Well the decision on who should take over management East -- last gen general hospital. Gets more complex by today. The choices are now narrowed down to either Children's Hospital or HCA. But what makes it more complicated is that each hospital has its favorite. West Jefferson has publicly said that her first Children's Hospital. And earlier this week east Jefferson medical executive committee held a news conference saying it agreed with east Jefferson's management. That HCA would be the best choice. The Jefferson Parish council will make the final decision. But could -- decide to let each hospital have its own choice. If so would that defeat the goal of being a more cost effective by joining under one management roof. Well today we're going to talk with east Jefferson officials about why they're hoping HCA will be that chosen company. We invited west Jefferson officials to join us but they wanted to discuss their choice separately. So joining us from east Jefferson is doctor John Lindsay chief of the east Jefferson non medical staff. Doctor Mark Peters president and CEO of east Jefferson and sheriff -- Norman who was chairman of the board of east Jefferson. And I appreciate all of you very busy people taking time out to. Kind of draws a better picture of what's going on in I would like you to start if you would. For myself and for the audience of why there is even this decision to have new management or having company takeover. This is something that we've looked at for some time at east Jefferson general hospital it's not a knee jerk reaction to anything. I think it's been a very thoughtful approach to where we are and looking now at where we think health care health care is going. We have some significant restrictions placed upon as being a service district hospital. And in order to continue to provide high level patient care. To our patients. To be a state of the art facility for positions we decided we needed to begin looking for a partner. That could provide not only additional resources. But experience and expertise in moving forward to deal with that the various challenges and the changes happening in health. Here the original concept though was before. Because both these in question -- public hospitals. That you would join hands and it would be like once and for hospital. Two facilities that. Wasn't that the concept that what ever management was chosen would then have the ability to share cost and it sent. I think that we we certainly looked at this process in this process with west Jefferson in searching for a partner. Prior to that we had actually looked at west -- and you chef coming together. Determined that bout wasn't gonna get -- enough to be. Where we need to be and moving forward so we started certainly this process. With an outside consultant in trying to find a partner for both. -- and just to clarify the these consultant that you hired. And Kaufman hall. That was paid that was a million point three correct contract correct and the goal of that contract was -- The goal of the contract to was to lead us through the process. To and help us get an RFQ that was sent out for proposals. To sort through the proposals. Help moderate our discussions as we have evaluated those. And moved through the process. And draw conclusions. We also look for them for their knowledge their expertise. Of working across the country. Helping us maybe avoid mistakes that others make in the process. And I think that we put great value on their understanding and knowledge. And helping guide as to what makes the most sense for us and this was paid for not with tax dollars but with hospital. On his game from yeah absolutely. And actually neither hospital receives any tax support so it came from hospital east and west jet funds. How can. I guess that that's the first surprise was was I think that for the general public and I am not talking inside people but the jump on the it was that this company. Does consulting company would in essence all cell. Recommend to make a recommendation of all that the people that you overlooked act and this is such a highly respected company. That in fact here's who we recommend and then it didn't happen. That in essence what they said correct me if I'm not saying this right. But in neither the boards can agree on one so we say have two separate is that correct. Well there was a little bit of a precursor to that in in that. There were discussions had amongst the boards as to whether or not. Kaufman hall would render an opinion. Easter very much wanted to you have an opinion rendered by them. West Jeff voted against them rendering an opinion. We believe that because. The differences of opinions between the two boards -- begged. Of the independent third party consultant. To. Opine on who they thought would be the best choice for the organization. When those discussions started it created quite a brouhaha. In a total war as to whether or not. Kaufman hall was going to be allowed to render an opinion. And we ended up having multiple meetings over that one particular issue. Ultimately. The opinion that was rendered by Kaufman hall is that he should go their own way. That because of the incredible divide. Exists between. EJ in west ship's position on this matter. That they felt like. It may be difficult to recover to impose a partner. Once someone who doesn't want that partner. And it doesn't Foster a very