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Voters will decide Munroe's fate

Ocala, FL - April 9, 2012

Published: Ocala.com/Star Banner - Monday, April 9, 2012 10:10 p.m.

Marion County Hospital District trustees voted Monday to ask the public to weigh in on Munroe Regional Medical Center's future.

The trustees voted 5-2 to ask voters in a November referendum to decide whether they were willing to fund a $130 million general bond. The bond would allow the not-for-profit hospital to pay off some of its debt and make capital improvements in order to be more competitive.

"The message is loud and clear what the people are saying in this room," said trustee Dr. Ravi Chandra, one of the five who supported the move.

A referendum was the best way "of sizing things up" to determine if the public was willing to support the hospital, Chandra said.

The motion failed the first time trustees considered it but passed when it was considered a second time.

Trustee Srisha Rao said the public should determine the hospital's future.

"This is a public hospital. The public should have a say …," she said. "Nothing is really going to change my mind tonight."

Trustee Dr. Mike Jordan said the bond option was the only viable tax of the four that trustees considered. If voters fail to support it, "I'll be more than willing to lease the hospital," he said.

But not everyone thinks a tax will cure the hospital's financial ills. Trustee Larry Strack said at the beginning of the nearly four-hour meeting the tax would be at best a temporary solution.

"We'll be back in three to four years from now," he said, adding that once a tax is approved "there'll be no end to it."

Strack said he doesn't favor a referendum because the issue is too complicated for most voters to understand.

The general public "will not take the time" … to educate themselves on the issue, he said.

Most of the 100 members of the public who attended the meeting said the issue should go to a vote.

"For us to call them ignorant, I don't get it," said former hospital board member Jim Schneider, adding later, "don't be afraid to take it to the people." Schneider is the CEO of Ocala-based Signature Brands.

He warned that if voters weren't able to vote on a tax and the hospital was sold or leased to a private hospital company, services would be cut.

Munroe Regional Medical Center's finances have been a problem for years.

Executives have had to dip into their reserves and rely on investments to make ends meet almost annually.

Also driving the search for money is an earlier hospital study that showed Munroe would need $150 million in capital improvements to remain competitive.

That's in addition to the annual $20 million for facility improvements and equipment. The not-for-profit, public hospital, often the hospital of last resort for many, has a higher-than-typical number of indigent patients, more bad debt and Medicaid/Medicare case loads .

Munroe Regional Medical Center is owned by the state-sanctioned Marion County Hospital District and overseen by seven trustees who are appointed by the County Commission. The seven trustees currently lease the hospital to Munroe Regional Health System, Inc., which is overseen by a 13-member board, some of whose members are also district trustees.

Beginning six years ago, hospital trustees began floating the idea of a public tax, but only more recently pushed the idea as local elected officials put more pressure on trustees to fix the hospital's finances.

Meanwhile, the trustees' other option is to lease or sell the hospital.

The four health care companies currently being reviewed by trustees are each offering to invest the $150 million trustees say is needed in capital improvements, in addition to between $50 million and $75 million over the next five years in other infrastructure improvements. The companies also are offering between $119.2 million and $325 million to lease or buy the hospital.

While most of the public who attended the meeting spoke in favor of a referendum, a few in the audience were against it.

"I'm overwhelmed with taxes right now," said Beverly LaCrosse, adding she had to take out a loan to pay her taxes.

"I can't even afford to see my grandchildren in New York," she said.

But Patti Orr was more typical of public sentiment.

A public hospital focuses on providing quality health care, while "a private organization is concerned about money," said Orr, a registered nurse at Munroe. "Who do you think wants to listen to us in a large organization."


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