If the Church and Hospitals share a mission, it might be time for a more formal revenue-sharing arrangement to be executed.  The various hospital systems have been built on the good faith established over the years by our churches and our membership, and it might be time, it light of the vast wealth enjoyed by the Health Care branch of our ministry, for the Hospitals to begin formally subsidizing our Adventist Schools and Churches.  Our church members built these hospitals, and they continue to be the lifeblood of these organization, filling their clinical and administrative ranks with employees whose faithful efforts fill the coffers - and apparently the executives' pockets - as well as bring healing and ministry to the sick. 

How might one begin a campaign to request the Hospital Systems step up to the plate and open their financial information and resources to the church that so faithfully serves the community and Christ at their side? 

I guess one could ask the Chair of the hospital board, the applicable Union President.  I'm sure they would all be thrilled to provide a transparent accounting.

Greed isn't that novel of a quality in business.  What troubles me the most is that the church apparently condones these activities.  It tends to make me wonder...

 

As a conservative SDA, I usually disagree with most stuff on AT, but this article is completely true about overpaid SDA Hospital execs.  I worked at Kettering Medical Center in Ohio, as a staff physician for over 20 years, and was acquainted  with many of the administrative staff.  Most weren't worth a "plug nickel!" 

And this doesn't address the issue of the numerous "Vice Presidents" usually on hospital adminstrative staff.  I think Kettering had at least a dozen of them, plus numerous other fraudulently titled this or thats.  I'm sure the salaries totalled into the tens of millions.  While the insurance companies were screwing physicians out of millions of dollars, the execs lived in luxury, some in hospital paid homes!  Plus "company" cars, travel expenses, etc.

The Board of Directors are usually palsy-walsy cronies, golf buddies, and sometimes relatives of the executives, so no real "oversite" is done.  Most things, including salary hikes are rubberstamped.  

 

 

RANT ALERT -  This issue pushed some buttons with me, so I'm just going to tell you what I really think if that's okay. 

Of course, Florida Hospital could probably find a way to perhaps apply these amounts being paid to executives to lower their fees.  That's kind of the idea behind non-profits - apply the profits to the organization?

Frankly, it's embarassing.  Our church which prides itself on having such a "large" health care system and brings it up as one of the first things mentioned when people ask about Adventism should not be engaged in this type of practice that brings out this kind of scrutiny. 

It is embarassing that Florida Hospital is always panhandling for donations (http://www.floridahospital.com/Giving.aspx).  If these execs are making millions a year, imagine what the overall profits are?  Their website says, "As a not-for-profit hospital, you can be assured that the dollars we receive and the decisions made regarding their use will always benefit the people who live within our community."  I suppose it is true because the execs live within the community.

There are donors who willingly give huge donations - one couple generously gave $4 million.  Of course Florida Hospital doesn't tell you on its Foundation web site that that entire amount was eaten up by executive salaries in one year. 

What do you call it when somebody asks for donations for a cause and then pockets the money?  Forget about the accounting procedures or the fancy decorations.  What do you call it?   

Will church leadership be doing anything at all about it?  No.  These hospitals are too powerful - conferences and schools and churches and colleges are small potatoes next to these mega-operations.  They will "lift it up in prayer" and "labor with these brothers," may do a sham investigation, but ultimately we will continue to hear these stories until the hospitals are nationalized. 

Then we will hear a great outcry that "separation of church and state" has been violated.   Maybe it's time for the hospitals to put some money back into the conferences so teachers and pastors don't get laid off, or so more Adventist kids can get a Christian education. 

If the hospitals refuse on the grounds that they can't transfer funds to the church or schools, then maybe it's time to call for a separation of church and hospital. 

 

 

http://www.timesunion.com/AspStories/story.asp?storyID=799366

Since 2008, Antonia Coello Novello has been vice president of Women and Children Health and Policy Affairs at Disney Children’s Hospital at Florida Hospital. 

