On Monday, Broward Health CEO Gino Santorio walked the halls of Florida’s Capitol, letting state legislators know how important critical care funding is to his healthcare system that serves two-thirds of the county.
Santorio’s task will be to convince legislators that his hospital system — and others like it in Florida — need the budgeted $318 million to treat Medicaid’s sickest patients who could not otherwise pay for care. Broward Health is one of 14 safety-net hospitals in Florida and would lose anywhere from $3.5 to $15.2 million under a current Senate plan to change the existing reimbursement structure.
“There is a high-cost structure to provide care to our most critically ill patients,” Santorio said in a March 26 interview with the South Florida Sun Sentinel. “Our job is to educate legislators on the pressing needs in our hospitals and across the industry. These are real people with complicated conditions that rely on the comprehensive, complex care we provide.”
Santorio’s efforts in Tallahassee for Safety Net Hospital Alliance of Florida’s “Day on the Hill” come as he simultaneously works to restore stability to Broward Health, also known as the North Broward Hospital District. As CEO since December, and acting CEO since October, Santorio, known for his expertise in turnaround management, has steered the health care system in a new direction. Broward Health had experienced several tumultuous years of highly publicized management and physician turnover, criminal charges against board members, and misspending. The criminal charges were dismissed last month by a federal judge.
Getting the public healthcare system on track — and keeping it there — is critical to patient care in the South Florida community. The hospital district, partially supported by property taxes, is one of the 10 largest public healthcare systems in the country with four hospitals, and 30 outpatient urgent-care and primary-care centers.
With healthcare legislation on the state and national agenda, 36-year-old Santorio recognizes he has work ahead of him on myriad fronts. In Broward County, admissions to hospitals are down 7.6 percent as technology has reduced lengths of stay, and more outpatient surgeries are occurring at facilities other than hospitals. Miami-Dade’s public hospital network, Jackson Health System, recently laid off workers after failing to reach patient admission targets and seeing more uninsured patients. Santorio says layoffs won’t happen at Broward Health.
“We’ve put a very tight focus around our expenses and flexibility,” he said “We made sure we structured our labor with part time and full time to flex up and down without having to do a reduction in force.”
Santorio says he has focused on improving Broward Health’s financial condition and spending money where patients see a difference. “Every dollar we are able to save is a direct reinvestment back to this community,” he said.
Under prior management, Broward Health publicly had suffered from improper staffing, physician turnover, low morale, unsigned vendor contracts, bills left unpaid and complaints from employees of a toxic work environment that affected patient care as reported over the past two years by the Sun Sentinel. The troubles even included the suicide of a former CEO. Santorio has made changes to fix many of the problems and bring financial stability to Broward Health. He said he has created $31 million in savings by controlling legal fees, renegotiating contracts with pharmaceutical companies and other vendors, and restructured bonds from variable to fixed rate. A new Standard & Poor’s report on Broward Health’s improved its credit outlook from negative to stable.
Physician turnover seems to have slowed. Dr. Rajiv Chokshi, former Chief of Staff for Broward General Medical Center and the Chris Evert Children’s Hospital, said Santorio has brought stability to the hospital system. Dr. Chokshi retired from private practice in January and continues to teach at Broward General.
“His ability and intent to work with physicians is very evident,” he said of Santorio. “He knows how important it is for the physicians to be on board.”
Santorio’s strategy of working physicians and investing in key areas has put the health care system on a path to offer better patient care by redesigning and expanding its neonatal intensive care unit to 70 beds, purchasing two new robotic machines to assist in surgeries, and sending a mobile care unit into under-served neighborhoods. Prior to joining Broward Health, Santorio had held key positions at Miami’s public health systems. He served as senior vice president and chief executive officer for Jackson North Medical Center and was chief operating officer of Jackson Memorial Hospital
One of the biggest changes has been to fire the Independent Review Organization hired by prior management to oversee Broward Health’s compliance with a federal integrity agreement. The IRO had launched investigations which some board members say appeared to be motivated by general counsel’s grudges against rivals. Earlier this month, the hospital district’s board voted to hire a new IRO at a $5 million savings.
Christopher Ure, vice chair of the Board, said Santorio is the right person at the right time, with enthusiasm and operational skills. Santorio already has put his stamp on the organization and mended broken relationships with the physicians, staff and community leaders, Ure said. “That has been an important exercise.” Now, the CEO’s next big challenge “is genuinely turning this into an actual system as opposed to a wonderful portfolio of assets that happen to be in proximity,” Ure said.
On Monday, Ure accompanied Santorio to Tallahassee to meet with legislators and urge additional funding, rather than cuts.
“People need to understand how critical the services we provide are,” he said. “This isn’t about giving the organization enough crumbs to survive. We need to be in a position where we’re not just surviving.”Image
cgoodman@sunsentinel.com, 954-356-4661, Twitter and Instagram @cindykgoodman