What Med Center programs make cut?
Wednesday, October 25, 2006
By KEN THORBOURNE
JOURNAL STAFF WRITER

State Health and Senior Services Commissioner Fred Jacobs said yesterday that it's "too early" to say which programs at the Jersey City Medical will stay or go, but he expects to have critical data about them in hand within 30 days.

Several of these programs at the cash-strapped hospital, such as the HIV/AIDS clinic, the Level II Trauma Center, and Children's Hospital, might also have to survive without additional state aid to the hospital, he added.

The commissioner's remarks came a day after JCMC officials released a "performance improvement plan" prepared by Chicago-based consultant WellSpring Partners that calls for strenuous belt-tightening at the 336-bed facility, recruiting better paying patients, and possibly eliminating several money-losing ventures.

Jacobs noted several of these programs would require state approval to be ended and said money won't be the only factor in deciding if they stay open, he said.

The "pre-eminent" consideration is the medical needs of the community, Jacobs said.

"(The programs) will be evaluated in a dispassionate and comprehensive way with the WellSpring Partners, and (JCMC) board, and the state," he said. "It is too early to say which program will go."

Jacobs also tamped down expectations the state might cough up more dough to keep the programs open.

"We (the state) are already a major financial supplier to the Jersey City Medical Center, not just in charity care, but in supplemental aid to the charity care," Jacobs remarked.

JCMC has received roughly $60 million in charity care reimbursements from the state the past two years, said JCMC Acting Chief Executive E. Stephen Kirby. In addition, the hospital has received roughly $35 million a year in supplemental aid, and Medicaid and Medicare reimbursements, he said.

But despite all this, the hospital is still coming up about $3 million-a-month short in making ends meet, officials said.

Kirby replaced Jonathan Metsch, who abruptly resigned as the hospital's chief executive officer on Sept. 22, following a board review of the draft report.

"I think whatever happens at the end of the day, Jersey City Medical Center and the state are going to have to be in partnership to make this work," Kirby said.

Alb, I have to disagree with you. Having worked in a number of "financially challenged" hospitals, and done a couple projects with payer-providers, there are two main problems that a hospital like this face.

The first is utilization. All of these special departments require specialized equipment and personnel, and if they are not fully and economically utilized, the hospital will see huge losses. Some private hospitals have proven that they can be very profitable, successful, and treat charity as well as medicaid cases by specializing in a type of care. The "Heart Hospitals" of the midwest are a great example. The one-stop-shop for all care just doesn't work. JCMC should have picked a couple specialty departments that were in short supply in the area and focused on those (my opinion).

The second problem is doctor acting as managers and trying to run the actual business of the hospital. Doctors have a tendency to get too little for their money when running the departments. I completely agree that doctors need to make 100% of the medical decisions with primarily their patient's care in mind, but some cost/benefit rationalization has to be done in the areas of equipment, supplies and staffing. That's just reality.

As an inner city hospital, I doubt there is much chance of JCMC turning a profit without significant state aid, but in my experience, shortfalls like this only occur through gross mismanagement.

Quote:

I'm sure JCMC has management problems, but it's clearly more of a victim of the national health care crisis than of any serious management problems.

The idea that the hospital should get rid of its children's hospital because too many of the patients are charity care patients or are on Medicaid is sad. If we want to make adults pay their way, even in emergencies, well, OK, but children can't pull out credit cards or decide whether to get jobs that come with health benefits. If we let children be born at all, we have to make sure that they have access to proper medical care.

CHALLENGES AHEAD
Tuesday, October 24, 2006
Jersey Journal

Here's a look at some of the findings in the Wellspring Partners report on the Jersey City Medical Center and its parent, LibertyHealth System

Jersey City Medical Center's inpatient volume ranks highest in Hudson County, but this has been achieved by providing "disproportionate" levels of service to Medicaid and charity care patients.

JCMC is having trouble attracting the more affluent residents that dominate the Downtown area, but even if this segment chooses JCMC, it would not be enough to change the hospital's fiscal situation dramatically.

LibertyHealth - which includes JCMC, Greenville Hospital and Meadowlands Hospital Medical Center - is not acting like a system, missing out on potential savings it could achieve by acting as one large entity.

LibertyHealth does not have the financial resources to sustain JCMC's current scope of specialty programs, clinical designations and commitment to medical education.

