Does anyone have the answer to these questions about our Hospital? | Eastern North Carolina Now

     Publisher's Note: We do very much appreciate this fine article on the BRHS debacle from our friends at the Beaufort Observer. It is the opinion of this publisher that their continued, complete reporting and analysis of this controversial issue is unparalleled in scope.

Here's our challenge to the WDN, our hospital leaders and anyone interested in the outcome of the hospital controversy. Do you know the answer to the following questions:

    1. What happens at the end of the lease?

    2. How much notice must UHS give at the end of the lease?

    3. How much working capital must they leave in the Hospital bank account?

    4. How much debt can they dump on the Beaufort County taxpayers?

    5. What if they decide to buy the hospital and then a couple of years later walk away?

    6. How much will they sell it back to the taxpayers for, including the assets and liabilities of the operating entity?

    7. What if UHS sells out to somebody else? Thirty years is a long time.

    8. What happens to Beaufort's CON if the law were to be changed?

    9. Who makes the decisions that the doctors, employees, patients and taxpayers will have to live with for the next thirty years?

    10. Beaufort has no guaranteed position on the board. Nor do the other communities that UHS operates their hospital. Is that acceptable?

    11. Is it not indeed callow to not insist upon something more than an "advisory" committee.

    If those who have already formed an opinion on the UHS proposal and don't know the answers to the above questions we would suggest you need to do some more research. Let us explain why we say that.

    The WDN has not told us the answers to these questions. Nor have seven members of the Hospital Board. They have all acted in shallow and callowful ways in their approach to the Hospital situation. They join the UHS Cheerleaders who don't care about structuring a sound deal that will insure quality health care and protect the taxpayers of this county over the next thirty years. Just do it, they say.

    But there are major issues yet to be settled. What happens at the end of the lease? If UHS decides to walk away, how much notice must they give? How much working capital must they leave in the Hospital bank account? How much debt can they dump on the Beaufort County taxpayers? What if they decide to buy the hospital and then a couple of years later walk away? How much will they sell it back to the taxpayers for, including the assets and liabilities of the operating entity? Remember, under current state and Federal law the County is responsible for providing health care as is being done now regardless of who the County leases the Hospital to. What if UHS sells out to somebody else? And contrary to what some seem to think, that is a distinct possibility for any health care organization these days. Can UHS sell or sublet the lease?

    Given these uncertainties, is it wise to allow those decisions to be made without the County even being at the table, much less having a "mutual agreement" provision in the process? Would the WDN or any of these board members run their personal business that way? We think not. And there are two lawyers amongst them. Unbelievable.

    Speaking of personal business, can you imagine an owner of a McDonalds leasing the real estate and the franchise without knowing how the franchise is going to be dealt with if the lessee exercises an option to buy the real estate? What happens to the franchise, which may be infinitely more valuable than the real estate? The franchise in this case is the Certificate of Need. It is the license to provide health care in this market. Can UHS move it to somewhere else?

    Some have said that "the law will not permit them to..." But we have heard no one say what happens to Beaufort's CON if the law were to be changed. And don't believe for a minute that UHS could not get the law changed if they wanted to.

    We would suggest that the Hospital board's actions were not only a failure to fulfill their fiduciary duty to the citizens and taxpayers of Beaufort County, but a very shallow approach to the biggest and most valuable business in Washington.

    But the issue that is even bigger than all the lease details is the issue of governance. If you read the UHS proposal it makes it very, very clear who makes the decisions that the doctors, employees, patients and taxpayers will have to live with for the next thirty years, at least: the CEO of UHS. One man. Read the proposals. You will see in writing that this is so.

    But, you may say, the CEO is accountable to the UHS governing board. And that is true. But look at that board. We warn you up front that you will not find much. You can't even find on their website who sits on that board, except that it does contain the CEO and a "Pitt County commissioner." But what is clear in their proposal is that Beaufort has no guaranteed position on the board. Nor do the other communities that UHS operates their hospital. From what we can learn the UHS organization is as centralized and autocratic as they come. And controlled in Greenville. It is not a partnership. And the two lawyers, at least, on the Hospital board should have talked about the legal aspects of a partnership and the fiduciary duty each partner has to the other. Such was not even mentioned.

    We believe the governance issue is the most important aspect of any contract with UHS. The current CEO and some of the management team of UHS we have been told are top-notch people. But who among us thinks they will be in place for the next thirty years? Who among us believes UHS will not change its business model within the next thirty years? Having a seat at the table when those decisions that could completely change the nature of this deal are being made is important to Beaufort County. It is indeed callow to not insist upon something more than an "advisory" committee.

    We find it very strange that the WDN and some of the UHS Cheerleaders have complained about the current governance structure for health care in this county but have no apparent concern about what kind of structure will be used going forward and even whether we will have a voice in or knowledge of the decisions that structure will make. If it is bad now, why would we not be concerned about insuring that it will not be bad in the future? Wonder why Pitt County has a seat assured on this board, but none of the other counties? Do any of the seven Hospital board members or the UHS Cheerleaders even know how the UHS board is appointed? (By the University of NC Board of Governors.) And if you know that, do you know who on the Board of Governors represents this area or better still, how one gets appointed to the BOG?

    Let's hope our Board of Commissioners does a better job of fulfilling their fiduciary duty than did seven members of the Hospital board.

    But the Commissioners will have a tough job. They are negotiating these very important issues from a position of weakness, not strength. That is because the competition has been chased away. And those responsible for putting the Commissioners in that position should be ashamed of themselves. We would dare say not one of them would have sold their home or leased their business in the way they have done the Hospital.

    The WDN's most recent editorial on this is the epitome of shallowness. Their cry to "Just get on with it...." Is not in the best interest of Beaufort County. And we have to wonder if the top dogs at the WDN did not exercise any more due diligence, than they have advocated for the Hospital, when they recently changed hands.

    Let us hope and pray the Commissioners will do their job better.