Four board members of Parkland Health & Hospital System in Dallas resigned last week after clashing with longtime Chief Executive Officer Ron Anderson, marking the second split in a month between a Texas public hospital board and its top manager.
In Houston, Harris County Hospital District CEO John Guest resigned in March following disputes with his board. Chief Operating Officer David Lopez was named interim head of the district. Parkland's mass resignation left the hospital's seven-seat board without a quorum until April 20, the earliest date new trustees can be appointed by the Dallas County Commissioners Court, a county official said.
A rift had grown for months between Anderson and at least three members of the board including Chairwoman Cynthia Comparin, who was accused earlier this year of trying to oust Anderson, Parkland's leader since 1982. Anderson said the members who resigned were carrying out the wishes of some county commissioners who want to reduce indigent-care spending.
"In my view, these folks were not acting as fiduciaries for the patients," Anderson said of the board members who resigned. "I'm not willing to withhold care to immigrants because of political pressure."
Last month, Anderson won the American Hospital Association's Award of Honor for his leadership in trying to expand access to care for low-income residents.
In a joint resignation letter with another board member, Comparin said county taxpayers "deserve better accountability" from hospital management. Without naming Anderson, the letter said management failed to provide timely information such as how much care is provided to out-of-county patients, dragged its feet on priorities including appointing a permanent COO and lacked appropriate procedures to evaluate contracts.
Comparin told Modern Healthcare that board members need to be accountable to taxpayers as well as patients. She said Anderson should "step up to the plate" and address issues such as asking other counties to pay for the cost of caring for their indigent patients.
Anderson and one of the remaining board members, nephrologist Lauren McDonald, said the board was provided with ample data on hospital finances and explanations of the difficulty of collecting from indigent patients, but Comparin and others did not seem to listen. "She wanted to believe what she wanted to believe about inefficiency," Anderson said.
The hospital has curtailed tens of millions of dollars of expenses this year to compensate for state budget cuts for Medicaid and the Children's Health Insurance Program that removed $24 million in revenue, Anderson said. He said he expects the hospital to report net income of less than $1 million for the fiscal year ending Sept. 30, compared with $13 million the prior year. Annual revenue is about $850 million.
County commissioners, concerned that they will have to raise property taxes to support the 708-bed hospital, recently stepped up their financial oversight and put a hospital replacement project on hold while they study ways to reduce indigent-care spending. The study includes an examination of whether Dallas County must provide care to illegal immigrants.
In recent weeks, physicians and community leaders rallied in support of increased public funding for the hospital. Two weeks before the resignations, 150 ministers and other hospital supporters attended a board meeting where they were not allowed to present their concerns about hospital spending cuts. The incident gave Comparin a black eye with the community. McDonald said Comparin's reputation was also tarnished earlier this year when the chairwoman hired a consulting firm to develop a succession plan without board approval.
The board could have fired Anderson with four votes, but Comparin said they agreed that drawing attention to their concerns in a mass resignation "would allow for more change to happen in a timely manner."
In Houston, Guest offered no explanation for his resignation, although the hospital district has felt similar budget pressures. Guest first tendered his resignation a year ago, citing "philosophical differences" with the board, only to rescind it a few weeks later. This time, his departure is expected to be permanent.