Trustee Matters — September 2022

• communication revisions improved billing practice strategies
• improvement charters now include a “voice of the patient” section
• physicians, residents, medical students, social workers, and nurses are educated on patient advocacy and respect for the patient voice in decision-making
• helped define exceptional patient experience
• installed cultural food equity and an on-site food pantry
• made accommodations to the discharge lounge
• developed a badge to recognize and support family caregivers
• revised its patient and visitor web page
• refined appointment reminder text messages

North Kansas City Hospital and University of Missouri Healthcare also received Honorable Mentions for their advanced efforts.

In the 1990s, facing increasing complexities, local leaders often looked for out-of-town “partners” to own or operate their hospital. During this same time, reimbursement declined and costs increased, and by the mid-2000s, the closure of rural hospitals accelerated. Nine of 10 Missouri hospital closures since 2010 were owned or managed by entities with no ties to the community. This is by no means intended to question the motivations or abilities of entities that lack community ties. But, as all of you know, the value of your community hospital to your community is not captured by the hospital’s financial statements. Only community members truly know the hospital’s value to the community. Consequently, local governance tends to enhance the ability to maintain a hospital in your community.

This begs the question, “What can you, as a hospital trustee, do to prevent your hospital from becoming another hospital closure statistic?” Below are eight relatively simple steps.

1. Take the time to learn about health care and your hospital. Of particular importance is learning and understanding the financials. You don’t need to be a CPA or have an MBA; you need information and a willingness to ask questions.
2. Require transparency from your CEO and other leaders. Trustees have a fiduciary obligation to ensure compliance with complex statutes and regulations.Create a culture in which your hospital leadership is willing to share their successes and failures.
3. In conjunction with your hospital CEO, develop a compliance plan that includes reports from hospital advisors, including lawyers, accountants and consultants. This allows you to ask questions on issues involving significant risk for the hospital.
4. Do not be pennywise and pound-foolish. Many small hospitals try to avoid using attorneys, accountants and consultants to save money, and they end up paying significantly more to fix the problem, which could have been avoided on the front end.
5. Work to “right-size” your hospital to the needs of your community. Every hospital needs an emergency department, but all hospitals must be thoughtful about how to invest to provide the best balance of additional services.
6. Consider making changes early. Too often a hospital waits until it is nearing financial calamity before it begins to consider changes that would help sustain it.
7. Do your research and strongly consider options before giving up control of your hospital. While affiliating with a nearby larger hospital or independent operator can pay many dividends, no one has a greater interest than you in seeing your hospital survive and thrive.
8. Look to the local community for support. In an era where even well-run rural hospitals struggle financially, community leaders need to consider the hospital’s broad economic impact when evaluating the needs and benefits of governmental, business and philanthropic financial support.

Health care (including hospital care) is best when it is local. By taking the steps outlined above, hospital trustees (with CEO buy-in and the help of the local community) can actively work to keep their local hospital alive and thriving.

Article provided by Spencer Fane.