Programs to be evaluated include Level II Trauma, Regional Perinatal, Children's Hospital, Open Heart Surgery, Bariatric Surgery, Mt. Sinai Affiliation, Graduate Medical Education, HIV/AIDS, Mental Health and Ambulance/Paramedic.

To achieve national departmental benchmarks LibertyHealth would need to reduce staffing levels by 212 full-time employees, including 65 employees at the JCMC. In an editorial board meeting with The Jersey Journal yesterday, representatives said 77 spots are now unfilled due to retirement or other attrition.

Rx FOR MED CENTER
Report says cuts needed to balance the losses
Tuesday, October 24, 2006
By KEN THORBOURNE
JOURNAL STAFF WRITER

To stay afloat financially, the Jersey City Medical Center needs to cut staff and programs while working to attract more private care physicians and a better paying clientele, according to a "performance improvement plan" hospital officials released yesterday.

Perhaps the only way to soften this radical change of direction for an institution that's catered primarily to the poor and uninsured would be for state government to provide significantly more aid, the officials said during an editorial board meeting with The Jersey Journal.

Rosemary McFadden, vice chair of LibertyHealth - JCMC's parent corporation - also suggested that the new course outlined in the report by Chicago-based WellSpring Partners is the reason Jonathan Metsch, the hospital's longtime chief executive officer, abruptly resigned on Sept. 22.

"It's very difficult to build up an organization and then have someone come in and say 'Take this thing apart,'" McFadden said, giving her reasons for the Metsch departure.

Metsch - who didn't return phone calls for comment - had told board members in the summer he was thinking about retiring at the end of 2008, McFadden said.

The LibertyHealth System includes the JCMC, Greenville Hospital in Jersey City and Meadowlands Hospital Medical Center in Secaucus, the only hospital in Hudson County operating in the black, the officials said.

The WellSpring report projects gaps in the roughly $360 million Jersey City Medical Center budget - $20 million this year, $47.7 million next year and $65 million by 2008.

Even assuming $34 million in state aid promised for FY 2008, that would still leave a $32 million hole in the budget, said George Whetsell, the WellSpring Partner principal.

Roughly half of this hole, $15 million, can be filled through "operational improvements," such as staff cuts, better collection of bills and restructuring contracts, he said.

But dealing with the $17 million balance would require slashing an array of programs.

JCLAW,

Good to hear about the changes coming to the Jersey City Medical Center.

Use of the Medical Center by people with insurance should greatly rise as more of the new buildings are occupied.

Even if it the center is only used just for emergencies, many of these wealthier newcomers might still often go to higher priced NYC medical services, but when you really have to get to a hospital you aren't taking the PATH, ferry or Holland Tunnel.

We are lucky to have it in downtown, it makes me feel safer, glad to see it is getting new management.

I would say america's health care system really needs a whole revamping -- but then it'll turn again into a left right name calling fest.

Michael Moore is doing a new doc on health care by-the-way.

The JC Med Center (the biggest and newest facility in the county) is being taken over by Wellspring Partners hospital "constultants" for a turnaround operation. Will be tough going in a market where more than half the customers can't pay 10 cents but still have to receive the same great service as the paying (insured) customers.

Is anyone on this board familiar with anyone in hospital administration at JC Medical Center? For that matter, I am interested in connecting with anyone who has networking possibilities in JC-area hospitals.

I am moving to JC and have a great deal of experience working at struggling institutions as a Hospital Executive. (I am currently at an organization that has been through a relatively successful re-org.)

I am interested in job opportunities there-- but my current connections are in NYC, not JC or surrounding NJ hospitals.

Thank you.

Jersey City hospital 'at risk of failure,' finance report says
Friday, October 06, 2006
BY ANGELA STEWART AND DEBORAH HOWLETT
Star-Ledger Staff

Despite "extraordinary infusions of state funding," both Jersey City Medical Center and its parent company, LibertyHealth, face growing financial losses, according to a consultant's report.

"Simply put, unless significant operations improvements are implemented, the entire system is at risk of failure," said the report, which was obtained by The Star-Ledger.

The report, which hospital officials called an early draft, is the same one that was presented to the hospital board last Thursday night and was followed the next day by the resignation of Jonathan Metsch, the 61-year-old hospital president and CEO and head of LibertyHealth.

"The system is dependent on, and will continue to be dependent on extraordinary state funding indefinitely," the report says.

