Dig back in your memory, and think of a time when we had two hospitals. I
know, it's been awhile, but bear with me....
We had a religious based, non-profit, and a for-profit that had the women's center. The for-profit started losing ground and went under Presby management--which was essentially Dallas-based and not terribly in tune with the community. The jacking up of leases on medical offices was a prime example. The Catholic hospital had a different management problem: They thought that not-for-profit meant spend all you want, we have deep pockets. In both cases, assumptions were made, erroneous ones it turns out, and big losses occurred. Both were management derived.
So, we have a for-profit that suddenly becomes a no-profit. It would have been bought by a more driven competitor, but for the management of the not-for-profit being scared witless by the thought of real competition. So they bought it. Paid far too much.
So now we have duplicated services, a mounting debt, and no real competition to keep the management on their toes. And we still have the "deep pockets will keep us afloat" attitude. We also have an outpatient surgical center that is a white elephant, Health Solutions which would have been more aptly named Health Delusions, and a "women's center" under the umbrella of a Catholic diocese (the rumblings over that gave Christus an out.)
Christus becomes tired of dumping money into a rathole, Dr. Royer (C
hristus CEO) might have felt the tug on his compensation (the highest of any Catholic hospital group CEOs), and so on the block it goes.
The decision to sell to Essent was poorly thought out. They might have dazzled the board with the idea of the tail wagging the dog--being a 'showplace' of the group...and it helped that the other serious contender intended to disolve the board. They also had never heard of Crossroads, Essent's first hospital that was being unloaded because it was only profitable for one out of five years, after dumping in millions to update it, and ARCON, the Essent CEO's previous failure.
Essent thought that the mess we were in could be settled by the wave of a ledger sheet and a heavy hand. Their due diligence was rather poor diligence, not accessing several factors. The number of properties that were owned, the Hatfields vs McCoys attitude of the two campuses, and the physicians. It didn't help that the Christus management had let things go towards the end, in maintenance, and in many of the basics.
Turning the attitude of the staff has been one of the major challenges, and a somewhat tightened purse strings by lenders in wanting to fund predominately capital assets, something having a sale value--in case. The intention of breaking the radiology group had its own consequences, actually placing them in a more advantageous position. Anesthesia was broken, and ortho came into line with the renovation of the ortho floor. Cardio was tamed by bringing in their superstar, but since the Advanced Heart are based out of Dallas, it didn't have as much leverage on them as those only in Paris.
What has happened is that the draw of the former medical community to a population base of 125,000 has dwindled. What was serviced by two hospitals can almost be handled by one--and could, if they added on to one of them. The North Campus has always had the advantage of land--but if they do such a complete move, what happens to the value of the South and the surrounding properties?
So, the Peds move to South is an adventure in utilization. This becomes a Rubik’s Cube of sorts, juggling departments from one to another, trying to find the best fit, only b
ean counters don't have the same perspective as health professionals. Just wait for the Women's Center to be moved to the South....
Friday, June 12, 2009
What We Have To Date....7/17
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14 comments:
Evidently the peds nurses put up such a fit at the thought of moving south that they just moved peds over to share with post partum.....
That's great thinking...sick babies with the new babies. Even with the room designated "peds" and peds nurses taking care of them....they still share a nurses station, supplies, etc with post partum...
how long until they figure out that they cant afford a lawsuit by a new mom whose baby gets sick because of poor location of services?
Paid too much for Christus; have made "body blow" mistakes with the Clifford fiasco and the anasthesia fiasco;Have a fool for a "Personel director";Can't understand that if they dont move to the north they are dead men walking.;micromanaging from Nashville by venture capitalists that know next to nothing about running a hospital;
Making these kind of clusterF's is the usual for these clowns. Why would they worry about cross contamination between sick children and newborns?Each and every Md in pedi and ob protested this decision strenuiously.
Methinks the only winners in this sad tale are the board members, who can strut around town with fat wallets and puffed-out chests over their alleged business acumen.Chritsus and THR were incompetent at best, poor managers of property at worst, and left a sick facility for the snake-oil salesmen from Nashville (led by the biggest serpent, Hud) to swallow whole.
