David Freed knows more about “hospital-ity” than many in his field. Nyack Hospital’s president and CEO’s original career path was on track in hotel administration – working in food service and hospitality – when he switched gears and began studying hospital administration.
“The hospitality industry and hospitals have more in common than people realize – both are striving to accommodate their guests – in our case, patients – while keeping food, linens, room service and professionalism at the forefront of their stay with us. Our goal is to provide great service, good patient outcomes and be consumer friendly so when someone need health care they will come back to us.”
Freed said he does not view other hospitals as competitors, but rather wants people to choose Nyack Hospital because they liked the experience they had when they stayed there or visited for a procedure in the past.
“I also see us as part of the fabric of the community here in southern Rockland and for Bergen County, New Jersey … not just another hospital.”
Freed, joined in this interview by William Trust, chairman of the hospital’s board of trustees, have worked together in their respective positions for the past decade.
Nyack started an affiliation with New York-Presbyterian Hospital in the 1990s. “By 2004, it became a much tighter bond,” Freed said. “We are a sponsored hospital of its health care system. That allows us to reach out to its resources, as well as those of Columbia University’s College of Physicians and Surgeons and the Weill Cornell Medical College. This gives our community hospital the ability to tap into services and procedures not necessarily available in the immediate area.”
Rockland County Executive C. Scott Vanderhoef has said he’s considering asking the county’s Legislature to slash certain nonmandated programs, particularly for uninsured women and children. Those programs are available at Nyack Hospital and both Freed and Trust agree they need to remain available.
“Our responsibility is to be the voice of this community,” Trust said.
“Management may be paid, but they are responsible to the board. When economic stress hits at the county level, we work with the administration to rationalize how we can continue services needed locally.”
Rockland’s shortfall is not the hospital’s only source of consternation. Like its counterparts, cuts in Medicare and Medicaid reimbursements continue to keep the hospital on a delicate balancing act in keeping services on par with its mission while performing them in the most efficient and cost-effective means possible.
“We’ve not yet been affected by the (Patient Protection and Affordable Care Act),” said Freed, “but we do expected to be impacted by what’s coming. The major change will be to become physically ready for the implementation of a hospital-wide electronic health system, which we expect to have fully in place by January 2012.”
Trust said the board understands and agrees that although economic times are more than stressful, the need to have $14 million available for the info-tech system was not up for debate. “Electronic health records will complement our MRI, CT scans and other imaging services, which are all digitized. Health care records will be seamless for anyone who is a resident of Rockland County and who use a county physician.”
Like other EHRs, Nyack’s system will be able to communicate with others. “They must be interoperative,” said Freed, “because they are all built on a common technical platform. Eventually, we’ll see county and state records become part of national records. Even if it were a mandate of the patient care act, it just makes sense for our nation’s population.”
Dealing with constant reductions in reimbursements is nothing new for the hospital. “They’ve been reduced constantly over the past four to five years,” Freed said. “We’ve stayed marginally in the black – but that is just for the short term. In the future, we are going to reach a point where policy decisions will have to be made … we are already reaching it.”
Freed and Trust agree New York has been more than generous than other states when it comes to the services offered by Medicaid.
Since Medicaid is a joint federal and state program, said Freed, “The government is going to have a say in what will be reimbursed. But I do believe in many instances we are not going to be challenged on ending some of the services other states are not providing.” Trust agreed. “I don’t see much push-back on the peripherals.” And those “peripherals add up to many millions of dollars under closer examination.”
Both concur today’s hospitals are expensive and costly – and will only become more so as technology advances. Collaboration, reduction in duplicating services while maintaining quality will be the goal. “We’ll find ways to deliver the same care with a bigger smile, more effectively and at less cost. It’s a way of life for hospital administration – and a never ending challenge we’re committed to keeping up with.”