"A popular government without popular information, or the means of acquiring it, is but a Prologue to a Farce or a Tragedy; or, perhaps both. Knowledge will forever govern ignorance; and a people who mean to be their own governors must arm themselves with the power knowledge gives."


Wednesday, July 12, 2017

Jackson County Health Care Authority, Part 2 - July 12, 2017 - Update (7-18-17) - 2015-2017 Financial Chart

This photo was found on JCHCA.ORG, Jackson County Health Care Authority, it was identified as a "coming soon site," the site was not developed. This image is utilized as Fair Use for non-profit news reporting and commentary. The Jackson County Health Care Authority, JCHCA, is a public entity and a separate corporate entity of the Government of Jackson County Alabama. The JCHCA Board of Directors are appointed by the Jackson County Commission. 

The Crisis - A health care facility CEO warns about the financial crisis and the decreasing of Medicaid funding for rural hospitals such as Highlands Medical Center.

Part 1 of this series, Jackson County Health Care Authority, may be found within at: http://arklite.blogspot.com/2017/06/jackson-county-health-care-authority.html 

This chart sums up the citizens hospital, Highlands Medical Center, and the Jackson County Health Care Authority's financial predicament, or should I say pending Financial Disaster.
Jackson County Health Care Authority officials OWE the citizens of Jackson County an explanation as to the financial stability of our hospital.(

I have had 2 meetings with Dr Albin, the CEO of the Jackson County Health Care Authority. One meeting was an in person introductory meeting, the second was a telephone meeting specifically discussing the new ambulances and the purpose of my series on the health care authority. I expressed the importance of the requested video interview. 

Unfortunately, at this time I must conclude it has been denied as to the questions presented in advance of a video interview. I was informed by Public Relations personnel that the attorney for the health care authority advised the CEO to not have a video interview. 

During the telephone interview Dr. Albin expressed concerns regarding the alleged unaccounted for money and other financial problems such as money lost on the "Mamo Bus." It has been reported to me the "bus" cost the health care authority an approximately $300,000 loss. Dr. Albin stated, "This was before my time and I can not answer any questions about this allegation." Referring to the missing/unaccounted for $1.2 million dollars.  He did state that money was lost on the bus.

1 - First, it is my belief that Dr. Albin is seriously concerned about the health care authority and wants to provide the best quality of health care possible to the community. 

Photo by the JCHCA, Fair Use for non-profit news reporting.
There are many excellent services offered by Highlands. One such admirable service is that of the Highlands Medicine on the move bus. The schedule of this service may be found at http://www.highlandsmedcenter.com/services_line/highlands_medicine_on_the_move.aspx

2 - Second, the health care authority has problems, which means Dr. Albin and the Executive Team have problems along with the entire Highlands and Jackson County Health Care Authority have problems which may be detrimental for the continuing operation of our hospital and its various services. Identification of problems may seem simple as to the "big picture," specifically these problems are far reaching and have been expressed by staff, executives and myself as a concerned citizen and retired health care administrator, "sometimes it is difficult to understand folks motivations within the community." 

There are 4, four, major problem areas which I identified: 1) Communications - (a) internal, professional in-service, team building - morale; (b) external, communications with public as to Highlands and the JCHCA accomplishments, financial status and direction in an ongoing community information program. The JCHCA web site is good, but external broad scale communications to community media is lacking, in my opinion. 

2) Financial development and problem solving: (a) long term/short term planning, commonly called a Capital Expense Procurement Program. Information from the American Hospital Association on Equipment Purchase Analysis and Practices - http://www.hhnmag.com/articles/6278-saving-on-new-equipment How long can Highlands Medical Center continue to operate with a $1.4 million  deficit, March 2017, and decreasing Medicaid payments? The annual report is out of date. It is listed as 2015  http://www.highlandsmedcenter.com/sites/www/Uploads/Annual%20Report/board%20hospital%20report2.pdf  An accurate Highlands and Jackson County Health Care Authority 2016 Annual Report should be listed.

