Mercy: Commissioners seek answers

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HUNTSVILLE — The CEO of Mercy Health Partners’ Community Hospital Division, who is also the interim CEO of St. Mary’s of Scott County, found himself on the firing line at an informal session of the Scott County Commission here Monday evening.

Jack Bryan, who had come before the commission to explain his company’s request to reinstitute lease payments for the local hospital in exchange for the county providing an annual “charity subsidy,” fielded a barrage of questions during a 90-minute session.

Shortly after providing a summary of Mercy Health’s request to establish a Charity Care Subsidy program, Bryan was put on the firing line by Sixth District Commissioner Ron Blevins, who criticized the company’s decision to become a critical access hospital, which he (Blevins) claims to have increased out-of-pocket fees from patients with insurance coverage.

Following a brief discussion on that topic, Bryan was bombarded with a rapid-fire series of questions from commissioners, which included:

• A series of specific, financial-related questions posed by Fifth District Commissioner Paul Strunk;

• A “Do you want to stay, or do you want out?” interrogative from Fifth District Commissioner Rothel “Tub” Cross;

• A charge of not keeping promises made after signing a long-term, payment-free lease agreement by Sixth District Commissioner Gerry Garrett;

• A question asked by Fourth District Commissioner Alan Reed as to whether or not Mercy Health would “bail out” if the commission failed to approve its request for the charity subsidy; and,

• A question posed by Commissioner Strunk as to whether Mercy Health was planning to sub-lease the local hospital to a third party.

While the question and answer session consumed the better part of the meeting, it failed to develop into a heated debate, as Bryan and Mercy Health Partners’ legal counsel Jan Van Dyne calmly responded to all the questions put before them, as well as making a strong case for their request of the charity subsidy.

Later in the meeting, the commissioners and Mercy Health Partners representatives finally got back to discussing the specifics of charity subsidy request. And, although no consensus was reached, the door was opened for further negotiations.

Bryan explained the purpose of Mercy Health’s request; namely, that by reinstating the $1 million lease, in exchange for an equal amount being paid to St. Mary’s of Scott County to offset the cost of charity patient care ($1.6 million in 2008, and $3.7 million in 2009), the institution might qualify for upwards of $400,000 a year in “critical access allowable expense” reimbursement from Medicare/Medicaid.

The proposal under consideration by the commission also includes a direct $100,000 a year payment to the county.

Ms. Van Dyne said Mercy Health has, through an outside legal counsel, determined that the proposal is legal, and that it can be accomplished by an amendment to the existing lease.

County Attorney John Beaty concurred, saying that the amendment to the lease “would be the easiest thing to do” if the commission gave its approval.

As to Bryan’s response to questions posed by commissioners:

• He told Commissioner Strunk, basically, that his questions comparing the finances of St. Mary’s of Scott County with other Mercy Health facilities was an “apples and oranges” type of comparison, that each facility was judged on its own merits. Also in response to a question by Strunk, he said that Mercy Health was involved in preliminary discussions with a Nashville-based management firm about the possibility of forming “partnership” with the local hospital aimed at obtaining funds for capital improvements;

• He responded to Commissioner Cross’s question by stating that Mercy Health “wants to stay” in Scott County, to which Cross replied that it didn’t seem that way to him, since the commission had “bent over backwards” to accommodate them, and Mercy Health “keeps coming back with something all the time . . . it’s just a continuous thing”;

• As to the charge of unkept promises, Bryan told Commissioner Garrett that Mercy Health was “trying to get its hands around the hospital . . . to make as much profit as possible” to make the improvements that are sorely needed, including a new Emergency Room and Operating Suite. As to Garrett’s remark about not having a CEO who lives in Scott County, Bryan indicated that they were still searching for a person to fill that position;

• Bryan informed Commissioner Reed: “No, we’re not going to bail out,” adding that Mercy Health “is just trying to break even . . . that’s our goal”; and,

• He told Commissioner Blevins that the only change resulting from becoming a critical access hospital, was that the Emergency Room is now considered a separate out-patient facility.

Throughout the meeting, County Mayor Rick Keeton’s role became that of a moderator, frequently trying to steer the discussion back to Mercy Health’s request to resume lease payments in exchange for the county paying a portion of the charity care costs.

Near the end of the meeting, Seventh District Commissioners Willie Boyatt and Mike Slaven spoke out in favor of Mercy Health’s proposal, both saying they felt it was a “win-win” situation for both sides.

In response, Bryan stated that Mercy Health had “no other objective than trying to continue the service here.”

Fourth District Commissioner Dennis Sexton said he feared the citizens of Scott County who were viewing the local cable TV’s videotape of the meeting would “really be confused” by the night’s discussion. He then posed his only question of the night to Bryan: “I’d like to know if it’s going to cost the citizens of Scott County money?”

Bryan’s response: “I don’t see where it would.”