Blunt Trauma

Pan American Hospital, an icon in Cuban Miami, is fighting for life as it battles its own employees

His jovial, back-slapping manner -- no doubt perfected at countless business lunches -- is complemented by flawlessly groomed, salt-and-pepper hair and a penchant for double-breasted suits. Sanchez's hound-dog face expresses sympathy for his beleaguered employees, while sternly worded memos to that same staff reveal the resolute attitude of a man clearly comfortable behind the executive desk.

If Sanchez's life has been a clear, unwavering trajectory to success in Miami's Cuban business world, Cardenas has followed a much more circuitous path. Desperate to leave Cuba, he nearly suffocated while buried under sacks of sugar in the cargo hold of a freighter headed from Havana to Jamaica. Once in Jamaica, Cardenas bluffed his way onto a cruise ship ("They believed anyone white was a passenger," he says) and disembarked in Miami. He took odd jobs and traveled to San Francisco, where he wound up driving a bus for the city.

"That was the first time I ever really heard a lot about unions," he recalls. "I didn't think about it too much. I certainly never saw myself being a vocal advocate for such an entity." He also acquired a massage-therapy license while in California.

Juan Carlos Cardenas
Jonathan Postal
Juan Carlos Cardenas
Pan American Hospital’s Generations Club provides a free lunch and hours of activities for the elderly Cuban Americans who attend every weekday
Jonathan Postal
Pan American Hospital’s Generations Club provides a free lunch and hours of activities for the elderly Cuban Americans who attend every weekday

In 1989 Cardenas returned to Miami, received a physical therapist's license, and began working at Pan American. He married a nurse who works at Jackson Memorial Hospital, and they had a son. All along his plan had been to stick with Pan American until he retired: "I still hope, when this is all over, to go back and work at the hospital."

Sanchez came to Pan American in September 2003. He took over a hospital with a crumbling financial infrastructure, the result of a disastrous decision to buy seventeen healthcare clinics from Minnesota-based UnitedHealth Group in 1999. The clinics hemorrhaged money. "The hospital's fiscal year ends in March, and from March 2002 until March 2003, the hospital lost eight million dollars," he says. "We had to act really fast just so the hospital wouldn't go out of business." Pan American filed for bankruptcy in March 2004, claiming $64 million in assets and $102 million in debts.

The hospital's 750 employees knew of the financial predicament well before the bankruptcy filing. As in any workplace, reports of instability, coupled with the arrival of a new boss, made staffers fear for their jobs. "This place is a rumor mill," Sanchez acknowledges. "In the two or three weeks after I started, while I was putting together a plan, I began hearing that there were going to be massive layoffs. Then key people started resigning."

The new executive director lit a fuse when, in November 2003, he announced a plan to curtail some worker benefits, cut vacation time, and limit overtime. Immediately after that notice, which many insist had a punitive tone ("As if we were the ones responsible for the hospital's money problems," Cardenas fumes), some of the nurses at the hospital talked to colleagues at Jackson Memorial, which unionized in 1990. Within a month a majority of Pan American's employees had signed a petition requesting a vote on unionization.

Sanchez is cautious when he talks to reporters, saying he understands the employees' concerns and that he wishes he'd done more to alleviate them. "People are petrified that there will be massive layoffs," he says. "I want to reassure the employees about that, and we haven't done that." But as pro-union sentiment built in late 2003 and early 2004, Sanchez's genial persona was belied by his administration's uncompromising position.

From the start, the hospital played hardball -- refusing to acknowledge the overwhelming election results and dragging out the quasi-judicial unionization process in court, even though it was clear they had little chance of winning. "It's typical," says Monica Russo, president of the local SEIU chapter. "They're trying to delay this thing and starve out all the pro-union feeling. This happens all over the country when people try to join unions."

The firing of Cardenas and two colleagues, management's distribution of an inflammatory flyer, and the hospital's continued refusal to recognize the union has left Sanchez justifiably worried that he is losing the public-relations war: "The union was saying they could force the hospital to restore benefits and get a ten- to twelve-percent annual salary increase. Saying these things addressed the workers' fears, and that I understand. But once [the union got involved] it turned into a propaganda war." Some say Sanchez is in a tough position -- trying to keep the hospital running, staving off open mutiny among employees, and managing a volatile PR situation, all while taking orders from a difficult boss.

Sanchez is the lap dog of Lourdes Sanjenis," sneers Vicente Rodriguez, ensconced comfortably behind a desk in his Coral Gables office. Rodriguez is in a position to have an informed opinion -- for decades he worked closely with Pan American Hospital and the man who was the driving force behind its creation, Dr. Modesto Mora.

A former journalist in Havana, Rodriguez was hired by Mora in 1968 to help organize and promote a physician's conference. The Pan American Cuban Medical Convention was Mora's brainchild and originally was tied to the hospital. From the outset it was a success, so successful in fact that for years it allowed Rodriguez to live large, traveling around the hemisphere with the ultrarich Mora (who lives in a Star Island mansion), hobnobbing with notables like former Chilean dictator Augusto Pinochet.

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