The Erlanger board of trustees is clearly singleminded in its sprint to finish turning our public hospital - one of the nation's largest public hospital systems - into a private, nonprofit business model.
So determined is the board that last Thursday trustees unanimously voted to make its chairman, Jim Coleman, its new CEO, not long after the last CEO suddenly was said not to be CEO anymore.
There was no explanation for the last CEO's departure - just that he'd be gone by June 10.
Becker's Hospital Review said Erlanger's seven-hospital system told them the exit was by "mutual consent."
What's more, there seemed little discussion to speak of in naming the new guy, other than to say Coleman "checks all the boxes" to "take Erlanger where we need to go."
If "where we need to go" is private, it would seem Coleman's resume works. He's a former chief operating officer of Parkridge Health System and the former Hutcheson Medical Center in North Georgia. He's also a former CEO of Bradley County's former SkyRidge Medical Center. And he's the current CEO of Alliant Management Services, a Louisville, Kentucky-based company that focuses on rural hospital managements and solutions.
Changing Erlanger's corporate governance structure is no small thing. Erlanger includes the region's only dedicated children's hospital and it - at least for now - continues to be the largest area health care provider for low-income and uninsured patients. In 2021, Erlanger provided around $150 million worth of uncompensated care - a figure officials said has grown 36% in four years.
But here's the thing. We already knew this hospital board, of which Coleman has been a member since November 2019 and the chair since November 2021, was making legal and other inquiries into going private long before they or anyone made those discussions public.
Hamilton County Mayor Jim Coppinger on Feb. 9 asked county commissioners to approve funds to hire a lawyer representing the county in such a transition. That same day Coleman told the Chattanooga Times Free Press:
"It's logical at this point in time that we sit back and look at all the changes that have happened since 1977 in health care [when the hospital board was established] and look at a structure that would allow us to respond to those challenges and changes in the health care arena more quickly and execute more efficiently."
Coleman also told our reporter - and later the editorial board - that "after nine months of due diligence," the board began approaching stakeholders, including Coppinger, to begin the process of privatizing the hospital.
That process indeed flew. Tennessee lawmakers amended the private act and Gov. Bill Lee signed it on May 25. We're just beginning to see the effect. Because Erlanger has been a public hospital, meetings and discussions like what we've described here should have been public.
But Coleman and other board members defended the not-public discussions by saying Tennessee law allows public hospital boards to meet in private to 'discuss and develop marketing strategies and strategic plans.'"
Mind you, the same board members argued they needed this change because by talking about things in public Erlanger somehow lost a competitive edge. They wanted us all to think other hospitals didn't know how many nurses and bed pans and doctors with contracts a hospital the size of Erlanger needs? Hogwash!
The following month, in March, trustees amended their bylaws to allow board members to be employed by or contract with the hospital in certain "extraordinary circumstances." What did that mean? we asked. The board's attorney said at the time that "mergers, acquisitions, divestitures, reorganizations or restructurings" qualify as "extraordinary circumstances."
Well. Extraordinary circumstances clearly are upon us.
Here's one more thing.
In addition to naming a new CEO from the board, the board approved a resolution to take out an up to $75 million loan "for the purpose of financing the cost of certain capital expenditures for the hospital facilities."
They then turned around and approved the fiscal 2023 budget, which includes $41 million in capital investments, 3% raises for employees and projects a net income of $16.5 million. But they did not at that public meeting - for the first time in five years - make details of the budget for Erlanger public.
Let us repeat that last part. They did not publicly discuss or make the details of the budget for our still-transitioning and therefore still-public hospital public. (By Monday, they had provided a copy of the budget to a Times Free Press reporter and said they plan to talk with her soon.)
But for crying out loud, why did and does this board need to go private? They've already been thumbing their noses at us public folks for months - nay, years.
Get ready, folks. This is just a little glimpse of the future.