long standing. Forward leaning relationship. To start off on -- -- on a bad foot with having a partner imposed on you that you didn't really choose. Very much. The partnership. With the suitor in working with them is going to be incredibly important in. Meandering to the future landscape in and preserving. And for filling our fiduciary obligation as the board of directors. In ensuring that they live up. To the promises the suitor that is lives up to the promises that that they made. Through that negotiation process. So it's really an in it to me it's very I wish. -- -- had chosen to be here I think it's much easier to have a conversation with everybody at the tables now working out that way. But isn't so different when you won't want. Well it out and well I have doctor Lindsay look and talk about that from the physician's perspective and then we'll give views that the board's perspective. Well we were not invited. In this process. We think doctors doctors. We. Inserted ourselves in this process relatively late in the game. Our board allowed us to have a representative. Provided that. The confidentiality. Be maintained for sensitive -- negotiations. So it has been -- somewhat problematic. For let's say the general staff. Position member to assimilate. A fairly large amount -- very complex information. But we decided we better pay attention to this and so. We participated in the process. And ultimately we got our own. Outside consultants. Which the medical staff paid for to help us. But this information together and to come it is some grips as to what's gonna happen because things are gonna change. And it just so happens that our consultant. Rendered opinions that were very similar to the Kaufman hall. Advice. And so when we presented this to our leadership meaning the medical staff leadership. The points that were enumerated were quite convincing that certainly on the patient care perspective. There are significant advantages with the HCA organization. I mean we would not be here talking about this today. If our consultant or if the administration's consultants said yes. Children's is definitely the better. We wouldn't be here. It's just that we have evidence and we have information. Which seems to be compelling and convincing. That if you are patient and east Jefferson hospital. Or if you're a resident of Jefferson Parish. Is more likely that you will be able to obtain high levels service. For the foreseeable future. If you go with the HCA route now. That got our attention as medical staff leadership. So that's how we became involved. What we're gonna have to take a quick break we're going to be right back we're gonna continue this very important discussion maybe one of the biggest decisions in Jefferson Parish in modern times. On who will take care of the hospitals will be right back this is Angela on W well. We're talking with doctor Mark -- doctor John Lindsay and sheriff -- Norman all involved with. East Jefferson general hospital as it looks at who is going in the future's going to be leasing. What started out to be both east Jefferson and west Jefferson but as we were talking about. Each hospital has their own choice and there has been no decision made that'll happen with the council on another -- But we're just trying to get the information on what led -- Jefferson's to choose HC day. West Jefferson has already verbally said they're interested in Children's Hospital so. -- doctor -- you were talking about what you saw as a physician and your group doing its own independence starting. Of what interested you in HCA. Would it it. Starts with patient care again and the what differentiates. Success from from failure an adult acute care hospital is a very small margin. In reading scores -- quality metrics or measures and and that sort of thing. In matter of fact -- the hospital doesn't perform up to standard money can be taken away by the government and awarded. T top performing hospitals and these margins are extremely small and can make the difference between success and fear. So it if you look at the performance. HCA institutions around the country as a whole. They are in fact the industry leader in visa performance measures -- basically you have a finely tuned. Well oiled machine. That knows how to do this over and over and over again they have the processes in place that the programs they have the physician. Prepackaged orders. They have what they need to come in and take a hospital which may be under performing. And improve it to the point that. Reimbursements may actually improve but -- I would like to comment on. What our consultant. Spent the first three pages of the report one and that was. That the health care industry in general. I don't know if you would use the term in a free fall financially but I think crisis would probably be correct in that. There is no doubt that the direction of health scares in a major way going towards consolidation. And it. If we become part of eighty. And he a university system where the designated flagship institution is going to be. Downtown which is under construction now. You know as a position -- having experienced say similar things we can see what's coming and that your concern is that patients will go downtown well I think -- it's you know the economic. Realities. Are. -- if you -- -- And that. Resources are going to be concentrated in that way. If we go down that route and