More Rising Compensation for Executives at Financially Challenged Hospitals, Justified by More Talking Points

In the spring, leaves turn green, and executive compensation turns greener.  The media has provided another set of stories about the inexorable rise of compensation for executives of non-profit hospitals, presented in order of the stories' appearance.

Westchester Medical Center

The Journal-News reported in April,

A Journal News analysis of salary data, obtained through a Freedom of Information request, revealed that 20 hospital administrators received increases in their total compensation for 2010, including one employee whose pay package jumped 18 percent.

Also,

The newspaper’s analysis of data for 2010, the latest year available, shows that 26 administrators at the medical center would have exceeded Gov. Andrew Cuomo’s limit of $199,000 a year for executive compensation. Cuomo signed an order, scheduled to take effect April 15, that restricts the amount of state money that nonprofit organizations can use toward salaries and benefits.

Overall, the medical center spent $11.8 million in compensation to 44 executives in 2010, during which three administrators resigned and three others had their titles downgraded to the director level. The executive payroll rose 11 percent between 2008 and 2010.

In particular,

Administrators who received increases in their total compensation included CEO Israel, who earned the top salary of $1.3 million in total compensation; the chief financial officer; an executive vice president and several senior vice presidents.

However, the fortunes of the top executives were rising at a time of financial trouble for the institution:

That same year, the medical center laid off 130 workers, instituted a hiring freeze and announced an $18 million budget cut for the following year.

'There is no shared sacrifice, there is no appearance of a shared sacrifice,' said Jayne Cammisa, a union representative and a registered nurse in the hospital’s transplant unit.

Those who defended the executives' compensation sounded familiar themes:

Hospital boards rely on compensation committees, outside consultants and market analysis and documentation to justify how much they pay administrators. The medical center uses an outside firm to analyze compensation packages, which are based on market values, [Senior Vice President for Communications Kara] Bennorth said.

The only way to keep the institution and be financially viable is you have to have top management,' [Chairman of the Board Mark] Tulis said.

Note that we briefly mentioned the CEO's compensation in this post.

Connecticut

In May, the Hartford Courant reported,

The health care system may be ailing, but newly compiled data show that compensation for top executives at Connecticut hospitals remains healthy.

Eighteen executives at the state's 30 hospitals made more than $1 million in 2009-10, according to information the hospitals reported to the Internal Revenue Service.

Some of the more notable examples included,

Hartford Hospital's outgoing chief executive officer, John J. Meehan, was the highest paid in Connecticut and one of the highest paid nationally. His compensation totaled $6.98 million – all but $1.1 million of it nontaxable and retirement benefits, according to the hospital.

Also,

In addition to Meehan, Connecticut's 10 highest paid administrators were two Yale-New Haven Health System executives, the departing CEOs at the Hospital of Central Connecticut and the Hospital of St. Raphael, the departing treasurer of Hartford Hospital, the treasurer of the Hospital of Central Connecticut and the presidents of Stamford, Yale-New Haven and St. Francis Hospital and Medical Center. All made more than $1.59 million in 'reportable' W-2 and 1099 miscellaneous compensation.

A few executives had significant 'non-reportable' compensation in addition to W-2 and 1099 pay. The outgoing president at William Backus Hospital in Norwich had $2.2 million in deferred compensation related to his retirement, for total pay of nearly $3 million, according to a C-HIT analysis of the data. The chief operating officer at the Hospital of Central Connecticut had $472,443 in reportable pay and $838,880 in other compensation, for a total of $1.3 million.

Again, there were complaints that executive compensation had nothing to do with the performance of the executives' organizations,

'I don't understand what the hospitals are getting for their money. Some of the highest paid are the worst performing,' said Ellen Andrews, executive director of the Connecticut Health Policy Project in New Haven. 'The system isn't working for anyone – for the state, for the hospitals or for consumers.'

Note, however, that the system is working for the top hired executives.

