On Wednesday evening, the board of the Broward Health hospital system praised CEO Shane Strum and presented him a plaque for four years of leadership and accomplishments. “It’s been an incredible four years. The guy is just killing it,” said Broward Health Chair Christopher Pernicano.
At the same time that evening, employees at Memorial Healthcare System, where Strum became interim CEO in September, launched a petition on Change.org accusing him of “dismantling Memorial from the inside.”
Bills HB 1253 and SB 1518 before the Florida Legislature that would create a virtual merger between Broward Health and Memorial are fueling the tension.
Much of the debate focuses on the role of Strum, a former Broward Republican chairman who had served as chief of staff to Gov. Ron DeSantis, who has initiated a round of reorganizations and firings at the Memorial System, under a mandate from the board to improve the organization’s efficiency.
The bills would expand on language in the two health districts’ charters and allow the systems to do almost anything jointly, including forming new nonprofit and for-profit ventures, partnerships, business entities, and service lines “regardless of the competitive consequences.”
Critics say this would give Strum “unchecked authority.”
There are varying viewpoints on whether the bill would benefit the people of Broward County.
For decades, the two taxpayer-funded hospital systems have independently provided care to insured, underinsured, and indigent patients. With Strum at the helm of both systems, they have been collaborating more and announced a “better together” arrangement in Broward last month to expand primary care together to underserved areas of the county.
Strum told the South Florida Sun Sentinel the bill, if approved, would benefit patients by better positioning Broward County’s public hospital systems to compete with the for-profit hospitals that are expanding their presence in the county.
“It’s going to create more efficiencies. It’s going to streamline the processes, and it will help us with recruitment,” Strum said. “Broward and Memorial working together is good for the community for a million reasons.”
However, in their online petition, some Memorial employees and physicians argue that the bill would “strip away legal protections that currently help safeguard patients, employees, and our community from monopolistic control and unchecked power.” As of Friday, more than 1,000 people had signed the petition.
It’s unclear whether the bills have much support. The leaders of each district’s governing board said they had not heard of the bills until they were filed, although they supported the idea of the two systems working together more closely. So far, the bills have not been scheduled for hearings, a key indicator of whether a proposal has a chance of winning approval during the busy legislative session, which ends on May 2. In the House, HB 1253 is sponsored by Republican Rep. Hillary Cassel of Dania Beach and in the Senate, SB1518 is sponsored by Republican Sen. Bryan Avila of Miami.
Cassel said she proposed the bill after conversations with leadership at the Broward health systems. She sees it as a way to allow the safety net hospitals that serve disadvantaged communities to be more innovative and collaborative. “The two districts are the only two organizations in Broward that are mission-driven to serve those populations,” she said. “I believe there are times when they could potentially share resources to better serve the population.”
Ron Book, the influential lobbyist who represents Broward Health and Memorial Healthcare System, says the bills still have time to be heard. “We are continuing to encourage it,” he said.
But there’s formidable opposition. HCA Healthcare, the giant, well-funded, for-profit company with nearly 50 hospitals in Florida, is lobbying against the bill. HCA lobbyist Robert Bradley of Oak Strategies did not respond to several requests for comment.
Even if passed, the bills do not allow for the merger of the two Broward public health systems. That would require a lengthy process involving legislative approval, a governor’s signoff, and a favorable vote from Broward County residents. However, the bills would allow the two health systems to do almost any type of business together within the county.
As public health systems, Broward Health and Memorial are required to treat every patient regardless of their ability to pay. Each system’s annual profits or losses affect Broward property owners who pay a yearly tax to help fund the health system in their district. The dividing line generally is Griffin Road. Memorial has been fiscally stronger than Broward Health for many years and has consistently maintained lower tax rates.
Luring privately insured patients, an essential ingredient in each hospital system’s financial health, has become more challenging. In the last few years, competition in Broward has intensified. Both HCA and Baptist Health South Florida have purchased land in South Broward with plans for free-standing emergency departments. Broward Health has more competition in the north with Holy Cross Health, Cleveland Clinic Weston, HCA Florida hospitals, UHealth and Baptist Health South Florida.
Book says the bill is needed so the health districts can compete in the marketplace beyond what their charters allow. They could jointly acquire for-profit companies or negotiate as one unit with vendors. Kelley Mallette, who works with Book, said the bills also prevent a federal agency from interfering with the local health districts’ activities.
“There have been instances around the country where some of this in healthcare has been seen as antitrust, so if the state makes an affirmative decision, the health districts can collaborate within their existing boundaries,” she said. “I really think a lot of the noise is to keep the public health systems at a competitive disadvantage.”
Broward County Commissioner Nan Rich said she endorses more collaboration between the two districts and wants to see the bills approved. “I want them to do more together. There are so many avenues for more effective healthcare,” she said.
