Hospital Leaders
In Their Own Words

“Why do we view it as a priority? Well, you’re nothing without the communities you’re serving. … I guess the best way to answer that is we are nothing without the communities we serve. You build patient loyalty. You build loyalty to physicians, the nurses, to the janitorial staff. I mean they are from those communities, and that’s what makes up our hospital. So, there is nothing better for delivery of the care, and also good business, than to be completely wedded to the communities we serve.”

“In the business sense, it's crazy if we're not involved in our communities, because if we want to be a long-term healthcare provider that is relevant to our communities, we have to be involved in our communities. They are an important stakeholder. We can't provide healthcare if you don't have your ear to the communities that you're trying to serve and you don't have that relationship.”

“It’s the right thing to do. That’s a simple answer. . . . I just feel like that is one of my major priorities, is to make sure – not only just make sure, but really be – we are one of the largest employers in our community, and as such, we should be good community stewards of who we are and how we interact together.”

“I think a lot of it was just feedback from the community. And then also with employee engagement and surveys that we send out to employees, we recognize that a lot of those employees were not necessarily proud to work here [sic]. And a lot of their comments were, "We don't do anything for the community. We stay to ourselves. We're not involved in anything outside of healthcare." And then a lot of the comments that we're getting from the community was, "You're not present. You don't support us. You're not here to help, unless it's a time of emergency." So I think that we finally really started to listen to our employees and the community. And everyone was really hungry for us to be a partner. And just a year and a half ago, we really decided that that was what we needed to do. And it's just been very successful.”

“I would just encourage others to, if they're not involved in their community, to do it. To not just be looked at as that place that only if you have to go there. It's been so much. I mean, literally my job is fun. Being able to interact with the community, offer education, partner with the community, I have loved the opportunities that I've had and to represent my hospital [sic] as far as being that anchor to the community to really be that healthcare driver.”

“Well, I think there's two things that come to mind. The first one is, we just want to have that relationship with our community. We want them to think of our hospital [sic] when they do have a need. And so just being available for them is a big thing for us. Secondly, I would say that we want to be an advocate for what's happening with healthcare recently. Healthcare costs, as I'm sure you're well aware, are just through the roof right now. And we want to become a partner with our community and really focus if we can get screenings done, whether they be the annual wellness visits or mammograms for women or colonoscopies. If we can get these necessary screenings done, it will just save us so much time and effort and cost on the back end as far as the healthcare dollars and how they're being spent.”

“It's biased for me to talk, but of course, obviously my role here at the hospital is to always make sure that our community is healthy. But, you have to look at, as a for-profit hospital, it makes sense for our marketing team to allow me to provide such services because it is something, we're visible, we're out there. And of course, it's marketing our services.”

“It's never really a decision of if we should do it, it's, sponsoring that event, that's taking care of our families. It's just, in reality, just an extension of what the hospital does on a daily basis on the medical side, supporting these organizations is just an extension of the care we give our families.”

“It's not just something that we say, it's actually something that we do. And so when there are activities, when there are things that need to be done, the leader from the CEOs all the way to the unit directors to the charge nurses, all the visible leaders are involved. They're all engaged. And so it's not one person saying, "Do this," it's all of us saying, "We're going to do this, and we're all going to participate." And so it's, again, to all the leaders. And so when you talk about leadership, we talked leadership on the frontline leaders that are caring for patients, whatever, all the way up to the c-suite. So again, everyone's involved, everyone's present, everyone's engaged and participating.”

“COVID-19 has really taught me that – retaught me that again, about how important it is that we work together with the community leaders, with the community stakeholders, with everybody to take care of each other. The more we interact and engage with each other, the better and easier it is to trust each other and to help each other be successful, so this is my priority. That’s a simple answer, in some ways.”

“Oh, yeah. It's called COVID. So you've heard everything that we were doing and then obviously in March it all stopped. So it's hard to figure out how do you do that connection?”

“Sometimes we got our heads down and we're working and we're out in community going to meetings and so on, but we're wondering, gosh, do people really know and understand what's going on in our facilities. But man, oh man, when COVID happened and the community came forward with hundreds and hundreds of gifts of food and all kinds of things for our employees and when they make clear that they were thinking of frontline providers in so many ways, the bell ringing and all that stuff, I mean, that really drove home the idea that people know and value the concept of healthcare provision. And it's never more poignant than in a global pandemic, right? But that, to me, was a very affirming time because it was clear that people do know and they may not understand every service that your hospital provides, but they know you are their neighbor and they know you are their anchor and they want to give back to us too.”

