My very best for the future

At 12:01 this morning, Community General Hospital became Upstate University Hospital at Community General.

Dr. John McCabe, the CEO of Upstate University Hospital, and I completed Upstate's acquisition of Community yesterday afternoon.

Our photo was taken in the New York City offices of Hogan Lovells, the law firm that represented Upstate in the transaction.

Community General was represented by Bond Schoeneck & King.

The files in the foreground are a fraction of the documentation we needed to close the deal. Dr. McCabe and I have been signing thousands of documents since last week in order to accomplish the closing.

That represents the mechanics of the deal. The substance of the combination -- the benefits for the community -- will now follow.

A front page story in today's Post-Standard recaps the history of Community General Hospital as we begin this next chapter of service as part of Upstate. Community's roots go back to Syracuse General Hospital, located on Castle Street in Syracuse. Our progress is shown graphically in the logotypes, pictured below.

This is my final posting for More than Medicine. This began as a weekly letter to employees in the fall of 2002, when I became Community's President & CEO. That weekly letter morphed into More than Medicine in 2006.

Effective today, I am no longer CEO. I have accepted a Senior Vice President position at Upstate, and I will be working in the administrative offices at the main hospital downtown.

Meredith Price is Upstate's new Chief Administrative Officer at the Community General campus. She has already been at work here for several months, leading the transition planning with Community's senior management group.

At the final annual meeting June 15, I told the Board of Directors

". . . the fact of Upstate’s acquisition does not, by itself, make this a successful deal. This deal is going to take hard work. We will have to execute for Meredith Price and for Dr. McCabe. . . .I have asked my managers to give their loyalty and support to Meredith in this important effort," and I am pleased to say that they have done so.

Thank you, Drs. David Smith and John McCabe, and congratulations. To Meredith Price and her team, I wish you the very best for the future.

To CGH employees, volunteers, physicians, and board members: it has been a privilege and an honor to work with you.

Today's milestone for the community

At 4:48 p.m. today, Dr. John McCabe and I signed the final documents, completing the sale of Community General Hospital to SUNY Upstate Medical University, effective 12:01 a.m. tomorrow.

This is a milestone for health care in Central New York. This allows our hospital to continue its service to the community under the aegis of Upstate. This allows the physicians on the medical staff to continue serving their patients at the Community General campus. This keeps most employees in jobs and brings the significant potential of a larger hospital and the academic world.

This helps our hospital prepare for the many changes coming from health care reform, as well as from the challenging demographics and economy.

Achieving this milestone has taken the hard and conscientious work of many, including and especially Dr. David Smith, University's President, Dr. John McCabe, University Hospital's President, and their highly capable staffs.

Community General's board of directors has consistently kept in mind the best interests of patients and the community-at-large, as well as the hospital's stakeholders.

My thanks to Steve Infanti, our board chair, for the past nine years of his leadership (and for many more years, before that). I thank John Hession, Chet Amond, Jim Getman, and all our board members, including the physicians whose participation has been invaluable.

The State Health Department worked diligently to review Upstate's certificate of need application, including the detailed due diligence that was completed within the Department's otherwise demanding agenda from across the state. In fact, all divisions of government, including the Governor's staff, the State University of New York, the Department of Budget, the Attorney General, and the State Controller worked carefully and in a focused way to approve the complex transaction.

I would like to acknowledge the many elected officials who supported the Upstate-community combination, and I specifically reference State Senator John DeFrancisco, whose work was personal and unflagging on behalf of the acquisition. County Executive Joanie Mahoney also was very helpful.

Excellus, the area's largest health insurer, has worked for this moment for more than a dozen years by sponsoring community studies and by encouraging hospitals such as Community General to work toward a well-planned consolidation. My special thanks goes to David Klein, Chairman of the Lifetime Healthcare Companies (the parent company of Excellus) and to Chris Booth, CEO of Excellus BlueCross BlueShield of CNY.

I salute Community's employees who, despite worry, uncertainty, and distractions, always understood our hospital's unique role in the community and the importance of our continued caring. Finally, Community's management team deserves laurels for staying the course, for working hard in support of the combination, and for keeping the focus on patient services and quality throughout the complex process.

