Annual President’s Report to the Corporators
Franklin Community Health Network
September 25, 2006
The past year has been a year filled with significant challenges. We have done very well, and in many ways we are stronger and better than a year ago. But some of our challenges continue and we have more work to do.
In the past year we were challenged financially as never before. Over the last several years State government has vastly expanded the MaineCare program… and they have financed this program expansion by not paying hospitals. As we finished the fiscal year in June, Franklin Memorial Hospital was owed over $10 million for services already provided to MaineCare participants dating back to July 1997. In the last two months we have received $3 million and State government has just given us a written commitment to pay us another $1.5 million in a few weeks. However, that still leaves us owed $5.5 million, including $1.5 million dating back nine years. We will take whatever steps are needed to recover that money.
Another financial problem we faced was that State government installed a new claims processing computer system that for most the year didn’t work at all. This gigantic fiasco caused indescribable problems and expense to this organization.
Over the past year we have had to respond to other unusual financial challenges: liabilities not covered by insurance, the cost of the start-up of four new practices, and the challenges that come to us as a result of increases in the number of patients we serve who do not have insurance.
We have also had to work hard in the past year to expand the number of physicians and other providers we employ. For many reasons, it is very rare to now find doctors who want to own and operate their own practices. Twelve years ago, when I came to Franklin Memorial Hospital, we employed two doctors--today we employ more than fifty. There are only a small handful of physicians in the region that continue private practice. It has been a learning experience for our organization and the doctors to find the best ways to manage the practices. But largely we have worked the kinks out. Our practices have been successful and we are working hard to make sure our four newest practices (Rockomeka Family Practice, Wilton Family Practice, Franklin Surgery and Franklin Urology) are also highly successful. We have expanded the hospitalist program at FMH to include four full-time internists and two physician assistants.
It is noteworthy that last year we were honored as one of four finalists for the Foster G. McGaw Award, one of the top honors of the American Hospital Association. Our volunteer program won the #1 volunteer award of the AHA for our Contract for Care Program. Franklin Community Health Network and Franklin Memorial Hospital have earned more national honors for excellence and our community work than any other hospital or healthcare system in Maine.
Other highlights in the past year include completing 50 Stories in 50 Days, obtaining a million dollar HCAP grant to install electronic Rx prescribing and obtaining a grant from the Maine Health Access Foundation for a quarter of a million dollars. Evergreen Behavioral Services expanded mental health services into the schools and also expanded service to Rumford. Pine Tree Medical Associates had a terrific year successfully recruiting new doctors, nurse practitioners and a nurse midwife. Pine Tree Medical Associates has expanded service to Wilton and Livermore Falls. NorthStar has successfully brought together five previously separate ambulance services. NorthStar has improved the quality of emergency medical service throughout the region and has become one of the best EMS programs in New England. The hospital installed a new 64-slice CT unit, the best technology available in Maine. We have started to implement PACs. The hospital opened a sleep lab, giving local residents convenient access to this service. The Franklin Health Access program expanded to give almost a thousand residents access to necessary medical and health services. Recently we were successful in achieving tax-exempt funding to build a medical office building and purchase an MRI imaging machine.
FMH was the first hospital in Maine to develop a plan to respond to a pandemic. Our work is the foundation for public health planning throughout Maine.
Our employee engagement scores a year ago were the highest ever recorded by the national company measuring our employee satisfaction. This company works with hundreds of hospitals throughout the country so it is an honor to have the highest scores ever recorded by this organization.
Our scores, however, measuring physician satisfaction were not strong… and improving physician engagement and satisfaction is a high priority.
Last year we also had great difficulty in our hospital licensure review, primarily because our systems for monitoring, documenting and improving medical practices were found somewhat deficient. We were also criticized for some aspects of our credentialing procedures. We currently have no deficiencies with the State survey team.
We have responded to the findings and we are now implementing more robust systems around quality monitoring and documentation.
I am pleased to announce this evening the appointment of two new members to the FCHN administrative team who will help us advance in improving quality and achieving higher levels of physician engagement and satisfaction. I am appointing Dr. David Dixon as our new Vice President of Medical Affairs and Education and I have also just appointed Ralph Johnson as our new CIO. Both will help us achieve great things in the coming year.
I would also like to acknowledge with gratitude the good work of Jerry Cayer, Mike Swan and Susan Bracket for their success in responding to the State survey and their success in improving service and quality throughout the hospital. The other members of my administrative team have also accomplished great things during the past year.
Over the next twelve months we will have some big challenges and big opportunities to extend the excellence of our service.
We need to get more of the money owed to us by the State. Very soon we will begin construction of the medical office building… we must keep this project on schedule and on budget. We will consider whether or not to offer in-patient mental health services at FMH. We need to recruit additional doctors including another orthopedic surgeon, another anesthesiologist, another internist, an OB-GYN doctor, a urologist, and two more family practitioners. We must assure the hospital meets its budget and we must create and begin to implement a financial plan to get the hospital back to an on-going level of a 3% surplus from operations. We own about a half dozen specialty practices now… we must wisely and effectively manage these practices. Several of the practices involve providers and staff who have never worked for an institutional sponsor… so new cultures and operating systems need to be created and settled.
Ours is not an easy business. The world of healthcare is rapidly changing. Across the nation and across Maine larger health systems are forming. We are seeing new deeper involvement by government, insurance companies and businesses. Public expectations are rapidly rising. Technology changes are occurring more rapidly. Public esteem for physicians nationally is declining. Everyone wants the best, but everyone wants healthcare costs to go down.
So overall how are we doing? … and will the next year be good?
First, my answer to the question How are we doing? Franklin Community Health Network is one of the best healthcare systems in America. We are not just one of the best rural health systems… no, we are one of the best health systems of any size or setting in the country. Because we all live here and FCHN is the healthcare organization most people see most of the time, we are apt to lose sight of the fact that we are superior to almost any other healthcare organization anywhere in this country.
So will we do well in the next year? My answer is a confident yes: because of you… all of you. Our strength comes from our staff, our volunteers, our physicians, and our other providers. Our strength comes from our Auxiliary members, from the many persons in the community that are involved in our work, who are friends to FCHN and our affiliates, and all who contribute their time and money towards helping us achieve our goals. Our strength comes from all the board members and board committee members. You give freely of your time and wisdom to contribute to our work of community service. Our strength comes from the leadership of the organization… from all the leaders of the medical staff, from all managers, from all board officers and committee chairs, and from each member of my administrative team.
We face substantial challenges that I outlined. We will also face significant challenges that are yet unknown to us. But we will come through it all successfully because of who we are, and because we have a noble vision and mission, we have clear values of pride, innovation, caring and excellence, and we’ll do well because we have smart strategies.
Thank you for serving others through the mission of our work. Thank you for all you do.
Richard Batt
President
Franklin Community Health Network