Jackson Health board working to reverse financial crisis up for re-approval

 

dchang@MiamiHerald.com

Miami-Dade commissioners will vote Tuesday on the reappointment of the seven-member board that runs Jackson Health System: the Financial Recovery Board, charged since 2011 with reversing a financial crisis that threatened to sink the public safety-net hospital system.

The board, which is due to revert to its old name, the Public Health Trust, on June 1, will include six members who formed the financial recovery panel. They have been nominated for reappointment to staggered terms, beginning on June 1. A new member, Irene Lipof, the designated union representative on the panel, is nominated for a one-year term.

The other nominees are: Marcos Lapciuc, the current board chairman, for a one-year term; Miami-Dade Mayor’s designee Mojdeh Khaghan, a Miami attorney, and Rep. Michael Bileca, designated by the Miami-Dade Legislative Delegation chairman for two years each. Stephen Nuell, a Miami attorney, and Darryl Sharpton, an accountant and business consultant were nominated for terms of three years each; and Joe Arriola, a former University of Miami trustee and former Miami city manager, is up for a term of four years.

Jackson administrators have begun to reverse a trend of financial losses, declaring the hospital system solvent in May for the first time in five years. In spring 2011, the hospital system was close to financial collapse, having lost $419 million over three years. More than one year later, Jackson eked out an $8.2 million surplus for its fiscal year that ended Sept. 30, according to an audit released in March.

But many challenges remain, according to administrators, such as increasing patient volume — a goal the hospital system’s board has said it needs to meet in order to ensure long-term sustainability.

There’s also the cloud of an ethics investigation hanging over one member of the board, Nuell, who was accused of abusive behavior toward employees in Jackson’s collections office as he tried to negotiate settlements for unpaid bills owed by his law firm’s clients.

The allegations against the personal injury attorney are detailed in complaints filed with the county’s Commission on Ethics and Public Trust by the director and the associate administrator of Jackson’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.

Nuell has declined to comment on the allegations that he exploited his position on the hospital’s board for personal gain.

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.

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 meeting on Tuesday — the same day Miami-Dade commissioners are scheduled to meet and approve the new board to oversee Jackson.

Ethics commissioners can 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 County Commission, also can act on the findings.

The board’s newest member, Lipof, declined to comment on the ethics investigation. A longtime South Florida educator, Lipof replaces Joaquin del Cueto, who resigned in February.

She was sworn in by Jackson’s board in April and served a one-month term. But she still requires county commission approval for a new term of one year. Lipof was a teacher at Miami Dade College for 39 years and is now retired, though she still teaches courses in psychology and human sexuality. She’s also active in her union, the United Faculty of Miami Dade College.

Lipof raised a question at the April 29 meeting when colleagues voted to renew the employment contract for Carlos Migoya, Jackson’s chief executive. Lipof asked about the measures for awarding Migoya bonuses of up to $295,000. Migoya earns a base annual salary of $590,000, plus benefits of about $142,500.

When he was hired in 2011, Migoya’s employment contract included bonuses only for financial performance. He earned a $220,000 bonus for 2012, and, after taxes, donated the remaining $160,000 to the Jackson Memorial Foundation, which benefits the hospital system.

Migoya now is eligible for bonuses based on financial improvement and quality performance, such as patient safety and satisfaction. Lipof asked know how such goals would be measured.

“The measures of those qualities, as far as I could see, weren’t specified that if you reach this mark, you get the full 50 percent, and if you reach a lesser mark you get some of it,’’ she said. “None of that was spelled out in the contract, so my question was regarding that. And I got an answer, which is one of the committees of the board actually looks at those qualities. There are, I guess, nationally accepted measures for those qualities.’’

Lipof declined to identify priorities for her term on the board, or to outline an agenda.

“It’s too early in the game for me to even tell you that I have priorities,’’ she said. “I don’t know enough yet.’’

Lipof said she has “a history with Jackson,’’ having attended nursing school at the hospital for three years in 1964, and added that she wants the hospital system to remain the region’s pre-eminent medical research institution and hospital.

“I want to see it survive as a first choice place,’’ she said, “where people who are really ill will go because they receive the best treatment.’’

A previous version of this article misstated Joe Arriola's relationship with the University of Miami.

Read more Healthcare Reform stories from the Miami Herald

  • Power of Price

    Healthcare prices: Many moving parts veiled by confidentiality agreements

    The price of a medical procedure can vary greatly for consumers and their employers, depending on the hospital’s operating costs, the patient’s condition, and even who’s paying and how.

  • Power of Price

    Patients take on more of healthcare costs, but struggle to find prices

    Health plans with high out-of-pocket costs are pushing consumers to price shop for healthcare. But prices can be hard to find before a procedure, and most patients don’t find them until the hospital bill arrives.

  • Power of Price

    Power of Price: A glossary of healthcare terms

    As if healthcare pricing wasn’t complex enough, try talking about it without running into some conversation-stopping jargon. Words that mean one thing to the rest of the English-speaking world can mean something completely different in healthcare — like a “charge” that isn’t the same as the price.

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category