 A financial turnaround gave this community hospital the opportunity to grow.
A month before Bill Falkowski arrived in December 2004, the board of trustees for Hubbard Regional Hospital had been debating whether or not to close the hospital. The 22-bed acute care community hospital’s financial outlook was dire. The pricing for its services was outdated, as were its third-party contractual arrangements, and its chargemaster reviews had not been accomplished. Cash was almost non-existent.
 Bill Falkowski, CEO and CFO
“When Paula and I came here, our focus was on survival mode to get our feet back on the ground,” Falkowski said. “We first turned our efforts into expanding and improving out-patient services. Now as we’ve turned the corner, we’re looking at what we can do to enhance our inpatient services.”
Increasing capacity
Located in Webster, Mass., Hubbard Regional Hospital’s history dates back to 1929 when it was founded as a home for nurses and nursing students. In the mid-1950s, the hospital was built and includes a medical office building, ICU, dialysis unit, and transitional care unit. Today, the hospital sees approximately 70,000 outpatient visits, 13,000 of which run through its five-treatment-bay ED.
“In looking at our monthly ED walk-out ratios, we realized we needed to put together a plan to increase our capacity while accommodating those patients who are in the ED for minor injuries,” Falkowski said. “We’ve just implemented a plan that increases our treatment areas from five to seven, and we’re looking at three potential areas in which we can expand to capture the walkouts.”
“If we have one ambulance after another come in, those five beds get filled pretty quickly,” added Bigelow. “We have an existing treatment space in the same hallway next to the ED, and three existing beds will be utilized. Those three beds will give our physicians the space to handle those patients with a lower acuity.”
The additional three-bed area is only a stepping-stone in Falkowski’s vision for Hubbard Regional’s ED. The hospital has engaged an architect to develop a plan for a new ED to house up to 15 treatment areas and additional space for a surgical expansion on the second floor. Square-footage and area-exchange requirements, explained Bigelow, limit what the hospital can do to the ED without building something brand new. “We are a year or so away from making the final decision on the expansion,” she said.
Meeting a need
As an independent community hospital, Hubbard Regional is challenged with balancing its budget while maintaining a high level of quality and responding to the needs of its community. In 2006, Hubbard Regional underwent a more significant transformation with the renovation and expansion of its physical therapy unit. The previous unit was located in a 1,200-square-foot facility that was quickly becoming outdated and was too small for Hubbard Regional’s primarily elderly patient population. The new 3,000-square-foot facility more than doubled the hospital’s capacity and, in the two years since it’s opened, has increased the hospital’s annual physical therapy visits by 7,000, or approximately 23%. “The expansion also helped cushion our financial pillow,” Falkowski said.
“We are expanding services we couldn’t offer because of the space limitations we had in the past,” Bigelow continued. “Now that we’re busier, we’re finding the need for more services.”
For a long time, Hubbard Regional did not have a speech therapist. However, its director of rehabilitation is a speech therapist, and the additional space made it possible to offer that service. “The unit is also working on adding massage therapy services, as well as supplementing the physical and occupational therapies already offered,” said Bigelow. “It’s a growing area that we’re looking at further expanding to capture more volume.”
Clear message
Physicalities are not the only aspect of the hospital to receive upgrades and renovations. As a small hospital located in close proximity to larger teaching facilities, Hubbard Regional strives to provide what those other medical centers can’t—personalized care. A small community hospital also offers a significant benefit large teaching facilities don’t,” Falkowski said. “When you come into our hospital, you’re not treated like another number.”
To further enhance that family-like culture, Hubbard Regional joined the CAHPS (Consumer Assessment of Healthcare Providers and Systems) patient satisfaction project. It has also associated with Stroudwater Associates, a consulting firm with regional headquarters in Portland, Maine, to implement a balanced scorecard to assess the softer side of patient satisfaction. “The CAHPS patient satisfaction survey addresses inpatient but not outpatient or the ED,” explained Bigelow. “Stroudwater has tools available to us to try to capture that information as well.”
In looking at the hospital’s mission and vision statements, both Falkowski and Bigelow realized that, in addition to being too lengthy, none of the staff could repeat the statements. They decided to tap into the hospital’s marketing and advertising campaign to provide a mission easily repeatable and understandable.
“Our slogan is Big City Care, Small Town Heart,” Bigelow said. “Our mission is to provide big city care with a small town heart, and that speaks to what we’re about here and what we’re trying to do.”
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