Evaluating town’s needs

Michael Beck, 50, is vice president of operations at Mission Hospital Laguna Beach. He has been with St. Joseph Health System for 17 years. He previously served as vice president of quality and systems at the Mission Viejo campus, one of St. Joseph’s 14 hospitals. During his tenure in Mission Viejo, he oversaw development and implementation of hospital policies and procedures based on health-care regulations.

A graduate of Abilene Christian University in Texas, Beck holds a master’s degree in speech pathology from the University of Oklahoma Health Science Center. He was certified in 2002 as a professional in health-care quality. Away from the hospital, Beck acts as surveyor for the Commission on Accreditation of Rehabilitation Facilities, a process that distinguishes rehabilitation and human services providers for their quality and outcomes focus.

A native of Orange County, Beck is married with two sons.

For coherence, questions and answers have been grouped more or less by subject, not as they were asked or answered.

Beck declined to answer questions that might be relate to a lawsuit filed in Superior Court by neighbors last week who want $15 million to compensate them for the generators that power the hospital’s heating and cooling systems before and after Mission acquired South Coast Medical Center, the use of the campus as a bus stop and other alleged annoyances. On the lawsuit, Beck said, “We are still trying to figure out what that means and what the scope is and that kind of stuff.”

Q. Any chance that Mission would bring back the Laguna campus maternity ward, including perhaps the highly regarded midwife program?

A. We never say never, but Mission is a very planning-oriented organization. Although it is not too exciting to say we are in the process of planning, one of the things I really appreciate about Mission in the acquisition and transition process is that we recognized we are new to Laguna. We did not come with the belief that we knew what was needed or that we knew what was wanted. So we are being very methodical.

Q. Being fairly cautious?

A. Well, there is caution, but I think there is also wisdom and being prudent in regards — if we don’t know. We know how to run hospitals, and we believe we are pretty good at that.

But what this community needs and what this community wants — we need to be listening to them, so we are going through an assessment process. From a strategic planning standpoint, we expect to be able to share the outcomes of that planning process.

Q. Will that happen at the Neighborhood Forum [planned for 6:30 p.m. Nov. 16, in the hospital auditorium].

A. Probably not. That forum is really more for us to listen than share information.

Q. When do you think you will share?

A. The early part of the next calendar year, 2010, is when we are hoping to be able to do that. And at that time, we do expect to invite folks in and kind of lay out the findings, because it is a partnership. From a planning standpoint in assessing there needs to be a partnership in what we do with this. But ultimately, we as stewards of the hospital need to be responsible for making those decisions.

Q. You call the shots?

A. Well, to a degree. But is that what people want or need? [If not] we are going to miss the target.

Q. Mission does not have a midwife program?

A: No, we do not. Within our health system, some of our ministries do have midwife programs.

Q. Ministries?

A. Sorry. We tend to use ministry for hospital. That’s kind of our own speak.

Q. Will sexually transmitted disease testing be offered at the hospital?

A. We don’t have plans to offer services that we don’t already offer. But again, we don’t know what the assessment process is going to identify. We also are an organization that tries not to duplicate things that may not be needed and since the [Laguna Beach Community Clinic] in town offers that — it is successful and has a very respected program, I imagine that will influence the outcome of the assessment. We have been really being cautious about programs. I don’t see us really offering new programs prior to the assessment process that will define what is necessary.

Q. Will AIDS and HIV services, including testing, be offered?

A. Same answer.

Q. Have mammograms been discontinued at the Laguna campus and patients sent to Mission Viejo?

A. There has been some confusion. Mammograms are offered here, and we have no plans to discontinue the service here. They are also offered at our Laguna Niguel site [Breast Clinic for Early Diagnosis, Suite 120, 25500 Rancho Niguel Road].

Q. What’s happening with the MRI?

A. When we first started looking at the acquisition and recognizing the core importance is preserving the core services that need to be here, to make sure we have an emergency department and all the requirements that support that. We weren’t sure about the MRI initially. We were thinking that because of the volume that has been shown that there was not a business case, there’s not a clinical need to justify it and then as we came on site and started listening to people…

Q. Screaming their heads off?

A. They did, but also at the same time, right away referrals increased. What we also did was talk to the folks about the lease because we also assess is this the right equipment, is this the right technology — that type of thing, you know. What turned out is that yes, this is the right technology; yes, there is a need for it clinically and there is a business case to support it. We have every intention at this point to continue MRI services on this campus. It needs to not to be in this [presently in a fire lane] location. We have been working with the city on that for awhile.

