Tuesday, August 21, 2012

Hayward's St. Rose Hospital Faces $3M Funding Gap By Sept. 30

Supervisors Wilma Chan and 
Richard Valle, St. Rose interim
CEO Mak Nakayama/Photo Shane Bond
ALAMEDA COUNTY//HEALTH CARE | Hayward's perennially cash-strapped St. Rose Hospital faces a projected $3 million hole by Sept. 30, according to county officials. In addition, another $3 million in cash flow issues by next January will require the hospital to seek $6 million in funds to help keep St. Roses's doors open.

St. Rose's interim CEO Mak Nakayama and Alameda County Health Care Services Director Alex Briscoe noted short-term funding will begin in January to help handle the cash flow issue. A long-term plan being discussed includes one of two options, one with a private provider and another is Alameda County Health Center as a public provider. Kaiser, who has a hospital located across the street from St. Rose, has pledged their support to help maintain St. Rose. Former St. Rose CEO Michael Mahoney resigned earlier this year in the aftermath of disclosures the facility was facing the possibility of imminent cash shortages.

News of uncertainty at St. Rose came to light last Friday at Hayward City Hall during a town hall to discuss the onset of the Affordable Care Act’s affect on the struggling Hayward hospital and hosted by Alameda County Supervisors Richard Valle and Wilma Chan. “The reason we are here today is to talk about healthcare insurance and the dramatic changes that we see in the field concerning the Affordable Health Care Act and how these changes will affect not only St. Rose but healthcare throughout the county,” said Valle, in his opening statement.

Chan spelled out a dramatic desperation for health services and rising costs that have weighed heavily on the shoulders of Americans for years; especially in the post-Great Recession era. Emergency room care is an extremely expensive financial burden compared to someone seeing a primary care physician, according to Chan. St. Rose has played an important role in general and acute care but most patients are either under or uninsured and rely on St. Rose as their general and primary care provider.

Since the economic downturn hit in 2008 the county has seen a climax in uninsured residents rising from 166,000 to 199,000. Hayward has a higher rate of uninsured residents than Oakland, according to Briscoe, who added to the potency of primary care’s role in rising health care costs and St. Rose’s financial situation. “There is not now nor will there be in the foreseeable future enough primary care,” said Briscoe, “Costs are rising because not enough people are seeing their regular primary care doctor due to the lack thereof; therefore the health care industry sends citizens to the highest level of care.”

This kind of financial upheaval is an additional weight to St. Rose, whose financial struggle was heightened after the Sisters of St. Joseph left the hospital to incorporation, becoming a non-profit stand-alone hospital who has the lowest per-patient income of any hospital in the East Bay. The hospital only earns $2,494 per patient per day and is reliant on a fractional reimbursement from Medicare or Medi-Cal. In 2007, the hospital saw both Kaiser Permanente and Sutter Health support a $7 million short-term emergency fund and Alameda County has provided a straight cash subsidy of $40 million in the last five years to help keep the hospital afloat. County and local hospitals have partnered in issuing a stabilization fund of $12.25 million this past spring.

When the hospital comes into the post-medical reform era St. Roses’s role for uninsured folks will only be enhanced, according to Briscoe. “This is the most sweeping reform since Medi-Care and Medi-Caid were created and it really closes one of the great ethical and moral gaps in our society’s approach to the safety net…Now 56,000 new folks will get free health care and another 107,000 who get some help to buy healthcare on the private insurance market,” said Briscoe. Briscoe says these newly insured citizens will be entering the safety net system and handled by hospitals that have the capacity to deal with the newly insured. “Alameda County is dependent on certain hospitals on playing a certain role, handling the uninsured or underinsured,” said Briscoe, emphasizing St. Rose’s importance for that role. Meanwhile, the short-term prognosis for St. Rose may also include help from labor.

Matthew Mullany, a representative of the Teamsters Union Local 856, spoke about pension money givebacks by union members to help keep the hospital open. “What has not been mentioned is that they’ve [union members] have taken wage freezes for two years now,” said Mullany, “We have all worked in good faith for the past few years to keep the hospital open. I am here to tell you that the union is still willing to do that.”