“I guess we are anchor institutions. And I guess, I want to really stress, I mean we’re really local, even the way we operate as a company... What happens in the far west, they know their communities best... So, it’s not like we have people sitting in corporate headquarters who are going, “Okay, this is how it’s gonna be.” No, it’s people there that are actually part of those communities making these decisions, understanding how they serve as an anchor institution in those communities.”

“Yeah, so obviously there's a couple of different categories. The first one, obviously being a medical center is offering outreach as far as healthcare. We work really hard to get our administrative team, and also our physicians, out to meet not only the administrators and physicians from other facilities and communities but even into the community. We've done a lot of sponsoring certain events….But we have, for example, later this month, a law enforcement appreciation that we're sponsoring. We participate in a lot of different golf tournaments. We worked very closely with the Chamber Of Commerce, where we sponsor and work with them to help local businesses and also sponsor events that are happening throughout our community. And obviously we're very engaged with education. We do a lot of seminars with physician that are actually aimed right at the community. We obviously do a lot of DMEs, which are catered more towards the physician. But we really want to be a partner with the community and educate them regarding their healthcare.”

“When I talk about the community benefit, I begin about the care that we provide to our patients every day. I feel like it starts there, but we also are large employers within our communities. We pay taxes within our communities. We contribute to charitable organizations and we're involved in business specific activities in our communities. So definitely, our involvement in our communities is part of our mission and encourage folks within our walls and outside our walls.”

“For us, it is both an honor and a privilege, but also a responsibility that we continue to push the healthcare that is provided in this area forward, specifically in things like investment in new technology. And so, I think it's important that you have a well-run, highly efficient facility or a hospital, healthcare organization, whether it be for-profit or not for-profit, that is able to build those kind of business plans, build those types of justifications, and execute on them so that smaller communities that depend on these anchor institutions are receiving the highest health care possible, highest level health care possible and feasible, in their economic situation. And that really requires those health care delivery organizations to be extremely efficient and well-versed, and oftentimes the for-profits are tied into larger systems that can share that knowledge and share those efficiencies across a pretty wide array of hospitals to make that possible.”

“So obviously since the beginning, we have been able to provide health screenings out in the community….So at most supermarkets, we're there once a month are providing different health screenings. And then, we do the same for food pantries, we do the same for fairly funded agencies, such as day cares, Salvation Army….I actually have one of my nurses who is allocated just for our congregational health services and she provides screenings as well as educational programs. In addition to the health screenings…we have a lot of our physicians will donate their time to provide a type of service out in the community….Right now, I've been participating in a homeless task force…and on shower days, we designate two days a month where our homeless individuals are shuttled from their locations by the health department in that area, as well as the police department, and in bring them over to this community center where we have showers and they're able to shower, get new haircuts, and they're being seen by our residency program.”

“So we engage in the community in a lot of different ways. I would say that our leadership throughout our network [sic] is very active, and the nonprofit sector as well, I'm engaging with different nonprofits in the community. We're also incredibly involved in school districts and the local colleges, universities, community colleges, et cetera. So we do a lot in terms of sponsorship, in terms of dollars, but then also, time….So we give money, our staff contributes their time, and then also, their expertise, in a number of different ways. Leading different classes or programs, contributing funds for health-related initiatives. We always tie it back to things that we're involved with, or that are important to us and the community. Improving access to health or education. A lot of education components, in terms of healthcare. And then I guess from the marketing side, we also do a lot of community health education seminars, often led by physicians, and we do all of that coordination, promotion.”

“We work closely with all the community schools in our service area. And we started off with providing kind of lunch and learning with the faculty and staff at the schools, and we would bring in a specialist, or some dieticians, therapists, just to go over a healthy work life balance with all of the schools in the area. We also, in conjunction with that, do community health fairs with the communities in the area, the counties in the area that host community-wide health fairs….Whether we're doing some medical screenings, whether it be blood pressure, glucose, cholesterol checks, PSN checks, as well as just educating the general population on all the services and specialties that they have right here in their backyard. We also do something very similar with the university here [sic]. They do a bi-annual health fair there on campus for their students and staff. So, we're there doing not so much of the screenings, not much blood pressure, glucose, as we are just providing support for those students and staff members.”

“As a hospital, especially when it comes to healthcare and supporting community health, I believe there's both the responsibility and expectation that the hospital and health system... Again as the largest employer, but also because of health is such an imperative in the community, we play a significant role on projects aimed at community health. So we have many people involved on various regional committees and organizations. And whether it's hospital or medical leadership, there are prominent roles in that, that have nothing to do necessarily with being a financial anchor….I mean, it's our objective to be seen as a good corporate citizen. And so there's an expectation. Again, some of it comes down to is that because it's a hospital or because it's the largest employer? But as part of being a corporate citizen, there are just things that you become part of the solution.”

