THE POA BULLETIN October 2004

The POA calls on Leesburg Regional Medical Center (LRMC) to sell The Villages Regional Hospital (TVRH) to any one of a number of hospital management companies in the U.S. that would relish the opportunity to acquire our hospital.

LRMC has positioned itself squarely as an obstacle to the expansion by insisting that the hospital tax pass before expansion is started.

LRMC says it cannot arrange for the required financing on its own because its balance sheet is not strong enough. It now is obvious that LRMC is the problem, and it should get out of the way and let some other hospital management company take over.

Mr. Wooten, CEO of LRMC, has said that they plan to try again in two years, in the 2006 general elections, to get this tax bill passed. He says that they did not do a good enough job of educating the taxpaying public about the proposal and need to try again.

The POA thinks that opposition to the hospital tax is so strong, that the outcome will be the same in another two years.

The POA calls on the board of LRMC to do the right thing and sell TVRH to another hospital management company that can handle the financing. (See the article starting on page 3 about four hospital management companies that might be interested in TVRH.)

So, please, Mr. Wooten, either start the expansion ... or ... get out of the way.

1. 20% to Morse Family Foundation -- This provision alone was onerous enough to most Villagers to justify the “no” vote. Why should Villagers pay a 20% tax out of their pockets to one of the wealthiest families in the state? This was the single most damning aspect of this proposed tax.

One has to ask why Representative Gibson ever conceived of doing this in the first place? This is a most serious question and serious answers should be demanded from Mr. Gibson.

The eleventh-hour offer of the family to forego the 20% while the expansion was in progress was meaningless. It affected only about three or four years out of the 30 year term of the bonds.

2. Case Not Made – LRMC never made the case that the tax was needed. It never provided financial information showing 10-year forecasts of the “with the tax” and the “without the tax” alternatives. How else could a reasonable business decision be made that the tax was needed and justifiable? In the business world, when there is not enough information to make a good decision, then the answer is “no.” LRMC just does not seem to understand this concept.

The POA refuses to believe that TVRH cannot be operated successfully, without a public tax handout, in this area of favorable demographics and high demand.

It should also be noted that various LRMC representatives, including Mr. Wooten, the CEO of LRMC, talked to many Village organizations attempting to sell the proposal – but in most cases they did an embarrassingly poor job of explaining the need for the tax.

3. No Sunset Provision – Mr. Wooten, CEO of LRMC, refused to agree to forego the tax if and when TVRH was successful enough to do without it. Mr. Wooten likes the idea of the free taxpayer handout going on forever. What an unreasonable position to take! Mr. Wooten showed his poor judgment on this issue with his imprudent position. So did Representative Gibson in not putting a sunset provision into his bill.

4. Cost Ballooning to $295 million – When the tax idea was first mentioned, the expansion was discussed as needing $100 million over 20 years. Just before the November election, LRMC sent out a slick brochure to all affected voters identifying the cost as $295 million over 30 years. This included $136 million for the expansion and $159 million for interest. Something doesn’t smell right here. Do you get the idea that LRMC is pulling the wool over our eyes on the true costs of the expansion? The POA wonders what the taxpayers’ final cost, plus overruns, might be.

5. No More Taxes – Villagers are sick of paying taxes for all the things we are hit with that come as a surprise. Our Amenity and Priority fees are going up. Likewise for greens fees. Then there are the bonds that attach to our property, and the impact fees. Then property taxes are always going up. What about those assessments from either Lady Lake or the CDDs? Then the VCCDD supervisors spend hundreds of millions to buy common property back from the developer, and we have no say in the matter but have to pay back millions of dollars. Enough is enough – it was time to say “no” to more taxes.

6. Reaction to Scare Tactics – LRMC said the expansion will not be done if the tax did not pass. This is a threat and LRMC is holding the very health and lives of Village residents hostage to its poor judgment on this issue. If LRMC cannot proceed immediately with this expansion, it ought to sell TVRH to some other financially capable organization that can.