A January 2009 report by the New York Inspector General's office claimed that during her seven-year tenure as New York State Health Commissioner, Novello routinely abused her authority over health department staff.

The Inspector General's office referred a criminal case against her to Albany County district attorney David Soares. On May 12, 2009 a felony indictment was unsealed charging one count of defrauding the government, three counts of filing a false instrument and sixteen counts of theft of government services. Upon arraignment by Judge Stephen Herrick, represented by attorney E. Stewart Jones, she pled "Not Guilty" to all allegations.

Michael, you said "If the hospitals refuse on the grounds that they can't transfer funds to the church or schools, then maybe it's time to call for a separation of church and hospital."

I'm thinking the hospitals would be fine with that arrangement, now that they no longer need the church backstopping them financially.   It is my opinion that they don't really feel "owned" by the church anyway.  They go through the motions of acting as if they are church affiliated but they don't really answer to the church in any way and haven't for quite a few years. 

I, like many Adventists, have intimate knowledge of the inner workings of the Adventist health system.  Not necessarily the Corporate entity, but definitely the hospitals themselves, the administrators, the physicians, the nurses, and the many support staff.  Many of these people are my good friends and family. 

I know for a fact that the Florida Hospital system, in particular, is well run by its administrators, well staffed by its fine clinical personnel, and that the vast majority of these people, and I mean the very, very vast majority of them, have a deep-seated sense of mission to serve God and their fellow man through their particular talents.  The administration, including the Vice Presidents, many though they may be, are blessed to be at the helm of such a fine institution, as much as the institution is blessed to have these people dedicate their careers to the obvious success of the Adventist health ministry. 

I do not begrudge them their salaries.  There has never been a case that I have either heard of or personally witnessed where an administrator has demanded wage increases, threatened to leave the system over their pay, or attempted to hold the institution hostage in salary negotiations.  Their salaries are determined by the board members, who clearly have been caught up in the recent wave of bloated executive pay.  Do administrators have a responsibility to refuse such compensation?  Perhaps.  Are they subject to the many temptations and complications that come with joining the ranks of the wealthiest Americans?  Absolutely.  Do they now have a responsibility to be good stewards of such generous pay?  One hundred percent, yes. 

I know we'd all love to have such problems as the rich.  But rather than castigate the instution or the administrators, let's pray that God will guide them in the decisions they make in their personal lives and with their personal fortunes as astutely and generously as he has clearly guided them (and our hospital ministry) in their professional lives. 

StatefarmSteve,

 I have nothing against wealth or being rich.  My problem is this - these administrators are rich off the backs of taxpayers who pay hospital bills and donors. If Florida Hospital was a real for-profit business and made that clear, then that's one thing. But they are constantly wanting people to give them money, which they then hand over to these executives.  It is a shame.

 Bill Gates and people like him add value to the world and increase income for a lot of people and deserve to have high salaries.  Donald Trump does not pretend to run a charity and ask for donations.  These guys do.  That's the difference.

 If Florida Hospital is going to be "for profit" than it should be a for-profit hospital. There is nothing wrong with that.  But if they are going to operate under the guise of a non-profit, these high salaries need to be drastically rethought.  More than the heads of Johns Hopkins and the Mayo Clinic combined?  That is nothing short of obscene. 

 They should also be required to post in their fundraising websites what the salaries are.  Maybe some people will still give, but my guess is that the hospital would not want all the donors to know this information.

Michael, I never assumed you dislike the wealthy.  In fact, you and I probably agree on much more than we disagree.  I think the executives were overpaid by the board of Florida Hospital, and if the board refuses to lower the compensation, then the executives should refuse it or donate a reasonable portion back to the hospital (something many of them already do...)  Short of this, we should put pressure on the board to bring the salaries in line with a more reasonable number. 

