Thursday, November 19, 2009

There has been a lot of talk in the community about Fishermen's Hospital and Health Management Associates (HMA). I am extremely proud to lead a talented group of individuals with a singular focus, providing high quality care to the citizens of Marathon and the Middle Keys. I am also very proud to be associated with HMA, a company whose focus is putting patients first.

As a nurse with more than 23 years of experience in health care, I feel I am uniquely qualified to say that HMA and Fishermen's Hospital are synonymous when it comes to providing high quality health care.

What truly defines Fishermen's Hospital is its talented, dedicated employees and physicians. Fishermen's Hospital has always been a good community partner and we predict it will remain as such, but we are definitely facing some significant challenges.

Fishermen's Hospital has a long-standing, proud history of service to the local community. The hospital opened in 1962 thanks to the vision of the Marathon Hospital Association. The hospital had several prosperous years, but that prosperity started to decline in the late 1980s, as was reflective of the health care industry at the time. By 1985, the hospital was in desperate need of help. It could no longer afford to pay employees, and new equipment was out of the question. HMA was solicited to take over the operation of the hospital. If HMA had not been chosen to lead the hospital, many say the hospital would have closed. In 1986, the board of trustees signed a lease with HMA. This lease was extended in 1991 and will expire in July 2011.

HMA has put millions of dollars each and every year into Fishermen's Hospital -- far exceeding the terms of the lease. The original lease required HMA to assume all liabilities and spend a minimum of $1 million dollars for capital renovations during the first 12 months of the lease, and a minimum of $1.5 million during the succeeding 24 months of the lease. The 1991 lease extension required an additional $2 million for each of the next 10 years -- total of $4 million over 20 years. Capital renovations include the purchasing of the lifesaving equipment we use at our hospital every day.

It is important to realize that Fishermen's Hospital has two boards. The first, Fishermen's Hospital Inc., board of trustees, is the board that is responsible for managing the lease for the building. This "landlord" board does not have daily oversight of the hospital, but it is responsible for the latest resolution that proposes to turn Marathon into a taxing district. The landlord board solely determines who will manage the hospital and, ultimately, what will happen with the hospital.

The second board, the Fishermen's Hospital Advisory Board, is responsible for maintaining the delivery of safe, quality health care that is responsive to the needs of the community. This board is made up of community members and physicians.

The relationship between the landlord board and HMA has not always been a difficult one, and let me be clear that we have never had an issue over patient care. The landlord board has had issues with HMA in recent years and has made it clear that they would prefer another management team in place. It was assumed that Baptist [Health South Florida] would be that team. When Baptist decided not to pursue the hospital lease, a small group of members from the landlord board starting meeting with HMA. We have had good conversations with this group and want to continue to have an open and honest dialogue with the landlord board.

We agree that board involvement is imperative, and have worked hard to foster solid relationships with the landlord board. HMA had not made its intent known as to whether they were interested in staying or renewing the lease, when the landlord board said otherwise. In fact, HMA was in the process of working in good faith with the landlord board to secure Critical Access Status as a way to financially support the future of the hospital, a move that is imperative, regardless of who the landlord board chooses to manage the hospital lease.

Critical Access is a designation given by Medicare and the state of Florida. This status will allow the hospital to be reimbursed based on the cost of providing health care in our community. I believe we all agree that this status will be a benefit to our community.

In these difficult economic times, for the hospital to remain viable, no matter who manages it, we must have the combined support of the community, physicians and landlord board.

Fishermen's Hospital has always been an essential part of this community. We proudly support numerous nonprofit organizations, local schools and community events. Is there an event T-shirt out there that does not have our name on it? Our administrative team and staff proudly sit on numerous boards and committees. Our employees volunteer for every event or fundraiser under the sun -- and in the Middle Keys, there are a lot of them! We are proud of our staff and their commitment to the local community.

Please know that we will continue to focus on the best interests of our patients, employees, physicians and community during these uncertain times. However, it is difficult for us to commit to any time frame beyond July 2011 when the landlord board has made it clear they do not want us here. When I say "we" I mean HMA and Fishermen's, because we are one and the same. Regardless of the decisions made, the Fishermen's Hospital administrative team is committed to ensuring this process will not interfere with the quality care we provide to each and every patient who enters our doors.

Kim Bassett is CEO of Fishermen's Hospital in Marathon.