moving forward
This has been an extraordinary week for Southwestern Vermont Medical Center. The pace and magnitude of change has been breath-taking. I recognize that the level of anxiety in the organization for the past few weeks has been high and difficult to tolerate. The pain of such change in the lives of people we care about is real.
First and foremost, I want to thank the hundreds of staff who have managed your anxiety while continuing your outstanding patient service. Our patients deserve our best, and I am impressed that SVMC’s caregivers have maintained your utmost professionalism throughout this recent ordeal. Our patients appreciate it -- and hospital leadership appreciates it enormously.
15 comments
why not all comments are posted
Some folks have submitted comments that are quite personal and even hurtful toward previous officers of this organization. While I am committed to clearing the air, I do have editorial authority over posting of comments. If people want to criticise me or current staff without inappropriate language, I will always post. I will not post profanity. I will also not post personally vindictive statements about previous officers of this organization. I know there is anger; but I will not further stir the waters. It is time to focus on the future.
Mark
Kara Leonetti, Administrative Secretary
There is much sadness in my heart. I understand reduction in force was a last option and to see those leave who have been here for 20 years or longer, brings a sense of mourning for some. Benjamin Franklin once said "if you would not be forgotten as soon as you are dead, either write things worth reading or do things worth writing". Those who have left have done some phenomenal things for this organization which will not be forgotten and that is what is important.
Last
week
was
not
easy
for
anyone,
but
I
agree
that
it
is
time
to
move
forward
and
to
focus
on
what
is.
Today
is
a
new
day
and
should
be
treated
as
such.
I
think
we
should
take
what
we
can
from
this
experience
and
learn
from
it;
I
know
that
I
have
changed
my
perspective
personally
and
professionally
for
the
better.
What happened to the money?
As employees whose jobs are at stake and who have already seen friends kicked out the door, we should have a right to know what happened to all this money? How could someone make that big of an error? If someone was embezzling, we have a right to know!
to "what happened to the money?"
Lots of people have this same concern. It is natural to worry that money could have been taken. A careful look back is going on to assess this. There is no evidence of theft. The errors were in projections of future revenue, and it seems, on the face of it, hard to see how one could steal money not yet received by the organization. We will find out, however.
Transparency
We hear this word a lot only to have the waters muddied or the windows fogged, you pick your analogy. I choose to pick muddy waters because it will take a very long time for the mud to settle and the waters to run clear. Having said that, why have we not seen individuals on the board accept and take responsibility for the issues that have and will continue to plague the health system with. It comes from unnamed sources that some of these individuals have not always had their integrity intact. I will not drop names, but do know that when the incident of the caterer hit the news some years back, there were board members that benefited from the services, but were never held accountable. LETS GET HONEST and QUIT COVERING UP what is meant to be TRANSPARENT, the trust is gone and it will take a lot more than you Mark to bring back integrity, honesty and justice and stewardship to the system. The Board needs to stand up and not make you the AXEMAN and possibly the final scapgoat. It is time to focus on the future, but the past is always is look into the future based on past practice creating future habits. Respectfully Submitted with restraint.
To Kara
your sentiments are well written (Ben Franklin would be proud of you) and capture the strange brew of emotions we are experiencing as an organization. You are right on about the learning piece as well. "those who do not learn from history are bound to repeat it"- George Santayana. In a learning organization, everyone can help remember the lessons of the past. It's values and contributions like yours that will support moving forward. Thanks!
to transparency
As CEO, I deal with the board frequently. Although I cannot speak for the board, I can assure you that the Board takes its responsibility to the institution, its employees, and our community very seriously. That should be evident by the amount of change at SVMC recently. This kind of change does not happen without the involvement and approval of the Board. As the Trustees’ representative in the hospital, it is my responsibility to carry out the Board's wishes regarding the overall direction of our organization. The catering incident you refer to happened several years ago and involved the misuse of our non-profit tax status. It sparked several major changes at SVMC. First, the incident was thoroughly investigated. No board members, physicians, or SVMC senior managers benefitted financially from the catering incident. Secondly, the health system promptly and fully settled our tax obligations.