Q. So you have every intention to continue the service but it probably will be relocated?

A. Oh, it will be relocated, yes, but the timing of that is kind of a domino effect. We would have liked to already have relocated it. It needs to be in place that is properly permitted.

Q. How is the cooling system project coming along?

A. No comment.

Q. What will be the cost of a new central plant (which includes heating and cooling systems), already discussed at a City Council meeting?

A. That story hasn’t really changed because we don’t have more information. We have started the process of formally “spec-ing” it out, which is not a fast process. When we need to deal with the state office that manages that scope of responsibility it is often not a fast process. Our best guess — which is really a guess — is probably somewhere between 4 and 8 million. It is not a terribly exciting investment — certain things are kind of fun and exciting — but it is essential for the safety and services on this campus. We need to do it. We will do it and we’ll be glad when it’s done.

Q. Did you know the central plant was not up to code when you acquired the hospital?

A. We knew the buildings were old and we knew they needed to be assessed, but we didn’t know if there were code issues or not. There are code issues and then there are things that need to get done just because it is the right thing to do. What Mission Hospital expects of ourselves from a corporate standpoint, from an aesthetic standpoint and from an operation standpoint isn’t necessarily the same as others [expect of themselves]. We certainly had surprises. But we are prepared to deal with them. Code can mean a lot of different things. From a physical plant standpoint, I am not really sure that there is code that is not being met. The challenge as I understand it — which could easily be wrong, because I am not the expert when it comes to the physical plant — but when I have questions, I know who to go to. They say that as buildings were added and expanded, the infrastructure from a physical plant standpoint wasn’t necessarily adjusted to meet the overall need from a cooling standpoint and the heating standpoint. So what does come up in code is that because the infrastructure cooling really wasn’t built in when it gets hot, the temperature and humidity in the [operating rooms] and other areas where there is code, goes out. So the code that was challenged on certain days wasn’t really for the physical plant or the central plant, it was for those areas where there is regulation. Did I say that in a way that makes sense?

Q. It’s not the building, it is specific areas?

A. Yes. Also those kinds of regulations change and you can have regulations changes in the O.R., but not changes in the central plant.

Q. Will the very, very locally popular cardio rehab program be reinstated in Laguna Beach?

A. That’s a very important question. Cardiac services is one of the core services that Mission Hospital offers. And what we have offered has been stellar. Because of that and the efficiency of what needs to happen from an economic standpoint, but also from the standpoint of what is required to meet the clinical standards that we are accustomed to meeting, I don’t really see that program being added on this campus. But at the same time, if we get through the assessment process and the assessment says these are the things you need to consider doing then it’s part of what we’ll consider doing.

Q. Looking back on the hospital acquisition, is there anything you would have done differently if you had a redo?

A. I’ll tell you what I would have liked different: It would have really been nice to have more time to make the transition. On the Mission Hospital side the needs were different than on the seller’s [Adventist Health] side. That’s understandable. Any situation is like that. The seller was in situation where they were regularly losing money and they needed to make a change.

Q. There is some dispute about how much money they actually lost, based on the fees they allegedly charged.

A. I am not in a position to know. What I have been told is really all I know and that is that on an ongoing basis for some period of time significant dollars were lost. Mission Hospital would really have liked to have more months to make a smoother transition. But the highest priority was for there not to be an interruption of services on this campus. To make that happen, we were agreeable to the time frames the seller needed.

Q. Would you have liked a chance to get to know the community a little better?

A. The simple answer is yes. It’s kind of hard to know what that would have looked like if we are not actually here and that would really be kind of awkward probably for a lot of the community.

Q. One of the things you did ask and ended up almost annoying people, well, ended up really annoying people, was asking people in Laguna what they thought the name should be and then not using South Coast Mission Hospital, which would have gotten the Mission name in and kept South Coast. It was South Coast Hospital before it was South Coast Medical Center and the name was cherished because it was built by local donations and grants local people got.