 Bill Gates accumulated wealth by being not only a smart computer guy, but by being a ruthless digital robber baron who squashed his competition by any means necessary, including practices that have resulted in fines and guilty verdicts in many courts around the world.  Donald Trump is a dynamic promoter who has seen many of his business entities go bankrupt, including recently his casino operations.  Our hospital system is not monopolistic, antagonistic, sadistic, nor bankrupt.  Either the execs are doing a fine job, or the Lord blesses the System in spite of their incompetence.  I think it might be both that they are doing a good job and enjoying the Lord's blessings besides. 

 And, if I recall from this season's Celebrity Apprentice, Trump is an active Philanthropist, contributing both from his pocket and lending his community celebrity status to encourage others to donate to charity.  And we know that Gates and his Bill and Melinda Gates Foundation recently accepted Warren Buffet's tens of billions of dollars to put to charitable work.  People gave to Gates and Trump, and it's no secret that both men have tremendously fat wallets.  I don't believe executive pay would negatively affect donations to Florida Hospital, as a $3.5mm yearly salary would seem downright poverty-stricken to many of the donors who contribute to the hospital foundation. 

 Again, I agree that such salaries are too high, and that when they are "exposed" by a local reporter, it looks like we have something to hide, which we very well might.  Florida Hospital is not a For-Profit facility, and it has not been run like one, and I don't believe they'll give up their advantageous position as a non-profit corporation.  I'd like to see it fixed, but I don't want to see these people demonized and ridiculed for doing a good job and making too much money.  Let's fix the problem and do away with our righteous indignation. 

First, bloated health care costs are a major concern that is driving us deeper into debt as a nation.  Do these salaries play a role in the bloated costs?  Of course they do.

 How much of Florida Hospital's margin goes to helping the needy and poor?  Probably less than 2%.  Of course they don't tell you.

Compare Florida Hospital's real cost with same faith based hosipital.  A not for profit, faith based institution implies really helping the poor....and not helping yourself to fancy offices and hefty salaries.

Also, have we forgotten this Department of Justice report?  http://www.usdoj.gov/opa/pr/2004/October/04_civ_723.htm

"ADVENTIST HEALTH SYSTEM, HOSPITALS, AMBULANCE COMPANIES TO PAY U.S. MORE THAN $20 MILLION TO SETTLE FRAUD CLAIMS"

"Winter Park, Florida-based Adventist Health System Sunbelt Healthcare Corporation, three affiliated hospitals and a management company that administered ambulance operations at the three hospitals have agreed to pay the U.S. $20.3 million to settle allegations that they overcharged Medicare, the Justice Department and the Department of Health and Human Services announced today. The government alleged that the charged were for ambulance transports for patients which were not medically necessary."

"

The government further alleged that Regional Emergency Services and the hospitals created false physician certifications regarding the medical necessity of ambulance transports operated by the hospitals and submitted or caused to be submitted claims to Medicare. The suit alleges that the false claims were submitted during 1993 through 2000 in the case of Florida Hospital Waterman and Metroplex Adventist Hospital, and 1993 through 1997 in the case of Huguley Memorial Medical Center."

 

What I find most troubling about this is that these issues have been reported both inside and outside the church for forty years:

http://www.advmca.org/html/sda_hosp_comp_cont.html

http://www.adventistreview.org/thisweek/storyhealth.htm

If the church has anything to say about these excesses, they are either consciously agreeing with them or are bowing to pressure.  If the church doesn't have any control in this area, why are these hospitals operating under the name of the church?

 

 

I live in Central Florida and have major concerns and disappointments with Adventist Health, but executive pay is not on the list. The head of the hospital has numerous hospitals and corporate has several states with hospitals and a multitude of other Adventist owned health entities. I actually agree that by far, the majority of clinicians and others in the system do have a mission of providing quality care. Florida Hospital is a great hospital. I had a good experience there several years ago.

Someone mentioned that high executive pay raises costs. In my opinion, what raises costs much more and raises more concern for me, is the continual focus on increasing revenue and market share in a market that they already dominate. Actions seem to suggest empire building may have become more of a mission than service.

Let me give you a few examples:
Adventist Health acknowledges in it’s own training sessions that population growth in Central Florida has been slowing down for a few years and recently has been stagnant.

