Situation: (This is a fictitious vignette and contains no reference to any organization.)
You are the CEO of Community South Medical Center, a large, urban for-profit healthcare facility. This is an institution having comprehensive health services including acute, residential, independent living, in-home nursing, hospice, maternal-child and advanced cardiac services, a major trauma center, a center of excellence in its pulmonary services, and neuro-surgery center.
Community South Medical Center has a very positive bottom line and is striving to enhance health services for the population it serves. The patient care mix has shifted in the last three years and is by reimbursement source is currently: 25% Medicaid (up 20%); 35% Medicare (down 12 %); 25% employer sponsored health insurance (unchanged), 8% managed care (down 20 percent), 4% private pay (unchanged) and 4% no-pay (up 25%).
The Medical Center is in an older urban area. Businesses with good paying jobs have been gradually moving out of the area, being replaced with small shops and other small business organizations. Overall, the population trend is that of an aging population.
The Medical Center has an excellent reputation and has been recognized in the past by receiving a Baldrige Center of Excellence evaluation and JCAHO for their quality of services; however, recent self-inspections indicated a slight decline in compliance with JCAHO standards. Patient satisfaction survey results have an overall mean of 95 percent. The medical staff is very much in support of new program development and there is a very comfortable supply of physicians.
The current major issues confronting the Community Couth Medical Center are an identified shortage of clinical staff including registered nurses, respiratory therapists and medical...