The union representative noted a potential sub-contracting issue that may take place at St. Rose. Mullany spoke against having a sub-contractor becoming the new employer for specific departments in the hospital, “There may be two departments there now that may be sub-contracted out,” said Mullany, “It is not definite yet…I don’t believe it is the right time to do such a thing.” Mullany said that he doesn’t believe that Nakayama, an interim president, should be making long-term decisions for the hospital, which includes sub-contracting, “I say that respectfully,” added Mullany. The union representative said that at the current time it doesn’t make sense to have two different employers in the hospital at the same time because of potential labor unrest. “I don’t say that as a threat or as a challenge,” noted Mullany, “We don’t want any unrest.”    


Guess who's been on St. Rose's board for many years now ..... Valle.

When will the county or St Rose come clean about how bad the situation is there? I read what seems like a lot of money to help keep it open, but then it's still in the hole $3 mil?

So much in the hole. Yet nepotism continues. Certain people appointed as director of bull*hit made up position 20 something year old daughter of board member. They advertise this throughout the workplace that we should applaud and congratulate her, as real people, people who actually care for patients are getting lay off notices. It is appalling. The interim CEO has no vested interest in the place, otherwise he would be ridding it of top heavy management. Do we really need 2 managers per each group of 20 workers? That is exactly what is going on. Seriously do we need one person (manager) dedicated to finding beds for patients? The answer is no. Nakayama is ignoring the real problem just like Mahoney did. What does he care? He is just passing through. The place is a complete mess. Very caring and professional WORKERS there who only want to do what is right for the patient but management keeps cutting back on those who do the real work. Shameful.

If Medicare and Medicaid have a historically low reimbursement rate and thousands of new patients are brought into the system under Obamacare how is this going to make St. Rose financially healthy? I can see the community will have to financially hold it up forever. It will never be self-supporting.

Kaiser has yet to write the check they promised months ago....

75% of Measure A funds (0.5% sales tax intended to subsidize uncompensated care in Alameda county) are guaranteed to go to Alameda County Medical Center (Highland and associated clinics). 25% go to everyone else. This was written into the law that was passed in 2004. Yet more uninsured in Hayward than in Oakland? That will make for an interesting debate when Measure A sunsets in a few years.

Healthcare reform could indeed make things worse for small community hospitals like St. Rose if the volume of patients with low-paying (Medicaid rates) insurance increases and the money available now to shore things up (DSH funds, Measure A funds, other state and federal money) dries up because 'well, everyone has insurance now'. I don't think anyone really knows the answer, but plenty of reasons to be pessimistic...

4:35 and 5:12,

Health care reform will help out St. Rose in multiple ways:

- Over 32 million Americans who currently have no insurance will be able to purchase private health insurance (not Medicare or Medicaid) with the help of the Affordable Care Act. Thousands of these newly insured are likely to be people who use St. Rose.

- Expansion of Medicaid eligibility will allow many additional St. Rose patients who are completely uninsured to have Medi-Cal coverage. Even if Medi-Cal reimbursement rates remain less than the full price of service, it is much better than giving care to uninsured patients who often are unable to provide the Hospital any meaningful payment.

We have ALWAYS supported our hospitals with public money. It is the right and necessary thing to do. What is this new, vicious America libertarians wish to coerce all of us into accepting? You get care if you can afford it, or suffer and die if you can't? I refuse to accept that.

and remember, mahoney and others wanted st rose to merge into SL hospital-any one recall my position? let me remind you-i stated it could not be done and furthermore i was surprised to learn that mahoney had acquised to involving himself with SL hospital-he had told me he had no interest in doing so previously-funding not there and never was-tony santos

I heard Mahoney received quite a payout when he left St. Rose

Can we all just keep our eye on the ball here? We are loyal nurses and employees who continue to work at st rose and support the mission and the right that everyone deserves the same standard of quality care. Wouldn't we all want that for our family members if they were brought to st rose in an emergency situation ? Regardless of your insurance or lack of? There are so many of us that have been committed to st rose and our patients out of ethics and out of love and passion for nursing. There seems to be a common concern that there is definitely a need for us and our service. We are here!!!! Everyday we are here to give our best to all in need. Many of us have been here thru the good and the bad, but we are still here and committed. We are not politicians. We are nurses who come to work everyday, knowing it may be our last, but dedicated to the same excellent nursing care we have always given to this community. Someone, please help us and help our community. We have essentially been operating as a county hospital for many years without the financial support. Help us now as we have helped this community all theses years without demands and expectations.

