Rossi Makes it Official

The Republicans will have a formidable challenger to Patty Murray as Dino Rossi made it official.

Dino Rossi will in fact make a bid for Senate in Washington state, several media outlets are reporting. Rossi has long been rumored to be considering a run and will reportedly make his intentions known publicly as soon as Wednesday.

Rossi is looking to defeat Democratic Sen. Patty Murray, who's represented Washington for three terms and is currently a member of Senate leadership. He's already signed up a senior strategist from Marco Rubio's campaign in Florida and a veteran of Mike McGavick's challenge to Washington's other Democratic senator, Maria Cantwell, in 2006.

Rossi is within a few points in most polls of Murray and the most recent has him down by four. He was a near winner for Governor a couple years back and he presents the Republicans' best hope to regain that seat in November.

The Merger that Wasn't

In the Spokane area, there appears to be a very high stakes confrontation between CEO's of two competing local hospitals.

Providence Sacred Heart Medical Center’s chief executive charged Rockwood Clinic’s leaders with bad-faith dealings and ethical lapses the day after Rockwood stunned Spokane’s medical community by announcing it would align with Sacred Heart’s main rival.

“It is clear to us that the interim leadership of Rockwood is leading the Rockwood physicians down a very dangerous path fueled purely by profit motive,” said Sacred Heart CEO Dr. Andrew Agwunobi.

Rockwood will be purchased by Community Health Systems Inc., which bought Sacred Heart rival Deaconess Medical Center last year. Agwunobi accused Rockwood interim president Dr. Craig Whiting and others of gaming Sacred Heart months ago when they initiated talks to “strengthen partnerships” – going to the point of having Sacred Heart officials sign confidentiality agreements to keep a lid on the discussions while Rockwood said it needed to finish leadership changes and complete an internal analysis

The salty language used by Providence CEO, Dr. Andrew Agwunobi (known as Dr. Andy) has gained him some notoriety, but what is much more curious is the set of events that lead to this broken deal. Dr. Agwunobi took over at Providence in the winter of 2009. Here's a piece of an email that he sent to the staff within weeks of his arrival.

Dear Providence employee,

I am writing to inform you about some difficult decisions that will be made
over the next two months to address current financial challenges and to ensure
that our Providence ministries in Spokane and Stevens counties can continue to
weather this serious economic recession. I know you are aware from previous
communications that the financial outlook is challenging.

We as a system have experienced significant investment losses; the state budget cuts to hospitals and health care will be drastic; and, in keeping with our Mission, it is inevitable that we will treat many more uninsured and underinsured individuals in the months ahead. What you may not be aware of is that Providence Health Care is already experiencing significant financial challenges year-to-date in 2009. At this point, we are $9 million behind budget and this gap is increasing monthly. The economic recession is part of the cause, but we also have some productivity and expense overruns that have contributed to our poor financial performance.

So, back in the winter of this year, the same hospital system that was now attempting multi hundred million dollar buyout of its competitor was telling its employees that their financial situation was so dire that there would need to be employment cuts.



In June, the same system was denied its plan to expand its beds by 152.

State officials have rejected Providence Sacred Heart Medical Center’s plans to add 152 patient beds.

The decision by the Washington state Department of Health puts an end to a $175 million construction project that was expected to span several years and employ as many as 700 people.

“We’re surprised, disappointed and, quite frankly, saddened at this decision,” said Dr. Andrew Agwunobi, chief executive of Providence Health Care, “because we know the Department of Health is very objective. We also know, of course, that we need the beds.”

So, at the beginning of 2009, the system was in such dire financial straits that they needed to lay people off. In June, the same system was trying to apply for an expansion that was going to cost them $175 million. Dr. Agwunobi, and management, explained this dichotomy by claiming that the money to be used for the expansion would come from long term bonds, which presumably they couldn't provide to keep people at work.