so our patience. In Jefferson Parish should be aware. That this is the likely path which would who'll follow. I do have to say and again I was sure other people were here but that very concern that was very strongly. Sent to the contrary that would be the case at all that. Children's hospital center medical center hospital would not take patience from -- Jefferson and in essence says. They want. -- Jeffs and to be more sustainable and they are today and that means growing services in that primary area I interpreted that as we won a -- Q walloped as much as we can't. That it wouldn't be. Thinning out two to go downtown I mean that's he said she says and -- again I'm sorry that they're not here. But I just feel that I must say that there there was some contradiction to -- what you were thinking. I would like to move on a little bit too. Understand what you're saying about the changing world medical care we all I think I understand that. I also understand from parish point of view and needing to to consolidate and make it strong. Savings. If we go a separate route though are we not. In essence not doing what we started out to do. Whether it should be both HCA or both children's doesn't that help. I'm looking at you because you were the manager of the hospital with that same on a lot of things that might be duplicated. Now with two separate ones. I think that there that was our intent at the beginning and there are some negatives business there's an associate with a splitting. That being said I think the fact that we are in two different places that we've come to to different conclusions. And the ramifications of that of them making the new system more. I think override some -- lost savings. I think that our board and myself that spent a lot of time on this subject. And hours of thinking what was best. -- often that probably early summer I think PGA board was pretty well split in and actually three ways on this but as more and more information came in. And the offers change in a positive fashion. And more thought given to who gives us the best. Chance to succeed. And succeed does is not maintaining the status quo we aspire to be better bigger. I think there's some great examples out there where HCA's done that and other communities. I think the additional dollars that they put forward that -- can that can be used for community health. I think all that tell us. -- some of the things that are lost with size and scale of what we initially started what. It's. It is what it is and and we did start that way but the process has gotten us to a different place. OK I hope everyone stays with us we're gonna continue this conversation and we do have a caller -- Jane really getting to you. But now let's I joined the newsroom and John -- We -- talking with three leaders at east Jefferson hospital doctor Mark Peters is to see you know doctor John Lindsay. Who was at the medical staff and sheriff -- Norman who is chairman of the board and they're giving their case for why they prefer HC -- over Children's Hospital to take over the lease for the management of east Jefferson and they hope last Jefferson as well in an in the changing world of medicine. As you all have been explaining this is what is happening. Groups have to get together to survive. And so and everybody has their own opinion yours is very very thought out I have to ask though because. I remember when HCA came up. Several people sent to me in the medical community. Well HCA has not done such a great job was tooling in -- Tulane medical. Center that. If that they may have other great hospitals but they haven't done wonderful things here and I'd like you to respond event. I'll get a shot that it first I think that. It's important to note that HCA has a modern succeed hospitals throughout the country. Under and 66 of them are community hospitals like hours. They have to academic medical senators won -- two lane and the other is University of Oklahoma and Oklahoma City. Our analysis. Their other facilities. It's been widely reported we made a visit -- saint David's in Austin. We've seen and reviewed other information at their other community hospitals. And we feel very very strongly that their niche and their strong suit is. The working with community hospitals. So I think that academic medical centers are a little bit different animal. Of how they're run how they operate. And where why. We gave consideration to HCA and where we ended up. Has to do with a 166 other hospitals. That they have involvement went. OK we have a caller Catherine from Jefferson Parish have a comment. Yes thank you hi Angela. Enjoy issue. -- your heart. Out. I'm concerned about. They see me because that -- that the people who are making the decision by looking at the macro view and that the micro view. I would like if -- -- it anyway -- talk to be nursing stay informed people who. Presently working HCA hospitals. As for the quality. The management. Yeah I mean we've talked to a lot of different post nurses. A lot of the support services. In those institutions we've talked to him. Folks as well in the children's system and there are anecdotal stories on on both sides of the issue that as it relates to. That a lot of times people are always talking about what's in their best interest. What's interesting about forward leaning organization is that the entities interest always outweighs the individual's interest. And