You can do all of the Six Sigma, Black Belt, Total Quality Management studies you want but until you address the real problems, you will continue to receive low public scores. Some of the issues that seem to be ignored are things like understaffed Emergency Room personnel, misdiagnosis of illnesses, indifferent employee mentality due to being the only hospital in town, inability to make an appointment to see a doctor for weeks, sometimes a month or longer. The list goes on. Like it or not, the underlying fact is that the general consensus here is that if you should require medical attention and live in St. Joseph, try your best to make it down to Kansas City if at all possible. When the day finally comes that the decision makers quit staying in their offices studying flow charts, financial spreadsheets and hypothetical simulation models and instead occasionally walk the floors and observe what is really going on, maybe some positive change can be made. Until then, status quo.

Fascinating. When I arrived in St Joe 30 years ago, the consensus was that you go to KC unless your emergency is so severe that it can't wait.

Last month, I received a forwarded email titled "You know you're from St Joe if..." and it went on and on with items that would make you chuckle. And on the list was the poor care from Heartland.

Sad to see that it's still the case, but glad I live elsewhere and don't have to worry about it.

I believe the article mentioned that Heartland is working on these issues and the next time these numbers are reported, they should be much better. Heartland has spent many years getting the clinical quality to meet or exceed national and local hospitals. Now they need to do the same for patient satisfaction. If you check out the Hospital Compare Web site, you will notice that the other KC hospitals did not do a whole lot better than Heartland.

Since Heartland's beds are always full and their nurses are always busy, I do not believe the consensus of the town is to go to KC when you are sick. I believe that is the consensus of a very vocal minority in this town. There is always room for improvement and Heartland seems to be well on their way to improving these numbers. If they don't then they are duty-bound to determine why that is and explain how they plan on fixing it. I look forward to seeing the next updated report and see if they follow through on their promises.

i don't know where you are looking up your info, familyguy, but this article plainly states that the heartland group falls 20-35% below other available care centers. that is not small change in terms of statistical analysis. if the beds are so full at heartland, why do their proponents relentlessly claim that there is no monopoly, but simply not enough pie to pass around in the form of dollars?

heritage, I agree that Heartland has a long way to go to get to where they need to be regarding patient satisfaction. If you are looking at the two specific area that the article mentions then Heartland does fall way short of the mark. I said to look at the site yourself and see how Heartland compares in the other areas. They are lower, but not by as much.

The beds are full of people who are Medicaid and Medicare. There are not enough insured patients coming to Heartland to support having two fully-functional hospitals. Two hospitals could not stay open having to share Medicaid and Medicare reimbursement dollars.

FG, do you not think that there are insured and monied individuals who, with the ability to choose, might stay in st. joseph, rather than go to one of the hospitals mentioned in this article? the poor and indigent simply have no choice. i am not slamming heartland, but i went to KU for my melanoma. i have insurance, and a choice. it has been my observation that this city uses its poverty to balance the budget, and is quite dependent on federal funding based on the drastic differences between the "haves and have-nots". there are many people here who claim that because heartland "doesn't make any money on the indigent". that is bunk. it is their bread and butter, a steady flow of taxpayer cash, and a calculated business decision.

Heartland has a bad name, without question.

First, they ran the competition out and bought up all the private practices.

Rumors that they built the building with extra floors just to assure no competitive hospitals could open up due to government funding based on bed count or some beauracraptic nonsense...

Check the administrative costs, I bet you find it amazing - justify a half a million dollar salary to me, please.

For a non-profit hospital, no less, come on, how naive do these people think we are?

I'll go to KC or even Columbia for anything that I really need to have done, as I've heard far more horror stories about Heartland than I have good things.

It's a shame, and it is not just Heartland, it is part of the broken medical system nationally.

Greed, basically, it comes down to greed it seems.....

When I start hearing good reports from people who actually go there, when I quit hearing about people coming out sicker than they went in, when the positive comments outwieght the stuff that scares me, I'll use them.

Are there any doctors in this town that are not owned my Heartland?

Sad, sad situation.....

And actually, probably nothing can be done about it, too much money involved......

I'd love nothing more than to be proven wrong.

You want to know what really ticked me off - We used to go to the MedClinic, and when we needed a refill for something we use daily, they would give them to us.

Heartland bought the place and charged me $120.00 +/- for a refill prescription, because "that is how we do it, must see a provider", and they were so arrogant about it, I'll possibly never forgive them for that.

Horrible management, management for one thing and one thing only - MONEY

I'm looking forward to making some time and reviewing their budget - be real nice if we had some real reporters in this town with the balls to dig into that stuff......

Errrrrrr

I have a daughter with a serious medical condition that went undiagnosed for a year and a half by Heartland doctors. I finally took her to Children's Mercy and she was diagnosed in about 10 minutes.

I once had an allergic reaction and stopped breathing. I would have gone to KC had I not stopped breathing completely. When I collapsed in the ER, the nurse yelled at my mother to put me in a wheelchair and then berated us both relentlessly to find out what drugs I was taking, even after she explained that I had just had a dental procedure and that the dentist phoned in to tell them I was coming.

My 6 month old son was sent away from the ER with a 107 degree fever and I was told that I was over-reacting by even bringing him in. This was after about a four hour wait, with my baby seizing in triage. I was told that "that's what people on Medicaid do, bring their kids in for every little thing". I had private insurance, btw.

These are just a few of the MANY examples I could give. I'm sure there are thousands of stories in this town just like it. I have little experience with the hospital outside of the ER, but what little I have had has been positive. Unless one of my children or I are about to bleed to death or something truly emergent, we drive to KC.

Heritage is right - the fact that my family (with good jobs and good insurance) choose to go elsewhere is very telling. I wish I could have participated in that survey!

Just this weekend a person went to the ER with a spider bite on their bottom that was swollen, red, nasty looking. They were sent home with no antibiotic, nothing. Well they returned to the hospital after seeing their physician on Monday to be admitted to the hospital with severe infection from the same bite, 2-3 day hospital stay with IV antibiotics ect. I couldn't imagine why anyone would want to go to KC for treatment.

But then the more I hear, I am wondering if the real problem does not lie with the ER. I know of 2 people who were sent home with abdominal pain, they were told it was gas and a kidney infection and both of them returned later with burst appendix! I know people could go on and on about the ER, so maybe the main focus needs to stay on quality of care in the ER.

