Dann: Bad decisions led to mess

Forum will likely downsize Tod Hospital and may move it to the Northside building.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
YOUNGSTOWN -- There clearly was "horrid management" at Forum Health for the last 10 years and they should be held accountable, said state Rep. Marc Dann after area elected officials met Tuesday with Forum Health executives and union leaders.
Dann, of Liberty, D-32nd, was among a delegation of Mahoning Valley's local, state and federal elected officials, led by U.S. Rep. Timothy Ryan of Niles, who met separately Tuesday with Forum Health management and leaders of the Service Employees International Union and Youngstown General Duty Nurses of the Ohio Nurse Association.
The state attorney general should look into the actions of Forum Health's leaders over the last decade, Dann said.
However, both Dann and Ryan, D-17th, said they think progress was made at the meetings in the critical area of Forum Health's informing employee unions and community leaders more fully about the financial information that led Forum leaders to think a "radical restructuring" is needed.
Forum Health projected a $60 million loss this year, and said if significant changes are not made, including $25 million in concessions from union employees within the next 30 days, the health system may not survive.
"Our job is to encourage both sides to sit down and share information so we can get the issues faced and maintain good health care and good jobs here. They know now the community is watching," Ryan said.
Wage index problem
Dr. Keith Ghezzi, interim president and chief executive officer, said he asked Ryan and other federal officials with help in addressing wage index redistricting.
Former Forum officials said when the Centers for Medicaid and Medicare lopped Columbiana County out of the district that included Mahoning and Trumbull counties, and added Mercer County in Pennsylvania, it served to lower the wage index formula.
The change means Forum Health receives $8 million to $10 million less a year in Medicaid and Medicare reimbursements for treating the same number of patients.
Ryan said he and the other federal legislators would try to get special legislation passed to help the district with the wage index issue. Also, he said they will work on possibly getting the area designated as a distressed health district, which might make some grant money available.
"This is an incredible complex situation. It can only be helpful that there is this level of interest by elected officials," said David Regan, president of SEIU's District 1199. The union represents some 1,400 of Forum's 5,200 employees.
"The community leaders had some questions of their own; and if we can get answers, it will facilitate the process and help us make informed decisions," said Eric Williams, president of the YGDNA.
Start of plan
Though Forum's board of trustees has yet to reveal its entire restructuring plan, it announced Tuesday after its monthly meeting that it has authorized Forum's management team to:
Explore the restructuring of Tod Children's Hospital in a way that preserves core pediatric services for the local community but will likely limit the scope of pediatric services provided through Tod.
Significantly downsize or close Behavioral Medicine services at Forum Health unless a strategic partnership or sale can be secured within 60 days.
Forum trustees remain committed to maintaining key pediatric services through Tod. In the organizational model under consideration, Tod would not reduce the number of inpatient beds and surgical services.
It would likely concentrate services, focusing on neonatal intensive care, pediatric cardiology, pediatric oncology and some other limited services, said Thomas Hollern, chairman of the board.
In addition, given the high costs to maintain and repair the Tod facility, one option under review is to move it from the current wing to Northside's main building as part of an effort to consolidate facilities and reduce costs.
Another option is to reduce the size of the residency program to better match trainees to the specialties and services provided at Tod, Hollern said.
The management team also will explore proposals to outsource Forum's behavioral health services to a specialty company. Absent securing an outsourcing arrangement within the next two months, Forum will likely discontinue inpatient behavioral medicine services, beginning at Northside Medical Center, Hollern said.
What's being done
In addition, Hollern said it has put Trumbull Memorial Hospital in Warren on notice that it must make material improvements in its productivity and operating margins.
Forum is making substantial progress on turnaround initiatives, narrowing losses and implementing an estimated $24.1 million of improvements to the system's bottom line. Forum also has reduced staff levels. As of the end of March 2006, there were 189 fewer full-time equivalent positions at Forum compared to 2005, officials said.
In a presentation to the board, Dr. Ghezzi said one key focus is whether Northside Medical Center can be restructured with fewer beds and fewer services to remain viable.
"A financial turnaround is possible but not a certainty. That's why we need the cooperation of the unions and why we are asking this board's approval to make these important, vital changes," he said.
The management team also is looking at other options, including potential sales for Forum's post-acute network -- Forum Health at Home, Hillside Rehabilitation Hospital in Howland, Beeghly Oaks in Boardman and the outreach labs.
Hollern said the board's next steps will be contingent upon labor's willingness to provide contractual modifications within the next 30 days, earn the confidence of company lenders, and make all of the structural improvements necessary to operate at a profit.
alcorn@vindy.com