In response to these complaints, the Courant cited the usual defenses of executive pay:

Others say the compensation reflects the complexity of the health care business, keen national competition for good leaders, and the uncertain future that executives face when they sign on for top-level positions in an industry undergoing enormous change. Pay needs to be competitive to attract and retain key executives, they say – even for nonprofits that are struggling to find their place.

'Hospital executives are responsible for extremely complex organizations,' said Michele Sharp of the Connecticut Hospital Association. In addition to managing advanced medical services and technology, a skilled staff and extensive physical plants, hospital CEOs are often responsible for an array of services beyond the hospital, such as primary care clinics, home health organizations and surgery centers. They work in a highly regulated environment and must comply with demanding standards in areas that range from patient safety and financial performance to institutional stability and community health, Sharp said.

'When you bring in exceptional talent, you can manage effectively and efficiently,' said Vin Petrini, senior vice president for public affairs atYale-New Haven Hospital. 'It's a very complicated and complex industry. We need to be thoughtful about how we manage and retain and recruit talent.'

Wake Forest Baptist

The Winston-Salem Journal uncovered the compensation of several local executives,

A commitment Wake Forest Baptist Medical Center made to Dr. John McConnell, its chief executive, when he was recruited led to a nearly 50 percent increase in his total compensation for fiscal year 2010-11, the center reported Tuesday.

McConnell was paid almost $2.5 million in total compensation, compared with $1.68 million for fiscal 2009-10.

The total included essentials such $25,560 for moving expenses and $9,568 for country club dues.

Other executives did well too:

Donny Lambeth, former president of N.C. Baptist Hospital, had a 36 percent increase in total compensation to $1.16 million. Lambeth now serves as president of Davie County Hospital and Lexington Medical Center. His salary dropped 11 percent to $537,997, while his bonus and incentive compensation rose 165 percent to $186,261.

Dr. Thomas Sibert, president of Wake Forest Baptist Health and chief operating officer, received a 2 percent increase in total compensation to $995,133, including $545,517 in salary and $166,027 in bonus and incentive compensation. Sibert took over his role in September 2010.

Edward Chadwick, chief financial officer, received a 32 percent increase in total compensation to $974,587. His salary rose 71 percent to $503,663 in salary, while his bonus and incentive compensation fell 42 percent to $200,000.

Dr. William Applegate, retired president of Wake Forest University Health Sciences and dean of its medical school, was paid $743,541 in total compensation, down 25 percent. His salary dropped 3 percent to $518,231, while his bonus and incentive compensation fell from $378,900 to $99,900.

Doug Edgeton, former president of Piedmont Triad Research Park, received a 38 percent decrease in total compensation to $655,048. His salary fell 1 percent to $484,360, and his bonus and incentive compensation fell from $361,600 to $111,700.

However, a Winston-Salem Journal article in April noted that the same CEO, Mr McConnell would be aggressively cutting costs and possibly laying off employees:

Wake Forest Baptist Medical Center has told employees it is considering reducing its workforce as part of a major initiative aimed at improving patient outcomes at a lower cost.

The center confirmed Friday a memo sent April 2 by Dr. John McConnell, its chief executive, which addressed what the center is calling 'accelerated transformational initiatives.'

In particular,

In a separate statement, the center said it is looking at expense-reduction opportunities that include 'energy conservation, cost savings through supply chain management, revenue-cycle improvements, efficiencies such as reducing length of stay, reduction in discretionary spending, and managed employment through attrition, retirements, eliminating duplication and process redesign.'

"Managed employment" seems to be the latest circumlocution for layoffs.

The largess given to top executives at a time when lesser employees may be sacked was explained by trotting out the usual suspects,

Wake Forest Baptist said the center is a 'very complex organization that requires a special set of skills and experience to manage relationships with physicians and researchers, the university, its patients and community.'

I wonder if "complexity" comes from a set of talking points, since it gets aired so often in this context.

Note that we discussed compensation given to Wake Forest executives the year before, and its relationship, or lack thereof to the quality of their leadership here.

