I attended the June 28th 2017 -Broward Health Board meeting. Last year we said ‘things can’t go on like this’ at Broward Health, and they didn’t, they got worse.
After taking a months-long break from writing this blog, hoping in vain for things to naturally get better, Although I missed several recent Board meetings, I have not been entirely absent thanks to the many people (both employees and other attendees) who regularly provide me with the meeting materials and their contemporaneous observations.
Following are my observations and comments on this meeting. But first some meeting context.
Recall the seemingly endless investigations without closure.
Florida’s Inspector General, Melinda Miguel, who you recall blew a loud corruption whistle on Broward Health just days after Dr. Nabil El Sanadi apparently committed suicide in 2015, resigned this April without making a public report of her findings. Governor Scott appointed Eric Miller to fill the vacancy. Miller’s first day as chief inspector general was April 21st, 2017.
Public reports in 2015 and early 2016 said The Florida Department of Law Enforcement(FDLE) was conducting some parallel criminal investigations into Broward Health as was the Federal Bureau of Investigation (FBI), and the Federal HHS Inspector General. So far, nothing. Not a peep.
More recently, Broward State Attorney Mike Satz opened an investigation headed by Tim Donnelly into alleged sunshine violations by Broward Health’s Board. Given the dismal track record of Broward State Attorney’s Public Corruption unit – it is not likely anything will come of it.
So, Broward Health’s Board apparently can act with justifiable impunity to the complete detriment of their public trust and both the spirit and rule of Florida’s sunshine laws guaranteeing transparency.
Revolving door of Broward Health Board members
Commissioner’s DiPietro & Wright removed by the Governor, Nieland under public pressure, Canada in objection to abhorrent Board conduct and VanHoose resigned citing a dysfunctional board. Of course, then there’s Commissioner Capasso, who after “spontaneously” accepting the appointment of interim CEO had to step down from the Board so she could “do the system a favor” and accept a $650,000 salary. More on this later in this article.
With the recent appointment of Commissioner Steven Wellins, the Board is again up to its quorum count of 4 members. 3 board seats continue to be vacant with the Governor apparently not particularly interested in appointing the vacant seats.
Interesting side note: Commissioner Wellins, he is a financial adviser for Wells Fargo, who recently “called” it’s 20-million-dollar loan to Broward Health due. While it may not be a conflict in fact, it certainly has the appearance of one! Hmmm….
And let’s not forget Broward Health’s senior staff.
The ‘Interim” Broward Health CEO’s since Dr. El Sanadi’s suicide include Kevin Fusco (El Sanadi’s designee) followed by Broward Health North Hospital CEO Pauline Grant (removed under unusual and suspicious circumstances by the 4-member Board – an action which led to ongoing litigation and allegations of wrongdoing), followed by Kevin Fusco again, followed by Commissioner Capasso (an action which led to the current State Attorney’s investigation).
Meanwhile, the search for a permanent CEO is inexplicably stalled by the Board.
Currently, while many senior staff positions are vacant, all senior staff is interim except for the IT and HR departments.
So much for the Executive leadership at Broward Health.
Given this back-drop, the June 28th meeting appeared more a carefully choreographed public relations event, then some respectable meeting where responsible leaders might transact the public’s business in the sunshine. With a wink, a smile, and a nod –obviously privately briefed commissioners cast their pre-arranged votes in march step, confident that their best intentions and the inaction of any of the investigative authorities would protects them from any public accountability whatsoever.
Meeting Tidbits[For those that like to follow along, I’ve excerpted the Agenda Book and other handouts to a PDF here.]
Without DeGroot in attendance (see previous articles ), no one offered any general public comments, so the agenda moved to 2 items brought forward by Chairman Rodriguez but certainly not on his own initiative.
The first item was to designate Chairman Rodriguez as the Board liaison to the Interim CEO Capasso as she hires senior staff. While this is provided in the Health System’s charter, it has been the custom for past Boards to honor the CEO’s selection of Senior Staff (his or her team, as it were). This item was odd because of the disconnect for an interim CEO to hire permanent senior staff thereby effectively preventing any incoming permanent CEO from selecting and hiring his own team. Qualified senior staff candidates would understand and be hesitant to accept a job with such an uncertain future without a significant severance package appropriately weighted for the uncertainty. On the other hand, if Capasso really isn’t that interim… After all, after only 3 days on the job, the Board said she was doing a “great job”. Really, they could tell after only 3 days?
The second item was to adopt a process to appoint external members of the audit committee. Recall that recently, an independent member of the audit committee had the temerity to object to staff recommendations and was summarily removed “for term limits”. Really?
Apart for the issue of independence, the recommended process appeared to make sense for the audit committee, but here’s what happened on his item, and again – it’s odd.
The board was presented with a “draft proposed process” which they dutifully read during staff’s presentation.