7. LRMC is the Problem – LRMC wants the tax because its balance sheet is not strong enough to arrange the financing on its own without the tax. The POA does not believe this premise. We suspect that LRMC just wants the free tax handout because it is available. Why not take the free money, they must be reasoning. If LRMC is unable or unwilling to proceed on its own, it should sell TVRH to another company that can get this done.

8. Appointed vs. Elected Tax Board – The governor appointed five commissioners to the hospital tax board. It was evident from the very start that a majority of the five board members was in favor of the tax, even before reviewing any financial documentation supporting the proposal. That was a stacked deck! If this tax ever goes through, we should have an elected board rather than an appointed board. We need to hear the board candidates explain their views through an election process before they get on the board. We need to have the tax board members responsible to the electorate. And, we need to make sure that board members are independent of The Villages developer – otherwise, we face another situation like we have on the VCCDD board where the developer’s interests are dominant. We elect county commission board members and school board members – why not hospital tax board members? We don’t want more Taxation Without Representation.

Summary – It is a major disappointment to have the expansion on hold. And, we do not like being held hostage to LRMC’s selfish objectives and morally dishonest position.

Villagers need to realize that there are smart and reasonable alternatives to LRMC ownership of VRH.

Russ will be truly missed – he was one of the really great men of not only the POA but also The Villages.

He was active in the POA for over a dozen years. He also was a board member of CDD #1 and served as its chairman for several years.

Russ had a gentlemanly manner that immediately made friends. He was known throughout The Villages as someone you could trust, someone who was willing to help on any problem, someone of high integrity, and someone who was willing to fight for you and me and what was right for residents of The Villages.

Many residents will remember Russ for his broad knowledge of Sumter County government, CDD issues, VCCDD matters, and Florida Chapter 190 CDD law.

Russ died before the POA officially told him that he had been elected as the first inductee into the POA Hall of Fame. He would have dismissed the honor as not befitting a common guy like him. But, we knew better – he was a great man, and we were so proud to recognize him with this special honor. And, to say that all of us respected him so.

And, we wonder why Mr. Gibson would have missed the boat on all three of these. We wonder if these are special favors for special people, or incompetence, or what?

Mr. Gibson laughed off several of these points when asked about them. But, Mr. Gibson, Villagers don’t think these points are so funny, as evidenced by the 74% vote against your hospital taxing district law.

These problem areas that Mr. Gibson should fix immediately with new legislation are:

1. The Morse Foundation Give-Away – Mr. Gibson’s legislation provides for a payment to the Morse Family Foundation of 20% of the tax proceeds each year. This was perhaps the most onerous provision of the taxing proposal and was the prime reason for its defeat. Why would Mr. Gibson do this?

Mr. Gibson should introduce legislation immediately to eliminate the provision for payments to the Morse Family Foundation.

2. No Sunset Provision – The current bill has no provision to end the tax when it is no longer needed by the hospital.

Mr. Wooten, CEO of LRMC, was asked about this in several meetings with Village organizations. He steadfastly refused to give up the tax when it was no longer needed. It looks like Mr. Wooten likes the idea of a free taxpayer handout going on forever.

Mr. Gibson should introduce legislation providing for an end to the tax when the operations of the hospital are successful and no longer in need of the tax.

3. Election of Tax District Board – The governor appointed a five member board without fully consulting with taxpayers. It was immediately obvious that a majority of the board favored the tax – even without the opportunity to review pertinent financial statements of TVRH operation. How could they have known, before starting their official duties, whether the tax was actually needed?

To remedy this situation, Mr. Gibson should introduce legislation immediately to provide for an elected hospital tax district board if the proposal is ever reconsidered and/or passed.

4. LRMC Board – This is not a needed piece of legislation. However, Mr. Gibson is on the board of LRMC. He should use his influence to convince board members to either start the expansion now with LRMC financing – or sell TVRH to another hospital management company that can do what is needed to arrange the financing and proceed with the expansion.

Summary – Mr. Gibson’s poor judgment on legislation caused a major part of this sorry mess. Mr. Gibson should now accept the task of cleaning up the legislation and doing what he can to get the TVRH expansion started. If he doesn’t, he will continue to be part of the problem.