Summary

There they go again. We have the latest additions to what has become a long series of examples of executive exceptionalism in health care organizations. Top hired executives, be they of for-profit health care corporations, or non-profit organizations, tend to be paid very well, even when their organizations perform poorly or are financially threatened.

The same rationales are cited repeatedly to justify their treatment. Executives are said to have very difficult jobs, Competitive pay is necessary to hire the brilliant people required.  Left unsaid, however, is how difficult these managerial positions are in comparison to the demanding work and sometimes life or death responsibilities of health professionals, how brilliant executives are in comparison to such well trained professionals, and why the executives deserve competitive pay when other employees may be laid off. Perhaps the close ties of those making the arguments to the executives explains the questions they beg.

So it is time to say it again,....  Health care organizations need leaders that uphold the core values of health care, and focus on and are accountable for the mission, not on secondary responsibilities that conflict with these values and their mission, and not on self-enrichment. Leaders ought to be rewarded reasonably, but not lavishly, for doing what ultimately improves patient care, or when applicable, good education and good research. On the other hand, those who authorize, direct and implement bad behavior ought to suffer negative consequences sufficient to deter future bad behavior.


If we do not fix the severe problems affecting the leadership and governance of health care, and do not increase accountability, integrity and transparency of health care leadership and governance, we will be as much to blame as the leaders when the system collapses.

Maybe Caging the Animal might be more appropriate at times

I'm not sure the wisdom of making this post, but something I read yesterday on Nikoley's latest post on Jack Kruse just didn't sit right with me.  Were it not for the fact that Dick did his best to contribute to the angst of the past going-on two weeks, I probably would just let it slide.  He's just not the sort of blogger I have ever had much interest in.  I can't relate, and, frankly, he's so cryptic at times as to be exasperatingly annoying.  Really, it's almost as frustrating as having a discussion with Fred Hahn, and anyone who ever has ended up getting talked in circles (as opposed to getting talked circles around) by Fred knows what I mean.   

So any way, here was Dick's first post on Kruse.  You see, he had "inside information" having spoken to Kruse on the night of Jan. 9 when Kruse claims to have undertaken his now infamous epic biohack -- complete with elective surgery, MRSA, no local/post op pain management, and 120 lbs of ice.  Here is what Dick wrote then:

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HKHC Buffalo gets ready for June Green Code meetings

The City of Buffalo has announced another round of Green Code meetings for the community.  The meetings will take place from June 4th through June 9th, with nine locations around the City.

For these meetings - there will be Youth and Family Sessions!  HKHC Buffalo will be at most meetings to help kids and parents provide input into the process in a family friendly setting.

More information to come next week.  For now, see the table below or visit the Green Code website for the dates and locations of the meetings.  We will update with the Youth and Family Sessions next week.

Community	Date	Time	Location	Address
West	Mon, 6/4	6-8:30 pm	Lafayette HS	370 Lafayette Ave.
Northwest	Tue, 6/5	6-8:30 pm	Riverside HS	51 Ontario St
South	Tue, 6/5	6-8:30 pm	South Park HS	150 Southside Pkwy.
Ellicott	Wed, 6/6	6-8:30 pm	Montessori School #32	342 Clinton St.
Northeast	Wed, 6/6	6-8:30 pm	Bennett HS	2885 Main St.
North	Thurs, 6/7	6-8:30 pm	North Park Academy	780 Parkside Ave.
Central Morning	Fri, 6/8	8-10:30 am	Central Library	1 Lafayette Square
Central Afternoon	Fri, 6/8	Noon-2:30pm	Central Library	1 Lafayette Square
E. Delavan-Masten	Sat, 6/9	9-11:30am	East HS	820 Northampton St.
East	Sat, 6/9	1-3:30pm	Matt Urban Center	1081 Broadway Pkwy.

3rd AL brief takes a look at policy

All over the world, communities are looking to make their communities safer and more livable - some strategies include making the community more friendly to active living.  Here in Buffalo, the HKHC Buffalo partnership looked to other communities to find the most innovative and exciting practices that we could share so youth and families could easily and safely walk and bike.