This “draft proposal” was not in the meeting “Agenda Book”, and no copies made available to the public before or during the meeting, After the meeting, Corporate Counsel Lynn Barrett had copies in a folder and gave me one. I did not ask why they were not distributed before the meeting, or why they were not contained in the “agenda book”, but it is important that her office promulgated the “draft proposal”. I wondered to myself if she has even read the sunshine law.
The Medical Staff Agenda
For the most part, the Medical Staff Agenda’s for each of Broward Health’s Hospitals was perfunctory and professional. However, a few warning flags were waived.
The first is, the medical staff wants to be a part of the CEO search and evaluation. Apparently, they are under the illusion that the search is earnest and in good faith. I predict that in six months, interim CEO Capasso will be named permanent CEO, at least until we have a new Governor and new Board.
Second, in some of Broward Health’s hospitals apparently physicians are not applying for available service contracts which now require some of the hospitals to transfer their patients to other hospitals. This is a different problem than physicians not getting qualified and contracted for services they want to perform. At Broward Health North this appears to be an additional bureaucratic problem which Capasso promised to resolve. Nevertheless, the possibility that physician and physician groups not applying for wanting contracts is a significant warning sign that things are not alright.
Interim CEO Update – Beverly Capasso
CEO Capasso gave us a brief, but unsatisfying gulp of Broward Health’s cool-aide. “Everything’s fine”, “we’re making progress”. Under the circumstances, what else could anyone expect she would she be saying?
Recently the Sun-Sentinel, the only news service making any attempt to cover Broward Health, ran a front-page story about Capasso’s “sketchy” MHA (Masters of Health Administration) professional credentials. See that story here. The well written story dared to show that not only did the Board fail to review Capasso’s professional qualifications, but even if they had – she clearly did not meet the minimum qualifications for consideration. Not to worry, the fact that Governor appointed her seems to be the only credential worth the $ 650,000 salary.
But let me take a slightly different perspective on Capasso’s appointment as interim CEO, aside from what appears to be an obvious sunshine violation. Because of incompetent past Board actions (of which she was a voting member) essentially abandoning the CEO search, mostly at the direction of the Commissioner Ure – when interim CEO Kevin Fusco resigned, the Board had literally no one to turn too. Not only was there no bottom of the barrel, there was no barrel at all. I do not believe, no – that’s not right, I hope that Capasso will be no worse than Fusco’s time in charge.
The only possible alternative the Board had besides Capasso who, at least, arguably had some relevant healthcare management experience was to negotiate and bring back past CEO Frank Nask, who although is available – likely could not be considered because Dr. El Sanadi spent his short tenure unfairly blaming Nask for everything including global warming.
Beside not knowing Capasso, I have no sense of her vision for Broward Health. I don’t know if she understands that Broward Health not only serves the public but belongs to the public. That aside, I am told, that despite Capasso’s allegedly close relationship with Lynn Barrett, she has told Ms. Barrett to stay out of operations. If true, that’s a good sign. For the moment, I’m inclined to give Interim CEO Capasso a chance to meet the challenge and grow in the position. After all, what choice do we have? I am reminded of what Henry L. Stimson said; “the only way to make a man trustworthy is to trust him“. Of course, that’s true for con-artists as well so a healthy public skepticism and transparency is even more important today at Broward Health.
Debt Restructure Presentation – Finance Department
This item was so important in its ramifications for Broward Health that I am devoting a entire post to this and the interim financial report. I hope I can finish this extensive post about Broward Health’s finances in the next few days. This will give me the time I need to review some facts and figures with some healthcare financial experts. My working titles for the post are “Now you see me 4 (about financial sleight of hand)” and “What’s wrong with this picture (when is an audit not an audit?)” and “lipstick on a pig”.
I would be remiss, however, if I failed to draw your attention to the 2 “emergency” and not publicly noticed agenda items Mr. Wallace brought up to approve “replacement” contracts for two contracts interim CEO Kevin Fusco signed apparently without authorization for in excess of 9 million dollars.
Since the finance department, through interim finance director Art Wallace, brought these items up during his presentation – I’ll fully address this and how the Board is being miss-advised by the corporate counsel’s office in my next post. You won’t want to miss it.
The only thing worse than being a liar is a liar that’s also a hypocrite. – Tennessee Williams
Finally, there’s a huge scandal brewing and because you have taken the time to read this lengthy post right to the end – I’ll finish with a riddle. Which Broward Health Commissioner might find it’s a good time to quietly resign? Here are 3 hints: I promise, its easy-peasy, lemon-squeezy.
- Sleazy hypocrites get cached.
- In Florida, it’s too hot for a cover-up.
If you can solve the riddle, post your answer in the comments. I will add 2 more hints to the riddle in my next post. Look for it in the next few days.
Remember: you can send me anonymous tips and information through my About/Contact page.