Paris has had no decent leadership in health care for many years, going back to L.P> McCuistion and the dods back in his day. The idiot moves made by the locals has led to what you have now. And only smart moves by somebody else (outside the local idiot power structure) can turn things around.
Not sure who the biggest cast of idiots is- Christus, THR, Essent, the current (mis)management staff at PRMC, or the local power structure whose business acumen doesn't go beyond tractors and cattle (or their own pockets).
Understand 4 ER nurses fired from South Campus. Don't know why yet. Could another lay-off be coming?
As to the comments accusing the Board members and business leaders for the disasterous situation in Paris'healthcare:You dont know what you are talking about!The history of healthcare in Paris is one of far sighted leadership by L.P. McCuistian and the Sisters going back to Fr. Duboise.When towns like Gainsville and Mckinney were languishing with run down inferior facilities ,Paris boasted two very fine hospitals that were the center of medical care in S.E. oklahoma and N.E. Texas.In 1970 Paris had over 90 board certified specialists in every field from pedi to orthopedics.What's happened is not the fault of complaicent boards of directors or fat cat businessmen.It is the result of cuts in medicare funding and medicaid funding that occurred in the early 1990's.At that time both hospitals together lost approximately 5 million per year in funding from those two sources alone!add to that the poverty of Lamar and Red Rver counties and you have a formula for WHAT HAS HAPPENED.The current payor mix is 65%medicare and medicaid and charity .The consolidation of the two hospitals was necessary to counter these cuts in funding.unfortunately no one has
found a way to close the south campus.until then the situation
will continue to deteriorate.The people of lamar county are already taxed to death, but I fear that a tax-based hospital is the only way we can return our hospital to what it once was. A for profit can never provide what we need; namely a good general hospital.
To the last commenter- I never doubted L.P.'s leadership, nor that of Father Dubuis. I'm also aware of how high the poverty levels of Lamar (and how much worse they are in surrounding counties on both sides of the Red) County was and is- I lived there for over 20 years. I DO know what I'm talking about. I still lay blame at the feet of local businessmen and near-sighted board members who failed to do their homework and let themselves be fooled by the first sname oil salesman to come along.
I have no issues with the local physicians, all of whom are excellent in their chosen fields of practice. I do have issues with the facility they are now forced to practice in. I also have issues with the hired guns brought in by Essent to replace local docs who wouldn't "play ball" with Essent.
I also have issues with how Christus and THR FUBARed things leading up to Essent's takeover. And of course, I have major-league issues with Essent, that motley collection of wannabe misadministrators, bean counters, and idiots who couldn't hack it in the real workforce and therefore got jobs of leadership at the various facilities (and you know who you are).
I have lived and worked in the area for 20 years, so I know what I'm talking about. I also agree that local ownership needs to be retained in order for the local healthcare scene to improve. I also agree with what you have just stated about the local economy and tax base, as well as closing the south campus, which has no more room to expand without buying up & condemning homes in adjacent blocks (which would not happen in our lifetimes). Essent's moving and consolidation plans can be summed up in two words, the first one being "cluster" (decorum forbids my mentioning the second word here).
I think you need to check your facts. Before Essent, BOTH hospitals in Paris were non-profits. McCuistion and St. Joseph/Christus. And Presbyterian out of Dallas, which bought McCuistion, is also a non-profit.
Also, shortly before Christus put the hospital up for sale, it was announced to a medical staff meeting that the hospital would be in the black in a couple of months. They were doing much better financially. The reason they sold out was because the set-up with sterilizations on the north campus was against Catholic Church teaching, and they never should have set it up. When that situation went national in a major Catholic newspaper, they very quickly decided to sell the hospital.
It was true that the "Women's Center" drew the attention (prompted by local Catholics),despite the attempts to hide the 'dirty little secret'.
Prior to the purchase, Christus had been pumping in significant amounts of change, despite the shell game that had been played with Health Solutions and the construction projects.
You remember, that was when it became obvious that you can't remove a load-bearing wall no matter how much better the ER would work without it....
I really didn't realize that McCuistion was actually purchased by Presby--I thought that it just went under their management. I guess I must have missed the discussion of loss of tax revenue back then.
Help me out here, had Christus gotten the Medicare rates readjusted to the Dallas area at that point? It was one of the fault points--letting the renewal lapse and when re-established, it was designated rural (a lower rate.)
