Providence Administrator Joe Fong reports to council on 2012. Heidi Zemach photo.

Heidi Zemach for SCN

The year 2012 was a challenging but good year, said Providence Seward Medical and Care Center Administrator Joe Fong, who gave his 2012 Annual Report at the City Council at the March 11 regular council meeting. The new administrator, who oversees 140 staff and medical providers, was officially hired four months ago, after being the interim manager following the resignation of Chris Bolton in July 2011.

The financial performance census shows it took in $18.11 million in actual revenues, and expended $16.3 million. It had $900,000 worth of charity care or bad debt. The recent negotiated increased reimbursements from Medicaid for client days at the long-term care facility will help the hospital’s financial situation, Fong said.

On the positive side, the staff at Seward Providence is working to perfect the “green care” model at Seward Mountain Haven. Inspections of the facility lately have shown “no significant findings,” which means they turned up no problem areas that needed to be addressed or corrected. Quality measures seem to be having a positive effect. Except for July, there were significantly fewer patient falls at the Seward Mountain Haven long-term facility, Fong said. The facility averaged four falls per 1000 resident days. The national average is five falls per 1000 patient days. At the hospital, there was only one hospital-acquired infection in 2012. Until that case in December, the hospital had gone14 months without a hospital-acquired infection, the result of a lot of work by hospital staff, “So Kudos to the team for that,” Fong said. An employee satisfaction survey showed that had also improved, and that the staff members felt they were encouraged to learn and grow.

On the other hand, Fong acknowledged that the facility still has challenges.

He has received several calls from patients who have had wonderful experiences, and who told him they received excellent care. But he has also heard from people who do not feel they get that. Concerns mentioned included the hope for another option besides the ER on weekends or after hours, and less time waiting or better communication on why they’re running late. “It’s disheartening to hear that we don’t provide excellent care consistently,” Fong said. It’s an area the team needs to improve, so that it is provided to every single patient. “That is what is expected of us, and we should expect that as well,” he said. “I have the pleasure of working a lot with these folks,” Fong said. “They are fully engaged, and want to provide the best service to everyone. But we are all human. I want to encourage them, to let them know that we can be more than human.”

Fong, who also sits on the Community Health Board, which is trying to bring about a federally qualified community health clinic, said Providence supports that effort, and sees it as a means to provide expanded access and services to the community, which was an area of need outlined in the two community needs surveys. Under the current hopes, a CHC board, not Providence, would operate a new clinic inside the hospital, divesting Providence of the existing one and its responsibilities and financial shortfalls. There’s no guarantee that Seward will be selected as a FQHC site, however, so Providence is making an effort to improve its own clinic in every area, from the way it delivers care, to the way it bills, Fong said. Offering a sliding fee scale and lab tests on demand, at subsidized rates, were part of those changes. Meanwhile, Providence also is reviewing its staffing, their skill levels and mix of skills. It is hiring a full-time Physicians Assistant to help with this provider piece. There’s a position open for a certified nurses assistant, and several support staff  positions . “There are still a lot of hurdles to overcome but I am confident we will be able to work through those,” Fong said.

Councilmember Bob Valdatta raised the issue of Seward’s reliance on a small volunteer ambulance corps, and intermittent service provided by ambulances and life flights from Anchorage that can sometimes result in a patient waiting days to get to an emergency care facility.  Ambulance service is not within Providence’s scope of authority, Fong said, but he has been talking with Anchorage Life Med ambulance services about the issue. The hospital also is using telemedicine to provide support care when a patient is awaiting emergency transport to an outside facility. A telestroke program hooks the providers here up with a neurologist in Anchorage for patients suffering from a stroke. The facility also may use electronic ICU services to provide critical care physician support for patients until they can be transported to a higher level of care, he said.

Mayor David Seaward mentioned a friend who had to pay $600 to stich up a gash he received, who felt the hospital charged too much. How would Fong convince people like his friend to go to the Seward hospital for care? he asked.

As we work on our challenges, and improve our services, I think that will go a long way to alleviate the concerns I’ve heard. From a payment, emergency department perspective, we are required to care for anyone regardless of their ability to pay. Fong said it would be better to work with these patients early in process however, rather than in an emergency, he said.

One of the “coolest things” he has learned and experienced during his four months here, is the interconnectedness between the hospital, the city, and other community and nonprofit groups, Fong said.  Providence Seward provided over 1800 community volunteer hours last year, including 50 hours volunteering for the Mount Marathon race. They provided over 30 pounds of food and $90 to the food bank and $800 in gifts for adopted families to the Angel Tree event at Christmas. It also donated $63,000 in-kind services for Seward Wellness For All, over $11,000 on-demand lab tests, and over $300,000 in charity care including sliding fee-scales.