My father had a heart attack and the ER docs at Heartland saved his life. The heart doctor at Heartland took it upon himself to help my father with the paperwork that allowed him to go into early retirement and spend quality time with his family.

My month-old son was diagnosed with RSV and the doctors in the Heartland ER got him admitted into the hospital and into a room on the pediatric ward in no time flat. He was there a week where we were taken care of by highly-skilled, friendly nurses and physicians that brought my son back from the brink of respiratory failure.

My mother had pancreatitis and almost died before they could get her admitted into the hospital. The physician at Heartland did everything in his power to pull her back from the brink of death and my mother eventually got better and has no side-effects from the condition.

My other son, as a baby, had a horrible stomach virus that caused him to go into advanced dehydration within days. The staff at Heartland took very good care of him and after a few days in the hospital, he was good enough to go home with no problems.

I have more stories, but I believe no one here is interested in the good side of Heartland. I have lived in St. Joseph my whole life and I spent a good amount of time at Heartland with family and friends. Most of the time, the care I receive is exemplary and compares with any of the care I've received from the KC hospitals. It's too bad some people in the community don't realize the gem they have in town. Of course, if I based my impression of Heartland as a whole on ER visits only, I could understand why people are so negative. Heartland has an ER issue and hopefully they can get that resolved ASAP.

I've only had three hospital stays at Heartland - the birth of my two children and an allergic reaction that I spoke about in my earlier post. The maternity stays were fantastic. The hospital care from the allergic reaction was okay in the since that they didn't kill me, but they sure didn't do anything for me either. I was checked in, barely able to breathe and unable to speak, and didn't see anyone but the lady that brought my food for two and half days. I eventually just left. They ran down the hall after me to make me sign a form indicating that I was leaving against medical advice (ironic, given that I never received any medical advice). Otherwise, my family members that have received in-patient care, for the most part, got good care. I have friends that work there that are truly dedicated, knowledable people, so I'm not just trying to bash Heartland. My point is that every hospital will drop the ball from time to time and will have some patients that give glowing reports and others that have nothing good to say. Overall, I think the biggest problem Heartland has is its ER services. As our biggest employer (I think), I would hope that their management would read some of these posts and take steps toward improving the ER. If I had better ER experiences, I would have considered letting them provide care for my daughter's disease and for my cancer treatments. Maybe it's not fair to judge a hospital as a whole just by multiple bad ER experinces, but my health and the health of my children is not something that I want to risk by hoping that inpatient care is better than ER care.

If I had about an hour or so, I could tell you some horrible things that happened to my mother while she was hospitalized at Heartland. I have never seen such inefficiency and poor care. The doctors were pitiful too. I have never seen the like. DON'T GET SICK, or head south if you do. It's a matter of life and death. Our community should be ashamed of itself for tolerating this bloated ineffective behemoth known as Heartland.

I also have had good experience with the Heartland staff, once admitted to the hospital. My father recieved wonderful care, the doctors and nurses were very proffesional and thorough. However, getting him admitted from the ER is definately the problem. He was in the middle of cardiac arrest and was in the ER for approximately 4-6 hours until I threw such a hissy fit that I'm sure the only reason they put him in a room and got a cardiologist in to see him was to shut me up! The cardiologist has been wonderful since that time and I really can't complain about the hospital itself, but the ER is definately another story!

Dondill, I'm sorry you had such a horrible experience at Heartland. I assume you went to the patient advocate at Heartland and told them about the horror you went through? Or at least sent a letter to the CEO? Since others here have stated that they have received good care at Heartland, maybe your experience was the exception and not the rule.

To HRMC - I believe that several others have complained about Heartland in the above comments. What are you talking about my complaints being the exception? I did complain frequently and went through the proper channels at Heartland. There was no positive resolution. My mother was discharged from the hospital in a wheelchair while vomiting. She did not receive a proper diagnosis and almost died. She was emergency airlifted from her home to Mayo in Minnesota after her care was botched at Heartland. One night at Heartland, I went out to talk to the doctor who was making weekend rounds. It was the first time I would be meeting this doctor. Before I had a chance to introduce myself, the doctor blurted out to a nearby nurse, "Why do I have to see this patient?"

One doctor told my mother that she was a 'couch potato' after Mother was unable to bend over during an evaulation to see if she could benefit from rehab. What that doctor did not know and what we did not find out until going to Mayo, was that my mother has Multiple System Atrophy, a neurological disorder.

My mother developed bed sores during her Heartland stay.

There were to be sitters in my mother's room at all times, even during the night. The sitters mostly watched T.V. real loud. They reeked of cigarette smoke. One sitter would sleep in a recliner during the night, when she was paid to be awake and to make sure my mother did not fall when attempting to get out of bed. I was able to snap a photo of her sleeping with the digital camera I had.

There are more similar stories, but the main disgrace is an inability to get a diagnosis after our mother was hospitalized for almost three weeks. It was a very harrowing experience that I would not wish on anyone, let alone a family member.

My mother is now stable and able to live at home alone. I don't think she would be alive today if she had not been airlifted to the Mayo facility.

It's horrible that those things happened to your mother, dondill. I would be as angry as you if they had happened to anyone in my family.

Fortunately, I have always had great care at Heartland and most of my friends and family feel the same.

For me and my family we go else where. Heartland has done nothing to help and the doctors are a huge joke in the ER.

I took my 7 yo in at one point because she was in a constant seizure and they tried to tell me she wasn't seizing and sent her home even though we had been there about 2 hours with her coming in and out of siezures they didn't give her any thing to stop them and told me it was rare for a child to sieze well guess what when that child has been seizing since she was 2 months old and we know what they look like and she has the dx's of seizures then it's not rare for her to be seizing. We ended up taking her to Childrens where they got the seizures to stop with in 5 minutes and she was hospitalized for a month because she had a really bad resportary infection (again heartland didn't even run tests on her to figure out what was wrong) they just told me i was overreacting. So now i don't trust them 90% of the doctors are just a joke. Thankfully we have found a PCP who feels the same way about heartland that we do so we no longer use theirs services thank god I would rather drive the hour and get good doctors then have to deal with them

LaCindaMae - I really sympathize with you on your horrible experience at Heartland's ER. Your childs life was in danger. You should be able to go to a hospital and feel comfortable that the doctors know what they are doing. But unfortunately, many times they do not have a clue. The recent survey results suggest that you are not alone in your negative assessment of Heartland. Soemthing needs to be done before more people are harmed or even killed by Heartland's incompetence.

