“Scenario Four: Large university system wants to expand its network and tertiary capacity by building a new community hospital.” It’s one of several thought proposals on Legacy Hospital Partner’s (LHP) web site. They’re a firm that offers financial joint venture options in a nonprofit industry that requires intensive capital outlays. It allows for collaboration that expands opportunity and the reach of health care access. In HUMC’s proposition for reopening Pascack Valley Hospital it exploits a synergy that would shift the financial burden and risk from taxpayers to investors, while maintaining the mission goals of a successful nonprofit business model. TO READ MORE, click here
December 21, 2009
December 6, 2009
Hope and Time
Valley Hospital generates profits and builds its surplus as it prepares to expand in their allegedly harsh economic environment. Englewood Hospital burns cash while it seeks a business model that can survive in its market location. Together they’re embracing the law of nature, viewing Hackensack Hospital’s proposal to reopen a hospital in Westwood as a threat to their survival; the perceived need of the public not withstanding. TO READ MORE, click here
November 24, 2009
Strategic Management (2)
Many organizations use a strategic management process to analyze their strengths, weaknesses, opportunities and challenges. The process is used to prepare an overall business strategy, balancing trade-offs, setting a course of action for meeting short and long-term goals. Done properly, and to remain efficient, it will also allow flexibility to make adjustments for changing markets and/or resources. It is a respected business practice for success and should be part of any hospital reopening discussion. TO READ MORE, click here
November 17, 2009
Strategic Management (1)
Two years and the likelihood for a new hospital returning to Westwood isn’t any clearer. We have a hospital organization, which deferred its application for the extended certificate of need, offering no new guidance as to their end game. We have Westwood elected officials placing a letter to the editor in the local papers saying they’re going to hold the governor-elect to his word. (Sounds good, means little.) We have a multi-town non-binding referendum passed with 72% in support of a reopened hospital. And we have a newspaper editorial presenting the options—“The choice pits expert evaluation against political desire”—but from perhaps a misdirected viewpoint. TO READ MORE, click here
November 9, 2009
A Rational Decision Required
DOH had extended the PVH Certificate of Need (CN) in 2007, initially acknowledging a hospital was needed in the northeast corner of the State. Unfortunately the only applicant, HUMC, had withdrawn its request before a decision could be made. Purportedly they believed a negative decision would be driven by political concerns over need, and wanted to enhance their application’s foundation for approval. TO READ MORE, click here
November 2, 2009
Election Day
A reminder—The following towns have non-binding referendums to show support for a hospital reopening in Westwood: Closter, Dumont, Emerson, Harrington Park, Hillsdale, Montvale, Northvale, Norwood, Old Tappan, Oradell, Park Ridge, River Vale, Washington Twp. and Westwood. ACT—Vote: YES TO READ MORE, click here
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October 26, 2009
Words, Action and Disclosure
Bergen County Democratic Organization’s former power broker, Joseph Ferriero, was found guilty this past week. His lack of disclosure in owning a company doing business with government officials was a contributing factor to that guilt. TO READ MORE, click here
October 20, 2009
Voter Involvement Is Now—The Voice That Must Be Heard
The Department of Health (DOH) usually has two hearings to discuss a hospital’s certificate of need status. The first is in the community affected. The second is in Trenton where it renders a decision—The perceived independent advocate for the State’s health and human services is the DOH; except its’ independent certificate of need (CN) for a hospital in Westwood is now immersed in the muck of political rhetoric. TO READ MORE, click here
October 13, 2009
Demographics and Hospital Markets (2)
“More than 90 million Americans live with at least one chronic illness, and seven out of ten Americans die from chronic disease. — For patients with chronic illnesses, geography matters.” 1 TO READ MORE, click here
October 6, 2009
Demographics and Hospital Markets (1)
