Hospital updates policy, may curtail some trustee travel

NEW HANOVER COUNTY, NC (WECT) - The New Hanover Regional Medical Center Board of Trustees has updated its travel policy following an active two years of travel by some trustees.

A WECT Investigative Team request found that 16 trustees had spent about $76,000 traveling to various conferences in the last 20 months.  Some of those conferences were as far away as Scotland. Others were much closer, to destinations like Pinehurst and Myrtle Beach.

But contrary to what you may think, the public is not directly footing the bills for those trips. While NHRMC is a public hospital, owned by New Hanover County taxpayers, the hospital does not receive tax money for day-to-day operations.

"We're self-supporting. Whereas most county hospitals are supported by county government through taxes, we don't receive a penny from New Hanover County in tax dollars," explained Bobby Greer, Chairman of the hospital's board of trustees.

But because the county owns the hospital, their spending is open to greater scrutiny under the law, and the board of trustees travel expenses are a matter of public record. Hospital leaders say they support that transparency and public oversight.

"I don't have a problem telling you or anybody else every little thing I've done on this board, because in my opinion you are getting a hell of a lot for what I get out of it," NHRMC Board Vice Chairman Jason Thompson said. "This is a real board. It's not fluff. And you need to come here prepared to work."

Trustee certification

Chairman Greer said he believed NHRMC was the only hospital in North Carolina that had a trustee certification program. Certification requires trustees receive 24 hours of continuing education in the hospital field. While certification is not required for trustees, it is encouraged.

All but the most recently appointed trustees have become certified. Some of them got their certification through online learning opportunities, but conference travel is a popular option for continuing education hours as well.

In many cases, the conferences involve luxury accommodations.

Travel expense records show the trustees booking hotel rooms at the Ritz Carlton in Naples, Florida, The Waldorf Astoria in Boca Raton, Florida, the Arizona Biltmore in Phoenix, and the JW Marriott in Chicago. The travel policy for the board dictates that trustees stay at mid-priced hotels while traveling on hospital business, but also says trustees should stay at the hotel that is hosting the conference.

"We don't pick where the conferences are held, so if we want to attend, we need to go where they are," Greer explained.

There are 18 members of the board at any given time. They serve three year terms. From the travel expense records we received, it appears some trustees are not traveling at all, while others travel several times a year.

Of those who did travel, Jerome Fennell, a board member whose day job is the Director of Property Management for New Hanover County, spent the least: $829 for a 2-day conference of the North Carolina Hospital Association in Durham. Half of that was a conference registration fee, the rest went to lodging, personal transportation expenses, and meals.

Trustee Conference and Location Cost
Jerome Fennell NCHA Trustee Institute 4/28/17  @ Doubletree Raleigh Durham Airport $829

Other trustees, including New Hanover County Commissioner Skip Watkins, and former Commissioner Beth Dawson, spent relatively little at $1,009 and $1,043 respectively on trips to Myrtle Beach and Pinehurst.

Trustee Conference and Location Cost
Skip Watkins NCHA Summer Membership Meeting 7/19/17 @ Myrtle Beach Marriott $1,009
Beth Dawson NCHA Summer Meeting, 7/13/16, Pinehurst $1,043

Vice Chairman Jason Thompson requested $1,673 in reimbursement for a national conference in Boca Raton, FL this year, but said he has attended two other recent conferences to broaden his understanding of the hospital industry, and did not request reimbursement for his expenses at those conferences.

Trustee Conference and Location Cost
Jason Thompson Governance Institute Conference 2/5/17 @ Waldorf Astoria Boca Raton/Boca Raton Resort & Beach Club $1,673

On the other end of the spectrum is Chairman Bobby Greer. Greer received $11,239 in reimbursement for five trips in a year and a half.

Trustee Conference and Location Cost
Bobby Greer Governance Institute Conference, 2/19/16 @ Boca Raton Resort and Club, a Waldorf Astoria property in FL $3,227
Governance Institute Conference 10/29/16 @ Omni in Nashville, TN $1,739
NCHA Winter Meeting Conference 2/15/17 @ Raleigh Marriott Crabtree Valley $712
Estes Park Conference 3/12/17 @ Arizona Biltmore/Waldorf Astoria in Phoenix, AZ $4,535
NCHA Summer Membership Meeting 7/19/17 @ Myrtle Beach Marriott $1,026
Total $11,239

The most expensive was a $4,535 3 day trip to the Estes Park conference at the Biltmore in Phoenix. Registration for that conference was $1,895, plus hotel, travel and meal expenses. Greer also traveled to Boca Raton for 5 days, Nashville for 4 days, Myrtle Beach for 2 days and Raleigh for 1 day on hospital business, according to the travel records.

Greer is a retired businessman and says his schedule allows him more flexibility than some other members of the board to travel. He says rules and regulations for the hospital industry are constantly changing, and conferences are an excellent way to stay up to date in order to make the best decisions possible on behalf of the hospital.

Rhonda Amoroso, who is active in the Republican Party and currently serves on the State Board of Elections in addition to her duties as hospital trustee, was the second highest spender. She had $9,976 in expenses for 4 trips to Nashville, Naples, FL, Boca Raton, FL, and Myrtle Beach.

