Slow but difficult progress
Frustrating would be the term used for last night’s Board Meeting. Who better to address this would be the reporter from the Tribune who sat outside for probably 2 hours before being allowed into the public portion of the meeting.
Once inside, all he heard was a laundry list of items presented for a vote to approve. There was no open discussion on any of the topics in the public forum. The public meeting took all of seven to ten minutes. This of course is because all of the real discussion occurred the two-three hours before in executive session.
I am sure the reporter wondered what the approval for the “Audit report” really meant. It is not being distributed publicly until it has to be when the auditing firm eventually makes it public.
The other big issue was the supply chain assessment. This continues to be a frustration because up until last night, they have refused to address the issue of staying with VHA as our group purchasing organization (GPO). Many of us believe we have been “ripped off” for years by staying with VHA. We have in the past asked for other GPO’s to be allowed to present their services so we can compare the value or lack of from VHA.
Thankfully, after much discussion and arguing, the board did make a motion to proceed with VHA for now, but administration was instructed to get other GPO’s in for presentations on what value and services they can offer.
The CEO’s long-standing relationship with VHA as well as serving as Chairman of one of their committees in the past has all the markings of a conflict of interest. The board finally did the right thing, but they are about 5 months too late. If this process would have been started in January with the original $11.5 million dollar error, we would now have the information needed to make this decision on the GPO.
With the amount of debt we are in and the ongoing cuts, VHA can no longer be the “sacred cow” it has been in the past. The Board needs to honestly assess VHA by comparing them to other vendors. The CEO’s direction of having VHA audit our purchasing processes is like having the fox guard the hen-house.
Labels: board, financial, purchasing
posted by Anonymous at 5:47 AM
23 Comments:
As a medical sales rep for over 20 years, I put the GPO's of the world into the same catagory as the health insurance companies of the world. They are both ripping us all off and skimming healthcare dollars off of the table for little or no value.
With net profits around 4 cents on the dollar, hospitals are looking for ways to improve the bottom line. Jewish decided that they were basically breaking even providing care, so they looked at the supply chain to improve revenues and decided they could do it better than a GPO(Premier). They decided to negotiate contracts individually with vendors and centralize supply. Not a bad idea.
Taking a different view however, the more we squeeze profits whether it be in a hospital or a company the more quality will go down and we will all end up unemployed or if we are employed, our pay and BENEFITS will be diminished. We live in a capitalistic society, without profits the wheels of the free enterprise system come to a screeching hault.
HB, what did the financial statements show?
HB, I know you cannot tell us what the financials are, because of a breach of confidentiality. However, can you comment on your reaction and comfort level?
Since they are not making things public yet, I can say my comfort level continues to decline. It will be interesting to see what the Tribune has to say tonight.
The Board is still reluctant to openly address the problem that created this financial mess.
As increased competition comes, if there is not a different mindset at Floyd, I see things getting even worse.
This VHA issue was brought up more than 2 years ago and again in January after the financial disclosure. Now because of the financial pressures, we are stuck with no option other than continue with VHA for a longer time. This is another bad decision. We are now another 6 or months away from having information about other GPO's or ways to purchase items.
HB, thank you for your comments regarding your comfort level. However, there seems to be a subtle message. You did not say your comfort level was declining because of the info, but rather because of the continued effort to "hide" that info. Did I read your comment correctly?
Second question: How do you purchase supplies for your office? Are you part of a purchasing group or do you purchase independently. And if you do it independently, who negotiates pricing for you and your partners? Just curious
Since when are FMHHS's financial statements confidential? The hospital's debt is a general obligation of Floyd County, meaning if the hospital can't pay, the county (read: taxpayers) will have to. I'd like to get some idea of what the debt service is in relation to the cash being generated to make those payments. That is public information.
As increased competition comes, if there is not a different mindset at Floyd, I see things getting even worse.
If you are referring to the hospital being built by some physicians over off of Veterans Parkway, I wouldn't be too concerned. I'm told the bankers wouldn't back them unless they used their houses for collateral. So if that's true, then they are already deep in it and the clock is ticking. I'm also told that the facility will have only a two bed ER. You call that a hospital?
With the local situation with nurses and other medical personnel, the only way they'll be able to attract them is through higher wages and benefits. Already, I can see they better be pumping out those caths because you still have overhead even on days that you're not busy. I can see within a year, they'll be looking for new financing or the way they'll probably make their money is to sell to Norton's , Clark or Floyd.
anonymous 1:46
Where does your information come from?
It sounds as if you are part of the Floyd administration and just wanting to get the heat off of your own mismanagement.
What proof do you have of any of this?
Anonymous 9:10 really hit the nail on the head. Profits, in health care, is goods or services NOT delivered.
If there are sacred cows at FMH heads should roll.
YOU SAID THIS WAS BROUGHT UP TWO YEARS AGO.WELL WHO WAS THE DIRECTOR OF THE BUYING GROUP THEN?
