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Friday, November 6, 2009

Q&A with Former Healthcare Director Suzanne Barba

Suzanne Barba was a Eden Township Healthcare District Director from 1990-2006. She was replaced by current member Carole Rogers. During the last half of her tenure she sat on the board as Sutter Health entered the District and helped negotiate contentious agreements with the hospital provider in 2004 and 2007. She sat down Friday afternoon with The Citizen in San Lorenzo.

Sutter Health, at one time, had great interest in building a facility in the lucrative Dublin/Pleasanton market. Is it fair to say the District was trying to cut its loses by keeping Eden Medical Center over San Leandro Hospital or risk have no hospital at all?
When the board sat down with the other Sutter boards to look at where the business would be going, when you're doing strategic planning, of course, the eastern section looked really ripe because that's where the growth is. Castro Valley isn't growing very large. San Leandro isn't growing very large. Hayward is pretty static. Yeah, that was one of things we were afraid of. We were wondering whether they were going to retrofit [Eden] because they would rather be in Dublin. Well, as it turns out, they stayed with Eden and they're going to build us a new hospital.

When you negotiated the Memorandum of Understanding in 2007 with Sutter was there any worry about the sections allowing San Leandro Hospital to be closed if it did not turn a profit and whether that could actually happen or was that not a concern at the time but subsequently became a huge factor in where the hospital's fate stands today?
We really thought it was going to be okay because of the kind of effort we were putting into it. We tried to make the employees happy by raising their benefits and salaries and I think you can look at the seniority at a hospital and know whether they love their hospital. San Leandro is a good hospital, but it has changed hands and I don't think this Prime Healthcare is a good deal for San Leandro. It's a for-profit. [Owner Prem Reddy] has a history, but some people in San Leandro think its worth it. He's promising the world and you know he's not going to be able to deliver because the hospital is not making money. If he's making money, it's because he's cutting corners.

When you talk about stars aligning, the county needed a place to put their rehabilitation facility, so here was a hospital losing a lot of its services anyway. So it seemed that we were doing good for the county. They don't have to worry about retrofitting [Fairmont Hospital]. It's good for Eden and the hospital stays in San Leandro.

There has been rumors that Sutter is using cost-shifting maneuvers to make it appear San Leandro Hospital is losing money when it is not. One story is Eden donates a large piece of medical equipment to San Leandro Hospital but is listed on San Leandro's books as a severely overpriced expenditure for installation. Do you believe San Leandro Hospital is losing money despite doctors and nurses who describe a bustling facility?

I think it's losing money. [District Director] Carole Rogers had an auditor look at the hospital's book. They spent $40,000 and when they did the audit it came out the same way.

Why is San Leandro Hospital losing money?
One of the problems is doctors like Vin Sawhney are part owners of a surgery center that is in competition with hospital and that's what a lot of the doctors did. They either have a surgery center or started doing some of the stuff in their offices.

What do you believe the outcome of this will be? Will it stay as a fully-functioning hospital with emergency room services or become rehab for the county?
I don't see how it can stay open. It's losing money. Nobody can really stay in business like that. That's the bottom line whether you want it to stay open or not.

Despite enormous pressure from doctors, nurses and the public, it is still likely San Leandro Hospital will become a rehab facility. Do you any remorse or regrets for your part of negotiating the agreement if this happens?
I regret all those things that came together as a perfect storm had happened and then got worse. The doctors got mad and a mad doctor is not a cooperative doctor and they're not working from the same agenda. The outrage I hear from San Leandro is the hospital being built in Castro Valley is too small. Well, the trend now is to outpatient surgery. The new hospital will have about 100 rooms that can be converted when needed. They're not staffed, so you don't have to staff those rooms that are empty, but if a pandemic occurs, they can convert those rooms into a larger hospital for all those people. You can look around, nobody is building monster-size hospitals anymore.

Critics say without an emergency room in San Leandro people are going to die. Is Castro Valley really too far for someone in San Leandro to get care?
It's ten minutes and if it was a trauma situation they would be helicoptered over no matter where they are. If they're talking about screwing up the building of the new hospital, they're talking about losing the trauma service, so they better not wish for something or the they're liable to get it. If they mess up Eden's plans then they don't have a trauma center in this area.

