ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, September 8, 1996 TAG: 9609090097
SECTION: BUSINESS PAGE: 1 EDITION: METRO
COLUMN: Health Care
SOURCE: SANDRA BROWN KELLY
Pssst! Did you know Carilion is having blood delivered by Yellow Cab? asked one caller.
No, but, yes. Carilion does occasionally use the taxi company to transport blood from the Red Cross to one of its hospitals if a hospital courier isn't available, said Tom Robertson, Carilion's chief executive officer.
Part of any reporter's job is checking on tips, often referred to as rumors and plentiful these days in the fast-changing health care business. Anyone who believes his or her workplace is in upheaval need only cast an eye toward Carilion for company.
Last week, Robertson sat in his new office at Carilion Community Hospital and agreed to indulge in some rumor-bashing.
He recently took up quarters at the hospital on the corner of Elm Avenue and Jefferson Street, in an office that used to belong to Dorman Fawley. Robertson's move from Carilion's corporate office building on Third Street Southwest has generated its own spate of speculation.
Fawley, Carilion's executive vice president in charge of patient care services, has moved to Carilion Roanoke Memorial in South Roanoke, where he joined Houston Bell, head of system services, and Dr. Kellogg Hunt, medical director. They also are executive vice presidents of Carilion, a company that offers a variety of health services in addition to operating 14 of the region's hospitals.
Robertson says all the top execs might end up in offices at Carilion hospitals, but he just hasn't decided where. His move to Community doesn't have a hidden meaning, he said. Business is good; what the company has lost in hospital income, it has more than made up for in home health and other services, he said.
But sometimes location does have significance. Lucas Snipes, formerly a Carilion corporate officer and, after restructuring, director at Roanoke Memorial, was spied at Carilion Community on Tuesday.
What was he doing there? Shirley Holland, Carilion's vice president for marketing services, said last week that the answer was so new that she only learned it that morning.
Snipes now oversees the daily business of Community as well as Roanoke Memorial. Don Love, who formerly had those duties at Community, has become practice manager for the Roanoke Orthopedic Clinic, which isn't owned by Carilion. Carilion, however, did just buy 31 doctors practices, adding 400 employees.
Carilion has about 7,800 employees, making it the region's largest private employer. It owns or manages hospitals from Big Stone Gap to Farmville and has divisions in home health and managed care services. For the last couple of years it has been redesigning itself into what it hopes is a more competitive, more efficient and more effective company. One that can compete with Columbia Healthcare Corp., which owns most of the hospitals that Carilion doesn't own in Southwest Virginia.
The only constant in the wellness business - a definition the industry prefers over sickness business - is that people still get sick. But, even then, they don't stay in the hospital as long anymore. One thing Robertson points out in is that hospital admissions have stayed strong for the system but patient days have fallen "substantially."
Robertson says he's glad to be back in a hospital setting, although the glare on his computer screen is bothersome.
Back at his old office at corporate, there was no window to allow light on the computer monitor. But his old office is being reconfigured, along with a few more vacant executive offices there. The new space will accommodate finance department employees being relocated from quarters in two office buildings on McClanahan Avenue that Carilion owns.
Re-engineering has been a "painful process," Robertson often says. The company pledged to get $70 million out of its budget in five to seven years, and he says it will happen. This year's $435 million budget was cut by $13 million.
"Employees have responded as good as we would have hoped. I don't think patient care has been affected," he said.
Carilion paid an across-the-board 1 percent bonus in June as a thank-you to employees.
But the pain's still coming. This week, employees are learning about a new standardized pay system. Traditionally, Carilion hospitals have been practically autonomous with each top exec making decisions for his facility alone.
No more. Beginning Oct. 13, a date chosen only because it's the beginning of a pay period, staff, mainly nursing staff, will be paid on a uniform system. A worker in Rocky Mount or Radford in the same pay grade can expect the same pay. Benefits will be uniform. No one lost benefits, said Laura Land, senior vice president for human resources, and some gained dental and education benefits.
The clincher, the difficult part, of the new pay structure is the change in shift differentials. In the new plan, everyone will get paid the same differential for the hard-to-fill shifts, mainly nights and weekends. In some cases, the differential has been lowered, too, from $3 to $2 per hour. Also, "difficult" shifts have been redefined; an example: additional pay will be given for the 6-11 p.m. hours, not the entire 3-11 as previously.
Robertson and Land say some employees gain and some lose in the new system, and that it doesn't save money. It is more efficient for the business office, though. Land and teams of employees have been working on the changes since February. Employee meetings on it began Tuesday.
This change and a new system for providing care to patients in the hospital, which is due to go into five nursing units next month, have contributed to unrest in the company, Robertson said.
The in-patient care changes required medical-surgical and critical care unit employees to reapply for jobs that had been redesigned. Not everyone got to keep a job similar to what she or he had before. Not everyone even got to keep a job, although Land said the company has a good track record of "filling from within."
From June 1995 to June 1996, Carilion's employment dropped the equivalent of 350 jobs. This year, 70 jobs have disappeared in the Carilion system. Forty people lost positions because of changes and 30 more left and the jobs were abolished, Land said.
"I'm concerned about how employees react," Robertson said. "I'm concerned about everybody's job security, but if we don't take pro-active moves ... "
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