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Cape Cod Healthcare leader’s 1st year praised

Cape Cod Healthcare leader’s 1st year praised

By Cynthia Mccormick

HYANNIS — Since taking over last year, Cape Cod Healthcare chief executive officer Michael Lauf has presided over the settling of a nurses contract, the opening of the Clark Radiation Center in Falmouth and a new dermatology center in Hyannis.

Not bad for a 41-year-old executive who was appointed following the abrupt and mysterious departure of his predecessor and mentor, Dr. Richard Salluzzo.

"It’s been really a seamless transition," said Thomas Wroe Jr. of Dennis, chairman of Cape Cod Healthcare’s board of trustees. "The core strategy is still intact."

The parent company of Cape Cod and Falmouth hospitals continues to operate in the black, for the third year in a row, with revenues of $35 million projected for this year, Lauf said in recent interview.

Wait times in the emergency department have gotten shorter, relations with physicians have grown tighter and patients are happier as measured by exit surveys, Lauf said.

Challenges ahead

But some of the biggest challenges are yet to come.

Looming restrictions on government spending for Medicare and Medicaid will have a big impact locally, as 67 percent of local hospital patients are on either Medicare or Medicaid, Lauf said. The health care organization anticipates losing $84 million in Medicare reimbursements over the next eight years. he said.

"That is potentially a very damaging scenario for Cape Cod Healthcare," he said.

Insurers and the government also are pressuring health care systems to invest in new payment systems, such as global or bundled payments.

That means instead of being paid a fee per treatment, health care providers including physicians, hospitals, physical therapists and home nursing agencies will get a certain fee per patient. They’ll have to work together to make sure the money is divvied up efficiently.

The idea is to move away from a piecemeal treatment of patients, but the new system will require lots of work and the forging of alliances among local health care providers.

In the future, the hospitals will have to partner with physicians and other groups to make sure health care dollars are used well, Lauf said. Currently, "the visiting nurses and nursing homes and hospitals are not aligned," he said.

"These are extraordinary times with extraordinary challenges," said Tim Gens, executive vice president of the Massachusetts Hospital Association. "It’s bad and it’s getting worse."

Salluzzo’s departure

Lauf was appointed CEO last year after Salluzzo abruptly left Cape Cod Healthcare the day before Thanksgiving.

Little is known about the reasons for his departure, although hospital officials have said Salluzzo was interested in partnering with other hospitals as way of staying financially viable while the local board wanted to preserve Cape Cod Healthcare’s independence.

The board wants the Hyannis and Falmouth hospitals to remain community hospitals "if at all possible," Wroe said.

Lauf, however, is continuing Salluzzo’s policy of involving physicians in decisions regarding the hospital system, such as which specialists to recruit, said Dr. Brian O’Malley, a Provincetown internist.

"We all wondered, ‘Has he had enough experience?’" said O’Malley, who chairs a doctors’ group called Cape Cod Preferred Physicians. Now, he said, "I don’t hear anyone expressing doubt."

Yet some nurses have concerns about Lauf’s leadership.

Nurses held an informational picket on safe staffing and mandatory overtime while negotiating a new Massachusetts Nurses Association contract with Cape Cod and Falmouth hospitals.

‘Tough year for nurses’

It shouldn’t have had to come to that, said Dianne R. Desruisseaux, vice chairwoman of the MNA local bargaining unit at Cape Cod Hospital.

"It has been a tough year for nurses and we never should have had to go to such great lengths to force Mr. Lauf to listen to us and address our concerns for patient safety and safe working conditions," she said.

It "demonstrates a lack of understanding and appreciation for what our patients need to be and stay well," she said in an email. "While we do appreciate his decision to finally address our concerns to resolve our contract, we hope in the future he will work harder to listen to nurses, as we are the ones on the front lines with the best information about what our patients need."

This year, Saluzzo generated more publicity in November when the state Board of Registration in Medicine fined him for writing prescriptions for family and friends, including a colleague at Cape Cod Hospital, without keeping adequate medical records.

The news has had "zero impact" on the community’s support for Cape Cod Healthcare, Lauf said. "The community gives to the institution, not to the individual."

In the meantime, Cape Cod Healthcare has to find a way to prosper no matter what insurers or politicians throw at it, Lauf said.

"I see it as an opportunity," he said. "We’re excited about the future."

Coming to Cape Cod Healthcare

Officials at Cape Cod Healthcare hope to complete several projects in the coming months,including:

Refurbishing the outpatient centers at Cape Cod Healthcare-owned practices in Mashpee, Bourne and Harwich.

Kicking off a $6 million expansion of the Stoneman Outpatient Center in Sandwich, including re-opening the urgent care function within a year. Opening the Wilkens Outpatient Medical Complex off Attucks Lane in Hyannis. A dermatology practice set up shop there this fall, and the Cuda Women’s Health Center will take its first appointments at that location this winter. Overseeing a $20 million expansion of Cape Cod Hospital’s emergency center. The 18-month project, tentatively scheduled to start this spring or summer, will create a segregated area for patients with psychiatric disorders and eliminate the need for beds in the hallways. The current ER was designed to handle 50,000 patients a year but actually sees 90,000 patients.