we begin to look at things I macro vs micro sense what we're looking at. Or what are the embedded operational systems in order to be successful. In health care. Change is a very difficult thing to manage. Often times the view of the anecdotal stories are really not. Something that should influence a decision. As big as this day in and day out when you're talking about. The merger of these huge organizations. The fact of the matter is is that. One of the reasons that a lot of the support service folks. Don't like consolidation. Is that they are less empowered. As a relates to the year -- ability to negotiate their pay. And other issues when they are less players in the market the fact of the matter is is that we can't afford to be that the salmon swimming upstream. Where we think we're going to survive without the consolidation. The market forces are dictating. A lot of that. As it relates to that you know I really don't want to get into a situation of of pitting one. Service providers employees against another service provider employees because I can tell you. Anecdotal horror stories about every hospital based on stuff that we've been told. Including our own including our own institution. So the fact of the matter is is that as fiduciary is of this process. We have to look at the most objectively. Available criteria. In order to make these very difficult decisions. When we look across the country and see. Huge medical systems joining with other huge medical systems. Because the operative word today -- scale. To be able to compete make money in the Medicare area. And try. And in diffuse some of the losses that you have in Medicaid and other government sponsored programs. It's hard for us to believe that we have a recipe for success by partnering. With a smaller system. The fact of the matter is it's not that they're bad they're great people you know and they have and they do good things. It. But the fact of the matter is is that when you look across the country you're seeing consolidations. Of huge systems. That you know that they seem to believe and have figured out and all of our consultants are telling us that is the mood. That is that's what you do to be in the best position to succeed. Now children's. Has made a conscious decision to manage. A state financed health care system otherwise known -- charity. As a fiduciary. Of -- Jeff hospital. My biggest issue is that I really don't have an interest in becoming part of the state finance health care system. In fact most forward leaning healthcare organizations are moving away from that. And they don't desire for that I desire for our institution to be something far greater. Thank you very much Katherine will be right back. Having a great conversation about the decision that will soon be made soon within months or maybe longer. About who will be running east Jefferson west Jefferson and we've been talking with the east Jefferson officials about their choice on HCA and it would be talking in the break about. The debate between non profit or profit and the only question I would have to that would be. With profit and which is you know god bless America profit. Oftentimes you have to answer to shareholders and sometimes an answer to shareholders having worked for many for profit groups. They do do a lot of belt tightening to make those profits is that. Well -- -- not for profit world you're you're responding to bond holders and bond insurers. In fact there right now these Jeff we're not for profit. We have bond covenants that we monitor at the board level. Every month we're on on the phone. Twice a month I believe with our bond dot underwriters and our bond insurers. Discussing where we are where are we financially and everything else the only differences is that. Your financing your organization and in the not for profit world in the capital markets and in the for profit world any equity markets appear probably trader corporation. Now you know we hear this local not for it not for profit verses for profit. We mideast Jeff pay eighteen million dollars and interest annually to bondholders. Who I know don't live in Jefferson Parish. They live all around the country. So when we talk about you know sending. Dividends to shareholders around the country there's no difference that's the financing scheme. How many people pay a mortgage to a local bank where it actually stays here locally. That's not how the financial markets are working today. So it's a little disingenuous to think that because you have the not for profit label which we do have at the present time. That that you're not making payments to people that have a vested interest in your organization's success stay in and day out. Let me ask a doctor Peters you have been CEO for a long time if AJ comes in will you remain the CEO. I think that's yet to be determined I think all three. Potential partners have stated they would like to keep the administrative teams in place. The good thing is. Is. I think this needs to be an objective decision of who the partner as -- get the best one for a hospital on our patients. And all that's couple subtle -- well. We'll be right. Well I want to thank each and every person here for giving us their information about. Their thoughts on why east judge go HCA and we will try to get western and find out why they wanna choose children's anyway thank you for joining us now let's go to donning.