Candidates question AVH move |

Candidates question AVH move

Janet Urquhart

Rebuilding Aspen Valley Hospital at a new site makes little sense given its current financial straits, according to all four candidates seeking election to the hospital’s board of directors.

Incumbent Bob D’Alessio and board hopefuls Greg Balko, Richard Jacobs and Barry Mink all expressed reservations about considering a new site for AVH, possibly near the Highway 82 intersection with Brush Creek Road. The candidates spoke during an informal forum at the Friday Men’s Lunch at Jimmy’s Restaurant.

During a sometimes-pointed discussion with about 30 attendees, some candidates criticized the current board for reacting too slowly to a host of looming problems. One citizen suggested current board members should be recalled, citing the financial “shambles” in which the hospital has found itself under their watch.

“We have been riding herd on the financial problems of this hospital more than you can imagine,” D’Alessio countered. “We have not been sitting on our hands. I don’t think the board of directors has made a shambles of anything.”

But Jacobs, a physician turned hospital administrator who moved to Aspen in 2000, suggested the board has been slow to respond to the concerns that swept three new members into office in an election two years ago.

“I’m a little frustrated with the length of time it has taken them to get up to speed and make the changes they are making now,” he said.

In recent weeks, the board has identified serious billing woes, parted company with both the hospital’s chief executive officer and chief financial officer, and is now contemplating what may amount to significant staffing cuts.

“When you’re bleeding, somebody needs to put a hand on that hemorrhaging,” Jacobs said. “It shouldn’t take 22 months to fire the CEO.”

Balko, an emergency room physician, expressed doubt that the hospital’s financial situation would be any different today with or without the election of three new members two years ago.

“I think our revenues were overstated,” he said. “I think a lot of us knew for a long time and felt the management that was here had long overstayed their welcome and needed to be moved out.”

AVH is facing the most trying time in its history, D’Alessio conceded, but Jacobs offered an even more dire assessment.

“The hospital is in technical bankruptcy as we sit here now,” he charged, voicing suspicions that the hospital’s cash reserves have dropped so low the institution can no longer draw on money it has borrowed for renovations without violating the bond covenants that set conditions on use of the borrowed money.

“He’s absolutely wrong,” said Dr. Robert Karp, interim CEO at the hospital, on Sunday. The hospital’s cash reserves are low, he confirmed, but AVH has not breached the bond covenants and has not halted the remodeling project in order to keep from doing so, Karp said.

Any pause in the remodeling work now under way is simply a response to the current debate over moving the hospital or expanding it at its current site, he said.

D’Alessio said he won’t support relocation of the hospital unless it makes financial sense.

“The board is very divided on this issue,” he said. “If I had my druthers, we’d stay where we are now.”

“I would be more in favor of keeping the hospital here,” Mink chimed in.

Balko said he favors putting talk of either moving or expanding the hospital on the back burner until its financial woes are resolved.

Relocating the hospital is a community decision, Jacobs concluded.

“If you and other citizens of the community think it’s an asinine idea, it isn’t going to happen,” he said. “Ultimately, the community is going to tell us what we’re allowed to do.”

The candidates generally supported sharing details of the hospital’s finances with the public. Balko and Jacobs both said the current board has been more open with the public, though Jacobs said he was hoping for more.

Mink, a longtime local internist and staff physician at AVH, said he had “no problem” having the hospital’s contracts with various physicians made public, but D’Alessio flatly opposed making the finances of individual medical practices open to public scrutiny.

“I don’t think it’s fair to lay every penny a physician makes on the table,” he said.

The hospital is currently negotiating contracts with about 14 physicians. Through the contract arrangements, the hospital provides services to medical practices, such as billing and nursing, and a salary to doctors “loosely based on productivity,” according to Karp. The contracts are necessary to recruit and keep physicians in a community that may not be large enough to retain them otherwise, he said.

Both Mink and Balko expressed regret that the system is considered necessary.

“The hospital shouldn’t really be subsidizing people,” Balko said.

Quizzed on how they would handle complaints of sexual harassment at the hospital, all four candidates said they would have “zero tolerance” for such behavior.

Karp confirmed that the hospital is currently dealing with allegations of harassment against a physician, but he said they are not sexual in nature.

The board candidates are vying for two seats up for election on May 4. A fifth candidate, Peter Nicklin, has dropped out of the race. Incumbent Morris Cohen is not seeking re-election.

Board members are elected to four-year terms.

Janet Urquhart’s e-mail address is

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“I think our revenues were overstated.”

Ð Dr. Greg Balko, hospital board candidate