There is one additional interesting detail to this process. One day before the final state$-$level Certificate of Need review, the general surgeon who had been recruited to support the for$-$profit hospital corporation's came to my office. He wanted to know if I would like to be CEO of both hospitals$-$the one I ran currently and the new hospital to be built by the for$-$profit hospital corporation. He seemed sure that the for$-$profit corporation would not only win the Certificate of Need and build

the new hospital, but would also buy the hospital that I worked for. I felt that his offer was a bribe. Now, as most people who have known me throughout my career and who know my values and ethics understand, I am not the kind of person who would accept an attempt to be bribed. I clearly told that general surgeon to tell whoever sent him with that offer from the for$-$profit hospital corporation $"$to stick it$."$ When he left my office, I called my attorneys and the chairman of my hospital board

to inform them that there had been an attempted bribe involved in the process. I then documented this conversation with the general surgeon, our attorney, and the hospital Board of Trustees chairman. We never had to bring up this issue during the final state hearing, but we were prepared to do so if necessary. Our hospital won the Certificate of Need, and we built our $$30$ million expansion. I may have been the right person in the right place, because nobody thought we were going to win

this political fight. When I was called back from my vacation, I told my COO, "you are going to run the medical center, and I am going to fight this organization." And that was literally all I did for $2$ years. I never gave up because I always had the feeling that we could win because we were on the right side of the issue, and they were on the wrong side. They had the money.They had the politics. They had everything that we didn't have. But we had the right issue. And on that day, we won out.

Describe what strategies you would use to compete with a powerful for$-$profit hospital corporation in a Certificate of Need application process.

Would you have reported the general surgeon's attempt to bribe you to the attorney? Support your answer.

Would you have attempted to negotiate a deal with the for$-$profit company? Would you have agreed to forego expanding your hospital and instead have negotiated for them to buy your hospital?