According to a recent California Hospital Association report, nearly 40% of all California hospitals are experiencing a bottom line loss (which puts us in the top 60% of hospitals in the State).  And we are not alone when it comes to struggles from operating income.  The average operating income for all California hospitals is a negative 0.5%.  Beginning on July 1, 2010 we  started a new fiscal year at MCDH.  This year we are going to be under more pressure than ever before to perform.  We have had to make some difficult choices and there are very likely to be more difficult choices ahead.  For example, for the first time in 4 years we chose to raise our prices this year.   Our prices are being raised 6% on average.  However, we are not raising our prices in all areas.  It is important that we continue to be the “hospital of choice” for the Mendocino Coast.   So, in some areas where we have historically been high, we are actually decreasing our charges.   We have also had to reduce expenses in some areas where it will not affect patient care.  There will be more difficult choices to face in the months ahead. 

I am thinking positively, however.  Our patient volume and our revenues have risen in the past 6 months.  We will be opening a new “state of the art” Diagnostic Imaging Center in January of 2011.  The new center should help us to regain some business that has been lost over the years.  Most importantly, we have a first class medical staff, nursing staff, clinical staff and support staff here.  I am very confident that we will make the necessary adjustments and in the end, we will be stronger than we have ever been before.  Thank you all for your continued support of our hospital!

And, of course, our young people are enriched by the fact that our Volunteers provide a number of college scholarships for High School Seniors each year.  I have said many times over the years that I do not know what our hospital would do without our volunteers!  The qualities that they provide, such as kindness, generosity, happiness, hardworking and joy, would not be as abundant without our volunteers.  By the way, the 814 hours donated in June was the full time equivalent of nearly 5 employees, saving our hospital $26,048 in salary dollars.  In 6 months our Volunteers have saved us $156,000 in salary dollars.  Thank you again to Carol, Edie, Norma, Nancy and to ALL of our wonderful volunteers!

It is great to see the amount of community involvement that goes into putting on an event of this magnitude.  Volunteers prepare all of the elements of a mouthwatering delicious meal, including a large hunk of salmon (from Alaska), corn on the cob, bread and salad.  The salmon is barbequed by an all-star team of chefs, including U.S. Congressman Mike Thompson, 2 members of the Mendocino County Board of Supervisors, Fort Bragg Mayor Doug Hammerstrom, most of the City Council members, Superintendent of Schools and many more.  The local service club organizations, such as Rotary Club and Soroptomist Club cook and serve as well.  It’s a great community event.   And it draws people from all over Northern California.  This year I met people from Sunnyvale, Orland and Sacramento.  You ever get a chance, be sure and stop by for the annual Fort Bragg “World’s Largest” Salmon BBQ.  We guarantee a great time and a great meal!

The significance of June 25 is that it is the anniversary of Custer’s Last Stand.  My fond memories of Hardin are related to my work at Big Horn County Memorial Hospital.  The hospital had a total of 53 beds.  16 were for acute care and 37 were for skilled nursing care.  It is still, to this day, the only hospital that I ever worked in that had a skilled nursing unit.  And I grew to have a great appreciation for the dedicated people that work in SNF facilities.  And even more appreciation for the residents that live in them.  It was always such a joy to spend time with the residents and learn about them and their lives.  Our hospital was their home and we did everything necessary to make it a home that they could be proud of.  So much has changed in health care since my time in Hardin from 1993 to 1998.  But it was in Montana where I got my first real experience with rural hospitals and rural health care.  And, here’s another little known fact.  The Critical Access Hospital program was actually born in Montana.  For, at least, 5 years before Critical Access Hospitals became a National model in the Balanced Budget Act of 1997, they were already in operation in Montana.  Of course, back in those days they were called Medical Assistance Facilities (MAFs).  Big Horn County Memorial was not a MAF.  But I learned about the model back then.  I have been a huge proponent of Critical Access Hospitals ever since.  Happy June 25 to Hardin!  I am imagining that you will be celebrating Little Bighorn Days this weekend.  I hope that this one is the best yet!

There was a visible “buzz” today around Mendocino Coast Hospital about the construction cranes and the moving day for our CT Scanner trailer and our MRI trailer.   Today the project was real because for the first time it was visible!  The arrival of the cranes and the movement of the trailers was visible!   Last night 2 VERY large cranes were brought in to move the 2 existing trailers.  This was necessary because before we can begin the site work portion of the $8.0 million new DI Center, it is necessary to move the current CT Scanner trailer and MRI trailer out of the way.  The new 8,000 square foot Imaging Center will be located on the east side of our hospital – in the same location that the hospital has provided MRI services in a trailer for years.  

