Elective surgeries at Broward Health’s four hospitals were postponed this week as unpaid anesthesiologists walked off the job and financial problems deepened for Anesco, the systemwide anesthesia provider.
Patients with planned operations such as hip replacements and hernia repairs were told their surgeries would be delayed. The hospitals — Broward Health Medical Center in Fort Lauderdale, Broward Health North in Pompano Beach, Broward Health Coral Springs and Broward Health Imperial Point in Fort Lauderdale — lacked anesthesiology staff, using the remaining medical professionals for more urgent surgeries.
Anesco North Broward, a privately owned anesthesia group, has had the exclusive contract to provide anesthesia services at Broward Health hospitals for over 25 years. Most doctors and nurses it employs have non-compete agreements, making it difficult to leave. Most of the professionals have continued to work, despite not being paid, while some nurses and doctors have resigned.
A dozen Anesco doctors and nurses told the South Florida Sun Sentinel recently they hadn’t been paid in weeks, some even as much as three months.
Along with staff, Anesco hires contract workers, who also haven’t been paid.
“This is our livelihood,” said a nurse who asked not to be identified out of fear of not being employable. “We are out thousands of dollars. We provided excellent anesthesia services and we were not paid. But our issues are nothing compared to the amount of people who need the care they may not be able to get. We have to make it known the care you get at Broward Health is lacking because anesthesia services are not adequately being provided.”
Friday is Anesco payday, but CEO Richard Meli told the South Florida Sun Sentinel on Wednesday: “We are not going to be able to make payroll. It might be like D-day on Friday. Our plan is to sort of plead with our practitioners to keep working for the patient care because that’s the biggest issue we care about.”
Broward Health CEO Shane Strum said Thursday that his health system is already working with recruiting firms to hire temporary staff to fill anesthesiology vacancies after Friday because they are anticipating more staff departures. The replacement workers could begin working as soon as Monday.
Because Anesco employees have non-compete agreements, the hospital cannot hire them as Broward Health employees. And because Broward Health has already paid Anesco, the hospital district’s position is that they would not provide the back pay either.
After learning that Anesco had not paid its employees, Broward Health terminated the contract on Jan. 28, giving it a 150-day notice through the end of May. Strum would not confirm reports that Broward Health has already hired another provider, Envision, to provide anesthesia services when Anesco leaves after that period.
“Broward Health wouldn’t be doing their job if we didn’t have a backup plan,” Strum said. “We are hiring and are 100% prepared for the minute he (Meli) breaches or his doctors walk. His anesthesiologists might not be able to work … but we have other anesthesiologists.”
It is unclear how Anesco plunged into such extreme financial distress; the company’s only client for more than 25 years has been Broward Health.
Meli attributes Anesco’s financial problems to rising labor costs and conflicts with Broward Health over fees. “What’s happened in the last few years is the cost for anesthesiologists has risen dramatically. And they keep going up and up. …The market for CNAs (certified nurse assitants) and physicians has doubled.” Meli said he asked Broward Health for subsidies, but they weren’t enough.
He also said billing problems were caused during Broward Health’s transition to a new electronic medical records system. The system is used nationwide by mutiple large hospital systems; Strum says the Broward Health implementation was completed by November.
Strum said Anesco asked Broward Health several times over the last 18 months for supplemental funds. He said Broward Health has given him money each time Anesco asked for it, providing millions in subsidies and even upfronting funds to Anesco through March. “He is constantly needing more money,” Strum said. Strum said Broward Health would not provide Anesco’s professionals back pay, but would hope to hire them in the future, if possible.
Meli and his attorney, David DiPietro, said Anesco wants to work with Broward Health to complete its contract and hopes to avoid filing for bankruptcy.
“We want to work to transition out where the patient continuum care continues and it’s a win-win for everybody,” DiPietro said. “If Broward Health wants a divorce from Anesco, we recognize that. We don’t agree with it. We would love to keep doing business with them, but we have to accept reality. We want make sure the continuum care is done and we’re compensated for what we’re owed.”
In a letter this week to Broward Health, Anesco requested “a lump-sum buyout of its contract for $6 million.”
Strum said the next few weeks may be “bumpy” as the health system and Anesco cut ties.
“Broward Health is built to last,” he said. “We’ve been in these situations before. We’re actually several steps ahead on our planning and when it does happen, we will be prepared to do everything that we need to.”
South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.