There are many reasons for doing a market area analysis. The interest in defining a pre-existing hospital’s market area is to determine whether an ongoing operation represents a main source of essential services to Medicare beneficiaries or other at risk groups and to assess an institution’s ongoing viability. The process begins by measuring its product―acute care services, and then determining its geographic service area. There is any number of ways of doing it, from studying an area’s demographics, analyzing a hospital’s discharges, employing a third party designation or developing a location / customer associated parameter. TO READ MORE, click here
September 29, 2009
Hospitals, Business and Need (5)
The State’s Report projected a slower growth in the population as compared to the nation, noting a shift to an older age group in the 45-64 range. This was just one data aspect the Report considered as it assessed the State’s underlying demographics. It used demographics to evaluate the population trend, project hospital utilization, and the future of health care needs in NJ. TO READ MORE, click here
September 22, 2009
Hospitals, Business and Need (4)
‘Bed capacity,’ Valley and Englewood’s battle cry for market share. But it holds different meanings based upon the perspective from which it’s approached. On a national level it is viewed as a motivator for unnecessary care, or supply-sensitive care. TO READ MORE, click here
September 15, 2009
Hospitals, Business and Need (3)
Each of the area hospitals is different. Each has its own management priorities and scope of services that adapts to its patient population and community characteristics. It is a factor highlighted within each hospital by their mix of licensed beds (Medical/Surgical, Obstetrics & OB/GYN, Pediatrics, ICU/CCU). Therefore when excess bed capacity is discussed, one might ask where the excess beds exist and which type of bed is available? TO READ MORE, click here
September 10, 2009
Hospitals, Business and Need (2)
The population share for which a hospital administers health care represents its’ service, market or catchment area, depending on one’s terminology preference. It can be generally measured through a variety of theoretical models with titles such as ‘Treatment-Intensity,’ ‘Elzinga-Hogarty,’ ‘Critical Loss,’ ‘Patient-Flow,’ etc. TO READ MORE, click here
September 1, 2009
Hospitals, Business and Need (1)
What is the primary role of hospitals in New Jersey’s public health policy? The State’s report assumes they’re part of a health system. A ‘system’ that theoretically would be proactive in cultivating an environment where ‘all residents‘ have access to health care resources, regardless of any socioeconomic concerns. TO READ MORE, click here
August 25, 2009
Emotion In Motion Is Not Action
“Hospital executives in this State have an obligation to examine the needs of their communities and meet with neighboring hospitals in an effort to right size the care available.” Suzanne Ianni, President and CEO of the Hospital Alliance of New Jersey in testimony before the Commission on Rationalizing Health Care resources, April 30, 2007. TO READ MORE, click here
July 28, 2009
Misplaced Priorities
What’s the difference between politics and a caterpillar? A caterpillar can change. Unfortunately the politics in New Jersey don’t. To prove it, Governor Corzine chose Senator Weinberg to serve as his running mate for Lieutenant Governor. Picking a seasoned individual in her mid 70’s, with liberal ideology, experienced in political pandering. The choice should assist in reinforcing past legislative failures, presumably with greater honesty. TO READ MORE, click here
July 21, 2009
Passionate Perspectives
The prior FTC Chairman, William Kovacic, emphasized the importance of health care competition in a September 2008 opinion, stating that, “The health care industry provides us all with fundamental services at significant and vulnerable times. Vigorous competition can promote greater access to cost-effective, high-quality health care.” Today in New Jersey, the significant and vulnerable times of those who live in the northern corner of the State are secondary to politics and profits. TO READ MORE, click here
July 14, 2009
Bobblehead Politics
NJ Assemblyman Gordon Johnson shifted the Pascack Valley Hospital (PVH) reopening to a new playing field, introducing the color of patients to the equation. (Click HERE to read.) Just when you thought rationale reasoning was going to offer healthcare a safe return to Westwood the jaws of racism raises it head. TO READ MORE, click here
July 9, 2009
Final Hearing Delayed!
