UMC fixes not expected to include service cuts

Sunday, Sept. 2, 2007 | 12:57 p.m.

Wrapping up a nine-month look at how to improve the financial health and management of the troubled University Medical Center, the Clark County commissioners are expected to scratch possible service cuts and a new oversight structure for UMC on Tuesday.

Commissioners also will decide at Tuesday's meeting what to do about hiring a permanent chief executive for UMC.

The meeting will close several major areas of review over how to fix the public hospital, which is staggering from massive financial losses and an ongoing police probe of its former chief executive.

Those problems came to light in January, when an audit revealed that UMC had lost more than $34 million in fiscal 2006, far more than then-CEO Lacy Thomas had told commissioners.

The audit results were presented the day police raided UMC looking for evidence that Thomas had illegally steered contracts to friends and associates in Chicago. County Manager Virginia Valentine canceled Thomas' contract that day and appointed Kathy Silver interim CEO.

In February, commissioners received a report from the Lewin Group, an independent health care consulting firm, that concluded that if changes were not made, the hospital's losses could double by 2011. The report suggested possible courses including maintaining the status quo, expanding the hospital, establishing a hospital advisory board or leasing the facility to a nonprofit organization.

However, a majority of commissioners said this week that they want to leave the hospital's current oversight structure in place.

Commissioners already combined the finance departments of the county and the hospital in May, a move intended to prevent what happened last year when Thomas stopped giving commissioners monthly financial updates.

A more drastic restructuring would not address the problems that have plagued the hospital, Commission Chairman Rory Reid said.

"What happened before with Lacy was we gave him too much leeway and trusted him more than we should have," Reid said. "What we need to do is demand more periodic reports and monitor more closely what's going on at the hospital."

He and other commissioners also expressed concerns about creating another layer of bureaucracy at UMC, putting oversight in the hands of non-elected officials and the potential for conflicts of interest among a governing board of medical or health care professionals.

Commissioners also will make a final decision Tuesday about a list of potential money-saving service cuts that hospital administrators presented in April.

The hospital lost $56.5 million during the fiscal year that ended in June, according to preliminary financial figures. It's expected to lose $41.3 million this fiscal year, after $12.7 million in savings from eliminating vacant positions, decreasing overtime, cutting supply costs and other measures.

The list of possible service cuts, which would have been in addition to those savings, included eliminating several quick care centers, the neonatal intensive care unit, the state's only burn care center and other programs.

Residents and UMC employees expressed concerns about many of the potential cuts, as did some commissioners.

A majority of commissioners opposes any cuts beyond the recent closure of the McCarran Quick Care, which was largely a victim of airport expansion.

"I think we heard the public loud and clear," Commissioner Susan Brager said. "I am not ready to cut anything."

A decision also is expected Tuesday on how to find a permanent replacement for Thomas.

"I think Kathy should be offered the job," Commissioner Bruce Woodbury said.

Others, however, are leaning toward a national search.

Commissioner Chris Giunchigliani said she has concerns about hiring Silver because she was an associate administrator under Thomas.

"She was part of the problem, not part of solution, under Lacy," Giunchigliani said.

Valentine, Silver's boss, plans to recommend a recruitment process, though she thinks Silver has done a good job, a county spokesman said.

Commissioners will receive a report Tuesday about the hospital's recent outreach efforts, which were intended to solicit feedback about changes at UMC from employees, health care industry representatives and the public .

Silver and Valentine are expected to present commissioners an action plan based on that feedback.

During the past nine months, the county has taken other steps to tighten procedures governing how the hospital awards contracts. In addition to dropping some contracts that drew police attention, Silver has said future contracts will be awarded through a competitive process and only after the district attorney's office signs off on them.