Situation

The Brooklyn Hospital Center (“TBHC”) in Brooklyn, New York is a not-for-profit safety net healthcare organization with approximately $400 million net revenue that operates  a full service teaching hospital with 501 certified acute-care beds, 17 outpatient sites, dialysis center, comprehensive dental care and a home healthcare agency.  TBHC entered Chapter 11 bankruptcy protection in 2006 after a 2005 operating loss of $30 million and was failing in every aspect of healthcare delivery including poor clinical quality, aging and exiting medical staff, under performing revenue cycle, poor reputation and community relations, low staff morale and high turnover, obsolete under capitalized infrastructure and poor management of risk and medical malpractice expense.  The post-graduate physician training programs (250 primary and specialty care residents and fellows) were on academic probation as was the entire institution.

Dr. Richard Becker was hired as President and CEO of TBHC in June, 2008, to design and implement a full turnaround.

Summary of Execution and Results

• Developed and implemented comprehensive strategic plan to establish TBHC as a destination community teaching hospital that provides high quality, accessible healthcare services.
• Improved hospital financial status dramatically from Chapter 11 bankruptcy in 2007 to an annual EBIDA margin of 5% – 6% (greater than NYC average) for 7 consecutive years and improved net assets > 100% from $60 million (2008) to $125 million (2015).
• Implemented new quality system that moved performance to top tier in CMS Core Measures, National Patient Safety Standards and other clinical quality metrics. Joint Commission Top Hospital recognition from 2012—2015.
• Improved labor management efficiency and cost reduction with FTE/Adjusted Occupied Bed decreasing from to 5.5 from 4.0; Supply chain and materials management cost reduction and process improvement; General improvement in all operational metrics throughout system.
• Improved employee satisfaction from 3rd percentile to 50th percentile with multiple programs to address important employee issues from compensation to work environment.
• Recruited voluntary and employed physicians in primary care and specialties to double the medical staff from 400 physicians to over 800 physicians and grow multiple clinical programs.
• Designed and implemented employed physician compensation model to retain 95% of full time physicians and improve physician productivity and salary from < 25th up to 50th—75th percentile.
• Redeveloped and expanded outpatient sites, improvement of staff, quality and services with growth (CAGR) of outpatient visits in excess of 10% per year.
• Negotiated new, successful clinical and academic affiliation and integration with Mount Sinai Health System.
• Achieved full ACGME academic accreditation for institution and all GME training programs (250 residents/fellows in all major clinical areas).
• Developed and executed, including complete rebuild of IT core, implementation of new EHR throughout inpatient and outpatient settings; achieved all meaningful use requirements.
• Created first Joint Venture in New York between a hospital and private investors to develop outpatient services in Brooklyn resulting in creation of ModernMD Urgent Care sites throughout Brooklyn.
• Improved with local businesses, community organizations and elected officials with creation of community/hospital working group.