Community Health System’s board operates in secret. It’s time to open up in Fresno | Opinion

Community Health System, Fresno’s largest health-care provider, says in a video on YouTube that it performs a “diverse set of services for a very diverse community.”

Yet there is an appalling lack of diversity in perhaps the most important group of the sprawling medical system: Its board of trustees.

As Bee staff writer Yesenia Amaro recently reported, 11 of the 13 board members either have ties professionally to Farid Assemi, the former board chairman, or are physicians who do business with the hospital or practice at its facilities.

Bankers and developers are well represented on Community’s board. But those who would advocate for the low-income residents from downtown and west Fresno who depend on the Community Regional Medical Center? There is no one like that on the board.

Assemi, himself a developer, stepped down as chairman and in April turned over leadership to Roger Sturdevant, a retired banker. The problem is that Sturdevant lives most of the year in Michigan. He considers the upper Midwest his home, for that is where he votes. Sturdevant also owns a residence in Clovis, but is only here for part of the year, according to Michelle Von Tersch, a spokeswoman for CHS.

Even in today’s wired world, the fact that the chairman of board for Fresno’s top health system does not live here is astounding.

Amaro dug into the details of Community’s board as a follow-up to her investigation last year that raised questions about Assemi’s leadership and the board prioritizing development of Clovis Community Medical Center over making $2 billion in state-mandated seismic improvements at the downtown facility.

Her investigation also found how developing the Clovis hospital could benefit California Health Sciences University, a for-profit medical school that Assemi owns and is less than a mile away from the medical center.

With Amaro now showing the multitude of links that CHS board members share, a key question arises: Do board members manage Community Health System to benefit the community, or their own interests?

Questionable ties

The tight links between board members and Assemi are overwhelming:

▪ Sturdevant oversaw Bank of the West’s farm lending division in Fresno. That is also where Community Health board member Susan Abundis worked before retiring. She has also worked for Assemi’s for-profit school and has known him for decades. Abundis is currently the vice chair of the board for Assemi’s for-profit school.

▪ “Three of four new board members who joined under Assemi’s tenure as chair are developers, and at least two of them are closely connected to Assemi,” Amaro reported. “That’s in addition to CHS board member Karen McCaffrey, who is vice president of McCaffrey Homes, and other sitting board members tied to him.”

The two developers with close ties to Assemi are Mark Coehlo and Joshua Peterson. Coehlo is manager for the Coelho Land Company, LLC. He formerly worked as a project manager for Granville Homes, founded by Assemi and his brothers.

Peterson is the chief executive officer and chief financial officer for Wathen Castanos Peterson Homes Inc. — another company owned by the Assemis.

McCaffrey sold land in Madera to CHS for nearly $10 million two years before she was elected to sit on the board. McCaffrey is building homes near the land sold to the hospital.

Deep secrecy

Amaro’s reporting also showed the utter lack of transparency under which Community Health System operates.

For one thing, board meetings are not open to the public, despite how Community receives millions of dollars each year in federal and state reimbursements for Medicare and Medi-Cal patients.

Recordings of board meetings are also not available, nor are the minutes of meetings.

Amaro asked Von Tersch for the board’s bylaws, the rules under which they govern. “She said the board’s bylaws and related policies follow state and federal law, such as when conflicts of interest arise. Von Tersch wouldn’t release to The Bee a copy of its board bylaws, nor would she say whether those bylaws have been updated, and if so, when.”

Yet Von Tersch had the audacity to claim that the board ensures the hospital’s “resources are used in the community’s interest.”

Amaro asked to see records of a $3 million land purchase CHS made in 2013 from then-board member Jerry Cook. He originally bought property adjacent to Clovis Community for just under $800,000. Von Tersch denied the request by saying CHS didn’t want to set a precedent “of sharing board minutes or materials” with the public.

The messaging that comes through is this: “Trust us to do what is right, we know what is best, but no, you cannot question or scrutinize us.”

How patronizing.

Quite a contrast to Community’s cheery slogan voiced over in its ads: “We are stronger, together.”

Be open and transparent

Community Health System also includes the Fresno Heart and Surgical Hospital and Community Behavioral Health Center.

The downtown hospital, Community Regional Medical Center, is home to the only Level 1 trauma center between Los Angeles and Sacramento and is the second-busiest hospital in California. Yet most of its patient rooms are located in towers that must be seismically retrofitted by a 2030 deadline. That is neither a small nor inexpensive job: the estimate for the work is $2 billion.

The needed towers at the downtown hospital could have been built by now, except the decision was made to spend millions to expand Clovis Community.

If Amaro had not uncovered how millions of dollars of government money to reimburse CHS for its care of poor and uninsured patients at the downtown hospital had been used to expand the Clovis facility, Fresnans would have been unaware, given the opaque nature of board decisions.

If Community Health System’s board really believes in “stronger, together,” then it should remove the developer tilt and add in representation from small business, neighborhoods, youth and ethnic communities. The board should look like Fresno. That is not being “woke.” That is respecting our reality.

Community Health System’s hospitals are vitally important to the Fresno-Clovis areas they serve. The system has a built-in advantage because it is based here and doesn’t have to send profits off to a faraway corporate headquarters. But instead of embracing this advantage, the system operates in needless secrecy and has been hijacked by the moneyed interests on its board.

Being a “private nonprofit” is not justification for acting like a private business. It is a quasi-public institution, and it is well past time for it to act like one.