Business Journal Q&A: Lee Domanico, CEO, Marin Healthcare District

Monday, June 7, 2010, 2:50 am

By Dan Verel, Business Journal Staff Reporter

Lee Domanico

GREENBRAE — The long-awaited ownership transition of Marin General Hospital from Sacramento-based Sutter Health to the Marin Healthcare District has arguably been one of the most contentious issues to play out in the county’s history.

Years of negotiations transpired over leadership, funding, seismic upgrades and the general direction of the 325-bed acute-care hospital, which is the largest in Marin County and is a level III trauma center.

Lee Domanico came into the health care district as chief executive officer in 2008 to help with the transition. In the months prior to the transition, the district has secured $60 million in funding from Union Bank in credit and loans, announced the formation of an oversight committee and is in the process of completing a brand new IT system.

Mr. Domanico previously was the CEO of El Camino Hospital, which has campuses in Mountain View and Los Gatos, overseeing operations at the more than 400-bed, nonprofit hospital. He’s also held executive positions in Chicago, as CEO of Columbus Cabrini Health System, and in Los Angeles, as the CEO of University of Southern California Hospital.

Mr. Domanico shared some of his recent experiences with the Business Journal and described some of the more difficult aspects of managing the transition, from the initial agreement brokered three years ago to the countdown to district takeover from Sutter in just a few weeks.

Business Journal: What were some of the biggest challenges the district faced during the transition process?

Mr. Domanico: By far the biggest challenge was building confidence in the district’s ability to assume control of Marin General Hospital. One way of building confidence is to say what you are going to do, and then do what you said. The district approved a public plan of transition in late 2007, has followed that plan closely and is now on track for a smooth transfer.

Business Journal: What were some of the other challenges?

Mr. Domanico: There were many business challenges, such as securing financing during the Great Recession, standing up an IT system from scratch and recruiting an executive team to a somewhat volatile and uncertain situation.

Business Journal: How did your previous experience at a nonprofit district hospital prepare you for the job in Marin?

Mr. Domanico: When I joined El Camino in 2000, it was a time following a very bitter separation of the then-merged Camino Medial Group and El Camino Hospital, bringing the hospital back under district control. The resulting distrust between the two parties was extremely high, making it extremely challenging to implement the changes needed to return El Camino to a high-performing hospital.

The historical animosity and conflict that has occurred around Marin General has similarly resulted in a lack of trust. … We at the district have spent much time and energy on rebuilding trust through demonstrating our competence to earn confidence.

Business Journal: What motivated you to join Marin General during such a time of contention?

Mr. Domanico: I was shocked as I learned the history but felt that the Marin community deserved and could support a free-standing, first-class hospital. Given my background in overseeing challenging situations, I felt I could contribute to the district’s chances for a smooth transition.

Business Journal: What are some of the challenges you anticipate upon the transfer of ownership?

Mr. Domanico: There is the challenge of rebuilding a seismically sound and new hospital. However, the building is only one element of delivering high-quality hospital service. Far more important are the people, employees and physicians who serve the patients. The challenge is winning over the hearts and minds of the employees and physicians to support Marin General’s free-standing future.

Business Journal: If you could describe the mood in the community, how would you say most people are feeling about the long-awaited transfer?

Mr. Domanico: Do you remember the song by Carly Simon, “Anticipation?”