Nash UNC Health Care is on the mend
The Nash Heart Center continues to bolster cardiology services, evidenced by the four national awards for excellence in heart care it received in the last year. Photo provided by Nash UNC Health Care.
Appeared as part of the Nash and Edgecombe counties sponsored section in the August 2019 issue.
By Teri Saylor
Lee Isley knew he had his work cut out for him when he stepped onto the campus of Nash UNC Health Care as its new CEO in January 2018.
It was a challenge he fully embraced, and the 18 months he has served at the helm have been a labor of love.
When Isley came on board, the hospital had not posted an operating profit since 2012 and reported a $25.6 million loss last year. The 18% patient satisfaction rate was at an all-time low, according to board chair Jeffrey Batts. The nursing shortage was so acute that the hospital was plugging the holes with contract nurses at a major expense.
Nash UNC earned a dismal “D” rating in 2017 from Leapfrog, a nonprofit that grades U.S. hospitals on certain safety factors. The latest scores for spring 2019 show it has improved to a “C.”
After making significant changes, Nash UNC is on track to cut its operating loss to $11 million this year and start making money in the next couple of years.
“I will tell you I am not a maintainer,” Isley says. “When I came here, there were opportunities, and I wanted to come in, find those opportunities and maximize them for the health system and for the community.”
That was what the 14-member board of commissioners was hoping for when it saw a crisis looming at the hospital. The first decision the board made was to replace then-CEO Larry Chewning. It brought in Ian Buchanan, senior vice president for operations at UNC Health Care in Chapel Hill, as an interim CEO prior to Isley.
“When things started going south two or three years ago, the board said, ‘This is not us,’” Batts says. “We have a better hospital and better people than this.”
Nash UNC is a Rocky Mount-based nonprofit medical authority that comprises four licensed hospitals with a total of 345 beds. The complex is made up of Nash General Hospital, Nash Day Hospital, Coastal Plain Hospital and Bryant T. Aldridge Rehabilitation Center.
The authority, which includes the state-of-the-art Mayo Surgery Pavilion, Nash Heart Center, Nash Women’s Center, Emergency Care Center and Danny Talbott Cancer Care Center, sprang from humble beginnings in 1971, when Nash General Hospital began admitting patients as the first all-private-room hospital in North Carolina.
Isley came in with 30 years of experience in health care administration. Prior to coming to Nash UNC, he was CEO of the Granville Health System in Oxford for 12 years.
His first action was to meet with the board and develop a short-term strategy that would lead to financial stability, quality care and positive patient
experience. This included improving salaries — starting with the nursing workforce — to deal with the labor shortage.
By April 2017, many of the hospital’s nurses had left for higher-paying jobs, driving the nursing shortage to 17.4%. To fill those gaps, management brought 80 contract nurses on board at an annual cost of $9 million, Isley says. The hospital raised salaries to market standards, but that was not enough to build the nursing staff up to the level the hospital needed, so the leadership team built a partnership with Nash and Edgecombe community colleges to build a nursing workforce from the ground up.
“We established nursing scholarships that pay for 25 students to earn their associate degrees,” Isley says. In exchange for free education, the students commit to work at Nash UNC Health Care for two years after graduating.
“It is a way to create a pipeline for nurses and to get a supply entering the workforce,” Isley says. In just two years, the hospital has gone from using 80 contract nurses to fewer than 10, a savings of $5 million.
In 2014, Nash Medical Center signed a management agreement with UNC Health creating a partnership that’s been beneficial, says Batts, who is a partner in the Batts, Batts & Bell law firm. The partnership included the hospital’s adoption of the Epic System, which medical centers use to access, organize, store and share electronic medical records.
“UNC has been a great partner for us,” he says. “Epic went live last September, and it has had a direct impact on documentation and quality of care.”
Nash UNC Health Care, with 1,600 employees, is the fourth-largest employer in Nash and Edgecombe counties, according to a 2018 analysis by the Carolinas Gateway Partnership. Average annual patient volume includes 13,000 admissions and 70,000 emergency-room visits, making it one of the busiest ERs in the state.
Batts is excited about the busy hospital’s turnaround. While the facility is still operating at a loss, its financial picture is improving, he says. And with 340 days of operating revenue on hand, the hospital is on solid ground.
“We see the needle moving in the right direction,” he says.