As I wrote recently to the board, there have been many instances of heroism and stamina in bringing the Upstate-Community combination to fruition. Too many, in fact, to recount, and so many, I do not know all of them.

In recent weeks many have expressed appreciation to me for Upstate's support and for the honorable way Upstate has worked with Community General and its employees. Such expressions have meant a lot to me, especially the kind words from individual employees and from patients and families.

To all who made this possible, thank you and congratulations. My best wishes to you, to Upstate, and to the community that is the ultimate beneficiary of this milestone.

"Seize this very minute"

Sometime after he succeeded John L. Brown, the founding President & CEO of Community General Hospital, Jerry Harris presented each of his vice presidents with a poem, displayed in small plastic stand for desk or book shelf.

Jerry became President & CEO in 1982, and it was probably several years later when he handed out the short verse by Johann van Goethe. Here is a translation by John Anster:

Lose this day loitering - 'twill be the same story
To-morrow - and the next more dilatory;
Each indecision brings its own delays,
And days are lost lamenting o'er lost days,
Are you in earnest? Seize this very minute -
Boldness has genius, power and magic in it.
Only engage, and then the mind grows heated -
Begin it, and then the work will be completed!

Jerry Harris was a key figure in my career. He promoted me to vice president and helped me return to college for an MBA degree. He also freely shared his hospital stories and his sayings about management. Among them was this challenge: "Sooner or later, somebody's gotta do the work!" That was an echo of Goethe's "Lose this day" eloquence.

One of the most impressive things about the leadership of SUNY Upstate Medical University is its action-oriented management team. Dr. David Smith, University President, and Dr. John McCabe, Hospital President, look for and expect results.

At a senior management retreat last fall, Dr. Smith passed out coffee mugs to his Upstate leadership team. "Get-r-done!" the cups read, referring to Upstate's acquisition of Community General Hospital.

To this day, I display in my office the Goethe poem Jerry Harris gave me. It is good to know that Community's work ethic will fit comfortably with Upstate's bias toward action.

Well done!

I’d like to acknowledge with gratitude the work of the Community General Hospital Employee Community Service Fund, which has assisted members of the Community family since 1993.

With Community’s transition to Upstate University Hospital, the CGH Employee Fund completes its exemplary, quiet service.

I say “quiet,” but the Fund could actually be quite noisy once each year during the campaign to aid the United Way of Central New York and the Community General Foundation -- and to resupply its own coffers for the benefit the Community General family members.

Once the annual United Way campaign was finished, the Fund board labored in relative obscurity, inconspicuously providing temporary financial assistance to employees and other “family members” for a “sudden, unplanned economic hardship due to accident, loss or disaster” (in the words of the Fund).

With the transition of Community's employees to Upstate (and to Upstate’s contract services), payroll deductions come to an end, and the Employee Fund completes its work and its lifespan.

Although employee pledges end as of mid-year, Fund directors voted recently to complete payment to the United Way of Fund's full pledge for 2011. Any amount remaining in the Fund goes to the Community General Foundation, which will continue as a fund raising corporation after the Upstate acquisition is completed.

During its existence, the Fund provided some $150,000 to assist CGH family members through hard times.

In addition, United Way contributions from the Employee Fund have been more than $400,000 over that period.

To all who supported the Fund and to the directors who made it work, congratulations and thank you.

Job well done!

Towsley Tourney Turns $150,000

When the sun set on Friday's Towsley Pro-Am Tournament, the Community General Foundation had raised more than $150,000. The photo by Dan Cameron shows the sun as it appeared over the first hole at the Shenedoah Golf Course at the Turning Stone Resort, where the event was held to honor the memory of Bill Towsley, the well-known business manager of IBEW Local 43. Bill died last year, following a battle with cancer.

This was the Foundation's 27th annual pro-amateur golf tournament, but it was the first named for Bill. I had the privilege of meeting with Bill's family when they joined us at the awards dinner at the end of the day. That's Ken (who also played in the tourney), along with Tracy, Jen and Bill in the photo, at left.

IBEW 43/ NECA was the Presenting Sponsor for the tourney, which was supported by IBEW chapters from across the state, including Long Island, Westchester, and Rochester.

