What is UCSD’s Plan?

During the Imperial Valley Healthcare District meeting held on March 11, the Kaufman Hall feasibility study was reviewed and discussed. One of the participants via Zoom was Patty Maysent, CEO for UCSD Health and a current member of the El Centro Regional Medical Center (ECRMC) Board of Trustees. While Maysent had some pertinent information to share, one comment in particularcaught my attention. Maysent strongly stated that UCSD had only managed ECRMC since 2022. That did not sound right, so a bit of research was needed. I reviewed the ECRMC Agendas and Minutes going back to 2015. Here is what I found.

• 12/1/2015: Approved of Amended and Restated Master Management Agreement with the Regents of the University of California, on behalf of the UC San Diego Health System and School of Medicine. Included in this agreement was the provision of a Chief Medical Officer for ECRMC. This agreement has been amended a total of nine times, the last amendment being in 2022.
• 1/26/2016: ;Patty Maysent, CEO of UCSD Health is listed as an ECRMC Board Member, a position which continues to hold. During this meeting, an agreement between UCSD and ECRMC was approved regarding Telemedicine Services. Additionally, the Physician Services Agreement was amended to revise the job description for the CMO.
• 6/28/2016: UCSD Health’s Adolf Edwards announced as the new CEO of ECRMC.
• 9/27/2016: Discussions held relating to Co-Marketing and Co-Branding with UCSD.
• 9/25/2018: An Advisory Committee was established regarding ECRMC’s relationship with UCSD Health System.
• 12/19/2018: Approval of new UCSD Specialty Health Center Structure Standards Policy. Approval of First Amendment to UCSD/ECRMC Leased Employees Agreement.
• 6/3/2020: Designation of Representatives to Direct Negotiation with UCSD.
• 12/13/2022: Patty Maysent, CEO of UCSD Health System, and Christian Tomaszewski, MD, CMO UCSD appointed to the ECRMC Board ofTrustees
• 2/24/2023: City of El Centro enters into a Letter of Intent (LOI) which determines it is necessary that UCSD assumes actual management and operations of ECRMC. Approved by ECRMC on 2/27/2023.
• 5/25/2023: Approval of Extension of LOI between ECRMC and UCSD for interim management and Operations of the Hospital while and Operations and Administration Support Agreement is developed. This extension was amended on 11/27/2023.

It is readily apparent that UCSD, ECRMC and the City of El Centro have had a very involved relationship for more than 9 years. Maysent’s comment on March 11th was misleading and the relationship between ECRMC and UCSD Health deserves more scrutiny. She may have been referring to the ECRMC Board action appointing her and Dr. Tomaszewski to the Board of Trustees even thoug she has been an ECRMC board member since January 2016. It would be prudent for all stakeholders and the IVHD Board in particular, to have a keen understanding of this relationship and just how it may be related to the economic position of ECRMC today.

Given UCSD’s involvement in the acquisition of Alvarado Parkway Hospital and its involvement with Tri-City and Palomar Hospital’s financial problems, it appears that UCSD’s future involves the acquisition of struggling hospitals. If the acquisition of hospitals is the goal, then ECRMC should have welcomed that effort. It is something that could have and perhaps should have happened before AB918 was rammed through the legislature on an urgent basis. As part of the leadership team, UCSD has had a front-row seat to the economic demise of ECRMC and even has had 2 seats as Hospital Board Members. Maysent and Tomaszewski share fiduciary responsibilities from day one of their appointed terms on the ECRMC board.

UCSD shares at least some responsibility for the financial conditions that now plague ECRMC. Those troubles started as early as 2016. My team has questions for ECRMC, UCSD and especially for Maysent.

1. Has UCSD at any time in the 9+ years, discussed or attempted an acquisition of ECRMC? If not, why not? If yes, then what happened?
2. What can we expect of UCSD going forward as it relates to the operation and management of a single healthcare system in Imperial Valley? What investment is UCSD willing to make in the immense tasks and financial resources needed to create a brand-new district?
3. Can the financial guidance and direction be trusted when the ECRMC leadership has not shown positive results to date?
4. Why did UCSD advocate for AB918 when there are other pathways to a single healthcare system that are less destructive and divisive?
5. If UCSD with all its resources and expertise cannot turn around ECRMC, are we supposed to trust that it will be different under a single healthcare district model?
6. What does it mean when UCSD sits in a leadership position for ECRMC and watches as it fails?

PMHD has turned its finances around and is showing profits. PMHD did not seek rescue from UCSD and it is not needed or welcomed. To be clear, the delivery of quality healthcare by UCSD is not in question. They have provided valuable and lifesaving care to many Imperial County residents.

However ECRMC’s financial management practices have been called into question and with UCSD’s representatives along with each of the ECRMC’s Trustees, they must be accountable for their fiduciary responsibility to ECRMC’s community. The IVHD has important decisions to make and must base these decisions on a full and complete picture. We need to keep asking questions. My team looks forward to some answers. The residents of Imperial Valley certainly deserve to know if the future of healthcare in our county will be like ECRMC’s past.