Blade: Hospital tech worker shortage weighs on UTMC’s budget

The University of Toledo Medical Center continues to lead the way in revenue growth for the school, even as costs mount to fill vacant lab tech and other similar job positions using third-party vendors.

Patient service revenues for the former Medical College of Ohio Hospital were more than $26 million higher than expected for fiscal year 2023, which ended June 30, with more than $377.5 million collected compared to roughly $351.1 million budgeted, according to the final budget numbers.

Those revenues are nearly $52 million, or 15.9 percent more, than the more than $325.6 million collected in 2022.

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Blade: Gov. DeWine, Rep. Kaptur eye UTMC expansion

“University of Toledo President Dr. Gregory Postel, who joined the elected officials on the tour, said a plan is already in the works to create an inpatient psychiatric unit at UTMC sometime in the next two years for adults. Doing so would connect other offerings at UTMC, which include pediatric psychiatric services, and geriatric psychiatric services, as well as research opportunities in those and other fields.”

“Governor DeWine spoke of how UTMC, which was put up for bid in the spring of 2020 by UT trustees before they backed away from that initiative months later, is vitally important to the quality of life for northwest Ohio residents.

He said that was clear to him Monday during the tour when he and the rest of the group saw the work being done at the Dana Cancer Center, the Kobacker Center — or behavioral health facility where they saw the child and adolescent psychiatric units — and the surgical intensive care units since it was upgraded from a Level 3 to a Level 2 facility.

“A governor is supposed to look at things from a big picture, and the big picture is this needed to stay — that relationship needed to stay,” said Mr. DeWine, in his second term as Ohio governor. “It would not be helpful to see that separation, and that was just abundantly clear from what we’ve seen across this country.”

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Blade: UT trustees look to revise affiliation agreement between medical college, ProMedicaBlade:

Following an executive session — and no public discussion on the matter — trustees unanimously adopted a resolution allowing UT President Dr. Gregory Postel and his leadership team to negotiate changes to the academic affiliation agreement between the UT’s College of Medicine and Life Sciences and ProMedica.

In separate action Wednesday, trustees approved the creation of a separate board to oversee the medical center, UTMC, and all health facilities and clinics, thus replacing the current Clinical Affairs Committee. 

The new UT Health Board will have 15 members consisting of two trustees, two department chairmen or faculty members, the dean of the health sciences college, the UT president, the dean of the College of Medicine and Life Sciences, the UT executive vice president/chief financial officer, and seven members of the public. 

Dr. Postel said the board allows for all the operations to run more efficiently to better plan budgets and strategy while standardizing operations for a more highly functioning organization.

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Blade Editorial: Transformation reversed

Note: this editorial was published in the September 25, 2022 edition of the Toledo Blade.

It’s never pretty when dreams are shattered. It’s nothing short of a calamity when two vital institutions are confronting the nightmare.

The partnership between the University of Toledo College of Medicine and Life Sciences. the former Medical College of Ohio Hospital, and ProMedica health system is a classic example. In 2015 when university and hospital leaders signed a partnership agreement under the gaze of city leadership, then-UT President Sharon Gaber said, “this is a transformational day for the University of Toledo, for ProMedica, and for the Toledo community.”

That dream of institutional-strengthening synergy between UT and ProMedica has turned into an ugly situation for both institutions at about the worst possible time. ProMedica’s coronavirus related fiscal troubles have caused a downgrade of the system’s debt to junk status. UT’s enrollment decline is so significant a $200 million housing upgrade had to be canceled.

The deal between UT and ProMedica was supposed to make each party stronger and thus be great for Toledo. The university’s medical students and residents would work with ProMedica as the exclusive clinical education partner. In return, ProMedica would pay UT around $50 million a year for 50 years.

Theoretically the ProMedica affiliation makes UT’s medical school more attractive to potential students and ProMedica benefits from access to a steady stream of physicians with ties to Toledo. But reality struck this week when ProMedica’s missed monthly payments brought Ohio Attorney General Dave Yost to town, threatening to sue the health system if it doesn’t make a payment by Sept. 28.

The A.G. is legal counsel for all of Ohio’s state universities. Mr. Yost accused ProMedica of using its financial weight to starve UT into submission in a dispute over expenses UT owes ProMedica. Mr. Yost called ProMedica’s contention that the contractual obligation was balanced out by expenses owed to them, “hogwash.”

Mr. Yost says the contract shows “miniscule” expenses compared to the monthly payment owed to the university by the hospital. He says it’s possible for the 2015 pact to be renegotiated but only if the parties operate in “good faith.”

This is much more than a blemish to the reputation of both ProMedica and UT. It hurts both institutions to have this bubble up in public and reinforce the perception of serious financial decline as the cause of a deal coming apart.

Just as both ProMedica and the University of Toledo were aided by a successful deal, each is weakened terribly by this display of distress. And of course the transformation that was good for Toledo in 2015 is terrible for us all as it unravels acrimoniously in 2022.

