Diagnosis: Critical Questions Kalispell Regional needs to answer

It has now been three months since the communities of the Flathead Valley learned that Kalispell Regional Medical Center was the subject of a “whistleblower” lawsuit filed by the U.S. Department of Justice. The 91-page script of that suit became available online in May, and the local newspapers, acting in the interest of good journalism, published the link to the entire text.

To date, the hospital has not responded to the public in any way other than to present articles touting the many excellent services that are available at KRMC. Additional information gleaned from press articles informed us that the hospital had chosen to “settle” the lawsuit, ensuring that the details would not be disclosed on advice of counsel on both sides. We also became aware that a $21.5 million penalty would be paid off in $3.3 million increments over six years. End of story? It shouldn’t be.

Community nonprofit hospitals are exempt from taxation, a privilege awarded by the citizens. Their revenue sources come primarily from those same citizens in the form of private insurance, Medicare and Medicaid, veterans programs, Children’s Health Insurance Plan, Tricare, and occasional government grants, ALL of which are funded by the taxpayer. In addition, there are private pay patients who choose to insure themselves, and also, thankfully, thousands of philanthropic donors who willingly hope to see their donations used for the common good. It is probably safe to say that none of these people, investing either directly or indirectly, wanted their contributions to health care to be used to pay a $21.5 million fine to the U.S. government for settling an alleged wrongdoing. Recently we learned that KRMC was approved for “up to” a $100 million revenue bond issue by the Montana Facility Finance Authority, having issued $57 million in bonds in 2010. That all leads to a few questions and the admonition to “follow the money.”

In any community, there is the assumption by the public that their tax-supported services will earn their trust by maintaining high ethical standards in all of their professional activities. Chief among these institutions are education, law enforcement, legal and judicial services, and health care. The first four of these have direct public input by way of local elections to boards, city councils, county commissioners, courts, and state officials. Unlike those, the public has no direct access to decisions regarding health care, especially in the area of fiscal accountability. Yes, there is a hospital board made up of public members, but the method of choosing them does not include any public review of resumes and interviews prior to selection. As a result of these recent events, this lawsuit and the lack of a hospital response have impugned the integrity of every health-care provider associated with KRMC. This is a terrible blow to inflict not only on its many employees and physicians, but also on the public, its customers.

I urge the board and administration of Kalispell Regional Medical Center to provide a clear and plausible explanation of how we got to this point and how trust in KRMC can be restored in the communities it serves.

Which parts of the lawsuit are fact, which are fiction, and which were most egregious and responsible for such a heavy penalty? Was the “settlement” made because a trial could have publicly disclosed additional facts and thereby cost even more than the penalty?

Who were the responsible parties involved in this compensation scheme?

Aside from the “excessively compensated” physician, who were the unnamed “administrators and directors?”

Is any of the loss recoverable?

Do any of the guilty face civil suits?

Where was the board oversight that might have identified the shenanigans taking place and corrected them?

What role did the selection mechanism and structure of the hospital board play in allowing this compensation scheme to go on for years and to reach the level of a federal lawsuit?

Most importantly, to reiterate, how will the hospital regain the public trust in both its billing procedures and capital budgets?

Leadership demands accountability.

James Bonnet is a long-time Kalispell physician.