“Our focus from a community engagement standpoint has been on the hospital being a member of the community. So we have wonderful conference rooms. We opened those to the community …we became a huge resource just for meeting space. And then typically as part of that meeting space, the hospital would donate refreshments or lunch or whatever was needed….And then add on top of that physician lectures on a regular basis that we invited the community into. We did two signature events, several signature events, but in the spring we did a car show and would have about a thousand people to the campus….In the fall, we did a girls' night out event, which was shopping and education topics and restaurant sampling. And the focus was to invite people to come and get to know us beyond an emergency room visit, to have the hospital be an anchor for fun things to do with a family, let alone receive healthcare….We've done childbirth education classes. We do preparing for orthopedic surgery as well as a variety of just like I said, support groups.”

“So just for example, in 2019, a snapshot of what we participate in is, first and foremost, we foster many local organizations, everything from local schools to national organizations that promote health, to local organizations that support outreach in the community through financial contribution. In addition, we host many educational seminars and events for the community, including for example, in 2019, a women's health lecture [sic], where we got 220 people, a behavioral health event here at the hospital, where we had 300 in attendance. An orthopedics symposium, where we had 200 in attendance….a big women's health symposium, where we had about 450 people in attendance….in addition, we participate in quite a few community events, such as breast cancer walks, Heart Association Walk, community celebrations [sic]. We also allow different organizations, support groups to meet here at the hospital. And we sponsor those activities for those organizations as well.”

“For-profit hospitals are really about how we’re capitalized. It’s about how we get the money together to build, invest, and go into a community or acquire and then how you go about doing that. There really is no difference in terms of what you do in that community. There really isn’t. We’ve been doing this a long time. For-profit hospitals have the same level of uncompensated care and the same level of charity care, the same level of, again, uninsured, all that. There is no difference.”

“We have every one of our hospitals has emergency departments. That means – as you know – you take every patient that walks through your door and we’re proud to do it. And so we serve our communities regardless of tax status.”

“We pay taxes, and that’s the thing that nonprofits don’t do, and we pay a lot of taxes and so – not only that – we’re funding the police, we’re funding the teachers, we’re funding the schools, we’re funding lots of things in the communities that we serve, making us . . . really intertwining us in these communities, as communities have become really dependent upon the revenue that we bring in, so it helps their tax base.”

“I don't think anybody ever knew the difference between a for-profit and a nonprofit hospital. They go to the hospital that’s geographically typically closest to them, or by word of mouth what they think is the right place to go, or where their doctor tells them to go and they go there without regard or knowledge of tax status. So, I think when it comes to that, it’s are you wedded to that community? Yeah, because no one knows that you’re a for-profit or not. You’re the hospital down the street.”

“I've also heard for-profits called tax paying entities. Because the other benefit that we provide to the community is the fact that we're paying both sales and property tax that goes back to our community and back to our state. So, that's another aspect and benefit of having a for-profit anchor in your community. They're also a tax paying entity for the municipality.”

“This hospital is really trying to push the investment in healthcare here. For us, it is both an honor and a privilege, but also a responsibility that we continue to push the healthcare that is provided in this area forward. Specifically in things like investment in new technology. And so, I think it's important that you have a well-run, highly efficient facility or a hospital, healthcare organization, whether it be for-profit or not-for-profit, that is able to build those kind of business plans, build those types of justifications, and execute on them so that smaller communities that depend on these anchor institutions are receiving the highest health care possible, highest level health care possible and feasible, in their economic situation. And that really requires those health care delivery organizations to be extremely efficient and well-versed, and oftentimes the for-profits are tied into larger systems that can share that knowledge and share those efficiencies across a pretty wide array of hospitals to make that possible.”

“I think as resources become more limited hospitals may want to see more of an ROI on their investments. I frequently challenge organizations that are asking us for contributions, how can we engage in this event? So some community organizations just want us to sponsor their event. They want us to get a tent, and they want us to set up a tent and handout plastic giveaways. Which is maybe the way things used to be done, but there is a high cost of participation in that, first to sponsor the organization, then the cost of the giveaways. Then manpower for a one, two, sometimes three-day event. So I would look and give priority to events that enable us to engage with people more, to have a deeper connection with people.”

“Honestly, every single thing that a nonprofit does, we do. The only difference, the only distinction that I can think of, from a public policy that we don’t have access to that nonprofits do is something called a 340BDirect program. And that is reduced priced drugs, which is kind of a controversial program, but it goes to nonprofit hospital outpatient facilities. We don’t have access to that, which is ludicrous because, again, we take the same number, if not more, uncompensated care, and if not more Medicaid, at least the same. But anyway, that’s the only functional difference in terms of any sort of public policy that impacts the community.”