Let's be honest here, Heartland as a whole is not incompetent. It seems like the main problem is the ER. Many people have only ER experiences to gauge how well Heartland treats its patients. Unfortunately, the ER seems to be hit and miss with its care. I have had nothing but good experiences and others have horror stories. There are highly-skilled and dedicated physicians and nurses working at Heartland. Denigrating the entire staff of 1,000s because of a few bad apples is unfair.

Heartland hospital surveyed 5,000 of their patients. The former patients have spoken loud and clear. Heartland fell short of the national average in the care they provided. St. Francis received higher marks. Kansas City hospitals were higher in rank. We are talking about life and death issues here, not an oil change for the car. You cannot single out the ER as the source of all of the problems. That is not the only reason that people head down I-29 for hospitalization. People want better care and service. It is not available at Heartland. It is simply shoddy care there. I do not recommend it whatsoever.

I totally agree with you dondill. There are so many instances of terrible things that I know about personally that happened at Heartland. My friend's husband went for an emergency appendectomy. Prior to surgery, he underwent an EKG and there was a serious abnormality on the results. Nobody told him that he was a ticking time bomb and he died of a heart attack some months after his surgery. His widow found out about the abnormal EKG just by pure accident. He had applied for some life insurance prior to his surgery and death. After he died, the widow found out that the insurance company had turned him down because of a abnormal EKG. When the widow found out, she checked Heartland's records and sure enough, his EKG had shown severe abnormalities and not one doctor had informed him of this. The widow sued Heartland, but it was all settled out of court. It was all kept hush-hush and I'll bet there are lots and lots of hush-hush cases that would blow our minds.

Thank you janiepoo. Here's one for you: My sister felt a lump in her breast. She went to Heartland for a mammogram. The radiologist read the mammogram and told her there was nothing wrong. He patted her on the head and told her to come back in six months. She knew better than that and requested a biopsy. The biopsy was positive for breast cancer. If my sister had not been on her toes and had not been persistent, she would be dead now. She was 30 years old when this happened. She is alive now, but only because of her own efforts. When the radiologist found out about the positive biopsy he was heard to say, "Oh no, I am going to get sued!" My sister did not sue him. But wouldn't you think that if there is a lump in a patient's breast, to be on the safe side, a doctor should recommend a biopsy. After all, breast cancer is now an epidemic. You really have to look out for yourself, or have a family member watch your back, if you go to Heartland.

To dondill - That is terrible about your sister and her experience at Heartland. That doesn't really surprise me though because of all of the other stories that I have heard about that place. One time, I arrived there late one cold night, to spend the night with my father, who was hospitalized at the time. As I tried to drive into the parking lot, there were about 15 or so smokers out there in the lot, blocking the entrance. They wouldn't let me drive onto the lot! They were a frightening bunch of hooligan looking people all puffing on their cigarettes. What a turn-off.

Hey, janie have you noticed that family guy and HRMC fan have sort of disappeared when we started describing specific examples of malpractice that our families encountered? Where'd they go hide? Behind Lowell's skirt-tails?

Ok so we see the service provided at our beloved hospital sucks, but at least they bill fairly and are patient on payments. NOT! Of people containing poor credit in St Joseph, it is amazing how many are a product of having collections from Norwest Financial, the cut throat collection division of Heartland. While your insurance company and the hospital are trying to determine what you owe, Norwest is sending you to collection.

A few years ago, I had a really bad urinary track infection.

I went to whatever clinic was at Heartland, and the Doctor tested me for STD's (a swab up my you know what) and then proceeded to tell me the thought for sure I had an STD -

Well well well, I had not been unfaithful to my wife, so guess what thoughts went through my mind!

Long story short, they called a couple days later to tell me the tests were negative and that I had an somewhat normal infection -

I'm not sure how to totally describe that experience.

I will say I once needed a couple stitches, and that went well.

Does not make up for the instance mentioned first or some of the other first hand experiences......

What can be done?

Probably nothing, too much money at stake......

Ideas???

You are right, there is too much money at stake for real change. I do like that Rob Schaaf tries to take on Heartland on occasion. He is like a David against that Goliath.

Though my family and I have had no super-terrible or beyond compare excellent experiences with Heartland, my overall impression of Heartland is "Good Enough." Sadly "Good Enough" is all that needs to be provided when you are the only game in town. There is little financial motivation to improve one's self.

We now live in a community with about half the population of the St. Joseph area, and there are two hospitals in town that fight vigorously to be better than the other in all aspects: Patient Care; Medical Technology; Customer Service. It is refreshing and reassuring to know that choices are available.

While in St. Joseph recently, I noticed very few cars at the urgent care center that used to be Heartland, and the new Heartland urgent care clinic's parking lot was about three-fourths full. It seems Heartland is still keeping the dumb masses (say "dumb masses" out loud and see how it sounds) coming to them.

gladimgone - you hit the nail on the head. There needs to be some competition for Heartland. I really enjoyed all of your comments. Especially the dumb masses one! Funny, funny.

I guess I'm one of the "dumb masses" that keeps going back to Heartland. Thank you for moving away, gladimgone.

We should look past our differences and see if we can find common ground. I have had great experiences at Heartland. I know that does not negate the horrible experiences that others have had, but it also does not negate my positive ones. Instead of divisive language and hateful rhetoric, we should discuss the subject rationally and find ways to improve the situation. Heartland is not going to go anywhere. No other hospital is coming into town. How can we make Heartland a better steward for the community? As a community-based hospital, how can we as members of the community exact change to make Heartland the world-class hospital it wants to be?

I'd like to see the hospitals budget, albeit a summary version written for the somewhat common person, published in the newspaper.

I'd also like to know what the salaries are for the employees, it's public knowledge, where can this data be pulled?

Also, are any employees also getting money/perks from suppliers/vendors/outside sources, such as the pharm, companies?