3) LEADERSHIP DEVELOPMENT. There are no so called "natural born leaders." Effective Leaders are educated team players facilitating all within their purview to excel in excellence and professional accomplishment. It is my observation and opinion the cooperation between the board and executive staff is lacking - you do not have the best interest of the community at heart - Ladies and Gentleman you must work together as a team to mange the facility for the continuing benefit of the community. If you can't do the job and are not a team player, get out. We must have a TEAM who will serve the community to build a great Health Care Authority. Yes board, you may hire and fire executives, however you are part of the team. Build cohesion, be a professional, honest leader or resign. CEO, CNO, CFO and the other alphabet executives, if this facility folds it is on you and the Board of Directors. Plan, continue planning, identify and resolve problems, and build the TEAM!

4) Facility Maintenance/Preventive Maintenance Programs - This must be coordinated with the Capital Expense Priorities and Purchase Programs

Here are the questions presented to Dr. Albin, CEO, JCHCA, on June 13, 2017; as of  July 12, 2017 the video interview requested has not been granted. As the old saying goes, 'better late than never.'  I have expressed to all concerned that this is an opportunity to communicate to the public at large which should not be passed up or thought of as a negative outcome, this is an opportunity to inform and communicate in a visual manner; to correct misperceptions, facilitate goodwill, and tell OUR and YOUR story about health care in our community.

June 13, 2017
Interview/ Questions with Dr. Lonnie Albin, MD 
CEO of the Jackson County Health Care Authority, Scottsboro, Alabama
Also present: _________________________________________________________________

The following questions are based on interviews with Jackson County Health Care Authority Employees, Citizens of the greater Jackson County Community, Physicians within the community and Board Members of the Health Care Authority.

1.      Dr. Albin, what do you see as your goal as the CEO for the Jackson County Health Care Authority relating to: 1). Patient care; 2). Employees; 3). Facility?
2.      What do you think about the wellness or health of Jackson County citizens?
3.      Could you please explain about the last Joint Commission Accreditation, how did that turn out for the Highlands Medical Center and associated services and clinics?

Financial Status-Capital Expense Program
1.      Sources within the Jackson County Health Care Authority informed me there was $1.2 million dollars which was unaccounted for/missing approximately 3 years ago, 2013-2015 time frame from the Jackson County Health Care Authority accounts, no specifically named account. Is this claim true, if so how do you explain this loss?
2.      It was reported to me that there was a $6.9 million dollar loss last year, 2016 operations year, for the Jackson County Health Care Authority. Is this true, if there was a loss how do you explain the financial loss; or was there a gain in funds?
3.      Sources within the Jackson County Health Care Authority have stated to me the Reserve Fund of the Health Care Authority was $12 million dollars 3 years ago, currently the reserve fund is approximately $6 to $6.5 million currently. Is this claim factual, if it is factual please explain or if not factual what was the reserve fund 3 years ago and what is it today?
4.      It was reported to me that the Health Care Authority is currently behind in paying their debts to the tune of approximately $300,000 is this true?
5.      Does the Health Care Authority have a policy in writing regarding a Capital Expense Program? Is there a schedule of major equipment purchases, Capital Expense Program – 1 year, 2 year, 5 year, 7 year, 10 year major equipment purchases submitted by sections/divisions/clinics/hospital, etc. approved by the CEO and CFO or Executive Staff and the Board of Directors on an annual basis? If you have a written policy, may I have a copy?

1.      Some folks within the community and the health care authority have expressed concerns about the quality of patient care available at the Highlands Medical Center. What would you like to say to people and possible patients expressing concerns about the quality of health care at Highlands Medical Center or any Clinic or Service associated with the Jackson County Health Care authority?
2.      Concerns have been expressed about the financial stability of the Jackson County Health Care Authority; what would you like to say to those folks expressing concerns regarding the financial stability of the Jackson County Health Care Authority and associated patient care services or clinics?

Future Vision
1.      What is your vision for the future of the Jackson County Health Care Authority, Highlands Medical Center and all the patient care facilities delivering patient care?
2.      Dr. Albin are there any further comments that you would like to make?

Thank you for your time, it is greatly appreciated.

This requested video interview to date has not occurred. I wish the best of all outcomes for the Jackson County Health Care Authority and  Dr. Albin as the CEO. We are very fortunate to have Highlands Medical Center and the professional dedicated team. 

