Friday, September 28, 2007

Welcome, Baby Oak !


LICH has put a beautiful little oak tree into what only recently was an ugly pit of weeds. As Joyce Kilmer already put it, back in 1914 (well, he almost said it):

Blogs are made by fools like me
But only LICH can plant a tree

On the other hand ... a phrase I hate to need so often ... there remains the problem of debris that is not cleared up. A nice environment needs daily attention ! Here is the tree pit just next to that beautiful baby oak:


Thursday, September 27, 2007

It takes 190 LICH nurses ....

At LICH, it takes 190 nurses to earn as much as the Chairman of the LICH Board of Regents. Even LICH executive salaries -- and those of hospitals generally (see previous posting, below) -- pale when compared to top executive salaries in private industry.

LICH's President was no doubt appointed by the LICH Board of Regents, a board that contains many accomplished men and women from many walks of life. The Chairman of this Board of Regents is Mr. John D. Wren, who is also the CEO of the Omnicom Group. Omnicom is required to file detailed reports with the SEC, including detailed information about its top salaries. For 2006, Mr. Wren's compensation package at this corporation totaled $13,241,034, roughly nineteen times the salary of LICH's President/CEO, almost forty times the salary of a LICH surgeon, and one hundred ninety times the pay of a LICH Registered Nurse.

Wednesday, September 26, 2007

Salaries at the Hospital -- the President and the Others

Rita Battles became President and CEO of LICH on Monday, September 20, 2004 -- three years ago almost to the day.

For the calendar year of 2004, which is the last year for which salary figures are readily available, Ms. Battles was paid $163,036, plus $8012 in benefits, or a total of $171,048. This covered the 102 days that she served in 2004. If we prorate this figure to arrive at an annual salary rate, we get $613,735 for that year. It is fair to assume that now, three years later, her compensation is higher than that, perhaps, roughly, $700,000 per year.

There is another job title at LICH for which compensation figures are readily obtained, that of Registered Nurse. According to the contract currently in force, RN's at LICH at the lowest level of experience are paid $61,188, and are granted regular increases until they reach the maximum, after 28 years of service, of $89,118. The President of LICH, then, earns between eight and twelve times the salary of the average registered nurse at her hospital.

Compensation figures for physicians are more difficult to ascertain. But the New York area median salary for (employed) family practice physicians is $184,555. For surgeons this figure is $335,751. These are current figures. Based on them, we can estimate that the President of LICH earns about four times the salary of the average family physician, and more than twice as much as the average surgeon at her hospital.

For a complete outsider like myself, it is difficult to compare the background and experience of the President with, say, that of a surgeon. Ms. Battles has had years of distinguished work experience in hospital administration, but her formal education does not seem to have gone beyond that of a master's degree in business administration from Suffolk University in Boston. The formal educational and professional requirements of a surgeon, on the other hand, are much more clearly defined. In addition to graduation from medical school, a surgeon must have served an internship, passed the State Board examination in medicine, and then have spent many years of specialized training leading to certification by his specialty Board.

With all that, LICH, which has 506 beds [not 258, as I had said originally], seems to lag behind certain other area hospitals in executive compensation. Or you might say, since its salaries are more modest, it is ahead of these institutions.

New York and Presbyterian Hospital is perhaps the most noteworthy. In 2004 it had two part-time chief executives, each working about 22 hours per week. The combined salaries of these two (one a physician, the other not), was $6,412,332. This hospital has 2233 beds.

Here are some other examples of presidents' 2004 salaries at New York area hospitals:

New York Hospital Medical Center of Queens (439 beds): $817,867

Bronx Lebanon Hospital Center (565 beds): $ 1,888,553

St. Vincent Catholic Medical Center (845 beds, as of 2003): $1,412,452

SOME WHO WORK FOR LESS

President of the United States -- $400,000, plus $50,000 benefits

Governor of the State of New York -- $179,000

Mayor of the City of New York -- 0

Associate Justice, U. S. Supreme Court -- $164,100

Commissioner of Health and Mental Hygiene, City of New York (currently Thomas R. Frieden, M.D.,M.P.H) -- $171,038

Chancellor, New York City Schools -- $250,000

President, Fordham University -- 0 (Jesuit priest)
highest paid vice president at Fordham -- $233,250, plus $40,472 in benefits


DATA SOURCES

Non-profit groups are required to file annual reports of their financial dealings, including salaries paid to their top employees (religious groups, unfortunately, are exempt from this requirement). These reports to the IRS on IRS form 990, and, in principle, become public documents. Each group is required to make its report available to any member of the public. In practice it is often difficult to inspect these reports in a timely manner, mainly because the groups have little incentive to make such inspection convenient.

Fortunately now, for the last few years, a great many of these reports are available on line at Guidestar.com. For most of the groups that I looked up for this posting, the last available 990's were for the calendar year of 2004. Readers who wish more up-to-date information should approach the organizations themselves.

The information on the salaries of public officials came from the 2005-06 edition (the latest) of The Green Book, an official publication of the City of New York, and a mine of information on matters of government on all levels -- city, state, and federal.

