- Brookdale Hospital and Medical Center (“Brookdale”) is a not-for-profit medical services provider that is a critical part of Brooklyn’s healthcare delivery system. Brookdale is a full-service teaching hospital including inpatient care, ambulatory care, long-term care, senior living, and emergency medicine
- Brookdale is located in one of New York City’s most underserved communities and approximately 87% of patients are on Medicaid or Medicare
- The hospital was experiencing increasing operating losses driven by declining revenues, operating inefficiencies and large medical malpractice claims
- Operating losses were being funded by deferring medical malpractice premium payments to its insurance captive
- The hospital was in default on its FHA loans and relations with the hospital’s parent company were significantly stressed
- The medical staff and employee group were demoralized by the lack of management and leadership. The facilities were dark, dirty and had suffered from years of neglect. Much of the equipment was broken and non-functional. The news that the community had heard for years was nothing but negative. Brookdale had become completely disenfranchised from the community that it was supposed to be serving
Execution and Results
- Engaged in April 2012 to serve as crisis management, including Chief Executive Officer, Chief Financial Officer and Chief Operating Officer, plus other management roles in operations and finance
- Facilitated the separation of the hospital system from a dysfunctional parent organization
- Developed a system of open communication and culture of responsibility amongst employees, medical staff, and leadership to support the mission of the revitalized Brookdale
- Obtained consensus amongst various stakeholder on settling liabilities in a practical manner to allow for operations to continue
- Worked with the state of New York on strategic alternatives and options for the continued delivery of healthcare to its critically underserved community, as well as improving the facilities despite having extremely limited capital to invest in improving its operations
- Implemented a Clinical Documentation Improvement Project to increase Case Mix Index and reduce denials
- Significantly reduced the use of premium labor including overtime and nurse agency
- Undertook a review of all clinical departments to drive revenue enhancement and expense reduction initiatives
- Developed relations with area nursing homes and worked with FDNY to put additional EMS units on the street to increase admissions
- Implemented a coding review project to identify lost revenue opportunities
- Undertook a comprehensive review of the hospital’s Medical Enterprise/Faculty Practice Plan to identify underperforming physicians, and
- Implemented a Patient Safety Initiative to reduce future medical malpractice claims
- $30 million of revenue enhancing/expense reduction initiatives were identified
- Cash from operations improved dramatically and an operating performance of 20% ahead of budget was achieved
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