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CARE To Give IHS A Bill Of Particulars

Inova Health System was accused of having "an evil history of causing Mount Vernon Hospital to fail" during the second meeting of the Citizens Alliance Rescue Effort (CARE) executive committee last Wednesday at the Mount Vernon Government Center.

That evaluation came from Dr. Stephen Goldberger during the committee's discussions to create a "bill of particulars" to be presented to Knox Singleton, CEO and president, Inova Health System, highlighting what CARE considers critical areas of poor management adversely impacting both Inova Mount Vernon Hospital and IHS overall.

"Somehow there has to be a summary showing this is not just mismanagement. It is a concerted plan to destroy Mount Vernon hospital," Goldberger said. The bill of particulars will be structured into two distinct areas : 1. Dealing with management concerns; and 2. Question to be posed to IHS.

It was decided that Mount Vernon and Lee district supervisors Gerald W. Hyland and Dana Kauffman, along with county executive, Anthony H. Griffin, will request a meeting with Singleton to express CARE's concerns and get answers. "We need strong material to get the Inova Board of Trustees to realize what's happening," Hyland said.

"If the purpose is to make the Board look at what they are doing to Mount Vernon Hospital, it would be better to structure the bill of particulars to show how they are mismanaging the entire system," Kauffman pointed out. "If we can get the Board to see IHS is doing bad things system-wide, it will get their attention."

In discussing IHS's claim that IMVH is losing money and IHS's overstatement of earning by approximately $30 million, Hyland said, "There have been millions of dollars lost by Inova because of bad investments over the years. But, this past May was the first time I knew they were losing money."

SOME OF THE examples cited in the bill of particulars included: Purchase of Jefferson Hospital, buying medical practices with resultant financial losses, buying an HMO insurance company that never got underway and negotiating insurance contracts that pit one Inova facility against another, rather than contracting system-wide.

"The reason many people didn't know about these on-going losses was due to the rising stock market and investments helped them. Now the market is down and the losses are obvious," said Dr. Khosrow Matini, immediate past president, IMVH medical staff.

"They [IHS] also took the loss all off in one year. No hospital can survive if you lose $1 million per month," said Steve Rupp, former IMVH administrator. "Unless you want to use the loss to justify the closing," Goldberger added. "Most companies don't advertise when they are losing money."

One of the questions that has been raised since the speculation began about a possible new hospital in the Lorton area was why would IHS invest an estimated $200 million in a new facility when the present one is fully operational?

Laing Hinson suggested, "This hospital is coming up to a major overhaul, due to its age. That is a major expense. I am aware of one hospital that just spent $100 million on such a project. And, moving a hospital can have a very positive impact on the number of patients being served."

Matini insisted that it has been IHS's plan to move the majority of services offered at IMVH to a new location since 2001. He referred to his letter written in 2001 to the IHS Board of Trustees which has never been answered.

"If we can show that this planning [to move the hospital] started in 2001, it will show a pattern of IHS not being honest with anyone," Hyland said.

As for the proposed meeting with Singleton, Herbert E. Harris, II, said, "Knox is not willing to discuss with anyone the possibility of expanding Mount Vernon hospital. He wants to move it. I offered to sit down and discuss the alternatives and was told Knox is not interested. He doesn't want to discuss anything that will keep this a full service facility."

IN ADDITION TO citing concerns about the overall management of both IMVH and IHS, Hyland pointed out that the bill of particulars will also contain questions to IHS that have been left unanswered in previous inquiries. Some of those listed for the Committee's consideration were: a list of all malpractice suits against Inova since 1990. Where is IHS losing $10 million at IMVH? Are systems costs out of line with other national chains? How are costs determined? How are costs of indigent care and losses determined? How are costs allocated throughout the system, both inside and outside the hospitals? What will be left on this site if IMVH is moved? Does any member of the Inova Board hold an option to purchase land in Lorton?

The meeting concluded with the agreement that the bill of particulars will be refined and presented to Singleton in a meeting with Hyland, Kauffman and Griffin. Hyland emphasized there is need to act quickly.

"Inova has to file by December 1, their intentions if they want to put some facility in the Lorton area. We need to do something before that date," Hyland said.