The 3rd active living brief, Transforming Active Living Policy into Practice: Municipal Best Practices, details these findings.  The brief explores public safety strategies, design strategies, financing strategies, as well as inter-agency agreements.

Our hope is to learn from these other communities, and translate their ideas into policy and action here in Buffalo.  Please find the brief here.

2nd AL brief takes a look at our City neighborhoods

The second Active Living brief from HKHC Buffalo explores how our neighborhoods - in terms of the form and quality - influence physical activity among youth.  This report looks at the strengths and weaknesses of our neighborhoods - also known as the built environment - in relation to youth physical activity.

This brief explores some of the realities of our city - where is the open space, where are people and houses located, and what types of destinations exist.  We look at what the sidewalks, bicycle networks and tree canopy - also called physical infrastructure - look like across the city.

The brief also includes an audit of two neighborhoods conducted by high school students from across the City.  The brief details their perceptions and ideas about the ability to be active in those neighborhoods.

Finally, there are recommendations for changes within our neighborhood that should make it easier for youth and families to be active in Buffalo.  Enjoy!

Read the brief, Do Kids Want to Play in the Queen City? Buffalo's Built Environment and its Impact on Youth Physical Activity here.

Active Living Policy Briefs Released

HKHC Buffalo is happy to announce the release of the second round of policy briefs around children's health in the City of Buffalo.  The first brief, Children's Health: A Growing Need to Incorporate Physical Activity into the Daily Lives of Youth, focuses on current conditions in Buffalo.  The brief outlines current demographic trends, current activity levels and how our city neighborhoods impacts our ability to be physically active.

This brief, like all the others, was prepared for the HKHC Buffalo partnership by the University at Buffalo's Food System Planning and Healthy Communities Lab.

To read the entire report, please download it here.

More on the latest LC/LF Diet Comparison Study, and Why LF & CRD's "fail"?

I thought of just updating the last post, but this is long enough on its own to warrant a Part II of sorts.  If you haven't read it yet, may I suggest:  LC v. LF Diet Comparison Study Shows Calories Determine Weight Loss.  What distinguished this study from many other comparison studies, was that there was an attempt at keeping calories constant between the diets.  Usually LC is ad libitum, which, especially the first time one follows a low carb diet, tends to substantially spontaneously reduce caloric intake more than what is generally prescribed for a "responsible" calorie restricted diet (CRD).  This was also a longer term study and also compared two different fixed prescribed diets rather than the usual Atkins-style induction/progression formula.  Presuming compliance, then, the study controlled for calories and sought to look at the effects of just the macronutrient composition of the diet.  

In my opinion, the rather negligible differences for both groups after a year and continuing through two years show that neither dietary intervention was particularly effective, resulting in under 10 lbs weight loss and only transient improvements in HbA1c as measured by one method only.   So why was that?  Well, the prescribed caloric intake was fixed at 1600 cal/day for women and 1800 cal/day for the men.  Right there this part of the study design pretty much doomed it to failure.  While men generally have higher caloric needs than women, total daily energy expenditure varies so widely between individuals that clearly some women have higher needs than some men, and some men and women have higher needs than others of their gender.

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hey ya'll....i would love to do a cool post but i am running around like crazy trying to get things ready for taylor's 5 yr old b'day party....why do i stress myself out by having it at the house??!!  have a stress-free weekend :)

Cara Masuk Ke Safe Mode Windows

Limit Komputer - Safe Mode sering di gunakan ketika kita mempunyai masalah dengan sistem operasai Seperti saat : Membasmi virus (Agar lebih ampuh), Uninstall Program (Sebagian program yang hanya bisa di uninstall saat Windows safe mode), Mereset password user, ataupun menjalankan System Recovery.