In a perplexing move, HUMC asks the State to delay the hospital license hearing 6 months. According to HUMC’s spokesperson, “”We needed more time to prepare for the State Health Planning Board meeting, to educate our constituents.” TO READ MORE, click here
June 29, 2009
Miles or Speed
July 23rd, 9:30 AM, is the date and time for Bergen County hospitals’ version of a ‘Thriller in Manila.’ The fight card has the power punching of HUMC and Legacy vs. the opposition bolo punching skills of Valley and Englewood Hospital. The outcome for the contestants will determine the primary market rights to an arena of 100,000 plus patients and money. For the Pascack and Northern Valley audience, it will define accessible healthcare in geographic terms for trauma patients. TO READ MORE, click here
June 22, 2009
Tantrum vs. Reason
Idiocy! Valley and Englewood Hospital excel in defining the word as they continue their opposition against a reopened hospital in Westwood. Their rhetoric is simple and passionate as it is empty and unreasoned. TO READ MORE, click here
June 15, 2009
June 8th Meeting — Passionate On Need
Last Monday evening’s public meeting on the status of PVH’s CN transfer approval, was another step in State process for reopening a hospital in Westwood. It was well attended by supporters with a minority showing of bused in opposition. TO READ MORE, click here
June 2, 2009
Opposition Babbles On
Valley and Englewood continue their efforts to oppose a new hospital in Westwood. They recently did another mailer (Click HERE to read) to area residents that repeats their rhetoric. And while some pro-hospital supporters may think it doesn’t matter, be assured, it will be that kind of over confidence that will play to the opposition’s advantage. TO READ MORE, click here
May 22, 2009
Beginning of the End: Hearing Date Set
A public announcement in the Record provides info on hearing. TO READ MORE, click here
May 21, 2009
Beginning of the End: Part Deux
The Record’s reporter, Lindy Washburn, reported the result of the Bankruptcy Court’s decision. TO READ MORE, click here
May 20, 2009
Beginning of the End
26:2H-1. Declaration of public policy
1. It is hereby declared to be the public policy of the State that hospital and related health care services of the highest quality, of demonstrated need, efficiently provided and properly utilized at a reasonable cost are of vital concern to the public health. In order to provide for the protection and promotion of the health of the inhabitants of the State, the State Department of Health shall have the central responsibility for the development and administration of the State’s policy with respect to health planning, hospital and related health care services and health care facility cost containment programs, and all public and private institutions, whether State, county, municipal, incorporated or not incorporated, serving principally as residential health care facilities, nursing or maternity homes or as facilities for the prevention, diagnosis, or treatment of human disease, pain, injury, deformity or physical condition, shall be subject to the provisions of this act. – The State’s statute directing the DOH’s authority. The DOH appears to have begun to assert that authority, concerning Pascack Valley Hospital’s operating license, (Click HERE to Read article) deeming the HUMC/Legacy application for its transfer complete. TO READ MORE, click here
May 12, 2009
Defining Need
The State’s commissioned report sought to offer a set of guidelines for a growing concern as to why hospitals were struggling financially, which ones’ warranted assistance and what efforts could be incorporated to assist in rationalizing the operation of our healthcare delivery system. Mr. Reinhardt’s introduction to the report, stated, “The criteria we have used … are not thought to represent the final word on the issue, because there are sundry other less quantifiable dimensions to the problem that you would wish to take into account when making decisions . . .” (pg. ii) TO READ MORE, click here
May 5, 2009
Capabilities are not created equal
“Let us all take more responsibility, not only for ourselves and our families but for our communities and our country.” Clinton 93′ Inaugural Address. In that spirit Westwood’s Mayor probably proposed his protest walk from the town’s municipal building to The Valley Hospital. It was an effort to draw attention toward Valley and Englewood’s actions to undermine health care accessibility in the northern corner of Bergen County. TO READ MORE, click here
April 28, 2009
300 Empty Beds