WAS THIS THE SAME DIRECTOR THAT JUST GOT BACK FROM A VHA RETREAT IN DENVER? WELL DUH,I'M SURE HIM AND THE CEO WENT TO JUST TAKE CARE OF BUSINESS.NOW IF THE HOSPITAL CAN'T AFFORD TO GIVE ASSOCIATES WATER IN THEIR DEPT,THEN WHO PAID FOR THE TRIP? I BET THEY PAID FOR IT OUT OF THEIR OWN POCKET,RIGHT!
To anonymous 1:20 pm: The hospital is in competition with other hospitals and therefore its strategies are confidential. The hospitals finances would come under the arena of a closely guarded concern that its competition would love to gain knowledge of. You are correct that the county is responsible for the debt service, but we will never know everything about how the hospital is run because competition with other hospitals keeps strategies closely guarded.
To anonymous 1:46: If what you say is true that the doctors had to personally guarantee the financing of the new hospital by placing their homes up as collateral, then you can bet they will forward all their patients to the new hospital. But I wouldn't bet that the bankers asked for only the docs' homes for collateral.
And if the hospital only has a 2 bed ER, let me remind you that is all Floyd had for years. An ER serves as a source for new admissions for a hospital. With so many md's owning the new hospital, I seriously doubt they will have trouble filling the beds. Therefore a huge ER isn't as important to them. The beds will be filled.
Hey HB, I am still waiting for your response to my two questions I posted at 11:12 am.
to anonymous 1:46.
You said, " Already, I can see they better be pumping out those caths because you still have overhead even on days that you're not busy."
Have you forgotten? There are physicians invested in that hospital other than just cardiologists. You have some Family Practioners who plan to admit to that hospital, too...who also are invested in it.
By the way, HB, whatever happened to the Senator Pete Stark law that said physicians couldn't be invested in a healtcare operation to which they make referrals? Is that still around?
anonymous 3:05
You are totally off base. I don't have anything to do with Floyd Memorial or their administration.
Proof, you ask. I use the Healthblogger science of truth. Gossip!
anonymous 12:38,
In all healthcare facilities there are going to be days that are slower than others, but the owners still have to turn the lights on, you still have to pay the ER physician, you still have to pay the nurse and the rest of the personnel. There is overhead in running any business. I think physicians often overlook this and if you up to your ass in debt, you can bet if you are patient experiencing a little indigestion, you'll probably end up on the cath table with a catheter stuck in groin.
2:05
Point taken. and scary...but you are right. Cynical, but right.
Cynical. Almost as if it were offered in memory of our dearly departed friend Diogenes. Well, departed or maybe just on leave of absence...
Pul-eeze anonymous 2:05. I doubt there are secret meetings in the morning saying hey we're two caths down, need 3 more CTs and 2 more appendectomies today. Need 6 more blood draws and one more brain surgery and 8 more chest x-rays and the hospital will be in the black this month.
Do you seriously think the physicians base their decisions of what is medically indicated based on the hospital's profit margin (or lack thereof)? This insinuation is far more ridiculous than ANYTHING hb has put on the blog by far.
As far as indigestion ending up with a "cath in your groin" - probably yes if you are a 50 something year old smoker with diabetes and hypertension. Probably no if you are a 22 year old female who ate too many white castles. There is some discernment in the decision for clinical treatment paths based on a patient's symptoms and physical presentation. Give the physicians some credit!
For you to suggest otherwise highlights your ignorance.
Stick to what you know best, whatever that may be.
DAN DOES THIS BLOG REALLY GET ANY THING ACCOMPLISHED?WHEN ITEMS ARE SHARED,THAT MAYBE EVERYONE IN THE HOSPITAL ISN'T AWARE OF.WHAT DO YOU DO WITH THE INFORMATION?DO you check and see if it's factual?Maybe some that are your bloger's would give you more credability if what you posted you knew what was factual? Will you ever stop looking at the CEO and look at where the issues began?The witch hunt stops with the CEO?IS that the only one that you want to blame?YOu DR.DAN can't see the forest for the trees,so to speak.
As far as indigestion ending up with a "cath in your groin" - probably yes if you are a 50 something year old smoker with diabetes and hypertension. Probably no if you are a 22 year old female who ate too many white castles. There is some discernment in the decision for clinical treatment paths based on a patient's symptoms and physical presentation. Give the physicians some credit!
Could we just try an EKG first?
Give the physicians some credit!
I am giving them some credit, but consider this: today, there aren't any admissions in your hospital, 1 bunionectomy in the O.R., 1 diagnostic cath in the cath lab and the 3 people in the hospital are going home today and you've put up your house and everything you own for collateral. Everything you've worked for all of your life is now in play. I just think this could skew one's vision of the hippocratic oath.
What's with all the hostility, 12:02?
I'm always puzzled by the bloggers who use all caps and only selectively use the space bar.
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