The nonprofit corporation that oversees Prince George's County's long-troubled public hospitals was created two years ago as a way to remove county politics from the health care delivery system.
But internal politics, petty bickering and corporate intrigue have continued largely unabated under Community Hospital and Health Care Systems Inc., according to confidential minutes of meetings from spring 1984 through early this year.
Management problems that the new corporation was supposed to remedy are "really worse than before,"former county executive Lawrence J. Hogan, who signed the legislation transferring hospital management to the corporation, said recently.
And if everything that happened at corporation meetings was put in writing for distribution, corporation Chairman Frank J. Aluisi said at a Jan. 16 committee meeting, "our landlord might think we are idiots." The corporation's landlord is the county government.
The County Council and County Executive Parris Glendening called for an investigation of the corporation (known through its initials CHHCS as "Chicks") late last month, after allegations of nepotism, conflicts of interest and fiscal irregularities were brought to their attention.
The corporation responded by establishing an ad hoc committee of board members to investigate itself and hired a Baltimore attorney to assist.
It is unclear whether the county has the authority to force the corporation to do more. The county ceded all management control in 1983 when the nonprofit corporation was formed to vote on union wage contracts, approve budgets and set overall policies for the county's three public hospitals -- Prince George's General, Greater Laurel-Beltsville and the Bowie Health Center -- and their nearly 3,000 employes.
The chief goal of the $100 million-a-year corporation was to make the hospital system more efficient and profitable. However since its inception, the county hospitals' bottom line has shifted from a $3 million surplus to an $11,000 deficit in the past fiscal year. The corporation's officers blame that drop on employes' wage increases and corporate start-up costs.
However, former vice chairman Fred S.G. Frederick attributes much of the deficit to inefficiency. The corporation has added a bureaucratic layer to the county's hospital system that costs $1.5 million a year, with little noticeable impact, he says. Frederick recently was fired by the board after he raised conflict-of-interest allegations with the county bar.
Most of the 22 men and women who sit on the corporation board -- among them politically connected lawyers, health care professionals, a banker, an investment broker and an accountant -- do not feel obliged to discuss its internal workings with the public, though the original directors were appointed by the council and county executive and the buildings they occupy are county owned. Indeed, confidentiality frequently has been an overriding concern.
Last August, for example, the corporation's 11-member executive committee discussed what Wayne Curry, the secretary and general counsel, called "corporate sabotage." The issue was testimony by Dr. Leon Levitsky, administrator and part-owner of Prince George's Doctors' Hospital, opposing the corporation's bid to expand its Bowie Health Center. Levitsky's testimony seemed to show that he had board sources.
"We should get to the bottom of who is leaking this information and to whom," board member Meyer M. Emanuel Jr. said, adding, "It might be appropriate to hire a private detective." However, none was hired.
The issue of confidentiality arose again in January in a discussion of "closed executive session" minutes. Board member Frederick argued that all 22 board members should have access to executive committee minutes. The discussion led to Aluisi saying he did not understand "why we cannot wash our dirty laundry in private and not have it written up."
One piece of the "dirty laundry," according to internal correspondence, is that Aluisi and corporation President Robert J. Brady Jr. have been less united on issues than they publicly concede. "The president and I are in the process of developing a routine for communicating with each other," Aluisi said in a Dec. 19 memorandum to all executive committee members.
In one executive committee discussion, Aluisi said Brady was" 'playing his cards close to his chest' and the board is being denied information because Mr. Brady does not know who to trust . . . . "
Brady, a 40-year-old lawyer from Bowie whose sister is married to former Maryland lieutenant governor Sam Bogley, has been the target of allegations that he used his hospital position to hire his relatives. Brady has said that the hospital system has employed his brother as a photographer and his two sisters and his brother's wife as nurses, but he denies any favoritism.
He also has been accused of using his position to promote his private interests. As president of his own firm, Brady developed a computerized system to enable hospitals to compare vendor prices before buying medical equipment or supplies. To help market his product, Brady tested it without charge in 50 hospitals, including Prince George's General. "I don't see any blurring of roles," he said in an interview. "Everything I've done for the system has been with the intent of giving them the opportunity to reduce costs."
Brady formerly headed the county board that oversaw construction of the Bowie Health Center, now the smallest part of the hospital system.
The corporation has been split over the relationship between the corporation and the subsidiary boards running each hospital. The corporation has consolidated its power while limiting that held by its "local management boards." Under amended bylaws, it appoints the members of the subsidiary boards.
During one meeting, Brady urged that the local boards be only advisory, with power to "recommend" policies to the corporate board for approval. Frederick, head of the Laurel-Beltsville board, voted no, but the motion passed.
At a June meeting, Brady complained about corporation board members themselves, saying that their "free lancing," or dealing directly with hospital staff, had "destroyed" his presidential authority and put corporation activities "in neutral." He said he thought it might be necessary to hire a management firm or a strong executive to "keep the board members at bay."
Indeed, corporation members were interfering in day-to-day hospital operations, Pat Noble, who had just resigned as director of nursing at Prince George's General, told the executive committee that day.
After she had left the room, board members disagreed on whether she should have been invited to address them. According to the minutes, Emanuel, a former state senator, "felt that members of this corporation are mature enough not to get carried away about 'underlings criticizing management.' "
The most persistent dissenter on the board and executive committee, according to the minutes, was Frederick, a Laurel car dealer.
In November, Frederick questioned corporation balance sheets showing the $11,000 deficit "when maybe that is not the case." Brady acknowledged later in an interview that the hospitals' operating deficit was $1.4 million until accounting adjustments were made.
The corporation board also split over overdue accounts, which amounted to $32 million in January. The number of days such accounts were overdue had jumped, on the average, from 85 to 116 days, despite the hiring of an outside consultant who had been paid $80,000 to resolve the problem.
Curry said the increase occurred because the hospitals were making greater efforts to collect past-due accounts previously written off.
Frederick's removal was discussed at the Jan. 28 full board meeting. "When you have trouble on the bridge, you got a ship that is going nowhere and it will lead to mutiny on the bounty," said the Rev. John Acie Burgess, head of the ethics committee, according to the minutes.
If corporate officers are not functioning, he told the board, "let's unload them or we will be unloaded."