What next wrote on Sep 6, 2008 7:12 PM:It must be the pave it over KFC group who is responsible for this latest fiasco. Just give them a little space and the next thing you know there is a problem like this. What next, I hope they do not take up in projects in my neighborhood.

Buyer wrote on Sep 6, 2008 9:08 PM:Scripps recently purchased Sharp Mission Park (the North County portion of Sharp). So it is very unlikely that Sharp would purchase the hospital since it no longer has a medical group in the area. Scripps would do a wonderful job running the place. It would be a tremendous boom to Oceanside to have a high quality program which will offer good jobs.

I predict wrote on Sep 6, 2008 10:07 PM:a fourth bond measure is in the planning for the general election.

Floyd wrote on Sep 6, 2008 10:17 PM:Let me see ... they said the annual cost to service the failed bond would be $25 million. Now they say they need a profit of $30 million to do it themselves out of existing revenue. But if you pay for the construction upgrades as the bills become due you don't have to pay interest. Interest is half the annual cost! Half of $25 million is $12.5 million, which is just a tad more than the $10 million profit recently reported by Tri City Hospital. In short, it looks like the Tri City Board is cooking the books again.

Why Not wrote on Sep 6, 2008 10:47 PM:Well, if all else fails, we all could still go to the Vista Clinic and wait in line behind all the baby strollers. They could turn TriCity into condos, considering the good views it has from the upper floors and private developers could make a fortune. Of course without a hospital in the tri cities, property values might go down further, but hey, who needs a hospital anyway? Better I save the extra tax money I would have spent on TriCity and that would help me buy my next Lexus...

Molly wrote on Sep 6, 2008 11:34 PM:I guess the hospital won't be closing after all. Glad I voted NO!

Bigger District wrote on Sep 6, 2008 11:45 PM:The Palomar Pomerado Health District should consider purchasing Tri City and extend its district - they are currently doing a great job with their expansion efforts and would improve the quality of care in this area.

john wrote on Sep 7, 2008 1:00 AM:why doesn't anyone consider asking for a delay like others on the basis that we are not on the fault line? Others got it including a hospital in SD county Tri-city needs a new board. resign Larry.

Deja Vu to I predict wrote on Sep 7, 2008 4:40 AM:No bond measure for november - not enough time for the ballots! Stupid board, lazy management with Rodriquez liken the doctors take over... Hey Mad Rod the docs already have taken over! While the ethical doctors leave, the ones left behind are the ones who have benefited from the community chest - leaving their patients with little nursing care - Bonuses for MANAGEMENT - Stipends for DOCTORS (to do little to next to nothing)- and now let's talk with Scripps... Sharp Mission Park would not have sold if Gonzo had not kept raising the bed rates (25% per year) to pay himself and his cronies the board's bonuses schemes!!!

Deja Vu wrote on Sep 7, 2008 5:05 AM:If the Mad Rodriquez and other doctors love Tri City then why not join in the effort to suspend your stipend of $4000 per month for doing nothing - and get back to practicing being a doctor rather than a manager?

By the way why not stop the bonuses to all - CEO, VPs, directors, supervisors?

Why not stop overutilization of consultants (who are hired guns to emphasize what the CEO wants not the board) and the use of a lawfirm whose strategic plan is billable hours for their partners to be able to benefit at the end of the year in their own bonus plan. Billable hours does not equate into good lawyering!!

I wonder wrote on Sep 7, 2008 6:40 AM:Why has Tri-City not forged any contracts? Palomar got $350 million from Kaiser for 1/3 of the beds at the new hospital. Sharp was definitely bringing paying business to Tri-City. Wonder if rejecting these kinds of contracts has anything to do with driving down the price? I can't figure out any logical reason....asked my board members...Managed care IS here now, patients receive services where their insurance tells them to go. Partnering with others that deliver these services only makes sense!

cents worth wrote on Sep 7, 2008 7:45 AM:What really needs to be done is remove the CEO,bring in new blood, plan on a two-year program to learn what the public really feels is wrong with the Hospital, then fix it and develop a first class education program to inform the public and THEN go back for another vote. The last PR campaign was a bush league joke. And the last election campaign was run by an out-of-town, overpriced consultant who did a very poor job.

It's time someone takes charge and does things right.

To Floyd wrote on Sep 7, 2008 8:05 AM:You forgot to add in the $1+ million monthly bleed TCMC claims. IF that stopped...they would be able to service their own bond!

Nicodemus wrote on Sep 7, 2008 8:07 AM:This is the same board who refused to explore other options after the FIRST failed bond. Now, after three losses, selling the hospital is on the table? Shows you how cluless the board members and Gonzo are.

CAN YOU PLEASE wrote on Sep 7, 2008 8:10 AM:Let Tri-City Be Sold

Joe B wrote on Sep 7, 2008 8:13 AM:Selling it would be a great move.

Earthquake Mamma wrote on Sep 7, 2008 8:43 AM:Tri City supposedly did ask for a new study on earthquake safety. They have received no answer yet continue to scare the public with threats of imminent harm. We need to clean house and get rid of this board AND the CEO fat cat, Art Gonzales. These people are not capable of leading or of good ideas.