Yes, we agree that there were many "deals" made that were not in the best interest of the hospital or it's future. We need to correct the bad choices and make smarter, better ones. We need to do it NOW! Whoever is in charge, make it right. I agree with the earlier post that we need to focus on our patients who need us and this hospital. Indeed, how does it look when you layoff nurses/employees but create a new job for a young director? How can we respect that?

Seems like you replace one hIgh salary with three. How is that effective when they aren't qualified for the positions and have never done them. All because you are friends or family of the ex Foundation Director? How is this showing you are an equal opportunity employer? Was the new director position that was created for IT project manager turned physician expert ever posted or offered to other employees? I think not...yet we laid off others and can't afford to bring in necessary product for patients. Makes perfect sense! An then we cry for the community to support this? Those who work hard get no recognition or raises and others who haven't done a thing get positions created for them and 100% increases. Then the county and community wonder why we are in this position. If management doesn't change nothing will. They do not have to community in mind only their overinflated salaries. It's sad when employees can't even go to HR.

Thank you Shane for attending the city hall meeting and writing about St. Rose. We need the public to be more aware of the incompetent people "running" the hospital. The current CEO only has CAL MORTGAGE's best interest in mind. He could not care less about Hayward or the employees of St. Rose.

Unfortunately Cal Mortgage holds the keys financially. No one has the power to keep them from making the decision for the future of SRH. Nada!

As long as the same administration/ management is the same nothing will change. They need to further invistagate where and how the hospital got in this financial burden. Stop making up stories and covering up. Get the FBI involved. Who ever is responsible needs to be accounted for. Mahoney? Mahoney's clan? It is so sad how this place has become. This new CEO Mak is a puppet hasn't done anything or will. He is clueless of the real issues. He goes by what the vice presidents Marie Ellen and Ken tell him. But they are as clueless as he is. Let the county take it over since they are the ones holding up the doors up.

They need to stop being selfish and worrying about their jobs and practice what they preach. Management Is not running by the mission of the hospital. They are not fighting for the community. They would rather the hospital shut their doors, many be out of a job, create a healthcare crisis in Southern Alameda County, etc then sacrifice their 10 or 15 jobs if an investor were to take over. Beggars can't be choosey!

What happened to the potential partnership with Washington Hospital?

I, too, am interested to know how a person goes from being an IT Project Manager to Director with less than two years of experience at the hospital. I can't believe that anybody who has worked there for 5, 10, 15+ years would appreciate this. As usual, the powers that be continue to make foolish decisions on how precious dollars are spent. It's no wonder that the Washington Township Healthcare Services has passed on adding St. Rose Hospital to their group after looking at the books. And now it finds itself, once again, looking for potential suitors.

This is too big for the local authorities to cope. The state Attorney General's Office (or state FBI) need to get involved with true focus on the corruption/ mismanagement that appears evident. Someone's from the Management/ Board/ etc. need to be investigated, indicted, and jailed; and then forced to relinquish their assets as retribution to the facility organization (under new leadership).

When the majority running the show are high paid consultants it's no wonder it's sinking fast. They just want a paycheck not a future. The recognition isn't too bad for their portfolio either.

They should get rid off Marciano and Mariellen Faria. Poor and failed management team.Hospital patient census is very low compare to other hospitals or previous years. Low census is because local MD 's lack of confidence in hospital management . Marciano's royal dynasty as medical staff director need to end in order to convince community doctors to send their patients to hospital. Ms Faria's management style lacks any vision or direction, Management by crisis! to lie, distort, micromanage & low respect from managers reporting to her...... She only cares about herself and her titles...She should have let go along with Mahoney. St Rose need a fresh team of dedicated leaders who care about our community. Let's not allow these cronies further destroy 50 years of St Rose dedication to this community.

