The fallout from media reports about salaries at county hospitals throughout the state has raised questions about requiring their disclosure.
Daviess Community Hospital and Dearborn County Hospital physicians were named in an Indianapolis Star article naming them to a list of the 20 highest-paid public employees in Indiana. Daviess Community surgeon Marcus Thorne and former surgeon John Clayton were Nos. 10 and 19 on the list. The Times Herald published the state list of all hospital employees following The Star's report.
While the two hospitals were featured on The Star list, many of Indiana's hospitals did not file or did not have to file at all. According to state data, out of the 29 required to file salary data with the state, only 11, or 38 percent, did.
Daviess CEO David Bixler, along with others involved with county hospitals, said the state should either enforce the law or change it for county hospitals.
"If there are rules that we have to follow, it should be for all of us or none of us," Bixler said.
According to Indiana Code 5-11-13-1, the State Board of Accounts requires county hospitals to file annual personnel reports, known as 100R. This is the same report that counties, cities, townships, schools, libraries and other units of government are required to file by law and are publically available. If not, hospitals are subject to a penalty. In a letter dated Feb. 10 provided by Bixler, the state agency said they had to fill out the 100R or risk penalties. Bixler said it was then that he and the hospital's Chief Financial Officer complied.
"We're going to keep the hospital in compliance with state laws, state regulations or things that we receive of an official nature," Bixler said.
But according to Paul Lottes, general counsel for the State Board of Accounts, there has not been a penalty issued to a hospital for not complying. He also said State Examiner Paul Joyce does not intend to take any action against other county hospitals for not following the law.
"There should be penalties that are put in place, or we retrieve our data," Bixler said. "Everybody should be all in or everybody should be all out."
Dearborn County Hospital, which had four physicians on the list, also complied and submitted its salaries. The hospital also falls under the state law, requiring disclosure. A spokesperson declined comment for this story, other than to say the hospital does not receive county funds. Daviess Community Hospital also does not receive funding from the county, but county government does back up the hospital's bonds.
Many hospitals did not choose to file with the state. One of those hospitals was Good Samaritan Hospital in Vincennes. A spokesperson with the hospital said they did not file the 100R form based on the advice of the Indiana Hospital Association. The association, as does Good Samaritan, believes county hospitals should be exempt from filing the 100R form.
Bixler said the policy leaves county hospitals at a disadvantage in terms of recruiting and keeping quality personnel. The salary criteria listed for physicians like Thorne and Clayton, Bixler said, comes from data supplied by the Medical Group Management Association, a group that supplies salary data to hospitals and member health organizations. He went on to say those salaries are competitive with other hospitals but if competitors get hold of that data, they could try to take advantage.
"We have a lot of positions that in health care are in high demand and it's very competitive," Bixler said. "They may be able to see this and say 'Hey, we could steal that person for whatever that be.'"
The Indiana Hospital Association, which serves 164 hospitals in the state, is working with the state Attorney General's office to change salary disclosures for county hospitals. Lottes would not disclose what those changes might be, and Bryan Corbin, a spokesman for the Attorney General's office, also would not comment or confirm the changes. Douglas Leonard, president of the IHA, said in statement they are awaiting to hear what the decision is from the state.
"IHA believes publishing this data violates the privacy of hundreds of hard-working employees and puts county hospitals at a competitive disadvantage compared to privately owned hospitals," Leonard said. "We look forward to continuing this discussion with the Attorney General until a final ruling is issued."
But if the practice is not changed, Bixler said he would seek legal counsel before complying in 2015.
"I think a lot will be learned in the coming weeks and months," Bixler said.
Joyce said in an email the Attorney General's office did affirm county hospitals did have to keep filing the 100R forms, but said he could use some descretion as to what actually gets posted on the state's website as a public document.
"I did just receive this advisory opinion last week and I am in the process of considering any changes that may be made," Joyce said. "However at this time no decision has been made. I would rather not speculate as to changes as that doesn't help anyone."
He went on to say that hospitals should follow the law, whatever that law is.
"If you disagree with the law, then you should focus your attention on getting that law changed, not violating it," Joyce said.
Bixler said he has been in contact with The Star concerning the newspaper's Top 20 list and the methodology behind it. He has asked for a clarification from the newspaper.
"If they had gone further and known that data was missing, they would have known their data was flawed," Bixler said.
Bixler, along with Leonard, sent a letter to the Times Herald expressing their disappointment in the release of salary data for all hospital employees. Bixler went on to say he has talked with many hospital staff members and the reports did cause issues for a short time.
"They kept their head up and kept plugging away," Bixler said. "We have a great group here and I'm proud of the work they do. They represent the hospital and this county very well."