NEW ERA AT BROOKS
Major changes for city hospital win approval in Friday voteBy MICHAEL RUKAVINA
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The way in which Brooks Memorial Hospital moves forward in the future was altered by way of vote Friday morning. One hundred ten years of history ended during a special meeting of the Brooks Memorial Hospital Corporation, to vote on recommendations made by the board of trustees.
The vote, which was passed 15-2 by the membership of the Brooks corporation, essentially turned what was an approximately 50-member corporation board, into one.
"The membership of Brooks as it currently exists, is an older style non-for-profit corporation which is local citizens are members of the corporation and you don't see that a lot today," said Lake Erie Regional Health System of New York attorney Gary Mass.
"What this proposes is to eliminate the membership of the local neighborhood members, and there would be one member of the corporation of Brooks, which is the Lake Erie Regional Healthcare System of New York. They would be the sole member of the corporation. You're basically voting yourself out of existence."
The fact members who have served the hospital for years upon years would ultimately be voting themselves out of the decision-making process loop was a difficult one to make and many had questions and concerns about the situation they were put in. Dan Reininga questioned the history leading up to this point.
"The Berger Commission mandated this and encouraged hospitals to join together to cut costs. TLC, Westfield and Brooks were encouraged to work out a plan between the three. Westfield went their own way because of their affiliation with St. Vincents. We reached out to TLC and TLC reached out to us and we decided it would be in the best interest of the people in Northern Chautauqua County if we could come up with a combined system to enhance the medical service," said Brooks Memorial Hospital Board Chairman Bruce Ritenburg. "It wasn't easy, but I think the plan we put together will serve us all very well in the Northern Chautauqua area in the future and also help us not only with better services, but perhaps at lower costs also."
The incentives for pursuing this were also questioned. Given in comparison to other medical facilities debt, Brooks was financially stable.
"Lake Shore has been running with a pretty significant loss for a pretty significant amount of time. Most of that loss though, operating loss and what they pay in interest, they essentially offset each other. The loss is because they have a lot of debt, and the argument is (not advocating on Lake Shore's behalf) is that they would eliminate that debt and that interest because the state is going to pay it off," said Brooks Memorial Hospital CEO Richard Ketcham. "It is something over $13 million which is a lot of interest on that type of money, 5 percent of $13 million is $800,000 a year. The argument is their debt is paid off, the interest goes away and going forward they are in a much stronger financial position. Brooks has interest payments of about $200,000 per year, which would also go away based on the model."
From a medical standpoint, the idea of broadening the population base of patients across the two facilities was also a point of future potential and growth.
"Financial is one, but I think creating efficiencies in healthcare was the main focus. This positions both institutions, when we first look at this as uncomfortable, but then decided it's a wonderful opportunity for both organizations to take advantage of what both organizations do well," said Jay Bishop, M.D. "Our community is in a precarious position in terms of man-power, we cannot retain doctors let alone recruit them; we need to address that. From a medical staff standpoint, we feel this is a great opportunity to combine resources and work together and learn from one another."
Ketcham explained that at this point in time this is not to be considered a merger, and cannot be, given items like finances and employee aspects will be kept separate. A full-asset merger, he said, would make some things easier. This active parent arrangement that is being created will also be defined as a "getting to know you" phase, according to Bishop.
"In my mind this is like living together before getting married because I think ultimately what we want to create is a system where it doesn't matter whether you get your care at TLC in Gowanda, Irving or at Brooks in Dunkirk," Bishop said. "These are baby steps we need to take to get to know each other. I think TLC has a lot to learn from Brooks and I think Brooks has things to learn from TLC."
From this point on, the Lake Erie Regional Health System of New York will continue to evolve and the self-perpetuated board will eventually be constructed of 16 people, eight initially nominated from Brooks and eight from Lake Shore. They serve three-year terms and can be re-elected. If someone no longer wishes to remain on the board, or their term expires, then the board would nominate good people from the community, interested people from the community.
During the meeting, members expressed their greatest appreciation for Ketcham, who announced he is not vying for the CEO position a few weeks ago, and urged him to reconsider.
"I appreciate the gratitude and support from current and past board members at the hospital," he said. "What I have committed to the board was that I will stay here until the new CEO is in place. I don't know how long that will take, but I would estimate it would be one to four months."
Some decision-making authority granted to the Lake Erie Regional Health System of New York over the Corporation are as follows:
n Appointment and dismissal of the Chief Executive Officer and hospital medical staff.
n Approval of the hospital operating and capital budgets.
n Approval of the certificate of need applications filed by or on behalf of either hospital.
n Approval of hospital debt necessary to finance the cost of compliance with operational or physical plant standards required by law in excess of $100,000.
n Approval of hospital contracts for management or for clinical services with aggregate consideration in excess of $100,000.
n Approval of settlements of administrative proceedings or litigation in excess of applicable insurance limits to which either hospital is a party.
Comments on this story may be sent to to mrukavina@observertoday.com
