Historically, Florida’s Broward Health was used a cash register for the politically connected where everything from lucrative land deals, insider supply & service procurement’s, to outrageous physician contracts given to cliques of gate-keeping physicians were the rule and not the exception for our public hospital. Typified by a revolving door of politically appointed CEO’s more interested in their next position than in the mission of Broward Health as one of Broward’s 2 public health care systems, Broward Health thrived as a financial political base for the political aspirations of Florida’s governor’s office.
Then a few years ago, almost by accident, a politically naive chief financial officer was suddenly elevated to the position of CEO (see my previous article). Not knowing any better, this professional CEO began to put the district on a firm financial footing for the first time in the hospital system’s history. But because this financial CEO never could master the politics of the system, he failed to correct the legacy of the past misconduct quickly enough, and did not address the dangerous politics of the well connected physician contracts. This was, in part, due to pressure from the politically appointed Board of Commissioners and the historically absent public oversight. Instead, this CEO focused on financially strengthening the system and investing in quality health care system initiatives, again largely ignored by absent public oversight.
The result was a whistle-blower complained to Medicare (OIG – Office of the Inspector General) about the excessive physician contracts at the system, and a federal investigation ensued. The financial CEO was named in the complaint because he did not confront the improper direction from his political board, and failed to address the problems quickly enough. In fairness, he was between the proverbial rock and hard place. Soon you will hear about this OIG investigation because it is widely believed that it is coming to an end with a significant financial penalty in the tens of millions of dollars, against our public hospital for the misdeeds of past politically appointed boards and CEO’s. A fine, we as taxpayers, must and will pay.
Recall that Broward Health was established many years ago as a tax supported public hospital system to serve the health care needs of Broward residents living north of Griffin Road. Over the years, with substantial tax support, the system has grown to 4 hospitals, over 50 facilities including urgent care neighborhood centers, close to 8,000 employees and annual billings of close to 4 billion dollars (with a budget of over 1 billion dollars). From every perspective, it has become a substantial economic engine in our county. Simply put, the money that goes to Broward Health generally stays in Broward – and that’s good.
But because of the governance structure of the hospital system, it essentially operates without effective oversight from those it serves, or the public that owns the system. Its Board of Commissioners are appointed by the Governor, and so it is no surprise that the Board of Commissioners are either political operatives or simply the unapologetic result of political patronage with little or no relevant experience.
For much of the past year, Broward Health’s 7 member Board of Commissioners operated with only 4 and 5 members because the Governor’s office failed to timely fill vacancies. 3 of these members effectively orchestrated the financial CEO’s ouster and replaced him with a well-connected politically active physician through a sham recruitment and interview process. 2 of the 3 are political operatives, only recent Broward residents, and have no business or public policy experience. In contrast, the leader of the 3, has an extensive but recent political pedigree – but no previous business or health-care experience. It is noteworthy that this new CEO – has given tens of thousands of dollars to political candidates, committees and PAC’s in recent years. It is not a coincidence that the current chair of the Board of Commissioners and the purported architect of the ouster is known as a prolific political fund raiser who maintains a number of political committees and PACs, which have benefited from the largess of the newly appointed CEO. Why else would the Board hire a person with no administrative experience running a hospital system? It is déjà vu all over again!
We should all be nervous.