Tim Hingtgen, Chief Executive Officer of Community Health Systems, recently shared his priorities for 2023 and explained why he’s optimistic about the future for CHS.
With all we have to accomplish as healthcare providers, it can be hard to align everyone around the same key goals. But, this year, our leaders are very focused on these four things – all of which are equally important.
Our commitment to Advance Safety and Quality is at the heart of everything we do. It shows up in our capital investments, work to deliver higher acuity services, physician recruitment, workforce development initiatives, and clinical care innovations.
Our purpose is to help people get well and live healthier, but you can’t do that if you don’t offer quality healthcare services. Our new Clinical Scorecard helps our hospitals benchmark safety, quality and patient experience across 34 measures. Another area of focus is our work to introduce innovations like remote patient monitoring for people who have certain chronic conditions and our maternal/fetal early warning monitoring system to support our OB teams and to make labor and delivery safer for mothers and babies.
I’m especially proud of our accomplishments in the area of patient safety. It has been ten years since we started measuring and reporting reductions in our serious safety events rate. Since 2013, our hospitals have reduced serious safety events by 87.9%. That’s an amazing success that equates to thousands of lives spared from harm. CHS has one of the largest, longest-running, and most successful patient safety programs in the industry.
Next is the important work underway to Strengthen Our Workforce. The COVID pandemic has been extremely hard on clinicians, caregivers, and support teams across the entire healthcare industry. All hospitals lost nurses and other important team members over the past couple of years with some going to travel and temporary staffing agencies, some to outpatient settings, some retiring, and some left healthcare settings to start new careers. As a result, contract labor increased, which is not only very expensive, it can also take a toll on teamwork and impact patient care.
The good news is we made tremendous progress addressing these issues in 2022. Contract labor in the fourth quarter of 2022 totaled $80 million compared to $140 million in the fourth quarter of 2021. That expense continues to decline and we believe it will keep going down in 2023. Even better, hiring of Registered Nurses was up 18% last year and we ended the year with a net gain of about 1,400 bedside nurses, compared to a loss of about 300 RNs in 2021.
We attribute this success to a few things, including the Centralized Nurse Recruitment function that we developed and fully launched in early 2022, enhanced employee benefits launched in 2022, and most importantly, the work of our hospital executive teams, department leaders and medical staff leaders to build a culture where respect, teamwork, recognition, and professional advancement is possible and encouraged.
We are also on a quest to Accelerate Growth in every meaningful way possible. We continue to invest capital to build inpatient capacity and surgical and procedural space and to add new access points in our markets wherever that makes sense – for both near-term and long-term growth.
We had our best physician recruitment year of the past five years in 2022, and we see more success on the horizon, even though physicians have many opportunities about where – and with whom – they want to practice.
Our transfer center continues to facilitate growth with a record number of requests for placements last year. Inbound transfers to CHS hospitals were up 14.5%. This growth requires support from the medical staffs at our hospitals, and we are grateful to partner with physicians who also want to ensure that when there is a patient who needs care, we will meet that need whenever we can.
Finally, work to optimize capacity by appropriately reducing length of stay and helping patients move out of the hospital when they are ready for a safe discharge opens beds for other patients who need them – and that also facilitates growth.
All of these initiatives are making a difference. In the fourth quarter of 2022, same store admissions increased 4.4%, adjusted admissions were up 8.2%, surgery volume increased 4.2%, and ER visits increased 8.7% compared to the fourth quarter of 2021.
The final near-term priority is to Control Expenses and that is an imperative for every healthcare system nationally, as we all work to mitigate inflationary pressures. Reductions in contract labor (and continuous improvements in permanent staffing levels) remain an area of opportunity. We also continue to focus on our supply expense, with a number of positive physician collaborations under our belt yielding positive results. We also see opportunities to reduce redundancies in some areas, and, as always, we will work to manage our fixed and flexible operating expenses to create as much efficiency as possible.
Our people certainly do. We have amazing clinicians and caregivers across the organization. We have so many great local leaders – and we are working hard to fill any vacancies with top-notch, experienced and committed CEOs, CNOs and CFOs. And, the CHS support team is working every day to provide resources to accelerate market developed strategies. I’m very optimistic about most of the markets where we operate. Work over recent years to refine our portfolio enables us to invest in markets where growth is possible, and where we believe we can create and maintain a competitive advantage.
Two things come to mind immediately. First, what more can we do to support our healthcare teams? That’s a question that has to be asked over and over, again and again – to be sure we are constantly viewing our business through the eyes of the people who deliver healthcare services. We’ve made great strides, and when I travel to our markets, I’m always impressed by the caliber of our physicians, nurses and others on the team. It’s important to me – and our entire management team – to make investments and decisions that really support our caregivers and their patients.
The other thing I spend time thinking about is how to continuously improve our performance. How do we ensure that we operate well-run hospitals and clinics, make the right investments, and even make some tough decisions at times? These are important factors – so that our organization, and every one of our hospitals, can be an asset in our communities and also can achieve sustainable long-term success.
I spend as much time as I can with friends and my family. My wife and I are empty nesters, so when we don’t have the opportunity to be around family, we are fortunate to have a strong group of friends who are equally focused on creating as many fun and unique experiences as possible! I like to watch sports (hockey and football are the top of my list) – and to be outdoors, so I do quite a bit of hiking, too. And, I do read a lot to stay as current as possible.
Now that’s a tough one to pin down, as there are so many people that are top of mind! But today I have to pick Pekka Rinne (retired goaltender of the Nashville Predators NHL franchise). For more than a decade, I watched his skills develop on the ice – but it was really his humility, genuineness, energy and innate leadership skills that impressed me. At least locally, everyone loves Pekka – and he is respected for being a kind and decent human.
My wife and I joke that I’d be running an outdoor adventure outfit somewhere. I would say surf shop – but I don’t surf! I like to create and participate in memorable experiences. I think it would be cool to constantly meet new people who are about doing the same thing, and helping them log that experience successfully.
“Accelerate” is my one word of the year. Maybe it isn’t overly inspirational, but it is essential to success in this type of operating environment. We have really good insights and ideas for each of our markets, we are committed to strong partnerships and support of our health system leaders, and we have built out critical components of contemporary operating models to deliver new levels of success. We want to be thoughtful and deliberate in our approach – but once we lock in on an opportunity or plan, this is the year to accelerate execution and deliver upon the opportunity.