Is it all about Shane Strum?
In emails to the South Florida Sun Sentinel and state legislators, Memorial physicians say they don’t want Strum to get the expanded power and “unchecked authority” this bill could provide.
Tension at Memorial has been mounting since Strum took over leadership six months ago. The board told him to make the organization more efficient and create a vision for the future. They noted how his political influence as DeSantis’ former chief of staff and community connections benefited Broward Health.
Strum, who once served as senior vice president of Memorial, has moved quickly to make changes at the South Broward hospitals, known for their “patient-first” culture and many years of profitability. After at least a decade with little change, Strum’s actions have not been well received.
Over the last six months, he issued a return-to-office mandate to about 1,300 corporate employees. He also moved people into new positions, demoted others, and eliminated some roles, including clinical positions. About five weeks ago, Ari Sareli, the Chief Medical Officer for Memorial Healthcare System, was let go. Strum also reduced doctor contracts from five years to three.
However, a recent round of firings this month and the proposed bills have ignited a new round of complaints about Strum destroying morale.
On March 17, Strum fired 30 employees in the district’s corporate headquarters, six from the Memorial Physician Group and 30 workers at its six hospitals. Another 11 corporate employees and 21 Physician Group members saw “role changes” in their employment. Strum told the South Florida Sun Sentinel Wednesday that no physicians were fired this month, nor will they be.
Strum said he is doing what the Memorial’s Board of Commissioners brought him in to do — eliminating inefficiencies. He noted that the newest reductions affected 0.5% of Memorial’s 17,500-employee workforce.
“We reduced for redundancy,” Strum said. “There could have been more, but I thought we must be cautious as we’re moving along here and the Memorial Healthcare System does well. This is a big deal that we did that. They (Memorial) don’t (make cuts).” Strum said the restructuring — at least for now — is complete.
No physicians or other district personnel would comment for publication, saying they didn’t want to antagonize Strum at a time of uncertain prospects for continued employment at Memorial.
Memorial’s board wants change
Memorial’s Board of Commissioners praised Strum at Thursday night’s board meeting for carrying out their mandate to make adjustments.
“We have entrusted Mr. Strum to look at the workforce and make some really hard decisions that impact human beings,” Vice Chair Steven Harvey said. “These are tough decisions and adjustments that must be made to stay efficient. Better to do it in small amounts to remain sharp like a knife rather than wait until a crisis comes and we’re looking at 600 people.”
In an email to Harvey after the meeting, copied to the Sun Sentinel, an unnamed employee wrote: “Memorial’s workforce was once the foundation of the system’s culture … you have demolished our culture.”
The current climate of fear has silenced any public discussion. Although given the opportunity, no one employed by Memorial spoke out at the board meeting to voice concerns. Chair Elizabeth Justen acknowledged she and other board members had received numerous anonymous emails expressing contempt for the recent changes. “If somebody wants to talk to us, then we’re available. We had a public forum last night, and nobody showed up to speak,” she said.
However, in their petition on Change.org, Memorial employees condemned the firings. “There was no warning. No conversation. These were individuals who served patients with heart and integrity — gone overnight. An additional 32 employees have been demoted and given pay cuts. Quietly. Strategically. Without transparent explanations.”
The petition says, “If these bills pass, that may become permanent authority — and could allow similar actions to occur more frequently, with even less accountability.” Along with the petition, someone claiming to represent Memorial physicians has been sending emails to Florida legislators urging them not to pass the bills and accusing Strum of ethics violations.
Will Broward residents benefit from partnerships and collaboration?
The chairs of both hospital system boards said they were unaware of the proposed bills before they were filed and had not read them, only heard of their content. However, both Broward Health Chair Pernicano and Memorial Healthcare Chair Justen said they want to see the hospital systems work together more and in new ways.
Justen said that while she hasn’t read the bills in depth, she supports aggressively pursuing new opportunities jointly that will benefit the hospitals and community. She noted that the two are now on the same electronic records system, allowing patient information to be shared across systems. She added that even if the bill is approved, Strum will continue to need both boards to sign off on new ventures.
The petition portrays a bleaker picture of what could happen if the bills were passed:
“Clinics could close. Procedures may be outsourced. Services that aren’t deemed ‘profitable’ may quietly disappear. The safety net our community relies on — especially seniors, low-income families, and the uninsured — may shrink or vanish altogether. This legislation could transform a public healthcare system into a corporate machine, where patient care becomes secondary to financial strategy.”
Justen does not agree with that view. “I don’t see this bill doing anything except helping to provide better care for Broward County,” she said. “We know that people can be uncomfortable with change, but the board really does care about the organization. We’ll always do what is right for the people of Broward County.”
South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
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