My special thanks for the successful to the Central New York PGA and its Executive Director Al Seamans. The character of this tournament day comes in large part from the unique chemistry that results when area golf pros are teamed with foursomes as they play a challenging course.

Thank you, Greg Cohen and Rock Shirtz, the Co-Chairs for the Foundation's golf committee. Thanks also to Scott Matukas, Board Chair, and to the entire Community General Foundation board.

I'd like to acknowledge TK99's Gomez and Dave, who provided MC services (and they play well too).

This was another successful golf tournament due to the thorough preparation and attention to detail by John Zacharek, Community's VP of External Affairs, along with Gillian Ottman, Amy Gulotta, and a host of tourney volunteers. My thanks to all!

"A job well done"

Because of the Department of Health meeting in New York last Friday, I was not able to return to Syracuse in time for the annual Service Recognition Dinner for Community General employees and for recent retirees.

This was, I think, the first Recognition Dinner I have missed for Community. I am sorry to have missed it, it being a poignant evening as the last one under Community’s independent status.

My thanks to Sharon O’Neill, Human Resources Director, and her staff for organizing the event again this year, and thank you too to Vice President Dennis Trepanier and to Medical Staff President Dr. David Halleran who “did the honors” in saluting employees and retirees at this milestone event.

A highlight of the evening was an “ode” by Jan Filsinger, an Emergency Department Coding Data Analyst. Here's what she said:

ODE TO MY ADOPTED FAMILY
Jan Evans-Filsinger

When I was very young you took me in.

You had patience with me and showed me skills.

You watched me grow under your tutelage and there were expectations.

I worked hard over the years and in return you helped me provide for my family.

You paid for some of my education and most of my insurance.

You provided me with the means to save for my children’s education, Christmas club, and even my own separate retirement.

When my children were born, I came to you and you took care of me and the expense.

When I or my family were sick or injured we came to you and again you took care of us and the expense.

Just like any other family, we had our ups and downs but you always stuck by me; even in some really rough patches when I left you in the lurch you were still by me and helped work things out.

Oh sure we have some siblings that have felt you should have done more, given them more, but with the economy changes that got harder to do. Yet year after year you have recognized us, given us gifts, some free lunches and never forgot a Christmas.

But just like any other family member on a fixed income, you began to falter under the weight of the economy.

You made some changes and tightened your belt.

But at the end of the day it proved to be too much and now you need assisted living.

As we move forward I will do all that I can to help you transition with your dignity and self-respect intact.

Tonight we recognize you for 48 years of hard work and a job well done.

I will always look back with fondness and say thank you to Community General Hospital!

The vote to approve

On Friday morning the Upstate Medical University's Certificate of Need (CON) application was the “main event” at a committee of the newly-reconstituted Public Health and Health Planning Council of the Department of Health.

The Establishment and Project Review Committee voted to approve Upstate’s application, a significant step in completing the combination with Community General Hospital.

The CON discussion took the greater part of an hour as committee members reviewed the transaction, considered the financial arrangements, heard about union issues, and considered what was best for the community.

The Department of Health noted that Community General’s services are essential in the area, and it specifically made reference to emergency capacity with Syracuse hospital emergency departments full to overflowing with some frequency.

Apart from the financial issues and policy questions involving the State University of New York (Upstate is part of the SUNY system), a committee member asked about the role and decision-making of Community General’s board of directors.

I explained that Community's board had considered the question of a strategic affiliation for several years, engaging outside consultants and undertaking extensive merger discussions with Crouse Hospital -- before deciding that the community’s interests would be best served by the combination with Upstate.

The support from the community-at-large was also well-established. Dr. John McCabe, CEO of Upstate University Hospital, explained that the combination has been endorsed by all local review panels -- the Central New York Health Systems Agency, the Hospital Executive Council, and the Affiliation Council that involves Upstate and Crouse Hospital (formed as a result of the state’s Berger Commission).

The Department of Health noted the support for this arrangement from health insurers, as well.

Last week was the debut meeting of the Council after it has been reorganized by New York State. New Council members were appointed by the Governor in May, and the State Senate moved promptly to approve them in time for a series of meetings this month. The Department of Health digested a voluminous amount of information to get ready for the committee review.