Good heavens wrote on Sep 7, 2008 8:44 AM:Why does Floyd keep talking about issues that are clearly above his head? He clearly doesn't understand the first thing about hospital operations. Just because TCMC showed a profit of $10 million one year, doesn't automatically mean they can see such profits year-over-year. And you can't pay as you go--that would be like saying you can pay for your brand new $600,000 home to be built without borrowing money up front because you have $10,000 a year in profit to pay as you go. Stupid.

Imagine wrote on Sep 7, 2008 8:45 AM:John, I am with you! I think this whole drama has been staged by the board and Dr. Gonzales, and the physicians that now want to buy the hospital. They can get a delay,and I wonder where they will get patients? They have not been honest with us at all. Remember that when it's time to vote.

Imagine wrote on Sep 7, 2008 8:52 AM:Deja vu, Dr. Gonzales is a PHd, not an MD. But you are right there will not be another bond in November. And Sharp did try to negotiate, and the CEO of a facility cutting staff hours in the form of "flexing" SHOULD NOT take bonuses. And boy oh boy should they get rid of ALL their consultants! And what does a "wellness center" in Carlsbad have to do with running a hospital? This board and Dr. Gonzales are definitely on another agenda!!

Imagine wrote on Sep 7, 2008 9:07 AM:OOPS! Sorry Deja Vu, you meant Mad Rod the board member. Yes, we are on the same page in terms of their ineptness. We need a new CEO and a new board. Larry is a yes man that seems to like the publicity.

I wonder wrote on Sep 7, 2008 9:12 AM:How much money would the Sharp contract and the Kaiser contract bring to Tri-City. YES, Sharp is gone, but Kaiser has a new clinic in Oceanside and can clearly see that managed care is not only here now, it is the future in medicine, so DO WANT TO EXPAND INTO THIS AREA...STILL! And from the comments Scripps is still even interested, how about partners?

Med - Economics wrote on Sep 7, 2008 9:13 AM:First, 2/3 vote of the people must vote to sell the District. Can't get 2/3 to retrofit so maybe selling is easier -- it takes a board majority to contract with management group. No matter what the board's designated funds have been depleated (73 million to now 53 million)since CEO Gonzo and his Shreveport team came to balmy Oceanside.

Its the board designated funds that makes Tri City interesting for a fire sale. No guarantees with a take over!

Imagine wrote on Sep 7, 2008 9:14 AM:Floyd, sorry to be ignorant, but what is the 1 million dollar bleed?

Mike wrote on Sep 7, 2008 9:17 AM:Keeping a public board is best as long as the elected - public board remembers they were hired by the people (voters) not their employee-handeler - CEO Gonzo and his likes.

Bounce Garrahy and Tweedy off the board and then target Shallock, Mitchell, Rodriquez (too many conflicts of interest for Garrahy, Tweedy, Shallock, Mitchell, and Rodriquez to make independet votes)

heres a thought wrote on Sep 7, 2008 9:20 AM:Why not have talks with Kaiser. I wanted to join Kaiser years ago, but there is no hospital here in North County.

Vista Watchdog wrote on Sep 7, 2008 9:30 AM:You might want to consider St. Josephs (current owner and operator of Mission Hospital in Mission Viejo) or Adventist Health (currently operating South Coast Medical Center in Laguna Beach). Both of these Hospitals had various financial difficulties and were purchased by non-profits that turned them around. Don't limit your options and you will find that wonderful things can come to North County.

Tri-City Healthcare District could also approach the Voters with regard to converting the Hospital District into an Emergency Management District. If this were done the new district could contract with the new owner of the Hospital for the various services that they want to ensure remain available. Also, the large sum of revenues realized from the sale of the Hospital, if properly invested, could be used to help the Communities with providing many other Emergency Management needs.

Look at it this way; it's not the end of TCMC, it's the beginning of something even BETTER! All it takes is the courage to move forward as opposed to remaining stagnant!

Proud Supporter wrote on Sep 7, 2008 9:31 AM:If Dr. Gonzales and the leadership run the hospital so poorly how is it that they have made an excellent profit this past year? Government regulators who review the hospital patient care and patient safety on a regular basis continue to give the hospital high grades.

Too many haters here who don't care about our community. They have self interest and bad agendas which have no basis but ignorance.

To Imagine wrote on Sep 7, 2008 9:37 AM:How clueless can you be? The hospital is about public health. The Wellness program is designed to help keep the community healthy and out of the hospital.

You also have no clue what Sharp did or did not do. Your making it up to make it sound like know what your talking about.

To good Heavens wrote on Sep 7, 2008 9:40 AM:But, since the past history shows year over year profits similar to those shown this last year, if these profits had been invested then the money would be here today to do the project! However, instead of planning for the known future needs of the Hospital (they've known since the 1970's that retro-fitting was requried) they spent these PROFITS on other things. Why? Because they knew that as a Publicly Owned Hospital they could just come to the Public and demand more money. We the Public are tired of being used as a DEEP POCKET and expet our elected officials to manage our tax dollars responsibly.

Selling the Hospital now and investing the revenues for responsible public use would be ideal!

