Nabil El Sanadi – Broward Health’s Million Dollar CEO!

Dr. Nabil El Sanadi, crying poverty, is Broward Health’s highest paid CEO in history with over one million dollars in “active” compensation by including his “part-time” work and his full-time position as CEO.  This for a person who has never managed a hospital let alone one of the largest public hospital systems in the nation.

Last April 2015, I wrote two posts about Dr. El Sanadi’s appointment and contract as Broward Health’s CEO.  SeeThe Best Broward Health CEO contract politics can buy! “ and “Has the Office of Inspector General seen Dr. El Sanadi’s CEO Contract with Broward Health?”.

montoya3-transparencyDr. El Sanadi refused to produce his “Medical Director” contracts with the Broward Sheriff’s Office (BSO), or his contracts with the cities of Fort Lauderdale, Sunrise, and Tamarac as requested by my first public record’s request, which was, in part, the subject to my four-part post (see  Just say No – How Not to Cancel a Meeting – Part 3).  When Dr. El Sanadi refused to produce these contracts, I asked BSO and each city for a copy, and all the contracts were produced electronically and un-redacted to me within 48 hours! (see BSO contract, Fort Lauderdale contract, Sunrise contract, Tamarac contract) This is in contrast to the heavily redacted response from El Sanadi’s attorney, which was produced close to 60 days after requested at a cost to Broward Health of about $44,000.00.  Ostensibly this is El Sanadi’s version of transparency!

These “Medical Director” contracts were made important in section 6.3 of Dr. El Sanadi’s Broward Health contract because it allows Dr. El Sanadi to maintain his “Medical Director” agreements despite requiring him to be full time with Broward Health.  This contract provision effectively ignores the time El Sanadi contracted to the various other governmental entities, and even the basic indemnifications for either the time or money predictable legal proceedings of all types might require.  It puts the deep pockets of Broward Health squarely at risk for these outside activities, leaving the tax payers holding the bag!

But not to worry, Dr. El Sanadi is being well paid for his “part-time outside” work:

El Sanadi-Medical Director Contracts

bruce-eric-kaplan-right-now-i-m-dealing-with-all-this-spring-bullshit-new-yorker-cartoonWhat’s more, these four “Medical Director” contracts incorporate the EMS (Rescue and ambulance) services for 10 cities plus Port Everglades and the Airport.  The cities include Fort Lauderdale, Sunrise, Tamarac, Dania Beach, Deerfield Beach, Cooper City, Lauderdale Lakes, Pembroke Park, West Park and Weston.  Mutual Aid agreements extend this service to all adjoining cities.  As I discussed in my previous post “Has the Office of Inspector General seen Dr. El Sanadi’s CEO Contract with Broward Health?”, these agreements on their face present serious ethical problems for “King” El Sanadi as well as unacceptable exposure to Broward Health in potential direct and indirect liability.  This, not to mention likely increased scrutiny by the Justice Department.Add this “part-time outside” work fees to his annual salary of $675,000.00 as Broward Health’s CEO and Dr. El Sanadi’s is being paid over $947,340.00 annually this year.  Next year, all these amounts automatically escalate.  Adding insult to injury, these amounts do not include generous benefits and potential bonuses which would make his total annual salary and benefits value at the public tit well over one million dollars.

Here are some (but not all) of the duties for which “King” El Sanadi has contracted.  (Every one of Dr. El Sanadi’s part time contracts incorporate similar language to this language taken from the BSO agreement (Emphasis added)).

