By Kyle Alspach
ENTERPRISE STAFF WRITER
Posted Jun 14, 2009 @ 03:46 AM
Last update Jun 14, 2009 @ 10:33 AM
BROCKTON — By day 68 of the nurses’ strike, all nine Massachusetts congressmen and more than 100 state lawmakers had signed letters to Brockton Hospital President Norman B. Goodman, pleading with him to reach a settlement with the nurses and end the standoff.
Goodman didn’t budge. The strike lasted five more weeks.
FIRST OF TWO PARTS
In the end, the 2001 strike cost the hospital more than $20 million and forced Goodman to drain a third of the hospital’s financial reserves, which were never restored, according to interviews with hospital officials and a review of financial records.
The handling of the strike also typified Goodman’s iron-fisted management style, according to critics, who spoke to The Enterprise last week following Goodman’s resignation amid allegations of “inappropriate behavior.”
The Brockton Hospital nurses’ strike remains the second-longest in Massachusetts history. But it could have been prevented, or at least shortened, if Goodman handled it differently, critics say.
“I think it all came down to just an issue of control,” said Linda Condon of Brockton, a former hospital nurse who co-chaired the nurses’ bargaining team during the strike. “He was the CEO of the hospital and what he said, he wanted done.”
Others say Goodman’s nearly two-decade tenure at the hospital, now known as Signature Healthcare Brockton Hospital, was marked more by successes, such as launching extensive cardiac care south of Boston and providing free hospital care to untold numbers of the uninsured.
“Mr. Goodman stayed true to his commitment to the mission of the hospital, which was to provide care regardless of the ability to pay,” said Fred C. Petti, a former chairman of the hospital’s board of trustees.
“He said that the mission is priority one. And he never deviated from that.”
End of an era
Goodman, who did not return messages left at his Easton home last week seeking an interview, resigned as president and CEO of the hospital on June 6.
Hospital officials had said an investigation into allegations of “inappropriate behavior” had been under way, and Goodman said in a statement he wanted to spare the hospital from “further distraction” by resigning.
Officials have declined to reveal the nature of the allegations.
With roughly 1,800 employees, the hospital is Brockton’s largest private employer and the largest hospital in the Brockton area.
Goodman took the top job at the hospital in 1990. Before that he headed a hospital in Oak Park, Ill., held various administrative positions in the health care industry and earned degrees in health care administration and chemistry.
He quickly put his mark on Brockton Hospital after arriving, said Dr. Laurence Wohl, who spent 25 years at the hospital.
“It had been a very friendly place to work. But I think after he came in, his style was a little different. He was interested in changing the dynamics of the hospital,” Wohl said.
“If you weren’t totally on his team, which required 100 percent observance to his policies, there was a problem,” said Wohl, who characterized Goodman’s management style as “very dictatorial.”
Over the years, numerous doctors would defect to Brockton’s other hospital, Good Samaritan Medical Center.
Among them were Wohl, who became chief of infectious disease at Good Samaritan; Dr. Barry Arkin, a prominent cardiologist who became chief of cardiology; and Richard Herman, longtime emergency department chief at Brockton Hospital, who left to take the same job at Good Samaritan.
“There was a lot of talent that left,” Wohl said.
Arkin did not return a message last week, and Herman declined to comment other than to say he left the job voluntarily.
Other doctors didn’t leave by choice. Dr. John J. McNamara, chief of pediatrics at Brockton Hospital, was fired in 1997 for being “insubordinate.” The firing came a week after McNamara had written letters to hospital accreditation officials, criticizing Goodman’s management style and several hospital policies.
Turnover among senior managers was also high. From 2000 to 2007, the hospital had five different vice presidents of human resources, according to hospital filings.
Everyone from middle managers to staff members were “under his thumb,” said Condon, the former nurse.
“Middle management was basically under the gun by him to run things the way he wanted,” Condon said. “They had to report absolutely everything to him. …
“It made it difficult to give the appropriate care that you needed to give to the patients,” she said.
Stormy relationships
Goodman became embroiled in conflicts outside the hospital as well.
John T. Yunits Jr., mayor of Brockton from 1996 to 2005, said Goodman wasn’t always easy to deal with.
“At times we had a good relationship,” Yunits said. “At times it was bitter and stormy.”
At the end of Yunits’ time as mayor, the relationship “wasn’t good,” he said, as the city and hospital clashed over the city’s eminent-domain taking of land that the hospital wanted for a parking lot.
On another occasion, Goodman fought a project that turned out to be a major boon for the city, the Brockton Neighborhood Health Center.
In a 2004 interview with The Enterprise, Goodman acknowledged he had opposed the center but didn’t say why. Health center executive director Susan Joss suspects it had to do with concern about competition.
“From his point of view, it might have been the competitive fears that we might take business,” said Joss, who said this never happened and that Goodman went on to become a supporter of the health center.
Some of Goodman’s supporters acknowledge he had a tendency for conflict.
