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At the County Fair this week, an important person came by my booth an asked a very important question: Why do I think Hazel Hawkins Hospital could be self-sustaining so that we would not have to turn it over to American Advanced Management Group (“AAMG”).

I do not like the idea of a private company that is not primarily in the business of operating hospitals like HHH taking over not only the operation, but owning the assets that we continue to pay for via taxes and bond measures that increases rents and home prices. If AAMG is successful, it will be to make that private company’s shareholders richer on our backs. We also have the issue of AAMG allegedly bribing the CEO of another bankrupt hospital. I could not get our interim CEO to state that she has never received any benefit from AAMG, which of course raises questions.

Be that as it may, by now everyone knows that Hazel Hawkins Hospital could have been managed better. I believe that either independently or with the help of a local non-profit entity that we can and should keep Hazel Hawkins Hospital in the hands of San Benito County residents, and not an unknown out-of-town group that apparently is either really sloppy or has really shady practices to account for.

Here is why:

  1. Necessity. Just like a community our size must have a police force, fire department, water, sewer, and schools, it must have immediate access to robust hospital services. Above the waterline is where you and I might have an appendectomy or get treatment for a broken leg. The community hospital is a quality-of-life issue because of proximity (I can get treatment fast and my loved ones can visit frequently). It is what is unseen that is the real danger; what is required by statute that a county must provide its residents and the other burdensome nuances of being a county. Absent an adequate facility nearby you would have an already short-staffed sheriff transporting arrestees and other charges transporting patients time-consuming long distances, making them and resources (i.e. patrol vehicles and ambulances) unavailable for duty. Other departments would have similar obligations as well. The overtime incurred would be unsustainable.
  2. That necessity is permanent and so must be the solution. There are risks to outside parties in that non-area entities, but especially AAMG, is that they are one or more steps not in San Benito County. They won’t have the commitment that those in-county must to make HHH work. If an arrangement in San Benito County does not work for them, they will leave and we will have lost domain knowledge on how to run a hospital that will take years to reestablish.
  3. We are an “island.” Today and for the foreseeable future, there is no quick way to get in and out of Hollister due to our poor transportation planning by others. There is no choice to make about whether to have a hospital, but there is a choice to how to have a hospital.
  4. HHH is going to have a lot more business. Borrowing from statistics from a presentation I went to by the San Benito High School District, in addition to being the recent fastest growing county in the region and among the top 5 in the state, San Benito County’s population is projected to continue to explode in the next 25 years. We don’t need a new high school, we need 2 or 3. Organic growth in demand for hospital services is here.
  5. Entrepreneurial physicians will lead the way. There are high-quality entrepreneurial physicians here in our community that are committed to delivering significant volumes of revenue-generating procedures and recruiting others in many practice areas. Physicians have motive to do this because they have income needs and quality of life desires.
  6. Marketing is key. Encouraging primary care physicians to refer to HHH and to the public to request HHH will lead to more procedures at HHH. Consider this: I asked every person who visited my booth and that apparently had a recent procedure, where their procedure was done. 100% said Salinas/Monterey. We need to change the paradigm driving this.
  7. Partnering with or not competing with the San Benito Health Foundation will increase revenues and/or decrease expenses. This strange occurrence defies logic and leads to hurtful outcomes such as the Foundation referring patients to other hospitals and/or the District or Foundation unnecessarily operating duplicate facilities.
  8. Proper management will increase revenues and decrease expenses (as a percentage of revenues). In many conversations with multiple parties, a common theme has been the underbilling for services rendered, and apparently it is due in large part to outdated software and inadequate oversight. Inefficient scheduling and bargained-for workplace rules increase expenses. These situations are relatively easy to correct.
  9. The use of technology in procedures and administration will decrease expenses. Implementing enterprise software applications such as EPIC will introduce efficiencies that decrease labor costs.
  10. Assume Knowledgable Risk. The seismic issue and non-or low-paying patients is a state problem too, and historically they do rescue critical infrastructure. Will the state actually shut HHH over a long-standing seismic issue that many other government entities have? My guess, based on experience is no. Is the state going simply stop giving the poor access to HHH? My guess is no.
  11. Planning for success can lead to success. If the governing board (if not the community) of any entity expects less, they typically will get much, much less. That is where we are now. An expectation and follow-through that not only are we going to have a hospital, but it is going to be a great hospital, changes the dialog and efforts at all levels.
  12. We can do hard things. The current regime consistently points out that many other hospitals are closing. The same could be said about any entity. To get more personal than you are expecting in this communication: Things that one hears: “My marriage failed but 50% of all marriages fail, so it’s normal.” I have been married for 34 years so I tend to believe marriage is good. “My business failed but so do many others, so it wasn’t my management that was the problem.” Yet how many similar businesses have not failed? I have been in the business of helping businesses survive and grow for over 25 years. “Our school district has been taken over by the state because of financial and academic issues that we could not overcome because of unions, parents, students.” Plenty of other school districts seem to muster through and adapt to changing variables. I personally have helped two. “The dam at the reservoir is broken, there are not funds for the expensive repairs, and because the District (owner) spans 2 counties it is impossible to get people and agencies to work together”. That facility is now slated (and funded) to be the state’s next large water storage facility. We can save HHH.
  13. Regime change will aid in resuscitation occuring and be long-lasting. The people in charge are good people. I have known many of them for years, if not decades. The connections are huge and meaningful. I am personally troubled about what I have had to say. But they have given up and seemingly just want the quickest path out of dealing with the situation, no matter what the real cost to the community is. The possibility of any bribe aside, I can surmise this is why there is a rush to partner with AAMG, no matter what the cost. This would explain how Finance Committee meetings, for a $100 million entity in financial crisis can be only 13 minutes long.

Let’s get everyone together (the nurses, other employees, the non-profit, and any others) that can lead us out of the crisis and get to work on the proper marketing and higher level of hospital operations. We can do this and you will always be assured you have a hospital.