Sun Sentinel Palm Beach Edition
Broward Health should reconsider troubled firing of its interim CEO
From the moment you stepped foot in the Broward Health boardroom on Thursday, you knew something was up. The normally chatty crowd was huddled, heads-down and hush-hush. The barebones agenda had a last-minute update: “code of conduct.” And when interim CEO Pauline Grant walked in alone, you felt a sense of doom.
Sure enough, moments after Chairman Rocky Rodriguez called the meeting to order, an outside lawyer hired by the system’s controversial general counsel announced probable cause had been found that Grant violated a federal anti-kickback law.
What? Pauline Grant was taking kickbacks? It was like hearing your devout mother had been caught stealing food from the grocery store.
Last January, when the board picked this popular Broward Health North administrator to replace then-interim CEO Kevin Fusco pending the selection of a permanent leader, the audience erupted in cheers. On Thursday, many of those same people sat in shock, waiting to hear what Grant had allegedly done wrong.
But no one ever said. Not a single specific was offered. And not a single commissioner asked.
Instead, by a 4-1 vote, they quickly fired Grant and restored Fusco, whom they’d demoted amid complaints of chaos and an atmosphere of fear. Also without discussion, they surprisingly voted to hire a management company. This, despite being down to three finalists in their search for a permanent CEO.
Before firing a respected employee of nearly 30 years, wouldn’t you think commissioners would want to know what Grant had supposedly done wrong?
We got the sense they already knew.
Board process ‘stinks to high heaven’
But that’s impossible, right? For not only does Florida’s Sunshine Law prohibit board members from talking to one another outside of public meetings, it prohibits people from serving as back-channel conduits who help decision-makers avoid public discussion of matters in the public interest, matters on which they will vote.
Yet in the absence of public information, there was Commissioner Linda Robison saying Broward Health could not have its interim CEO “be under criminal investigation and still be in charge of the facilities.” Under criminal investigation? By whom?
And new Commissioner Beverly Capasso, a former CEO of Miami’s Jackson Memorial Hospital, saying: “We all know what the right thing is to do.” Really? What all did they know?
And Commissioner Christopher Ure warning attorney Burnadette NorrisWeeks, who answered Grant’s urgent call for help an hour before the meeting, not to dig too deeply. “Your suggestion that we go into those type of details in this forum would be horrible advice.” When we later asked Ure for specifics, he directed us to General Counsel Lynn Barrett, who didn’t return our call.
The lone dissenting commissioner, Maureen Canada, told us Barrett had twice tried to reach her before the board meeting. She asked the general counsel to put the information in writing, but received nothing.
“It clearly shows that Lynn is a conduit,” Canada said. “She called me the night before and left a message saying she wanted to speak with me before the meeting. I did not call her back because I don’t trust that what she says is what she will do. And I have made clear to her several times that whatever you have to communicate, you communicate via email. She texted me the next morning saying she needed to speak with me before the meeting, to please give her a call . ... She was clearly reaching out to the board members, at least she reached out to me.”
The irony is that Broward Health commissioners regularly trumpet their commitment to transparency. We don’t buy it.
A history of closed-door impulses
Last December, board members went behind closed doors to approve a no-bid contract with Zimmerman Advertising, which is now under the state review. Two months later, they tried to go behind closed doors to discuss a private investigator’s allegation that Barrett was obstructing justice in an FBI investigation. Regularly, the district gives severance agreements with confidentiality clauses to people being dismissed, including those accused of wrongdoing. Now, after reaching the finish line on a CEO search, they voted without discussion to instead hire a management company. And after brief comments from a Louisiana attorney they met for the first time Thursday, they fired their interim CEO.
“It stinks to high heaven,” says Barbara Petersen, president of the First Amendment Foundation and an expert on Florida’s Sunshine Law. “If the attorney individually briefed the board members in an attempt to avoid a public discussion of the allegations and/or relayed information between them and/or polled them, then (she) certainly violated the law.”
Petersen says there’s case law out of Duval County, where an attorney met privately with school board members facing a federal desegregation order. “We don’t know that the attorney was relaying information or polling the members, but she was discussing the case individually with each board member and somebody sued under the Sunshine Law and the court said that was a violation of the law. They said rapid-fire oneon-one meetings were a violation of law.”
“We also have the Florida Supreme Court saying anything done in an attempt to avoid the Sunshine Law can itself be a violation of the law, so what they (Broward Health board members) did is highly questionable. It is certainly a violation of the spirit and intent of the law,” Petersen said.
We agree. So we called Broward State Attorney Mike Satz on Friday to ask whether his office — which has the statutory authority to prosecute alleged violations of the Sunshine Law — might investigate this incident.
Satz called back a few hours later and said he had decided to open an investigation. “We’re looking into it.”
What welcome news. With $1.3 billion in revenues flowing through this taxpayersupported health care system every year, this board needs to know our community expects the highest standards.