When asked about Goodman’s management style, longtime board of trustees member John Svagzdys responded that his approach differed from Goodman’s. “I had a different style, a little more friendly style,” Svagzdys said.
But Petti, who served on the trustees for a decade, said Goodman’s approach got results for the hospital.
“Was he an aggressive manager? Absolutely,” Petti said. “But my thinking was that you needed to be, in this environment and in that industry.”
‘Huge passion’
In the 1990s, during a time when many Massachusetts hospitals were closing their doors, Brockton Hospital was growing, supporters of Goodman say.
The hospital opened a new cardiac care center in 1991, a rehabilitation unit in 1997 and gained more than 100,000 new patients in 1999 when Bridgewater Goddard Park Medical Associates switched its loyalty from Good Samaritan to Brockton Hospital.
And the hospital never strayed from its pledge to give free treatment to uninsured patients, Petti said. The hospital provided $18.5 million in free care in 2007, the largest amount of any hospital south of Boston, according to records from the state health care finance division.
Cardiac care was a “huge passion” of Goodman’s, said Yunits, who recalled attending meetings where Goodman shared figures on local populations that weren’t getting the cardiac care they needed, due to the distance from Boston hospitals.
With the opening of its cardiac center in 1991, Brockton Hospital became the first hospital in the state outside of Boston to have a cardiac catheterization lab, allowing doctors to better evaluate heart conditions.
In 2006, the hospital became one of seven outside Boston offering elective angioplasty, a procedure to clear clogged heart arteries. The hospital also expanded its emergency angioplasty service to 24 hours a day, seven days a week, that year.
Offering more cardiac care was always one of Goodman’s top goals, Yunits said. “It really drove him, and he worked really hard on it.”
For years, Goodman pushed to bring open-heart surgery to the hospital, completing the spectrum of cardiac services at the hospital.
But permission was denied by the state Department of Public Health, which disagreed with the hospital’s estimates of the number of patients who would be served by the procedure.
Nurses’ strike
But Goodman’s commitment to patient care came into question by members of the hospital nursing union, a chapter of the Massachusetts Nurses Association, in the months leading up to the 2001 strike.
Nurses were being required to work mandatory overtime shifts — so the hospital didn’t have to hire more nurses — and were also being forced to work in areas they weren’t qualified for, said association spokesman David Schildmeier.
“These are people who are caring for people’s lives,” Schildmeier said. “And when you’re tired, exhausted and overworked, you can make mistakes.”
Petti, chairman of the hospital’s board of trustees during the strike, disputed that mandatory overtime was the central issue.
Instead, he said, hospital officials objected to a measure that would’ve let the union file grievances over any staffing decision made by the nurse manager.
“What (the union) wanted would’ve destroyed the integrity of the hospital,” Petti said. “It would’ve brought the hospital to its knees.”
But this almost happened anyway due to the strike, critics of Goodman say.
The year before the strike, the hospital enjoyed a budget surplus of $2 million, and its financial reserves and investments — including cash, stocks and securities — totaled $70.2 million, according to records filed with the state attorney general’s office.
The year of the strike, that all changed. The hospital’s budget saw a huge shortfall as its expenses rose $19.5 million higher than its earnings.
Those expenses included $17.7 million paid to the U.S. Nursing Corp. of Denver, which provided replacement nurses to the hospital during the strike, according to the financial records.
The hospital also paid for hotels and transportation for the nurses, and spent more than $1 million for police details around the picket lines at the hospital.
To cover the costs, Goodman had to draw money from the hospital’s financial reserves and investments, Petti acknowledged.
That year, the reserves and investments dropped $23 million, to $47.2 million, according to documents. Much of the money came out of cash reserves — $13 million was pulled out in that year alone, documents show.
The financial reserves would continue to be tapped in the coming years, according to the filings.
By 2007, the reserves and investments would stand at $21.9 million — less than a third of the amount in 2000. More recent records were not available. Goodman made just under $1 million himself that year.
By way of comparison, the similarly sized Lowell General Hospital had $77.3 million in reserves and investments in 2000, filings show. In 2007, that figure had dipped only slightly, to $76.5 million.
“Paralleled by operating losses, clearly that signals a big problem” when financial reserves disappear, said Alan Sager, professor of health policy and management at the Boston University School of Public Health.
Investments are important because the interest income can be used to help support the hospital, and reserves can be used as a “rainy day” fund, Sager said.
“You can tap it when you need it, when times are bad, and replenish it when you’re earning large surpluses,” he said.
The fact that Goodman left the hospital with minimal financial reserves may end up being a big part of his legacy, said Richard Rosen, a former trustee and a critic of Goodman.
“It’s a good hospital,” Rosen said. “It’s just been run poorly.”
Coming Monday: What role the board of trustees played in running the hospital — and Goodman.
Kyle Alspach can be reached at kalspach@enterprisenews.com.
Editor’s note: Comment on this story on our Conversation blog. Posts will be reviewed before they appear on the site.
READ MORE of our stories on Goodman’s departure from the hospital.
“
