INDIAN RIVER COUNTY — The Indian River Hospital District is requesting records and answers from Treasure Coast Community Health following a series of leadership changes that drew concern from some board members.
The move comes months after the abrupt departure of former CEO Vicki Soule in November, with limited public details about the decision.
Hospital District Trustee Paul Westcott said his concerns center on how the organization handled the leadership change and whether it followed its own governing procedures.
"Organizations that don't follow their governing documents tend to not be good partners. They also expose themselves to liability that may interfere with their ability to serve the community," he said. "I don't want to tell them who to hire and fire. That's not what this is about. This is about governance and whether or not they are following their governance procedures."
Westcott emphasized the importance of oversight given the relationship between the two organizations.
"When I see the manner in which it was handled, it just gets my attention. I want to flip over rocks and see what their governing documents say, how that correlates with their minutes, and see where they stand there," he said.
Trustees also raised questions about a previously discussed partnership involving Sunshine Physical Therapy at TCCH’s new West Health Center. The arrangement had been presented as part of the broader plan for the facility but has since encountered a road block.
"I didn't make the decision based on the commitment to have Sunshine share space with them, but it was definitely a selling point. Had they not made it part of the ribbons and bows on the million dollars, I would be less concerned," Westcott said. "But for me, it was an important part of the package, and I liked it because it was a synergy that doesn't seem to be seeing itself out."
Not all trustees were on board with how far the district should go in its inquiry. Board member Karen Diegl expressed caution about delving into internal governance matters.
"But when it comes to the governance piece and asking them to be transparent about what happened, I would get concerned as a trustee, getting involved with that part of it all," she said.
Board member Michael Kint supported taking a deeper look.
"I don't think it's outside of our purview. The harder questions need to be asked, we need to get what we can get and make some determinations," he said.
Alongside governance and partnership concerns, the board discussed the organization’s financial standing following the leadership transition. Auditor Dawn Carbone said prior reviews of TCCH have not raised issues.
"Their prior audits have all been very clean. No material weaknesses whatsoever," she said. "They go through a whole federal process. They give us a copy of that. That's been plain to me that says, OK, they're being looked at with a high level of scrutiny. Our last review of the agency, our last audit, had no recommendations."
Hospital District Executive Director Frank Isele noted broader financial pressures facing community health providers, which can influence operational decisions.
"The decisions are money-based. When you close a site and you relocate providers to a new location, they're not busy enough because if they were, you keep them," he said. "It's really challenging this year and it's not going to get any easier. And so there are reasons for why certain things happen. And mostly in the community health center world, it's financial decisions. They want to do what's best for patients, but they need to stay in business so they can't do anything for anyone."
The board ultimately agreed to request TCCH’s bylaws, along with executive committee and board meeting minutes related to the CEO’s departure. Trustees also asked for clarification on the Sunshine Physical Therapy arrangement and requested a financial audit along with recent financial statements.
Once those materials are reviewed, the chair of TCCH’s board is expected to address the hospital district at a future meeting.