San Diego Grand jury wants independent review from Tri-City

By Keith Darcé, Union-Tribune Staff Writer

2:15 p.m. June 2, 2009

The San Diego County Grand Jury on Tuesday called on Tri-City Medical Center's board to launch an independent review of the troubled hospital's governance structure and consider a new system for managing the North County public district facility.

“The current model of governance by elected board members may not be a productive model for use in meeting the kinds of complex problems faced by modern health care organizations,” the grand jury wrote in an eight-page report.

It recommended creating a panel of “qualified stakeholders” to conduct the review.

The review could consider several alternatives for Tri-City, such as merging the district with the neighboring Palomar Pomerado Health district, turning over hospital operations to an outside party or selling the hospital to another health system.

The grand jury noted that conditions in the district today are far different than they were in 1961 when the hospital opened. Tri-City faces increasing competition from Palomar Medical Center and Scripps Memorial, both in Encinitas, as well as mounting pressure to renovate its aging buildings.

Last week, disgruntled physicians at the Oceanside hospital asked the Tri-City board to study the way the hospital is governed and possibly affiliate with another health care operator to run it. The board rejected the proposal in a 4-3 vote.

Tri-City wouldn't be the first public health district in the county to go through such a governance review process. In 1991, the Grossmont Healthcare District turned over operation of its hospital in La Mesa to Sharp HealthCare, a nonprofit health system in the county.

The grand jury investigation of Tri-City was triggered by a complaint concerning a controversial Dec. 18 special board meeting. Today's report didn't identify the person who made the complaint.

In a closed session during that meeting, a newly elected four-member majority of the Tri-City board placed the hospital's CEO and eight other senior executives on administrative leave, hired new lawyers and launched a vaguely defined investigation into hospital finances and employee relations.

The complaint filed with the grand jury suggested that the meeting might have violated The Ralph M. Brown Act, a state law requiring advance public notice of government meetings.

While the grand jury declined to weigh in on that question, it concluded that “there are serious problems and questions related to the Dec. 18 meeting.”

The grand jury also avoided passing judgment on the board's decision to replace Tri-City's management team. However, the investigative panel said the abrupt move was ill-conceived and led to potentially costly litigation and negative publicity for the hospital.

Keith Darcé: (619) 293-1020;

http://www3.signonsandiego.com/stories/2009/jun/02/bn02tricity141532/