Most importantly, that incident prompted the Board to establish a strong Compliance Committee and hire an independent, experienced compliance officer that reports only to the board. The Compliance Committee's job is to oversee how well management follows the numerous regulations and regulatory agencies governing non-profit health care organizations.The committee has developed a strong conflict of interest section in the Board's bylaws and oversees the Trustees’ compliance with this provision. One of the first acts the committee and the compliance officer took was to put in place 13 recommendations to help prevent problems like the catering incident from recurring and to preserve SVHC's non-profit status.
In the same way that personnel files are confidential, what disciplinary procedures the board takes regarding its own members also remain confidential. In my view, transparency does not include public humiliation of employees, trustees, or physicians.
SVHC’s compliance department is built on the ability of anyone to raise a question confidentially and anonymously about the regulatory, procedural, or legal matters without the fear of retribution. If you know of a conflict of interest or a rule or regulation that's not being followed, I strongly encourage you to contact our chief compliance officer, Austin St. Hilaire, via email (stha@phin.org), phone (802.447.5055 or 802.558.0173) or in person at the SVMC Lodge Building.
Blame Game
Let's stop the blame game. The people who should have been fired and will be fired know who they are. Let's move on and fix this mess and stop complaining about what went wrong.
Transparency and Services
It seems as though the full extent of the shortfall will be larger than first projected. My concern, and the community's fear, is that additional services and support staff that deliver services, will have to be cut. In fact, some have already been cut.
In
order
to
heal,
our
community
needs
to
know
that
those
responsible
are
held
accountable.
That
includes
a
sincere
apology
to
the
community.
After
all,
every
hospital
was
affected
by
our
global
financial
crisis,
and
many
have
not
suffered
as
much
as
SVHC
has.
to transparency and services
The Board, the senior management team and I are aware of the pain these cuts have caused some within the SVMC family, and in the effected families in our community. If there had been any other way to manage this financial problem with less disruption to the lives of our neighbors, we would have chosen another route. This does not lessen the pain for those who have lost their jobs, and for this we are very sorry. We are endeavoring now to take each step as carefully as time allows, to minimize the chances of this kind of pain ever happening again.
Several communications to me, the Board, and to others in the SVMC have suggested a need to hold accountable those that “got us into the mess” that the Board and I have been struggling with since I became CEO in March. It is now time to address those suggestions.
The difficulties being experienced here are not unique to Bennington Vermont. Our community is close, and the effects on our hospital have touched almost every family in our community. So perhaps the effects are as unique as our community, but 40% of hospitals in the United States are operating in the red this year. There is no person or people in Bennington that can be held accountable for the global financial recession we are experiencing. Government, private payers, and individuals have less to pay for ever increasing costs of healthcare.
The information we have demonstrates that the local accountability is for a failing to correctly project the realities of our financial position at an earlier point in time. An earlier realization may have allowed the layoffs that have occurred to have been done over a longer time frame. Knowing the severity of our revenue shortfall earlier might have resulted in pursuing other initiatives for the mechanical plant renovations sooner. We could have taken more time to review and revise service and vendor contracts. We might not have made decisions to add services or staff this year. We will never know. What we do know is that these changes would still have been required of us. The reality could have been realized sooner, but the reality would have been the same.
The world is in a recession. How healthcare costs are paid has changed in the past two years, and may change again dramatically in near future. We are earning less money than we have in the past. We had to adjust how much we were spending or face a new reality of failing this community on a catastrophic scale. At SVMC, we have chosen to focus on the changes we need to make to secure our future for this community. The past is useful to us only as a lesson for making a better future for the people who rely on SVMC. Those responsible for failing to realize our dilemma earlier in time no longer work here. But we will not engage in a continuing focus on past mistakes. We will continue to focus on our future, working through the difficult recession we are all experiencing, the changes we need to make today, and the well—being of our neighbors. We will not look back, but work together today to make a great future.
The mid-year audit scheduled for completion in June will provide an accurate accounting of our financial status and will influence whether additional adjustments to income and spending are required. Senior management will share the results of the audit with the community when they become available.
