Hospital crisis: Broward Health battles a ‘cultural civil war’


Operational mismanagement, high senior management turnover, low employee morale and inappropriate interference by members of the hospital's former board of commissioners into operational matters. These are just a few of the findings of an independent review of the North Broward Hospital District.

The blistering 209-page report by the Baker Donelson law firm, which was hired to serve as the independent review organization (IRO) under a settlement with the federal government over a whistleblower lawsuit, states the South Florida health system is confronted with many serious problems.

The problems are the result of what the report says “can only be described as a cultural civil war” within the system.

Broward Health
Medical Center

Broward Health is one of the largest public health systems in the country. It includes four hospitals, three outpatient facilities and approximately 9,000 employees. A seven-member board of commissioners appointed by the governors oversees the system, which is in a special taxing district.

The report, obtained by Florida Bulldog under Florida’s Public Records Law, is especially critical of the system’s senior management team, describing a lack of communication and actions taken were based on self-interest and protection of leader’s positions and department--and not for the betterment of the system.

“The conduct identified by the IRO shows a lack of professionalism and collaborative work effort previously unseen by a team of lawyers, who regularly represent hospital systems, failing not only the patients the system serves, but the taxpayers who help fund it,” the report says.

The culture war relates to what the report describes as a “pervasive physician-centric tradition.”

During the first three months of the IRO’s investigation, the health system had three different chief executive officers with the current one serving as an acting CEO. It also lost two members, including the chair, who was suspended by the state as part of a Florida Inspector General investigation. Last week the chief compliance officer--the third to hold the position in the past year--resigned after only a month on the job, according to an article in the Sun Sentinel.

The culture war relates to what the report describes as a “pervasive physician-centric tradition,” in which leaders and staff defer to physicians, particularly over compensation issues.

Problems at the system came to light in 2015 when a whistleblower lawsuit revealed illegal pay deals between the system and physicians, in violation of The Stark Law and anti-kickback laws. The $70 million settlement included a five-year corporate integrity agreement and the establishment of the IRO to review the system’s policies, procedures and operations.

"In reading through this document, it's abundantly clear to me that we've got some pretty significant deficiencies."

But the infighting and blame-shifting has led to failure to fix problems that led to the federal fines in the first place, according to the report.

The findings were one of the reasons the system’s board decided this week to indefinitely postpone a vote to choose a new CEO, according to the Sun Sentinel.

The newspaper reports that during a board meeting this week member Christopher Ure said the board should be honest about the problems at the organization.

"Let's not beat around the bush here," he said. "In reading through this document, it's abundantly clear to me that we've got some pretty significant deficiencies ... I personally think it would be a wise move to point out the areas where we as an organization are deficient. I think that some level of contrition, some level of acknowledgement of the problems that remain would ultimately serve us well."