“I think the perception that's out there that a for profit hospital is only here to make money and not provide any service, it's just always going to be there. I think that's just the perception initially, until information, and we become an organization that's open, and out there sharing information. I think that's important. But if you're not willing to get up there and let people know what we do, and show numbers, that people are always going to have that perception, it's always going to be there.”

“How do you focus to have the most impact? Because there are so many needs in our communities, some of which we have expertise around and some of which we really don't. So I think the challenge is to be data driven. How do you get good community level data? Because it's really uneven from community to community what kind of data bank the cities have or universities have. Then, the other is focus. At the end of the day…there are limited resources and so how do you get these resources, how do you focus?”

“Probably the biggest barrier is that we can’t help everybody.”

“The major challenge I would say are sometimes the politics of who we can partner with and who we cannot partner with. . . . And so we have to really be careful as far as who we partner with, and when we partner with, and how much we partner, just to make sure that we're not partnering more with certain groups than others. Those I would say are probably our two most difficult, is equally partnering with everyone, not showing favorites to anyone. And then secondly, choosing the correct partner to partner with as far as politicizing certain events and things like that. We have to be really careful with that.”

“I think that they may be a little less interested, just in my opinion. I think time restraints are very difficult, and I don't think that you'll find the majority of hospitals may not be extremely involved. I've seen the hospitals in the past will throw money at different things to have their logo here, be mentioned in this ad, or whatever. But as far as true involvement, by true involvement I mean like a true partner, I don't see a whole lot of for profit hospitals, at least in our area, really involved and as a true partner with their community.”

“Yeah, so there's always going to be that scenario where we finally are able to identify a community or a group of individuals who possibly need healthcare services. After we meet them and encounter them, and we realize that there is some sort of help that they need, and being a for-profit, sometimes I feel as if our hands are tied when it comes to particular services. One particular one that I can give an example is when we are providing education on breast cancer, and being a for-profit hospital, obviously we don't have the foundation to practice that if we were to ever need free services for possibly mammograms for say, for example. So in that perspective, as a for-profit, it's hard because I just don't have the opportunity for grants and maybe possibly a foundation that can support me when we do need those things.”

“Yes, I think so. I think, like I said, I talked a little bit about the rising cost of healthcare. I think it's important for the community to understand at least some of the reason of why those costs are rising, and how they can partner with us to keep those costs low. And how they are truly in charge of their health care. So, I think communities would really benefit from knowing about opportunities to partner and learn with the facility about how they can manage and drive their healthcare.”

“I want to say from the economics are always barriers. I think our city [sic] is, for the most part, a very low-income city. So that there's always going to be an economic need placed on these community partners, and the need is always going to exceed what our resources are. We can only do so much. So that's always going to be a challenge for sure, being able to contribute to all the great causes and needs in a community like our city [sic].”

“There's always, obviously, budgetary constraints and limitations. While we would like to do everything possible, sometimes we're hampered by expectations and limitations there, fiscally.”

"Yeah, it's tough to pick winners and losers, so to speak. We never really enjoy being in that position. And as far as that regulation and record keeping, like my colleague [sic] said, we'd love to offer different services that we think would benefit different populations, but we have to log everything that we provide to community members in case they become patients, and there's gift log amounts that we have to maintain and show record keeping and whatnot and so, instead of trying to do all of that paperwork, it's just easier to not do anything due to staffing constraints or whatever it might be. And so, I think the community sometimes misses out due to those over-regulations.”

“I think the legality and the compliance side of it is one of our biggest barriers.”

“Just off the cuff, I would say that you're probably going to get a mixed bag, and I think it's really just as difficult for the hospital or the health system. Here, like I said, our leadership is very engaged, very proactive and creative in their approach. I know just speaking from key competitors in our market, I don't think they're nearly as engaged, I don't think that they would be as progressive in sharing what they're doing, because of those limitations. I think the key, just like anything else, the leader in the market is going to share and be proud of what they're doing, and everybody else may take a different approach, because they realize they pale in comparison.”

“Yeah, just like I mentioned, I think they need to speak up. I think that employees need to be given an opportunity to anonymously really speak their mind about how they feel about their employment. And I think that if questions are asked correctly, you'll really get to understand the pulse of your organization. And the same with the community. If there's an avenue or an opportunity for them to really give their feelings regarding their healthcare community and their healthcare relationships, I think you'll find that communities are really hungry for a relationship. Like I said, other than an emergency room visit or something. But really knowing that their hospital cares about them and wanting to offer them education and opportunities to partner.”