Case Study:
DePaul Medical Center Engagement

Discontinuance of Acute Care Hospital Licensed Services, a Merger and Hospital Outpatient Department (HOPD) Conversion during a Global Pandemic

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Case Study Breakdown

Spectrum Health Partners (SHP) experts conducted a deep assessment of the market, provided numerous solutions for the complex problems facing the hospital and health system, expanded the scope of the initial project to preserve key services and revenue, while also improving the quality of care at the facility during the closure activities – amid a global pandemic.

SHP Services Delivered

Facility Repurposing, Wind Down & Closures | Interim & Crisis Leadership

SHP Leadership Engaged

Ken Doran, CPA | President & CEO
Supervising Partner

Cindy Segar-Miller, RN, FACHE | Principal
On-site Principal and Interim Campus President providing in-person day-to-day leadership at the hospital while collaborating with Division and Market Leadership

The Client

DePaul Medical Center, located in Norfolk, Va., owned and operated by the Bon Secours Mercy Healthcare System, Cincinnati, Ohio.

The Situation

Spectrum Health Partners (SHP) was engaged in November 2019 to help the corporate and the local market leadership negotiate and ultimately agree on a plan for the future of a 199-bed 165-year-old faith-based non-profit hospital. Corporate leaders wanted to close the underperforming facility as market leadership was exploring alternative ways to preserve revenue and possibly expand services at the hospital.

Length of Engagement

November 2019 to May 2021

Number of Internal Stakeholder Groups Involved

There were 27 internal stakeholder groups involvedrepresenting all functional areas:

  • Providence Group – Corporate Executive Leadership
  • Hampton Roads Market
  • Clinical – Ancillary Services: Lab
  • Clinical – Ancillary Services: Pharmacy
  • Clinical – Clinical Operations and Population Health
  • Clinical – Conduit Health Partners
  • Clinical – Nursing, Quality/Safety, Regulatory, Care Management
  • Clinical – Physician Services
  • Community Impact: Community Health
  • Community Impact: Foundation
  • Community Impact: Government Relations
  • Community Impact: Mission and Sponsorship
  • Compliance
  • Finance: Accounting and Tax
  • Finance: Capital
  • Finance: Shared Services
  • Human Resources
  • IMO (Internal Management Office)
  • Information and Technology
  • Infrastructure
  • Insurance, Risk, Claims, Protective Services
  • Internal Audit
  • Legal
  • Marketing & Communications
  • Real Estate
  • Revenue Management
  • Supply Chain
  • Treasury

Number of Individual Decison-Makers Involved

There were 50 individual decision-makers involved.

The Work

  • SHP conducted market research to determine the viability of various service configurations.
  • SHP developed and presented multiple options for consideration.
  • SHP was able to successfully bring key stakeholders together to create a shared vision for the hospital’s campus.
  • The responsible parties decided to close the facility as an acute care hospital by spring or summer of 2020 but continue to offer outpatient services of high value (The Cancer and Women’s Imaging services) on campus.
  • SHP conducted a deep-dive analysis of margin-draining services and worked to ensure that patients’ continuity of care needs were met as services were discontinued.
  • A decision was made to merge the campus with another market hospital to preserve graduate medical education slots and dollars.
  • SHP assisted with Certificate of Public Need (COPN) filings and ambulatory venture plans.
  • SHP successfully oversaw the conversion of two hospital departments into HOPD to be affiliated with the newly merged entity that had been created.
  • SHP managed the discontinuation of the acute care hospital license and post-close wind-down activities.

The Challenges

  • The hospital was struggling with accreditation issues, declining quality, financial stress, low market share, leadership instability, and low employee and physician morale.
  • The COVID-19 pandemic hit the community in March 2020; SHP created a plan to expand the bed capacity of the hospital to greater than 300 to prepare for possible COVID patients.
  • Expanded ICU capacity from 8 to 24 beds.
  • A second wave of COVID-19 hit the community in June 2020, and the hospital closure was postponed.
  • Despite the fluid discontinuance of the acute care licensed services timeline, SHP led wind down and closure activities while concurrently improving processes and operations of the facility.