Public Use wrote on Sep 7, 2008 9:47 AM:What specifically are you asking for in your statement. "Investing the revenues for responsible public use"

I wonder wrote on Sep 7, 2008 9:47 AM:To Med-Economics,The article (if correct)if correct, says that simple majority is required to sell...less than to pass bond. Larry, David and Mad obviously in the pocket of Gonzales, but who is he working for? He will just take the money and run, nothing to loose. But someone is pulling these strings! Why did gonzo make the Sharp contract go away?

Vistulian wrote on Sep 7, 2008 9:51 AM:So the truth finally comes out in defeat. Despite all the Prop 1A propaganda from the management and employee unions about how "we" the property owners need to pay more taxes, the only reason for a government run hospital is to make sure there is service for the uninsured. Of course if they had been honest and admitted this there would have been no contest at all. When will people wake up and realize all of pro big government politics is BS - its all about seizing power and individuals hard earned income so they can force us to pay for stuff they believe in. When will we get some relief from greedy government employee unions with their ridiculous COLA protected pensions?

A Little Truth wrote on Sep 7, 2008 10:05 AM:The District Board is elected by the community. They do not get paid for the hours and hours of oversight they provide to this community. I dare say the jerks commenting in this blog on the Board motivations would not give one minute of their time to help direct the good care of the hospital.

If you have something to say about their motivation why don't you go to the monthly televised Board meeting and have your voice heard. Better yet, join one of the oversight Board committees as a public representative's. Oh, you don't want to give up a few hours YOUR precious time. It's much easer to bloviate your stupidity.

To Public Use wrote on Sep 7, 2008 10:09 AM:There are plenty of ways to invest funds and then use the revenues from those investments. As for responsible uses: Contracting to keep the Mental Health unit operating, Aiding in the operation of the ER or Trauma Center by purchasing the Equipment needed to operate, building an Emergency Management Communications and Command Center, aiding cities and the county with the purchase of communications equipment, leasing and operating a Helicopter for firefighting and medical evacuations,... the list goes on and on! TCMC was originally built because the community was too small to attract a LARGE Private Hospital. Although we had three small private, or Doctor owned, Hospitals in the area, they could not provide the quality of care available by consolidating and building a Community Hospital. When TCMC was first opened, one of those three Hospitals was purchased by TCMC. Later they purchased the second. The Third was put out of business as it could not compete with the GOVERNMENT run Hospital.
So, with North County now having well over 2 million people in the area of TCMC (granted, not all are within the District, even though that is the rough number of residents served), there is only one reason why a Private Hospital doesn't consider moving in: competition with a GOVERNMENT run Hospital.

It is far past time to sell the Hospital and return the People's money that was originally invested in this project!

Med - Economics wrote on Sep 7, 2008 10:24 AM:A simple majority of the board to place the item on the ballot but a 2/3 vote to sell!

Gonzo is working for himself along with the insider doctors (who all receive BIG STIPENDS) approved by the board albeit moved, seconded, and approved by the hospital board's committees stacked with administration (Gonzo, Wardwell, Coleman, Ellerbe, Howell, Sanderson, Grozkruger plus the insider doctors with affiliations with Scripps).

The board should be ashamed of how they only rubberstamp -- setting all in motion. Arrogant Garrahy, Tweedy, Shallock, Mitchell, and Rodriquez have mutual direct and indirect conflicts of interest!

To a little truth wrote on Sep 7, 2008 10:32 AM:If the public was ever to be invited as to how the oversight committees are managed... then the board should have those meetings: a) held in the early evening for people to attend; b) audio-tape the meetings for the public to review the committee meetings when unable to attend the noon meetings; c) remove the majority of insider doctors, and staff (CEO, VP, COO/CNE) who are moving and approving their very own recommendations to the full board -- which then only board and public members have 3 minutes to ask any relevant questions before the full board votes... It's a shame set-up for failure all along... nothing more!!!

To A Little Truth wrote on Sep 7, 2008 10:36 AM:You're right, it is far too much to expect a person who ran for and won a seat on the Board to do the right thing simply because it is best for the Community. Did you not know the time it would take or the money you'd make when you took the job?

Deja Vu wrote on Sep 7, 2008 10:36 AM:Every where Gonzo and his team have been over the last 20 years -- the same scenario exists...

What on earth is wrong with the North County times... why have you failed this community in not doing the full investigation report necessary? Could it be that the origianl Blade Citizen folks were also in bed with the small town thinkers (local insider doctors) of keeping it all?

CEO critique wrote on Sep 7, 2008 10:45 AM:Before CEO Gonzo there was CEO Lauri -- North County Times wrote multiple stories about Lauri, the San Diego Grand Jury investigation and Lauri leaving to Valley Health System. Connect the dots folks -- Lauri leaving never stopped this train -- the bloodletting just continued once a CEO Gonzo came because the insider doctors have been running the show -- their hands have been in the cookie jar for a very long time...

for profit wrote on Sep 7, 2008 10:51 AM:Tri-City had the biggest profit ever in the last 6 years. That's due to new homes and population to this area. Where did it go?