Residents should also see that LRMC needs to be frank and open about this situation. If it cannot arrange financing on its own, then a company like any of the four listed below should be given the opportunity to own, operate, finance, and expand our hospital. For LRMC to block this alternative, to suit its own ego or because of its own financial problems, would be morally wrong and unethical.

Some of these hospital management companies are profiled below. This information was taken from company data provided on the My Yahoo! financial web site.

HCA Inc., Nashville, TN, is a holding company whose affiliates own and operate hospitals and related healthcare entities. It operates 191 hospitals, consisting of 176 general, acute care hospitals; seven psychiatric hospitals; one rehabilitation hospital, and seven hospitals included in joint ventures. In addition, it operates 83 freestanding surgery centers.

HCA's general, acute care hospitals provide services for such medical specialties as internal medicine, general surgery, cardiology, oncology, neurosurgery, orthopedics and obstetrics, as well as diagnostic and emergency services.

Outpatient and ancillary healthcare services are provided by HCA's general, acute care hospitals and through HCA's freestanding surgery centers, diagnostic centers and rehabilitation facilities.

HCA's psychiatric hospitals provide mental health care services through inpatient, partial hospitalization and outpatient settings.

Community Health Systems, Inc., Brentwood, TN, is a non-urban provider of general hospital healthcare services in the United States.

The Company owns, leases or operates 72 hospitals, geographically diversified across 22 states, with an aggregate of 7,810 licensed beds.

The Company's hospitals offer a broad range of inpatient and outpatient medical and surgical services. These include orthopedics, cardiology, occupational medicine, diagnostic services, emergency services, rehabilitation treatment, home health and skilled nursing.

Health Management Associates, Inc. (HMA), Naples, FL, owns and operates general acute care hospitals and psychiatric hospitals in non-urban communities.

The Company operates 47 hospitals, consisting of 45 acute care hospitals with a total of 6,337 licensed beds and two psychiatric hospitals with a total of 142 licensed beds. It has facilities in Florida and fourteen other states.

Services provided by its hospitals include general surgery, internal medicine, obstetrics, emergency room care, radiology, oncology, diagnostic care, coronary care, pediatric services, behavioral health services and psychiatric care and, in several of its hospitals, specialized services such as open-heart surgery and neurosurgery. HMA hospitals also provide outpatient services.

Tenet Healthcare Corporation, Santa Barbara, CA, operates 101 domestic general hospitals with 25,116 licensed beds, serving urban and rural communities in 15 states. Of those domestic general hospitals, 82 were owned by Tenet subsidiaries and 19 were owned by third parties and leased by Tenet subsidiaries.

In 2003, Tenet subsidiaries also owned various related domestic healthcare facilities, including a small number of rehabilitation hospitals, specialty hospitals, long-term care facilities, a psychiatric facility and medical office buildings.

The Other Alternative – One possible compromise alternative would be for LRMC to arrange a joint venture ownership of TVRH with another close-by regional hospital. This could be Ocala Monroe or Ocala Regional Medical Center or Florida Waterman in Orlando.

From LRMC’s own words, it appears that it is unable or unwilling to shoulder the expansion on its own. So, its alternatives are to go it alone, sell TVRH, or partner with another hospital which can arrange the financing. For LRMC to not act to start the expansion as soon as possible is morally wrong and unethical.

Summary - The reader is asked to think about these hospital management companies. Given the problems and all the tax entanglements with LRMC, is there any doubt that we would be better off with any one of these four hospital management companies?

The point here is that LRMC is apparently not up to the task of financing, expanding, and efficiently managing TVRH. Let’s not agonize about it – let’s just get some other company that is up to the task.

And, let’s be honest about it – don’t any of these four companies look really attractive compared to LRMC?

We deserve the best hospital we can get – and we don’t think we will get it with LRMC.

So, to LRMC and Mr. Wooten: either start the expansion ... or ... get out of the way.

