North Shore Health board focuses on strategic planning and legal action during December 5 special meeting

The North Shore Health board held a special meeting at 10 a.m. on Tuesday, Dec. 5, for board members and Administrator Kimber Wraalstad to discuss and identify objectives and tasks as the hospital moves forward with a strategic planning process. Seven community members attended the Dec. 5 meeting. 

The special meeting agenda also included a closed session stating: The meeting will be closed as permitted by the attorney-client privilege to discuss litigation regarding defamatory statements made against the hospital. The hospital is exploring legal action due to growing community concerns regarding the dismissal of Dr. Bruce Dahlman on Nov. 1 from Wapiti Medical Group, a South Dakota based company that staffs doctors for North Shore Health’s emergency department. Community members and former and currently associated North Shore Health staff have recently shared their concerns on the matter on social media and in letters to the editor of the Cook County News Herald.

The Dec. 5 meeting started with the board outlining and discussing strategic planning tasks for Wraalstad to accomplish in the coming months. Board chair Kay Olson said, “In order to give Kimber some direction, this was our opportunity to have some input and decide in what direction we want to go.”

The board wants to explore current operations, financials, administrative activities, operational procedures, medical staff, and human resources in the strategic planning process. “So really a top-to-bottom type of organizational review,” board member Randy Wiitala said. 

Wraalstad said she would contact numerous outside organizations, including the National Rural Health Association and National Rural Health Resource Center, for assistance. 

While the intent of the strategic planning discussion was not specifically to address or discuss the recently raised community concerns and public comments regarding the end of Dr. Dahlman’s contract with Wapiti Medical Group on Nov. 1, board member Mary Sanders spoke out on the matter. 

Sanders said, “So we find ourselves in a situation we can’t wish away. And I firmly believe that we need a thorough investigation of our situation by this board before we make any decisions regarding our CEO. In my opinion, it should be guided by an independent outside source.”

She added that she contacted Bill Auxier, the National Rural Health Association program director, to inquire about conducting an internal investigation at North Shore Health. Auxier agreed to conduct an organizational culture assessment for North Shore Health free of charge with no strings attached. “So I think that would be a starting place,” Sanders said. 

The discussion then briefly circulated between board members and various individuals about how an in-depth look into the culture of North Shore Health fits into the larger strategic plan. The hospital initiated a culture survey in early 2020 to assess staff morale following difficulties with staff retention. The COVID-19 pandemic hit the healthcare facility before the culture survey was finished. The survey has yet to be completed or used in any tangible way. 

Wraalstad followed the discussion by saying, “In the strategic plan, one of the initiatives that had been identified was human resources. So, part of what has been brought up is culture. So let’s bring in that third party to look at that. So it’s kind of strategic plan and more.”

The board then moved on from the discussion and spent the next 30 minutes discussing the strategic planning process and finalizing tasks for Wraalstad to complete. 

Towards the end of the meeting, Sanders reiterated her original statement by saying, “I certainly support this effort to move forward on the broader scale.” However, she added, “It’s not on the agenda, although I guess I was hoping that by saying an investigation of the situation (it) would be included. I guess I’m a little frustrated that we’re not being more specific in the immediate need.”

Wiitala said, “That’s a sensible comment. Our part is to focus on the cultural component as far as this assessment goes. As far as the current situation goes.” 

Olson then acknowledged the number of emails and calls from the public that each board member has received regarding community concerns relating to Dr. Dahlman. She then suggested that if the board would like to discuss the matter further, it would need to be put on an upcoming agenda. 

The board agreed and intends to schedule a separate meeting to discuss and work through the matter. While a meeting after the holidays seemed more achievable, the board did not settle on a date.

Then, right before 11 a.m., the board moved into the closed session to explore and discuss litigation regarding defamatory statements made against the hospital. 

The board’s decision to hold a closed session on Dec. 5 to explore litigation after nearly a month of seemingly unanswered public and media inquiries and comments regarding the end of Dr. Dahlman’s contract with Wapiti Medical Group left the public confused and uneasy.

In early Nov., word spread through Cook County that Dr. Dahlman, a long-established and respected emergency doctor, would no longer be staffed in the emergency department at North Shore Health. The reasoning given by Wraalstad in an initial statement was that Dr. Dahlman had a contractual relationship with the Wapiti Medical Group and Wapiti decided to end his contract, effective Nov. 1. The North Shore Health board reiterated this statement to over 50 community members who attended the Nov. 16 board meeting and assured the public that North Shore Health did not play a role in that decision. During the public comment period, Dr. Dahlman stated he had proof that was not the case. 

Following the Nov. 16 board meeting, community members, including some former and currently associated North Shore Health staff, voiced their concerns through social media, articles, and letters to the editor in the Cook County News Herald. Chief of Medical Staff Dr. Michael Sampson submitted one of the letters to the editor. In his letter to the editor, Dr. Sampson questioned the discrepancies and reasoning behind Dr. Dahlman’s dismissal from Wapiti and North Shore Health. 

Soon after, a petition was formed by the Citizens Concerned for Cook County Healthcare, asking the North Shore Health board to remove Wraalstad as the administrator. The petition made the rounds through the community, collecting hundreds of signatures in a short timeframe. 

The group had intended to present the petition to the board during the Dec. 21 meeting. 

However, after North Shore Health released the Dec. 5 agenda for the special board meeting, which stated the hospital was actively exploring litigation regarding defamatory statements against the hospital, the group decided to end the petition. The petition gathered 750 signatures before it closed. 

Before the closure of the petition, WTIP reached out to all five North Shore Health board members for comment. Board members Mary Sanders, Kay Olson, and Randy Wiitala responded. 

WTIP also contacted Greg Ruberg, the president and CEO of Lakeview Hospital in Two Harbors. Ruberg also works for St. Luke’s and oversees the management agreement with North Shore Health and the Duluth-based hospital. Approximately 13 years ago, North Shore Health entered into a management agreement with St. Luke’s Hospital. The management agreement allows North Shore Health to remain independent while receiving administrative leadership and support from a larger health system. When asked about the management agreements between North Shore Health and St. Luke’s, particularly to what extent the board has full independence, Ruberg referred WTIP to board chair Olson on the matter. Olson has yet to respond to the request for comment. 

During the Dec. 5 special meeting, WTIP was given by a member of the audience a St. Luke’s/North Shore Health Contract Provisions document that described the legal relationship between North Shore Health and St. Luke’s relating to management personnel, physician and non physician personnel, termination of the contract, and more. The document stated that the hospital may at any time request in writing that St. Luke’s remove certain management personnel from their position at the hospital and appoint a replacement per a removal request. The request must reasonably specify the performance related reasons that the hospital no longer desires the services of the employee. In regards to medical staff, the contract states, “all matters requiring professional medical judgements shall remain the responsibility of the medical staff and its allied health professionals. St. Luke’s shall have no responsibility whatsoever for the such medical judgement and St. Luke’s shall not in any way be responsible for the credentialing of any health care professionals on staff at the hospital, except as any such matters may be specifically and exclusively delegated to the administrator under the medical staff bylaws and related rules, policies, and procedures.”

While the North Shore Health board intends to explore and discuss community concerns formally and the order of events that occurred regarding Dr. Dahlman in the coming months, in the meantime, many are left with lingering unanswered questions. 

Kalli Hawkins December 5, 2023