Frank Nask Does
The Lazerus Tango

   NOTE: Less than six months ago, the old board of commissioners running the North Broward Hospital District sought – and failed – to oust Frank Nask as CEO of the nation's seventh largest tax-funded hospital.
   However...
   Last month, the District's new board unanymously voted to pay Nask $600,000 a year – plus bonuses – for the next five years.
   Which is how and why I've chosen to re-post the following item which appeared on my blog earlier this year.
   Trouble is, the four new District Commissioners lack both basic health care knowledge and/or experience to grasp the data below. JKdeG

   Of course there's a difference between redemption and resurrection.
   But it's not always easy to tell.
   Take the two top executives credited with cataclysmic financial collapse of Palm Beach County's two oldest hospitals a decade ago.
   Faced with combined operating losses totaling nearly $72 million, Phillip C. Dutcher and Frank Nask resigned as the Chief Executive and Chief Financial officers of the jointly-operated St. Mary's and Good Samaritan hospitals in 2000.
   Just three years before, the two hospitals had a combined healthy surplus of more than $10 million.
    In other words, in two years, the two hospitals suffered a downward bottom line “swing” of more some $92 million – which, as swings go, is way bigger than anything Tarzan ever tried in his best jungle movie.
    Anyhow...
    The financial collapse of the two hospitals under the Dutcher-Nask management team's leadership led to the court-ordered sale of St. Mary's and Good Samaritan to Tenet Healthcare for some $244 million in 2001.
    In an in-depth article detailing the near-death of the two hospitals, the Palm Beach Post placed the blame on the Dutcher-Nask team's “inept and incompetent management.”
    That was then...
    But now today:.(early 2010).
    Phil Dutcher earns $127,000 a year as the chief operating officer of the 566-bed Naples Community Hospital in Collier County.
    While Frank Nask earns an annual $540,000 as President and Chief Executive Officer of the North Broward Hospital District (dba Broward Health) – the fifth largest public hospital system in the nation.
    Talk about the Comeback Kids meet Lazarus.
    Especially Frank Nask, who is both President and CEO of the tax-funded North Broward Hospital District which boasts its four hospitals, 7,400 employees and a $3.7 billion annual budget.
    After resigning from the two Palm Beach hospitals, Nask spent the next five years as a self-employed “consultant” – until his old friend and the District's new CEO Alan Levine hired him as Chief Financial Officer responsible for the system's $1 billion-plus budget..
     Brought in to restore the District's corruption-tarnished image, Levin lasted less than two years – leaving South Florida to become Louisiana's secretary of health and hospitals under the national Republican party's rising star, Governor Bobby Jindal.
     When questioned about hiring Nask as his CFO, Levine told the New Times Bob Norman that Nask had been the innocent victim of board politics.
     “That was a situation where two independent hospitals merged and both wanted the other to be closed down,” Levine told Norman. “Frank (Nask) has told me it was absolutely one of the most impossible situations imaginable. It couldn't work.”
     More on this later.
     But for now...
     Shortly after his interview with Norman and less than two years on the job, Levine left Fort Lauderdale for New Orleans in early 2008 .
      Which led the District's seven commissioners to replace Levine with his former mentor Frank Nask – with an apparently underwhelming degree of due diligence.
      In fairness, Levine merits the decade's Happy Face Friendship Award for portraying his old friend (and new CFO) as the innocent victim of an allegedly unworkable hospital merger a few years before in Palm Beach.
      The two had met years before when Nask CFO 295 bed Bayonette Point Regional Hospital in Paso County where Levine had gone to work fresh from grad school. (Note: Nask left his job as CFO at Bayonett Point to become second in command as CFO of St. Mary's and Good Samaritan in January of 1997.
      But...
      For Levin – or Nask – to blame the horrendous financial disaster that slammed St. Mary's and Good Samaritan on a failed merger was like saying cold weather sank the Titanic.
      For the record*:
     The near-death of the two hospitals was caused by a devastating decline in hospital revenues....
      Which was caused by a total IT meltdown of the hospitals' patient billing system...
      Which happened after Dutcher and Nask outsourced their Palm Beach hospitals' billing system to IPN Network in Nashville…
      Which had a computerized billing system that crashed when the two Palm Beach hospitals transferred their financial records to the IT system in Tennessee...
      Which destroyed more than $100 million in outstanding bills for patient care...
      All because nobody had bothered to see if the two computer systems could communicate – without destroying each other.
      Which is a classic example of doo doo diligence.
      As opposed to due diligence on the part of Dutcher and Nask.
       So how bad was it?
       Dutcher and Nask outsourced their billing system to the (now defunct) IPN Network billing company on July of 1997 – six months after Nask became CFO..
       Naturally, it took several months for the IPN to hook up its computer in Nashville with the system at St. Mary's and Good Samaritan in Palm Beach.
       And then....
       As the Palm Beach Post would later report:
       “IPN had a computer system that couldn't handle more than six digits or cities with three names – like West Palm Beach.”
        Which, in non-technical terms, totally screwed the two hospitals'  IT pooch.
        Just consider, dear reader, the following nightmare numbers garnered from Florida's Agency for Health Care Administration. 
                                             1997                      2000 
                                             Dutcher CEO        Dutcher &
                                             Nask CFO              Nask split
St. Mary's
Adjusted Admissions      23,242                    25,396                9%
Net Revenue per
Adjusted Admissions      $6,544                    $4,136               (38%)
Surplus (Loss)                   $6,844,585           ($42,745,000)
Per Adjusted Admission  $294.                     ($1,683)             (674%)
Good Samaritan
Adjusted Admissions       17,106                    17,383                2%
Net Revenue per
Adjusted Admission          $5,987                    $4,497              (25%)
Surplus (Loss)                    $3,539,626              ($29,189,348)
Per Adjusted Admission   $207                        ($1.679)          (911%)
Average Florida
Hospital
Adjusted Admissions        2,590,330                2,935,456       13%
Net Revenue per
Adjusted Admission          $5,904                      $5,954            0.8%
Surplus (Loss)                    $890,379,478          $934,393,069
Per Adjusted Admission   $335                          $318              (5%)

   Naturally, as in the case of the Titanic, folks in Palm Beach wondered what the hell had happened to damn near sink dear old St. Mary's and Good Sam.
   As reported by the Palm Beach shortly after Nask resigned as second in command at the two hospitals in march of 2000:
   “A major reason for (the hospital system's') financial problems is its inability to collect more than $107 million in patient bills.
    “The responsibility for failing to collect those bills, many of which probably are noncollectable because they are so old, fell at the feet of Nask and his boss, Dutcher.”
    To a man, the hospitals' board of trustees said whatever happened sure as hell wasn't their fault.
     Checking out the catastrophic deal to outsource the billing system had been “management's job,” the trustees told the Palm beach Post.
     Further, as reported in the Post:
    “Management had checked out the company (IPN) and recommended it, they (the trustees) said.
    “They had relied on the judgment of (CEO Phil) Dutcher and Chief Financial Officer Frank Nask... the trustees asserted.
     “'If the board can't rely on them, God help us all,” (former Board Chairman Frederick) Adler snapped. 'They were highly experienced people.
     “'If they blew it, they(Dutcher and Nask) blew it as managers”, Adler told the Post.

   *FULL DISCLOSURE: For the record,I was working for Florida Attorney General Bob Butterworth when he successfully kept St. Mary's from closing its doors a decade ago. And, in my capacity as Butterworth's policy wonk, I was privileged to play a key role in investigating the cause of the two hospital's near-fatal fiscal crisis,