Folks, the problems may be resolved with leadership, teamwork, and professional problem solving.
Organization Effectiveness professionals maybe helpful. Here are some references: 

1) The Profile of an Effective Healthcare Leader http://www.beckershospitalreview.com/hospital-management-administration/the-profile-of-an-effective-healthcare-leader.html  

2) Effective governance: the roles and responsibilities of board members - (from my alma mater, Baylor University) An important article and direction for board members. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1276331/  

3) Developing an Effective Health Care Workforce Planning Model - American Hospital Association  http://www.aha.org/content/13/13wpmwhitepaperfinal.pdf

4) Performance Measures For Health Care Systems  http://www.hret.org/chmr/resources/cp19b.pdf 


Anonymous said...

Saw where Albin did have time to do a PR spot on channel 19 like you did for him on the new ambulances. Too bad he has no time to answer questions. Nice new ambulances and equipment but reduced services, less ambulances n the road, station closed days at a time. CEO, hospital board members and County Comm. all aware but nobody seems to care. Maybe the public needs to know.

Garry said...

Thank you for your comment. The county commission is aware of the problems, the executives of the JCHCA are aware of the problems, the JCHCA Board are aware of the problems. The entire purpose of this series of articles are to bring attention to the problems endemic to rural area hospitals and the authorities managing them. Think of our hospital and the managers as a patient hemorrhaging blood, which in this case is money. Our patient, is dying in front of us because of a loss of money. Unfortunately, our culture in the southland supports silence and a penchant to cover-up truth. The Jackson County Health Care Authority, JCHCA, has a responsibility to accurately inform the public of their financial status. For example-in the 2015 financial report it is reflected there is a net gain of $2,609,528.16, Link - (you may have to cut and paste the link) http://www.highlandsmedcenter.com/sites/www/Uploads/Annual%20Report/board%20hospital%20report2.pdf . If this is a true statement all should be concerned, as of the current fiscal Year second quarter, March 31, 2017, the JCHCA has a -$444,358.45 negative balance, that is a loss, and it is much greater than the $444K!! This means since September 2015 the Jackson County Health Care authority has a loss of $3 ($3,053,886) million dollars plus in less than 2, TWO, years. our patient is bleeding to death, hemorrhaging money to the tune of financial death!! The Highlands Medical Center has a loss of $1.4 million this fiscal year, 6 months in. The JCHCA March 31, 2017 financial statement may be viewed in part 1 of this series.

Anonymous said...

Well you can count around 1 million going to 5 new ambulances, new equipment and paying guaranteed overtime to employees. All the while laying off low wage earners to balance out the account. Not saying the material was not needed but if you are bleeding money is that the best time to open a new wound? I would think they know exactly why they are losing so much money. The question is whether they want to let everyone else know.

Garry said...

Thanks for your comments. I think a multi-government entity funding of a Health Facility Organizational Effectiveness Evaluation and recommendation from an outside health facility management corporation should be accomplished. How can patient care, clinical, hospital, administrative, financial, logistical operations be improved, and costs reduced, without compromising patient care quality?

Anonymous said...

I don't think we will have to worry about it much longer. I think the plan all along has been to sell the hospital,even before the county had the financial problems. The plan got side tracked for a time when 2 commissioners did not get reelected but seems to be back on track. I know everyone says they can not sell the hospital, but just look up the Healthcare Authority Act. The board of directors can vote to disband the authority, the property reverts to the County. The commission can then sell the property which a few years ago was worth more than $8,000,000.00 That should help the financial trouble of the county. And it had to be done because the hospital was losing so much money. A for profit taking over would be very different.

Anonymous said...

Did it ever cross your mind that the financials showing "good numbers" we're maybe not all that honest and accurate? That maybe the current numbers have been the true financial state for quite a long time? Ya think maybe that financial mismanagement and incompetence are the order of the day at Highlands? Cmon, dig deep.

Also, the ambulance fiasco (service and vehicles) is costing $$$, a drop in service quality, coverage and morale. Maybe you should ask the county population what they think about losing ambulance coverage and increased response times to the most needed areas?

You're being played like a fiddle Gary.

Anonymous said...

Not really to hard to understand. You have 1 board member that had the MAMO bus eliminated because it conflicted with one of his business interests. You have 1 board member that announced in public the only reason he was appointed was to get rid of the CEO. None of the board has experience overseeing a hospital. A couple have been on the board a couple years. Board members with experience were forced out. The CEO ran a private practice that had to close. People with over 200 years hospital experience have been fired, retired or eliminated. Fail to see how anyone could expect anything different than what is happening.