All of us at Community are very grateful for the cooperation and the time and effort devoted to this important project by state officials and by the Council members.

97% voted for the Bridge Agreement

On Thursday Community General employees ratified the Bridge Agreement, as negotiated by 1199SEIU and hospital management.

The Bridge Agreement was supported by 97% of the voters.

Ratification of the new collective bargaining agreement is a notable accomplishment that helps set the stage for Community's employees making the transition to Upstate University Hospital at Community General.

Collective bargaining began on February 11 and continued through the last week of April. There were 12 bargaining sessions, in all. Community's labor agreement expired April 30, and a tentative agreement was reached on May 13.

My sincere thanks to all members of the labor bargaining team who helped reach the agreement, and congratulations to Community's management team for its concerted efforts over the many weeks of discussion.

Onward!

Widespread support

This week we saw an example of union dues at work. 1199SEIU sent over-sized postcards to thousands of Central New York residents, objecting to the "ill-conceived takeover of Community General" by SUNY Upstate Medical University.

Residents are asked to call State Senator John DeFrancisco and Assembly Member Bill Magnarelli. Presumably, they are expected to affirm SEIU's position that Community General Hospital's combination with Upstate is "rushed" and "badly-flawed."

Actually, the combination has been very carefully planned. Upstate has gone to great lengths to assure that vital patient services remain at Community General's campus, and it is taking steps to broaden and deepen patient care here.

Upstate intends to employ most of Community's workforce, and it has made special efforts to transition Community General's employees. The State Legislature even passed a special law allowing Community's employees the option of remaining in Community's pension plan after they join Upstate.

Some people who got the post card told me they called the legislators' offices but with a message the opposite of what SEIU intended. "I support the Upstate plan," one of them told me this week in the cafeteria, "and that's what I told them."

SEIU's post cards do not state the real reason for its opposition. The real reason is that most Community General employees would become public employees. That means they would join the public unions, and SEIU would lose the membership.

SEIU stands pretty much alone in its opposition. The Upstate-Community plan has widespread support.

Elected officials have already endorsed the plan in letters to the Department of Health:

State Senator John DeFrancisco: "I write you in full support of Community General Hospital’s application. . . . (as) essential for continued available services, and assuring uninterrupted employment . . . and providing high levels of care to patients.” (February 22, 2011)

State Senator Dave Valesky: “I believe the merger of the two entities is critical for the continuation of quality health care in Central New York and will benefit the entire region.” (March 21, 2011)

Assembly Member Bill Magnarelli
It is my belief that Upstate Medical University’s acquisition of Community General Hospital is the most reasonable approach . . .and is in the best interest of the community-at-large.” (May 5, 2011)

A number of community health planning organizations have also endorsed the Community-Upstate plan. They are:

▪ Hospital Executive Council
▪ Crouse Hospital/ University Hospital Affiliation Council
▪ Community Health Information Planning Service,and
▪ Central New York Health Systems Agency.

Why 1199SEIU is worried

A recent letter writer to the Post-Standard suggested that Community General’s plans with Upstate University Hospital are somehow part of an “attack” on workers’ rights.

The writer said: “At a time when the rights of workers are under attack, it is important for people concerned with social justice to speak out when management and policy makers display insensitivity to process for the resolution of labor concerns. Such appears to be the case in the plans for the acquisition of Community General Hospital by Upstate Medical University.”

But the letter writer misunderstood what is happening at Community General. When Community becomes part of Upstate University Hospital, employees will continue to be represented by unions.

This is not a question of union vs. non-union. It is simply an issue of how Upstate structures its operations in a way that maximizes community benefit, fosters its mission, and preserves the most jobs for Community employees.

This week 1199SEIU held a rally in downtown Syracuse at which critical comments were made about Upstate for its approach in working to preserve the employment of Community workers. I would think that’s exactly what a union should be working for. But 1199SEIU cannot guarantee anyone's future without a job.

It is Upstate that offers Community workers continued jobs at the Community campus as part of the larger health care system.

To understand what’s behind 1199SEIU’s concerns, look at what’s happening.

