By Meghan Cunningham : April 13th, 2020

Recommendations include short-term stabilization efforts and steps toward a long-term solution

Citing ongoing fiscal challenges, exacerbated further by the COVID-19 pandemic, The University of Toledo will seek requests for proposals for a potential acquisition, lease, management agreement or other transaction of its community hospital.

“We are undertaking this process to be responsive to the community’s concerns about access to healthcare and the University’s economic realities. We remain challenged as a small, independent hospital,” UToledo President Sharon L. Gaber said. “We hope that a solution emerges that addresses both of these concerns.”

In moving forward with examining all options for the hospital, University officials announced a planned public request for proposal (RFP) process during Monday’s regularly scheduled board meeting. The RFP to seek possible partnerships or sale of the University of Toledo Medical Center hospital (UTMC) is being finalized and is expected to be posted this week, with qualifying criteria needed to participate in the process. University officials have been keeping the Governor’s office informed, most recently communicating to the Chancellor of Higher Education, Randy Gardner, who the Governor designated as the University’s contact for this issue. An update on the RFP process is expected at the Board’s next regular meeting scheduled for June 22.

The University’s decision to move forward with an RFP process followed a financial update presented by Rick Swaine, UTMC’s current CFO and incoming CEO, who noted the hospital continues to struggle financially with the losses at the close of February at nearly $14.8 million. Preliminary implications of the COVID-19 response, including the state’s order to suspend all elective procedures, has substantially increased the financial strain on UTMC.

The RFP process also follows short-term stabilization efforts. On March 9, 2020, the Board of Trustees amended UTMC’s medical bylaws by removing the faculty-appointment restriction for practicing physicians. This has resulted in 12 additional community physicians applying for practicing rights at UTMC.

UTMC leadership also continues to work on a number of cost reduction strategies, including reviewing and reassessing all contracts and adjusting staff levels to align with the current needs during this pandemic response.

“We have committed to being as transparent as possible as we work through the RFP process and the cost reduction strategies,” UToledo Board of Trustees Chair Mary Ellen Pisanelli said. “As stewards of the University and the state, we must consider all options.”

The University previously shared at the February Board of Trustees meeting that UTMC’s losses for fiscal year 2018 totaled $3.5 million and grew to $7 million in fiscal year 2019.

its future? gone from UT

Guys,

Could someone in plain english explain how UTMC arrived at this point of decay. Is president Gaber culpable? Promedica? How long has the decline been going on? Is this directly related to the medical school merger? What happened? Will the doctors at the Pavillion building remain (ie. pain specialists, etc). I have read almost all of the fantastic, well detailed posts in this site digging deep into this issue. Obviously some people are well connected with inside knowledge but I’m still not getting it and I have many holes in my understanding. I’m asking a lot but if someone could take the time I would be deeply appreciative.

Sincerely
Ned

Go Rockets

Good questions.

From the customer side, I've felt more comfortable there by far over any other hospital or diagnostic center in Toledo. Nicest recovery room I've come across, that includes UM or the Clinic and the prep nurses, the doctors every bit as good, comforting, within their lane of course. The campus is well organized and IMO the best architecture in the area. It's a neat place for a walk with a ton of different views and comfortable places to sit and think. Has the best hot chocolate machines. Well ok, one complaint. There's that one restroom where the TP dispenser is about a foot off the floor. That's probably what went wrong. Things domino.

(04-14-2020 06:42 AM)IamN2daRockets! Wrote:  Guys,

Could someone in plain english explain how UTMC arrived at this point of decay. Is president Gaber culpable? Promedica? How long has the decline been going on? Is this directly related to the medical school merger? What happened? Will the doctors at the Pavillion building remain (ie. pain specialists, etc). I have read almost all of the fantastic, well detailed posts in this site digging deep into this issue. Obviously some people are well connected with inside knowledge but I’m still not getting it and I have many holes in my understanding. I’m asking a lot but if someone could take the time I would be deeply appreciative.