1. Every single campus in the Orlando tri-county area has multi-million dollar additions of surgical units and more. In 2009, in the middle of a major recession, AH bought 22 acres and plan to build a new corporate headquarters estimated to cost $30 million dollars when their current building looks great from the outside! They have been there about 10 years.

2. Adventist Health has directly hired many of it’s own physicians in the past 4 years and many more through its wholly owned subsidiary, Florida Physicians Medical Group (FPMG). They buy up current practices or recruit young physicians and set them in over 90 practice locations in the tri-county area – NOT because there is a need in the community, but for their ‘strategic needs’ which means more revenue and more market share in a market they already dominate. So, they hire a breast surgeon, set her up with expensive equipment in a building where there is already a good independent breast surgeon (who does all of her procedures at Adventist facilities, but sends radiation referrals to a competitor). They do not put them in low income or rural areas, but in high income areas like Winter Park and Celebration where there are plenty of physicians and lots of patients with good insurance.

Office space, staff, benefits, equipment, marketing, paid malpractice for specialties that pay over $140,000 a year for insurance – and doing that at 90 locations raises the cost of healthcare.

As a result of flooding the market with their own surgeons and funneling all the referrals to them, in one quarter their unknown surgeon from out-of-state surpassed the best known surgeons in Orlando in volume of procedures. If there were truly community need, ALL surgeons – independents who operate at Adventist facilities and even competitors – would increase in number of procedures. Instead, as Adventist/FPMG owned surgeons increase because of the closed referral system, independent surgeon procedures have dropped proportionately. The same approach has happened in ob-gyn, other specialties and even primary care (which then feed their specialist practices). (I am not a physician).

3. They deliberately market and present these Adventist/FPMG owned/employed practices as if they were independent practices, so the public has no clue they are even in ‘the system’ of Adventist Health and will be referred from one Adventist provider to another.

4. Some of their FPMG employed physicians have regularly earned about $3 million annually, even when FPMG was operating in the red. That is more than 5 times the national average for people in that specialty.

I always trusted Adventist Health because of what I thought were their values -- things like honesty, integrity, compassion, putting patients first. I don’t anymore. I am disappointed at their ethical fudging, at what appears to be their greed, at their disregard for our physicians in this area—many of whom have been loyal to them for years and made them a pile of money, for deliberate deception, and for raising the costs of healthcare.

I have no faith in Adventist leadership to do anything. Hopefully as a church, members will call for more integrity with what Adventists stand for.

Respectfully, but frustrated,
Dawn

I don't know when I've seen a blog on AToday that generated such a cauldron of heated agreement. It makes me wonder...has Adventist healthcare outgrown the Church? It is my understanding that a very small percentage of the employee and physician staff at the Orlando Hospital are Adventists; and I suspect that far fewer than 50% of the staff are SDA in any Adventist hospital in the country. Now of course management is still SDA, and certainly, as large employers, our hospitals can be wonderful witnesses to both their employees and their communities.

But what kinds of compromises are being made in order to maintain profitability and stature? Is the SDA health message dependent upon state-of-the-art acute care tertiary centers? The Church's mission, as expressed in its health care institutions often looks more predatory and imperialistic than missional. And when it seeks to be mission driven, it quickly finds that community wages and salaries are sacrosanct among employees and staff. Core principles and religious autonomy often need to be compromised or sublimated in order to raise funds and obtain government contracts.  How much easier would this process, essential to success in today's healthcare world, be if our hospitals did not have the albatross of SDA doctrine tied around their necks?

In both education and health care, the SDA Church has demonstrated, over the past 100 years a tendency to identify its success with institutionalism.  And certainly, its institutions have been invaluable to advancing its mission. Can what was once vital to mission become a drag on mission? Rather than trying to fit executive compensation into the Procrustean bed of Adventist mission, maybe we should step back and re-examine whether the delivery of costly, high tech medical care, should be at the heart of our Church's mission.