Winkler: Past is prologue with ProMedica & UT

Note: this letter to the editor was published in the September 25, 2022 edition of the Toledo Blade.

A kerfuffle between ProMedica Health System and University of Toledo College of Medicine and Life Sciences, the former Medical College of Ohio Hospital, involving their 2015 clinical affiliation agreement and money?

Who could have possibly seen this coming?

With apologies to Claude Rains’ Capt. Louis Renault in Casablanca, I could pretend to be shocked — shocked — that these two institutions aren’t getting along.

But guess what?

We’ve seen this movie many, many, many times before — the old tempestuous, mercurial MCO-ProMedica relationship that now has been inherited by University of Toledo and with new actors and new plots.

Who can forget, for example, that classic film noir, World-Class Medical Center, a story about the messy, doomed three-year merger discussions starting in 1993 with MCO selling its teaching hospital to ProMedica as part of an effort to create what the MCO president at the time called “a world-class medical center?”

Who remembers that 1999 gem, Fighting’ Hospitals, a tale of ProMedica unilaterally severing its academic affiliation with MCO in retaliation after MCO Hospital closed its inpatient pediatric unit to join then St. Vincent Medical Center to create a children’s hospital?

Toledo Hospital already had a children’s facility in its building.

Sure, it’s all ancient history, but provides some meaningful context for the latest imbroglio.

For the sake of medical education in northwest Ohio, let’s hope the parties can work things out.

But it is probably too much to ask for “the start of a beautiful friendship” like that of Humphrey Bogart’s Rick Blaine and Claude Rains’ Captain Renault.

Toledo is not Hollywood.

JIM WINKLER

Gainesville, Fla.

Editors note: The writer worked in several communication positions at MCO and UT for more than 30 years and is one of four editors of the book, A Community of Scholars: Recollections of the Early Years of the Medical College of Ohio.

Blade: AG Yost threatens lawsuit amid ProMedica, UT financial dispute

Ohio Attorney General Dave Yost said Wednesday his office would sue ProMedica if it does not pay the University of Toledo at least $3.8 million under a medical education agreement the two organizations struck in 2015.

The community organization Save UTMC organized a news conference Wednesday calling on ProMedica to catch up on its payments. The hospital had struggled in recent years, facing a deep budget deficit in 2020, though it has since rebounded.

Critics of the affiliation agreement said the deal was hurting UTMC — siphoning faculty and resident talent from the teaching hospital to ProMedica and contributing to the facility’s financial woes. UTMC has since rebounded, but the Save UTMC group on Wednesday said they are again concerned after the missed payments, and proposed cuts to the medical school.

“It’s really simple — ProMedica and UT have entered into an affiliation agreement, and if one party is not adhering to the terms and conditions of that agreement, then that’s a breach,” said Randy Desposito, president of American Federation of State, County, and Municipal Employees Local 2415. “So what we are asking the UT administration to do is to stand up and hold ProMedica accountable for the monies that is alleged that they owe to the University of Toledo.”

Former Toledo Mayor Carty Finkbeiner, a leader of the Save UTMC group, said the affiliation agreement “has been disrespected and recently totally disregarded, walked away from, by ProMedica.

“We want ProMedica to be successful,” he added. “We do not wish them to be as challenged financially as they are at the moment. But that does not give the right to ProMedica to walk away from an agreement with UT and UTMC.”

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Blade: ProMedica, UT financial dispute forces medical college to cut budget

University of Toledo officials say ProMedica has fallen behind on its required payments to its medical college as part of a seven-year affiliation agreement, but ProMedica counters that UT owes it money, not the other way around. 

UT spokesman Meghan Cunningham said Monday that ProMedica missed its August and September payments to UT — but wouldn’t say how much those payments are — as part of a 50-year affiliation agreement in 2015 that calls for millions in annual payments from ProMedica. Beginning in 2020, that amount was set at $50 million.

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Blade: UT, BG trustees approve new budgets, receive enrollment projections

In projections through the end of June, UTMC appears to have exceeded the 2021-2022 budget’s overall operating revenue prediction by over $25 million. Numbers for clinic visits, surgeries, admissions, and kidney transplants are all trending upwards, Mr. Holmes said.

Accompanying a 5 percent increase in the price of their medical services, UTMC also hopes to increase their patient volume by 4.5 percent in the next year. They anticipate $284,888,076 in patient services revenue alone, which accounts for 35 percent of all budgeted revenue for UT.

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Hussain: UTMC a success story in our own backyard

Note: this editorial was published in the May 11, 2022 edition of the Toledo Blade.

Today I wish to report on a success story. In an era of doom and gloom, preoccupation with the ongoing scourge of the coronavirus and the drumbeat of spurious slogans to make America great again, there is positive news about something in our own backyard. It is about the University of Toledo Medical Center, the former Medical College of Ohio Hospital.

