Litzenberg Memorial County Hospital: Tad M. Hunt, Chief Executive Officer

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Apart from a few urban centers, most of Nebraska is rural. For critical-access hospitals like Litzenberg Memorial County Hospital in Central City, Neb., this presents the challenge of maintaining interdependence while cultivating affiliations with tertiary hospitals in more populated regions.

Tad M. Hunt, chief executive officer, has focused on building these bridges with tertiary hospitals during his first year as Litzenberg’s CEO, and he feels that the organization is forming strong bonds with other healthcare entities, as well as the surrounding community.

He also cites positive benchmarks from his first year, such as the strides Litzenberg has made in operational and financial performance, the improvement of physician and medical staff relationships, and increased employee engagement.

A focus on services

Hunt has placed a high priority on expansion of services during his first year as CEO. Currently, Litzenberg is expanding its outpatient and imaging services.

Outpatient is important, Hunt said, since more than 60 percent of the organization’s business comes from those services. Therefore, he is looking to expand the operating room so Litzenberg can perform more outpatient surgical procedures, along with stronger trauma ER, laboratory, and therapy services.

Hunt is also determined to outsource fewer of the hospital’s imaging services.

“We have been very dependent on mobile services to provide a lot of imaging services,” he said.

In October of this year, Litzenberg brought in-house general ultrasound and digital mammography for five days each week. Additionally, the hospital has been awarded a mammography grant that has enabled it to go digital.

Just recently, Litzenberg was awarded another grant to incorporate e-pharmacy into its care provision, something that will allow the hospital to upgrade its Pyxis systems, thus supplementing pharmacy services.

Hunt is also looking to shore up vendor relationships.

“I think that with healthcare reform and also with accountable care organizations, it’s very important that we have a strong affiliation with our vendors, either through a tertiary-hospital relationship and working with that or through just some type of a GPO relationship,” he said.

A focus on facilities

As Hunt looks at the big picture, his goal is to build a replacement hospital for Litzenberg’s current facilities. The hospital is in the process of negotiating for some land as part of the project’s Phase One.

So far, Hunt said, they’re very pleased with how the negotiations are going, even if they’re unsure of some key details, such as how much larger the new facility should be. Hunt doesn’t see a need to increase the bed count so much as the looming necessity of offering more outpatient services and adding a new rural health clinic.

One of the models they’re examining is the medical campus model. This would add a dental office, an independent physician practice, and other ancillary healthcare services to the hospital. Should they go down this route, Hunt hopes to find partners who would want to build their operations in conjunction with Litzenberg and its values.

When the hospital does acquire land and starts selecting architects and contractors, Hunt is looking to apply evidence-based design to the facilities.

As a new CEO, though, he is trying to take developments one step at a time, ensuring that he doesn’t forget such current issues as operational performance, lowering net ratios, and securing better financing.

A focus on quality

As participants in ACS NSQIP, HCAHPS, and CMS core measures, quality is a driver of the organization.

“Quality is our number-one agenda item at all board meetings,” Hunt said. “We’re also working on a balanced scorecard which is looking at quality initiatives and financial operations.”

Additionally, Hunt is trying to increase the culture awareness of his employees, along with better outcomes for patient care. Litzenberg participates in the Values Collaborative Program, a system that ties employee engagement into patient satisfaction.

Finally, Litzenberg is expanding its relationship with BryanLGH Health System in Lincoln, Neb., with whom it already has an articulation agreement for transfers, to do revenue-cycle assessment. In conjunction with BryanLGH, Litzenberg is looking to provide short-term and long-term care resolution for revenue cycles. Litzenberg has also hired a revenue-cycle director to bring together  billing and medical records.

A focus on community

How are small hospitals going to continue evolving and surviving in light of ACOs and healthcare reform? How can Litzenberg maintain its interdependence as a hospital without being completely independent of affiliations with other hospitals? How can it continue to evolve community involvement in healthcare matters, keeping everyone involved and informed of healthcare changes?

These are the questions Hunt asks himself and his board about the future. There is no doubt, he said, “community is very important.”

“The executive needs to be involved with the Chamber of Commerce, participating in the economic involvement of other imperative programs in the community in order for the hospital to be successful,” Hunt said.  “We need to show continual support of all community activities.”

Litzenberg offers a full range of health-education initiatives for the community, using medical-staff providers and allied health professionals to provide these services. Hunt himself holds monthly community-health forums to keep people informed of developments in healthcare and healthcare reform.

Perhaps the most pivotal lesson he has learned in his first year, Hunt said, is the importance of developing close relationships with tertiary hospitals.

“It’s important to create that feeling of interdependency so you don’t feel dependent or independent of any one organization, that you have the resources out there to be successful and meet the needs of rural communities across the country.”

-by Pete Fernbaugh

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