The Mock Voting form provided by the POA in the previous issue of the Bulletin is being continued for at least the next one or two issues. We want to give everyone the opportunity to vote their preferences in this project.

We pointed out that residents are not given the opportunity to vote for key administrative officials in the VCCDD, the primary government body in The Villages. And it is these officials who make all the big money decisions in The Villages. Residents are not given the opportunity to approve these decisions or accept the millions of dollars of debt piled up by these officials in purchases of common property from the developer of The Villages.

So, if you think the officials listed below are doing a good job or a bad job, take this opportunity now to vote your preference.

Remember, you do not currently have this opportunity to vote for these officials in a real election. But, you can voice your opinion now in this mock vote on the form below.

Please vote as soon as possible, but only once. Then please return the form to the POA at the address on the bottom of the form.

Thanks in advance for your participation in this mock vote. We plan to publish the results in the near future in your POA Bulletin.

Bulletins are sometimes not delivered to your driveway as they should be in the first week of the month. If this happens to you, remember that you can pick up the Bulletin at the following locations:

We do not yet have home distribution of the Bulletin west of Buena Vista Blvd, or into Marion County, or south of Highway 466. Residents in these areas can get a copy at one of the distribution points listed above.

Happy Birthday to us! November 20, 1975, was the formal incorporation date of the POA. So, we are 29, and we are starting our 30^th year. Congratulations to all of us!

The POA has survived for going on 30 years because it represents the best interests of residents rather than the best interests of the developer.

In many ways, it is still “Our POA” as it was referred to in the early days. This is because the POA represents you, the residents.

The POA is more dynamic today, with more members and stronger finances, than it has been in, perhaps, the past twenty years. We think we articulate a message that more and more residents are agreeing with. And, more and more residents are responding to the POA message with active support.

So, Happy Birthday to us – and thanks to all members for making the POA the vital and significant property owners’ association that it is.

Tim Melton, CEO of The Villages Regional Hospital (TVRH), announced a special grant of $40,000 to The Villages High School to start a Healthcare Academy. The idea of the grant is to inspire high school students to pursue careers in the healthcare field.

Mr. Melton did not explain how the hospital was able to spare $40,000 at the very time it is asking taxpayers in the area to approve a sizeable tax increase to support the hospital. Furthermore, Mr. Melton did not explain how $40,000 is available given the comments recently that the hospital has costly operating problems and can’t afford to finance an expansion that will benefit local taxpayers.

Are you starting to see that TVHR and LRMC have no credibility on the tax issue?

Dear Editor: I am 8 years old. Some of my little friends say there is no Santa Claus. Papa says, If you see it in The New York Sun, it's so. Please tell me the truth, is there a Santa Claus?

Yes, Virginia, there is a Santa Claus. Your little friends are wrong. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy. Alas! how dreary would be the world if there were no Santa Claus! It would be as dreary as if there were no Virginias. There would be no childlike faith then, no poetry, no romance to make tolerable this existence. We would have no enjoyment, except in sense and sight. The external light with which childhood fills the world would be extinguished.

Not believe in Santa Claus! You might as well not believe in fairies. You might get your papa to have men to watch in all the chimneys on Christmas eve to catch Santa Claus, but even if you did not see Santa Claus coming down, what would that prove? Nobody sees Santa Claus, but that is no sign that there is no Santa Claus. The most real things in the world are those that neither children nor men can see. Did you ever see fairies dancing on the lawn? Of course not, but that's no proof that they are not there. Nobody can conceive or imagine all the wonders there are unseen and un-seeable in the world.

There is a veil covering the unseen world which not the strongest man, nor even the united strength of all the strongest men that ever lived could tear apart. Only faith, poetry, love romance, can push aside that curtain and view and picture the supernal beauty and glory beyond. Is it all real? Ah, Virginia, in all this world there is nothing else real and abiding.

No Santa Claus! Thank God! he lives and lives forever. A thousand years from now, Virginia, nay 10 times 10,000 years from now, he will continue to make glad the heart of childhood.

Whatever method you use to support your POA, please know that it will help enhance the wonderful way of life we enjoy here in The Villages.