Am. Samoa Senate To Investigate Hospital ‘Power Struggle’

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Management contradict each other, board accused of micromanagement

By Fili Sagapolutele

PAGO PAGO, American Samoa (The Samoa News, April 15, 2014) – As chairman of the Senate Government Operations Committee, Sen. Galeai Tu’ufuli plans to assemble an investigative team to look into "the power struggle" within LBJ Medical Center, whose Chief Executive Officer, Joseph Davis-Fleming has accused the hospital board of micromanaging hospital operations, and perhaps it’s time to discuss terms of his resignation.

The move by Galeai followed the latest revelation of the disagreement between top hospital officials over the merging of the Primary Care Clinic and the Medical Clinic into the Internal Medicine Department.

Galeai was among a handful of lawmakers who received communications signed by Chief Medical Officer, Dr. Iotamo Saleapaga announcing to LBJ physicians the official merging of the two units. Included in the information Galeai received was a separate communication sent to two Primary Care physicians, who appeared to be unhappy with the merger.

Also in Galeai’s possession is the CEO’s letter saying that the merger had not been approved by the board, whose chairman, Mase Akapo then fired back a missive saying that it had been approved by the board. Mase also accused the CEO of being "obstructive".

Responding to Mase’s correspondence, Davis-Fleming noted that the board had never voted on the specific plan which complies with hospital bylaws as well as the legal employment rights of affected physicians.

"More importantly, LBJ is required to adhere to established policies and procedures that are on record with [the Center for Medicaid and Medicare, or CMS] and this proposed merger is being done by the CMO in direct violation of our current medical staff bylaws, which will result in major and potentially expensive actions when CMS conducts their review of our hospital operations," he explained.

Davis-Fleming said Mase will find in the board meeting minutes that "I recommended that no further action be taken on this proposed merger until we — CMO & CEO and both affected departments — work out comprehensive details and mutually agree on the final proposed plan to present to the board when that process is completed."

However, he said to date (Apr. 9), the "CMO has acted without involving me, the CEO and his boss, as clearly specified in his job description and employment contract, in the planning process, discussions and issuance of those directives that also violate the terms of the employment contracts of the Primary Care staff."

According to Davis-Fleming, it is his duty as CEO to insure that federal and local regulations as well as policies and procedures are followed, "since I am held accountable to protect the board and the hospital from any activities that result in non-compliance that could put LBJ at risk of losing its CMS certification status and federal funding.

"Additionally, the CMO’s office needs to stop circumventing and undermining the CEO’s authority to run the hospital and approve all action under the scope of his authority as outlined in the job description and employment contract."

"If we can’t resolve this never-ending problem regarding my role and authority as CEO, then perhaps it’s time to discuss the terms of my resignation, since I can no longer tolerate having staff that is supposed to work under my direction constantly doing their own thing and undermining my authority by always going to the board to micromanage the hospital’s operations."

He went on to advise the board to consult their legal counsel, in order to protect their interests and the best interests of the hospital "to avoid making a major mistake that would be detrimental to the hospital and the people we serve."

Davis-Fleming apologized for "coming across as an obstructionist" or if he has upset Mase or any other board members, saying that he is only trying to do the job he was committed to do when he was recruited by LBJ and "by passing other much better paying job offers."

He stated, "I only want to make sure that we implement improvements in the correct manner and do what is in the best interest for the people of this territory, and the CMO’s proposed plan will not achieve that goal."

Before he left last Friday for an off island meeting, Galeai told Samoa News that he is very disturbed with what is happening with the hospital management and the board. And when he returns in two weeks time, Galeai plans to put together an investigative team to look at the "power struggle’ issues and other problems at LBJ.

He called the fiasco at LBJ "really stupid", saying that while residents are suffering the top people at the hospital are "pulling rank" as to who has the higher authority to make changes. "It's all about power hunger" by those at the top at LBJ, he said — adding that the CEO has his responsibilities outlined in the law and the CEO should be allowed to do his job.

"It’s just too many problems at the hospital and this is the best time to find out why all these problems are happening to a brand new LBJ administration" he said.

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