If so, it might have helped. But prior to the sale, Christus let maintenance contracts end, and from what I've been told, even the periodical subscriptions in the medical library had run out.
McCuistion was essentially taken over by Texas Health Resources in order to set up PCA clinics in Paris and Greenville and to garner more "lives" for their Harris Methodist H.M.O. which was losing huge amounts of money(ultimately it lost 100 million in a single year!)the board of governors of McCuistion had been stampeeded into believing that the hospital had to merge with T.H.R. or go under. This fable was propagated by Dagle in concert with his old roommate from Trinity who was working for THR.Unfortunately, shortly after the merger the Harris methodist HMO scandal broke in the Dallas Morning News.(Harris went bankrupt owing the physicians over 22million,but the stock holders of the medical service company that were doing the billing etc for the HMO were taking %25 off the top and it turned out that the CEO and several members of the THR board were the stock holders!!!They, of course made out like bandits.Well, when the HMO went under, it made no sense to operate a small money losing hospital in Paris , so THR, after "carefully studing the impact on Paris" decided to sell to Christus(did they ever buy it?).Christus rejoiced that they had finally defeated their competitor ;but sadly,just like the python that ate the alligator ;it proved to be too big to swallow HaHa.I was amused to see a comment by a prior commentator that"Christus was profitable "before the sale to Essent.What A CROC, THEY LOST 12 MILLION THE LAST YEAR THEY OWNED THE HOSPITAL!!sO THERE, MY FRIENDS, IS THE SAD TALE OF HOW A SMALL TOWN HOSPITAL THAT HAD SERVED FOR ALMOST 100 YEARS CAME TO THE STATE THAT WE ARE IN NOW.nOT BY LOCAL BUSINESSMEN OR IATTENTIVE BO9ARD MEMBERS, BUT BY LOSING CONTROL OF OUR DESTINY TO THE SHARKS OF BIG MEDICINE. WE WILL NEVER BE ANY BETTER THAN WE ARE NOW UNTIL WE GET RID OF THESE ESSENT CLOWNS AND SOMEHOW HAVE A LOCAlly owned and controlled hospital.Ennis Tx has come up with an innovative way to finance a county hospital we could do the same.
To the poster wondering about the reason ER nurses are being fired (more like quitting) in droves, look no further than their illustrious leader...PHYLISS. She hates being there so is determined to make everyone else's life hell as well.
RE: ER Nurses. The ER has lost alot of good nurses to other places. You have the "contract" nurse down there that doesn't give a crap about the patient, just when they are going to there next nursing job. They can't find anything in the ER. Good one Phyllis.
Let's talk about Phyllis. She has run off all the good ER nurses, medic techs. She kisses Dux's ass and the worthless ER docs ass (Goodman and Mitchell) to make herself and her dept look good. She is worthless.
Paris needs a hospital, and not the crap we have on Clarksville street.
OK,OK,OK, I get it........you have a situation with medical care in Paris,Texas. I have been reading this blog for 2 years and HAVE NOT ONCE heard of a solution. This country is full of whiners and finger pointers. Come on people, step up and put some backbone in it and solve the problem. I am a physician and have watched things fall apart. I cannot agree more that the Big Boys snookered the "ownership" of the not-for-profits and sold you down the river.
OK, now for the solution....take back control of your destiny. It is too expensive to "buy back" the facilities that exist with dwindling profits and ownership is now private (not subject to oversight). You need a new facility with options for inpatient care and cooperation with a larger facility for transfers. You need a robust outpatient facility for the majority of ambulatory care. Allow the hospitals to carry on with their "for profit" management and they will soon learn that Paris no longer "needs them". Once this occurs, the doors to the meeting room will fly open.
"OK, now for the solution....take back control of your destiny. It is too expensive to "buy back" the facilities that exist with dwindling profits and ownership is now private (not subject to oversight). You need a new facility with options for inpatient care and cooperation with a larger facility for transfers. You need a robust outpatient facility for the majority of ambulatory care. Allow the hospitals to carry on with their "for profit" management and they will soon learn that Paris no longer "needs them". Once this occurs, the doors to the meeting room will fly open."
best idea i've heard yet, doc. how do we make this happen?
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