James Kiser was recently the featured speaker at the Forum at Heidi’s Brooklyn Deli, telling the crowd about his background, and his plans as Montrose Memorial Hospital’s new Chief Executive Officer.
Kiser was hired on June 1. Previously, he had been the CEO of Providence St. Joseph Medical Center in Pulson, Montana. He has more than 25 years of experience as a health care executive, including time at a hospital in Olympia, Wash.
He has some ideas about how to increase medical services and financial security at MMH. Kiser told the hospital board during his job interview that he would like to see MMH acquire the ability to do more spinal surgeries. “And,” he said, “I saw we needed to shore up our operating room staff.”
From Kiser’s vantage point, he sees a national shortage of physicians. “There is a national shortage of health care professional staff, particularly in operating rooms,” he pointed out. “Surgery, like it or not, is the economic engine of the hospital.
“Most services lose money in a hospital,” he explained. “I know that when you see exorbitant bills you can’t believe it; I had a lab bill personally for a blood draw that was over $700, and I had ‘sticker-shock’. I thought ‘No wonder people complain about this!”
But, in Kiser’s words, “It’s costly to provide.” Some hospital services that are critical to the community, e.g. delivering babies and emergency room help, are inadequately reimbursed. “Some services still reimburse well,” he said,” for example, spinal surgeries.” Kiser says that even orthopedic departments can lose money unless they are well-managed and get good deals on prosthetic devices.
Then, too, there are the regular costs that any building or business has to deal with. “At a hospital that I was at 15 years ago, our utility bills were $750,000 a year. That wasn’t even directly related to health care, just keeping the lights on.”
Kiser also told the audience that hospitals have to deal with the phenomenon of traveling surgical staff. This, he said, is related to the shortage of surgeons and surgical nurses. “They’ve chosen to become traveling staff because they’re paid more.” The traveling nurses are booked through an agency. “Our cost for a traveling nurse, through an agency, was $87 an hour.” Montrose Memorial RN’s normally make an average of $40 an hour. “$44 an hour is our maximum pay grade for an experienced surgical nurse. So, we said ‘Why don’t we pay them what a traveling agency is paying them, get the good ones to stay here, and recruit and retain staff as opposed to seeing them move on?’. And we made that change, and now we’re attracting and retaining talent.”
Kiser said that this can also help the hospital financially by reducing the wait-time for elective surgeries; many patients have chosen to have those surgeries done in Grand Junction, or other places, because there has been a waiting period of up to six weeks at Montrose Memorial.
In the new CEO’s opinion, advanced planning is very important to the hospital’s success. “We can’t be looking five years down the road; we have to be looking 30 years down the road.”
Kiser revealed that MMH is gathering information and opinions from its medical staff, other employees, patients, and the community. Results of the survey will be given to the hospital board in September to help it decide what needs to change, and what should remain the same.