing entities in the county to get together next
summer to discuss tax collection and to look at the cost factor to
ensure it is being done according to the law and is equitable.
Garcia appointed Alligood as mediator for tax collection.
Quorum Health Resources gave notice they would not renew their
management contract when it expires in January, and the board discussed
possible affiliation with a group of area hospitals.
Garcia said that a group of hospitals, including Abilene, Shannon
Medical Center in San Angelo, Odessa Medical Center, Midland Memorial,
Texas Tech and St. Mary's in Lubbock are going to offer an "affiliation
type situation."
"We have also let Tech know this letter has been tendered so we can
proceed now without fear of interference from any angle," he said. "I
think this was holding some people up."
He said Tech is still interested in management if RCH can come to
agreement with the area hospitals.
"I think we should ask Lubbock Methodist to give us another proposal,"
said Prieto.
Lovett and Alligood agreed.
"It will be open to anyone," Garcia said. "We don't have to advertise
for professional services."
"We have advertised ad nauseum," Alligood said.
Priscilla Apolinar presented an offer by Ruben Fuentes to purchase two
lots adjoining his property at 517 S. Pecan Street. All other entities
involved in the tax sale have accepted the $500.
Prieto, whose wife Lydia is school tax assessor-collector, said he did
not think the school had voted on the sale as yet.
Lovett made a motion to approve the sale if other entities have approved
it.
"Why do you think you have to go last?" asked Scott Johnson, attorney
for the board.
"We have always waited until last," Garcia said. "The school gets $1.40
and we get 35.5 cents (per $100 valuation), so we follow their lead;
whatever they want to do."
Johnson advised the board to consider the value of the property in
accepting a bid.
Alligood seconded Lovett's motion, and it passed unanimously.
Carolyn Riley, administrator, recommended the board approve purchase of
the EKG machine that the hospital has leased for the past five years.
The purchase price would be $750, and the machine needs about $500 in
repairs, said Frank Vasquez, radiology technician. He said he has
located parts for it and believes it would last another two or three
years.
Since the board had put $8,000 in the 1996 budget to buy a new EKG
machine, they approved the purchase.
"We can take it out of the savings on tax collections," Alligood said.
Riley presented a revised employee handbook for the board's
consideration, and they delayed discussion until each has a chance to
study it.
Proposed changes include eliminating a five-day cooling off period
before termination of an employee; prohibiting solicitation at any time;
streamlining the labor union policy to state that employees may or my
not unionize; and adding physical appearance to the list of criteria for
testing employees for drug use.
Employees will be eligible for drug-alcohol rehabilitation only if they
volunteer that they have a problem and are seeking help.
The section regarding disability leave was modified to reflect the
federally mandated Family Medical Leave Act.
Riley asked the board to review the proposed handbook and to contact her
or Nadine Smith if they have questions.
In her monthly report, Riley noted that Medicare re-opened the 1991 cost
report and it appears the hospital will receive $7,600 additional.
Another bit of good news was that Medicare will increase their average
DRG reimbursement $400 per inpatient stay.
A public meeting is set for 8 a.m. Friday to allow the public to comment
on a proposal to allow a registered nurse to ride in the ambulance along
with one emergency medical technician.
Riley said the comment is required before the state will approve a
waiver of the requirement that two EMTs accompany every patient. The
hospital's ambulance is used to transfer patients to Odessa and Midland.
She said that Quorum group vice president Andy Epps is contacting
compiling a list of groups that RCH could join to take advantage of
large group purchasing discounts. Quorum's discounts for September saved
RCH $13,213, she said.
She introduced John Lowrey, who began as interim chief financial officer
on September 28. He replaced Mike Hathorn, who transferred to Del Rio.
Hathorn, business manager Lily Serrano and Riley met with a
representative of Transorrld Systems Inc. regarding their collection
service.
They use a flat dollar rate per bill, which they guarantee to double in
collections or refund the fee. Riley said she hopes to use them on a
trial basis and present something to the board October 24.
Discussion of the management contract with Quorum Health Systems and two
tax collection offers headline the Reeves County Hospital District board
agenda for 6 p.m. Tuesday.
Both Quorum and the board have indicated they will not renew the
management contract when it expires in January. In order to cancel it,
either party must give 90-day notice.
RCH has twice invited management proposals. In the second round of
solititations, the request was altered to also invite proposals for
affiliation only.
Midland Memorial Hospital submitted an afilliation proposal. No
management proposals were received, and Methodist Hospital withdrew its
earlier management proposal.
Both Reeves County and Pecos-Barstow-Toyah ISD have offered contracts to
collect hospital district taxes. Those offers and contracts will be
considered.
Other agenda items include sale of property at 517 S. Pecan St.,
purchase of an EKG machine, changes to the employee handbook and reports
from the medical staff and administrator.
Meetings are held in the hospital classroom and are open to the public.
Copyright 1996 Pecos Enterprise
324 S. Cedar, Box 2057, Pecos TX 79772
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