Ann Marie McCrystal

Ann Marie McCrystal’s answers to 10 community questions posed by Vero Communiqué.

1. Have you ever spent any time at the health care providers funded by the Indian River County Hospital District (IRCHD) to observe how their facilities work (e.g. spent a day in the Indian River Medical Center [IRMC] emergency room) and have you ever met with any indigent members of the community to understand their life situations?  If so, generally speaking, what have you learned?\

“I have spent time at a number of the provider agencies funded by the IRCHD, as well as the ER of IRMC.  I am familiar with the overall needs and problems of those members of our community classified as “indigent”…and understand the stress related issues that these people are faced with.  I have learned that not all issues can be resolved, but the District is in a position to address many of those issues with the programs that are provided through the funded agencies.”

2. Are you concerned about the adverse impact of Sebastian River Medical Center’s (SRMC) $64 million expansion may have on any of the health care providers supported by IRCHD? Would you be in favor any opportunities for the IRCHD to partner with SRMC to better serve the county’s underserved populations?

“SRMC is entitled to expand its facility as it deems appropriate.  SRMC has the right to approach IRCHD regarding the underserved populations.”

3. Are you familiar with the District’s Vision, Mission and Strategic Plan recently developed and approved by the Trustees? Do you support the IRCHD transitioning from a “Hospital” to a “Health” District? Additionally, if IRCHD is to become a “Health” District what other organizations, would you like to support?

“I am familiar with the IRCHD’s Vision, Mission and Strategic Plan that was recently developed and approved by the Trustees.   The subject regarding IRCHD transitioning from a “hospital” district to a “health” district is in a preliminary stage of discussion.”

4. In the strategic plan it says that: “By November 1, 2016, staff will recommend method for utilizing the Health Needs Assessment data in all District communications.” Is there a need for a new Health Needs Assessment to collect data from for-profit health care providers such as private practitioners and even SRMC itself, rather than only the not-for-profit organizations that were included in the current assessment?

“I believe there is sufficient data in the current Health Needs Assessment to guide the Trustees in its mission.”   

5. On August 18, 2016 IRMC CFO Greg Gardner spoke before the IRCHD Trustees and projected a breakeven operation for the fiscal year ending 09/30/16. When asked why the Sebastian River Medical Center, with the same demographics, makes money and we don’t, Mr. Gardner said it was due to the “egregious” disparity in private payer rates between what IRMC, LRMC and SRMC are paid for the same services. With Blue Cross, for example, SRMC is paid twice what IRMC is paid and Lawnwood Regional Medical Center (LRMC) is paid three times as much for the same services. This speaks to different contracts between the hospitals and the private payers. SRMC is owned by Community Health Systems (CMS), who owns 200 hospitals. Mr. Gardner said if IRMC was paid the same rates by Blue Cross as SRMC, it would bring $50 million to IRMC’s bottom line. Obviously an organization like CMS has more leverage. Do you support the IRCHD taking the necessary steps to sell IRMC to organizations like CMS to gain leverage to bring more to the bottom line?

“No..for a variety of reasons.”

6. Hospitals that are not part of a university, a health system or a chain of private hospitals are often called “community hospitals.” A regional hospital is a hospital that serves a larger area than a local hospital. On its website, IRMC indicates that “in late 2006, to reflect the transition from a good community hospital to a top-quality medical center, the hospital changed its name from Indian River Memorial Hospital to Indian River Medical Center. Indian River Medical Center is focused on providing quality healthcare to Indian River, St. Lucie, Martin, Okeechobee, Orange, Osceola, Polk, Brevard and Seminole counties in Florida. Counties.” So is IRMC a community hospital and what would be the difference if IRMC became part of a chain of private hospitals?

“Indian River Medical Center is a community hospital. IRMC has a Board of Directors that can address this question together with the IRCHD Board of Trustees and the residents of Indian River County.”

7. There has been a lot of community discussion that IRMC is not transparent to the IRCHD with its financial data surrounding personnel issues, other subjects including financial details on IRMC’s Heart and Cancer Center, affiliations with Duke University’s programs and why, for cancer, IRMC chose Duke rather than the Moffitt Cancer Center; as well as, whether or not the private practices acquired by IRMC are making or losing money. In accordance with the IRCHD lease with IRMC, Section 9.f.i. b, “with reasonable promptness such other financial data requested by Lessor (IRCHD) as may be demonstrated to be necessary to protect the interests of the Lessor” shall be furnished to IRCHD.  Additionally, two IRCHD trustees sit on the IRMC Finance Committee.  With this background, why can’t these transparency issues be resolved as a duty to the Indian River County taxpayers who support the IRMC?

“I believe any transparency issues of the past have been resolved to the satisfaction of both IRMC and the IRCHD.  Also, IRMC BOD meetings are publicized and can be attended by any taxpayer that might be interested in doing so.”

8. Do you feel that the IRCHD is over-reaching its duties by trying to run the IRMC rather than just fund it? Do you feel the IRCHD is trying to run it?  If not, should they pay more attention to doing so?

“I don’t believe any IRCHD trustee feels it is the responsibility of the IRCHD to “run” the hospital.”

9. Have you had any communications of any type with IRMC administration, any members of the IRMC Board of Directors, or any of the IRCHD funded organizations related to running for or serving on the IRCHD?  Do you have any personal relationship with any member of IRMC administration, members of the IRMC board of directors, or members in the same capacity of any IRCHD funded organizations? If yes to either, what was the content of those conversations about the IRCHD or nature of the personal relationship and how do you plan to avoid any perceived or real conflicts of interest

“Both boards are composed of volunteers who wish to serve in the community.  Both the BOD of IRMC and the BOT of the IRCHD are governed by the State of Florida Government in The Sunshine Law.”

10. Please share your thoughts on how the Affordable Care Act (Obamacare) has affected our indigent population, IRMC, the health care providers IRCHD supports and the private practitioner community.

“The Affordable Care Act has impacted our community as well as every community throughout the country.  The trustees of the IRCHD are aware of the many changes that have affected the traditional health care delivery system in our country and are actively engaged in dialogue pertinent to the effects that these changes have on the county’s indigent population, funded agencies and IRMC.”

 My last thoughts:

“In August 2015 I was appointed by Governor Scott to fill a seat on the Indian River County Hospital District Board as a result of the resignation of a trustee prior to completion of his term.  This past year I feel I have made a valuable contribution as a trustee and my years of experience as a Registered Nurse and volunteer health care advocate, as well as an administrator for a medical practice lends support to my desire to continue as an IRCHD trustee for the remaining two years of the four-year term. 

 This past year the BOT adopted a well formulated Strategic Plan, which I have reviewed in great detail, as well as the recommendations provided by the members of the Healthcare Needs Assessment Task Force.  There is still many critical issues that need to be addressed, and I would like to continue as a Trustee in resolving those issues.  Vote November 8th for Ann Marie McCrystal, Indian River County Hospital District Seat 6.  Thank You!”