About The Study

Industry: Healthcare

Services:
  • Management Services
    • Crisis
    • Interim
    • Operations
    • Strategic
    • Transformation

Situation

Brookdale University Hospital and Medical Center (“Brookdale”) is a not-for-profit health system in Brooklyn, NY, that includes an acute care teaching hospital, level 1 trauma system, ambulatory care, long-term care and senior living.  Brookdale, a critical part of Brooklyn’s healthcare delivery system, is located in one of New York City’s most underserved communities with approximately 90% of patients on Medicaid or Medicare. The hospital had increasing operating losses driven by declining revenues, operating inefficiencies and large medical malpractice claims. Brookdale was in default on its FHA loans and relations with the hospital’s parent company were significantly stressed.  Poor leadership and mismanagement led to low physician and staff morale, neglected facilities, poor clinical quality and total disenfranchisement from the community. ToneyKorf was engaged in April 2012 to provide management, including Chief Executive Officer, Chief Financial Officer, and Chief Operating Officer, and management roles within the system.

Summary of Execution and Results

  • Strategic Plan Design
    • Facilitated the separation of the hospital system from a dysfunctional parent organization.
    • Collaborated with Northwell Health, to develop a feasibility study, “The Brooklyn Study: Reshaping the Future of Healthcare,” that included initial recommendations for providing comprehensive, sustainable healthcare to residents of central and northeast Brooklyn.
    • Led planning and initial development of a new, clinically integrated healthcare system in Central and East Brooklyn, serving more than one million people, that transforms an obsolete and redundant hospital-centric system into a new comprehensive, efficient and accessible healthcare delivery system named One Brooklyn Health (“OBH”).  The OBH System plan will create a new and advanced distributed ambulatory network that optimizes resources and greatly improves access to care and outcomes.
  • Financial Performance Improvement
    • Took control of the cash operations and implemented an aggressive cash improvement plan.
    • Sold non-core assets to fund operations including health services plan and the underutilized home health care agency.
    • Settled approximately $21 million in various liabilities with numerous parties that had put the Board and Management at risk as well resulted in liens on property.  These parties include the IRS, utility companies, medical and surgical suppliers, professionals, food service vendors and other government agencies.
    • Negotiated a $47 million settlement with 1199 National Benefit Fund which improved the balance sheet and reinstated employees in fund.
    • Implemented a coding project to identify lost revenue opportunities.
    • Achieved $93 million reduction in med-mal reserves from clinical risk management.
    • Negotiated and managed various City and State capital grants ($28 million) to enable replacement of significant medical equipment and the construction of an Urgent Care Center.
    • Awarded the highest NYS Value Based Payment Quality Improvement Program Award ($140 million per year) following a successful application and achieving defined targeted metrics. This reduced net loss from operations by 93% to a nearly breakeven level.
    • Secured capital grant to effect three hospital merger for creation of OBH.
  • Clinical Quality Improvements
    • Recruited key clinical leadership positions.
    • Improved clinical documentation resulting in increased Case Mix Index and reduced denials.
    • Improved patient revenue by $22 million (7%) despite reduction of inpatient volume by 3,000 discharges (17%).
    • Reviewed all clinical departments to drive revenue enhancement and expense reduction initiatives.
    • Initiated Patient Safety program which reduced future medical malpractice claims.
    • Expanded program to include Emergency Medicine residency.
    • Implemented reviews and protocols that are current and standard practices.
    • Addressed deficiencies identified by CMS upon our arrival, which could have resulted in loss of reimbursement for Medicare patients.
  • Employee and Medical Staff
    • Developed a system of open communication and culture of responsibility among employees, medical staff, and leadership to support the mission of the revitalized Brookdale.
    • Reduced the use of premium labor including overtime and nurse agency.
    • Created Brookdale’s own physician and faculty practice group.
    • Improved the level of communication, treatment and attention to Brookdale’s over 220 medical interns, residents and students.
  • Information Technology
    • Transitioned from the former parent company’s IT systems which were obsolete and high risk to a new platform using up to date and industry compliant technology.
    • Implemented EPIC, the state of the art Electronic Health Records systems. A typical implementation requires 18–24 months and Brookdale’s implementation was completed in 9 months without major disruptions to the organization.
  • Expanded primary care access and specialty services in an underserved community
    • Constructed a new Urgent Care Center with approximately 20,000 annual visits.
    • Achieved American College of Surgeons Level II Trauma Accreditation.
    • Expanded orthopedics and oncology including the installation of a new linear accelerator.
    • Developed a neuro-interventional stroke program.
    • Strengthened primary care sites with renovated facilities, additional sessions and specialty services.
  • Facilities
    • Completed large capital projects including facilities renovations and ambulatory care site expansions.
    • Developed a complete plan to make Brookdale self-reliant for electricity and a reduction for total utility costs by way of a Comprehensive Cooling, Heating and Power Plant.
TKP is unique among consultants: excellent personal service and very invested in the client. They do not consider themselves consultants, but rather part of the entity with which they are working.
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