Hospital in shakeup mode

The top administrator at Coulee Medical Center narrowly avoided a vote of no confidence from his board Monday night, with a decision by the hospital district commission that clearly disappointed members of his staff.

In a special meeting of the Douglas, Grant, Lincoln, Okanogan Hospital District 6 commission, members voted to form a committee to immediately intervene in a deteriorating relationship between the hospital’s top administrator, Scott Graham, and the medical staff, who had taken their own vote of no confidence in him Nov. 8.

With the financial climate for small hospitals becoming increasingly challenging, Graham has reportedly instituted budget tightening measures, including reductions in hours and pay for staff, which they believe is not shared by administrators. And doctors, who have for years advocated the need for another physician to share the load, say the administration won’t recruit one.

The situation is critical, with a possibility the doctors could quit over the impasse.

Following a 45-minute closed session, Commissioner Geary Oliver moved for a vote of no confidence in Graham. With all four current commissioners present, the motion died for lack of a second, but Commissioner Jerry Kennedy offered an alternative.

Kennedy moved to form a two-person committee to immediately meet with the medical staff “to try to find a way through the conflict.” That motion carried and President Greg Behrens appointed Kennedy and Commissioner Kris Hare to the task.

Kennedy said Tuesday afternoon that he and Hare were to meet with the doctors Tuesday night.

The space for the Monday night meeting was double its usual seating capacity and still overflowed.

With employees, and many community members, critical of hospital rates, staff reductions and an increase in administration, commissioners moved next to take a critical look at the whole issue of how resources are allocated. Oliver said they needed to hire an independent firm to audit the last three years of financial records “to make sure we are doing things correctly,” noting large differences in the last two years.

“A second set of eyes to look at not just what we’re spending but how we’re spending it — particularly the administrative budget,” Kennedy added.

Behrens noted that a group of eight hospitals around Goldendale were comparing each other’s operations in that manner. He suggested contacting them.

Behrens said it was certainly worth looking at "what we spend on executive team, what we spend on nursing staff and what we spend on dietary … and see how we compare to like hospitals.” He appointed Kennedy and Oliver to that task.

Commissioners also decided to look into seeking legal counsel independent of that provided by the firm retained by the district since 1990, Foster, Pepper, Shefelman, of Seattle. Behrens said the firm is a good one, but agreed with Kennedy’s assertion that it may be prudent to seek a second opinion on recent matters.

Kennedy said some of the firm’s recent advice had been “limiting and conservative.” He noted the counsel’s advice to stop offering a popular lab discount week and its assertion last week that calling the Monday special meeting, outside of a regular meeting, violated the state’s Open Public Meetings Act.

That statute states: “A special meeting may be called at any time by the presiding officer of the governing body of a public agency or by a majority of the members of the governing body ….”