Collaborative relationship--We think not
As reported in Modern Healthcare, the aggregate profits at community hospitals hit another all-time high last year at $28.9 billion. This was up from 2004 and is predicted to be up again this year. The aggregate profit margin for the registered community hospitals like ours was 5.3% and was the highest margin in seven years. Our margins are below this and trending downward.
These hospitals reported aggregate net patient revenue of $505 billion in 2005 which was also an increase. The AHA reported that the total number of hospitals in the U.S. dropped even though their total inpatient admissions rose to just over 37 million.
Since 1977, the total number of hospitals has declined and the number of licensed hospital beds also fell. This has created the increasing crunch we are now seeing with the ever-frequent diversion issue. The AHA also reported that Medicare reimbursement to hospitals has stayed about the same for the past 2 years.
All of this begs the question as to if we are doing the right things at Floyd to anticipate and make plans for the future needs of our County. With the addition of the Heart program, all the consultants say it will lead to many other types of surgical procedures and medical admissions.
So why are we considering building a new surgical floor in the unfinished addition that will provide fewer beds than we currently have? Even if some of the surgical beds are now being used for medical admissions, the next 10 years will certainly see a rise in surgical procedures if we are to remain financially solvent.
The physicians don’t think it is a good idea but there has been no open forum for discussion up to this point in time. The architects have already given preliminary blueprints to administration with little to no input from the Medical Staff. I have contacted administrationour and hopefully we can give some needed input and direction before any final decision is implemented.
Does this sound like a collaborative working relationship with the Medical Staff? Physicians should be involved with these decisions before blueprints and other decisions are made. We shouldn't continually have to approach the administration after the fact to try a prevent another bad decision.
posted by Anonymous at 6:00 AM
19 Comments:
This is at least the third time you have cited that data from Modern Healthcare. However, you never get around to actually stating what the profit (or loss) margin or loss was for Floyd last year AND how that compared with other hospitals in our region. You have been asked for that information at least twice and have ignored it. I can't help suspecting that you are only using data that supports your agenda rather than telling us the whole truth.
Ask your commissioners for the information as they are your elected officials who are supposed to be the final overseers.
Ask why the hospital is proposing eliminating ~130 FTE's to meet the 2007 budget.
Ask why their was a "hiring freeze' this year even though they won't use that term.
Ask why managers were asked to cut their budgets mid year.
Ask why managers are getting reprimanded for using the term "lay-offs" for the upcoming year.
Open your eyes!!
Anon 7:05, your point is a valid one but your efforts will be futile. Again your question is dismissed, and it will likely never be answered here. Repeatedly on this blog, there are half-truths presented as the whole truth. This guy is just a power-hungry nut who, instead of allowing the facts to form his opinion, twists the facts to fit his opinion.
Sorry, Dr. "Hold Everyone ELSE Accountable." YOU are the one making accusations about the relative competence of hospital management, not the County Commissioners. Either back up your charges with the whole truth or back off.
Right or wrong...at least HB has the integrity to stand up, voice his concerns, ask the hard but unpopular questions, all the while doing so publicly behind his own name.
You anonymous posters taking your shots are pathetic.
Here are the numbers for the year to date at the end of the 3rd quarter of 2006.
Net income was $3,604,000 actual while the budget called for $7,315,000.
This compared to last year of $6,056,000.
This is 40.5% decrease from last year at this time and more than $3 million dollars under the budget set for this year.
You cited 2005 profit margins for the industry but you are providing only dollar amounts in 2006 for Floyd. And you still ignore comparision with other local hospitals which, in several cases, you know to have suffered operating losses. Seems like basic honesty would require that you provide a more balanced appraisal of Floyd's situation rather than cherry-picking only the data that portrays hospital administration in a negative light.
Sorry to say but if the hospitals net revenue is down, what is the reason, I would say that people have wised up and are seeking healthcare in other places. Is it not true that people admitted to FMH is being directed their by mostly Physicians in Floyd County?
Could it be that the Physicians in FC are so good that none of their patients require hospital services? Perhaps, it is because many FC Physicians have dropped their patients Insurance and these patients had to move on. Think about it.
Once again, these are the numbers at Floyd. I don't have numbers for other hospitals. Maybe you do and would like to enlighten the readers.
The profit margin at Floyd in 2005 was about average but certainly not stellar.
In addition, the bond rating also has been lowered but this also is being kept very, very quiet.
Why don't you enlighten us on the reason for that as well.
You wrote: "I don't have numbers for other hospitals." So you know that Floyd is in trouble and isn't performing up to snuff but you don't have any comparative data for this market that shows how Floyd is doing relative to the competition? Sure looks to me like you pick and choose which data (and how much of it) to use based on what you are trying to prove rather than to truly educate. And Lawguy says you have integrity!! God save us from integrity like that.
Read the articles listed in the multiple references on the multiple different blogs.
You compare the performance with the standards in the articles.
I already have and Floyd is not where it should be or where the CEO and CFO said we would be.