In 2009 A.L. Lee Memorial Hospital (with over 200 employees) closed in nearby Fulton, NY. 1199 had a labor contract with Lee Memorial. The former hospital is now an urgent care center operated by Oswego Hospital.

This year Community General (with 1,100 employees) will become part of SUNY Upstate Medical University. 1199 represents about 800 of Community’s workers.

In our region at least two other hospitals with 1199 labor contracts also contemplating mergers with larger hospitals.

No wonder 1199SEIU is worried.

When I was asked about the rally and some of the statements made by 1199SEIU, I told reporter Jim Mulder: “As a business, 1199 is understandably worried about maintaining its client base.”

Jim's news report on the rally was published yesterday.

"The changes we're facing . . . '

Earlier this week the Post-Standard published a letter to the editor from three nurses who work in the ICU at Community General Hospital.

Their letter noted that, among the public comments on Upstate's acquisition of Community, many have been by representatives of a labor union.

Most employees, said the writers, "understand that. . . the changes we’re facing are in the best interest of our patients, the community and the employees."

Despite some unanswered questions, they acknowledged "the management teams of both CGH and Upstate . . . have shown a good faith effort in keeping everybody informed."

These nurses have worked at Community between eight and 21 years, each. I thank them for taking the time to voice their opinion.

From the Board Chairman

This letter from Steven Infanti, Sr., appears today in the Post-Standard.

Much has been written about Upstate Medical University’s planned acquisition of Community General Hospital. This combination will have significant benefits for our community and our region.

Health care is changing — not gradually, but rapidly. Cost pressures, changes in physician practices and progressive changes in Medicare and Medicaid all make it increasingly difficult for smaller, stand-alone hospitals to continue their services.

However, there also exist opportunities for doctors and hospitals to work together in new ways and in new structures to improve health care services and quality.

As part of Upstate, Community General Hospital will be in a larger, better positioned health care system. Upstate has a regional mission, one that becomes more important as health care reforms are realized. Today, Upstate is operating at essentially full capacity, and it needs to expand.

Community General Hospital has available capacity, and it brings to the table a strong reputation, a history of service and a 42-acre health care campus in which our community has already invested.

Upstate’s acquisition of Community General will make the best use of existing health care resources and will provide a cost-effective means for Upstate to grow clinical services and develop its teaching role.

Together the combination will be more than the sum of its parts.

● It solves two problems with one cost-effective stroke. Upstate’s capacity limitations will be solved and increased patient volume at Community General will improve overall financial performance.

● The cost of services at Community General’s campus will be spread over a larger base of operations. This will, over time, achieve efficiencies not possible as a stand-alone hospital.

● Community General’s 1,100 employees will be maintained substantially intact, preserving jobs and providing Upstate with a skilled workforce, already in place.

● Changes in Upstate’s medical staff bylaws accommodate the private medical practices that depend upon, and support, Community General Hospital. And Upstate’s stronger clinical platform will broaden specialty services for patients using the Community General campus.

● The Community General campus will maintain a broad complement of services, including emergency, acute care and outpatient care, continuing access for residents of its primary service area.

● This transaction is right for patients, for doctors and for employees. Most importantly, it is right for residents in and around Central New York.

Community’s board of directors has carefully planned this strategic affiliation. We have used independent consultants, and we have spent countless hours in study and consideration, including the examination of different scenarios about how best to serve the community.

Having analyzed the facts, we feel, unanimously, that the combination of Community General Hospital with Upstate Medical University is the right decision for Syracuse and Central New York.

-- Steven J. Infanti Sr. is chair of Community General Hospital’s board of directors.

Our new name will honor our past

When employees of General Hospital of Greater Syracuse joined the then-new Community Hospital in November 1964, the new hospital changed its name. It became Community-General Hospital of Greater Syracuse.

The name is used today without a hyphen, but the link to General Hospital was important for many. It recognized their association with a caring institution that served the community for 69 years.

Leonard Markert, Sr., a long-time community leader and a past director of Community General Hospital, once spoke earnestly to me about the linkage. "Don't forget," he said, "where we come from."

Upstate has talked about Community General's tradition of caring, even as our campus becomes part of SUNY Upstate University Hospital -- a single hospital with two campuses, as described in the Certificate of Need application.