Trustee Conference and Location Cost
Rhonda Amoroso Governance Institute Conference 2/19/16 @ Boca Raton Resort and Club $3,191
Governance Institute Conference 10/29/16 @ Omni, Nashville, TN $1,692
Estes Park Conference 1/21/17 @ Ritz Carlton Naples $4,067
NHCA Summer Membership Meeting 7/19/2017 $1,026
Total $9,976

The average reimbursement request for the 16 trustees was $4,760 over the period of time we analyzed.

Remaining Trustee Spending
Trustee Conference and Location Cost
Barb Biehner Governance Institute Conference, 2/3/17 @ Waldorf Astoria in Boca Raton, FL $2,806
NCHA Winter Meeting Conference, 2/15/17, Raleigh Marriott Crabtree Valley $727
Total $3,533
Brian Eckel Governance Institute Conference, 1/17/16 @ Ritz Carlton Golf Resort, Naples FL $1,548
Estes Park Conference, 1/22/17 @ Ritz Carlton Naples (not the same as golf resort) $3,649
NCHA Winter Meeting 2/15/17 @ Raleigh Crabtree Valley Marriott $701
Total  $5,898
Dana Cook Estes Park Conference 4/23/17 @ JW Marriott Chicago $3,265
NCHA Trustee Institute 4/28/17 Stayed @ Doubletree by Hilton Raleigh Durham Airport $809
Total $4,074
Dick McGraw Governance Institute Conference 2/19/16 @ Boca Raton Resort and Club, a Waldorf Astoria Resort $3,099
LEAN Team site visit at National Health Ministry of Scotland, 7/30/16 (not a conference) Stayed at Radisson Blu, Glasgow $3,229
Governance Institute Conference 2/3/17 @ Waldorf Astoria Boca Raton $2,789
NCHA Winter Meeting Conference, 2/15/17 @ Raleigh Mariott Crabtree Valley $719
Total $9,836
Heather Downs Horty Springer Seminar, 1/27/16 @ Naples, FL Ritz Carlton $1,841
Howard Rockness Governance Institute Conference 2/19/16 @ Boca Raton Resort and Club $2,999
Estes Park Conference 3/9/17 @ Waldorf Astoria Phoenix/Arizona Biltmore $4,778
Total $7,777
John Pace Governance Institute Conference 9/10/16 @ The Broadmoor in Colorado Springs, CO $3,719
NCHA Trustee Institute 4/28/17 @ Doubletree Raleigh Durham Airport $688
Estes Park Conference 4/23/17 @ JW Marriott Chicago $3,898
Total $8,305
Pat Leonard Governance Institute Conference 2/20/16 @ Boca Raton Resort and Club $2,333
Rod Andrew Governance Institute Conference 10/29/16 @ Omni Nashville $1,825
NCHA Winter Meeting Conference 2/15/17 @ Raleigh Crabtree Valley Marriott $715
NCHA Summer Membership Meeting 7/19/17 @ Myrtle Beach Marriott $1,051
Total $3,591
Ron Isyk Governance Institute Conference 1/17/16 @ Ritz Carlton Golf Resort, Naples FL $2,145
NCHA Summer Meeting @ Pinehurst 7/13/16 $1,061
Total $3,206

Local boards with spending caps

For comparison, New Hanover County Commissioners set spending caps on travel at $4,000 per commissioner, per year, while Wilmington City Council members must stick to an annual travel budget of $2,750 for council members and $3,500 a year for the mayor.

"Having been a city council member and a county commissioner, much more stringent rules when it goes to using tax payer dollars for something," Thompson said when asked about other local boards that cap travel spending. "When you are using private, business dollars generated by business operations, it's a little different, but I think in all of those scenarios you have to be frugal and smart with what you spend, and every organization I've been a part of has done that."

New hospital board travel policy

The trustees came up with a new policy in June, with final approval coming in October.  It was the first update to the policy in five years.

The new guidelines limit trustees to taking one national meeting and one state meeting per year. The policy allows the Board Chair to "approve additional meetings at his/her sole discretion."

"Guidelines are always a good thing," Thompson said of the changes. "I was on the committee that helped bring these guidelines to the board. Before, it was simply you had to get 24 hours of CEUs. Well that was so broad, maybe I did it through conferences and you did it through online courses. Now there's a little more structure to it and I think in the end it's going to be a good thing. It's going to spread out the education [travel] for all the committee members…versus 3 or 4 people going to all the conferences."

Another update to the policy involves the per diem reimbursement. The new policy is more restrictive, saying that trustees may not request per diem payment on days when meals are covered as part of the conference.

Per diem allows a person traveling on business to be reimbursed a set amount each day for meals and incidental expenses.

The old policy set the per diem rate between $52-$65 per day. The new policy says trustees will go by the Federal General Service Administration Guidelines for per diem, in which the cost of living at a particular destination determines the allowable rate for reimbursement.

While some of the trustees have traveled more frequently in recent years than is advised under the new guidelines, it does not appear there was any abuse of the old per diem reimbursement system. In fact, in many cases trustees did not ask to be reimbursed at all for their out of pocket meal expenses while traveling on hospital business.

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