The nut of this thing, though, is market share. Per the plan, the Clinic would be "principal health care system affiliate" of the foundation and would retain first refusal rights for any partnership with a wellness program or service that pulls in at least $500,000 in revenue. And despite the city's repeated claims that the health care marketplace is highly competitive in Northeast Ohio, the Clinic has balked at the idea: "Unless the Clinic were to grant prior approval," the letter states, "no health care system provider would be permitted to operate or manage a facility ... on the land currently leased by the city to LHA while the Clinic owns and operates the [family health center.]" MetroHealth, the community later learned, had twice submitted its own proposal that would have maintained inpatient hospital operations and contractual obligations. Attorneys there have since backed away.
There's also the provision in the LOI that the city may not pursue legal action — for example, breaches of contract — against the Clinic or the LHA. The Clinic specifically insists that the mayor, a member of the LHA, publicly support this transition.
The letter may have expired, but the idea remains very much alive. The mayor's big announcement — the plan, concrete or abstract as it is — has set a community to wrestling with its past, present and future.
The city and the Clinic have, in some ways, always had a bit of an odd relationship. When the Clinic wanted to come into Lakewood in the mid-'90s and open a hospital north of Detroit, negotiations culminated with the Clinic taking over Lakewood Hospital and the LHA overseeing operations — serving the will of the public, in theory.
The LHA, a Clinic-dominated board that includes two council members and the mayor, is seen by the public as an outpost of Clinic policy. Its purpose, though, is to represent the city's interests through the lease it maintains. With, for instance, $91 million in estimated deferred maintenance on the hospital property to date, the public has questioned the aptitude of the LHA — now more than ever.
Lakewood Hospital was never the hallmark of the Clinic's innovative portfolio. Even in the past 20 years, under Clinic rule, the place has functioned as a community hospital, a bigger and more modern version of what Dr. C. Lee Graber envisioned 100 years ago.
Over time, though, medical services and specialties came and went. In 2010, under then-mayor Ed FitzGerald, the LHA adopted a contract revision with the Clinic that ushered in the Vision for Tomorrow plan — a comprehensive policy shift that would mark Lakewood Hospital a "center of excellence" in four specialties. In return, the hospital would lose its pediatric and trauma care programs. Monahan and the Save Lakewood Hospital contingent point to this as the beginning of the current crisis, one helmed by the Clinic itself.
"Lakewood Hospital is committed to the Lakewood community and will continue to maintain its status as the city's major employer," Clinic officials wrote in a 2010 letter to FitzGerald. City Council approved the Vision for Tomorrow plan with the public intent to continue operations through the lease and agreement's expiration in 2026.
Now, this latest contract revision — merely a "proposal," as it were — would eliminate the hospital entirely. The LHA's $1.15 million in lease payments to the city, the nearly $1 million in payroll taxes, the $5 million in required capital improvements annually: The city would immediately lose a bevy of financial benefits. And the Clinic's $7 million in annual charity would disappear too, replaced with a foundation outfitted with $32 million paid over eight years.
The $32 million is a major carrot here. As the city reckons with the Clinic's ideas, the $32-million end game has become attractive to many. It's a blank slate.
Instantly, battle lines were drawn. State senator Michael Skindell, a Lakewood resident, pulled petitions to run against Summers in the mayoral race this year. A lawsuit was filed, alleging breaches of contract and fiduciary duty. Legions of residents asked: Where did this come from? Why does the hospital need to close? Don't we have another decade to continue negotiating? Others responded: This is the best thing for the city. This is the future.
The details were heavy, but the news didn't come as a shock to most people in Lakewood. Rumors about the demise of the hospital had circulated informally for years. Scene took its stab in 2013 at tracking down the details of dwindling services, only to be met time and time again by physicians or other stakeholders unwilling to talk. But Jim O'Bryan, the publisher of the Lakewood Observer and a long-ago classmate of Summers (Lakewood High School class of '72), pushed the over-the-fence talk into the open.
On Dec. 29, 2014, O'Bryan dumped the story online: "Clinic to Announce Changes to Lakewood Hospital in 1st Quarter." His reporting bore out the following month with Summers' announcement.
O'Bryan tells Scene that the Clinic's LOI was read over the phone to him in September 2014. The rumors had been true. Before publishing, though, he ran the discovery past city officials.
"Nothing has been decided at this point," Summers wrote to O'Bryan in a now-published email sent at the time. During the fall of 2014, City Hall routinely denied that a plan was in the works to shutter the hospital, making January's announcement all the more alarming to the public.
The publisher of the Lakewood Observer structures his paper around the voices of the community. He'll publish whatever anyone would like to submit, whether that be an opinion piece from City Council President Mary Louise Madigan or a coifed-up press release from one of Lakewood's countless local community organizations. It is the archetypal town square in print form, and there are plenty of rumors that don't come to fruition.