I agree with the fact that many times on this blog there are half-truths given by HB. However, in this circumstance he is dead on. We said all year long "We DON'T have a hiring freeze" yet we did. Now it's "We're NOT laying off, we're overstaffed." We are in trouble and for the first time many of us are beginning to dobut the abilities of our CEO to see that. The CFO however is another thing. He is a man who does his job very well, better than any CFO I have worked with in other hospitals. He is personable, intelligent, knows what he's talking about and genuinely cares about those under him. I have to ask an obvious question. Why, when we have a new wing that sits unused are we still diverting patients to other hospitals, and why on Earth are we finishing the fourth floor, when we can't pay for the wing we have? A bed is a bed and a cardiac nurse can take care of regular patient's just the same as critical care ones, right?
The only half truths on this blog is the half these anonymous writers won't admit. HB is accurate and on-target more than 90% of the time.
I work at Floyd and things are bad. The CEO is a flat out lier.
The CFO is anything but nice. Their may be a select few that are favored in some way by him, but overall he is not a nice man, nor fair in any sense.
The anonymous critic may very well be the CFO as he hates HB with a passion
Doesn't the State if Indiana have any say over new programs ie. Cath Labs, Heart Programs and new beds. In New Jersey where I worked in a hsopital for 25 years you had to obtain a Certificate of Need from the State Health Commissioner's office after the organization showed a staffing plan, a business plan and other patient related info.
You also had to obtain a certificate of need to increase inpatient bed licensing..In this State it seems that hospitals and whoever wants to build a hospital ie. the hospital going up in Clark County,do whatever they want..Who reviews construction drawings in this State.. Does Indiana have an architectural review of the planned construction ? Who has the oversight on all the hospitals. The JCAHO still hasn't given Accreditdation to Floyd Memorial. As far as the budget, doesn't the CFO figure the expected patient stay, procedures both inpatient and outpatient, etc. and if these figures aren't met with actual dollars earned create a need to cut budgets to keep pace with losses. Job freezes are very common in Healthcare because of unexpected budget problems so that shouldn't suprise anyone. Lay offs are usually a last resort to help meet the budget
I don't get it. If the financial picture at Floyd is as bleak as these postings would indicate, why isn't anyone other than Dr. Dan getting upset? Why aren't the Commissioners up in arms? It is they who are ultimately accountable to the public. And why do we not hear anything from the Board? Is Dr. Dan just exaggerating? Or are the Board and the Commissioners just not knowledgeable? Are they not responding because they are in over their heads? I am very concerned. No, the word is frightened. Can someone please come forth and validate Dr. Dan's comments? Or give a logical argument that refutes his facts?
Is there no one out there who will use their own name and debate Dr. Dan? Please give credence to your debate.
After following this Blog site for months and reading the comments, I am leaning heavily in believing that there is truth in what Dr. Dan says. If it is not true, then why doesn't someone publicly put him in his place. Why is no one coming out and debating him in the open? Is he the one who is right?
If the VP is indeed responding anonymously to Dr. Dan's blog, why doesn't he use his own name. Is he truthful? Then why not stand behind his convictions? Of whom is he afraid? Dr. Dan? Why?
Where is media coverage? Isn't this newsworthy? Is there no one who can "take control" of analyzing and reporting in an unbiased manner?
The public needs direction. The public deserves the truth. It is our hospital and our healthcare. And it is our taxes that will pay for the mess. Please help us.
Dr. Dan has a great personal dislike for the hospital CEO and he pursues a single-minded objective of bringing him down, whatever it takes. The great majority of people in responsible positions recognize this and understand that there is more to running a successful hospital than catering to Dr. Dan's personal biases. He is essentially a rabble-rousing alarmist who focuses only on negatives and ignores the great successes achieved by the management and staff at Floyd. It is no accident that Floyd has remained profitable every year while Jewish, Clark and others have had several years of operating losses. A blind person can see how much the hospital has grown over the past years and how much it is valued in our community. Dan doesn't want to hear any of that. He only wants to hear that the CEO needs to go. You don't hear any other uproar because most people just understand where he is coming from and ignore him.
To Anonymous 12:05 AM 12/14
If what you say is true, then why has the Medical Staff elected him to a position to represent them? Are they relying on him to have the fortitude to speak for them? And how objective are you? Your comments seem biased. Are you fighting with Dr. Dan also? What position do you have to actually know the truth of what you speak? Again I ask for someone who is in the position to know to publicly debate the issues with Dr. Dan. Why doestn't someone come forward? Where is the Chairman of the Board? Seems to me that is the person who should stand and represent the Board publicly in these issues?
Those people do have a forum--it is the board meeting, not this blog.
Anonymous 12/13/06 5:39 is incorrect. "CFO is a nice man" - as an employee under him, I can tell you this is absolutely 100% not true. He questions employee truthfulness without investigation, question or hesitation. How is that for support?
The statements: "He is personable" (disagree), "intelligent" (I'll agree there), "genuinely cares about those under him" (OK, I'll stop laughing now, not unless you are one of the two directors who are his favorites).
More accurately is the statement by anonymous 12/13/2006 5:59 PM:
"The CFO is anything but nice. Their may be a select few that are favored in some way by him, but overall he is not a nice man, nor fair in any sense."
Absolutely true.
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