What can we do, what will we do?

Take a look around you, we are a fat community, we need to take better care of ourselves. We can get healthy, that's quite a concept, eh?

Seriously, we took a trip to another city a few hours away, and my kids even commented on how "skinny" everyone looked - When we got back, I looked around, we are not a real healthy community overall, maybe Heartland is what we deserve?

I stand by my comment to gladimgone. He/she essentially called our community a bunch of dumb masses. That's offensive to me, my friends and my family. If gladimgone thinks so lowly of the people in our area, then I am glad he/she is gone. If you agree with him/her, janiepoo, then we have nothing to talk about. Have a great day! :)

StJoeMoe, those are good ideas. I don't know much about the inner-workings of Heartland, but I believe most of the things you mentioned are available in one form or another. I went to the Heartland Web site and found their Community Benefit Report: http://www.heartland-health.com/document... It looks like they put quite a bit of their financials on that.

I believe you can contact the HR department of any company and they will release salary range of any position. That's how it works in the company I work for. With 1000s of positions available, it may be difficult to find all of them.

I don't now how to find out about perks from vendors. I'm sure Heartland has a very stringent ethics process that prevents them from accepting perks from vendors. My company has rules in place to prevent people from accepting gifts over a certain amount from vendors. I have to assume Heartland does that as well. I'm guessing they have someone in charge of that process. If you called out there and asked for the ethics coordinator, they might be able to find someone who can answer that for you.

I agree that our community is very unhealthy. I would like to see Heartland become more of a positive force in the community when it comes to keeping our citizens healthy. I know they already sponsor many healthy initiatives in the community such as the Pound Plunge, Women's Wellness and various runs, walks and sporting events. Unless the citizens of this town WANT to get healthy, I'm not sure what else Heartland can do.

i don't know how anyone can trust a hospital that own most, but not all, of the care centers in this area, and who owns their own insurance. seems to me that is a bit unethical, let alone a conflict of interest.

Kudos to Mr. /Ms. gladimgone and St. Joe Mo.

Those who make unhealthy choices perhaps have earned a title of "masses." However that is not the theme of this article.

Since Heartland is the only local choice for hospital care, and there are those who decry Heartland's care, it may behoove the community to take more responsibility for their health so they don't have to visit the hospital.

People become ill for various reasons. Some illnesses are due to poor lifestyle choices but many are not. Regardless of the reason that one goes to the hospital, one should not be afraid of the hospital and many people in our community are afraid to go to Heartland Hospital because of their poor reputation. Avoiding the hospital by 'staying healthy' is not a solution at all.

familyguy needs to chill out. Rxyrch makes a good point about Heartland owning most of the care centers in town and even owning their own insurance. That is a recipe for trouble.

ITS SAD WHEN YOU GET BETTER CARE FROM THE SMALL ER'S IN THE AREA THAN YOU DO AT A LEVEL 1 TRAUMA CENTER...

I'm not sure why you think I need to "chill out" dondill. I didn't realize I was anything but chilled. Maybe YOU need to chill? :-)

Rxyrch and Dondill, how is owning an insurance company a "recipe for trouble"? So what if Heartland offers insurance competition to people in the community? I thought competition was a good thing in this town. I found the Web site for CHP and they explain themselves very well: http://www.heartland-health.com/body_myc...

It looks like their customer service scores are high compared to KC insurance companies.: http://www.heartland-health.com/body_myc...

Just because you don't like the hospital doesn't immediately mean everything the hospital does is shady and underhanded. It's hard to believe that you all think 3,000 people that work at Heartland and live in our community are that horrible at the their job. Making blanket statements demeaning Heartland Health as a whole is unfair and inaccurate.

So far I have yet to hear any constructive ideas regarding how to make Heartland a better hospital. Do you all really want Heartland to fail and close down? Since Heartland is a community-based hospital, the community should dictate what they want. You are all missing a great opportunity to dictate those terms. I believe the first thing Heartland needs to do is fix their ER problem. I believe we can all agree that the ER is a trouble spot in our community. Any other ideas?

I appreciate everyones input.

familyguy included, without question.

Solutions - we need to come up with solutions......

Who said anything about wanting Heartand to close down? We just want a decent hospital in our community. Family guy, the community can and has been dictating all they want. It is falling on deaf ears. We've 'dictated' through surveys and lawsuits and complaints year after year. What more does Heartland need? Making blanket statements that Heartland is just fine and the problems are confined to the ER are misleading.

family guy - I have a constructive idea, how about Heartland's well paid CEO come up with some constructive ideas. He is paid very well and has many years of hospital experience. He should use his vast knowledge to earn Heartland some better scores and also earn his salary.

janiepoo, I believe Heartland is a decent hospital. Actually, I believe Heartland is an above average hospital trying to become a world-class hospital. If you look at the ratings Heartland received on the patient satisfaction report that started this discussion, you will notice that the actual care people received was scored pretty high and compared favorably to other hospitals. When it got to the reputation part of the survey, Heartland scored much lower. I know people have personal stories about bad incidences at Heartland. I'm not negating those experiences. I'm just saying that not ALL experiences at Heartland are bad. Hopefully Heartland will take these rankings seriously and make some important changes in their processes and make the bad experiences at Heartland less and less. According to the article, it sounds like they already have a handle on the situation and are trying to make changes. We'll have to wait and see what happens.

BTW, I'm not naively making blanket statements that Heartland is okie dokie and the ER is the only problem. I realize there may be other areas of Heartland that need fixing as well. I just noticed that many people here have had bad experiences in the ER (sometimes multiple) and that could be directly attributable to their negative impression of Heartland Health as a whole. Since the ER could be a root cause of much of the negativity in the community, it would behoove Heartland to do something about that area immediately.

Actually, dondill, I've heard that Heartland's current CEO is retiring in a couple of years. I've been in St. Joseph my whole life and I remember hearing how Heartland was the hospital that nobody wanted to go to when I was growing up. I believe within the last 10 years the hospital has really stepped up their game. It will be interesting to see how the new CEO takes Heartland to the next level.

family guy - I've been here all my life too. In St. Joe, there was the Methodist Hospital and the Sister's Hospital. I didn't hear stories about people not wanting to go to those hospitals. They had good reputations. It wasn't until they merged into Heartland that the negative stories began to circulate. To suggest that Heartland has 'stepped up' their game in the last 10 years is comical.

