As Jackson Health System has struggled to pull out of a daunting financial hole for the last two years, a member of the board that oversees the system has been accused of abusive behavior toward employees in the collections office as he tried to negotiate settlements for unpaid bills owed by his law firm’s clients, according to ethics complaints filed by two Jackson administrators.
The allegations against Stephen Nuell, a Miami personal injury attorney and member of the Financial Recovery Board appointed to help turn around the troubled system, are detailed in complaints filed by the director and the associate administrator of the hospital’s business office.
They allege that Nuell repeatedly called the business office between May 2011 — when he was appointed to the board — and October 2012 to resolve matters for private clients despite being told specifically not to do so.
The two employees also accused Nuell of screaming at them over the phone, calling them “incompetents” and contacting hospital executives directly to intervene when he was unhappy with their efforts.
Nuell declined to comment on the allegations that he exploited his position on the hospital’s board for personal gain.
“There’s a confidential investigation going on,’’ he said.
Edwin O’Dell, a Jackson spokesman, said hospital executives and employees familiar with the complaints against Nuell would not comment.
“We don’t want to damage the investigation,’’ he said.
The complaints against Nuell were filed in October with Miami-Dade’s Commission on Ethics and Public Trust, which is investigating the allegations. It is unclear from the documents whom Nuell was representing in the settlement negotiations.
Joseph Centorino, executive director of the ethics commission, said the complaints and investigation are confidential. He declined to comment on Nuell’s case.
But copies of the employees’ complaints were made available to the Herald, along with a February 2013 memo from the commission’s deputy general counsel recommending a finding of probable cause that Nuell violated Miami-Dade’s Conflict of Interest and Code of Ethics ordinance.
The complaints against Nuell were notarized, and signed by JaNene Church, director of the hospital’s corporate business office, and Norma Linares, associate administrator. Employees in the business office collect outstanding patient bills and negotiate settlements with personal injury attorneys.
Church and Linares did not reply to repeated requests for comment. But the memo from the ethics commission attorney indicates there is merit to their complaints, which are very similar.
Miriam Soler Ramos, deputy general counsel for the ethics commission, wrote in a memo dated Feb. 13 that she believes Nuell violated three sections of the county’s ethics ordinance, which prohibits hospital board members from appearing before any county agency on behalf of a third person — and then receiving payment from that party. The Financial Recovery Board has been temporarily handling Jackson during the financial crisis but the board will revert to its previous name, the Public Health Trust, in May.
The ethics ordinance also bars hospital board members from participating in settlement negotiations of claims or lawsuits involving the hospital without prior approval from the governing board, which Nuell did not have.
According to Ramos’ memo, Nuell represents numerous clients against Jackson, and he speaks to and meets with employees of the business office frequently — even though Mark Knight, the hospital’s chief financial officer, told ethics investigators that he advised Nuell in fall 2011 not to contact the business office staff directly.
Knight declined to comment through a hospital spokesman. But emails between hospital staff and Nuell show that Nuell has contacted Jackson executives regarding private clients numerous times between November 2011 to November 2012.
The ethics complaints, though, stem from two phone calls that Nuell made to Church and Linares in October 2012.
Church described for ethics investigators a call she received from Nuell on Oct. 11. He made the call on behalf of a private client, Church wrote in her complaint, and he spent more than an hour on the phone, much of it screaming at her in a manner that she termed “abuse.”
“He said he is embarrassed to be on the board and is bombarded by complaints about the CBO [corporate business office],’’ Church wrote. “He called me and my staff incompetent many times, shouting that we didn’t follow through and were not doing our jobs.’’
Church said Nuell then demanded a meeting within 10 days. But when Church raised a scheduling conflict — and requested time to speak with Knight, the chief financial officer — she said Nuell called Don Steigman, chief operating officer for Jackson, on a conference line.
In Church’s account, Steigman did not object to Nuell’s request for a meeting.
According to Church: “He told [Steigman] that he had a lot of issues with me and the CBO as he wasn’t getting appropriate answers and responses. He wanted a meeting with me, Norma [Linares] and his assistant. Don asked who else he wanted there.’’
Steigman declined to comment through a hospital spokesman, and it is unclear if the meeting that Nuell requested ever took place. It is also unknown if Jackson settled with the client that Nuell called about in October.
According to Church’s complaint, Nuell had called the business office concerning a 2010 bill with more than $85,000 in charges, and for which the hospital had been paid $6,000 from an auto insurance policy.
Nuell proposed a settlement with Jackson for $5,000, according to the complaints, but the hospital’s business office denied it, and asked for another offer. Nuell never followed up, according to Church and Linares.
Church explained the reasoning behind Jackson’s denial of the initial offer:
“When we see that the Trust is only being offered a small part of the settlement,’’ she wrote, “we always try to see if we can obtain a fair share of the proceeds for the Trust since normally that is where most of the expenses for care for the patient occurs. Mr. Nuell, as a board member, should not be trying to push settlements for his firm for patients who owe the PHT [Public Health Trust] money for their care.’’
According to Church’s complaint, Nuell also called the business office on behalf of a patient who was not his client — violating federal healthcare privacy regulations for hospital patients.
The county’s ethics investigation, however, focused specifically on Nuell’s alleged breach of public trust. And though much of the investigation appears to be complete, the five-member ethics commission has yet to issue a finding because Nuell has twice requested an extension on the hearing.
The case is now scheduled to be heard during a closed session at the ethics commission’s May meeting. Commissioners can choose to dismiss the complaint or issue a finding of probable cause, which could lead to fines, a letter of instruction or a reprimand for Nuell.
Though the ethics commission does not make recommendations for removal, other authorities such as the Board of County Commissioners also can act on the findings.
The two Jackson employees who filed complaints against Nuell indicated this isn’t the first time they’ve seen him act this way.
“This is not the first time that Mr. Nuell displays this type of behavior,’’ Linares wrote in her complaint. She added later that he would “throw his weight around by stating he is a board member.”