by George Bischalaney
President & CEO, Eden Medical Center
National health care reform is now apparently right around the corner. After years of discussion, and more recently, weeks of debate in the House of Representatives, legislative action is now in the hands of the Senate. If enacted, it will be the most significant health care legislation in decades.
As a provider, it is both welcomed and feared. Welcomed in that it will help bring insurance to millions of people for whom it is now out of reach. In making this possible, it creates the possibility of opening doors for routine health care services that should help prevent late diagnosis of disease, which becomes problematic and costly to treat. From our perspective as a hospital provider, better access should redirect many people who use our emergency departments as their primary care providers.
But change comes with a cost. The mind-numbing price tag of reform is expected to be offset by future savings. In the short term, it will require shifting payments currently dedicated to the Medicare program.
Most hospital providers do not make a profit in caring for Medicare patients overall. There is no doubt that we need to drive inefficiencies out of the health care system in order to help address this issue. But that alone may not do it. When costs are rising at a rate of 4-8 percent per year and reimbursement is 3 percent or less, we are constantly falling behind. There are many reasons for escalating costs. Consider the constant introduction of new drugs, high tech and high-cost diagnostic and therapeutic equipment, and of course labor. Health care is a service business and 60% of hospital costs can be tied to salaries and benefits. The cost escalation of these items alone will keep us chasing the elusive break-even point. And once there, if achieved, there is still ongoing capital investment that is necessary to maintain the capabilities expected of community hospitals.
The final package is likely still months away. Even then, it will take time to analyze and truly understand the effects, positive and negative, of this landmark movement. We hope that the final outcome will have the proper balance, consider as much as possible all the consequences, and result in a healthier and more stable provider system.
I welcome your feedback.
By George Bischalaney, President & CEO
Among my mail is an envelope addressed to the CEO and marked “confidential.” It is handwritten, obviously not from a business partner or one who hopes to be. Someone has taken the time to write and make sure it gets read by me and not screened or redirected. It has my attention.
As I expected, it is a letter from an individual who wants to tell me about the care delivered to a family member. As I begin to read, there is a moment of apprehension. Will this be the grateful letter that praises the care of doctors, nurses and other staff members encountered during the stay? Or is this the letter that expresses concerns and expectations not met? Actually, I look forward to either. An individual in a position to assess our performance has taken the time to tell me about it.
I receive letters several times a week, and they are often the most instructive of a given day’s activity. Patients and their families have much to teach us about what we do and how we do it.
I am still surprised at how often it is the little things that make a difference. We put so much effort into providing the highest quality of care and avoiding mistakes that we often overlook the obvious. Those entrusted to our care need the human touch. A moment of compassion, a word of support, encouragement or just someone to listen can provide a sense of healing equal to many more clinical interactions in a patient’s mind. Letters rarely praise the well-placed IV or express gratitude for the timely administration of medication. What many patients remember are the kind words of the nurse, the cheerfulness of the dietary worker delivering the meal, or the respectful nature of the person who comes to clean the room.
There is much that we can do to improve the health care system in our country. Even as the debate continues, there is much that is working well – and it hasn’t been legislated. It is the commitment of countless individuals to go about their work with an understanding of the impact they can and do have on the people they care for. It is remembering the little things that help a patient through the day or a family member find relief in knowing that the caregivers are more than clinicians completing rounds and performing tasks. We create moments every day that will be remembered forever.
As I open the next letter, regardless of the message, I know it will help me remain connected to our purpose and be a reminder of what health care really needs.
Sutter Medical Center Faces Costly Delay, Loss of Construction Jobs as State Deadline Looms
The California Nurses Association (CNA) has filed a lawsuit that threatens the future of the new Sutter Medical Center Castro Valley now under construction.
“That the nurses union would sue to stop us from building our new hospital after a decade of planning is extremely frustrating to our employees, physicians, volunteers and patients who have worked so hard and so long for this,” said Eden Medical Center President & CEO George Bischalaney. “This political action by the union hurts everyone, puts thousands of jobs in jeopardy, threatens the future of the hospital and could cause irreparable harm to the community.
“This type of action drives up the cost of health care for everyone. After an exhaustive and inclusive public process, the union’s lawsuit could mean will not be able to meet the State’s 2013 deadline to replace the Eden hospital. Not meeting the deadline could result in closure of current hospital before the new hospital is completed and certified for occupancy.”