The Valley and Englewood website notes several reasons for their opposition. In the last post, their mock concern over a for-profit motivated decision process was the subject. Based on Valley Hospital holding a quarter billion$ in profit investments, and their actions to consolidate market share, their decision process doesn’t appear that much different from a for-profit operation. Except, instead of paying back investors or reducing the cost of health care, they throw millions$ to restrict competition and deny equal geographic access to all residents. Their next conjured concern — excess bed capacity. They point to the State’s Rationalizing Health Care Resources report as validation to their concern. TO READ MORE, click here
April 21, 2009
Money vs. Accessibility
Valley and Englewood continue their rhetoric declaring the sky will fall if HUMC North is allowed to replace Pascack Valley Hospital (PVH) in Westwood. Their expressions of distress, to be polite, are hypocritical at best. TO READ MORE, click here
April 13, 2009
Pass Go, Collect 200 Patients
The Valley and Englewood Hospitals continue to press their efforts to gain and hold market share since Pascack’s closing. They shift back and forth between defense and offense in their Monopoly game with Hackensack. Manipulating the end use of the prized Westwood ‘Park Place’ property is at stake. TO READ MORE, click here
April 6, 2009
NonProfit Profit
Mike Kelly, a columnist for the Record, offered in his (April 2nd Column) an editorial on the state of affairs in New Jersey’s hospitals. It revolves around, “a persistent worry by local hospitals about losing money.” Unfortunately the column appears to be based more on Valley and Englewood’s rhetoric then any substantive facts. TO READ MORE, click here
April 1, 2009
The Opposition Sees Green
The Valley and Englewood Hospitals, acting like bankrupt millionaires, have become town criers, feigning concern from a financial flu. The virus, HUMC’s proposed new for-profit hospital in Westwood. TO READ MORE, click here
March 24, 2009
Hospital Bankruptcy
Since Pascack Valley’s bankruptcy, there have been questions about bankruptcy within the perspective of a hospital as a non-profit. This type of corporate structure has a number of distinct characteristics based upon its services, tax-exempt status and integration within a community. TO READ MORE, click here
March 17, 2009
Transformation Challenge
Hospitals are struggling in NJ but it’s difficult to appreciate whether it’s inefficient management or an evolving healthcare market. The subprime mortgage debacle, was it poor management, a current of greed or just an evolving financial market? All markets evolve, like the wind in a boat’s sail; tack wrong and the market’s current may distance you from a destination. TO READ MORE, click here
March 10, 2009
Hospital Auction Do Over?
“After the rancor and fierce debate of the past few months over the re-opening of a full-service hospital in Westwood, both sides are awaiting a decision over whether the license of the former Pascack Valley Hospital (PVH) can be sold. … Megan Fraser, the director of marketing and communications at Valley Hospital in Ridgewood, points specifically to the auctioning of the MICU license as a valid precedent for the current court debate.” (Community Life 03-03-09)
“The opponents of a proposal to reopen the former Pascack Valley Hospital in Westwood have asked a Bankruptcy Court judge to throw out the hospital’s sale to Hackensack University Medical Center and hold a new auction.” (Record 03-06-09) Valley and Englewood want a do over. You just can’t make this stuff up. TO READ MORE, click here
March 3, 2009
How Much Is A Life Worth?
The idea of auctioning a hospital license in NJ goes completely against the DOH’s mission for meeting public healthcare needs. If such a concept were to be considered, than the ‘certificate of need’ (CN) regulation process would be reduced to a charade rife for manipulation. TO READ MORE, click here
February 24, 2009
Code Blue
Valley and Englewood began their opposition to HUMC North, Hackensack and Legacy’s new proposed hospital, by questioning the integrity of care offered by its for-profit corporate structure. And like a Cosa Nostra looking over its province, seeking to protect its business’s monopoly in an interfamily feud, they fired a short-barreled shotgun — of fear and rhetoric. They highlight justifications with concerns of their own financial stability and the well-being of Pascack Valley Hospital’s (PVH) creditors, offering the possibility of generous compensation for the killing of the PVH hospital license. TO READ MORE, click here
February 17, 2009
Dance with the Devil
Valley and Englewood reached the epitome of arrogance last week. They’ve contrived a scheme to possibly block a hospital license for HUMC’s proposed reopening of Pascack Valley Hospital (PVH) in Westwood. The creditors legal representative, in conjunction with “Valley and Englewood, opponents of the proposed hospital reopening, support the idea of auctioning the license to the highest bidder in Bankruptcy Court. That’s because they could buy the license at auction and then “extinguish” it.” (Record 02/11/09) TO READ MORE, click here
February 9, 2009
Opposition concerns – Relative and Fair?