  1. [El Sanadi] shall serve as liaison between the [EMS Department] and the various community hospitals, other local emergency medical services agencies, and any other agency, physician, institution or organization affecting the [EMS Department] provision of emergency medical services.
  2. [El Sanadi] shall be available and on-call twenty-four (24) hours per day seven (7) days per week every day that this Agreement is in effect.
  3. [El Sanadi] shall make radio or ‘telephone contact with the [EMS Department] within fifteen (15) minutes of the Medical Director’s receipt of an electronic notification or page from the Fire Rescue operations center.
  4. [El Sanadi] shall issue standing orders and protocols to the [EMS Department] to ensure that the [EMS Department] transports each of its patients to facilities that offer a type and level of care appropriate to the patient’s medical condition if available within the service region.
  5. [El Sanadi] shall audit the performance of system personnel by use of a quality assurance program to include but not be limited to a prompt review of patient care records, direct observation, and comparison of performance standards for drugs, equipment, system protocols and procedures.
  6. [El Sanadi] shall assist, and make recommendations to, [EMS Department] regarding planning for emergency medical services, ambulance transportation policies, deployment of vehicles, distribution of resources, personnel matters, emergency medical technician training, paramedic training, utilization of medical facilities, hospital supplies, medical equipment, medications, narcotics, emergency medical services billing and reimbursement systems, and recovery of costs associated with the [EMS Department] emergency medical services system.
  7. [El Sanadi] shall perform at least forty-eight (48) hours per year, to wit: eight (8) hours every other calendar month, of in-the-field operations riding in rescue vehicles and/or EMS supervisor vehicles, reviewing the performance of Fire-Rescue Department’s emergency medical services personnel, and reviewing different incidents in which emergency medical services are rendered.
  8. [El Sanadi] shall participate in monthly and/or quarterly meetings with emergency medical services supervisors and/or field training officers, to last 1-4 hours.
  9. [El Sanadi] shall audit the performance of system personnel by use of a quality assurance program to include, but not be limited to, a prompt review of run reports, direct observation, and comparison of performance standards for drugs, equipment, system protocols and procedures.

Remember, multiply all these duties and time commitments by 4 – for BSO (and its contracted cities), Fort Lauderdale, Sunrise and Tamarac.

El Sanadi has a contractual obligation to direct patients being transported by BSO and the contracting cities emergency (EMS) to particular hospitals within a competitive hospital environment.  Another word for “direct” is “steer”?  When El Sanadi steers patients to any Broward Health facility – potentially, his annual bonus increases!  This arrangement would seem to be so facially offensive to the Justice Department, and so many anti-kick-back laws that it is curious why the Broward Health Board of Commissioners, or any of its attorneys wouldn’t have serious concerns.  How can the Broward Health Board reconcile the time El Sanadi, let alone the accompanying potential liability, will spend with his “part-time” work at the expense of Broward Health? Aren’t the taxpayers entitled to a full time CEO?  Aren’t we paying enough for a full time CEO?   Clearly, the Broward Health Board of Commissioners in their reputed inexperienced wisdom, who are putatively irresponsibly led by their Chair David DiPietro, and seemingly rushed by a sham process to coronate El Sanadi, didn’t think so.  Either that, or Dr. El Sanadi was less then candid about his outside obligations when he negotiated his CEO contract with Broward Health.

DoAsISaySo how has Broward Health been managed by its highest paid CEO?  Among cries of “Patient’s First”, and “Manage Broward Health as a Hospital, not as a bank”, “King” Nabil El Sanadi has been busy putatively running Broward Health as his kingdom.  Inside sources at Broward Health tell of rumors of a growing horrific working environment, lack of confidence votes, sweetheart deals, erratic behavior, and retaliatory tactics against any employees proximate to anyone articulating objections abound.

El Sanadi and his mirrorFor my part, it has been difficult to discern what measure of criticism is caused by necessary reforms that have been a long time in coming, or the product of El Sanadi’s personal administrative style that is seemingly characterized by these sources most often as two-faced, publicity craven narcissism.  “King” El Sanadi  has much in common with the Emperor with no clothes.  To some high ranking sources, “King El Sanadi is writing a new chapter in ineffective management and leading Broward Health backward into the bad ol’ days of rampant and corrupt insider double dealing starting with his contract.

Note:  Dr. El Sanadi’s apparent conflicts are not restricted to just his “Medical Director” contracts, which are all in his name, but they also likely include his ownership, control or participation in his or his wife’s companies all of which seem to be in competition with Broward Health (See: Has the Office of Inspector General seen Dr. El Sanadi’s CEO Contract with Broward Health?”):

  • South Florida Fire Rescue Medical Directors’ Association, LLC
  • N & L Services, Inc.
  • Total EMS, Inc.
  • El Sanadi Holdings, LLC
  • Green Harbor Company

I will post information on these companies as information is developed.