The Environmental Impact Report and land use entitlements were approved by the Castro Valley Municipal Advisory Council, the Alameda County Planning Commission and Alameda County Board of Supervisors. The first phase of construction has been approved by the Office of Statewide Health Planning and Development. Alameda County granted necessary permits and construction started July 1.
The new medical campus will create more than a 1,000 union jobs during the three years of construction and pump millions of dollars into the local economy benefiting many local businesses.
Construction crews demolished the vacant Pine Cone Apartment complex and began relocating the helipad and are readying the site for the foundation of the $320 million, seven-story, 130-bed hospital and regional trauma center. The new medical center will expand needed emergency and urgent care services. A new 80,000-square-foot medical office building for physicians is also planned. Sutter Health is financing the entire project with no public taxes or funding.
Sutter has invested more than $200 million in capital in Eden Medical Center’s facilities since acquiring the hospital from the Eden Township Healthcare District in 1998. The new hospital and medical office buildings would bring this investment in the regional medical campus and trauma center to more than $600 million by 2013.
Employees enjoy the Groundbreaking Ceremony
By George Bischalaney, President & CEO, Eden Medical Center
It’s finally begun! Twelve years of planning, ten years of actively working, and finally, ground was broken on Wednesday July 1, 2009, for the new hospital on the Eden Medical Center campus. It has been an extraordinary effort by so many to get us here. Persistence, patience and untiring efforts have paid off.
The first phase of work involves relocation of the helipad, a necessary step to clear the way for development of the hospital and medical office building. It will be challenging throughout and very difficult at times.
The immediate impact is loss of on-campus parking. Not a lot, but unfortunately in a place where it is needed. This work is occurring adjacent to the Emergency and Trauma Services entry points. Ambulance bays remain accessible and the existing helicopter landing site remains functional throughout this phase. Parking for patients and visitors is affected and will be relocated a couple of times as work progresses.
Already there is activity in other areas of the broader construction zone. An apartment building facing Stanton Avenue was reduced to rubble in a matter of two days. The neighborhood is experiencing the onset of three years of traffic associated with the project, as debris is removed and equipment and supplies arrive.
Work was temporarily interrupted and the worksite cleaned up for a brief but well received ceremonial groundbreaking event on July 1. Employees, physicians, the project team and Eden Medical Center as well as Sutter Health leadership officially christened the site with the photo-op tossing of dirt. It was an exciting moment for those who have waited to so long for this day.
As the work progresses, our official site for tracking the work will keep those who check in up to date. And coming July 20, there will even be a webcam for viewing the work as it proceeds.
Let us know if you have any questions or comments.
George Bischalaney, President and CEO, Eden Medical Center
By George Bischalaney, President & CEO, Eden Medical Center
Health care reform is on the agenda, again. The stakes are high, but our President is determined to make some significant changes. As the discussion moves from general to specifics, special interests are staking out their positions. None of the stakeholders—hospitals included—wants to feel the impact or be at a disadvantage.
Amidst the demand for cost reduction and health care coverage for all, there is and must be continued investment in care. Physicians demand it. They expect to be able to practice with state-of-the-art equipment and facilities to produce outcomes that meet national, state and local quality standards. Patients demand it. They want to know that their local hospital has the right number of well-trained staff as well as the latest diagnostic and treatment equipment, and contemporary facilities.
With this backdrop of conflicting needs, Eden Medical Center is about to begin a three-year project that will result in the replacement of the Castro Valley hospital. The project cost is estimated to be $320 million. The current 55-year-old building is anything but contemporary. With few private rooms, small operating rooms and inadequate support space for clinical services, a new hospital is very much needed.
Eden Medical Center has served the community well, but it was not designed for patient comfort and needs, more for staff needs and functionality. While our project may seem ill timed given the uncertainty of hospital reimbursement, we are required to meet California legislated standards for seismic safety in hospitals. And it truly is needed.
We’ll celebrate our long sought goal with a ground-breaking ceremony on July 1st. Then we’ll spend the next three years continuing the investment in the new buildings and equipment, while observing and hoping that decision makers do not enact legislation that essentially penalizes us for the commitment we are making. When we celebrate the grand opening and our new beginning early in 2013, it should be with the same hope and dreams as those who celebrated the first ceremony in 1954.