Three years ago, the hospital was in dire straits. As a small free–standing academic hospital, it was feeling market pressure. It was assumed that unless it found a partner it would not survive. Efforts to find a suitor were made as early as 2012 but nothing materialized. In 2015 the University of Toledo entered into an academic affiliation agreement with ProMedica, the large local health-care system, to train students and resident physicians.

A bit of background:

The Medical College of Ohio Hospital was built in 1964. At the time it was thought that a small, 300-bed hospital would be sufficient to meet the needs of the medical college. And it did by providing excellent patient care, teaching, and robust research in the clinical and basic sciences. The founders had not realized, they could not have, the changing health-care scene in the United States. Soon it became evident that the days of a small free-standing teaching hospital were fast disappearing.

By 2010 it was becoming clear that UTMC, as a stand-alone facility, could not survive for long. Some visionaries had realized early on that in a highly competitive atmosphere, mergers were the only way to cut costs and continue the mission. Such mergers and acquisitions happened all across the United States.

The dilemma for UTMC was that there were no viable options to join a bigger hospital. ProMedica was gun shy after its attempted acquisition of St. Luke’s Hospital in 2010. That deal was challenged, and the Federal Trade Commission ruled that the merger was ‘illegal and anti- competitive’. ProMedica had to divest itself of St. Luke’s.

In 2015 the University of Toledo signed an academic affiliation with ProMedica in which ProMedica committed a large sum of money for the affiliation. It offered hundreds of millions of dollars up front and then $50 million yearly for 50 years. According to the agreement, the Toledo Hospital would become the main academic hospital for the UT College of Medicine.

Left out of the negotiation was the fate of the UTMC. Some people at ProMedica did not shy away from saying that UTMC should be closed. And it came precariously close to being shuttered up.

Here one must acknowledge the community effort led by the former Toledo mayor Carty Finkbeiner and the local unions that started a campaign to save the hospital.

Enter Dr. Gregory Postel, the new president of the University of Toledo. Soon after his arrival as the interim president of the University of Toledo he put an end to the process of selling or leasing the hospital. He brought with him the experience of two academic affiliations that he presided over in Louisville.

A neuro-radiologist by training, Dr. Postel is a visionary and possesses a decisive mind. And he can read the proverbial tea leaves with uncanny insight and accuracy. Within a year, thanks to his efforts, the hospital became solvent.

Instead of considering UTMC a liability for the university, Dr. Postel called it an asset.

The operating rooms, providing a bulk of revenue for the hospital, are busy providing surgical care that was once the hallmark of UTMC. Though functioning at a lower-bed capacity, the hospital is busy in all areas providing excellent university-standard care and in certain areas specialized care that is not available elsewhere in Toledo. Cardiac-surgery services that some pundits on North Cove Boulevard wanted to shut down has resurged and is leading the way in innovative heart surgeries.

Most recently the hospital received level 2 designation for trauma.

And there is something else that I observed during my recent hospitalization at UTMC. It was a sense of pride exhibited by physicians and health-care workers in their work. They take care of patients beyond the call of duty. I remember this spirit so well during my long association with the medical college and the teaching hospital.

It is much easier to demolish and dismantle than build something from scratch. My argument to retain UTMC as a teaching hospital is based on ground realities, a continuum of excellence, and the continued need for such a facility in South Toledo. It is not based on nostalgic longing for a past that has long passed.

S. Amjad Hussain is an emeritus professor of surgery and humanities at the University of Toledo. His column runs every other week in The Blade. Contact him at aghaji3@icloud.com.

Blade Editorial: UTMC’s rocky road gives way to right path

Note: this editorial was published in the May 10, 2022 edition of the Toledo Blade.

The University of Toledo Medical Center faced a rocky road of ups and downs for several years. Most of those roads seemed to be going downhill.

University and community leaders, dedicated physicians, health-care providers, and staff turned things around. The latest example of the good news for UTMC, the former Medical College of Ohio Hospital, is its designation as a level 2 trauma center. It’s a significant step forward in a short period of time from difficult times.

Facing financial troubles, in 2019 UTMC downgraded their trauma center from a level 1, the highest designation, to a level 3.

In 2020, the plan was to put the medical center up for sale. Things were that bad.

It didn’t happen. A plan, the support of the community, and the incredible, dedicated efforts of UT President Dr. Gregory Postel turned things around.

One sign of that change in attitude was a plan to upgrade the trauma center designation.

The move forward from the loss of status and capabilities took place with remarkable speed. The new status means an increased ability to care for patients with a wide variety of trauma. Level 2 trauma centers must be able to call on certain staff 24/​7; that isn’t required of level 3 centers. It means specialists in orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, and other staff can respond to get patients the care they need.

That’s what a hospital, and a trauma center are all about.

UTMC’s future looks bright, and each step forward should be celebrated. It’s more than a feel good story.

Having multiple high-level hospitals and trauma centers helps our community. It’s also key to attracting new residents and new businesses because high-quality medical care is high on the list of considerations for most corporations and the employees who work for them.