Calm in the Storm

By James R. Teeter, President and CE0, Arkansas Hospital Association

There are tragic national incidents that are indelibly marked in one’s mind. In my case, there’s the scary Cuban missile crisis of 1962. The shocking assassination of JFK in 1963. The coldblooded murders of RFK and MLK in 1968. The senseless Oklahoma City bombing of 1995.

And now, the unimaginable horror of the September 11, 2001, terrorist attacks in New York and Washington, the death toll of which will likely exceed 7,000. Will anything more devastating than this occur on American soil in our lifetime? Let us pray not.

As fate would have it, I was about to leave my room for a meeting at the Mayflower hotel, four blocks from the White House, when suicide skyjackers flew American Airlines Flight 11 into the north tower of the World Trade Center’s 110-story twin towers in New York. Minutes later, United Airlines Flt. 175 slammed into the south tower. The nation, still sipping its morning coffee, was aghast as hellish fireballs began to incinerate the huge buildings.

By the time I got to my meeting, both WTC towers had collapsed. And American Fit. 77 had crashed into the Pentagon just across the Potomac. The Pentagon was in flames. Sirens wailed. Peo­ple scrambled. Chaos set in. Federal offices, businesses, and the Metro shut down.

So did our meeting: Suddenly, plotting strategy to funnel more dollars into Medicare seemed inconsequential. We began monitoring a large TV in the meeting room where we learned that the nation’s airports had been shut down, all planes in flight ordered to land immediately.

But at least two jumbo jets were unaccounted for, said CNN! Had they been commandeered, too? Were they zeroed-in on the Capitol? The White House? Maybe so, because terrified White House staffers were running out into the streets. The CIA and FBI were stunned. The president was returning to DC. No, wait. He wasn’t. Where was the vice president? Congressional leaders had been taken off to a bunker somewhere? What next, a gas attack?

And then, amid all the confusion and anxiety, some of us began to notice it: A kind of calm began to emerge. It could be seen in the faces of harried but focused hospital caregivers as they prepared for and began receiving casualties in both Washington and New York. While a reeling world watched, doctors, nurses, emergency crews, and other workers rose to the occasion, as they always do, performing heroically and demonstrating the enormous skill, care, and compassion America has come to expect of its healthcare workforce.

Ah yes, our workforce. For so long now, we’ve been explaining to the Congress that among this nation’s greatest assets is its skilled and compassionate hospital workforce, one that is experiencing alarming attrition for a variety of reasons, including inadequate compensation caused in part by federal budget cuts and reduced or denied commercial insurance payments.

Hours after the September 11 attacks, the Congress approved a $40 billion emergency appropriation to shore up national defense and to wage a “war” on terrorism. President Bush said this war would be a protracted one, fought not only in America but also all over the world.

Nobody knows the human price of this war or the number of casualties from both overseas and here at home that may eventually be rushed to our medical centers.

So, it occurs to us, and perhaps one day it will to Washington, that hospitals and their caregivers not only provide healthcare services to millions of Americans every day, but they are also one of the most critical components of this country’s national defense infrastructure. A healthy hospital system with an adequate and competent work-force is absolutely essential. In times of peace, and in times of war

Arkansas Newsmakers and Newcomers
Charles Mitchener has been named president of Arkansas Heart Hospital in Little Rock, succeeding David Blackburn, who retired earlier this year. Mitchener, a native of Corning, Arkansas, formerly served as CEO of Jacksonville Hospital in Jacksonville, Alabama, and also served in administrative positions with Quorum and Triad facilities in Mississippi, Virginia, South Carolina, and Georgia. Earlier in his hospital career, he worked in the business/finance offices of Jefferson Regional Medical Center in Pine Bluff.

Jeff Buckley has been named interim CEO at Helena Regional Medical Center, succeeding Jim Richardson. Buckley was previously associated with William Kramer and Associates in Jeffersonyille, Indiana, and CEO of Gateway Regional Health System in Mount Sterling, Kentucky.

Vince DiFranco has been named CEO of Mena Medical Center, succeeding Doug Garner. DiFranco previously served as CEO of Wills Memorial Hospital in Washington, Georgia and as associate executive director of East Georgia Regional Medical Center in Statesboro, Georgia.

Andy Altom is CEO of the new Methodist Behavioral Hospital, a 60-bed residential care facility in Maumelle, which officially opened September 14. Altom is a former chief operating officer with United Methodist Children’s Home in Little Rock.

John V. Oliver has been named acting CEO of SemperCare Hospi­tal of Little Rock. He succeeds Brian Holt. Oliver is a representative of SemperCare corporate offices in Dallas and was a former regional vice president for the southwest region with Vencor Inc.

Anthony M. Grasse, M.D. has been named interim CEO of Com­munity Medical Center of Izard County in Calico Rock. He succeeds Terry Amstutz who resigned August 1. Dr. Grasse is a founding board member of the hospital, which opened in 1959.

William E. Golden, M.D., vice president for clinical quality improvement at the Arkansas Foundation for Medical Care (AFMC), has been awarded the national Healthcare Quality Improvement Excellence in Physician Leadership Award by the American Health Quality Associ­ation. In addition to his position with AFMC, Golden is director of the Division of General Internal Medicine at UAMS in Little Rock. 

Scully Addresses Arkansas Providers
Centers for Medicare and Medicaid Services (CMS) director Tom Scully addressed an overflow crowd of state healthcare provider representatives and professionals September 1 in the auditorium of the Reynolds Center on Aging on the campus of the University of Arkansas for Medical Sciences.

Scully spent a few minutes at the beginning of his comments reviewing his plans for changes at CMS, then opened the floor for questions from the audience. The two items he touched on that hold the most interest for hospitals concerned the possibility for changes in the Medicare area wage index (Awl) and his desire to limit all hospital Medicaid payments to 100% of the Medicare upper limit.

Regarding the Awl, Scully said there was little his agency can do to implement a change, since the wage index value is statutory rather than regulatory in nature. He suggested that hospitals, particularly rural hospitals that could be most affected by higher wage index values, continue to work with their senators and congressmen to secure changes, but expressed doubt that Congress would add to the Balanced Budget Act (BBA) relief measures allowed in 1999 and 2000. He said he understood that some hospitals may still be suffer­ing consequences from the BBA, but that, in general, hospital margins seem to be improving and are about where they should be.

Scully did little to hide his lack of support for Medicaid disproportionate share hospital (DSH) payments or the Medicaid upper payment limit (UPL) program, noting how some states have abused UPL payments by channeling healthcare dollars toward other purposes. He believes the UPL rule published last January allowing some public hospitals to claim Medicaid payments up to 150% of Medicare upper limit per case payments should be revoked, even though he admits that some states aren’t guilty of misusing UPL dollars.

While Scully mentioned in his initial comments his hope that CMS could be more flexible in dealing with states and healthcare providers who participate in Medicare and Medicaid and more rational in its policies, he failed to mention any options for preventing future abuse of the UPL program as an alternative to eliminating the 150% limit.

Workforce Development Tool
The American Hospital Association (AHA) recently began offering a new resource to help hospitals and health systems better communicate, market, and plan for the workforce challenges they face. Developed jointly by AHA’s personal membership groups for human resources and marketing communications, Building a Framework for Workforce Solutions will help healthcare organizations assess their suc­cess as employers, identify staffing goals, and create strategic plans to meet those goals.

The report provides a collection of resources, including self-assess­ment checklists, analysis tools, marketing programs, partnerships, and other initiatives that hospitals and health systems around the nation have undertaken to address work­force issues. To purchase a copy, visit www.ahaonlinestore.com.