I know wrote on Sep 7, 2008 11:15 AM:Yep, the 'good ole' boys club still exists to this very day.

To public use wrote on Sep 7, 2008 11:30 AM:Your not going to get any of the money. Get a clue. It would be a fire sale. Thats what you nay sayers wanted so here it comes. You don't support the hospital but now you want the money from the sale?

A little truth wrote on Sep 7, 2008 11:40 AM:The elected Board members are (I assume as I am not one) are very happy to provide oversight to the community hospital no matter how much of their time they commit. My point was not about no-pay for them sitting on the Board, they know this! My point was to the PEOPLE on this blog that question the Board member decisions without themselves being one bit involved in the hospitals operations. If the full Board meeting dose not allow you to make your point join one of the community oversight committees.

The other commenter complains of the process and that is why they don't get involved. Well guess what Government code sets the rules for how the Board conduct their business. It's a cop-out to use the process as your excuse to complain but not be involved in the actual operations.

To CEO Critique wrote on Sep 7, 2008 11:45 AM:Examples please. It's one thing to puke out your misinformation. It's a much different story to provide some examples that can support your lies. Give us some examples and show some creditability to your statement. I thought not, your comments are steeped in dark brown BS.

upset wrote on Sep 7, 2008 11:54 AM:The loss of a mental health inpatient unit would be a travesty to north county and the people with mental illness. These services are needed.

Proud Supporter wrote on Sep 7, 2008 12:01 PM:I sure hope the real folks reading this blog realize the absolute negative bias of many of these bloggers. I list the exceptional accomplishment the CEO, Board and leadership provide for the hospital but they continue to suggest, imply, and outright lie to make their negative case because they some other lame agenda. They do not have your interest or well being in mind in the least. They only want to try and tarnish a wonderful community hospital.

1. Records profits last year
2. Hight Health grades by government regulators for the past 8 years.
4. Reinvested millions of dollars in advanced technology. With many first in all of SD County.
5. Provid care for the less fortunate in our community.
6. 70 thousand emergency department visits by our community annually.

Just to name a few of the outstanding accomplishments of our hospital.

Greg in Oceanside wrote on Sep 7, 2008 12:01 PM:While I'm not a structural engineer or expert on earthquakes, but somehow this whole bond issue begs for answers to a lot of questions.

Ok, everyone would like a new house to live in, or a new building to work in, but what's really wrong with the aging buildings on West Vista Way? Not up to "earthquake standards?" What "standards" were they built to when originally constructed? And, can any 'fat' be trimmed for the refurb?

Or, is there a deeper, underlying need for all this money that they're trying to secure with the bond?

To for profit wrote on Sep 7, 2008 12:20 PM:Uh, new homes? Where have you been the past 4 years? I don't know of any new homes.

The profit was generated from smart operational decisions. Where did the money go. Try 3 million for a 64 slice CT scanner or 3 million for a new cardiac cath lab or multiple millions for an advance electronic medical record that Sharp is just now adding to their hospitals.

Floyd wrote on Sep 7, 2008 12:29 PM:I did not include the monthly million-dollar bleed because it can't be controlled. The hospital is required by law to treat anyone who comes through their doors regardless of ability to pay. Most hospitals with an unable-to-pay patient have several options such as refusing admission (if the patient is stable) or stabilizing a patient (using the minimium necessary effort) and redirecting them to another facility. Tri-City Hospital, as a public entity, doesn't have that luxury (to the best of my knowledge, anyway).

For discussion purposes, I ignored the monthly million-dollar bleed and concentrated on controllable factors such as administrative salaries. With the top guy making a half-million a year and several Vice Presidents who report to him, an administrative salary cap of $99,000.00 should add a couple of million to the existing $10+ million reported profit. This would make it practical for the hospital to fully fund the construction effort from existing revenue.

Imagine to a little truth wrote on Sep 7, 2008 12:41 PM:Who would have ever imagined that citizens asking questions and discussing issues would cause anyone to be so upset? I did contact the 3 board members that have e-mail and asked a few questions. You wouldn't be surprised to hear, would you, that answers were not forthcoming? Is that what you expect of ELECTED officials? I kinda thought defending their position with facts was part of the deal. So, according to your thinking, unless I go to the California Legislature I shouldn't be upset that California has no budget. Sorry, I have sent e-mails and made my voice clear. My right to ask questions shouldn't upset anyone, except someone with something to hide.
And to Proud Supporter, how many hours have you had to flex to achieve the "profit" and in case you haven't noticed MANY PEOPLE in all businesses question the taking of huge profits by CEO's. Here's another one, are they going to mess with your retirement in this sale?

Vistulian nailed it wrote on Sep 7, 2008 12:57 PM:100% agreement with Vistulian's comments above.

Funny how these Board members think they are indispensible to the community or to anyone who might buy Tri-City. Kick them out and their sacred cows too. Tri-City is not a tertiary care hospital and it does not need to have every service available.

I completely disagree with the comments made in this article by Ralph Ferguson of the Association of California Hospital Districts. He is only concerned that another of his dinosaurs is dying. Take all his comments in the context of his position, which is to PROMOTE these relics called Hospital Districts.