Hospital operations aren’t simple or cheap. The opposition cites’ one of their concerns with the proposed HUMC North Hospital lies in its for-profit structure. Valley and Englewood are nonprofit. Hence, we are to assume a for-profit focus is somehow different then a nonprofit’s quest for market share. TO READ MORE, click here
February 2, 2009
Access — A Medical Requirement
Valley Hospital’s proposed expansion application in Ridgewood has rankled more than a few of its area residents with the prospects of increased traffic. The roads around Valley are already dealing with rush hour congestion problems. How will Valley’s increased managed care capacity magnify those problems? How will the general area’s healthcare access be affected? TO READ MORE, click here
January 26, 2009
Access — A Geographic Requirement
Fred M. Jacobs, M.D., J.D., the former Dept. of Health Commissioner was interviewed by the Physician’ News Digest, on the topic of NJ hospital resource rationalization. He noted, “One of the essential characteristics … not listed in the report, is the travel time from one hospital to the hospital that may survive it in a region. That travel time depends a lot, particularly in the northern part of the state, on the time of day and the traffic patterns.” In the face of this fact, in contrast to Valley and Englewood’s ads, why wouldn’t a new hospital in northern Bergen County be a consideration? TO READ MORE, click here
January 19, 2009
Access Trumps Bed Count
The Muhlenberg closing faced a chorus of organized protest but ultimately, like with any corporation, business parameters framed the restructuring. Solaris Health Systems closed a nonperforming asset. It followed State guidelines and filed for a ‘certificate of need’ closure approval. Had the State said no it might have affected Solaris as a whole, subjecting it to possible bankruptcy and thereby closing two hospitals. TO READ MORE, click here
January 12, 2009
Access To Essential Services
NJ’s certificate of need program is a component to the licensing procedure of healthcare facilities. It also reviews the planned, unplanned and possible closure of hospitals in financial distress. The action attempts to ensure the quality of healthcare, control costs and assure residents are not deprived access to essential services. TO READ MORE, click here
January 5, 2009
December 29, 2008
Put Patient’s Lives Over Rhetoric
- “The foundation of northern New Jersey’s healthcare system is at risk.“
- “This for-profit joint venture could significantly damage the financial strength of the other Bergen County hospitals, thereby destabilizing the region’s access to healthcare and reversing the benefits that have been provided to local residents.“
- “When an oversupply of hospital beds floods a market, services and equipment are duplicated, driving up costs. Existing hospitals, their employees and the communities they serve pay a very serious price. The public bears the costs while profits go to a few.“
The issue is whether the DOH should transfer PVH’s extended certificate of need (CN) to a renewed hospital in Westwood. When you break down the foregoing statements from Valley and Englewood’s fantasy of fear website, their opposition is focused on their own ‘nonprofit‘ margins. — The so-called ‘nonprofits‘ that are funding their current ‘expansions.‘ TO READ MORE, click here
December 22, 2008
Hospitals Sell Health Care
Demographic analysis provides essential characteristics when assessing a community’s high risk concerns. It is especially important when planning services whether they be for police protection, fire prevention or hospital health care. Health care needs tend to rise with age, an underpinning demographic characteristic important to this blog’s objective concern. TO READ MORE, click here
December 15, 2008
Adequate and Effective Health Care Services
The hospital business isn’t rocket science but it is complex. The revenue sources are mostly limited to bureaucracy based insurance vehicles guided by patients seeking medical care. Pascack Valley Hospital closed with its certificate of need (CN) extended for 2 years to November of 2009. Valley and Englewood are attempting to torpedo that CN extension in an attempt to drive higher patient counts and revenue to their operations. TO READ MORE, click here
December 11, 2008
Going Beyond Words
Westwood held its annual ‘Home for the Holidays’ parade this past Saturday. Local businesses, area organizations, sports groups and school bands contributed to a community tradition in the spirit of the holidays. Several thousand area families were in attendance enjoying holiday music, colorfully lit floats, characters in costumes, drinking free hot chocolate in the brisk evening air, catching candy canes from clowns and marching participants. Attendees watched with eyes aglow and bountiful smiles as the parade culminated with Santa greeting the children and the lighting of the holiday tree. TO READ MORE, click here