Upstate has considered several versions of the Community General name. As we anticipate the closing of this transaction on or about July 1, the name "Upstate University Hospital at Community General" recognizes the new role of this campus, as well as "where we come from."

95% have applied

I am pleased to report that Upstate has received applications from more than 95% of those eligible to apply.

Thank you, all!

78% have applied so far

In the first 11 days of sign-up, 78% of Community General Hospital employees have made applications to SUNY Upstate Medical University.

The applications are a necessary step for employees to continue their jobs at the Community General hospital campus once Upstate completes its acquisition of Community in mid-year.

Benefit infomation sessions continue at Community for the next two weeks.

Upstate-Community provides economic boost

Syracuse is poised to build on this robust eds and meds economy, with an opportunity to create a powerhouse academic medical center through Upstate Medical University acquiring Community General Hospital.

So writes Dr. Wlliam Eimicke in today's Post-Standard. You can read the full op-ed article here.

"How excited I am . . . "

Yesterday, the Human Resources staff from Upstate University Hospital began a series of 24 meetings at Community General during April.

They are explaining the Upstate benefits and answering questions about working for Upstate. I attended the first two sessions yesterday and found the Upstate people friendly and very capable. My Community colleagues were engaged and asked good questions.

This morning, one of the employees who attended yesterday’s sessions wrote me:

My e-mail is to state just how excited I am for this new venture for me and to be part of such a large cutting edge Facility with many many opportunities for the staff at CGH.

I moved here . . . (from out-of-state) and worked in a hospital that was purchased four times. None of the owners were really interested in the hospital staff or took the time that Upstate has taken to keep the CGH staff informed.

I very much advocate for this venture and share my opinion as often as opportunity has risen . . .

The advantages Upstate brings to Community are becoming clearer day by day.

Setting the record straight

One day last week I came upon an employee reading intently a poster that displayed a recent newspaper article about the Community General Hospital pension plan.

She looked distressed, and I asked her about it.

She explained that she was very worried and didn’t know what to believe. She said she has read and has heard many things and was concerned.

I explained how, thanks to Upstate's efforts, New York State had changed the law so that, when Community's employees are offered positions with Upstate, they will be able to choose if they want to stay in the Community pension plan or switch to the state retirement plan. She was very relieved.

It's no wonder people are confused. Labor representatives have actively promoted errors and misinformation, and they have ascribed to me and to others the worst of motives.

That's why Community posted Setting the Record Straight last week.

My mother

My mother died on March 29. I have had to attend to a number of matters in addition to my responsibilities at Community. This exlains the absence of recent postings, desite so many things taking place at Community.

My mother, Elizabeth, was dear woman, much beloved by her family and all who knew her. I am grateful to all who took the time to remember her and to express their condolences. I was touched by your thoughtfulness.

Honoring their memories

I would like to acknowledge the passing of several wonderful people, whose lives were of service to others, each of whom played a big role at Community General Hospital over many years.

John Morrissey, Jr. passed away on March 23. He was 94 and very much “a gentleman of the old school.” An attorney with the Mackenzie Hughes law firm, Jack practiced law for 70 years. He was a kind and considerate man, whom I admired. Jack joined the Board of Directors at Community General Hospital in 1981, and he served as an officer for most of the 1990s.

One of the original volunteers at Community General, Louis Ketchum died on March 11. Over her decades as a volunteer, Lois gave 9,000 hours of service. She and her husband, Gordon, were mainstays in the volunteer organization. Gordon passed away in 2002. He had a considerable volunteer career himself with 4,700 service hours. A very community-minded couple, Lois and Gordon were a wonderful part of Community General.

William Burke, MD, died on March 11. Bill was a thoracic surgeon who practiced at Community and at other Syracuse hospitals. He worked as a physician into his seventh decade. Bill was well known for his affability and his athleticism. He was a Major in the US Army and was very proud of his service as a MASH surgeon in Vietnam. I will miss his humor and commentary in visits over coffee in the cafeteria.

Finally, I would like to remember Brendan McGrath, our colleague in senior leadership at Community until his untimely death on March 13, 2010. Brendan died in a fierce windstorm in Westchester County while visiting his daughter and his first grand child. We miss his decency and quiet kindness.