Seven months after calling the 128 physicians and faculty members who penned a letter of no confidence in University of Virginia Health System leadership a handful of "dissatisfied" employees, UVa President Jim Ryan has apologized.
What’s changed in the seven months since Ryan dismissed the concerns of his own employees: UVa paid a prestigious law firm $4 million to investigate the allegations against UVa Health CEO Dr. Craig Kent; that law firm presented what’s been described as a "damning" report to the university’s governing Board of Visitors; and Kent promptly resigned.
What’s not changed: Ryan and other university officials see no reason for "corrective action," despite the law firm’s report being described as "damning" by at least one person who read it.
Last year, Ryan’s first public response to the Sept. 5 letter of no confidence was one of dismissal and disappointment.
The letter claimed UVa Health officials, including Kent and UVa Medical School Dean Dr. Melina Kibbe, were encouraging physicians to criminally overbill patients and creating a "culture of fear and retaliation" in order to silence dissent. Kent and Kibbe, their employees said, put profit and pride over patients.
“The letter itself is daunting. There are many accusations. There are few details,” Ryan wrote in a letter of his own to the 1,400 faculty members of the School of Medicine dated Sept. 9. “It is unfortunate, in my view, that these faculty have taken this route. … Instead, through some of their allegations, they have unfairly — and I trust unwittingly — cast a shadow over the great work of the entire health system and medical school.”
In a more recent letter dated March 1, Ryan wrote that his initial response "has been weighing on me for months." While reiterating that he “disagreed with the approach” taken by the physicians and faculty members, Ryan acknowledged that the Sept. 5 letter “was nonetheless intemperate and disrespectful.”
Additionally, he acknowledged that his previous statements failed to sufficiently commend the health system’s physicians for the work and care they offer to the 500-plus patients who seek medical treatment at UVa Medical Center in Charlottesville on a daily basis.
“I also did not fully appreciate at the time the sum of the efforts made prior to the letter to redress outstanding concerns and therefore the level of frustration that prompted the letter,” wrote Ryan.
In late September, UVa hired the Washington, D.C.-based Williams & Connolly, one of the world’s premier litigation firms, to investigate the allegations against Kent and Kibbe and share its findings with the Board of Visitors — and no one else.
That presentation took place at a special board meeting on Feb. 25. Kent resigned later that same day.
For months, UVa officials declined to provide any insight into the report or presentation.
Until Wednesday, when a recently fired member of the Board of Visitors sat down with the host of a local Charlottesville podcast.
Gov. Glenn Youngkin removed Bert Ellis from UVa’s Board of Visitors on March 26, citing his disregard for the "Code of Conduct for our Boards and Commissions." Ellis, who says Youngkin appointed him in 2022 to shake up UVa, told "I Love CVille" host Jerry Miller on Wednesday that the governor told him personally he was too "caustic" to remain on the board.
Turning their conversation to UVa Health, Ellis said the board was left with very little choice back in February.
“The investigative report was very damning,” Ellis said. “We needed his resignation or we needed to fire him, one or the other. He saw the writing on the wall and realized he didn’t have the support of the board, and he resigned."
Resignation, Ellis pointed out, allowed Kent to maintain his severance package. Kent was UVa’s highest-paid employee, with an annual salary of $1.6 million, and his contract with the university was extended in 2023 through 2030.
Ellis did not go into specifics, but he did confirm that UVa Health has been "upcharging" patients — though he disputed if that constituted fraud.
"Many different medical operations upcharge," Ellis said. "We just say any upcharge is a fraudulent upcharge? No, there’s a gray area. They were upcharging, and that’s one of the ways if you’re running a hospital or medical facility that you do your best to take advantage of the Medicare payment methodologies to get maximum payment."
“I can’t say that I saw anything that looked fraudulent to me, but you’d have to look at every charge to do that,” Ellis continued. “But there were a number of other things that, added together, created a track record that necessitated change. The leadership of the health system was going on the wrong direction, and they were running completely afoul of their doctors.”
Ellis agreed with Ryan’s determination that “there is no basis for corrective action regarding healthcare billing or other regulatory compliance issues.”
However, Ellis and Ryan disagree when it comes to why Kent departed. Ellis made it clear Wednesday that the board was going fire Kent if he did not resign. But in his recent apology letter, Ryan attributed the CEO’s resignation to "concerns about leadership and trust that Dr. Kent recognized would make it difficult to remain in his position, which is why Dr. Kent stepped down.”
While Ryan has repeatedly said he was unaware of any claims of unethical or criminal wrongdoing within the health system or medical school, the physicians and faculty members who penned the letter of confidence maintain they had been sounding the alarm since Kent arrived in Charlottesville in 2020. On multiple occasions, they sent messages to and met with university administrators to discuss Kent and Kibbe’s leadership.
“For four years, serious and pervasive concerns were raised multiple times by multiple physicians in the quiet of the administrative process with zero public discourse. After four years of dismissive responses and even retaliation, concerns were escalated to the Board of Visitors, who retained a law firm to investigate the allegations.”
That’s according to a Monday letter sent to The Daily Progress and signed by 21 health system and medical school staff.
The Daily Progress followed up with a handful of those signatories regarding. None responded in time for publication.
UVa administrators, physicians and faculty have said they want to repair trust within the health system that “is fractured now,” as Ryan put it in his recent letter. They agree the state’s leading academic health system needs to move forward, not just for its thousands of employees, but also its tens of thousands of patients.
The parties, however, disagree on how to move forward.
Ryan said he and Dr. Mitch Rosner, who is temporarily filling Kent’s position as executive vice president of health affairs, will soon begin to meet with faculty “to hear your ideas about how we can best navigate the road ahead.” A national search will also be conducted to find a new health system CEO.
But the signatories of the original letter of no confidence have told UVa administrators that even though Kent is now gone, ongoing safety issues remain in his absence and must be addressed. Furthermore, they continue to call on UVa to release the Williams & Connolly report.
Source: www.dailyprogress.com
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