PORT ANGELES — When Mark Gregson walked into Olympic Medical Center on Aug. 18, there was no easing into the job. The interim CEO confronted a federal compliance crisis that has jeopardized the hospital’s Medicare funding, and he’s moved quickly to steady its finances and rebuild trust across the organization and in the community.
At the top of his agenda has been tackling persistent findings by the Centers for Medicare & Medicaid Services that have put its reimbursements at risk.
“Quality is what matters — No. 1,” Gregson said. “And if you’re not getting paid for Medicare and Medicaid, you’re done. That’s 80 percent of what we do.”
The CMS review process had stretched back months, with multiple warning letters citing ongoing deficiencies.
“The first thing I did the first day I was here was have them bring me the most recent report,” Gregson said. “We went through every one of the unresolved items. I said I needed a report every day of how we’re doing in these areas because this is too important not to monitor immediately.”
Gregson spoke to both the state Department of Health and CMS within days of his arrival.
“I wasn’t going to wait for them to call me,” he said.
Chartis contract
Gregson reached out to health care advisory firm Chartis to help the hospital create a plan of correction for the CMS that outlined what it would do to rectify each of the deficiencies. A $248,000 contract was negotiated and signed within 24 hours.
The amount was just under the maximum amount of $249,000 that the OMC CEO can authorize without board approval. Gregson explained that OMC needed to act quickly because it was staring down a deadline by which it had to submit a plan of correction to CMS.
“It was helpful that it was under that number because I did not have to wait for a board meeting, but we needed to make things happen because we were staring down the pike at the Friday deadline,” he said.
Chartis immediately helped the hospital request an extension of the CMS cutoff deadline — from Sept. 20 to Oct. 10 — and an extra week to submit its corrective plan.
OMC is expecting CMS’ response to its plan of correction by the end of this week, although the government shutdown will certainly push that date forward.
When OMC is finally out from under the termination cloud, Gregson said the focus will remain on continuous, permanent improvement.
“We’re not slowing down,” he said. “We’ll go systematically through every department to make sure we are survey-ready everywhere, not just where issues were found.”
Concurrent with resolving the CMS crisis has been moving the hospital toward financial stability.
OMC lost $56 million over the last three years and will lose $16 million this year if it doesn’t change course, the board was told.
It has less than 30 days of cash on hand and retains a hefty amount in accounts payable because it has held off paying vendors in order to manage its cash flow.
Gregson has imposed an immediate freeze on capital spending and hiring. The hospital, which typically invests about $11 million a year in capital improvements, has spent roughly $5 million so far this year — and that’s where it will stop, he said. Going forward, only projects essential to patient health and safety will be approved.
The hospital also is adjusting staffing daily to match the patient census, which could mean giving employees the option of going home early.
“If census is low, we look at how many people we actually need that day,” Gregson explained. “We can ask people if they want to go home early that day. It’s about right-sizing resources every day.”
While that kind of change could be difficult for staff initially, Gregson said, it will build a stronger long-term attitude toward of accountability.
“This becomes part of the culture — every day, you line up resources with what you need,” he said. “It’s how most businesses operate.”
The emergency department remains the hospital’s most visible point of contact with the public — and one of its biggest challenges.
“We measure everything from door-to-doctor time to how long it takes to get lab or imaging results,” the interim CEO said. “The goal is to make care faster and the experience more positive.”
He noted that new ER Medical Director Dr. Aaron Small, formerly of the Mayo Clinic, recently joined OMC through Sound Physicians.
“He’s talented, wants to be here, and brings experience that will help improve our processes,” Gregson said.
He acknowledged that changes to federal programs such as Medicare and Medicaid and state programs like the Hospital Safety Net Assessment Program will impact OMC.
“There’s concern there’s not going to be as much money coming our way,” he said. “So you’ve got to line up your expenses accordingly and take care of your people, your patients and your community appropriately.”
Likewise, he said, emergency department metrics like time it takes to see a doctor and how many people walk away without being seen will be scrutinized to look for staffing efficiencies.
OMC’s potential partnership with UW Medicine, formalized with a letter of agreement signed in September, holds a lot of promise, but it will not be a cure-all for everything that ails the hospital, Gregson said.
He added that OMC must rebuild confidence through openness and communication following recent leadership turnover, financial losses and the CMS crisis.
“Perceptions matter,” he said. “Even if you’re doing the right thing, if people think you’re not, that becomes reality.”
Monthly performance dashboards tracking financial and operational progress, including emergency room metrics and wait times, will be shared at every board meeting, Gregson said. Whether those dashboards will be published online is still being discussed.
Transparency, however, will extend beyond board meetings.
“We can’t just rely on the board structure,” he said. “We need to be out in the community — at chamber events, civic groups, everywhere. In most communities I’ve worked, you’ll see us everywhere until you’re sick of us.”
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Reporter Paula Hunt can be reached by email at paula.hunt@peninsuladailynews.com.
