Roy Exum
I was told, by three different sources, that the Erlanger Hospital Board of Trustees was going to make bold and forceful moves at its monthly meeting last Thursday in a concerted effort towards curbing $13 million in losses, a deplorable leadership problem, and a multitude of easily identified problems that now plague Chattanooga’s largest health provider. Guess what? My sources went 0-for-3. That’s right: Nada. Zero. Zilch.
What actually occurred at last Thursday night’s session was just more smoke-and-mirrors from a weak administration and a mangled infrastructure that has doctors, nurses, staff and the public begging for immediate and dramatic action.
Board chairman Ron Loving was unable to be present, presumably due to more pressing matters, so guess what everybody did?
According to an account on Chattanoogan.com, they listened as interim CEO Charlesetta Woodward-Thompson told of her warm reception with state legislators in Nashville, and heard her say administrators are “doing a lot of listening” to lesser employees. Then medical director Cy Huffman gave a talk on infections caused by IV therapy. That’s it. That’s what the Erlanger Board accomplished while voting on not one single item of extremely pressing concerns. Oh, but they did make my blood boil. I shall proceed.
The most incredible symptom that the floundering hospital is now without any leader - on any level - is the fact that it will be mid-April at the earliest before the trustees meet again in hope of appointing a search committee to find a competent CEO. Then it will be many more months before a new executive team can come in and begin a cleanup to rival a savage tornado in a trailer park. Until that blessed day occurs, now-drowning Erlanger will be stuck with the same moribund crowd that got the hospital into this huge and unwieldy mess to begin with.
Since Erlanger’s board of trustees – as a group – seemingly refuse to face reality, let me tell you what I would do after talking with hordes of doctors and hospital employees all last week. Mind you, mine is a small drum and, since I have no reason to even get involved, my recommendations are simply one man’s opinion but, my goodness, what must we do to get these jokers off the dime!
CHIEF EXECUTIVE OFFICER – An intense effort by a search committee should begin at 7 a.m. today. To get the best person in America may call for a million-dollar salary but if he or she can make us a $25 million yearly profit, who cares? Let’s get going! The longer we wait to move, the worse it will get. I’ve got the first quarter of this year as ample evidence to guarantee further failure by the current executives and, for that matter, the currently-seated board as well.
INTERIM CEO – Charlesetta Woodward-Thompson is a kind and wonderful woman. Nobody will deny that, but neither will anybody deny that she is clearly mismatched and unfairly overwhelmed in the role of a CEO or leader. She simply has none of the skills that assure success and, candidly, there are some monumental problems few believe she can master. The best interim CEO is obviously the medical director, Cy Huffman. He is best equipped and best trained to confront issues with doctors, sagging surgical numbers, rampant morale issues and some pressing problems with accreditation that are quite chilling.
COO – The current chief operating officer is Lynn Whisman and, in my opinion, she should resign immediately. She is being increasingly targeted as the source for poor decisions and is thought to be the reason many good and well-qualified supervisors were brutally terminated in February. Put her under a microscope and some long-time physicians say it gets worse. Conversely, it is believed the popular Denise Ray, who now holds the COO position at Atlanta’s Piedmont Hospital, would return to her beloved Erlanger “in a heartbeat” if given the necessary power and leeway to stage a dramatic turn-around like she just accomplished at Piedmont. She was great when she was at Erlanger previously but the “skinny” is Charlesetta and Jim Brexler ran her off. Today she’s a brilliant success. This ain’t rocket science.
CHIEF FINANCIAL OFFICER – Britt Tabor currently holds the post and has been unjustly criticized in the wake of the $13 million loss for the fiscal year. He hasn’t got any money! While he has indeed been part of the inept management team, Huffman’s integrity and sound leadership could trigger a greater emphasis on incoming revenue, better record keeping and the hospital’s deplorable collections process. Tabor’s future, of course, would depend on the whim of a new permanent CEO.
