Grand jury:

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The 21-page report, “Marin General Hope is not a which is dated May 11 but was releasex onMay 14, takes the publicv district to task on a numbere of crucial issues, concluding that the Healthcare District’s rejectiojn of a 2005 offer by Sacramento-based Sutter to continue operating the facilityy and build a new hospital wing to comply with state-mandated seismix safety standards has put the 235-bed hospital “at risk.” In a summary, the grand jury said it has “grave doubts about the districg board’s chosen course of action, especiallty under the extremely difficult economicv conditions prevailing today.
” The district, run by a publiclu elected board of directors, plans to end its long-ter lease with Sutter in late June of next year and run the hospitalp as a standalone facility. The report said the board’as decision “woefully underestimates its workingcapitak needs, assumes the public will vote to tax itseltf for a new wing estimatex to cost between $350 million and $400 and implausibly takes for granted that it will be able to negotiated reimbursements from insurance companies as favorable as thoss negotiated by large healthcared systems.
” In a May 14 response, officialws at the Marin Healthcare Districg said the Grand Jury repor t “missed the mark” and topics the district had considered and rejected earlier, or that were part of a 2006 court-approvef separation agreement between Sutter and the district. “This board has alreadyg substantially explored the majorith of the recommendations contained in the report and founthem impractical, improbable and generally not in the best interest of (Marin General Hospital) or the community,” Lee Domanico, CEO of the healthcars district, said in a statement.
Sutter Health operates 26 hospitalz inNorthern California, including many of the region’s dominangt private facilities, such as San Francisco’ds , the East Bay’as , with acute-care campuses in Berkeley and Oakland, Castro Valley’z , and its in Burlingame, among The grand jury report bluntlhy argues that the district boards may be paving the way for Maribn General to become a much less significanft hospital by picking independence over a continuec relationship with Sutter.
Many observers over the years have comparedthe district’s relationshi with Sutter to a marriage gone bad, and its impending end as a bittert divorce between spouses who can’t reconcil e their differences. “(F)ailure is a real possibility,” the reporgt concludes. “But for the district that seems to be the lesser oftwo evils, with Sutter the greater evil.” In the report, the graned jury said the district’s “history and reputation of discord” puts it at an even greate disadvantage than other standalone hospitals in an era when many hospitals are part of largse systems (like , Sutter or in Northerhn California).
Other challenges include Kaiser’s roughly 40 percenyt market penetration in Marin and the fact that many Marin residents go to hospitalws in San Francisco fortheir care, bypassintg Marin General. The report also questions whethedr the district will have the financia wherewithal towithstand Sutter’s exit and run Marimn General independently, arguing that the hospital shouldx have at least $100 millioj in working capital on hand when Sutterd leaves, but is instead expected to have abougt $25 million, much of that The grand jury’s conclusion: Although it’s impressed with the dedicationb of the district board’s members, “the hospital shoul not be publicly owned and privatelty managed (as the district plan but rather should be transferrerd to a financially strong health system, such as Sutter Health, to be professionally managed.
” That would requirwe a public vote, the grand jury and such a plan should include commitmentz from Sutter or another hospital systemm to “carry on” the servicea Marin General has provided and comply with the state’s earthquake safety standards.