The state provides $583.4 million a year to New Jersey hospitals for charity care, as well as $169 million a year to 30 hospitals as supplemental appropriations. Jersey City Medical Center received a $25.7 million supplemental appropriation in this year's budget.

Besides Jersey City Medical Center, the system also includes Meadowlands Hospital in Secaucus and Greenville Hospital in Jersey City.

"The reason Jersey City Medical Center is in this position is because only 25 to 30 percent (of patients) have private health care insurance. The rest of them are either charity care or Medicaid," said Alan Marcus, a hospital spokesman.

According to the report, Jersey City Medical Center faces a $20 million gap this year before it could break even, and that amount is expected to grow to $32 million by 2008. If the hospital wants to achieve a 3.5 percent operating margin this year, it would have to close an even bigger budget hole -- $29 million.

As a system, LibertyHealth would have to close a $20 million gap this year before it could break even, and that amount is expected to grow to $33 million in 2008. To achieve a 3.5 percent operating margin this year, the system would need to plug a $33 million budget hole, and by 2008 a $42 million gap, the report states in its executive summary.

Recommendations made by WellSpring Partners of Chicago, the consultants who put together the performance review, include: layoffs, limiting purchases to a single purchasing organization, drastically reducing food costs and sending more medical devices out for reprocessing.

Two Assembly Republicans yesterday called upon hospital officials to publicly release what they described as the "private audit" that led Metsch to step down on Friday.

Assemblyman Kevin O'Toole and Assemblyman Richard Merkt (R-Morris) also asked Gov. Jon Corzine to immediately freeze supplemental appropriations to the hospital until officials at the institution give an accounting of how state money is being spent.

"(The audit) raises a lot of questions that need to be answered by those of us in state government," O'Toole told reporters at a Statehouse news conference.

"Certainly the fact that the CEO disappeared from the scene immediately following the presentation of the audit raises red flags," said Merkt.

Marcus, reacting to the comments, called the legislators' remarks completely "irresponsible," saying the hospital has already entered into a consent agreement with the state about how the supplemental appropriation is being spent. He said the agreement was signed on Aug. 18.

"In their rush to make political hay, they are wrong, flat-out wrong," Marcus said. "They either didn't do their homework, or are just wrong or dumb."

Gretchen Michael, a spokeswoman for State Health Commissioner Fred Jacobs, confirmed that an agreement was signed.

"Yes, there was a settlement agreement with LibertyHealth and it was tied to $38.1 million, $25 million of which was contained in a state appropriation and $13 million of which was a federal Medicaid match," she said.

Jacobs, who attended last week's board meeting, made it clear that allowing the hospital to fail "is simply not an option." Michael noted the hospital sought the consultant's report at the urging of the commissioner.

Marcus said the hospital so far has paid WellSpring $3,000 to $4,000 for the work, which is not yet finished.

"Our total focus is on the delivery of health care and stabilizing our fiscal situation," Marcus said. "Quality of care has never been an issue." _LINK

Med Center chief resigns
Saturday, September 23, 2006
By ANGELA STEWART
NEWHOUSE NEWS SERVICE

The president and CEO of Jersey City Medical Center yesterday suddenly submitted his resignation, a day after a report delivered at a board meeting painted a dismal financial picture of the institution.

Jonathan Metsch, who also heads the hospital's parent company, LibertyHealth, had lunch with the board leadership yesterday and soon afterward stepped down, according to State Health Commissioner Fred Jacobs, who attended Thursday night's meeting, which lasted more than three hours.

The state has been pouring $3 million a month into the center to help keep the hospital in business, but its financial problems continue, Jacobs said.

While there were no direct calls for Metsch to resign at the board meeting and Metsch never indicated he would do so, Jacobs said, there were strong statements made about the urgency of the financial situation.

Metsch, in a prepared statement released yesterday, chose to focus on his greatest accomplishment as president - getting a new Jersey City Medical Center constructed.

"I am proud to have participated in the transition of Jersey City Medical Center to a private institution and from a 60-year-old hospital complex into a 21st century state-of-the-art healthcare facility."

Just last month, state health officials shut down the hospital's trauma center for two days because its certification with the American College of Surgeons was allowed to lapse. A hospital spokesman, William Dauster, at the time blamed the problem on a "procedural paperwork issue."

A search committee has been formed to find a successor to Metsch, said Brett Harwood, acting chairman of LibertyHealth. Steven Kirby, LibertyHealth chief operating officer, will serve as acting chief executive until a successor is found.