Sell it now before the Board changes its mind and goes for Bond attempt #4. Any buyer can have my share for FREE!

healthcare exec wrote on Sep 7, 2008 1:00 PM:to Floyd
Regarding your suggestion to cap executive salaries at $99K/year. You would end up getting the very bottom of the management pool. You get what you pay for. Your suggestion would literally doom the hospital and kill people who need the services provided. Would you cap the salaries of doctors, nurses, other professionals also? Price and salary caps never work - study history.

To Vistulian nailed it wrote on Sep 7, 2008 1:12 PM:Please explain your "sacred cows" statement? What is in it for the Board members? They do not get paid for their service. Their only motivation is for the good of the hospital and the community. If there is no longer a District Board with the fire sale it does not affect them! It affect the community that depends on their vision for the community.

Mental health is a great example. There is no real profit in caring for these patients. If this service is not valued by a for-profit operation who will deal with these poor people? You and me at our door step because they will not have adequate care and medication so you and I will suffer due to violence and misbehavior because no one wants to care for them. But of course that is not your concern is it?

To Imagine to a little truth wrote on Sep 7, 2008 1:18 PM:So the reality is you REAL issue is that you are being flexed when there is no work to be done. Well, that just does not fly in the economy we are in. Business need to be as productive as possible just to make the bottom line in the economy.

CEO pay is consistent in this industry. The truth is that the CEO of Tri-City Hospital is the lowest paid CEO in all of San Diego County. That is the fact! You can complain of CEO pay in general but do NOT use the Tri-City CEO as a reason for your woes.

to Upset wrote on Sep 7, 2008 1:24 PM:That's crazy talk.

To Imagine wrote on Sep 7, 2008 2:41 PM:I agree with you 100% in regards to flexing and bonuses. Any time you hang that carrot in front of managers, there are some that will abuse their staff in order to get that bonus. There are many times we are working fast and furiously, without even time to catch our breath, only to be told to hurry up and finish our work so we can flex. It's one thing to flex when there is no work; most everyone understands that. It's another thing to overextend your staff and push safe staffing levels to the limit in order to improve that bottom line. Just ask nurses why some are still not getting breaks even though it's supposed to be mandatory. Or ask patients how long they have to wait for services even though they may have an appointment time. All that just so the manager can get his/her bonus. The caring hands of TriCity? I don't buy it anymore.

reply to Imagine to a little truth wrote on Sep 7, 2008 2:58 PM:I have never felt CEO's should get huge bonuses, IN ANY COMPANY but especially in hospitals. Searching for answers to the question "Why is work slowing down?" Askling questions and getting cajoling and non-responses.And people like you who act like there is something to hide.If you're not hiding anything, simply answer the questions and enlighten us all. Enough is out there for all to see, so that it appears decisions by Dr. Gonzales AND the board are the reason business has fallen off. Turning away contracts like they did with Blue Cross earlier, all without public in-put or discussion. Sharp was a good partner, so would Kaiser be as you can tell by the success at Palomar. Look at the earlier comment by a Kaiser pt., they'd love to go to a North County Hospital. The Board and Dr. Gonzales have gone out of their way to NOT imvolve the public.

This helps me wrote on Sep 7, 2008 3:25 PM:Good to know supporters of the board and CEO say too bad to workers. It is a fair question to ask why they let work go.

Ok lets take a look at it. wrote on Sep 7, 2008 3:54 PM:Good try. Who says the patient volumes are off? Your rhetoric thats all. Volumes are not off. Most of the Sharp business was capitated and just may come back because of better service at Tri-City. There is nothing to hide as you put it. Patient volumes fluctuate on a weekly basis. For example there is rarely elective surgery done on Friday so inpatient volume declines over the weekend. When the volume is up no one is flexed when volume slows down staffing needs to be reduced. Usually, the registry or per-diem is reduced for full disclosure.

I ask you, if the inpatient census is 300 patients and over the labor day week it reduces to 200 would you keep full staff at the hospital? Now lets take a little ownership here it's your business and your volume drops by 100 patients. Do you keep everyone there? Now remember your it's your business and your profit margin is 1 to 2% at best. Give us your CEO best practice?

Why not...... wrote on Sep 7, 2008 4:18 PM:Simply fire Art Gonzales. A less expensive, and less complex solution. He is incompetent, and his $600,000.00+ annual compensation package could clearly be put to better use. Tri-City needs an administrator who can bring together the Medical Staff, Non-Medical Staff, and Community. It can be done....I did it in LA, and it didn't take me having a Ph.D., and I clearly didn't require such an outrageous salary. Appropriately paid is one thinsg, this is another. The voters need to vote in a new board, who will be committed to responsible oversight, as relates to now and the future. A responsible board will locate a dedicated and responsible Administrator, who will create the "culture" that will allow this institution to provide quality care, compassionately, and who will set the tone, that Physicians, Nurses, Patients, Ancillary Staff, and the community are ALL customers, and who ALL should be treated with respect. When Tri-City has a CEO who garners ALL of our respect, then we will see change, not before. Healthcare is a profession that I went into for others, not for myself......Mr. Gonzales and the Board should consider thinking this way, as well. Art Gonzales, show some integrity, and resing....