By Cassandra Clark, Project Communications Director
After much debate and public input, the Alameda County Board of Supervisors voted unanimously to certify the EIR (Environmental Impact Report) and approve the zoning and land use entitlements for the new hospital to replace 54-year-old Eden Medical Center.
Passage of the EIR and land use entitlement approvals is a major milestone for the Sutter Medical Center Castro Valley project—and the communities that will be served by this new, state-of-the-art hospital and adjoining medical office building.
About 20 speakers addressed the Board of Supervisors about the new hospital as well as concerns about future plans for San Leandro Hospital. Eden President & CEO George Bischalaney expressed to the Board members the overwhelming support for the new hospital, even among those who encouraged rejection of the EIR to “save San Leandro Hospital.” Bischalaney and others urged Board members not to delay approvals in order to meet “a very tight project timeline” and advised the Board not to tie the new hospital project to the uncertainty around San Leandro Hospital’s future.
In the end, the Board of Supervisors maintained that its obligation was to make a decision on the land use entitlement proposal before them. However, Board members promised to continue to work with Sutter and the District to come up with an optimal plan for San Leandro Hospital, and to meet the health care needs of the communities.
We are grateful to the many people of Eden Medical Center, San Leandro Hospital and our communities for participating in this process. We had tremendous support at both Board of Supervisors meetings, through the petitions, and all the phone calls and letters of encouragement.
What Happens Now?
The Board’s approval clears the way for SMCCV to use the designated property to build the new hospital, which will be on the northwest side of the Eden Medical Center campus, adjacent to the existing hospital.
In the coming weeks, we will file the appropriate permits to begin work on the land, including the demolition of the vacant apartment building and other site improvements, and the foundation work for the actual construction of the new hospital. Oversight and approval for the further construction is handled by the
California Office of Statewide Health Planning & Development.
The immediate work around the campus will get the land ready for construction and help minimize delays so we can proceed with building the new hospital as soon as possible in order to meet the deadline for State-mandated earthquake safety requirements.
We look forward to moving ahead with the project. As always, your questions and comments are welcome on this blog and on our social networks!
George Bischalaney, President and CEO, Eden Medical Center
By George Bischalaney, President & CEO, Eden Medical Center
On May 12, 2009, the Alameda County Board of Supervisors deferred action on the Environmental Impact Report (EIR) and related actions needed to begin the redevelopment of the Eden Medical Center campus.
The delays were for the most part caused by the late submission of information from a group opposing the approval. Their opposition stems from a misguided effort to link the future of the San Leandro Hospital to the future of the new Eden campus hospital. Opponents contend there is a nexus in the decision making as well as an unaddressed impact to the new Eden hospital.
Our initial assessment is twofold. First, the future of each hospital is distinct from the other. The Board of Supervisors’ actions regarding the Eden redevelopment will not affect the decision process to determine how the San Leandro campus will be used in the future. Secondly, there was very little or nothing new in the comments that actually addressed the EIR itself. Hopefully, the Board will draw the same conclusion and move forward with the needed approvals on June 9th.
Eden Medical Center has been the designated trauma center for Southern Alameda County for more than 20 years. It has served thousands of patients over that time, including victims of the 1989 Loma Prieta earthquake that shut down the Bay Bridge and collapsed the Nimitz Freeway in Oakland. It is absolutely critical that Eden is replaced as soon as possible. Earthquakes, like all natural disasters, are unpredictable. People will rightfully ask why we weren’t prepared if avoidable delays in preparing for the inevitable are not overcome. We have a need to rise above politics and special interests to meet a greater obligation of the health and well being of the community of being served. People of good will and with good intentions can do so. Let’s hope we see this kind of sentiment on June 9th.
You can take action and sign a petition to the Board of Supervisors and urge them to stop delays and vote yes on the EIR. Please take a moment to sign the petition at the link below.
http://www.thepetitionsite.com/1/rebuild-eden-medical-center
Thank you for your continued support of the new hospital.
By Cassandra Clark, Project Communications Director
To follow up on the May 12, 2009 Alameda County Board of Supervisors meeting, the decision to certify the final Environmental Impact Report (EIR) has been delayed to June 9th to address concerns raised about San Leandro Hospital, which is leased and operated as part of Eden Medical Center, but owned by the Eden Township Healthcare District (the District). For more information, please see our previous blog post.