Accomplishments and Outcomes (Period of Nov. 2019 to May 2021)

Outcomes were improved the entire length of the engagement.

Regulatory
    • ZERO fines, penalties and or negative survey findings.
Quality
    • All-Cause Readmissions below the target of 0.76 at 0.61.
    • Heart Failure Readmissions below the target of 0.88 at 0.54.
    • Designated “Best Maternity Care Hospital” by Newsweek
Safety
    • Leapfrog Letter Grades for Safety – sustained a letter grade of “A”
    • Leapfrog “Top Teaching Hospital Award” earned
Throughput
    • Emergency Department
      • Admitted LOS Median reduced from 573 to 351 minutes
      • DC LOS Median reduced from 171 to 139 minutes
      • ESI 4/5 LOS Median down from 110 to 89 minutes
      • Reduced LWOT rate from 1.2% to 0.8%
    • Radiology reduced outpatient diagnostic exam turnaround time from 28 to 22.6 minutes
    • Laboratory reduced Chemistry turnaround times from 55 to 40 minutes
Finance
    • 96% increase in revenue over expenses: Radiation Oncology from Oct. 2019 – $2,018,834.00 to October 2020 – $3,947,483.00
    • Exceeded the goal for fiscal Pharmacy Clinical Savings Initiative by 218%: Goal = $61,754, Achieved Savings = $134,921
    • $282,600.00 in over payment to Hospitalist group discovered and recovered
Service Line Growth
    • 129% increase in utilization of Intensity Modulated Radiation Therapy (IMRT) on the True Beam Linear Accelerator – October 2019: 221 compared to October 2020: 507
Physician Satisfaction and Engagement
    • Engagement scores most improved in market: 46% to 64% favorable engagement compared to Company -8 average score
 Employee Gift
    • Facilitated and gained approval for self-funded independent medical staff to donate $145,500 ($500 each) to 291 employees for their loyalty and service to DMC

Client Testimonials for Cindy Segar-Miller’s Work on This Engagement

“It was great to be able to work with you over these last 18 months. You demonstrated amazing leadership skills to be able to assess and manage the DMC transition. Thank you for all your support with the medical group. You will be missed!”
Stephen Jones, COO, Bon Secours Mercy Medical Group

“It has been a pleasure to work with you and watch you lead the transition of DePaul, a beloved hospital in our community. Thank you for your commitment to excellence and the compassion and leadership you demonstrated along the journey. Wishing you much success in your next endeavor!”
Marne Naas, Vice President of Service Lines, Hampton Roads

“I wanted to extend my heartfelt thanks – both for what you’ve done for our market and to support the best possible transition of DMC that we could have asked for, and for your support of me. I’ve appreciated your leadership, your mentorship, your willingness to listen and offering solutions and ideas. You will be missed, and I wish you all the best in your future assignments. Thank you for being a part of our team and family these past months.”
Kate Brinn, Campus President, Maryview Medical Center

“Thank you for your commendable efforts serving our community.”
Cynthia Romero, Board of Trustees Member, Hampton Roads

“Cindy- Thank you for your never-ending optimism and leadership throughout this difficult transition with DePaul. I wish you much success in your future!”
Susan Pilato, Foundation Board Chair, DePaul Medical Center

Subject: A Fond Farewell and Thank you!
Dear Team,
Please join me in wishing Cindy Segar-Miller a fond farewell and a thank you for her 18 months of leadership and service at DePaul Medical Center. Cindy joined us at a time when DePaul was struggling with issues related to accreditation, overall leadership stability, declining quality, and financial performance among many other challenges. With her leadership, the team was able to deftly navigate these challenges and identify a path that would lead to long-term stability and the consolidation of DePaul and Maryview. I am very thankful for her leadership during this time and appreciate her many talents and gifts. As Cindy’s engagement comes to a close, I hope each of you will offer a prayer for her continued success and leadership at Spectrum. I pray she will continue to bring her talent and experience to benefit all of her future clients and the communities they serve! Best Wishes to our friend and colleague, Cindy!
Amy Carrier, Market President, Hampton Roads

Find a Principal/Partner

Kenneth Doran, CPA

Cindy Segar-Miller, FACHE

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