Not so fast wrote on Sep 7, 2008 4:32 PM:By the way "THIS HELPS ME" Your statement shows some real insight. You refer to me as a "supporter of the Board and CEO"

You must be a non-supporter if so, there is no bond issue so what is your true mission to be working this blog. It's a fair question to ask.

To Why Not wrote on Sep 7, 2008 5:39 PM:Again, please give us some facts! You make some very bold statements about the CEO but you provide nothing to support your clams. Your statements is completely baseless but you show us an utter lack of integrity to make clams that you have done it before.

Give us some facts to back up your statements. The successes of the hospital has been stated here several times but you and many other here ignore the fact because they do not fit the model you are trying to create. You want to try and create a negative atmosphere at the hospital that does not exist. People reading this see through you rhetoric. Please give it a rest!

To why not wrote on Sep 7, 2008 5:53 PM:This must be the start of your campaign to run for the Board correct? Why don't you provide us with your name so we know who not to vote for.

To lets take a look at it wrote on Sep 7, 2008 7:06 PM:If you were CEO, would you force staff to take a cut in their pay for the good of the hospital while making no financial sacrifices yourself? Then, when the hospital ends up with a surplus thanks to the financial sacrifice made by staff, take a huge bonus for yourself, while giving staff a miniscule bonus? (I lose thousands of dollars a year due to flexing. My last bonus was less than $200. The CEO can get up to 30% of his salary, which would be around $150,000. Don't forget about the $12,000 per year car allowance.) Is this the best CEO practice you're talking about? Then no, I wouldn't do that because I wouldn't take money out of other people's pockets to line my own. I wouldn't ask those under me to make sacrifices I'm not willing to make myself.

lifer wrote on Sep 7, 2008 7:43 PM:As long as I have lived in the Tri-city area, the hospital has been asking for more funds for one reason or another. Seems to me, that like other big "agencies", better management would go a long way to improving services and hire more working staff.
Would really like to see an effective change at the hospital.

Not getting what we paid for wrote on Sep 7, 2008 7:46 PM:with millions paid to consultants, expensive ads, the management team still could not pass a bond for the last 3 years. There were virtually no oppositions the first 2 times. How can we possibly get worse management? We sure did not get what we paid for. I had enough with this bond.

Are all board members Saint? worked for absolutely nothing? Why will they fight so hard to keep such a position?

With so many problems, doubts, it is best that TriCity becomes a new hospital. A clean slate and fresh start. Employees deserve a better working environment.

what a mess wrote on Sep 7, 2008 7:51 PM:Ditch TriCity. It has no credibility left whatsoever.
Many cities have no District hospital and people are living and thriving just fine.
So sick and tired of the TriCity's scare tactic, treating everyone as an idiot.

To the person replying to all the comments wrote on Sep 7, 2008 8:17 PM:What is the reason you are so angry? I'd say you are a Board Member or manager with an ax to gind? You are full of half truths. As far as the CEO, it is simple, he should not take a large bonus out of a public facility, simple. As far as staffing, you should walk around and take a look on the floors, and in the ER, and lab. As for all the rest...you are half right in all cases. Since this seems to be one person arguing with many, perhaps you should learn to listen. Good Night!

What is up wrote on Sep 7, 2008 8:23 PM:Really except for Proud Supporter there appears to be someone with a definite agenda here. REally gotta wonder why?

Hoo wee wrote on Sep 7, 2008 9:39 PM:Looks like CEO critique's 10:45 am post hit a nerve!

Public Use wrote on Sep 7, 2008 9:43 PM:The Hospital has a Value. Even if you deduct from that value the cost to retrofit you will find the value is in the Billions of dollars of total Assets. If you take just 1 Billion and pay only 10% you will still have 10 Million. Last time I checked the total asset value of TCMC was in the 100s of Billions, and I know from experience that even at a "Fire Sale" the "Fair Market Value" is typically only discounted by no more than 20%. Thus, we could easily expect to get will in excess of a couple Billion from the sale of TCMC. I know how much Mission Community and South Coast Community were sold for and they too had financial difficulties at the time of the sales. South Coast still needs retrofitting. Both these Hospitals sold in the 1980s/1990s, and both went for a few Billion. TCMC is much larger than South Coast and actually larger and more established than Mission Community was at the time of its sale.

There are no "nay sayers" amongst us, just realists who understand that the Government should not run every enterprise nor should they be allowed to prohibit the Free Market from entering into a market area. Presently TCMC, as a Government Hospital, is the primary prohibitory for North County to receive a Private Hospital. However, if it is put up for sale in a fair and free market offer, you can be sure there will be significant bidding for the operation. Remember, TCMC is a well established and well respected Hospital. The ONLY real problems (other than current management) are that the ER is too small and one of the many buildings needs a retrofit for earthquakes. And we know that TCMC estimated the costs for such at about $600 Million. So, as a private investor looking at a few 100 Billion in assets that need about $600 Million in renovations and improvements, there is no reason for this to be a "Fire Sale!"

