The Master Plan: We Want a Hospital

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.

The opposition sees it as survival of the fittest. In nature you kill, adapt or be killed. In the civilized field of Bergen County’s health care industry, it’s about retaining opportunities to grow and endure; kill the competition. The difference, nature seeks a balance. Here, they seek to dismantle the scale, placing money over needed patient access.

There are various viewpoints to defining a hospital’s need and objectives. Similarly there are many aspects in viewing their challenges. Gauging how well a facility engages them is a task that the DOH will have to meet in coming years with more efficiency. And a process that will have to play out in determining a hospital’s return to the Pascack Valley.

The State’s Report laid out a topography of concerns that will require integrated performance benchmarks. No easy task when you consider the range of services within a hospital and the array of details from financial to community that require assessment.

Consider just the financial perspectives with costs, utilization, revenue, liquidity, capital structure and profitability, all of which are affected by patient volume, payer mix, clinical staffing and cost management. Each in turn is affected by a hospital’s operational structure, i.e., teaching, general acute care, behavioral/ geriatric, critical access, etc. Each with different expense definitions and account assignments that effect their numbers, and thereby the application of any financial measures.

Of course the foregoing is an amplification of analysis parameters, but the portrayed complexity is what Englewood Hospital would like you to ignore in assessing their prospects. They have focused their lifeline for success in limiting competition. They offer a management technique similar to cats playing in a litter box, satisfied in shuffling their distractions. They seem to ignore that NJ hospitals have been addressing rising costs, declining reimbursements, and competition for decades.

No one questions that hospital management is difficult in today’s market. Health care demands continue to grow and the challenges increase. Inadequate reimbursements, uninsured, staffing, productivity, service performance, defensive vs. preventive medicine, quality compliance, patient safety, rising malpractice costs, governmental regulations and patient satisfaction, all require timely decisions that enable the flow of operations to succeed. That requires a management that accepts the realities of an industry in constant flux, and rises above it.

When it comes to the return of a local hospital, recent local articles leave little more then hope. The local political antics have failed. Here and elsewhere the issue has been talked to death. Two years ago today the State’s Health Planning Board voted to extend the hospital’s certificate of need for two years. Today, HUMC, the partner in the closed hospital site, has its own financial challenges and thus has been less than direct in its guidance to the future of a hospital in Westwood. It seems like the reopening is an opportunity that will continue to be a work in process wrapped in hope and time.