For almost three months, the Motion Picture and Television Fund has argued that its hotly-contested decision to close both its hospital and long-term care facility was the result of a “perfect storm” -- a collapse in the stock market, cutbacks in medical benefits and the worst economic downturn since the Great Depression.
But past and present medical staff, nursing-home experts and others with connections to the MPTF or its board of trustees say the closures are also the culmination of a series of management decisions stretching back several years.
They accuse the fund's chief executive, Dr. David Tillman, of a failure to plan ahead, of an over-reliance on outside consultants and a lack of respect for the opinions of his own most experienced medical and administrative staff. They also accuse him of lavish spending in some quarters and self-defeating cutbacks in others.
One fatal decision may have been the move three years ago to close the intensive care unit of the MPTF hospital, against the advice of Tillman's staff. They argued that closing the unit would make the hospital less attractive to patients, even if it saved money in the short-term.
These were the kinds of decisions, say Tillman's detractors, that led inexorably to the January decision to close the hospital and long-term care facility.
“The time to act would have been seven to 10 years ago, because it was very clear then that there was a problem,” an employee privy to management decisions said. “Unfortunately, the board and Tillman had very little vision or foresight about problems of this magnitude. They had their own limited way of dealing with things.”
The problem, these people say, was that the MPTF slowly turned from an organization with an operating loss somewhere in the order of $1 million a year -- a figure easy to recoup from charitable donations, or from the stock performances of a large endowment -- to an organization with an operating loss of $10 or $20 million a year.
The problems were far from trivial. California’s nursing-home reimbursement rates ranked in the bottom 10 of U.S. states, even as medical costs skyrocketed. The MPTF’s unionized workforce enjoyed salaries and benefits on the upper end of the elderly care spectrum -- an environment in which labor accounts for 65-75 per cent of all costs. Both the hospital and the nursing home were aging facilities, which created added costs in and of themselves.
Such problems, though, were not insurmountable. The Los Angeles Jewish Home for the Aging in Reseda, which has a similar profile to the Motion Picture home and very similar financial pressures but a much smaller endowment managed to build a brand-new medical center and is due to break ground next year on a new nursing home building.
This was possible largely thanks to long-term planning by its chief executive, Molly Forrest, and targeted fundraising making up a shortfall of about $10 million a year.
Tillman and his team, by contrast, made no such long-term plans and used the MPTF’s charitable money simply to break even year to year -- as attested by the Fund’s audited accounts and tax returns.