Plus, votes taken in meetings that violate the Sunshine Law can be overturned in court.
What did Pauline Grant do?
In the absence of information about the allegations facing Pauline Grant, it’s easy to think the worst — she took bribes.
To her credit, Grant was the only person willing to speak with us about the allegations. We also received a copy of a letter she sent the board the day before she was fired.
Grant says the complaints against her are three-fold.
First, for about five years, she’d served on the board of directors of the elder-care community John Knox Village. She said her volunteer community service was well known at the district. But in October, three investigators hired by Barrett told her she had a “known conflict of interest” because John Knox has a financial arrangement with Broward Health.
“I was without words,” Grant said. She immediately resigned and sent a copy of her resignation letter to Broward Health’s ethics officer. To her surprise, absent a public records request, someone sent her letter to a Tallahassee-based Politico reporter, who wrote that Grant’s letter “comes amid allegations that for four years she accepted kickbacks.”
Four years of kickbacks? The Politico article paints a terrible picture. Grant called it “character assassination.”
From speaking to Grant and others, reading the report of the independent review organization recruited by Barrett, and listening to what was said at the board meeting, here’s the broad outline of the allegations, as best as we can tell:
In November 2015, someone made an allegation on Broward Health’s anonymous hotline that for four years, Grant had accepted kickbacks on surgical call coverage.
Grant says the complaint came from Dr. Steven Silberfarb, a Margate orthopedic surgeon who wanted to be placed in the call rotation at Broward Health North. Silberfarb didn’t respond to our request for an interview.
Like all hospitals with trauma centers, Broward Health North pays specialty surgeons a daily rate to be on call for emergencies. Grant said Silberfarb was eventually placed in the rotation, but had a bad patient outcome, missed a peer-review meeting and was dismissed by the medical director. She said he then filed a complaint alleging she gives trauma call to surgeons who send their patients to her hospital. Federal law prohibits hospital administrators from giving doctors anything of value in return for referrals.
We don’t pretend to be an expert on the Stark Law, but the system’s in-house compliance officer, as well as an attorney from Barrett’s office, had looked into the complaint and found no basis.
But the outside review organization took a second look because, as Barrett told the board, the first review “wasn’t substantive.”
In her letter, Grant noted that 84 complaints had been logged on the hotline — including several against Barrett, other senior staff and certain board members — but the only one targeted by the outside review organization was the allegation against her. “This appears to be a retaliatory action and deliberate effort ... to damage my character,” she wrote.
The third allegation leveled by the review organization was that Grant planted negative stories in the local press. Readers of this editorial page know we’ve written extensively about Broward Health this year. And while we don’t identify our sources, we’re willing to state for the record that Grant has never tipped us off to negative matters, though unlike others, she did show the courage and courtesy to return our calls for comment. Given that, we’d like to see the review organization’s evidence. We don’t believe it exists. And if it got this wrong, what else did it get wrong?
We asked Grant, as she walked into Thursday’s board meeting, whether she’d taken bribes or kickbacks. She denied it. She said so again during the board meeting, after laying out Barrett’s role in the unfolding events. “I want to say categorically that I did nothing wrong. I served at Broward Health North. I did the best job I could, and I did nothing wrong.”
Without asking Grant a single question, the board acted as judge, jury and executioner — and fired her. She sat at the board table for the rest of the meeting, looking shell-shocked.
Late Friday, Commissioner Sheela VanHoose, who didn’t attend Thursday’s meeting because she was out of town, sent a letter she asked be distributed to her colleagues.
“I am shocked at the board’s decision to terminate an individual under the pretense that there could be an investigation of criminal activity and I emphasize ‘could be’,” she wrote. “Are we decision shopping? Are personal agendas playing out in a harmful way?”
“The independent law firm retained by our general counsel (who briefed me by phone) concluded that anti-kickback laws MAY have been violated — but not to Ms. Grant’s benefit, but rather the bottom line of the hospital she managed. Isn’t the role of our CEOs to increase profitability?”
Like Canada, VanHoose wondered why the board’s first course of action was termination.
Couldn’t they have suspended Grant and given her some time to prepare a response?
At their next regularly scheduled meeting on Dec. 14, we encourage board members to reconsider their rush to judgment in terminating Grant. There’s talk of cancelling the meeting because some people will be out of town. But given the urgency of matters facing Broward Health, this meeting should proceed. Members commonly call in. They can do so again.
As we always stipulate in writing about Broward Health, there’s much we don’t know about what’s going on there. And though our confidence is shaken in the outside review organization, its report does raise important questions about billing, coding and oversight problems.
Given everything, the last thing Broward Health needs to do is delay the selection of a strong CEO who can come in and right the ship.
But after watching this board throw their interim CEO under the bus, it’s hard to imagine who’d want the job.
Without asking interim CEO Pauline Grant a single question, the board acted as judge, jury and executioner — and fired her. She sat at the board table for the rest of the meeting, looking shell-shocked.