St Rose has a history of hiring people that are not qualified. A good example is ER. How many people does the manager need to help her? She can't walk down the hall by herself. Supervisor doesn't have a clue. She tries to take credit away from her people when she hasn't make a single contribution. St Rose has very caring employees that do a good job. Hopefully we will still be around when this financial issue is resolved and not working elsewhere.

I hear he gets his salary for life
Not a bad deal for someone who sank st rose

I have worked at St Rose for many years and would first like to say that Mariellen Faria is doing a fine job. She was thrown into this mess. She has always looked after the patients cares and the employees. She is not the reason that we are in the financial mess that we are in. She is trying very hard and doing what she can to help keep us open. For as long as I have worked with her she has always been about the patient!!! Dr Marciano is one great doctor and I think that we should stop pointing our fingers and trying to blame the ones who are still here and trying to keep us alive! St Rose has some of the best employees a hospital could ever ask for and I personally am proud to be part of that team. Hopefully all of this can be worked out and we can continue to give the kind of care that we do with great love, kindness and knowledge.

People are still living in a dream world I see. Either that or they can't see through all of the smoke. The time is coming and hopefully Michael's gang will be gone for good!

Sounds like the Sep 12 "Anonymous" writer is the newly hired "director of Physician services" . Party is over for these corrupt/toxic management team. The hard working St Rose employee and this community deserves a honest and dedicated leadership team.

Central issue is not management but the mission statement. Mission statement of St Rose is not compatible with survival of this institution. St Rose has become a preferred place for underinsured , Medical and non insured patients from Fremont to Oakland. It is no longer Hayward community hospital. Middle class and insured patients do not want to be in St Rose because of its profile as safety net hospital for indigents. . St Rose unfortunately does not have the resources nor manpower to service this population. Highland dumps its patients by creating bottlenecks in Clinic appointments and ER Access. Washington supported physician do not take the underinsured patients with medical. Saint Rose does more medical deliveries than Highland hospital. Underinsured and underinsured patients from Eden find their way into St Rose. Ambulances bypass Kaiser and Eden and bring sick uninsured patients to Saint Rose. Saint Rose gives the most charity care as proportion of its revenue compared to any East Bay hospital. St Rose is unfortunately a victim of national healthcare crisis. Despite this it beat all the rest of East bay hospitals including Washington hospital in safety ranking (see consumer reports released in August( . No mean achievement to underfunded hospital in dire financial straits. To survive St Rose needs to change its mission statement.

9/7 poster are you talking about the supervisor that was putting together urine cups or someone else?

To the sept 14th reply regarding about my posting on Sept 12th. No I am NOT the director of physicians services I am a Nurse who has worked there for more than 15 years. I still stand behind Mariellen, Ken and Dr Marciano. I believe in St Rose and feel we will be OK. BTW how long have you been with St Rose? and did you attend the forum the other day announcing the one who bought us? What is your take on that? I pray that this will turn out to be a good thing...not too sure though

I have been a patient at St Rose many times coming to the ER. A few weeks ago I saw the new ER supervisor get into a full blown argument with a patient infront of other patients! Very rude unprofessional woman. Never seen her before but I had to ask who she was so I never have to deal with her. Who hires these people? People like her make the hospital look bad.

To the nurse of 15 years - st rose hasnt been bought. It is in a management agreement only. The fact that you are so poorly uninformed about this critical difference, explains how you could be so misguided and hold such unrealistic opinions of the very leadership who have failed this hospital, its employees and most unfortunate, it's community and patients. Being a nice person does not then make one an effective leader. Many people are now suffering as a direct result of their mistakes. Take off your blinders of bias and walk into the light.

Was a patient there with insurance. I don't have much to compare it to but didn't feel comfortable. Next time I will go somewhere else. There FIRST concern was how was I going to pay. They said and spelled my name loudly twice (HIPAA violation I think). They apparently don't take Blue Cross. So humiliating. Everyone in the waiting room stared at me like I was trying a scam to get care. If I wasn't so sick I would have left I don't think they will be in business much longer. Everyone takes orders from the money collecting clerks in charge. I got out alive but I won't be back. Not looking forward to the bill!

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