So my opinions are comical to you, eh dondill? It's obvious you are too blinded by your hatred of Heartland to engage in respectful debate. Go ahead and keep spewing your vitrolic anger toward Heartland, its employees and supporters. I choose to be optimistic and hopeful that Heartland can become a better hospital and support our fine community. I will continue to work toward supporting Heartland as long as I see that they are striving to become a better facility. For the last 10 years or so, I have seen them doing just that.

Heartland, a non-profit hospital "didn't hit the mark for patient satisfaction" has another worry: - An overpaid CEO with too much power! (close to seven figures...not counting expense accounts & other allowances.) Check out Heartland's financial disclosure on the net...

Don't get me wrong, I can understand someone making several hundred thousand per year, but when they're pulling in close to seven figures, they're acting like they are part of the NBA of the hospital sector. Hospital executives rank among the highest paid CEOs in the non-profit world.

I would not begrudge the salaries if they weren't at the same time putting so many families in financial ruin with their billing and collection practices. The debate over hospital executive salaries is set against a backdrop of general concern about privileges in Corporate America and rising hospital costs.

That being said, I have heard of other problems about Heartland that have yet to be mentioned: Inattentive boards of directors, autocratic management styles, underpaid rank-and-file workers, under funded defined benefit pension plan, conflicts of interest with high-dollar consultants, "creative" hiring practices, unique job creation for politicians and ex-board members, a problematic and inadequete multi-million dollar software system, ownership of a money-draining health care plan, forcing doctors to sell out or get out (remember the anti-trust investigation?)--the list goes on and on.

Heartland's decrease in operating income compared with historical experience; due in large part to losses on Heartland's owned health plan

Continued losses on employed physicians

Monopolized community providers with concentrated referral patterns

Last, but not least, Heartland's executive pay practices and the inexperienced, "bobble-headed" managers that are one foot behind the boss.

Let's focus on the real problems mentioned above and not on concocted metrics rooted in patient satisfaction surveys & public sentiments. Critics say Heartland may have lost sight of their mission...I wonder why? Clean up the mess and Heartland "will hit the mark!"

bwheat1000 - Wow! That's about all I can say about your comments. I am sort of speechless. You sure did hit the nail on the head in so many ways. I agree with you completely!

bwheat200 made some very good points about Heartland. One point that he made that I do disagree with is that Heartland's billing practices put families into financial ruin. I think that Heartland is a business and they provide a service and it is not Heartlands fault if a patient does not have insurance or if a patient will not pay their copay. So many patients think it is their right to receive medical care and many could care less about paying for it. People need to be responsible about paying their copays and making payments on their bills. So many times medical bills are the very last thing that people will pay. They will have their cell phones and their fancy cars, but they will not pay their medical bills. I don't blame Heartland one bit for going after deadbeats. Many patients have insurance, but will not even pay the remaining bill after their insurance is paid. Heartland is not a free hospital. These deadbeats unpaid bills are passed on to all of the rest of the paying patients.

However, I do agree with the rest of bwheats comments.

I have no problem w/Heartland collecting what patients who have received services owe them. HOWEVER, most of the time they do not even wait for insurance to pay before they send people to collections. I have had NW Financial Services (Heartland's collection agency bulldogs) come after me within one month of receiving services at the hospital. It wasn't because the insurance company was delayed..Heartland didn't file my claims immediately. I can understand sending someone off to collection if it's been 90 days since services without any type of payment, but they start harrassing almost immediately. Happens to people all the time and it's not just "deadbeats" as janiepoo references.

That's a new one on me. Surely it was a mistake for Heartland to go after you even before filing your insurance. Usually, they wait until the insurance has been filed and have received payment from them. I know that they do send out bills before the insurance pays, but as far as I know, they don't turn over to collections before that.

Well, it wouldn't suprise me if Heartland's billng system was as bad as their hospital care. Why would it be any different?

I have encountered billing issues with Heartland, being doubled-billed for the same services for one. Another that has happened more than once is that some of my services they have my insurance for...and bill and it is covered. Then, other services performed at the same time go to collections for nonpayment...why? They say they didn't have insurance information to bill. How is it they have it for one service but not the other performed at the same time? I would think that new fancy software they have would catch something like this!

Just reading one comment from familyguy wondering how it is a recipe for trouble for Heartland to have its own insurance-CHP. Well, I can't say that I understand it all, most definitely not. I can be totally way off here. But, something doesn't smell right when the non-profit hospital performing the services, buying out the doctors that perform the services, then also own the for-profit insurance company dictating what kind of services are "allowed". I can see how that can seem like a recipe for trouble...again whether there is a conflict of interest or not...I can see where it would seem like one.

Well I have to stand corrected (correcting my earlier post here) after reading, I do see where CHP is supposedly non-profit insurance plan whereas I assumed they were for-profit. However, I wonder...is there anyway to find out if the same execs at Heartland are also being paid an additional salary from CHP? Just wondering.

bwheat100, you made some very astute observations. What I appreciate is that you don't blame the employees or the services that Heartland provides. That's the point I have been trying to make. The employees and physicians that work at Heartland are diligent, highly-skilled, dedicated and patient-centered. There may be a few bad apples, but they don't spoil the bushel in my POV.

I've listed the issues you bring up and give my opinion next to it:

1) Inattentive boards of directors - I'm not privy to the board of directors at Heartland. If you have some insight or influence on the board at Heartland, it would be interesting to see how you would change things.

2) autocratic management styles - Again, from the outside looking in, I am not privy to the management styles at Heartland. It would be interesting to know more about what you know. I know my friends and family like their bosses at Heartland.

3) underpaid rank-and-file workers - I have a few friends and a family member who work for Heartland. They seem content with their salary. How did you determine how much the rank-and-file workers made at Heartland? What do you consider rank-and file workers?

4) under funded defined benefit pension plan - No idea about this.

5) conflicts of interest with high-dollar consultants - Who is the conflict with? I'd be interested in knowing.