In fact, the whole thing is nonsense. As of December 2008, this system sat on just under $2 billion in investments and cash. Their financial position was just fine. In fact, in 2008, the system had operating profits of $288 million. The system lost significant amounts of money on investments however even after those losses they still had $1.94 billion in cash and investments. It's still unclear why the cuts were announced but to blame it on finance is disingenuous if not simply a flat out lie.

As for Dr. Agwunobi, it's fair to characterize his term, now near one year, as a total disaster. Multiple sources within the hospital have characterized the environment at the hospital since he arrived as much more stressful, full of fear, and and a hospital divided. In fact, management took great pains to remove my own articles about Dr. Agwunobi and some hospitals in the system went so far but to block access for google searches of Dr. Agwunobi.

This latest episode is the latest in a string of embarrassments. The incident in June "surprised, disappointed, and saddened" Dr. Agwunobi. Now, a major merger was pulled out from underneath Dr. Agwunobi and he went into an irate rage to a member of the media.



It's important to review Dr. Agwunobi's history prior to arriving at Sacred Heart. I first tracked him to South Fulton Hospital in Atlanta, Georgia. He was the CEO there. He arrived there in 2001. At the time, South Fulton had recently finished a review by JCAHO (Joint Commission for the Accreditation of Hospitals Organization). That review was equivalent to roughly a C. He left South Fulton about two years later. Right after he left, JCAHO finished another review and failed South Fulton and put them on probation. They have since turned themselves around. He then went to Grady Hospital, one of the largest hospitals in the world. He left Grady about a year later following the release of an investigation by the Center for Medicare and Medicaid Services that concluded

Grady presents an immediate and serious threat to the health and safety of the patients

He then moved across country to St. Joseph's medical system and became its COO. He left there about a year later for reasons that are still unclear. He moved to Florida and served on the board of WellCare. About six months later, he cashed out about a million dollars worth of stock options and moved to the Florida's Association for Health Care Administration, within the Florida Department of Health. His first official move as head of AHCA was to investigate his former employer, WellCare. Following a raid lead by AHCA along with nearly a dozen other agencies, the stock price of WellCare tanked. Wellcare eventually went under, but Dr. Agwunobi had long cashed out. Within a year, he left AHCA and moved to the Spokane area. As such, he's had six high level jobs on both coasts in the last eight years. He always seems to leave under suspicious circumstances. Frankly, it's not entirely clear why he continues to get work.

An Update on Rank Choice Voting in Wa.

About a month ago, I did a story about a voting battle being played out in Pierce County in Washington state. Back in 2006, Pierce County put on its ballot an initiative to change its voting system to ranked choice voting.

RCV) is the American English term for a voting system used for single-winnerelections, in which voters rank candidates in an order of preference. If no candidate is the first preference of a majority of voters, the candidate with the fewest number of first preference rankings is eliminated and that candidate's ballots are redistributed at full value to the remaining candidates according to the next ranking on each ballot. This process is repeated until one candidate obtains a majority of votes among candidates not eliminated. The term "instant runoff" is used because the method is said to simulate a series of runoff elections tallied in rounds, as in an exhaustive ballot election.[1]

The initiative passed by 53-47%. Then, the county council attempted in 2007 to postpone it unti after the 2008 elections. That failed by a 2-1 margin. Now, the forces of the status quo are once again trying to eliminate ranked choice voting. On the ballot this November, the county council, the county's legislative body, has once again engineered a referendum on Rank Choice Voting. It's the third of three referendum that will be on the ballot. I've confirmed that one individual that is leading the charge to reverse Rank Choice Voting. He's the recently appointed Prosecuting Attorney for the County Mark Lindquist. His old boss, Gerry Horne, resigned only recently. By law, the county council would appoint a successor. Lindquist,who until now was the Deputy Prosecuting Attorney, had already started campaigning to be the Prosecuting Attorney and so this would be perfect. Lindquist, a Democrat, was recently approved by every single member of the county council even though 5 are Republicans. Now, he's favoring the same ballot initiative that the council is pushing itself.





Well, now somethings have come to light that make the story. First, the county council is blocking efforts to change the language for first referendum. Currently, here is the first referendum.

