Banner executive offers advice
Allen Reiners, system director, finance operations, for Banner Health System, of Fargo, N.D., spoke to the St. Luke Hospital Board of Directors Thursday night at its regular August meeting.
Banner leases and manages St. Luke Hospital. Transitions planning by a hospital's management team and board, he said, usually starts several months before the actual change in management.
He added that eight to nine months would be a realistic time to expect a complete management transition to take. "Six months would be very fast," Reiners said.
Three items are most difficult and time-consuming in this transition planning, he said: Information systems, human resources, and getting general and professional liability insurance coverage.
"There are not that many vendors (of such insurance) out there anymore," he said. "It can be difficult to get bids at an acceptable price."
With information systems, it's necessary to revisit needs, look at various product lines and outside vendors, and make requests for proposals. "It takes time," Reiners said.
With information technology, internal layout must be considered as well as Internet access, communications with external parties, the facility's Web site, and other matters.
In regard to materials management, Reiners said St. Luke could "stay on Premier at no charge, through Banner."
Human resources can be "very difficult to work through," he said. Benefits, wages, health insurance and other matters must be agreed upon. It must be decided whether to leave human resources as it is, or modify it.
Most facilities in transition have kept it intact, as best they could, Reiners said.
Doug Newman, administrator/CEO of St. Luke, said a survey had been conducted of employees' desires and needs.
The hospital, after management transition, may have to use two or more companies to provide or arrange pension benefits, life insurance, health and dental insurance, Newman said.
Payroll benefits administration can be very complex, Reiners said, with laws changing constantly. It's hard for just one or two people to be experts on this, to know all the ropes.
It can be contracted out to a firm with expertise in this, he said.
Risk management insurance is an area that "Banner can help you with," Reimers said. "We can make some calls, use some leverage."
This would include malpractice and related types of coverage.
Reimers also spoke of marketing and public relations needs, and of exterior reimbursement — developing a financial forecast of costs.
Articles and bylaws governing the hospital will need to be reviewed, as well as policies, Reiners said. The medical staff's bylaws and credentialing also will need to be reviewed.
A change of ownership, if one transpires, will have to be studied.
Development of a strategic plan, making changes, additions and deletions, is another matter, he said.
A "free-standing" facility is the goal sought for St. Luke. This would mean, Newman said, it would not be part of a group or system, but would stand alone, while nevertheless being managed by a professional company.
Other concerns to be addressed will include corporate compliance and HIPA (the Hospital Information Privacy Act), management support, and a review of the contract with management or owners.
Newman said, "We've already started the wheels turning on a lot of this — we're in the process. HR (human resources), location of vendors, several other of these matters. Governance and management will be time-consuming.
"A lot of this is already under control, in the process," he said.
A transition team list or roster will be needed, and a community transition plan, Reiners said.
Dec. 31, 2004, is the expiration date of St. Luke's management contract with Banner. St. Luke is the last of Banner's hospitals in Kansas due for a transition.
Banner "will do all in our power to make the transition as easy as possible," Reiners said. "We'll provide support wherever and however we can."
He said Banner would exert no influence on vendors or on production selection. "That would be inappropriate," Reiners said.
Kevin Cronkleton, St. Luke's chief financial officer, said that by this time a year ago, seven babies had been born at the hospital. This year, by Aug. 14, the number of births was 18 — something of a mini-baby boom.
Martin Tice, a member of the board who also is an administrator for USD 408 of Marion-Florence, said that gain of 11 births was "not enough to make up for (the district's) losses in enrollment" this year.
Final figures on that will be released Sept. 20 by the State of Kansas.
Newman said corporate compliance training was under way at St. Luke, and a new automated time and attendance system for employees (time clocks) would begin being used Sunday.
Greg Bowers, board treasurer, said the mill levy is remaining the same for the hospital, although valuation in the hospital district is down somewhat.
He said motor vehicle taxes were coming in at present, to help "bump it up." The hospital will raise $456,888 in taxes this year, up $16,400 from a year ago, Bowers said.
Board member Peggy Blackman said, "Foundation grants are out there (available). We need to go after them."
Newman said certain "trigger words" need to be in the grant application. "If they're not in there, you don't get the money," he said.
Several agreed politics plays a big part in who gets grants and who does not. Gene Winkler, chairman of the hospital board, said, "It's not what you know, but who you know."