Average salaries come from another fabulous source of information, the Salary Wizard of salary.com. This site takes a bit of practice to get the hang of it.

The information on the salaries of nurses at LICH was furnished to me by the New York State Nurses Association.

A particularly interesting source of data on New York City public salaries is the City's Civil List. It is thousands of pages long and contains salary information on all city employees. All the other sources I have mentioned so far only have information on top salaries, but the Civil List is exhaustive. Your cop on the beat, if you happen to know his name, can be found there. (Are there still cops who walk beats ? Never mind.)

Finally, I must report an unfortunate gap in what is easily available in this area. The New York City Health and Hospital Corporation (HHC) seems to fall between the cracks. It was created by state legislation, and, while run by a board that is appointed by the Mayor, it is an independent body, at least in some ways. Anyway, I was unable to find the salaries of its top officers anywhere on line. I was told that I am entitled to the information, and that I will, in fact, receive it in good time ... but the good time has not yet arrived. My interest in the HHC stems from the fact that it operates the twenty-odd public city hospitals, and of course it would be interesting to know how its top officers are compensated.

Tuesday, September 18, 2007

Beautification is progressing !

LICH has put a couple of planters on our block last week, so the beautification project seems to be under way. To express my appreciation, I've sent the first half of my promised $300 contribution to the LICH Corporation.

So there's light at the end of this tunnel but we're not altogether out of it yet:

a) The graffiti on the wall are still there, in all their gory.

b) As the picture shows, the planter is a big improvement over what that tree pit used to look like. But as the picture also shows very clearly, the pit around the planter obviously needs attention. The ground there looks ugly and detracts from the flowers in the planter. Perhaps some sort of ground covering would do the trick.

c) A different topic but not entirely unrelated: No matter how beautiful the flowers on the perimeter, data for what goes on inside the hospital are still inadequate. Here LICH should emulate the City's hospitals (see my posting of 9/8/07).

Saturday, September 8, 2007

How Good a Hospital is LICH ? --Part II

The New York Times of Friday, Sept. 7, published an important article by Sarah Kershaw about a new policy of openness on the part of New York City's own hospitals, the New York City Health and Hospitals Corporation (NYCHHC). This policy affects city-owned hospitals, not private hospitals and nonprofits like LICH. The data to be made available concern infection and death rates, preventable blood stream infections and pneumonia cases, and other items. One of the new HHC web pages for this purpose gives data for heart attack care; data for other crucial categories are linked to this page.

Kershaw's article makes it clear that this is a new step by the city administration to provide data that are crucial to patients. The article also makes it clear that the rest of the industry, and this presumably includes LICH, has a long way to go to match this level of transparency.

Ladies and gentlemen of the LICH administration: follow the mayor on this !

Below please find data taken directly from the website of the HHC. It shows that in the crucial area of preventing surgical infections, the city hospitals do better than other hositals in the NYC area. Where does LICH stand here ? It would sure be good to know !

Note: the remainder of this posting is taken directly from the HHC site.

==================================================

The chance of surgical infection can be minimized if doctors adequately seal wounds, ensure completely sterile conditions and administer appropriate antibiotics in a timely fashion. The appropriate antibiotic should be given no more than one hour before surgery and should be stopped within 24 hours after surgery.

As reflected in data reported by the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health, many HHC hospitals have achieved some of the best results in the nation in this category of care.

Preventing Surgical Infections

Hospital-Specific Data
HHC Average= 85.1%
NYC Vicinity Average = 76%
National Average=74.5%






Tuesday, September 4, 2007

How Good a Hospital is LICH ?

How good is the Long Island College Hospital from the point of view of the patients that it serves ?

Here is my short answer: I think it's good, but I am not sure.

The Department of Health in Albany publishes grades for hospitals in the state, broken down by several dimensions. Readers should study these materials themselves on the site of the Health Department. But the matter is highly technical and without interpretation by experts, these data may be misleading.

I gave the matter only a preliminary study. Moreover, I have no expertise in interpreting public health statistics, so my impressions may be wrong.

The site, as far as I can see, has four areas that give meaningful information about LICH performance when compared to averages for the state.

1) Overall performance related to heart failure conditions.
LICH gets a grade of 94.58, as compared to 91.35 for the state average. This would seem to be an excellent performance by LICH. Columbia-Presbyterian gets 94.45, about the same as LICH.

2) Overall performance related to pneumonia care.
LICH gets 74.64, with a state average of 87.77. LICH does not seem to be doing very well here. On the other hand, Columbia-Presbyterian is worse than LICH, with a grade of 70.47. So -- I am guessing -- for a city hospital, LICH seems to be doing well, even though it falls short of the state average.

3) Heart attack care.
Hospitals in the state seem to do very well in this category. LICH gets 97.06, Columbia-Presbyterian 97.30, with a state average of 95.28.

4) Overall grade related to Surgical Infection Prevention.
This area, at least on the surface, may well be reason for concern for LICH patients. LICH is given a score of 77.13, the statewide average is 80.11, and Columbia-Presbyterian gets 80.77.
Do we need to worry ? I really don't know. But LICH may very well wish to explain its score here, and, indeed, explain its other scores as well.