6) "creative" hiring practices, unique job creation for politicians and ex-board members - I assume you are talking about hiring a state senator and local business person for Heartland positions? I don't get this one. Isn't the CEO in the best position to determine who would work well in a high-level position at their place of business? Don't state senators and prominent business persons have the right to work where they want? If the person is capable of performing the job duties, what is the problem?

>>more below<<

7) a problematic and inadequete multi-million dollar software system - I'm a little familiar with Heartland's electronic medical record from my friends and family member. They don't seem to have a problem with it. I do know there are some people at Heartland who don't feel properly trained on it. I know that it's nice having my medical records available at whichever Heartland clinic I visit. It makes getting my medical history over with much quicker and the doctors already know which medicines I'm taking.

8) ownership of a money-draining health care plan - I have no idea if CHP is draining money or not. I'm not sure how this affects the general public at large.

9) forcing doctors to sell out or get out - My kids pediatrician is a non-Heartland physician. He used to work for Heartland, but didn't like it so he went out on his own. I liked him so I folowed him. Whenever one of my kids is in the hospital, he comes and visits no problem. His practice seems to be doing very well. I'm not sure what you are talking about here. There were some issues years ago about radiology doctors or something. It seemed to be a singular incident and not a conspiracy against non-Heartland physicians in town. I am interested in your experiences if you care to share them.

I appreciate your candor and obvious inside experiences at Heartland, bwheat. It's always interesting to hear the perspectives of people who are "in the know" as it were.

bwheat100 - Thank you for putting into words what the majority of us think about Heartland Hospital. Heartland's survey results confirm what most of us in the community believe - that Heartland is not up to par with other hospitals. Heartland ranked below average. I do not like having a below average "as it were" hospital in our community. Bwheat100, come back and post some more. Your comments are intelligent and right on the mark.

Yes, I'm with dondill here...thank you bwheat100, I agree 100%. You are right on the money here. The problem though I believe is that some of the upper echelon just don't quite get it. And to familyguy, maybe your relative and friends are apart of this group and thats why they are so happy? Either that or they just really lucked out with their specific department. I think alot of employees there would love to say what they wish would change and have their concerns heard, but for fear of retribution, they don't speak up. It falls on deaf ears. Looking forward to hearing more of bwheat100 right on the mark comments and concerns.

I also agree that bwheat's comments were very intriguing. I would like to hear more as well.

dondill, according to the survey, a MAJORITY of patients that were surveyed actually would recommend Heartland and gave them a 9 or 10 rating. That is a far cry from the "most of us" you refer to that are negative about Heartland. Get your facts straight before you post.

suzyQ, my friends and family are part of the "rank-and-file" that bwheat alluded to in his post. I agree that maybe not all the leaders at Heartland are perfect, but I can assume based on what I hear from the inside that most of them are. Again, a few bad apples...

family guy...agree a few bad apples can spoil it for everyone else. I have just have heard of too many frustrating circumstances and situations. Its sad though when the good ones are ran out for trying to speak up and do the right things for the patient and the hospital. So much so, they quit speaking up or they get a "smack down". I've known physicians that have left because of the political mickey mouse arena going on. I've seen too much where they run hardworking folks into the ground and then they find employment elsewhere. I know of instances where the some middle management sugar-coat one thing to the higher ups, but in reality, its a different story. I could go on and on. Overall, I believe that Heartland is trying to be a better hospital, I think they have many positives, and I definitely think they have alot of hardworking dedicated employees, I just think they need to open their eyes and do a little cleaning house so to speak (the bad apples), listen to what the employees and patients concerns are and ADDRESS/FIX them. For the record, I do get my care at Heartland, I haven't lost faith with my Heartland-owned physicians, I trust their care and I know that even some of them are just as frustrated, I know alot of healthcare workers, some are good, some are not (but I do know enough to know when things aren't right and speak up, thats not the case with alot of patients), I just think they could improve...and in some areas greatly, mainly management. That would fix alot. If they aren't hitting the mark, you have to look at the management. Look at what areas of patient and employee satisfaction aren't so great. There's a reason.

suzyQ, I cannot disagree with you. I know that the "bad" execs/leaders can taint the reputation of the rest of the organization and Heartland must address those issues immediately if they want to change the patient satisfaction scores that started this conversation. That's why what bwheat stated was so important. Any organization is only as good as its leadership. If there is a problem with the leadership at Heartland, then that dialogue needs to occur before real change can be implemented.

Thank you for the respectful debate. I'm glad we can agree that Heartland is for the most part made up of dedicated, highly-skilled and compassionate employees.

Theoretically, society is interested in maximizing both the quality and quantity of medical services to it through the hospital. However, other groups may also want to use the hospital to maximize their own wealth. Heartland’s compensation arrangements with employed physicians and other professionals (i.e. consultant groups, executives, etc) have been a hot topic for years.

My intent in pointing out the “real” issues of Heartland, was not to demean the non-managerial staff…as familyguy pointed out are dedicated, highly-skilled and compassionate employees, but rather, to expose the problems at the top.

When you have “near-sighted” executives receiving gold plated compensation packages and many generous perks, calls into question whether non-profit hospitals deserve the billons of tax breaks they receive from federal, state and local governments.

Unlike “for profit” hospitals, non-profit hospitals cannot maximize shareholder wealth, since they have no shareholders. Non-profit hospitals are granted non-profit status, to some degree, so they can provide complex medical services, which consumers cannot easily monitor. The consumer is more likely to trust the findings of a non-profit hospital, since the institution is legally barred from distributing any profits to principals (at least directly.)

In addition, non-profit hospitals are popular because they provide complex services with substantial economies of scale. The complexity of the service provided makes most consumers poor judges of the quality of service. This is where I have some issues with the skewed satisfaction surveys.

As SuzyQ mentioned, you have to look at the management. Look at what areas of patient and employee satisfaction aren't so great. There's a reason.

Shifting points, I would like to expand on comments regarding CHP. CHP has been faced with a perpetual “cycle of fiscal convulsions” since its inception. Clearly, the financial quagmire in which Heartland “bales” CHP out of financial ruin is not a one-time phenomenon. The on-going financial challenges may just create the “perfect storm” that will devastate Heartland’s financial standing. If you would like to test the veracity of that prediction, do the research. How can Heartland assure that their joint ventures with other entities (such as CHP) will not deplete the hospital’s resources by tying up cash and other liquid assets that otherwise would be available for more charity care?

