The element of surprise is too strong a factor in future of Forum Health

One day in the not-too-distant future, Mahoning Valley residents are almost certain to be told that one or more parts of Forum Health has been sold.
It could be the Northside or Beeghly medical centers in Youngstown or Trumbull Memorial or Hillside hospitals in Warren or any combination thereof to any one of a number of out-of-town or out-of-state nonprofit or for-profit interests.
If that seems more than a bit fuzzy and more than a little confusing, well, that's the point.
The public knows virtually nothing about the future of these institutions, which were built by their communities over roughly a century.
An early example
The dismantling of Tod Children's Hospital, the first institution to fall, is instructive.
Forum announced last summer that the hospital was being moved from the old Tod building to the newer and adjacent Northside building, the better to continue to serve its patients. Early this year, rumors surfaced about the possible sale or merger of Tod. Spokeswomen for Forum and Humility of Mary Health Partners said there was no truth to a rumor that St. Elizabeth's and Akron Children's Hospital, which have a partnership, would buy Tod.
The wrong question was being asked. The use of the words buy or sale allowed everyone to issue denials. Indeed, Tod wasn't sold; it was absorbed. But it will cease to exist, nonetheless.
It is that kind of parsing that gives public relations people the plausible deniability on which they thrive. But how should the person who sent his 20 or 50 check to the Tod campaign in December feel when it was announced in January that Tod will be no more?
Forum, which speaks primarily through prepared statements and open letters, has indicated that a number of factors make it impossible to continue functioning as it is. Chief among those problems are labor costs and debt.
Consultants on parade
Last year, the board hired "one of the top hospital turnaround firms in the nation," to use the description of Forum Board President Tom Hollern, to help solve the problem.
Now the board has hired one of the top hospital liquidators in the nation to help it sell its assets.
But in the meantime, Forum is negotiating with its unions to reduce costs. March 31 is a contract deadline for the hospital with one of its largest employee groups, and before a blackout was imposed, progress was being reported.
Are the negotiations actually aimed at saving Forum, or just at each party getting the best short- term deal that they can (i.e., the board gets concessions that save it money now while the union gets preferred hiring status or severance pledges for its member in the event of a sale)?
If a contract deemed favorable to Forum is reached, will Dr. Keith Ghezzi, Forum's interim president and CEO, announce benchmarks that would allow Forum to avoid a fire sale? Will the New York sale consultant be sent back to the Big Apple? Or will we be left to await word on what was sold to whom?
Forum's "Mission Statement" is a pledge "to enhance the health status of the communities it serves," and its stated "Values" include working to build a patient-oriented healing environment and "balance our priorities equally among patient care, community commitment, financial health and physician and employee well-being."
Is Cain Bros., the New York company shopping Forum's assets around, equally invested in that vision? Has it accepted those values?
Profit and loss
In a press conference two weeks ago, Ghezzi revealed that Forum had been negotiating with Ed Muransky, owner of Southwoods Surgery Center in Boardman, for the sale of Beeghly Medical Park as a jump-start to his plan for a for-profit hospital in the Boardman area. They couldn't make the deal.
Obviously, Forum has no philosophical problem selling its assets to a for-profit manager. How does a board of trustees of a nonprofit institution decide that its best option is sale to a for-profit company? Is it strictly the bottom line, getting the most cash for any particular asset? Does the board have any responsibility to the community and those philanthropists, living and dead, who built the institution to assure that a for-profit successor is best for the area's health care consumers and providers?
And where does one community begin and another end? Forum has said that Trumbull Memorial is profitable and has been carrying Northside. Understandably, TMH cannot provide a permanent crutch for Northside. But is it OK to sell TMH to outside interests to satisfy debts that administrators of the past and some trustees of the present allowed Northside to amass?
Are there no other options?
Finally, there is a word that Hollern used just once in an open letter to the community two weeks ago: bankruptcy. Hollern used it as the worst-case scenario: "We could allow the losses to mount, risking inevitable default, eventual bankruptcy and the near-certain closure of Northside Medical Center."
But might not bankruptcy, as distasteful as it may be and as averse as the unions might be to it, be an option preferable to selling off Forum's assets? Is it impossible for Forum to reorganize under bankruptcy, as some local companies have done, and continue to function, even prosper?
Are operating expenses the problem or is debt the problem or is Northside the problem?
There are more question marks in this editorial than would normally appear. That's because we -- and the public -- have so many unanswered questions about the very future of community health care in the Valley. Forum owes us all some answers.