New Crouse Hospital CEO lays out objectives

CNY Business Journal (1996+), May 07, 2004 by Rombel, Adam

SYRACUSE - Dr. Paul Kronenberg, an internist who took over the reins at Crouse Hospital in February just a few months after it emerged from Chapter 11 bankruptcy protection, says it's a "different time" for Crouse.

The hospital completed 2003 with EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization a measure of the amount of cash generated by a company's operations) of $12.6 million. Crouse has also finished the first three months of 2004 several percentage points ahead of budgeted revenue and profit figures, says Kronenberg, CEO and president of Crouse. "And, we budgeted for an improved financial performance to begin with," he adds.

The improved financial standing - largely put into motion by David Speltz and Timothy Weis, hospital-turnaround experts who served as Crouse's CEO and CFO, respectively, for two years before leaving earlier this year is allowing Crouse to focus more on improving patient care and clinical services.

To that end, Kronenberg is a first among Central New York hospital chief executives. He continues to see patients, two half-days per week at his office at Internist Associates of NY PC, a group practice located across the street from Crouse, and at the hospital when the patients are admitted.

"Our mission is taking care of patients. What I bring to this is seeing things from that side. If I don't continue [seeing patients], I'll lose that perspective," says Kronenberg, who has been on Crouse's medical staff since 1975.

Kronenberg has given up his president's post and partnership in Internist Associates.

In an exclusive interview, Kronenberg lays out four challenges or priorities facing Crouse today:

* Despite the improving financial picture, the hospital's finances remain a "large challenge," he says. "There are still many hospitals throughout New York State that are... unprofitable, so that's always a concern." This month, Kronenberg has put into place a system designed to increase usage of Crouse's operating rooms to at least 70 percent, up from 50 percent now. Physicians will be held more accountable when blocking out time for operating rooms. If rooms are not utilized, doctors will lose their time blocks. Crouse is also working hard on improving staffing and patient flow to decrease backups at its emergency department and to increase admissions.

* Employee recruitment and retention is another focus for Kronenberg and his hospital since there's intense competition for workers in the medical field. Crouse, which has 695 registered nurses on staff, actually finished the month of April with no registered nurse vacancies, an unusual occurrence for hospitals locally or nationally. But Kronenberg and his staff aren't complacent. The hospital plans on "overhiring", by about 20 nurses to ensure it has enough fully trained RNs to replace retiring nurses. It Usually takes about three to six months to prepare a newly hired nurse to be on par with existing staff nurses, hesays. The CEO also cites maintenance, environmental services, and food and nutritional services as departments where the hospital must focus on recruitment and retention to deal with a competitive hiring landscape.

* A third challenge is how to deal with technological advances that are rapidly improving the quality of care but also boosting costs. Kronenberg and his staff are focusing the hospital's Medical Cost Quality Management Committee's mission on the important questions of what technologies are needed and how does Crouse pay for them, he says. "We're no longer doing business as 'whatever you want you get,"' he says.

* Kronenberg is committed to initiating a closer operating relationship, but not a merger, with next-door neighbor, University Hospital, a unit of SUNY Upstate Medical University. Kronenberg envisions initiatives that reduce duplication of efforts and create synergies. He says that Crouse and University Hospital are "very close to working on a major collaborative project." Kronenberg declines to say what the collaboration will be but provides a couple examples of areas where the two institutions may benefit from partnering: cardiac services and facilities such as parking structures

A previous effort by the two hospitals to join forces was scuttled a couple years ago after Crouse's employee union opposed it. Kronenberg is mindful of that.

"Anything that we will do will be with the involvement of the unions," he stresses.