That being said, one only has to search the internet for Heartland’s IRS 990 form. This public disclosure will fill in the gaps of what several of you questioned of my original post. Too bad Heartland won’t publish a detailed breakdown for the last three years of travel for the top 10 executives, including hotel, meals, airfare, recreation and all other reimbursed items as well as the purpose of the trip...

The next time you walk the halls of Heartland, do so with a smile.

family guy- Maybe HH should set up an anonymous intranet forum for employees to share concerns and get answers, start a dialogue for real change. I know for a fact that some will no longer speak up or raise questions/concerns for fear of job loss or retribution, they don't feel that they have a real voice. As I said, I have several close friends in the healthcare industry, and from what I hear, they have many valid concerns.

bwheat100- I plan to do some research on the 990 form you mentioned. I'm sure that will be very interesting. Your comments about HH joint venture with CHP raises some very good points. That combined with the multi-million dollar venture with Cerner (I assumed thats what you were referring to with the problematic and inadequate electronic medical record system) not to mention the exec salary/perks really scares me about the financial direction HH is taking. Maybe some have lost sight of their mission?

bwheat, again I appreciate your candor and willingness to engage this topic and give due respect to the excellent staff and physicians at Heartland. When people paint Heartland Health with broad-brush strokes of hate and anger it really annoys me. They need to remember that 1,000s of people in our home town rely on Heartland to sustain their families and pay their bills. When they tear down Heartland as a whole, they also tear down the wonderful people that work hard every day to give compassionate and skilled medical care to their loved ones. If what you say about the leadership at Heartland is true, then those are the issues that need to be addressed by the community.

Stop blaming "Heartland Health" the entity for the bad experiences you may have had. If you receive bad care from someone at Heartland, scream it from the rooftops and demand an explanation. But, that experience should not taint everyone who works there. I promise you, EVERY hospital has problems with bad experiences at one time or another. I have many bad stories I can tell about Lukes in KC. It was specific to one area and one doctor, but I would still go there for care... as long as I didn't have to see that doctor.

suzyQ, I spoke with my family member who works at Heartland and she told me that there is an anonymous forum on the intranet that staff can send comments/complaints/issues to get answers. She tells me that she's sent issues through the link and received responses with no repercussions. This is why I have been saying that Heartland seems to be taking these issues seriously and we should give them a chance to raise these numbers. If they can't, then that sheds the light on the real problems and those issues can be addressed.

Please tell your friends to take advantage of the link and get their voices heard. That's the only way to start the change that is needed.

I might have my facts wrong about the forum, or maybe it has changed since I last talked. I was aware that they did have one that they kind of somewhat abandoned when too many employees were upset by the upcoming switch to "Paid time off" versus vacation, holiday, and sick time. While it works great for the newcomers, its not going over so well with alot of the ones who have spent years at Heartland. It will overall reduce total yearly time off they worked years to achieve. You have to take your PTO when you call in sick, unless of course you are sick for more than 3 days, then you get to use your sick time. That worries me that the healthcare workers would tend to come in even when they are sick as to not use their PTO (vacation)...the last thing they should do when taking care of people sick in the hospital. I know this is how it is done in alot of business, but I dont think a hospital should encourage people coming in sick by making them use their time they would otherwise use for vacation. Again, Im not on the inside, and I may have misunderstood, but thats what my friends are telling me. I guess a bunch raised alot of questions, and basically told this is how it is going to be and ultimately quit getting responses to their concerns on that forum. Im not sure it that was a forum just for this..or for any problems/concerns.

family guy- you are so right when you say about bad experiences/good experiences, and not letting it taint HH as a whole entity. I have both good and bad at HH, but I also know that all hospitals have issues. I also know if something tragic is going on, things can seem so momumental. They should always be striving to make it better. I did scream from the rooftops when a nurse left my Mom lay in bed when she rang her buzzer many times that she needed help to get up on the commode or a bedpan (she was paraplegic) but always went ignored or got the infamous "I will be back in a minute"...trying to hold off so the next shift would take care of it...well that minute never came and she was left to lay in her excrement (and all this AFTER having surgery for extensive bedsores cause by this very same reason). Where did I find her nurse? Popping herself a bag of popcorn and telling jokes. You bet I was hopping mad, and I did speak up and to her boss too. I didnt, however, speak up to the rude (not sure if tech or nurse here) was so rude to my Mom because she asked for a blanket and to be turned (mind you she was paraplegic and very weak) Apparently my Mom was annoying her with her requests so she felt the need to shut my Mom up by saying she was complaining too much and she didnt have time to babysit her. You know what, my Mom passed a few hours later unexpectedly. Can I just say, how much it sickens me to know that last few hours of my dear mother's life was spent by some grumpy person and their uncompassionate ways, those are the ones whom need to find another profession. I was too devasted to speak up, but I guess I am ...sort of... here. However, that being said, I believe for the most part that is the exception and not the rule at HH. I cant compliment enough the compassion and care my Father received upon his last few days alive in the ICU/CCU. Now there are some really on the ball as well as compassionate group as I have seen. Utmost regards to them as well as the HH cardiologist who was just so kind beyond words and thanks. I, too, also let it be known of that positive experience...you cant always complain of the bad, they need to hear the good too. I'm probablly getting way off topic here as I have tried to resist stating specifics.

I agree if something is not right with leadership, that should be the focus here. There are definitely things that need to be addressed. How do you suppose we get that out in the open so real change can happen?

Or the better question is...how to get it out in the open...and will they have an open ear? Will it really be heard? I think that some of the management will hear you...but not listen...just do what they want anyways. Rank-and-file simply do not matter to some management. In fact, I have heard it be told that managers are to be loyal to the upper administration and not to rank-and-file...Funny, I thought they were there in part to ensure their employees have sufficient means to meet the needs and care of the patients and community. I would think if they had concerns, that would be important. I guess I had better stop before I get too carried away here...but ultimately bwheat100 said it best: Clean up the mess and Heartland "will hit the mark!"

suzyQ, let me just say first that I am so sorry to hear about your loss and that your mother was treated so poorly by the nurse staff at Heartland. There is absolutely no excuse for that kind of behavior and those nurses should have been terminated on the spot. These are the types of stories that cause people to be turned off by Heartland. But, I also appreciate hearing about how Heartland treated your father in ICU. I too had a personal family experience in the ICU and they were fantastic! They treated our whole family with the utmost respect and dignity.