Sincerely
Ned

Go Rockets

There really is not a "clear" answer to the problem, as many factors combined.

1) The ProMedica partnership pushed some operations/practices to Promedica facilities, thus cutting the number of both inpatient services and sub-sequentially patient registrations, which was coupled with a general year to year trend of fewer patients visiting UTMC thus cutting overall operating revenue.

2) The hospital itself has been paying exhorbitant fees for unnecessary services and licenses given the market it services (Trauma I and various pharmaceutical and treatment licensures that were going unused, but still being paid for). Some of these were in the 7-figure rate PER year, either just to have the designation, or to staff to ensure that designations were kept.

3) Administrative and Clinician bloat, as certain departments and independent physicians were moved to Promedica facilities, their salaries were being paid in part or in full by UTMC, thus causing expenses to not drop by a similar rate that revenue had been.

The ProMedica partnership is looked at by many as a "bad" thing, but it has brought in considerable research dollars, and is a $50,000,000 positive line-item on the budget every year. The primary issue is how that money was SUPPOSED to be split between both the patient care and instructional portions of the campus, and how it has basically been fully absorbed by he patient care arm, thus causing more budget stress for University Academic Affairs.

Also, whenever UTMC is mentioned, I'm obliged to also mention that UTMC depleted University cash reserves by roughly $30,000,000 by way of Lloyd Jacobs due to unnecessary and underutilized capital improvements (the Sim Center boondoggle).

Thank you very much. It sounds like an incredibly ill managed situation. This is shameful. How could we deplete such a valuable asset with such poor execution?!?!. Rhetorical question for sure and cynical as well. This entire situation is DEEPLY disturbing to me as a Toledo resident. Our civic and educational leaders are an embarrassment. A COMPLETE EMBARRASSMENT

(04-14-2020 09:33 AM)IamN2daRockets! Wrote:  Thank you very much. It sounds like an incredibly ill managed situation. This is shameful. How could we deplete such a valuable asset with such poor execution?!?!. Rhetorical question for sure and cynical as well. This entire situation is DEEPLY disturbing to me as a Toledo resident. Our civic and educational leaders are an embarrassment. A COMPLETE EMBARRASSMENT

I know that your response was one of exasperation, but to lend some additional context to all of this, the ProMedica deal was done to try to save the hospital, as it was has been in poor financial straits since the merger in '06 (hell, that's WHY the merger happened). Unfortunately (or fortunately depending on your position), the University now has to worry far more about the financial position of it's primary function for the past 148 years, educating students, not just the past 13 years of providing patient care, if it is to survive. It's not the UT's leadership (save the Jacobs years...) caused anything worse to happen, heck, they may have prolonged the life of the hospital itself...and remember, this educational entity will still remain AND be a part of UT, this is simply the hospital, and it will likely remain a primary care facility after the sale as well. There isn't really anything completely embarrassing about this in the grand scheme...an educational entity was asked to operate a patient care facility, something that is most certainly not their expertise, and this is the end result.

(04-14-2020 10:27 AM)BearcatMan Wrote:  

(04-14-2020 09:33 AM)IamN2daRockets! Wrote:  Thank you very much. It sounds like an incredibly ill managed situation. This is shameful. How could we deplete such a valuable asset with such poor execution?!?!. Rhetorical question for sure and cynical as well. This entire situation is DEEPLY disturbing to me as a Toledo resident. Our civic and educational leaders are an embarrassment. A COMPLETE EMBARRASSMENT

I know that your response was one of exasperation, but to lend some additional context to all of this, the ProMedica deal was done to try to save the hospital, as it was has been in poor financial straits since the merger in '06 (hell, that's WHY the merger happened). Unfortunately (or fortunately depending on your position), the University now has to worry far more about the financial position of it's primary function for the past 148 years, educating students, not just the past 13 years of providing patient care, if it is to survive. It's not the UT's leadership (save the Jacobs years...) caused anything worse to happen, heck, they may have prolonged the life of the hospital itself...and remember, this educational entity will still remain AND be a part of UT, this is simply the hospital, and it will likely remain a primary care facility after the sale as well. There isn't really anything completely embarrassing about this in the grand scheme...an educational entity was asked to operate a patient care facility, something that is most certainly not their expertise, and this is the end result.