But……in the future, we will have a new building and it will be attached to our hospital.  There will no longer be a need to cover the heads of our MRI and CT scan patients with umbrellas on rainy days.   But, probably more important, it will be equipped with modern and state-of-the art new equipment.  New MRI, new CT, new flouroscopy and new digital mammography!  The new building is scheduled to open in January of 2011.   Needless to say, we can hardly wait!

Last Friday was an incredibly sad day when the news was received that former MCDH Board Director and Finance Committee Chairman, Don Tucker had passed away.   I always thought of Don as a true Southern Gentleman.   And I admired his wisdom and his fairness in handling the many difficult issues that we have faced as a hospital on the Mendocino Coast.   His many years as a corporate executive in finance, served our hospital very well during the time that Don was on our Board and our Finance Committee.  Don was fond of letting us know that he almost went to medical school, but his plans for a career in medicine were thwarted early in life by other obligations.   The world missed out on a truly gifted physician, when Don ended up going into finance instead of into medicine. 

I remember on several occasions, seeking him out for his counsel.  He will be sorely missed.  Not only by the hospital but also by the number of community groups and organizations that he has become such an integral part of.   I offer my most sincere and heart felt condolences to Wilma and to Don’s children.   Don Tucker will always be remembered as a leader and as a gentleman at Mendocino Coast District Hospital.

The solution is for each of us to take personal responsibility to give our best to our patients, our co-workers and our community.  Dr. Wong has created an acronym for the attributes that it takes on an individual basis.  The acronym is T.R.U.S.T.E.D.   It stands for Teamwork, Responsive/Respectful, Understanding, Safe, Talented, Executes, and Dedicated.  82 members of the MCDH family, including physicians, managers and staff members took a pledge last week to take personal responsibility, as follows:    I pledge to become a T.R.U.S.T.E.D. Colleague, Every conversation, every time with everybody, To the very best of my ability, And to be open to feedback, positive and corrective, From any of my peers and colleagues, beginning today.   I for one, feel different, after having heard Dr. Wong speak and after having gone through this experience with my colleagues at MCDH.  I am committed to standing by my pledge and to lead the way so that every member of our MCDH family can reap the benefits of the “care plan.”  In fact, we named the benefits.  They include “best patient care, best working environment, joy and fulfillment and improved reputation across the board.”

The anticipated opening of the new DI Center is January of 2011.  When it opens our community can look forward to the following state of the art equipment:  (1) 1.5 Tesla Magnet Magnetic Resonance Imaging (MRI); (2) 32 slice CT Scanner; (3) Digital Flouroscopy Room; (4) Digital X-Ray Room; (5) Digital Mammography; and (6) Digital Ultrasound.  Cheers went up after each new service was announced.  Especially Digital Mammography.  Obviously our community has been waiting anxiously for that new service! 

Financing for this project has come from contributions from our Mendocino Coast Hospital, revenue bonds that were purchased by United Healthcare Group and lease financing.  Thank you to all of you that made tax deductible contributions through our Foundation.  You helped to keep this project affordable for us.  This helped to keep the costs of the building low.    We could not have gotten this far without the support of our community.  Thank you Fort Bragg, Mendocino and to all of our family and supporters!  We cannot wait to bring this state-of-the art building to you.

Ray and Wayne

It was great to get away last week for a little relaxation and also to see an old friend in Hawaii.  Wayne Allen was the CFO at Mendocino Coast District Hospital when I started here in 2006.  He had started just a few months before me.   Wayne did a great job as CFO at our hospital and deserves most of the credit for our financial turnaround in the past few years.    However in late 2008, Wayne decided that it was time for him to move on to a new challenge.  
Today he is CFO at the North Hawaii Community Hospital in Waimea on the Big Island of Hawaii.   It was very interesting for me to tour NHCH. It is a 14 year old hospital which was built from the very start to be a Healing Hospital. I was extremely happy to see that many of the elements of a Healing Hospital that we are using at Mendocino Coast District Hospital, are also important elements at NHCH.   They include use of colors, quiet environment, natural sunlight, greenery and most important of all, a staff attitude that is dedicated to Healing and Wellness. That was evident by the way that the hospital incorporates healing themes into their artwork. The bottom line for me is that Mendocino Coast District Hospital is very similar to NHCH in many ways.

It made me feel very good about our decision to create a Healing Hospital environment on the Mendocino Coast in California.

Thank you Wayne for the tour and for showing me what a Healing Hospital looks like in Hawaii!