 

The Best Broward Health CEO contract politics can buy!

dejaVuThere is little doubt that Dr. Nabil El Sanadi is as ambitious as any Wall Street wolf.  Taking the political route for career advancement, it is believed that Dr. Nabil El Sanadi and his wife Lori have given tens of thousands of dollars in contributions to secure his very lucrative political appointments as “Medical Director” to Broward Sheriff’s Office, the City of Sunrise, the City of Tamarac and the City of Fort Lauderdale as Medical Director[i] and appointment to the State of Florida Medical Board where he serves as its current chair.  It has been estimated that these contracts pay Dr. El Sanadi over $300,000.00 in additional taxpayer funds while he receives his $675,000.00 (plus benefits) Broward Health “full-time” CEO pay.  It is noteworthy that the wife of David Di Pietro who is currently under consideration for a gubernatorial judicial appointment in Broward was also previously appointed to the Florida Medical Board in September 2012 and serves closely with Dr. El Sanadi prior to his CEO appointment.  This reputed close relationship between the Di Pietro’s and El Sanadi continues through today. Recall that David Di Pietro is the current chair of Broward Health and the alleged puppeteer behind El Sanadi’s CEO appointment as well as one of Governor Scott’s political fundraisers. Coincidence?

Based on public political contribution records, here’s how generous Dr. El Sanadi has been to his republican benefactors:

Tens of Thousands of Dollars

More detailed contribution report:

Detailed Conributions

But Dr. El Sanadi is not only an “emergency medicine” physician, he is also somewhat of a business conglomerate prior to becoming Broward Health’s CEO in that he and his wife either jointly or severally own and control a number of businesses including (according to SunBiz – http://www.sunbiz.com):

  • Shhhh its a secret
    Shhhh…. It’s a secret.

    South Florida Fire Rescue Medical Directors’ Association, LLC

  • N & L Services, Inc.
  • Total EMS, Inc.
  • El Sanadi Holdings, LLC
  • Green Harbor Company

It is also widely believed that David Di Pietro not only force the resignation of Frank Nask, Broward Health’s previous CEO, but also through his fund raising relationship with the Governor, packed the Broward Health board with political appointees and created a sham CEO search process to guarantee El Sanadi’s appointment as CEO of Broward Health.  What is unknown is the extent that Governor Scott played in El Sanadi’s selection as CEO and if so, what if anything was offered as a quid pro quo.

What is curious is that the script that the Governor used to unilaterally replace the state director of corrections in 2014 that drew so much public fire and the script Di Pietro used to appoint El Sanadi are remarkable similar.  See the Sun-Sentinel Editorial here. (I’m reminded that just because you are paranoid, it doesn’t mean you are wrong!)

This story continues with the contract negotiation between Broward Health and Dr. El Sanadi.  The negotiation responsibility fell to Di Pietro’s Board confidant and fellow political appointment David Nieland or as he is affectionately called “Country”.   You will recall that David Nieland was the Homeland investigator who implicated the Obama White House intern in the Secret Service prostitute scandal thereby becoming a darling of the Republican Party.   Allegedly,Nieland was also later implicated in his own prostitute scandal right here in Broward when he was ensnared in a BSO sting operation as a “John”.  Reportedly, Nieland said he was “undercover” in an “investigation” that later turned out not to be true and the matter was dropped through the efforts of political insiders. Mayo: Should hospital commissioner step down after prostitution reports?, Washington Post: Investigator of Secret Service prostitution scandal also linked to prostitutionNY Post: Investigator for Secret Service hjooker scandal quits after paying for sex

The Nieland Broward Health contract with Dr. El Sanadi can be found here)

The contract between Broward Health and Dr. Nabil El Sanadi makes El Sanadi a public official and his duties as CEO creates a fiduciary responsibility to the public.  He is bound by the State ethics, financial reporting, and other state requirements that are common to all public officials in Florida.  Following are some notable excerpts of his contract about which we should all be concerned:

Salary

“4.1 In consideration for his service as President/CEO the DISTRICT agrees to pay EL SANADI a salary of Six Hundred Seventy Five Thousand and 00100 Dollars $67500000 per annum or such higher figure as shall be determined by the Board of Commissioners at an annual review of his compensation and performance by the Board as provided in Article 5 or at such other times as determined by the Board of Commissioners”

Full-Time?

(Summary:  El Sanadi gets $675,000.00 for full time as CEO, and also seemingly works for the Broward Sheriff’s Office, the City of Sunrise, the City of Tamarac and the City of Fort Lauderdale as Medical Director making an unknown amount of money in competition to Broward Health and as a physician – with some unknown amount of the ‘outside’ income to be voluntarily paid to the Children’s Diagnostic Treatment Center. Talk about triple dipping potential on the taxpayers!)