Wouldn't you say it's too late to use the "we might lose Eden, too" scenario when Sutter is already tearing up the earth in Castro Valley?
[Former District Director] Frank Rico is of the opinion that Sutter is just waiting to leave. No matter how much money they have put in so far, it's nothing compared to what it is going to cost to build the whole thing. They are just looking for an excuse to back out and maybe go to Dublin.

And, you know, poor San Leandro, they are going to have a beautiful Kaiser there and I don't think people realize you can go to the emergency room at Kaiser even if you're not a member--it's state law. I went to Kaiser emergency once. They stabilize you and then they send you, if they have to, to your regular hospital and then they bill. I remember at Eden, they had over a million dollars in money owed by Kaiser for patients they treated. They are so slow to pay.

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4 comments :

It's telling that Barba quotes Dr. Rico approvingly, another former Board member voted out of office by their constituents. She remains wrong on the issues, and rather cold and uninformed to boot.

A Board member should be aware that ten-minute delays in acute care for critically ill patients will kill many of them. I believe she's acting deliberately ignorant with that statement.

Suzanne's credibility flatlines with her views regarding the hospitals' financials. Surgery centers also compete with Eden and every other hospital in the East Bay, and none of them are claiming they need to close. Barba does use this to attack Dr. Sawhney, who is courageously fighting to preserve needed services, so there's that.

The audit, which was approved by the entire Board, was a general look at the entire District, and was not targeted to discover unethical transfers of funds. Now that other hospitals in the Sutter system have documented the theft of tens of millions of dollars unethically transfered to Sutter corporate, perhaps a forensic audit would be worthwhile.

It is simply implausable for two hospitals separated by less than six miles to report such radically different financial performances. In 2008, Sutter reported over $20 million in profits at Eden and about $6 million in losses at SLH. How could their markets be that different? Swallowing whatever Sutter shoveled their way led Barba and other Board members to take actions which placed our health care in danger.

"...the county was looking for a place to put its rehabilitation facility, so here was a hospital losing a lot of its services anyway." This is unbelievably irritating in its passive voice claiming no responsibility.

The Healthcare District bought SLH in 2004. Did the Board wish to buy "a hospital losing a lot of its services anyway"? No, they sat by and allowed Sutter to intentionally run the hospital poorly and misreport its financials in order to justify closing services. Is Suzanne proud of her Board's acumen in spending District money to purchase a hospital for $35 million and, five years later, having Sutter say they have the right to take the hospital for a penny?

"...they better not wish for something or they're liable to get it." Barba joins Sutter in thuggishly threatening the public: "Nice hospital you got there, shame if something happened to it." I hope, unlike Sutter, she's at least a little regretful about all the needlessly dead people.

"The new hospital will have about 100 rooms which can be converted when needed." She has absolutely no idea what she is talking about. I would venture she thinks she is talking about a Universal Care Center which Sutter has proposed for the new facility. The UCC is currently proposed to have only 34 beds, and these beds are not planned as licensed inpatient rooms; none are likely to be unsuitable for a pandemic. In fact, on weekdays the beds will be occupied with patients having surgeries, transfusions, infusions, colonoscopies, gastroscopies.... By the way, how does she propose to instantly staff nurses for these rooms if an earthquake or illness crisis arrives?

People want to be able to choose to go to a hospital where, if neccessary, they can be admitted until their condition has improved; they don't want to be placed in an ambulance and taken to their "regular hospital". Kaiser Hospitals are set up to serve members; they serve non-members less comprehensively.

The fact that State law requires a Hospital to recieve a patient regardless of their ability to pay is not a defense for Barba and her Board. Sutter's operation of SLH currently requires the same; Suzanne thinks it's OK for Sutter and the District to avoid this legal responsibility by closing the ER.

Finally, "It's good for Eden and the hospital stays in San Leandro." Finally, she cuts to the chase with this quote: Suzanne thinks it's OK to have reduced SLH services bcause "It's good for Eden." She also thinks we're really, really stupid: THE HOSPITAL WOULD CLOSE IF THE COUNTY TOOK IT OVER AS PROPOSED. The building would deliver limited medical care, but it would cease to exist as a full-services hospital.

Pardon for my error: in the fourth paragraph of the last post, I meant to write that none of the UCC beds are likely to be suitable for a pandemic.

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