Thank you,
Mark Novotny
Gary Strubel, Health Sciences Librarian
I agree that we need to move on, but we also need to fully understand how we got here. We can't just put the past behind us. We need to learn from that past. To quote George Santayana (in what has now become cliché), "Those who cannot remember the past are condemned to repeat it." That said, I believe that the frustrations that are permeating our community and institution are due, in part, to the waiting. We have become an impatient culture, where we want more, better, faster. As frustrating as it is however, I am more than willing to wait for a careful and reasoned analysis of how we got to where we are. How much of it is simply due to the recession and how much do to poor planning? Could we have planned better, or was this inevitable? How can we plan better in the future. I'm not looking to place blame, nor am I looking for a public hanging. Rather, I'm looking to learn. In order to move forward, we must educate ourselves. But to properly educate ourselves, it will take time. The mid-year audit is the first step, and a careful analysis is the next. Mark, you have been very gracious and patient with all of us during this trying time. I appreciate your optimism. I'm also looking forward to learning what we can from the audit, even if it means another restructuring (and I say that knowing that I may well be a casualty of that restructuring). Either way, I call for all of us to have a reasoned patience.
Audit Complete ?
With all the discussion and focus on the audit I feel the timing coincidence ? Rumor is Audit has been completed ? Any truth?
Board Member Elsewhere
I read the article about the defined benefit plan being part of the cause of the deficit. I'm sorry, but that is unacceptable. I have no doubt that this may be an issue, but certainly a strong CEO, CFO or strong Board would have planned for such a scenario (as most companies have in switching out of defined benefit plans). Not only should the administration have been aware of the possible future ramifications, but the Board should have also known. I'm assuming that the Board isn't comprised of just people off the street. The Board President says he has confidence in the current administration. With no offense to Dr. Novotny the Board also apparently had complete confidence in the previous administration. Perhaps more Board members should take a hard look at their positions. They need to evaluate whether they have the ability and commitment to take on the job. Not just anyone can be an effective Board member. Their action or inaction can have a deleterious effect on the whole area being served by the hosptial.
a comment about Board accountability to Board member elsewhere
I have had extensive discussions with our Board about how we got to where we are. I have shared with the Board, medical staff and hospital staff my own regrets about not speaking up more about my own concerns, and not challenging financial assumptions I was given to work with. The following is a quote from our Board Chair, Dr. Guerrero, on this issue:
"My
greatest
pain
as
Chair
of
the
Board
of
Trustees
is
the
suffering
of
those
who
have
lost
their
jobs
and
the
frustrations
of
those
staff
and
employees
who
have
found
their
jobs
more
difficult
because
of
management
failures.
We,
the
Board,
could
have
and
should
have
done
better.
We
are
reviewing
past
events
in
order
to
improve
our
performance.
However,
there
is
no
bright
line
between
reviewing
and
excuse
making
and
we
need
to
avoid
the
latter.
We
accept
responsibility
for
our
failure
to
adequately
oversee
management.
I
see
the
angst
of
the
Board
and,
yet,
I
feel
the
energy
and
the
conviction
to
do
it
right--
to
look
at
our
processes
and
the
tools
of
governance
so
that
this
does
not
happen
again.
SVMC,CLR,Home
Health
and
Hospice,
Northshire
and
Deerfield
Valley
Medical
Centers
are
too
important
to
our
communities
to
expect
less."
Leader?
If I understand what you said, you should've spoken up more about concerns and challenged financial assumptions that you apparently didn't think were accurate. After reading the Bennington Banner this morning, I believe you should take yourself out of the running for CEO. A leader is not afraid to stand up and speak his/her mind. An adminstrator challenges all assumptions for the good of the hospital. This doesn't mean that you are a bad person or that you are not a good doctor. It simply means that you were high enough in the hospital to have made a much more positive difference, and you did not.
As for the Board Chair's comments, the board thought they were doing right for many years while overseeing management. They didn't listen to the docs who were telling them of the problems. I've been around long enough to know that the Chair has heard complaints from some of the most prestigious doctors ever to walk the hallowed halls of the Putnam. Those complaints were poopooed, and now it is time to pay the piper. From a business perspective, I don't know how the Board can justify not resigning. They can still do the hospital a service by looking for other members to fill their positions.
Please
don't
misinterpret
this
as
personal.
These
comments
are
purely
business
as
I
have
no
interaction
with
any
of
these
people.
I
do
however
wish
to
see
the
SWVMC
in
business
for
many
years
to
come.
