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As Broward Health bleeds, doctors warn mismanagement is affecting health care

By Dan Christensen, FloridaBulldog.org 

Broward Health’s top doctors have warned the district’s leadership that the medical staff’s ability to function “is being compromised to the detriment of Broward Health as a viable health care system.”

A Jan. 19 letter from the Unified Medical Staff Committee obtained by Florida Bulldog also says that Broward Health is bleeding physicians due to mismanagement.

“The Medical Staff is critically concerned that the alienation of the physicians is affecting the delivery of health care,” the letter says. “Across the system there is physician attrition as physicians do not feel valued and necessary personnel and other support is delayed or denied, resulting in a continued downward spiral of [patient] volume and worsening morale of the non-physician staff as well.”

The North Broward Hospital District, as Broward Health is legally known, is the independent taxing district that serves as the safety net hospital system for the northern two-thirds of the county. It is led by a board of political appointees installed by Republican Gov. Rick Scott. It collects about $140 million in property taxes every year.

The doctor’s letter was given to Broward Health’s board of commissioners and its President/CEO Beverly Capasso. In December, Capasso, General Counsel Lynn Barrett, Chairman Rocky Rodriguez, Commissioner Christopher Ure and former Commissioner Linda Robison were indicted for violating Florida’s Government-in-the-Sunshine Law. All except Robison, who was not reappointed when her term expired late last year, remain in office.

“For many months the Medical Staff leadership has endeavored to address these concerns in a collaborative manner,” says the letter prepared by attorney Amy Galloway, who represents the medical staff. “Those efforts have largely been met by a lack of urgency to find practical, timely solutions to patient centered issues and shoulder shrugging reference to ‘corporate’ decision-making while Broward Health roils from one crisis and controversy to another.”

Compounding the problem

Broward Health’s leadership has compounded the problem, the doctors said, by taking actions and implementing policies “in violation of the medical staff’s bylaws” and the district’s “own corporate compliance program.” Broward Health established its compliance program in 2015 as part of its $70-million settlement of federal healthcare fraud charges. The physicians’ accusations could trigger a federal inquiry.

Through district spokesman Gary Bitner, Broward Health CEO Capasso declined to comment on the letter.

Dr. Gary Lehr, a Deerfield Beach surgeon who chairs the Unified Medical Staff Committee, and urologist Dr. Louis Yogel, chief of staff at the district’s Fort Lauderdale flagship Broward Health Medical Center, did not respond to requests for comment.

The physicians’ letter lists four “primary concerns:”

  • Broward Health’s plan for the “unilateral adoption” of an on-call coverage policy for the emergency department “that strips the medical staff from meaningful participation in the process.”
  • The “unilateral elimination” of Chief of Staff reports from the agenda of board meetings.
  • A continuing “crisis” caused by significant delays in contract renewals routine primary care and specialist coverage, as well as contracting for non-clinical duties.
  • The defunding of the physicians’ legal counsel. Until recently Broward Health paid that cost.

Traditionally, the chief medical officer at each of Broward Health’s four hospitals – Broward Health Medical Center, Imperial Point, Broward Health North and Coral Springs – provided the board with monthly reports about their hospitals, including grievances.

‘Smacks of censorship’

When the medical staff asked for the chiefs’ reports to be reinstated, however, it was “suggested the chiefs could request being placed on the agenda if and only if they submitted their comments to corporate in advance (and presumably for approval).  Such approval smacks of censorship,” the letter said.

The doctors’ most detailed complaint was about Broward Health’s draft policy to establish on-call emergency schedules without their input. Those schedules are now overseen by the department’s chair in consultation with the hospital’s chief of staff, and under ultimate oversight by the board.  “This process has been in place and when respected limits the ability of any one individual or group, physician or administrator, to use call as inducement for referrals…”

The federal Anti-Kickback Statute (AKS) forbids individuals or entities like hospitals from paying or receiving anything of value in exchange for referring patients whose care is paid for by government healthcare programs such as Medicare or Medicaid.

The physicians’ letter calls Broward Health’s draft on-call policy “seriously troubling” in light of the Dec. 1, 2016 termination of former district President/CEO Pauline Grant for alleged anti-kickback violations. The accusations arose after one orthopedic surgeon claimed that calls at Broward Health North, where Grant was then chief executive, were not being dispensed equally to doctors on the call panel.

“Independent of the veracity of those allegations, a safeguard against even the appearance of an AKS violation is the establishment (of) meaningful oversight and participation of the medical staff,” the letter says. Existing rules guard against “the quid quo pro grant of primary or specialist call” and ensure that “no administrative team has unilateral control over setting call.”

The termination of Grant is central to the criminal indictment against the four current and former commissioners and general counsel Barrett. Among other things, the charges say, the quintet conspired at unannounced meetings to oust Grant.

