The Medical Center of South Arkansas's general medical staff has again voted "no confidence," this time specifically naming CEO Scott Street and his leadership.
The general medical staff also voted to maintain the hospital's contract with SCP Health, an ER and hospitalist staffing agency, which Street announced last week MCSA would be ending its relationship with, said Vicki Gilliam, an attorney representing 11 MCSA physicians.
Street's announcement about the end of the relationship with SCP Health was emailed to hospital staff the morning of Thursday, August 9. He also announced in his email that MCSA Chief Nursing Officer Amy Triplet had resigned, that Chief Quality Officer Danna Taylor had been "promoted to the role of associate administrator" and that several interim leaders for the nursing and quality departments would be starting at MCSA in the days following the email.
Alexandria Bennett, executive director of business development for the hospital, declined to answer questions about Triplet's resignation and the end of the relationship with SCP Health on Thursday afternoon.
Thursday evening, the general medical staff met and held the two votes, Gilliam said.
"The result of that meeting was two letters which were sent to Kevin Stockton, Regional President (for Community Health Services (CHS), the company that owns MCSA)," Gilliam said in an email to the News-Times Saturday afternoon. "The first letter addressed the very serious concern that Scott Street remains CEO while the General Medical Staff have repeatedly emphasized and continue, in this letter, to make it clear that they have voted 'no confidence' in his leadership for the hospital. ... The second letter addresses the ending of the relationship between MCSA and the physician staffing agency SCP."
Stockton, in an email sent to MCSA staff by Street on Monday, August 2, announced that CHS would be sending a "resource team" to the hospital "to help support the current administrative team." His announcement followed a July 29 vote by the MCSA Board of Trustees to "request new administrative structure" at the hospital, according to a July 30 email Street sent to MCSA employees.
The general medical staff voted "no confidence" in MCSA administration earlier this summer. On June 5, MCSA Chief of Staff Dr. Ezinne Nwude, said the vote was unanimous and was held specifically with regard to Street's leadership.
"There was a unanimous vote of no confidence in the current leadership of this organization spearheaded by Scott Street," she said in June. "This is the first leadership that the general medical staff of this hospital have had enough concern about their practices and policies that they decided to come together and speak up and make this unanimous vote of no confidence."
She said the leadership issues at the hospital were affecting both quality of patient care and staff morale.
Street, in a June 6 email to MCSA staff, disputed that the vote was unanimous and announced that the hospital had "engaged independent counsel to conduct a thorough and complete investigation of the matters raised," referring to concerns the general medical staff outlined in a letter to the hospital's Board of Trustees informing the board of their vote of no confidence.
A report on the investigation's findings was presented to the Board of Trustees at the July 29 meeting. According to Street's July 30 email, the Board, eschewing several recommendations made by the investigative team, voted then to "request new administrative structure."
The News-Times has reached out to members of the Board of Trustees, including chairman Rob Robinson, John Moore, Wayne Gibson, Dr. Larkin Wilson, Dr. John Ratcliff and Dr. Bernadette Fincher, but requests for comment have not been answered. Gibson declined to comment when asked two weeks ago, deferring to chairman Robinson. Additional requests for comment were not answered by press time Saturday.
The News-Times also reached out to CHS corporate and did not receive a response by press time Saturday.
Gilliam said Thursday's second vote of no confidence in Street was "unprecedented."
"They (general medical staff members) have testified, with detail, in interviews. They have sent letters outlining, very specifically, their ongoing concern for the quality of patient care and treatment and their ability to continue to meet their standard of care owed to patients with Street at the helm. And, they feel that CHS has continued to seemingly ignore them," Gilliam said. "They simply ask 'what will it take for the owners of this hospital to understand that we have no confidence in the leadership of Street?'"
Gilliam also noted that several of her clients, all of whom participated in the original vote of no confidence, are employed through SCP Health, including Nwude and her husband, Dr. Ugo Nwude; Dr. Greg Smart, Dr. Joseph DeLuca and Dr. Abrar Khan. She said the hospital's medical staff received no explanation for the decision to end the relationship with SCP Health, nor were they involved in that decision-making process.
"The conclusion by my clients, along with the other members of the medical staff, is that this likely is retribution or retaliation for the SCP doctors who have been vocal in their support of the level of quality of patient care and treatment for the people of this community. Practically speaking, my clients believe that this would effectively mean that doctors from a new staffing group, who may or may not have any local patients or connections to Union County, may be used to treat the hospital patients, instead of doctors who have been here for years and invested their lives in this community," Gilliam said.
Bennett denied that the decision to change staffing agencies was retaliatory. She said the change to the hospital's staffing agency has been in the works since the beginning of the year.
"Any characterizations that the decision was retaliatory are untrue," she said in an email to the News-Times Saturday. "This was an operational and business decision that we believe is in the best interest of the hospital. We hope that any SCP employee who wants to continue to practice at MCSA will continue to do so through the new vendor."
Street's email Thursday announcing the end of the hospital's relationship with SCP Health said the decision was made "amicably" and that over the next 90 days, MCSA would evaluate potential new staffing agencies for the hospital while SCP Health continued to provide staffing services.
"MCSA and SCP Health have worked together for several years, and we each appreciate the opportunity to serve the El Dorado community," Street wrote in the email Thursday.
Street, who was named to the role of MCSA CEO in 2017, has worked at a number of other hospitals in Arkansas, Texas and Louisiana; most recently, before coming to El Dorado, Street as CEO led Nacogdoches Memorial Health in Nacogdoches, Texas, a position he resigned after less than three years, according to Nacogdoches community newspaper The Daily Sentinel, in January, 2017, nine months before starting at MCSA.
According to text from an email Bennett said Street sent to MCSA staff last week, Street "sent a note to the physicians who are employed by SCP letting them know they will be able to discuss potential opportunities with the new group or in the community, if they are interested."
The text from the email went on to make mention of the general medical staff meeting Thursday evening, at which Street was present.
"The physicians in attendance asked me about a number of matters -- including staffing, transfer center operations, our decision to end our relationship with SCP, and other operational issues," the email says. "I am always willing to discuss these things with members of our medical staff. While it is evident that some of our physicians do not agree with all of the decisions that have been made, it remains my hope to build a constructive relationship with every physician who works at MCSA."
Bennett noted that the meeting Thursday evening included "approximately 15 of the hospital's more than 80 medical staff members" present. She did not respond to an inquiry about whether the physicians present were in leadership roles at MCSA. She said some doctors in attendance Thursday abstained from the votes held there.
Gilliam said there were 16 physicians present for the first vote Thursday, regarding SCP Health, and 15 present for the no confidence vote. She said in the vote to keep SCP Health as the hospital's staffing agency, 13 doctors present voted yes, and three abstained. In the no confidence vote, Gilliam said 12 doctors present voted yes and three abstained.
"Scott continues to communicate proactively with our staff, physician and board," Bennett said.
Gilliam said she and the doctors she represents are waiting to find out now whether the two votes will have an impact.
"My clients now wait to see if the unprecedented second vote of 'no confidence' will affect CHS in any way," she added.