In the days prior to the May 12th meeting, after many rounds of public commentary, and after the EIR and related land use entitlements were approved by the Castro Valley MAC (Municipal Advisory Council) and the Alameda County Planning Commission, several community members and labor representatives raised last minute concerns about parts of the EIR. Those opposed to the EIR certification claim that there was not an adequate assessment of the impact of any possible closure or change of services at San Leandro Hospital, despite the fact that the EIR consultant and County planning staff have stated that the EIR is complete and the issues around San Leandro Hospital, while not related to the project, have no impact on the project. Supervisor Nate Miley made a motion for the Board to meet again to make the decision on June 9, 2009, which would provide attorneys for Alameda County an opportunity to examine these claims in more detail.
Supervisors Miley and Haggerty voiced their concerns about speakers making false or misleading allegations as a political tactic, in order to delay the EIR approval process, thereby “holding the Sutter Medical Center Castro Valley project for ransom,” which he and the other Supervisors warned could endanger the future of both Eden and San Leandro Hospitals. While there has been no decision by Sutter Health or the District on the future of San Leandro Hospital, the issue remains a topic of community discussion.
Eden Medical Center President & CEO George Bischalaney and other Sutter and Eden project team members emphasized the urgency of not going beyond June 9th to approve the EIR, as the delay of even a month could significantly hold up construction and may cause Sutter Health to withdraw its support from both hospitals. Sutter Health has already promised the $320 million to pay for the completion of the new Sutter Medical Center Castro Valley.
At the conclusion of the May 12th meeting, the four Supervisors present, with Supervisor Keith Carson absent, voiced their support for the new hospital project and the need to rebuild Eden Medical Center. They also are concerned about the future of San Leandro Hospital, and that concerns over San Leandro should perhaps be discussed in another forum, unrelated to the land use entitlements for Eden.
As our project team discussed in previous articles and blog posts and at the hearing, any delays in approvals and construction have serious repercussions, in terms of meeting state deadlines to rebuild, in creating a safe environment for patients and staff, and in funding this major project. The new hospital must be rebuilt, or it will close as an acute care facility effective January 1, 2013. We now have before us a fully funded hospital project—without public funding or taxes—that will secure the future of Eden Medical Center, preserve jobs and bring nearly 1,000 construction jobs to the region at a time when the economy is depressed and construction is drying up.
As I stated before, the issues around San Leandro Hospital are complex and important. The community has a right to know what is happening. But the information being discussed now is no different that it has been for the past several years: the hospital is struggling and must be reinvented to bring value to the community and ensure that it can sustain itself over time. It is clear to me that the residents of San Leandro desire a full service community hospital, yet the majority of them will never use it. The community and local elected officials have known that this is a concern, and yet this last minute effort to stop the EIR based on what some claim to be “new information” is not justified. San Leandro Hospital, its employees, physicians and patients need to be part of the solution for the hospital, to be discussed in its own forum with regional providers who can bring truth and substance to the discussion. It should not be used as a political maneuver to stop Sutter Health from rebuilding Eden.
Please speak up, let our Board of Supervisors know they must not delay any further. These delays put both hospitals in jeopardy. I encourage you to stand up and let your voice be heard on this issue. Don’t just wait for the next hearing, but instead pick up the phone or send a letter to the Board and let them know you support the new hospital project, and encourage them to certify the EIR so the project can move forward before it’s too late.
Call today!
Supervisor Nate Miley — 510-272-6694
Supervisor Alice Lai-Bitker — 510-272-6693
Supervisor Gail Steele — 510-272-6692
Supervisor Keith Carson — 510-272-6695
Supervisor Scott Haggerty — 510-272-6691
George Bischalaney, President and CEO, Eden Medical Center
By George Bischalaney, President & CEO, Eden Medical Center
Last week, the Obama Administration kicked off its efforts to address one the President’s stated priorities, health care reform. What does that mean, and what will be the result? I wish I really knew.
According to the President’s advisers—and Obama himself during the campaign—there is a need to extend health care coverage to millions of uninsured people across the country, while reducing cost and improving quality. Truly admirable goals with which very few could disagree.
Early discussion of President Obama’s plan calls for creating a savings of $634 billion over the next ten years to help fund reform. A recent article referred to this as a “down payment” on the overall expected costs. About half of this amount is targeted to come from reduced payments to Medicare and Medicaid (known as Medi-Cal in California) providers. On the surface, this is a disquieting concept.