Grant sued Broward Health shortly after her ouster, leading the district to hire a number of private lawyers at high, yet undisclosed cost to taxpayers. The district’s legal costs rose significantly in December when more lawyers were retained to represent the five who were indicted.

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Latest comments

  • It is The Board’s, Barrett’s and Capasso’s plan to destroy Broward Health. They do not care what the physicians-employees or community thinks. What better way to destroy Broward Health than to have as few providers as possible?

    They are executing Rick Scott’s via Billy Rubin Plan.

  • NO NO NO I am sorry physicians at Broward health have milked the system for so so so long
    Inappropriate consults, disgusting behavior abusive behavior, Grant had it right STOP the bad Doctors improve care and improve outcomes
    There is often gross failure to provide proper care to patients, bullying intimidation and abuse to those who speak out There is a big future change needed This process of change has a long way to go, UNFORTUNATELY we were let down by Capasso et al and the damming Grand Jury, or were we, is this just another ploy by the governor to weaken the system, I just hope that the physicians in breach of their duty to care and protect the public are held accountable
    These people living their Champagne Dreams and Caviar Wishes have their judgment coming,
    ACTION is needed just remember a DRAFT policy is a DRAFT not worth the paper it is printed on,
    Broward Health has some amazing nurses and people working for them, they provide fantastic care for little money, what some of my colleagues spend on cars and vacations isome nurses salary for 5 years, yet we still have free food, when the staff pay, and yes some of my colleagues really do take advantage of this feeding their whole staff each day, Do I sound angry I hope so because this has to stop YOU know who you all are Your little mafia groups I could go on but will not
    Go ahead BH FULL STEAM AHEAD

  • WELL SAID !!

    THE ENEMA IS COMING TO BROWARD HEALTH FLUSHING THE SH 1T AWAY

  • It will be like WW3 when all of this comes out, BUT the physicians at BH have had it so good for so long. Hopefully we will have better quality physicians, and a higher level of care.Physicians are abusive to staff and treat us all like sub humans, they are the gods and we are the little minions to be controlled. It is time for BH to be re built, and for administration to stand up for us instead of bowing down to the doctors, it is difficult enough

  • Ok, short and sweet. HORSESHIT. Appreciate your candor, but posting on an anonymous blog does little to shed light on the Doctor abuses. Free fucking lunches really. What about negligent patient care that results in catastrophic outcomes. Verbal and physical abuse to patients and employees. If you see it REPORT IT. How many patients do you know of that have died because of criminal care of Doctors. REPORT IT. Don’t whine about it here. STEP THE FUCK UP. DO THE RIGHT THING. If not, please SHUT THE FUCK UP. Free lunches, christ almighty. SMFH.

  • Ha I have reported this abuse and NOTHING gets done, I mean nothing the bastards just try and blame you as “not been able to get on with people” ! and try to report negligent care NO ONE stands by you at all, it is a disgrace these doctors literally get away with everything, I HAVE STEPPED UP I HAVE REPORTED IT and nothing gets done
    Free food, its sucks anyway, let them have it
    Next I am recording the abuse and going to an attorney,

  • Capasso is convicted. If you get the money or anything that you are not entitled, you will pay back eventually – in any form that you can imagine. That is the real rule in this world, regardless who you are.

    Capasso reads here every single day. Hope she won’t have a heart attack.

  • Underdog, thank you for trying and working the system. We know the system is corrupt, we know the enablers are corrupt, we know that there are dangerous doctors perpetrating crimes against patients and staff and healthcare in general. WE KNOW YOU HAVE TRIED. But, try again. If you knew your neighbor was sexually abusing his young daughter, or beating his wife, or even a peeping Tom, you would call the police, right? He’s a criminal, needs to be arrested. So what’s the difference? A crime is a crime. You are right to record and report, TO THE POLICE, and your attorney. Thank you, we stand with you. Please, don’t fuck us., fuck them.

  • Whoever wrote about Capasso reading this is mistaken if they think she cares. Timeline of her brilliant rise to the top spot. Capasso-
    a. Applied twice to CEO positions within Broward Health and was not selected
    b. Was recruited by Barrett to be a Board Member because Barrett needed Board members who would not fire her
    c. Conspired to break the law and fire Grant based on trumped up charges already cleared by two compliance officers
    d. Conspired with Rocky Rodriguez Barrett and Board breaking the law to be named as Interim CEO. Board Members start talking about her great Career. All 11 months at Jackson ha ha
    e. Voted to enrich herself as Interim CEO from Volunteer Board Member- If she were brilliant she would not have voted for herself because she had the three conspired votes in the bag without hers.
    f. Sun-Sentinel discovered she didn’t have an accredited degree from her Jackson File. Capasso blames others at Broward Health and treated a 30+ year employee like shit and drove her out in the same year she lost her husband although there was proof she did nothing wrong
    g. Goes around telling everyone she is interim only. Makes a ton of VP appointments after she fires or good people quit to unqualified people like her giving them lots of money
    h. Breaks the Lobbying Policy by having others Lobby the Board for her to get the job even though she was to be interim. Has a few blacks show up to support her although she was not to be considered. Another violation of the sunshine law.
    i. Pretends she has to give up going back to school for her PhD to take the job. She doesn’t even have a Masters which is required on the Job Description and would have to get a Master’s before a fucking PhD!