The Pierce County Council passed Ordinance No. 2008-113 proposing to amend the Pierce County Charter. If approved, Proposed Charter Amendment No. 1 would (a) move the election of Councilmembers and the Executive to odd-numbered years by 2015; and (b) increase term limits for Councilmembers and the Executive from two consecutive four-year terms to three consecutive four-year terms, consistent with term limits in effect for Auditor, Assessor-Treasurer and Sheriff; all as set forth in Ordinance No. 2008-113.

The objectionable language comes at the end, "consistent with the term limits in effect for Auditor Assessor..." This initiative would loosen the term limits to three from two. The reason that there is objection is because there is a subtle bias in that statement. It's totally irrelevent what the term limits are for the Auditor, yet, the referendum is implying that it's fine because of this. Then, here's the second referendum.

The Pierce County Council passed Ordinance No. 2008-113 proposing to amend the Pierce County Charter. If approved, Proposed Charter Amendment No. 2 would move the election of Auditor, Assessor-Treasurer and Sheriff to odd-numbered years by 2015; all as set forth in Ordinance No. 2008-113.

Now, there's language in the first referendum about moving some elections from even to odd years. In this one, they want to move a bunch more from odd to even years. Doesn't it seem as though you'd have to vote for both or neither? I've confirmed that 4 of the 7 council members would be term limited out November 2010.

Finally, there's the salt in the wound. On the ballot, the voter will vote affirmative or negative for the initiative. It's usually the standard yes/no. They obviously didn't tell the folks that are opposing this initiative. I spoke with Kelly Haughton, who leads the movement to keep RCV in Pierce County, and he told me that his supporters had already made hundreds of sign that say Vote NO on 3. With the change in language, it's unclear what they'll do with the signs. Here's how Haughton describes how the process is supposed to go.

The state process for ballot measures is for the Attorney General's office to consult with the pro and con committees BEFORE writing the ballot title.

Here's how Haughton says his side was treated.

Not only did the Pierce County Prosecuting Attorney's office write the ballot
titles without consulting the committees, the Auditor and the Prosecuting Attorney's office refused to discuss the ballot titles with the committees outside of court. They informed us that the only way they would discuss the issue was if we sued them

It should be noted again that the new Prosecuting Attorney is the afforementioned Mark Lindquist. He's conveniently in place to make sure that these initiatives are given as much help as possible. As such, Haughton and his supporters are saying no to all three initiatives and frankly I smell a rat. Both Lindquist and the County Council, lead by Shawn Bunney, returned emails yet.

Dr. Andrew Agwunobi Strikes Again IV

It appears that Dr. Agwunobi's cancer has spread. Dr. Agwunobi has, within the last year, take over as the CEO for the Eastern Washington region of Providence Health Systems. Dr. Agwunobi's first official act as CEO was to announce that cuts would need to be made. This pronouncement was met with fear and trepidation. A few months ago, I described the situation at Sacred Heart Hospital in the Providence Health Systems. (part of Dr. Agwunobi's region)

Following my initial report, this was posted the hospital board of Sacred Heart Hospital, (hit download attachment) one of the hospitals Dr. Agwunobi is responsible for. It addressed my previous post as well as my reporting on Dr. Agwunobi in general. The posting in the hospital refers to my reporting as "untrue" and refers to me as a "disgruntled former medical student". I am of course not now nor have I ever been a medical student. (I would agree with the characterization of disgruntled
but I would call that a lucky guess) While they characterize my reporting as untrue, the post never refutes any of the specifics in any of my pieces on Dr. Agwunobi. Let's put that to the side for a minute.

Dr. Agwunobi characterizes the region of Providence Health Care that he controls as being in dire financial straits and that's why he will have to make significant staff cuts. According to the financial statements filed by Providence Health Care system itself, the hospital had an operating profit of $288 million year ended December 2008. They carried a net loss but that came mostly from losses on investments (almost exclusively bonds and stocks). Given how poor the equity markets performed in 2008, that was to be expected. Furthermore, the hospital was still sitting on $1.95 BILLION in investments as of December 31, 2008. (page 21 of the financial statement) Does this sound like a hospital in dire financial straits?