Floyd wrote on Sep 7, 2008 9:54 PM:It's not true that "we get what we pay for" because the chief administrator isn't providing $500,000 worth of performance. Right-sizing administrative salaries to their current performance level (that $99,000 cap) would match income to skillset.

Let it go... wrote on Sep 7, 2008 10:49 PM:"However, hospital board member Kathleen Sterling said she would not support any move that would remove the board from direct control of Tri-City."

Kathy can't you go find a homeowners association to get yourself on? We just want to sell this damn thing, okay?

from the back gate wrote on Sep 8, 2008 3:45 AM:If ignorance is bliss, we have some very happy people out there who write bad things about (their) hospital. Find out how much more money the great wonder of Palamor is going to [take] the people for because of their poor planning. Some where in the area of 500 million. Kind of like the second comming of a school bond in Oceanside. The building not only needs to be earthquaked but it is falling apart at the seams due to age and constant pounding it takes due to every day use. That 150.00 you spent to see the chargers lose yesterday could have paid for a couple of new pipes or some new fans. Stop complaining about the problem and do something. Selling the hospital sure wont help you get stitches in your thick heads after you get in a fight while tailgating and you dont have health care. Wont be a freebe around. Maybe some of you that complain the most, should re-evaluate what is a priority in life and what is entertainement.

To To the person replying to all the comments. wrote on Sep 8, 2008 7:47 AM:Your correct I have an agenda. To point out the truth. You again try to skew reality by saying I am making half truths. You try and redirect what the community should hear with your misstatements. You don't want the public to know how good of a hospital we have you want to beat it down for some reason. Why don't you tell us why?

You argue I am angry and to look at the hallways. Hello McFly! Good reason for a bond I would think. But of course you ignore the millions reinvested into the hospital. Now they need to move on from the bond because a few cannot see the value of having a new building to provide care or hate the hospital.

I personally am happy they are looking at alternative funds so people like you wont have a sounding board to trash the hospital for no real reason but hate.

I stand by ALL of my statements they are not half truths in the least. They are fact and the public needs to know the truth not your lies.

To wanna be CEO wrote on Sep 8, 2008 7:56 AM:Why wont you answer the flexing question? Because your only reasons for being in here is to trash the CEO. You don't want to comment on the real issues do you?

While I do not agree with the bonus program at the hospital you must give them credit. The bonuses are distributed based on patient outcomes and financial benchmarks. If the hospital hits them ALL staff from the CEO to the part time lowest paid employee receives a bonus. Again, I would rather them no use the bonus program but you cannot dispute that it's a fair program for all.

To Proud Supporter wrote on Sep 8, 2008 12:38 PM:You obviously didn't read the letter last week from a nurse in the Neonatal ICU/CCU. She was shaming all of us for voting no. She described having to use fans in the unit where they care for critically ill BABIES, because the heating/cooling systems were in poor working order. Your list of "wonderful" things TCMC has done-Record Profits, Reinvesting MILLIONS of dollars in new Technology-doesn't hold much water if TCMC can't even invest in keeping the ILL BABIES and nurses comfortable! How can anyone be a "proud supporter" of a hospital that spends it's money elsewhere (bonuses, millions on ads/commercials, etc) and not on itself, in a unit where critically ill babies are cared for? What a joke!

Randy wrote on Sep 8, 2008 1:42 PM:Discussion of the sale of the hospital is premature. If the bond's failure is primarily due to the economic recession, all that the hospital needs to do is propose another bond once the economy's economic health is restored.

Kathleen has got to go wrote on Sep 8, 2008 2:10 PM:"However, hospital board member Kathleen Sterling said she would not support any move that would remove the board from direct control of Tri-City."

Sounds like we need to sell the hospital to a private concern and encourage Kathleen Sterling to find herself a new line of work.

Floyd wrote on Sep 8, 2008 5:27 PM:I am still amazed that anyone would think a $99,000 cap on administrative salaries would cause medical doctors to run around killing their patients. That's just loopy logic. If you happen to be in a position of authority anywhere, please resign immediately and seek out the services of a mental health professional for your own good (and ours!).

Proud Supporter wrote on Sep 8, 2008 5:31 PM:The nurse that wrote the letter only has the absolute best interest of her patients in mind. Thats why nurses are so wonderful.

The hospital has invested millions in the facility and infrastructure also. Expanded ED, New womens diagnostic center, new cath lab, new 64 slice CT and suite, hyperberic medicine facility, remodeled the NICU just to name a few. I never said the did not.

Where do you focus your limited dollars when the building needs over 700 million in upgrades? That's why the the hospital asked the community to help.

Spending money in advertising to try and pass the bond was necessary because much of our society does not get involved anymore. The hospital had the opportunity to address all of the facility issues at one time with the bond but now they will need to focus on one area at a time. This will be very challenging and some area cannot be addressed for many years.

Many in the community complain the hospital did not do enough in advertising and marketing to get the bond past. Rather than be so negative why not support them? They really are doing a great job for our community. Regardless of the older parts of the building the are provided advance medical care to our community. Thats why I support them.

Susan wrote on Sep 8, 2008 6:45 PM:Where is the suggestion about flexing the CEO's salary?