“6.1 EL SANADI will render full time professional services to the DISTRICT in the capacity of President/Chief Executive Officer of the DISTRICT and any of its subsidiaries He will at all times faithfully industriously and to tie best of his ability perform all duties that may be required of him by virtue of his position as President/CEO and all duties set forth in law the DISTRICT Charter DISTRICT bylaws and in policy statements of the Board of Commissioners as may be created or amended from time to time It is  understood that these duties shall be substantially the same as those of a chief executive officer of a business corporation.”

Compete with Broward Health

“6.3 Except as provided herein with respect to existing Medical Director Agreements with the Broward Sheriff’s Office the City of Sunrise the City of Tamarac and the City of Fort Lauderdale Medical Director Agreements EL SANADI agrees to refrain from any other service or employment which would restrict his ability to devote his full time to employment as President/CEO to faithfully perform the duties and work of the Office of President/CEO and at all times to work in the interest and furtherance of the general business of the Charter of the DISTRICT EL SANADI shall be permitted to perform services required pursuant to the Medical Director Agreements up to a maximum of sixteen 16 hours per calendar month for the term of this Agreement Upon the expiration of each Medical Director Agreement EL SANADI shall be permitted to renew the Medical Director Agreements subject to the consent of the Board Commissioners of the DISTRICT such consent shall not be unreasonably Withheld In the event it becomes necessary to seek an informal opinion from the Florida Attorney General regarding the ability of EL SANADI to continue providing services pursuant to the Medical Director Agreements the DISTRICTs General Counsel shall make such a request to confirm that the Medical Director Agreements do not create a conflict for EL SANADI as prohibited by Chapter 112 Part III Florida Statutes Florida’s Code of Ethics for Public Officials If there is a conflict the parties agree to negotiate in good faith to secure a compliant alternative that provides for EL SANADI’S continued functioning in a medical director capacity during the term of the Agreement.  EL SANADI covenants and agrees to voluntarily contribute a portion of the income derived from the above referenced Medical Director Agreements on an annual basis to Broward Health with a specific destination to be the Children’s Diagnostic Treatment Center a direct support organization of Broward Health Further on request EL SANADI shall provide evidence of such contribution in writing.” 

Clinical Services

“6.4 EL SANADI shall be authorized to provide clinical services to the DISTRICT up to four 4 hours per week subject to the consent of the Board of Commissioners of the DISTRICT reviewed during the annual evaluation period such consent shall not be unreasonably withheld and shall be supportive of EL SANADI in maintenance of his specialty Board certification.  Any and all income derived by EL SANADI for clinical work performed hereunder shall be paid voluntarily and directly to Broward Health with an ultimate destination of all funds to be provided to the Children’s Diagnostic Treatment Center.” 

El Sanadi’s contributions to the Children’s Diagnostic Treatment Center so far:  2/4/15 – $930.00.

When the Nieland Broward Health contract with Dr. El Sanadi was approved by BrowardTheManOutside Health board, El Sanadi said “Nieland was a tough negotiator”.  What? Was El Sanadi serious or simply deflecting?  You decide.

What is not generally known is that previous to the appointment of El Sanadi as CEO of Broward Health is that there was an initiative from the previous CEO Frank Nask to offer medical directorship services to all municipalities and governmental entities within the North Broward Hospital District as a free service of Broward Health which would make the El Sanadi medical directorship agreements a direct as opposed to indirect competitor to the public interests of Broward Health.  It is not surprising that this initiative under El Sanadi can’t be found.

Essentially, this contract “negotiated” by “Country” David Nieland makes a mockery of the independence and fiduciary responsibilities of the Broward Health CEO where almost anything in the health care sector in Broward is in tacit competition with the public interests of Broward Health.  That is, apparently, unless you are part of the Governor’s republican fund-raising apparatus.

In a future post, the El Sanadi, Coventry, Phoenix Emergency Services, and the BSO incestuous relationship of insider double dealings will be examined.  My working title is “Bend Over and Smile – Broward style”.

 

[i] In order for Firefighter/EMS units to be allowed to perform certain medical protocols as non-physicians, the department needs to have a certifying physician a.k.a. “Medical Director” under contract.  Both the contract time requirements and demands for the Physician is limited so these very profitable contracts are highly competitive and political charged.