Vencor pinned much of the blame for its bankruptcy filing earlier this month (Sept. 20, p. 6) on Medicare's prospective payment system for skilled-nursing facilities. But it wasn't too long ago that the Louisville, Ky.-based nursing home chain was bullish on the PPS.
In an April 1998 filing with the Securities and Exchange Commission, a few months before the PPS took effect, Vencor told shareholders that the system "will benefit nursing center operations" through higher payments and the company's ability to reduce costs on its ancillary services. In August 1998, after several weeks of operating under the PPS, the company was still standing by its prediction of profitability, qualifying it only with "in the long term." By November, the company had replaced "will benefit" with "may benefit."
By April of this year, the positive language was out altogether, replaced by the statement that nursing centers "have been impacted adversely" by the PPS, largely because "federal per-diem rates for higher-acuity patients do not, in the company's opinion, adequately compensate" for care provided.
Who's the wolf? Three years ago, Gloria Mayer portrayed MedPartners as the big bad wolf after the giant physician company gobbled up the Friendly Hills Healthcare Network and fired her and her husband from the medical group.
Now publicizing a new book, Goldilocks on Management, Mayer admits to having her own set of sharp teeth. The book, co-written with her husband, Thomas Mayer, M.D., teaches fundamental management principles by relating them to fairy tales.
Gloria Mayer, a former chief operating officer at Friendly Hills, says the idea for the chapter on Little Red Riding Hood was based on her experience in HMO contracting, "where I devoured a new and inexperienced MBA in a negotiating session."
Mayer says she "was happy to get such a great contract for the medical group."
The book makes few references to healthcare, but industry buffs will recognize an allusion to MedPartners and FPA Medical Management in a chapter titled "The Three Billygoats Gruff," which tells the story of a fictional company called Team Dental, whose aggressive expansion strategy leads to its demise.
Try the MRI ride. This week the Radiological Society of North America, Oak Brook, Ill., will unveil a 3,000-square-foot exhibit devoted to the wonders of diagnostic imaging at Disney's Epcot theme park, perhaps one of the few venues larger than cavernous McCormick Place in Chicago, where radiologists from around the globe convene each winter for the RSNA's annual scientific meeting.
Visitors to the radiology playland, part of Epcot's millennium celebration, will enter through a doorway that resembles the opening of a magnetic resonance imager. Thankfully, the portal is much bigger than life-size. And that's not the only outsize feature. At more than $6 million for a planned three-year run, the price tag for the exhibit surpasses even the average radiology bill.
At deadline, the list of sponsors underwriting the interactive installation was still hush-hush. The RSNA board agreed to fund the project itself but says it preferred "to accept financial contributions from others in the field of radiology. . . ."
Who wouldn't? In case one of your vendors participates, take a close look at the fine print on your next invoice for an MRI, CT scanner or package of X-ray film for any Epcot surcharge.
The fattest paychecks. Seven hospital and health system chief executives are among the top 20 highest-paid executives of not-for-profit organizations, according to the Chronicle of Philanthropy's annual compensation survey. The Washington-based journal surveyed 246 organizations from its "Philanthropy 400," a listing of not-for-profits receiving the largest private donations.
Two executives earned more than $1 million. Topping the executive list for the sixth straight year was John Rowe, president of Mount Sinai Medical Center, New York, who earned $1.16 million, followed by Paul Marks, president of Memorial Sloan-Kettering Cancer Center, New York, who earned $1.07 million.
At 59 of the 246 organizations, the top executive wasn't the highest-paid person. In fact, the survey's highest single earner was Wayne Isom, chairman of the cardiothoracic surgery department at Cornell University. He was paid $1.73 million. And David Hidalgo, M.D., chief associate attending surgeon at Sloan-Kettering, earned $1.27 million, out-earning his boss Marks.
The median salary for top executives of not-for-profit organizations was $207,990.
Stormy relations. Even with a raging hurricane bearing down, two battling health systems in Brevard County, Fla.-embroiled in several antitrust and certificate-of-need lawsuits-found something new to squabble about.
As Hurricane Floyd moved up the Atlantic coast, 27 patients were evacuated Sept. 14 from Health First's Cape Canaveral Hospital in Cocoa Beach and transferred to Wuesthoff Health Systems' Wuesthoff Hospital in nearby Rockledge. Wuesthoff officials complained that the patients were transferred with incomplete medical records, no accompanying doctors and insufficient nurses and technicians to care for them. Health First disagreed.
But days later Melbourne-based Health First fired 32 of its employees and reprimanded another 70 for failing to show up for work during the storm. Wuesthoff fired one nurse for failing to show or call in but said it was not storm-related. Wuesthoff spokesman Mark Cohen said senior managers met last week to ensure that "we can work together cordially, collegially, so this will never happen again."