Cancer center chief defends planned move

A secret deal conceived over champagne at the Detroit auto show in January led metro Detroit's best-known cancer program to make plans to leave its home base at the Detroit Medical Center and move to St. John Detroit Riverview Hospital.

The DMC filed a lawsuit May 4 to stop Barbara Ann Karmanos Cancer Institute's move, saying it would cause the medical center irreparable financial damage.

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Now, in what will likely be a public feud, the DMC and Karmanos are headed to a hearing Monday before Wayne County Circuit Judge Gershwin Drain.

In his first detailed interview on the suit, Dr. John Ruckdeschel, chief of the Karmanos institute, laid out for the Free Press how he cut the deal with Warren-based St. John Health to buy its failing Detroit Riverview Hospital.

He talked about how his board unanimously supports the move. He also said the larger site with an additional 100,000 square feet of space will benefit Karmanos patients and the city of Detroit.

"Instead of a boarded-up, 300-bed hospital that could become a crack house, they'll have an institution that will serve as another anchor to development along the Detroit riverfront," Ruckdeschel said.

The move to Riverview is planned for 2009, but "if DMC starts to do a scorched-earth policy with us," shutting down services Karmanos needs at the DMC before the move, it will move to Riverview immediately and move services there "piece by piece," Ruckdeschel said.

Ruckdeschel also said he's tired of patients receiving what he called rude treatment at DMC facilities.

Mike Duggan, president and chief executive of the DMC, declined to say much about the lawsuit. But Dr. Brooks Bock, president of the DMC's Harper and Hutzel Women's hospitals, elaborated on the issue in an interview Friday, after hearing that Ruckdeschel had talked at length about the dispute.

"Our desire is to have Karmanos continue in its location and to enjoy the adjacency of services that we both continue to provide," Bock said. But he added: "They certainly aren't working with us at this point."

Unpleasant surprise

Bock said the DMC didn't know the Karmanos institute planned to leave the campus until Ruckdeschel announced at an April 24 news conference that a letter of intent had been signed to purchase Riverview.

"The first time we heard about this was when it was publicly announced," Bock said. Karmanos officials never complained to him or others at the medical center about the care its patients received at DMC hospitals, he added. "We have prompt, friendly, courteous and exceptionally high-quality services and we work on it every day," he said.

Ruckdeschel acknowledged he held four months of secret meetings with St. John officials after he and Elliot Joseph, St. John Health CEO, shared champagne in January at the North American International Auto Show. Joseph acknowledged he had been trying to sell the hospital in the last year.

"Elliot stopped me at the auto show and asked, 'Do you want a hospital?' " Ruckdeschel recalled.

The Karmanos institute actually had inquired several years ago about buying Riverview but the health system wasn't interested then, Deborah Reinheimer, St. John spokeswoman, said Monday.

Secret planning

Ruckdeschel arranged to tour the facility secretly on a Saturday in late January when Riverview was staffed at lower levels. He found Riverview in "spectacular, in many ways move-in, shape."

St. John had invested $30 million in the facility in the past few years, to renovate its bariatric and geriatric services and a parking lot, to build a medical office building and to buy equipment, including a mobile MRI machine and 64-slice CT scanner.

Ruckdeschel and Joseph already had a cordial relationship despite rivalry between the Karmanos and St. John Health cancer programs. Both men grew up in New York and have homes in Tampa, where they vacation and bump into each other at the airport.

The two worked out a deal where Karmanos would take the failing hospital off St. John's hands for $40 million.

That's pretty cheap, Ruckdeschel said, especially at a time when costs for the 122-bed cancer hospital he wanted to build on the DMC campus had grown to $90 million, he said.

Headed to court

There are three key issues in the dispute:

• The contract: In December 2005, the DMC and Karmanos signed a complex legal agreement, 18 inches thick, with 82 sub-agreements. It allowed Karmanos to obtain all cancer equipment, patient records and staff from the DMC in exchange for leasing other DMC equipment and four floors of Harper University Hospital.

Ruckdeschel contends the contracts all allow cessation of the sub-agreements within 90 days. The DMC contends they go on for years.

• Financial effects on Detroit Medical Center: The DMC claims in the lawsuit that it stands to lose $25 million a year, for several years, for "purchased services and shared expenses, such as fees Karmanos pays to lease DMC space." The DMC will lose more if it gets the burden of Medicaid patients Riverview Hospital serves now, the lawsuit says.

Ruckdeschel argued the DMC stands to make at least $15 million a year if it ends up serving Riverview patients because most have either Medicare or Medicaid insurance. Ruckdeschel said the DMC receives higher reimbursement rates for serving more Medicaid patients than most hospitals, but T.J. Bucholz, spokesman for the state health department, said that's not the case.

• Patient care issues: DMC doctors and others worry that cancer patients might face obstacles to getting care for noncancer problems if Karmanos becomes a freestanding hospital.

Ruckdeschel said this is not a big issue. If necessary, patients would be transported to nearby hospitals if they have heart attacks or other serious problems. Karmanos also has good relationships with Wayne State University doctors who will provide care in a range of specialties, from lung problems to infectious diseases, he said.
source:www.freep.com