Aspen Valley Hospital officials revealed during a Monday board of directors meeting that the health care facility received an unfavorable review from state health-facility regulators last year that put its status as a Level III trauma center in question.
Dropping to a Level IV would mean that the hospital would be required to pass along certain emergency cases to other hospitals. Remaining at Level III was one of the reasons why the hospital elected to contract with a Denver company, Surgical Services of Colorado, to provide two surgeons for the hospital, officials said.
The decision to go with Surgical Services was made in lieu of retaining AVH’s longtime surgical chief, Dr. Bill Rodman, under a direct employment model and having Rodman bring in a second surgeon to work with him.
Rodman has had an exclusive-provider contract to oversee surgical services since 1993. He relinquished that exclusive-provider status in August, believing that the hospital wanted him and a second surgeon to work as direct employees, a model that had been discussed for the past few years.
Instead — amid the process of shoring up Level III status — the hospital board looked to work out a deal with the Denver group, a process initially unknown to Rodman. He met with representatives of the group late last year to discuss the possibility of working for them, but those talks ultimately failed.
Rodman and more than 30 local residents packed Monday’s board meeting to make their concerns about the turn of events known. Many people who attended the meeting — including former Mayor Mick Ireland — expressed displeasure over what they perceived as a lack of transparency by the board in contracting with Surgical Services of Colorado. The meeting’s public comment period ran 90 minutes, twice as long as scheduled.
“Most of what has happened has happened behind closed doors, out of the public eye,” Rodman said at the start of the public comment period. “In the past year, I have found myself being slowly pushed out of Aspen’s health care community by a series of decisions made by the hospital.
“There was a bait and switch,” Rodman continued. “Though I was led to believe an employment model was in the plans, it turns out that contracting with the group was actually the focus. I was not consulted. It was presented as a fait accompli. I was to become the junior partner of a group that I did not have a hand in selecting.”
Rodman suggested that the board acted with malice. The news that his employment with the hospital, and his office lease, would be terminated on June 30 “was delivered to me on Christmas Eve,” he said.
Though Surgical Services of Colorado officially begins its role with the hospital on July 1, Rodman will be allowed future hospital privileges — meaning that three surgeons will have access to patients at Aspen Valley Hospital.
“While it may be argued that choice is good, the demographics of the upper Roaring Fork Valley can only serve 1.2 surgeons,” Rodman said. “We will have three surgeons.”
Rodman said the arrangement doesn’t make financial sense, since he likely will manage 55 percent to 75 percent of the surgical caseload. He said he’s not privy to the hospital’s contract with Surgical Services, but he expects that it requires the Denver group and its two surgeons to be made “financially whole.”
“Is this fiscally responsible?” Rodman asked the five board members.
During the first half of the comment period, board members were mostly silent, allowing various members of the audience to speak. Dr. Barry Mink, board chairman, said the purpose of the meeting was to listen to what Rodman and others had to say, not to hold a debate.
Later, after several people spoke in defense of Rodman or questioned the public hospital board’s transparency, Mink spoke up.
“I’ve been on this hospital staff for 40 years,” Mink said. “I’ve been on this board for almost 11 years. I can tell you that transparency is not the first thing that we try to avoid. We try to be as transparent as we can possibly be.”
Mink said that while he understands Rodman’s feelings about the situation, “some personal loyalties have to be put aside” when elected board members make an objective decision in the best interest of patient care.
“That’s how this process really took place,” Mink said. “There was never any intention for Bill Rodman to be persecuted or harmed by this process. We knew that he was not going to be happy with it. ... It’s a heartbreaking situation.”
Mink said if the one-year contract with Surgical Services of Colorado doesn’t work out, changes can be made.
“Hopefully, it will work out, where Bill and whoever the surgeons are have some collegial relationship ... and provide the care that’s necessary,” he said.
But Rodman quickly chimed in and said that Surgical Services hasn’t agreed to provide cross coverage when he is unavailable.
The board discussed the coverage issue during an executive session just prior to the public comments, according to Mink.
“Their answer was, certainly in emergencies, they would absolutely cover and do what’s necessary,” Mink said.
“As far as routine coverage, like you go on a vacation and they’re supposed to cover, they weren’t happy with that, because of some of the relationship discussions you’ve had with them, but also because of their medical-legal insurance coverage situations,” Mink said, adding that CEO Dan Bonk would explore the issue soon.
“That means I’ll be on 24/7, 365, which is difficult,” Rodman replied. “Obviously you’re working on this, and I appreciate that, but I’m just expressing my anxiety and concern as to where this is going forward.”
Near the conclusion of the discussion, board member Lee Schumacher said he recused himself from the discussions about Surgical Services last year because he was Rodman’s friend and attorney.
But Schumacher said the number of people in the room Monday night was an indication that something had gone wrong.
“Clearly, if we are having this meeting, our process failed somewhere,” Schumacher said.