MV's Hospital Future Murky

MV's Hospital Future Murky

Task force takes up issue of Inova Mount Vernon.

For the second meeting in a row, the Southeast Health Planning Task Force, charged with evaluating Inova Mount Vernon Hospital's (IMVH) future, closed its meeting to any "outsiders" including the press. That caused two of its most prominent members and Mount Vernon supervisor Gerald W. Hyland to exit as well.

Prior to making his exit, however, former U.S. Rep. Herbert E. Harris II, a member of the task force, attempted to get Knox Singleton, president and CEO, Inova Health System, to commit to the fact that Mount Vernon Hospital would not be closed. Singleton would not give a definitive answer.

"We should put to rest the terrible rumor that Inova is going to close this hospital," Harris asserted. "Will you commit to that?," he pressed Singleton, who countered with, "To rule out any option would not be responsible."

Prior to task force chairman Warren Cikins’ closing the meeting and the challenge to Singleton, Harris was successful in getting a motion passed, stating, "The goal of this task force is to sustain the Inova Mount Vernon Hospital, to enhance existing services and to add such other services that will ensure its financial viability and serve the community health-care needs."

The motion further noted, "The task force shall achieve this goal by developing and presenting specific recommendations for this vital institution to assure its long-term survival and growth as the health-care centerpiece for the community it serves. We will oppose any proposal that would diminish its role or inappropriately encumber its efforts to serve."

Joining Harris and Hyland in expressing their objections to conducting the entire task force deliberations in secret was former state Sen. Joseph Gartlan. "Since the actions of this task force have a great impact on the public interest, I don't think the answer is a complete closure of meetings," he said.

ALTHOUGH NOT A formal member of the task force, Hyland had put members on notice at their original meeting in February: "My mind will stay open as long as this hospital stays open."

He then attempted to persuade Cikins to close the meeting only for highly sensitive matters under discussion but to debate all other matters in an open forum. "This is the rule of the chair (to close the meeting), and it takes a two-third vote to override the chair," Cikins insisted.

"Hopefully, by closing the meetings, people can discuss without showboating or posturing for the media. Ultimately we are going to issue a report and release what we want the community to know," Cikins said.

Singleton admitted, "Inova asked for the executive session. Most of the items we want to present cannot be done in open session. If it is an open session, then we will not present those items for your consideration." Cikins added, "If we are going to discuss these items and get the results we want, we can't do it in open session."

Cikins was supported in his insistence on a closed meeting by Dr. Cleveland Francis, the hospital's medical staff president and a member of the task force. "I don't think there is a lot of work that can be done with the press present. I am opposed to this being a public workshop," he said.

THE OTHER MEMBER of the hospital's medical team on the task force, Dr. Khosrow Matini, the immediate past president of the medical staff, argued for an open meeting. "If the discussion is to deal with the potential closing of this institution, then it shouldn't be done in secret if we really care about this community," he said.

Jeffrey C. McKay, another task force member and chief of staff to Lee District supervisor Dana Kauffman (D), said after the four-hour session, "I supported the closed meeting because there was some information we (the task force) wouldn't have gotten if it had been open. It's more important for us to get all the facts than have an open meeting."

Reflecting on the competitiveness of health care, McKay noted, "I've never seen anything like health-care battles. It is one ugly sport. It makes politics look like kids play." He also assured, "Nobody on the task force is going to recommend closing Mount Vernon Hospital."

The rationale for closing the meeting centered around Inova's professed need to not divulge certain financial details about both the entire system and Mount Vernon Hospital specifically. "Inova faces many organizations that are in competition with us. We can't reveal sensitive financial data and remain competitive," Singleton insisted.

"Inova is a nonprofit organization geared to help the community. The discussions are based on how we are to best serve that community in a competitive environment. If we lose control over a lot of this information, it would be catastrophic," he explained.

"Our goal is to sit and try to talk about alternatives. If we can't do that without divulging the information to the public, we are going to help our investor-owned competitors. The goal is to find the best way to save this institution. If we are forced to open the meeting, it will harm us and that goal," Singleton said. "Reckless disclosure of this information would be terrible for this institution. We need to strengthen health-care services in this area of the county," he emphasized.

Cikins said, "We can have open sessions all the time and will end up with zilch. If we see people are blabbering outside the meeting, we'll know."

IN MAKING HIS decision to close the meeting, Cikins cited his experience in working with Congress many years ago and how "they often held closed-door meetings." He also cited the fact that, under Roberts Rules of Order, "it is the chair's prerogative to make this decision."

After leaving the meeting, Gartlan said, "One of the tragic elements of Warren's statements is that they are indicative of all the worn-out notions about public meetings." Harris also noted that Singleton's answer to his request for a pledge to keep the hospital open "was unsatisfactory."

After all the effort at the meeting to keep Inova Health System financial data secret, an article appeared in the Business Section of The Washington Post on Saturday, 48 hours after Cikins' edict, announcing, "Inova Health System ... overstated its 2002 revenue by $30.7 million ... ."

In comparison to total revenues of $1.3 billion, the overstatement did not represent a large portion. But, The Washington Post reported, it "has forced the company to reduce earnings it will report later this month when it releases its audited 2002 statement," according to Richard Magenheimer, Inova chief financial officer. It could also impact Inova's bond ratings, which could in turn adversely affect their ability to raise money.

"Inova executives called it a serious but honest mistake, not in the league of recent accounting scandals" attributed to such corporations as Enron and WorldCom. It was based on a miscalculation in expected revenue from 15 to 20 health-insurance plans, according to Magenheimer.

DRIVING BOTH task force deliberations and Inova's desire for secrecy is the financial health of the hospital, the possibility of another Inova medical facility in the Springfield/Lorton area, and potential competition from HCA, a for-profit medical corporation with facilities in the region.

At the task force's first meeting, Singleton tried to squash rumors Inova was contemplating a facility in the Springfield area to counteract HCA in that area. Speculation was Inova was not investing in the Mount Vernon facility because of its plan to invest in a new facility in Springfield.

He stated at that time, "There have been rumors Inova is not investing enough in Mount Vernon Hospital. Part of the future is going to be investing in this site and its program. Five years ago HCA proposed a hospital in Springfield. This (the task force) isn't about HCA. It's part of our five-year planning process. This is not a short-term response to HCA."

HCA recently lost a bid to put a new medical facility in Loudoun County. There is speculation that has reignited their interest in the Springfield area.

AS FOR IMVH'S financial health, it was also reported at that first meeting by Susan Herbert, IMVH vice president/administrator, that there had been a dramatic change in annual net operating income from 1993 to 2002. In 1993 there was a positive net income of $200,000. By 2002 that had shifted to a net loss of $300,000, a $500,000 spread.

Herbert attributed the primary cause of this to "The shrinkage in physicians" and thus, services. Dr. Francis noted at the time, "It is clear to the medical staff, if the hospital remains on its current course, we will not be able to serve the community. ... It's been our goal from the beginning to be a full-service facility."

In opening the initial task force meeting, Singleton made the following statement: "This is not a back-door way (the naming of the task force) to get the hospital to close. It is a viable way to get the hospital to become stronger."

The next meeting is set for June 5.