Not too long ago, Eden Medical Center was recognized as one of lowest cost hospital providers in California. It should be no surprise that our costs have risen over the past few years. We have invested heavily in new equipment, both in medical technology and information technology, in order to continue to bring state-of-the-art services to our communities, and to provide our physicians and clinical staff the best tools to diagnose and treat our patients.
Last year, our labor settlement with registered nurses resulted in a three-year agreement that will give the nurses a 20% wage increase over the term of the agreement in addition to improved benefits. This kept our wages comparable to other local hospitals.
One of the benefits Eden Medical Center employees enjoy is a fully paid health plan for themselves and their families. Last year, the average cost was approximately $22,000 per year for an employee and family.
Despite these costs, Eden remains one of the lowest cost providers when compared to peer groups throughout the State. But as can be imagined, it is difficult to contain costs in our environment, especially when 60% of our costs are employee-related expenses. We are, after all, a service industry that is people- and technologically-driven.
The early announcements about health care reform create some concern. To expect to realize the savings needed to fund the plan through reduced payments to health care providers is very troubling.
Physicians are increasingly affected by efforts to reduce reimbursement. Many physicians talk of extending their days, working longer hours, much of which is devoted to the increasing amount of paperwork demanded from them. At the same time, we as patients expect them to remain current in the knowledge of new drugs and treatments in order to serve us to the best of their ability. This is resulting in a shrinking primary care base at a time when our population is aging. How does the plan for reform intend to address this?
Government payers of healthcare services for hospitals—the Federal Government for Medicare, and the State for Medi-Cal—are not paying the full cost of care at the present time. For each patient that is covered by Medicare or Medi-Cal, the cost to care for that patient exceeds current reimbursement. Further reductions will increase the gap that is, out of necessity, made up by insured patients—those lucky enough to have coverage through their employers. This is a cycle that needs to be broken if we are to have true health care reform.
The problems with our health care system are very complex. Reducing payments in an attempt to reduce costs will not yield the full reforms that are needed. I can only hope that this is not another piecemeal approach to change. A broader view of the systemic issues is needed. With the President’s staff talking about implementing reforms by the end of this year, it is questionable as to whether or not this will actually occur.
As always, your questions and comments are welcome. We will respond as quickly as possible.
By George Bischalaney, President & CEO, Eden Medical Center
Yesterday, one of Eden Medical Center’s neurosurgeons, Dr. Dickinson blogged about what’s in store for neuroscience at the new Sutter Castro Valley hospital. Coincidentally, Eden was also mentioned in an article in the AARP Bulletin on February 2, which it picked up from the Contra Costa Times.
The article basically said that the State of California through its Office of Statewide Health Planning and Development (OSHPD) had released statewide data on “hospital death rates.” This data has been collected for some time and the most recent release includes data for 2007.
Eden was identified as having a “Better-Than-Average” rating for patients who undergo craniotomies, which is a procedure for removing brain tumors. The statewide average was 6.7%, while the rate at Eden was measured at 0.7%. We were one of 25 hospitals, among 400 hospitals statewide, with better than average results, and one of only three in the Bay Area. These results do not come about by accident or good fortune.
Eden has been a designated trauma center in Alameda County for over 20 years. The experience and training of our trauma center staff has helped strengthen the services we offer in surgery, critical care, diagnostics, rehabilitation and general medical care. The methods used by the trauma center surgical team have carried over to every patient treated at Eden.
Building upon the trauma center’s effectiveness and with the support of Sutter Health, Eden established the Sutter East Bay Neuroscience Center several years ago. One of the mainstays of these programs is neurosurgery (brain surgery). Eden is blessed with a core of very highly regarded and skilled neurosurgeons as part of its medical community. It is because of their expertise and our joint commitment to excellence in neurosciences that we have been able to have such outstanding results with this critically ill patient population.
OSHPD has a website with a link to all of the recently released data (go to www.oshpd.ca.gov and click on AHRQ). OSHPD points out that this data is risk adjusted, to ensure that all hospitals are treated fairly and that evidence suggests that high mortality may be associated with deficiencies in the quality of hospital care provided.
Public reporting of hospital data will become more common, and its use by consumers greater over time so that they can be better armed when making important decisions about where to seek their health care services.
FaceBook Group
YouTube
LinkedIn
FriendFeed
Twitter