CHIEF ADMINISTRATIVE OFFICER – Gregg Gentry showed mettle with sound decisions in the Hutcheson Medical Center negotiations but some areas of his responsibility, most notably a weak marketing/public relations crowd and a questionable security arrangement, could be costly upon close review. Payer/government relations are critical right now and you must remember that under the old regime (Brexler), Gentry was a pawn instead of a knight on the chess table. He, too, would work at the whim of the CEO.
BOARD OF TRUSTEES – The board is seemingly split and some are either too timid to contribute or too uninformed to respond on either side. The divide was best noticed by those who voted for the ousted CEO’s severance pay and those who did not. The nominating process is outdated and thus is now muddled but the day when a careless politician made “crony” appointments has long passed. The new board needs a healthy mix of physicians, business experts, a human-relations whiz or two, and those with sound and sage wisdom who will actively contribute for the common good.
THE BEST TRUSTEES – Based on many conversations, the most highly-regarded by the employees are Donnie Hutcherson, Richard Casavant, Jim Worthington and Jennifer Stanley. Phyllis Miller and Russell King are solid and newcomer Nita Shoemaker will be tremendous based on her past service to the board. The others are all nice people. Currently there is one open vacancy and there has never been a time it needs to be used more wisely. Incidentally, I believe board members should be paid a stipend but only when they attend meetings and committee assignments. Face it, the job is a tough one when done right and a stipend will enhance the role.
THE STAFF – Erlanger’s nurses and techs should be assured there will be no more mass layoffs and the intense “bullying” has to stop. Had the board not paid severance packages, the hospital would have made money last month. Layoffs are unnecessary and patient care is vital. So is a good morale and pleasant workplace. That said, there needs to be continual trimming of “dead wood” and unnecessary positions. Reverse racism, duplication and benefit issues must be addressed for the fear and uncertainty to be absolved for good.
HUTCHESON – Some are critical of Erlanger’s acquisition of the Hutcheson Medical Center in Fort Oglethorpe but with a persistent need in a three-county area easily recognized, there is a “mission to the community” that should be acknowledged. Hutcheson continues to bleed money so a new Erlanger CEO, with a clear vision, is obviously the answer. Get this: the trustees haven’t even got a search committee and Hutcheson has used almost half of its $20 million bailout!
PLAZA MEDICAL TOWER – Owned by the hospital, the doctors leasing space have been brutalized by increased rate hikes from the very hospital itself. The answer is to sell the office complex to some big developer, taking the multi-million buyout and applying it to more urgent needs – updated equipment, better billing systems and a terrible “information technology” system that everyone in the hospital abhors.
COMPUTER SYSTEM – Right now Erlanger has three information systems in place where the software systems cannot be interfaced. That means one system cannot “talk” to another and it is costing Erlanger thousands in duplicity, man-hours, and stress. Everybody recognizes the problem but no one has stepped forward to confront it.
SURGERY NUMBERS – Erlanger has the finest surgeons in Tennessee and elective surgery – by those with insurance who can pay for procedures – is the best way to increase income. Because the past regime alienated many surgeons and made it “harder to work at Erlanger than Memorial,” in the words of one who left, the hospital’s bed ratio – surgical to medical – has fallen according to state figures. For instance, Memorial’s surgical-medical bed ratio is around 48 percent while Erlanger’s ratio has dropped to less than 30 percent. Think there might be a problem there? But most trustees don’t even know it.
INDIGENT CARE – Erlanger has huge indigent costs, giving $9 million in care last month, but it is said that state figures will soon show that Parkridge, a for-profit hospital, is now providing more indigent care than Memorial, a not-for-profit that is Chattanooga’s second-largest hospital. Clearly Erlanger must be better subsidized by local and state governments and, as Trustee Russell King pointed out last week, the disparity of what is given to other hospitals in the South compared to Erlanger is absolutely heart-breaking.
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Now, if I can do all of that, while typing with just my left hand, why in the name of Jehovah can’t the Erlanger Hospital Board of Trustees do more in a regularly-called board meeting than listen how much fun it was to visit in Nashville, hear that small groups are talking and take a short lecture on IV-borne infections.
I am absolutely affronted by the whole thing.
royexum@aol.com