More fallout at Health Care District as two top hospital administrators depart

— Turmoil at the Palm Beach County Health Care District continued to roil Wednesday as CEO Dr. Ron Wiewora said the district's two top hospital administrators had left and their administrative duties moved to the district's headquarters to "ensure fiscal accountability."

Brian Gibbons, Jr. -- who was Lakeside Medical Center's top administrator -- and Larry Singleton -- the hospital's chief financial officer -- have both left.

Wiewora's announcement came after the district's board agreed in a two-hour-long closed session to accept a settlement offer of $85,000 with another terminated employee, ousted compliance officer RoxAnne Harris, who has sued claiming she was retaliated against for launching an investigation into the district's information technology department. Harris filed suit after the district's board deadlocked on a similar settlement proposal last month.

Insurance will cover a portion of the Harris settlement, Wiewora said, although the exact figure is still to be determined.

At Lakeside Medical Center, Wiewora said there wasn't any single issue, but multiple administrative problems that led to his decision to make a leadership change.

The hospital required a taxpayer subsidy of nearly $6.7 million on admissions of about 3,000 patients last year. The subsidy was $6.1 million the year before. That was required in part, because of an accumulation of $17 million worth of uncollected bad debt over the years, said Chief Financial Officer Holly Vath.

While it's true that the region is poor and unemployment is significantly higher than the state average, Vath said, the district has assumed that 100 percent of uninsured or "self-pay" patients' care is uncollectable. That may not be the case, said Vath, speaking during the district's strategic planning meeting.

Vath said the district will soon publish a request for proposals to see whether an outside firm could affordably take over the hospital's entire revenue collection duties, from the gathering of insurance information at the time of admission, to the business office billing process and the keeping of medical records.

Wiewora said there may be benefits to having a larger firm with billing expertise take on the job.

"One of the issues we have had at the hospital is, we have had maybe one person who knew Medicaid well, one who knew Medicare well, and as people would go out on family medical leave, have sickness, things would not get done as well," Wiewora said.

Public records obtained by The Palm Beach Post show that some staff doctors in the Health Care District's physicians practice had gone months without submitting bills for their services in 2010 and 2011. A recent inventory of hospital supplies was inexplicably off by $370,000. Recent audits have found problems with the documentation required by some external grants.

Dismissed were Brian Gibbons, Jr., who had been Lakeside's top administrator since the new hospital opened in 2009, and Larry Singleton, who had served as the hospital's chief financial officer since July 2010. Both worked their last day Feb. 1, said district spokeswoman Robin Kish.

Gibbons had launched the district's medical residency program, a training program intended to create a pipeline of young doctors willing to consider practicing permanently in the rural community, Wiewora said. Singleton had been working to stop outsourcing billings at the physicians' practice and instead bring them in-house.

While the district searches for a news hospital administrator, patient safety officer and registered nurse Nancy O'Nea, will direct the hospital's operations, and she will report to the district's chief institutional officer, Darcy Davis, Kish said. The district is looking for a new administrator.

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