CarlsbadDude wrote on Sep 8, 2008 10:20 PM:Current Tri-City Hospital Board = OUT! Scripps = IN!
PS - NO MORE BONDS TO VOTE ON, AND NO MORE TRYING TO SNEAK STUFF BY US USING A "MAIL BALLOT". SHAME ON YOU TRI-CITY BOARD.... SHAME ON YOU!

Hey the price went up wrote on Sep 8, 2008 10:35 PM:Proud Supporter: You say the place now needs "over 700 million in upgrades." Are you hinting that TCMC's TAX "A" was just the first installment of many more to come? If you wanted a never-ending account on the backs of the taxpayers to build the west coast version of the Mayo Clinic*, why didn't you just state this fact up front?

*FYI: Mayo is not a beloved Hospital District. It is one of those private institutions that you fear so much. How could they possibly build such a thing without nailing the local homeowners?

Kathleen Has Got To Stay wrote on Sep 9, 2008 6:42 PM:Hey Randy at 1:42 who misstated P.Sisson's summation - the following is what Kathleen stated selling the hospital is the easy way out.

That's why Kathleen Sterling said "Absolutely not, the public has more control over the destiny of their health care by maintaining a public health care board. Selling ---- that's a process of looking for an easy way out."

Sterling said she believes the hospital can cut costs in order to free enough money to pay for needed upgrades.

Remember -- back when CEO Lauri, and board members - wanted to sell to Sharps, Scripps, Tenet, Columbia, Fallbrook or Palomar, etc... The troika (Garrahy, Mitchell, Merlock) 3:2 against Reno & Kellet... At that time today's current board member Rodriquez an insider - Chief of Staff.

Horton and Halfon you got elected when the board increased from 5 to 7 -- With adding these you two guys to the mix... you joined with CEO Gonzo pushing policies "singing a song" about "no river of return."

Modestly spending the hospital should been -- hiring a million dollar team and saved money... but Tri City's leadership lacks self-control or ability to be fiscally conservative.

Similarly -- like most families living on credit cards, with a big SUV, no or limited health insurance, and a loan they refinanced failing to read the small print -- but like the guy who sold them the goods... poor decision makers -- tainted the house of Tri City long before Sterling.

To Proud Supporter wrote on Sep 9, 2008 8:11 PM:You missed my point! The nurse that wrote the letter was saying "shame" on all the NO voters. I'm saying the same thing to all the "proud supporters" out there! Shame on TCMC for not taking care of it's own employees and the critically ill BABIES in their care by not fixing something as common as a heating/cooling problem! Instead, this nurse described having to put out fans so the nurses don't pass out, not to mention the burden it puts on the babies. TCMC has paid millions on the ads, bonuses, wellness center, etc, but can't fix the heating and cooling system? Then they come to the property owners for half billion dollars!? No wonder the public doesn't trust TCMC when we hear this kind of thing going on. It's sad to say the least. I know the nurse has her fragile patients best interest in mind, that's what wonderful nurses do-I know because I've been a nurse for over 30 years and I would do the same thing. Problem is, I'd go to the right people to get the problem fixed, not expect a select group of citizens to hand over a blank check.

Attn Kathy and Board wrote on Sep 9, 2008 11:41 PM:Selling TCMC is not only the easy way out, it is the OBVIOUS way out. The question is are you collectively smart enough to see that?

We don't want you or your hospital district. Got it?

Full Parking Lot wrote on Sep 11, 2008 9:37 PM:Guess if things are so bad, the parking lot should be empty, but it was full today, not in the ER, but everywhere. Hopefully, Palomar and Scripps will have overflow parking. Sometimes you have to invest into the future, and it looks like alot of Tri-City residents did not want to do that. With only 1/3 of the prepaid ballots being returned, one can assume that the other 2/3 should have been printed in Spanish. Like Randy said, the 3rd time was a charm and he was one of those former board members who went to Sterling University. Should be lots of parking spaces in 2013, site of the new Charger stadium.

Deja Vu wrote on Sep 13, 2008 6:51 AM:The bond's failure is due to a board who hired a CEO and his "million dollar" team - all they have done is thought of themselves -- while buying the support of insider doctors (who have undermined Tri City's independence for Scripps) to giving themselves big bonuses using accounting maneuvers, to keeping the same accounting firm for 15 years. Come on its about the culture of the organization -- its now a tyrannical dictatorship ran by CEO Gonzo with a lap-sucking board who is compromised with multiple direct and indirect conflicts. And the board’s legal counsel -- a noted law firm -- benefits from all of those billable hours when it comes to the end of the year for their partnership’s bonuses too.

Hit me babe one more time wrote on Sep 13, 2008 2:40 PM:I am proud of voting NO’s on the three more-and-more-miserably-failed bond measure ballots?

Deja Vu wrote on Sep 14, 2008 4:59 PM:Sterling said, "Absolutely not, selling is an easy way out ... that's a process of looking for an easy way out."

Sterling said she believes the hospital can make the "appropriate changes and cutbacks in order to free enough money to show the community we mean business to partner with you to pay for needed upgrades!"