    The system is corrupt and when God was giving out humility he skipped Capasso. But she certainly kissed the right ass to land where she is. I don’t know how we can ever trust her as our leader. Compliance at Broward Health is a joke. It is only used to get rid of someone who doesn’t play the game.

    I’m just a peon and I know this shit I’m sure there is more.

  • Thank you for so eloquently listing the “highlights” that are CapASSHOLE and her shitty career. Everything she has done and those that enable her rise are fraudulent. A life of lying, backstabbing, and whoring. Stepping up on the backs of those that do the real work, all the while stealing credit for their hard work. This, POS, is what we are left with. There’s no one to help us. Admin is complicit, management is scared shitless, the Medical Staff uses the void for their advantage and runs rough shod over the employees. We are left to leave or fend for ourselves. So what are our options. UNIONIZE. Drag the fucking Union to the District, Organize. Get the God Damn nursing staff recognize their power. Everyone else will be pulled or dragged along. We need an advocate, a bodyguard, to punch these bullies in the face. Make them realize THEY CANT FUNCTION WITHOUT THE WORKERS. We can shut this motherfucker down. And, position ourselves better for the bankruptcy and sale. STAY STRONG, STAND STRONG. TOGETHER. Oh yeah, fuck you Bev

  • I completely AGREE the only hope is to unionize and to do it asap, we will see a real show as they get the poor manager to serve breakfast to us and “novelties” in the evening, my scared shitless manager will be there together with “Bo Jangles” the HR Director slinging hash at us in an attempt to generate good will towards Capasso. IT WILL TAKE MORE THAN THAT
    The bankruptcy and then the sale is only around the corner, we need a union, and we need one now
    OH YEA CAPASSO STUFF YOUR BREAKFAST WHERE THE SUN DON’T SHINE

  • As we care for those shot or injured in the Parkland School shooting, our care exemplifies the reason why Broward Health is here–For our physicians, nurses, patient access, reps, all workers to care for our loved ones and neighbors.
    We are NOT here to support a corrupt indicted Board, indicted General Counsel and CEO Capasshole as well as the cronies hired by her.
    They do not DESERVE to represent our work and value to the press or community. They must resign or things will get worse. TIME IS UP!

  • “History will have to record that the greatest tragedy of this period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people”
    – Dr.Martin Luther King.

  • “There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest”
    -Elie Wiesel

  • Have you ever seen anyone so rude treating the employee like a dog?

    If not, take a look at Capasso – snapped the finger and came out Gino!

    So obsessed with powder and so eager for money!
    – poorly educated probably by her family since little
    – poorly educated to be a person with respect and care

  • The whole response to the recent shootings at BHN shows a total new thinking of the ED and trauma program, Do you think this would ever have happened with Dawn or Martine, with Johnson as the trauma medical director, NO it would not The new staff the new trauma program with Dr Nichi is supported by US the great ED team, we showed the world what BHN is made of, its about time I am so fed up of BG taking all the lime light for so long we have been second best, and now we have people to speak up for us to work with us instead of shouting screaming and been a total bitch like Johnson does, I am only pleased she was not there
    Change is on the way in more ways than one, there has been injustice, we have protested and I will not stop BUT I have got to say Dr Nichi was excellent the way he worked the way he handled the situation a REAL trauma surgeon who respected us in a disaster WAY TO GO THANK YOU SIR
    As for Capasso Gino and others …I just blew a raspberry….

  • You must be joking he is one of the worst

    GET THE UNION IN NOW
    STAND STRONG RESIST

  • I am heart broken to learn this morning that Miss Jasmine Shirley left or was fired. She was the rock that advocated for an underserved community and she was stayed true by living in that community. The new corporate admin is very good at blaming but they can’t fix anything and they make it worse.

    No one external is going to save Broward Health from this group of criminals.
    We must resist and protest and demand their resignations. Leaders cannot lead if no one follows them. Stop the fear and run this group of bandits out of our health system.

