Exec says CHS has the Rx for success, profitability

By William K. Alcorn



Forum Health was more cash-strapped than its new owner, Community Health Services, anticipated, says a CHS official.

Some things had been let go during the bankruptcy, said David Fikse, chief executive officer of Northside Medical Center and of the entire former Forum Health system.

As a result of Forum’s lack of spending, CHS spent more than $10 million in the first three months after it acquired Forum on Oct. 1, 2010, for new medical technologies and upgraded patient-care equipment, Fikse said during a recent interview.

Items such as patient beds and nightstands were purchased, and some $2 million was spent for basic equipment and supplies for nurses and physicians to do their work, things the average person wouldn’t notice, Fikse said.

The initial investment also includes new video towers; anesthesia machines and monitors for surgical suites; ventilators, vital-sign monitors and computerized IV pumps for critical-care units; and EKGs, defibrillators and intubation systems for emergency departments, he said.

Community Health Services, which purchased Forum Health for $120 million, pledged to spend at least $80 million over the next five years to upgrade hospital facilities, medical equipment, technology and services.

Major hospitals in the CHS system in Trumbull and Mahoning counties are Northside in Youngstown, Trumbull Memorial Hospital in Warren and Hillside Rehabilitation Hospital in Howland. In addition, there are outpatient clinics and various other facilities in the two counties.

Fikse said several million dollars will go toward renovating patient rooms and converting many of them to private rooms, which he said will be quieter and more comfortable and should translate into higher-patient satisfaction.

Also, CHS is seeking quotes for big-ticket diagnostic equipment, he said.

But CHS’ 2011 initiatives are not all about equipment.

For instance, TMH is chest-pain accredited, and Northside is stroke-center accredited. “We are looking to get both hospitals accredited in both areas,” he said.

Fikse said he is working with physicians to identify needs and positions that need to be filled and is looking to recruit physicians from outside the area, or those who have left the area but who want to come back, and help them get started in private practices.

Fikse believes CHS can be successful and profitable in the Mahoning Valley and become competitive with Humility of Mary Health Partners — HMHP operates St. Elizabeth Health Center in Youngstown, St. Elizabeth Boardman Campus and St. Joseph Health Center in Warren — for several reasons.

CHS is partial owner of a cooperative that cuts out the middleman and enables it to buy supplies and equipment in bulk at lower costs. There may be some centralization of processes, perhaps in the financial area, that will lead to cost savings, and CHS has the capital to invest and fund growth, Fikse said.

Also, CHS has found that doing certain things well leads to better patient satisfaction, he said.

An example is the concept of “hourly rounding” that includes the “3 Ps”: position, potty and pain, Fikse said.

When patients’ positions are changed hourly, skin adhesions go down; when they are offered help to the bathroom hourly, falls decrease; and when pain is monitored hourly, it is easier to stay ahead of it.

The “3 Ps” improve medical outcomes and the perception of the patients, he said.

Regarding competition with HMHP, Fikse said things can change over time, as evidenced by the fact HMHP and Forum were about equal in size just a few years ago.

“I know that HMHP is there. But my goal is to improve our care and processes, and develop a relationship with employees and physicians that is collegial and respectful. I believe the rest, including becoming competitive with HMHP, will fall into place,” he said.

Fikse said the No. 1 cost of any health-care system is labor, which means it is always necessary to look at the work force from a cost standpoint.

“We haven’t made any wholesale changes, but we look at positions as they are vacated and decide if they need to be filled or if the work can be combined with another position ... to match the needs of the business and the manpower,” he said.

Regarding labor relations with unionized employees, Fikse said: “We’re still feeling our way. There are multiple contracts that we are still learning about.”

One of those contracts, which expires in July, is with the Ohio Nurse Association’s Youngstown General Duty Nurse Association, which represents registered nurses at Northside.

There have been some positive steps, including some new equipment and more general upkeep than has been seen in a while, but it’s early, said Eric Williams, YGDNA president.

“There hasn’t been a lot of sharing of future vision and direction, and I think people are eagerly awaiting to see what CHS has in mind,” Williams said. “We are all hopeful that CHS’ ownership is going to be positive for the employees and the community. The employees are part of the community and are in it for the long haul.”

Fikse said CHS is actively looking to grow in the Mahoning Valley but would not be specific about plans and whether Boardman, where HMHP has become very strong, would be targeted for expansion.

He did say, however, that several locations are being evaluated to develop a greater physical presence in the Valley and that CHS is having discussions with current entities with an eye toward collaboration.

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