Berikut caranya agar Windows masuk ke safe mode :

1. Klik Start --> All Program --> Accessories --> Run atau bisa langsung Klik Run

2. Ketik msconfig dan tekan Enter

3. Kalau sudah masuk di System Configuration, Klik Boot

4. Lalu Centang Safe Boot, Seperti gambar di bawah ini :

5. Dan Klik Ok, Maka Komputer anda masuk ke Safe Mode Windows.

Nah jangan lupa untuk di kembalikan ke Booting Normal (Windows Normal), dengan cara menghilangkan Centang tadi (Hilangkan Centang di Safe Boot yang kalian tadi Centang), agar komputer tidak berjalan di safe mode terus menerus.

Salam Limit Komputer

Misteri Harta Karun Peninggalan Bung Karno

     Harta karun peninggalan mantan presiden Soekarno selama ini masih misteri, bahkan tak sedikit yang meragukannya. Kasus kegagalan pencarian harta peniggalan Prabu Siliwangi di Istana Batutulis beberapa waktu lalu, sepertinya memupus harapan orang untuk memercayai hal-hal yang sulit dibuktikan kebenarannya.

     Namun lelaki yang menyebut diri satria piningit bernama Soenuso Goroyo Soekarno mengaku dapat mengangkat peninggalan Presiden Pertama RI itu. Bentuknya berupa ratusan keping emas lantakan, platinum, sertifikat deposito obligasi garansi, dan lain-lain. ”Ini baru sampel dan silakan mengecek kebenarannya. Jika bohong, saya siap digantung,” katanya, Jumat kemarin, kepada pers.

     Mantan anggota TNI yang dahulu bernama Suwito itu sengaja mengundang wartawan di rumahnya, Perumahan Cileungsi Hijau, daerah perbatasan Bogor-Bekasi, untuk menyaksikan temuannya. Di rumahnya yang cukup megah disiapkan hidangan layaknya orang hajatan. Maklum, Goroyo, begitu dia biasa disapa, juga mengundang Pangdam Jaya, Kapolda, dan anggota Muspida. Tetapi dari mereka, tak ada pejabat datang.

     Kepada tamunya, suami RA Lastika ini memperlihatkan peti besar berisi ratusan keping emas lantakan, masing-masing beratnya 8 ons bergambar Soekarno dan di baliknya ada gambar padi dan kapas. Pada satu sisinya ada tulisan 80 24K 9999. Sementara itu emas putih (platinum) juga berbentuk lantakan berlogo tapal kuda putih bertulisan JM Mathey London. Logam itu dibungkus emas dan bersertifikat emas pula.

     Meskipun bersertifikat dan diyakini keasliannya, pada kesempatan itu tidak dihadirkan orang yang mengetahui emas atau pakar yang bisa memastikan asli atau tidak harta benda tersebut.

     Peninggalan lain berupa sertifikat deposito bertanggal 16 Agustus 1945 yang dikeluarkan oleh BPUPKI yang menyebut sejumlah harta yang disimpan di suatu tempat. Ada pula sertifikat berbahasa Inggris yang juga disegel dan ditulis di atas lembar kuningan. Sertifikat itu ada yang bertuliskan ”Hibah Substitusi” yang dipercayakan kepada R Edi Tirwata Dinata (108).

    Yang terakhir ini, konon karena sudah tua, lantas memberikan kuasa kepada R Anton Hartono untuk mengurus harta benda yang disimpan di Swiss. Bentuknya mikrofilm, dua lembar dokumen, anak kunci boks deposit di JBS, Jenewa, dan dua buah koin. Di dalam sertifikat itu disebutkan, ada dana berjumlah 126,2 miliar dolar AS dan 63,10 miliar dolar AS.

     ”Insya Allah, jika saya diberi izin, semua harta peninggalan Bung Karno ini bisa membayar utang kita. Saya yakin bisa melaksanakannya,” ungkap Goroyo sembari membantah dirinya paranormal. Dia juga membantah berambisi menjadi presiden atau jabatan politis lain. ”Semua saya lakukan dan beberkan untuk membangun negara kita,” tegasnya. 


Sumber : http://kabarnet.wordpress.com