  • To my fellow healthcare workers. Thank you job well done. That said, to the few employees that posed with President Shitbag, I am disappointed and dismayed that you would prostitute yourselves so this Asshat could have a photo op. He doesn’t give a shit about y’all or the survivors and victims. He is devoid of any ability for empathy or feelings. What y’all did was to enable this POS to pretend to America that a 20 minute photo op was meaningful.what it was, is fraud, that used a horrific national tragedy to perpetrate it. All with the aim to garner praise for himself. And, y’all are complicit in that magnanimous act of a self aggrandizement, by this treasonous Asshole. So, thank you again, but you could have said no thanks. Instead of standing there , less than 48 hrs after the mass murder of 17 innocents, SMILING, while he give a big thumbs up for fucksake. Like y’all were at a grand opening of a new hotel. SMFH, idiots. JUST SAY NO. Have a fucking conscience.

  • There is STILL injustice
    Bowers is leaving…there is a god
    As long as Ruditz is the CNO there will be injustice

    We are lead by indicted criminals what do you all expect

  • TIGERLILLY well said, To the hard working ED staff who cared for the tragic victims THANK YOU , We saw people normally in suits or ties don gowns and get down to it in the trenches , who would believe they could do it, but then our fearless Bowers was at the “desk” Who was it who brought water to the staff and cared for us during the time of crisis, NOT Bowers or Ruditz, yet I witnessed a lot of people not involved in caring for the victims meeting the president. ALL of you disgust me, you are scum bags. We were the workers in the ED, the OR director and staff the silent heroes who helped us, the program manger of trauma donned gowns and did patient care, The OR director was there sweating with us, crying with us, THANK YOU THANK YOU to the OR staff I don’t know the names, to Kim and Tom thank you. So to all the chosen lined up and smiled with shit face at a national tragedy, you disgust me What was this a new spa or hotel opening Many surgeons came to the rescue, many staff came in from home, yet for the people who completed the work NO THANKS AT ALL . I cared for the patients I know who I worked with I know who I am grateful to for help and who were true hero’s BUT As usual the chosen few, who support bitch Bowers were there smiling and giving the thumbs up. YOUNG people died and BH used it as a marketing tool. Did Capasso thank us in the ED NO she thanked the Physicians in her e mail,
    STAND STRONG COMRADES< STAY STRONG<USE YOUR FIRST AMENDMENT RIGHT OF FREE SPEECH< WE ARE A LONG WAY FROM HOME AND THIS IS NO PLEASUREDOME BUT remember what happened to Grant when she stood her ground for patient safety and quality yes she was , FIRED

    As Balance reminds up , just remember most of the senior leadership are indicted on criminal charges, THEY ARE SCUM BAGS they are criminal
    Also if you are black be careful these people are after us they want us out

  • This was one f’ing fiasco poor innocent children killed and BH uses this as a marketing tool DISGRACEFUL

    I witnessed people usually in suits and ties don gowns and sweat with us, The OR director the OR staff all there, YET I see none of these recognized

    Capasso you are one rough nasty BITCH, using this as a marketing tool is criminal ….OH but I forgot you are a criminal.

    TIGER you said it all Who did we see in that photoshoot all the chosen few NOT the ED or OR who worked to save these innocents, the usual Bowers and Ruditz puppets

    BH IS NO PLEASUREDOME BUT remember what happened to Grant when she stood her ground for patient safety and quality yes she was , FIRED

    Just remember most of the senior leadership are indicted on criminal charges, THEY ARE SCUM BAGS they are criminals

    I could go on I hope someone reads this of influence and reacts

  • I work in the ED
    I was sweating working hard to save these people
    That is my job
    I did not go to any regal presentation or pose with the president,
    Do I care NO I did what I had to do…… end of story

    do think it disrespectful certain managers and staff were not included in the “line up” YES I do but who knows they why they were not there, hate plain did not like them or any one of many many reasons.

    Life is precious too much attentions to people like Capasso, Bowers Ruditz, Taylor Gino, Gd will face them out at judgement day, Really I do not sweat about it, I live my life clean and free of crime against people and the law of the country , I did my part on that fateful day I helped my fellow human so tragically taken I did it saying. prayers as they departed this earth
    I would like to thank people l worked with and the great care we all gave… people who I never thought would be able to work in trauma ! so many yellow gowns
    BLESSINGS TO YOU ALL, GD and the angels were there with us, GD will judge these criminals and they will have the opportunity to be one with Christ again or face Hell, we have not to say anything at all

  • So many comments for so long (and some repeated or copied LOL)

    And there is STILL NO action

    This too will end one day and there will be justice

  • Yes – it’s long overdue for Broward Health North’s Trauma team to be recognized for its outstanding work and excellent medical leadership. And Im not referring to any comments made by our idiotic president. His praise is as meaningless as his clueless agenda. We have outcomes just as good as our sister hospital to the south, and with less resources and hospital/district support. We just don’t spout our accomplishments the way the pompous trauma medical director at BHMC does. We don’t have to — they’re evident for all to see. Stay strong my co- workers and we will persevere.

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