A. As a hospital, our desire is to engage stakeholders, whoever the stakeholders may be on that particular issue. So in this case it is probably community, different agencies, folks who are part of the heritage and if we did that in a way that just didn’t work for some folks, I apologize. Our intent was not to annoy people. I believe there are requirements from the naming standpoint, I believe state requirements, and what your business license says versus what is filed with the state and what is on the license of the organization. Because this is one license for two campuses and the license that exists says Mission Hospital, there is a requirement that Mission has to be in the name.

Q. But you can file DBAs — Doing Business As?

A. There are DBAs that you can use. I am probably not the one to tell you how the specificity of how those issues all lined up, but I think the real answer is that what was experienced was we wanted to engage folks and we did use that input to try to evaluate what’s the right name. I don’t thing the intent was ever to put the decision making on whatever happened with the survey. But it was a source of lots of discussions at the executive level.

Q. What about the drug program? Is that to be phased in, phased out?

A. We have no plans for changes. The strategic plan process that we are going through on this campus, we do on a regular basis as an organization. We tend to go on a three-year cycle because needs change. So that is a process that this community can anticipate occurring on a regular basis.

Q. And what about the (therapy) dogs, which were so popular, particularly in drug rehab?

A. It is a program that has to go in place, but I don’t know what the risk factors are. They have to go through screening like the employees, health screening, those types of things.

Q. Any programs you can think of that the hospital will be doing for the homeless, which is a huge issue in here in town, in case you have been insulated from that?

A. I have not been. I don’t profess to be fluent on it. But by being part of this community, it is part of the issues that we need to be a part of. I mentioned earlier that we are going through a community medical assessment. We hope to have the results of that in the next couple of weeks and homelessness is part of that scope. Our intent, just like with medical services is not to duplicate efforts, but to try to complement them.

Q. So you think you will have the assessment results or evaluation or what?

A. My understanding is that in the next few weeks, prior to the strategic planning, we will have the community assessment results. Then we sit down [and discuss] what do we do, these types of things and try to prioritize. We can’t say yes to everything, but the whole purpose of an assessment is what is it that we do. It wouldn’t be surprising if homelessness is part of that.

Q. What about any other particularly important outreach programs are you considering or definitely will include?

A. When you say outreach, what comes to mind is community benefits. So it will really come out through the assessment process. If you had seen the types of things we involve ourselves in, what you see is pretty diverse. And we try to involve ourselves in things that are sustainable. So it’s not one-time shots; it is things that will make a difference on an ongoing basis.

Charitable efforts or philanthropy efforts, whatever you want to call it, are part of St. Jo’s mission.

When we focus on efficiency like any organization, the dollars don’t flow to stockholders. They flow back into the organization, into the services, expanding services, to our communities and the health and wellness standpoint that is morally justified. That’s why we try to see ourselves as a ministry.

Q. Will the hospital rent parking spaces to the city during Festival Season?

A. We anticipate collaborating with the city on many things. On that, I don’t know if the request has been made. We are in the process of evaluating how parking needs to be on this campus from a safety standpoint as well as from just a utilization standpoint.

I don’t anticipate the assessment process saying yes or no to that, but I don’t know. I don’t know if I’ve ever even thought about it.

Q. Any new services or departments to be offered?

A. The short answer would be yes, I would think. But we don’t know yet because of the assessment and all. Part of what the assessment is trying to focus on is what services could potentially be added to this campus to complement what is already offered at Mission Hospital that are needed within this community and in the larger community.

Q. Any progress on the foundation?

A. Again, we are kind of methodical, we’re purposeful, intentional — that’s how we want to be. How we have approached the foundation is similar to other things I have spoken to you about. We are going through about a six months window of time to meet with folks, to listen to them, for different stakeholders to get to know us.

Q. Individuals have been interviewed by whom?

A. The hospital foundation. So the intent is to go through the assessment process and see what this community is interested in from a philanthropic standpoint.

Q. Would it be locally staffed and boarded?

A. There is one foundation that supports the whole organization.

Q. Any chance that the donated funds to [South Coast Medical Center Foundation] that were absorbed by Adventist before the acquisition would be restored?

A. I don’t even know what that is.