Muhlenberg Community Hospital: Lloyd K. Ford, Jr., CEO

by HCE Exchange on August 19, 2010

Muhlenberg Community Hospital is a community-based non-profit in Greenville, Kentucky. With 135 beds, 565 employees and 130 physicians the hospital provides a full array of services of basic medical services, including a surgical department and emergency room. Additionally, the hospital also offers care in the departments of urology, orthopedics with wings dedicated to obstetrics and pediatrics. The hospital also offers a long-term care facility that is connected to the main hospital. Begun in 1938, the hospital is the second largest employer in the county.

The current CEO, Lloyd K. Ford, Jr. was brought on in 2004. At this time, the hospital was very different from what it is today. “When I took over, we were in a dire financial situation, the hospital had lost 1.8 million and hadn’t made a dollar in years,” explains Ford. “Muhlenberg was looking at possible closure, community perception was poor and the organization was just floundering.” Ford goes on to site one specific example of the hospital’s inefficiency and weakness, “Building a reputation within the community was essential. We had to repair how the public perceived us. Our ER, for instance was horrendous for wait times and performance.” Add to this problem a physician team that lacked subspecialties and a low surgical rate (about 100 surgeries per month) and you have a hospital that was not only unpopular with area residents, but was also losing significant profit opportunities.

Transforming a Declining Hospital

From a hospital in this state of disrepair, Muhlenberg has done a complete 360-degree turnaround. The ER wait times are significantly down, going a 4 to 6 hour wait to a current wait time average of 1 hour and 46 minutes which is half the national average. A diverse surgical team has been recruited and monthly surgical rates have tripled. So how did Ford accomplish this impressive task? He says that first he reached out to the community to show residents that change was in the works. By attending town hall meetings, Ford learned about specific needs of the community, including being alerted to the condition of the hospital’s emergency care. Ford also made overall operational efficiency a major focus of the turnaround. He also used his experience in recruitment and relations to improve the physician recruitment and retention process and create better lines of communication specifically with the hospital’s board of directors and also the larger Greenville  community. Today the hospital is exceeding national averages  in operating profits.

A Hospital With Lasting Appeal

Ford says that he was first attracted to the faltering hospital because of the commitment of the staff to turning the hospital around. “I was in the for-profit world before I came to Muhlenberg. I walked around for the first time when I was considering coming to the hospital and asked a nurse why she worked here .She said she loved the hospital. That feeling that had struck me and I saw that there was potential here.” Today the hospital reports 96% of employees are proud to work at Muhlenberg. “We brought back patients that were going elsewhere. They wanted to keep their healthcare here but they needed a reason to come back and I knew I could give them that reason to return.”

Keeping Up the Momentum

Now that Muhlenberg is back on track, Ford is looking to the future for the hospital. Capital investment plans now currently focus on continuing to improve the ER and the radiology department. New equipment is being purchased for the radiology and surgical department. “We are hoping to get more capital dollars to expand the obstetric department and surgical wings. Ford would also like to enhance the patient experience of the hospital. “ I plan to make the older parts of the building more patient friendly with more private rooms and just an overall better atmosphere for patients.” These initiatives Ford plans to have met within the next three to five years.

Obtaining and maintaining access to capital is essential particularly for the smaller sized Muhlenberg. “We are not a huge institution and we do not have access to big capital. Sometimes you can’t do something as soon as you’ like.” Ford cites two problems that affect capital: Medicare reimbursement and charity care. “Our Medicare rates for reimbursement are based in the rural wage index so we get the lowest reimbursement rates. We compete with different hospitals and are actually taking some of their customers, but they are getting millions more in reimbursement and we are getting less.”

Muhlenberg last year gave out seven million dollars in free care because of bad debt and charity care. “This is continuing to raise. We had a very good year, but would have had a phenomenal year if we had not had so much spent on free care. We need to begin to ask ourselves “where do we cut these services off to people that can’t pay?” Muhlenberg currently is working on an upfront payment system for elective surgery. “To ensure that this community hospital is here for the community you have to set limits. There’s only so much you can do for free before the organization starts eroding.”

Facing the Challenges of Modern Healthcare in a Rural Setting

As with many hospitals, physician recruitment is a top priority for Muhlenberg. However, being a small rural hospital Muhlenberg faces very specific challenges here. “I am committed to changing the philosophy that people think bigger is better. We give people reasons to be here.” Ford explains that this is accomplished by marketing the hospital as the best career and lifestyle choice for them. “We sell the area. As compared to the bigger city hospitals, we have a way of life where we are close to everything, so a physician won’t have to deal with going to three different hospitals. We also are not tied to managed care like a lot of big cities, so income wise physicians can make a better income here.”

Ford goes on to say that he tries to explain to prospective physicians the rural way of life for physicians. “They need to realize they  will be a big fish in a small pond; physicians are put on a pedestal in this community and they will soon find out how friendly people are and accepting. The community really wants our hospital to be number one.” Ford adds that physicians have the opportunity for unlimited career growth, because unlike at a big city hospital, a physician won’t be relegated to a strict specialty. “Here you aren’t limited, you can build a reputation here.”

“We just don’t take warm bodies, we look for the right people for the right fit,” adds Ford. Management positions are given particular care in selection. Colleagues from various departments are able to weigh in on hiring decisions. In hiring staff, Ford says that the hospital is looking for people that fit into the mold of the team culture. “Now we have a waiting list for nurses because of word-of-mouth; people talk about how good it is to work here and that makes others want to join.” A recent pay raise has probably helped the hospital’s reputation too. “We try to celebrate our successes through an employee recognition program and we do a lot of little things to keep them pumped up, like sending out thank you cards with gift certificates to acknowledge good work.”

Culture of Care

Muhlenberg Hospital is all about teamwork. Ford says that there are no “employees” at the organization, just colleagues. He says everyone works together to help build on the hospital’s success. “There’s nobody here that will say, “That’s not my job. Everyone expects good outcomes from the volunteers all the way up to the top management. Our goal is to treat patients very well. When I first came here, patients told me they felt like they were inconveniencing the staff when they had a need or concern. We needed to change that- our focus is all on our patient. We always make sure patients have a good quality outcome and are satisfied”

Our hosp might be small, but our people believe in the organization. We know we are number one in providing care to our community.” Ford has even personally challenged residents to come back. “I tell them to come back and if they want to they can tell me about their experience and I give them my card with my phone number. I want them to know that they are going to get the best care in the whole state of Kentucky.”

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