Magnolia Ball, a major fundraiser for NCH Healthcare System, has been canceled
Here are some things to know about NCH Healthcare System’s admissions policy. Liz Freeman, email@example.com; 239-263-4778
Donors to the NCH Healthcare System are withdrawing support as hospital leaders show no signs of backing down from a controversial admissions policy that has outraged the community.
Co-chairs of a major fundraiser slated for late March resigned last month and were notified this week that the event, the Magnolia Ball, has been canceled, according to Alice Arena, who stepped down as co-chair of the event with her husband.
The fundraiser this year aimed to raise money for cancer programs, Arena said.
NCH issued a statement that read: “Due to the generosity of its donors and an extremely successful fundraising quarter, NCH is on track to meet its donation targets for the year. We are grateful to our donors who contribute to NCH so that we can continue to provide the highest quality care to the Naples community.”
The cancellation of the event that has been held every two years since 2001 demonstrates that people who historically support NCH are backing down and that hospital leaders realize virtually no one would attend, said Joe Trachtenberg, a critic of NCH leadership.
Opposition has been mounting to NCH’s admissions policy move, in which employed hospitalists are being directed to handle more admissions, over the objections of independent primary care physicians and concierge physicians.
NCH officials say the project with employed hospitalists on select hospital units, who work with a team from support disciplines, has led to shorter lengths of stay, fewer bad outcomes and improved quality of care.
After extensive outcry from the community, NCH held two public forums in December that didn’t appease the audience. Concerns were expressed that NCH will expand the policy systemwide and that it could lead to a closed medical staff. A closed medical staff means only NCH-employed physicians can admit and treat patients, and it enables all referrals for medical care to stay within NCH facilities.
Dr. Allen Weiss, NCH president and CEO, has said NCH is not moving toward a closed medical staff, and he has dismissed rumors NCH will be sold to the Mayo Clinic or any other hospital system. He has said there have been no talks of a sale.
But an internal notice sent earlier this month of an upcoming event is refueling speculation about further changes to the community hospital of more than 60 years.
Mayo Clinic official coming later this month
The notice is for an invitation-only event Jan. 23 with a Mayo official, and the topic is a “culture transformation” at NCH, according to the notice. The Mayo official is Dr. Richard Winters, medical director of professional leadership development at the Mayo Clinic Care Network.
A regularly scheduled meeting that day of the medical staff has been canceled, and it is not clear who was has been invited to the Mayo event. At the bottom, a statement said “attendance is strongly recommended.”
NCH said in a statement that the event with Winters has been scheduled for months and that the cancellation of the medical staff meeting was to accommodate his visit.
"Visits and speaking events with Mayo physicians occur regularly and are part of our long-standing participation in the Mayo Clinic Care Network," the statement said. "NCH can confirm that there are no plans to sell the hospital."
Winters also will be visiting Jan. 24 with the different groups and the medical staff, and those meetings are open to anyone on staff, according to the statement.
In 2012, NCH announced it was the first Florida hospital and the first in the Southeast to join the Mayo Network to have a clinical relationship so local physicians could consult with Mayo physicians on difficult cases.
The renowned Mayo is headquartered in Rochester, Minnesota, and has a Florida campus in Jacksonville.
When the affiliation was announced nine years ago, Mayo officials said they are not acquiring any ownership interest in NCH. A Mayo physician, Dr. Stephen Lange, who was part of the 2012 affiliation launch, is a member of the NCH board of trustees.
Residents and physicians who have been vocal about the admissions policy change say it is disruptive to the patient/physician relationship.
Despite the medical staff opposition to the policy, NCH has not backed down from its stance, emblematic of a heavy-handed management style that has been going on for years, NCH critic Trachtenberg said.
NCH’s philanthropist base is grappling with how to respond to Weiss’ leadership approachwithout causing harm to the community hospital system.
“It’s a very tender balance,” Trachtenberg said. “The way that Allen Weiss and his cronies have managed the hospital has been a well-kept secret which the medical staff has completely known about. This is the first time the public has really seen it.”
Former board chairman will continue limited support
Dolph von Arx, who served as chairman of the NCH board of trustees for 13 years, said he will continue to support programs he has funded in the past, namely the von Arx Diabetes and Nutrition Health Center and others, but he is making cuts elsewhere.
The recent announcement that a group of radiologists has given notice will end up reducing NCH’s margin, von Arx said.
More so, NCH will face competitive headwinds from the well-run Lee Health System, the publicly operated system in Lee County, von Arx said.
In terms of critics who are calling for Weiss to resign or be forced out, von Arx said Weiss is stubborn and a difficult person to change.
“Unless he can change his position, I think he in some way may be forced to resign, but he will never resign on his own,”’ von Arx said.
Richard Bodman, a Naples resident who served two terms on the NCH board many years ago, said NCH is where it is today because of the contributions from the community.
“I want to see the hospital improve, not be eliminated,” Bodman said.
He has spoken with Weiss and said he is stopping his contributions.
“He said, ‘I don’t care. We don’t need it,’” Bodman said. “A number of even larger donors than I have had similar conversations with him.”
Weiss doesn’t listen to what residents and donors have said about the admissions policy, his treatment of the medical staff or how NCH is a community hospital, Bodman said.
Hospitalists have a role and nobody is against them; the problem is that Weiss moved too quickly with the change, Bodman said.
Significant donors who oppose NCH management’s actions are giving money to help support campaigns to stop the admissions policy, he said.
A group of physicians and residents have hired attorneys and are considering legal action on the basis that NCH’s action interferes with the physician/patient relationship, according to a Dec. 7 letter from the group's attorneys to NCH.
The hospital's actions may be anti-competitive and could jeopardize its license with the state and accreditation with the Joint Commission, according to the attorneys.
Separately, the Collier County Medical Society is running advertisements and has conducted a survey among physicians, with results that show 95 percent do not agree with the admissions policy and 96 percent do not have confidence in NCH’s management team in the future.
Fundraising efforts falling short
Arena, the recently resigned co-chair of the Magnolia Ball, whose term on NCH’s philanthropy committee has ended, said she initially wanted to learn more about the admissions policy. She believes there had to be an important reason for it, but NCH leaders have fallen short and refuse to listen to the concerns of residents.
“The explanation, the rationale for this decision was not forthcoming to the community,” Arena said.
It became clear it is not a good time to raise money for NCH or approach donors for the Magnolia Ball, she said. At a kickoff brunch in December, there was little response.
“The writing was on the wall,” Arena said.
The Magnolia Ball, which had been scheduled for March 29 at The Ritz-Carlton, Naples beach resort, usually raises between $1 million to $1.4 million, she said. It usually is attended by 300 to 350 people.
What’s discouraging is that NCH leaders are not acknowledging the disconnect they have wedged with the community and the medical staff, and fixing it will be a task, Arena said. Holding two public forums in December just before Christmas did not suffice.
She and her husband, Andy Arena, have been coming to Naples since the 1980s and have witnessed NCH’s transformation.
“It has become a fine community hospital; to see this kind of breakdown with the community is just really, really sad,” she said.
In terms of a leadership change, Arena said that is a tough call, but the longer NCH leaders stay in the trenches with their position, the options narrow and the only solution may be a clean sweep.
“It’s hard to imagine a solution with the current administration, as it is a little too dictatorial,” Arena said. “The focus needs to be, ‘How do we solve this problem?’ Some solution needs to be found that is acceptable to all parties.”