BREAKING NEWS UPDATE: Three separate boards of directors with St. Cloud-based CentraCare Health Systems voted Thursday night to move ahead with affiliation plans with New River Medical Center in Monticello. Jeanine Nistler, CentraCare’s director of communications, confirmed via email the boards had approved the affiliation partnership plan that was passed 6-1 by New River Medical Center’s Board of Directors earlier this week. See next week’s print edition of the Monticello Times for additional information.
The New River Medical Center Board of Directors selected St. Cloud-based CentraCare Health System as its affiliation partner of choice Monday night.
The hospital district board voted 6-1 to approve a task force recommendation, which received additional non-profit board support. Rob VanDenBerg, representing Otsego, cast the single dissenting vote.
If CentraCare Health System’s board approves the affiliation partnership later today (Thursday, Nov. 29), documentation regarding the process and partnership will be drafted and signed and a due diligence process will begin. An interim management agreement may be discussed by the two health care systems.
Joni Pawelk, New River Medical Center’s director of marketing, said earlier this week the boards of CentraCare Health System, St. Cloud Hospital and CentraCare Clinic would meet in a special session to discuss the affiliation partnership with New River.
Jeanine Nistler, CentraCare’s director of communications, confirmed the boards would meet today at 5 p.m. CentraCare’s meetings are not open to the public because of its non-profit status.
Linda Doerr recused herself from the final board vote Monday, citing a conflict of interest. Doerr is employed by CentraCare as its vice president for senior services at St. Cloud Hospital and serves as CEO of St. Benedict’s Senior Community.
In an email sent before Monday night’s meeting, Doerr stated she would recuse herself from a vote but would listen to the task force’s presentation. She made a similar statement during Monday night’s special board meeting, which lasted less than an hour.
Task force members included Ervin Danielowski, hospital board chairman, Candace Benoit, board member, Steve Heath, community member, Bob Esse, community member, Dr. Mark Bonneville, M.D., Dr. Troy Ivey, as well as seven non-voting and advisory board members from New River: CEO Marshall Smith, Nancy Friesen, chief financial officer; Lynn Wieczorek, chief compliance officer; Dr. Mark Dietz, chief medical officer, Euretta Sorenson, chief nursing officer and Karen Lindgren, executive assistant.
Doctors speak during open forum
Esse and Heath provided comments throughout Monday night’s presentation. There was a 15-minute public forum just prior to the presentation.Dr. Glenn Nemec and Dr. Charles Yancey addressed the board. Both offered highly critical comments regarding the overall affiliation task force process.
Nemec offered one concern and two observations during his comments Monday. “You are about to make a recommendation that’s going to permanently change the face of medical care in this community,” he told the board and task force members.
“It’s not just the hospital that’s involved here, it’s the entire medical community.” Nemec said, adding there was no involvement of practicing doctors or nurses in the design of the task force committee. “I see that as a huge, glaring critical fault in the process that the affiliation task force used,” Nemec commented. “This hasn’t been a high-quality process.”
Nemec said New River Medical Center “was broke” because its patients were going to other locations. “The buck stops at the CEO’s office,” Nemec said, referring to Smith. According to Nemec, North Memorial, not Fairview nor CentraCare, would serve as a better affiliation partner. Many applauded after he spoke Monday.
Nemec’s comments drew Danielowski’s ire: “I normally don’t comment on letters to the editor, but that was about the biggest bunch self-serving crap I’ve ever heard in my entire life.” Danielowski then asked Yancey for his comments. “I’m stricken by the speed at which this process occurred,” Yancey said, adding there was a lack of communication, and that he heard about the affiliation task force process through the grapevine.
“I actually learned about this from the president of the Buffalo Hospital,” he said. “I agree with what Glenn said. This type of process has to be done directly.” Yancey said most of the physicians he had spoken with said they totally disagreed with the way the task force process was unfolding as well as its speed. “You should step back and get everyone involved,” he said. “You should start over.”
Yancey added he was surprised by Danielowski’s heated reply to Nemec. “I thought that was very disrespectful,” Yancey said. Danielowski replied: “Your 15 minutes are up.” With that, the public forum portion of the meeting was closed.
Affiliation process explained
Thomas Schroeder is the board’s current legal counsel. He provided background and historical context when explaining the significance of Monday night’s vote.
Once the non-profit gets its Internal Revenue Service determination letter, Schroeder said the board’s predominant interest would be serving as a landlord. “You are here tonight predominantly to listen as landlord of an important community asset,” he told the board.
Task force members scored each system’s presentation and supporting documentation on established criteria and discussed each system’s pros and cons.
New River Medical Clinic’s non-profit task force received interest from Allina, CentraCare, Fairview and North. Those systems visited with the Affiliation Task Force during the month of September and early October.
Based on the systems’ initial presentations, Fairview and CentraCare were selected. Phase 2 of the process included corporate and hospital site visits, interviews with system board members, leaders and physicians as well as additional Fairview and CentraCare presentations.
“We deliberated for several months about changing the legal status of this hospital,” Heath said. “This situation has been accelerated by the withdrawal of patients,” he said, adding 24 to 30 months ago, the board was looking at the possibility of an affiliation partner.
“I want to talk about the visceral nastiness that passes for constructive dialogue,” he said. “One of our task force members, Dr. Mark Bonneville, he came to the task force, as a member of North Memorial’s affiliation with New River. He has been onsite here for 16 years. He brought a lot to the task force process.” According to Heath, once the list of prospective affiliates didn’t include North Memorial, Bonneville was fired. “This is the kind of thing that pushes the limits. It wasn’t coincidence he was dismissed from his position. So, before anyone mounts their white steed and casts dispersion on the [task force] process, maybe you should take a look and see how the game is played.”
Esse said after the affiliation partnership cut list was announced, two days passed, then North Memorial decided to exercise an option to let Bonneville go. “If that’s not retaliation, I don’t understand the word’s definition,” Esse said. After the meeting, Bonneville confirmed North Memorial had opted not to retain him.
Decision is reached
There were 20 people who participated in the final day of affiliate analysis and review on Nov. 13, Esse said. The affiliation task force had six voting members. There were seven hospital management advisory team members, five non-profit board members present and one member each from the New River Physician Clinic and Buffalo/Monticello Clinic. According to Esse, CentraCare was selected as an system affiliation partner because of its similar culture and community focus, commitment to quality, its status as a critical access hospital and its long-term care experience as well as its strong behavioral health emphasis. CentraCare’s physician-led organizational philosophy, its commitment to quality and previous affiliation experience were also listed as positive qualities.