I spoke with two medical professionals at Sacred Heart and they each described the same environment. It's a non profit hospital acting like a for profit. That's the worst of both worlds. What I mean is that the bottom line comes first. As such, staff is cut and everyone is pushed to the limit. Because everyone there is pushed beyond what is safe, patient care ultimately suffers. As such, the bottom line becomes the most important and only factor in all decisions.That's not merely a semantical point. Sacred Heart is part of the network of hospitals called Providence Health Care. Providence is a non profit hospital. Because it doesn't pay taxes the hospital is supposed to give the tax savings back to the community. That's not what's happening at Sacred Heart Hospital. Instead, the hospital is pocketing massive profits, cutting hospital resources, and forcing doctors to treat more patients than is safe. That is threatening patient care. That's the strategy that Dr. Agwunobi has implemented at the network.

Now, I can confirm from multiple different sources that, at Mt. Carmel in Colville, Wa., describe a similar situation. The administrators there are also being mistreated. There, they're being forced to take pay cuts and mandatory time off without pay and at the same time they also have added duties. On top of this, their IT department has blocked employees from using a google search of Agwunobi from work computers. Most of the staff is afraid for their collective jobs.

It wasn't even a year ago that Dr. Andrew Agwunobi took over as the CEO of the Eastern Washington region of the Providence Health Care System. This is a hospital system that has just under $2 billion in INVESTMENTS as of its last financial statement. Yet, he claims that it's struggling so much that he needs to make budget cuts. That's what he's doing and it's clear that all over every hospital that he controls, the employees are near panic. They're afraid for their jobs. Everyone is made to work twice as hard with fewer staff, less hours, and less money. All because you are being lied to and told the hospital is struggling when it's really flush with cash.

At the same time, the employees are clearly doing searches of his name and winding up at my site. That's how I've found out almost everything there. I've been tracking Dr. Agwunobi's career since 2001. That's when he took over as CEO of South Fulton Hospital. That's a small Atlanta hospital that serves most the poor. In two years, that hospital went from passing to failing JCAHO (a hospital governing body) reviews. Though, they didn't do that before Dr. Agwunobi was able to leave South Fulton and move to Grady Hospital. As such he left, and months later the next report came in as a failure.

He moved to Grady Hospital and a year later, HHS issued a report that concluded.

the conditions at Grady Hospital pose an immediate threat to the health and safety of the patients.

That stunning conclusion cost Dr. Agwunobi his job. To be more accurate, it caused him to take the fall for much bigger corruption that he was only one part of. In fact, he was told to take the fall in return for a cushy job as COO of St. Joseph's Hospital System in California that was arranged by then Grady Hospital board chairman, Robert Brown.

He spent a year at St. Joseph's and then moved to the board of Wellcare. He spent about six months there, cashed in his options of about $1 million. Then, he moved to the Florida AHCA (Agency for Health Care Administration), part of Florida's Department of Health. His first significant act not more than months into his job was being among ten state and federal agencies to raid WellCare. The stock dropped off a cliff after the raid. Of course, Dr. Agwunobi had already cashed out his options. He only survived about a year in part from the controversy surrounding this set of events. Now, he's spent nearly a year at the Eastern part of Washington of Providence Health Systems.

Things have gotten so bad that recruiters have set their eyes on the hospital and part of their pitch is to ask in shock.

What's happening at Providence?!

Of course, the most important thing is that this sort of mismanagement also becomes a time bomb or a cancer even. It's only a matter of time before every part of the hospital that he controls becomes infected with working conditions that are unbearable for everyone there. Right now, the upper management, which hired him despite having to know everything I recounted (r at least they should have), is calling anyone that leaves a "Rat." It's only a matter of time before people start dying in these conditions. Dr. Andrew Agwunobi is a menace and he must be stopped.