Bayfront Health St. Petersburg dogged by questions about finances, patient care

ST. PETERSBURG — The city's routine annual checkup with its largest hospital turned into an acute case of confusion Thursday as executives for Bayfront Health struggled to explain their own financial numbers under tough questioning from City Council members and confronted troubling accounts from area nurses, who aired complaints of deteriorating care.

Joseph Mullany, regional CEO of Bayfront Health, the health care network which has the St. Petersburg hospital as its flagship, painted a rosy picture in a presentation before council members. He said the 480-bed facility had increased charity care for the uninsured and was intent on growing and serving the community.

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"I do think it's important for people to know there's a commitment from us to be part of this city," Mullany said. "I know when you're trying to recruit, one of the first things people ask is, 'What is the health care like in the city?' I view us as part of that economic fabric of the city."

But local members of National Nurses United countered his portrayal with a flier outlining serious problems at Bayfront Health St. Petersburg. The union detailed issues with understaffing and equipment shortages that reportedly had led to high infection rates, unnecessary deaths, bed sores and other problems — all quickly denied by Mullany.

Members of the union also spoke directly to council members, insisting that conditions at Bayfront — a long-standing institution with a history of serving the city's poor — had declined since it was taken over in 2014 by Tennessee-based Community Health Systems.

Terrie Weeks, a registered nurse in Pinellas County, said in an interview that colleagues at other area hospitals were getting reports from Bayfront nurses about unsafe staffing levels and unclean conditions.

"We're hearing that nurses have too many patients and they don't have the equipment needed to do their jobs," Weeks said. "When I moved here 23 years ago, Bayfront was a good hospital. It's where you went if you lived in St. Pete, but it's definitely gone downhill since (Community Health Systems) has owned it. The people who work there are by and large not happy."

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The for-profit hospital sits on city-owned land, and thus operates under a lease with the city that requires an annual report to the City Council.

Also Thursday, council members questioned the figures Mullany shared with them about the financial state of the hospital, its admission rates and charity care figures, which fluctuated depending on which document they looked at.

Mullany and his team submitted one report to council members on Monday, then updated it Wednesday at 5 p.m. with new figures, but did not explain why the numbers had changed.

Vice Mayor Kanika Tomalin asked Mullany about layoffs at the hospital in July. She said she was told by an employee that nearly 100 people had lost their jobs.

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Mullany said 100 positions "was not accurate," and that the real figure was 32. This was the second round of layoffs at the hospital so far this year. Bayfront officials told the Tampa Bay Times in April that the company laid off 19 employees.

Mullany also described Bayfront's contribution to charity care, or treating the city's uninsured residents at no cost, as the hospital's greatest challenge. The hospital spent nearly $86 million in 2018 in charity care, up from $73 million in 2017, and the highest amount recorded since 2007, he said.

Another concern, he said, was the number of hospital bills that have not been paid by patients or insurance companies.

But council members raised doubts about his data.

"There are significant number changes from the original presentation to the new one," said council member Amy Foster. "The numbers are different from what was submitted Monday versus last night at 5 p.m."

Mullany said the numbers were updated in an effort to be "accurate and transparent with this group." And in a startling admission, he said the figures the hospital presented to the council last year were inaccurate.

Mullany stated that Bayfront's charity care commitment was three times higher than its competitors in Pinellas County. But Foster cited a recent survey from the Foundation for a Healthy St. Petersburg that showed two BayCare hospitals in the county — Morton Plant and Bayfront's direct competitor in St. Petersburg, St. Anthony's — significantly outpaced Bayfront in charity care in 2017.

Foster said she's not convinced that the figures Mullany shared, which came from the Agency for Health Care Administration, are the same as outlined by the charity care agreement in the city's lease with Bayfront.

But Mullany balked at the idea that the charity care figures were wrong.

"The hospital has 480 beds and 2,000 employees. A report could be this thick and we could be here all day," he said. "There's no need for us to feel like we're not being transparent."

Council member Ed Montanari questioned Mullany about the hospital's financial numbers, which showed a $153 million deficit, including $10 million for what he described as depreciation.

"As the landlord, I get concerned when I see those big numbers. From a financial point of view, it causes me a lot of concern," Montanari said. "I've been through three of these annual presentations with Bayfront and never recall receiving this document."

Bayfront's new chief financial officer, Charlie Tyson, struggled to address questions about the hospital's balance sheet, including an inquiry as to how debt was being passed to Bayfront from its parent company in Tennessee.

"That's outside of normal business operations," Tyson said. "I'm unfamiliar with how that is passed onto us from another entity inside the organization with my short tenure here. This is my third month at Bayfront."

Council members asked Mullany to schedule a follow-up conversation. But neither Montanari nor Foster felt good about where the meeting ended Thursday.

"I'm not comfortable with how we're protecting our community asset, the hospital, or protecting patient care for our residents," Foster said.

Montanari echoed those sentiments.

"As their landlord and representing the residents of this city, we want Bayfront to be successful," he said. "If I was going to take somebody to a hospital, I'd want to take them to a good place. By a couple of different measures, they need to do some work."

Contact Justine Griffin at jgriffin@tampabay.com or (727) 893-8467. Follow @SunBizGriffin.