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Leaders: More work to do at Gaston hospital

GASTONIA Local officials say the recent firing of CaroMont Health president and chief executive officer Randall Kelley has helped improve strained relations between the county and the hospital, but there’s still more work to be done.

Amid criticism of his management style, Kelley was dismissed on April 16.

The action followed controversy over the name of Gaston Memorial Hospital being changed to CaroMont Regional Medical Center and the hospital adopting a marketing slogan, “Cheat Death,” which was later dropped.

County commissioners had heard physicians complain that, under Kelley, the CaroMont administration had created an environment that raised concerns about safety, health care and adequate numbers of medical staff on duty.

Now, leaders say they hope to mend damaged relationships with doctors and improve overall communication in the community. And they say there may be more changes ahead in top leadership.

Another divisive issue has lingered for months – renegotiating the county’s current $1 a year lease agreement with CaroMont. In tough economic times, commissioners believe the tax-exempt hospital should pay more.

For now, the county will shelve the lease talks, giving CaroMont time to regroup.

“I’d like the county to put negotiations on the back burner and let the hospital administration and board get back on track,” said Gaston County commissioner Tom Keigher. “They need to be focused on getting back to their job and getting their house in order. They don’t need the distraction of the lease there.”

In the past, the two boards have been at odds. But Keigher hopes the air has been cleared for a better relationship.

“We’d like them to be true partners with commissioners,” he said. “We’d like to be included instead of excluded.”

Meanwhile, the hospital name change is still drawing fire. At Thursday’s county commission meeting, about 20 veterans showed up to protest the change.

“We request you support us in an effort to change it back to Gaston Memorial Hospital,” said Tony Sherrill, chairman of the Gaston County Veterans Council. “We’re pretty upset about this.”

Veterans weren’t consulted about the name change, and an important piece of history was overlooked in the process, he said.

According to Sherrill, Gastonia City Hospital was overwhelmed by injured veterans after World War II, so American Legion Post 23 in Gastonia spearheaded a fundraising drive to expand and upgrade the facility.

Sherrill, who is Post 23 adjutant, said the effort brought in $1 million, with some textile workers pledging a day’s wages.

The new hospital was renamed Gaston Memorial, a living memorial for veterans who died in the war.

“We all gave money to build a memorial hospital,” said World War II veteran Ray Stewart, 89, who wore a military cap with a “Hell on Wheels” emblem belonging to the 2nd Armored Division, a unit he served with during the Battle of the Bulge. “Leave the name like it is.”

County commission Vice Chairman Tracy Philbeck told the veterans the board had no legal authority to make the hospital reverse its decision, “but we can call attention to history and concerns of citizens.”

He said CaroMont interim CEO Doug Luckett “has made it clear mistakes were made and has asked for a meeting to address these concerns.”

“He’s reached out to veterans and hopefully will make right some of these mistakes.”

Philbeck said veterans are invited to the meeting, which will include Luckett, Donnie Loftis, a member of the CaroMont board of directors, and himself.

Physician complaints

CaroMont Regional Medical Center is a private, nonprofit hospital. The parent company – CaroMont Health, with nearly 4,000 employees – is the largest employer in Gaston County.

It’s a $500 million business with nearly $1 billion in assets. The county owns the buildings and land and leases the property to CaroMont. There are 23 years left on that contract.

County commissioners appoint 13 of the 14 members on the CaroMont Health board of directors.

Directors hire a president/CEO who, in turn, hires an executive team.

In January, as talks on lease renegotiation stalled, commissioners appointed three new members to the CaroMont Health board of directors.

CaroMont board Chairman Spurgeon Mackie Jr., who has served on the board for 11 years, said directors try to strike a balance between the hospital administration, the medical community and patients.

The mission is providing “guidance and governance … and assuring management is doing what it’s supposed to do,” he said.

The roots of CaroMont’s problems go back several years.

Mackie said CaroMont has been moving toward a new reimbursement system for health care.

The old model was fee-for-service – that is, paying for each individual procedure; the new model is “value-based,” or a bundled payment system with payments divided by doctors.

Last year, contract renegotiations with CaroMont-based and independent medical specialty groups “left very damaged feelings between doctors and the administration,” Mackie said. “The good old days aren’t around anymore for anybody in health care. Today, it’s about alignment of services and managing expenses wisely.”

While contract renegotiations caused discontent, another issue arose over doctors in CaroMont’s hospitalist program. Hospitalists, a fast-growing health-care speciality, are hospital-based doctors who serve in place of family doctors.

Mackie said Cogent HMG, a national leader in hospital-based internal medicine, was hired to manage and oversee these hospitalists.

In December, 20 hospitalists – the majority of the staff – gave notice they were resigning and left at the end of February.

“The transition did not go well,” Mackie said. “The turnover was greater than anticipated.”

A national network of doctors, along with local doctors, has been filling in, and Mackie thinks the situation is being stabilized.

“He’s one of the finest human beings I’ve ever known,” Mackie said of former CEO Randall Kelley. “He cares deeply about what he does. I think he did a lot of good things. He took on some bold challenges while he was here. If anything, in hindsight, he may have done a little too much too fast.”

More active role

Newly appointed members to the CaroMont board of directors want that group to take a more active role in running the hospital.

“I’m a huge flag-waver for the hospital. We do good work,” said CaroMont board member Donnie Loftis, former chairman of the county commissioners. “But we could do better, in leadership, governance and management and more involvement for board members.”

He thinks the board needs to see “the complete picture, not a small snapshot. And I want better communications. You can’t sit back and accept things are running smoothly. The board should be fed information, daily if necessary.”

Board member Jason Williams, who is also a county commissioner, recalled that during an orientation for new CaroMont board members in January, “you could tell it was a very closed group. The administration made the decisions, and the board didn’t take an active role.”

In addition, he said the administration made it clear they thought the new board members came with an agenda and that county commissioners were trying to stack the board to get a better lease.

“We got off on the wrong foot,” Williams said. “What I hoped to offer was somebody who hadn’t been a part of the lease negotiations. I came in to listen with an open mind. I was a fresh face with a new perspective.”

He felt the board didn’t get all the information it needed and that “transparency was an issue.”

Kelley’s dismissal was “a very important first step” toward improving things, Williams said.

“It got the message to employees, physicians, staff, nurses and the community that we heard what they were saying, recognized what was going on and we acted on that,” he said.

In the meantime, the CaroMont board will continue to evaluate hospital leadership and also “engage the county and citizens” in decisions, Williams said.

Despite the recent uproar, Williams still stands by the hospital.

“Everybody has a vested interest in it,” he said. “It’s in our best interest to have a top-quality health-care facility. I think we have that, but we need to make sure we strive to make it better.”

DePriest: 704-868-7745
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