From what I hear about Heartland, they are in the process of "retraining" their leadership staff to be more responsible for their departmental patient satisfaction scores. That means they must have the best staff on the floor to ensure that the patient is taken care of and chooses to give Heartland a good score. My family member tells me that she's hoping that this may make the leaders more receptive to "weeding out" the bad employees and providing more support to the good ones. Hopefully when they post these scores again from October 07 - September 08, Heartland will have increased their numbers. We'll have to wait and see.

Also, I asked my family member about what you said about PTO and the forum. She said that there is a link on the intranet called Employee Opinion and that employees can submit any type of question, concern, comment that they want and it remains anonymous if they choose. She said one of the big issues was PTO awhile back and there was a big stink with that. Some people really want it, others don't. But, employees concerns were listened to and addressed in this forum. It sounds like they may not have liked the answers, but they were addressed. : )

family guy- thank you for your words about the care my family received. Also thank you for a respectful debate.

I also appreciate your willingness to get your family members perspective and the dedication you have to this topic, etc.

I do have one question and this may go back to what bwheat was trying to say...what if some of the weeding out that needs to be done is towards the top?

Interesting question. I'm not sure I have a specific answer. Heartland Health is a community-based hospital. As part of the community, I believe these types of debates and dialogues are instrumental in making sure the execs at Heartland know what we are saying about them. Heartland's CEO is retiring in a couple of years. This may be a great time to open that dialogue and make sure the new leadership strives to be a good steward of the community.

I believe it is our responsibility to hold Heartland's feet to the fire, but also remember that at this time Heartland is our local health care provider. We should support Heartland in its mission as long as they are holding up their end of the bargain. These government reports are helpful to show what is happening inside Heartland, but it's the real-life experiences that people have at Heartland that will make a true difference.

Sometimes it's very difficult to defend Heartland because people immediately start telling you how horrible Heartland is and that you must be an idiot or a Heartland-bot to say anything good about them. We all got a taste of that on this comment board. But, I believe Heartland is worth defending because my friends and family are worth defending. Methodist, Sisters and Heartland are ingrained in our local heritage. I don't believe Heartland has crossed to the darkside. I'm an optimist and I believe Heartland has the community's best interests at heart. Hopefully the leaders of Heartland, and the citizens of St. Joseph, will step up and take our community hospital to the next level.

I work in the ER at heartland everday of my life and half you people don't no anything about what really goes on.. Someone said they had to wait for there mothers room after cardiac arrest for hours that does not have anything to do with the ER this is something called patient placement we can not move someone into a room when it is not ready.... All of this stories people keep talking about i have never seen anything like that... If a child has a temp.. of 107 it will be brain dead and we do our temp in cels so would you no what it was there and if you did it rectally you take off a degree... If there was not patients coming in to the ER for toothaches and ear pain and people just seeking pain pills then maybe people would not have to wait in the waiting room for hours... Has anyone ever had a bad day at work or not been able to figure something out at there job... But the ER and hospital staff are supposed to be perfect and can't have a moment... In the past month at my job we have saved at least 10 people lifes.. can anyone say that about there job..you have to ask what drugs if any people on are it part of putting the puzzle together... Take yourself and kids to kansas city and hope nothing happens to them during the car ride and have to life with that for the rest of your life i no my child with be safe at heartland we have people come down here from kansas city that hate kansas city hospitals... It all depends on where you are from no one likes the hospital in there own town.. Also gald you have PHD's and no what sould have been done you peple just like to bitch

I agree that lots of people complain about the hospitals in their area, but the survey results show that people in our area are more dissatisfied than most. Other hospitals in our area recieved higher marks on the survey.

ERnurse.......all I can say is I'd hate to be the person who audits your charts. Your spelling and grammer are atrocious. While I agree the ER is often abused by patients who are not true emergent cases, it is very unprofessional of you, as a supposed "ER Nurse" to be complaining about them in a public forum. It is people like you that help give HHS a bad name!

ER Nurse, if your nursing skills are in any way as bad as your grammar and spelling, it's no wonder so many people have trouble through Heartland ER. No one has said there are never any lives saved at HRMC. But, each of the stories you have read have personal accounts of bad care and cannot be discounted. I agree with scrubnurse, it is very unprofessional for you to be talking about patients in this forum. It's great that 10 lives have been saved in a month but it in no way makes up for poor care given to someone else. Yes, ER workers, actaully healthcare workers are held to a higher standard because if you screw up because you are having a bad day or for whatever reason, people can die, or be damaged for life!!! Every patient who walks through that door deserves the same level of care and consideration and professionalism. I will admit the services are abused by some but sometimes it is HRMC clinics that tell patients they are too busy to work them in if they are sick or injured and even though it might not be an emergency room case that is where they end up. I personally went through 4 HRMC doctors to try to get my son treated for an urgent care issue that was not emergent but was told more than once that he could not be seen for his problem, take him to the ER. Believe me, the ER is the last place at HRMC I want to use and only use it in a true last resort for care. It is not all the employees, but it is enough of them that they all get painted with the same brush now. If the employees don't like hearing the complaints, get together to fix things and make them better.

When did Heartland become a level 1 trauma center??? WRONG !!!!!! They have only been a level 2 they do not have the resources to be a level 1.

Thank you, scrubnurse, for providing some equalibrium to ERnurse's comments. Hopefully your attidude is the norm at Heartland and not the exception. Yes, there certainly are those that abuse the ER, especially if they are on the state's dime. Anyone working in an ER, or any public safety entity, should know that. It's a part of the business.

I assume ERnurse has touched many lives, whether bringing someone back from the Grim Reaper or consoling somebody that just lost their spouse of more than half a century.

ERnurse, your professional and Heartland pride are obvious. I'm sorry if you had a bad day and felt the need to vent in this forum. I'm sure at one time or another you've had patients call you every name in the book for no sensible reason while you are treating them. Sadly your comments have confirmed what some feel: Heartland staff members need help with their attitude, which is one of the bricks that built this huge wall of feedback in the first place.