Part of the problem, documented on the college of medicine's website under Affiliation Agreement, is that UTMC was diverting $25 million of its yearly profits to the college of medicine. Promedica pledged $50 million yearly to the COM for 50 years. I assumed, obviously wrongly, that part of that money would take monetary pressure off of UTMC and make it solvent. Nobody, including the president, has addressed this. And nobody has been transparent.

Thank you Bearcat and Detroit.

Certainly a long term issue now reaching a Covid boiling point. Covid will be the "tipping point" for so many things when we look back like 9-11.

There is certainly something amiss in the UT/Promedica merger financials. Something doesn't seem to add up to me. I too believed that the merger also included some spin-off of funds for UTMC but maybe this was never the case. Perhaps the merger was done with the defined intent to close UTMC and "merge" the medical school program with the ever growing Promedica and remove the lead weight. That time has arrived with a thud.

Go Rockets!

(04-14-2020 09:33 AM)IamN2daRockets! Wrote:  Thank you very much. It sounds like an incredibly ill managed situation. This is shameful. How could we deplete such a valuable asset with such poor execution?!?!. Rhetorical question for sure and cynical as well. This entire situation is DEEPLY disturbing to me as a Toledo resident. Our civic and educational leaders are an embarrassment. A COMPLETE EMBARRASSMENT

You also need to look at the changing heath care industry across the US, small independent operations like UTMC have been failing and either merged or disappearing everywhere in recent years. Mercy and Promedica provide full range of services and treatments that have attracted customers, UTMC simply can not compete against those entities in this regional market. Large scale corporate heath care is the current trend. Plenty of mistakes and mismanagement regarding UTMC (and MCO/MUO) have occurred over the last 20 years,but I doubt that their prospects would have been in any better given current regional and national health care marketplace. Go ahead and blame Gaber and Promedica but the agreement was to benefit College of Medicine students and their training after all UT is a institution of higher education, so that is where the focus and priorities needs to be, not running a local hospital. Better to move on and let others in the health care business operate a hospital.

(04-14-2020 04:13 PM)PaulJ Wrote:  

(04-14-2020 09:33 AM)IamN2daRockets! Wrote:  Thank you very much. It sounds like an incredibly ill managed situation. This is shameful. How could we deplete such a valuable asset with such poor execution?!?!. Rhetorical question for sure and cynical as well. This entire situation is DEEPLY disturbing to me as a Toledo resident. Our civic and educational leaders are an embarrassment. A COMPLETE EMBARRASSMENT

You also need to look at the changing heath care industry across the US, small independent operations like UTMC have been failing and either merged or disappearing everywhere in recent years. Mercy and Promedica provide full range of services and treatments that have attracted customers, UTMC simply can not compete against those entities in this regional market. Large scale corporate heath care is the current trend. Plenty of mistakes and mismanagement regarding UTMC (and MCO/MUO) have occurred over the last 20 years,but I doubt that their prospects would have been in any better given current regional and national health care marketplace. Go ahead and blame Gaber and Promedica but the agreement was to benefit College of Medicine students and their training after all UT is a institution of higher education, so that is where the focus and priorities needs to be, not running a local hospital. Better to move on and let others in the health care business operate a hospital.

I will say this, UTMC is the only hospital besides Toledo Hospital in NW Ohio that has high performing specialties according to USN&WR. Mercy has none.

Also, where is the $50 million Promedica is giving to the COM each year? Take half of that and you make the medical school tuition free (in-state) and start getting students that would usually pick top 20 schools. Promedica said they wanted to improve the COM, but incoming MCAT scores don't show that. And then there is the $250 million for improving the COM facilities. Haven't seen that yet, but expect it may happen when the college is moved to the Promedica Toledo Hospital campus.