Q&A with Mark Nosacka, CEO of Good Samaritan Medical Center
by Boardroom Brief on November 19, 2010
1. You are CEO of Good Samaritan Medical Center, Palm Beach County’s first permanent hospital, which opened in 1920 with 35 beds. At that time, many considered the waterfront location “too far out in the swamps”. Today, Good Samaritan Medical Center is a 333-bed acute care facility where you treat thousands of patients every day with a staff of 400 physicians and 750 employees. Appointed CEO in 2008, will you share your personal approach in creating and facilitating a culture of people dedicated to the healthcare profession and to the community?
Everything we do here is centered on how we do one thing very well and that’s take care of patients. When I first got to Good Samaritan, there was more of a threatening and retaliatory culture from a management standpoint and employees felt disconnected. In our effort to increase management visibility and build trust and communication, we spend a lot of time outside of our office, talking to people where they work and in the clinical departments where they’re doing their jobs. As a result, today, within Tenet’s 50 hospitals, we’re on the higher end for employee and physician satisfaction. Culturally, people feel happier here, and we couldn’t have said that before.
2. As Good Samaritan Medical Center has expanded its services to meet the needs of the growing population, can you discuss the range of specialty health and medical programs offered today?
One of our primary business strategies focuses on answering the question, “At 3 a.m., what do the people in our community need from Good Samaritan?” Because you never know when a medical crisis will hit, people needed to know they can trust their community ER to provide state-of-the-art care, 24 hours a day, 7 days a week. Today, advancements in medical science and technology have enabled us to provide life saving medical treatments which previously were only available in a large academic setting. This initiative led us to improving service in our emergency room across all specialties including becoming a certified stroke and angioplasty center so we can provide advanced stroke care and treat heart attacks at any hour of the day. I also want to reinforce Good Samaritan’s long tradition of delivering babies. Prior to my arrival, that service had eroded but we have since placed a new emphasis on having a strong women’s health service. We reinvested capital dollars in the fiscal plan and recruited additional obstetricians and now, more and more women are choosing to deliver their babies at Good Samaritan. Another area we focused on expanding is the array of oncologic and surgical specialties we offer. People really trust coming to Good Samaritan to have their surgeries so we added high-tech robotic surgery such as the Davinci robot and our latest acquisition, the Mako orthopedic robot which is used specifically for minimally invasive robotic surgery of the knees and other joints.
3. Good Samaritan Hospital is owned by Tenet Healthcare Corporation, the 2nd largest investor-owned healthcare delivery system company in the United States. Today, the company consists of 49 hospitals in 11 states and 63 outpatient centers in 12 states. You are obviously operating at the center of the country’s raging debate over healthcare. Can you discuss how Tenet’s operating strategy has positioned Good Samaritan Medical Center to perform well in a post-healthcare reform environment? When you look down the road 5 or 10 years, what are the leading uncertainties you see as a result of healthcare reform and what are the main opportunities?
Our focus at Good Samaritan has been primarily upon offering thriving, quality services and quality outcomes at the highest level. So as we look to the services we provide, we are constantly measuring and refocusing our efforts to ensure we’re achieving some of the highest quality metrics in the industry as a company. We also recognize with rising healthcare costs, the expansion of high deductible insurance plans and the economic downturn that we need to provide mechanisms whereby people can afford health care. We’re actively driving down cost of care in our own facility. In terms of the future, the entire industry is waiting to learn what healthcare will look like as a result of President Obama’s healthcare reform legislation. It is possible that healthcare and hospital management may look similar to what happened to the airline industry. As kids, when we took a flight, we got hot meals, wings and extras. Now we live in a world of discount carriers where the consumer has to pay more for the extras. It’s possible this is what we can expect from healthcare in a post-healthcare reform world.
4. Good Samaritan Medical Center has adopted Tenet’s Compact with Uninsured Patients Policy. Can you discuss how this policy addresses the needs of the growing number of uninsured patients in the South Florida area?
There are many complex issues facing the uninsured and Tenet became the first major hospital network to offer solutions to the patients without insurance. Basically, our Compact with Uninsured Patients policy applies to all patients without health insurance, with exception to those that fall under the exclusions, including out of country patients and elective procedures which are not usually covered by a health insurance company, such as cosmetic surgery. A compact rate is applied to the account of the uninsured if they are receiving urgent care or emergency visits. At Good Samaritan, we have and will continue to provide life saving and emergent care to people who come from the greater Palm Beach area.
5. As the CEO of Good Samaritan Medical Center, you work with the skilled, experienced leaders on the hospital’s administration team to help guide the hospital in serving patients and progressing toward more advanced care. Can you discuss your commitment to quality, C2Q, and how this evaluation process helps promote better health practices, better quality medical care and improves patient safety? What are the specific accolades and designations Good Samaritan Medical has received as a result of C2Q?
C2Q represents a laundry list of publicly reportable data and other hospital initiatives we monitor constantly which is tracked both internally at Good Samaritan and within the company as a whole. This evaluation process, which is localized based on the company culture and unique needs at Good Samaritan, allows us to routinely examine all the data from our quality control metrics to ensure compliance, identify opportunities and promote better practices to improve the outcome for the patient.
As a result of C2Q and other initiatives, Good Samaritan has been the recipient of many awards and designations including Cinga’s 3 Star quality designation for Heart Failure, Heart Attack and Spinal Fusion; the American Heart Association’s Get with the Guidelines Awards: Silver Level for Stroke, Gold Level Coronary Artery Disease, Gold Level for Heart Failure; and Certified Primary Stroke Center by the State of Florida Agency for Healthcare Administration.
6. Many South Floridians live from June through November in fear of a threat of another major hurricane. In August of 2005, Hurricane Katrina threatened six Tenet hospitals and one hospital, Memorial, was severed from all services. Within 24 hours, Tenet safely evacuated 2,000 people. Can you discuss Tenet’s Disaster Preparedness Task Force and the key elements of Good Samaritan’s disaster protection program?
Tenet has learned much from its experiences with hurricanes Gene, Francis and Katrina. As a result, we have re-engineered our hurricane preparedness throughout Tenet and within Good Samaritan. The current disaster preparedness structure involves a national command center for all of Tenet’s hospitals which is based in Dallas. In the instance one of Tenet’s hospitals anywhere in the country is threatened by any kind of a disaster, natural or man-made, the national command center goes on alert and investigates the risk. Here at Good Samaritan, we have our own internal disaster preparedness plan where if the threat to us becomes imminent, the national command center takes over any evacuation plan for the hospital. Once that decision to evacuate is made, Tenet has in place a number of relief services that are contracted and waiting for the call including mobile generators, fuel, evacuation vehicles, etc. It’s complex system costing significant revenue but is essential in ensuring the safety of our patients and those who take care of our patients.