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Deal struck with Alliant to manage Weems

David Adlerstein
The Apalachicola Times

There’s now a new face at Weems Memorial Hospital, a health care management firm the county hopes will boost the fortunes of the small hospital.

By unanimous vote at the Oct. 6 meeting, county commissioners approved a three-year management deal with Alliant Management Services, a Louisville, Kentucky-based firm specializing in rural and critical access hospitals, that will make Alliant responsible for financial, operational and clinical oversight for Weems.

Jim Coleman

The deal calls for Alliant to complete a host of services in exchange for a $17,500 monthly fee. The salaries for the hospital CEO and the chief financial officer are not included in the fee.

While commissioners signaled their backing of the deal, they underscored County Attorney Michael Shuler’s statement that in the event the deal does not work out, the county will have the option to end the arrangement, with 90-days’ notice.

“If we don’t like what’s going on, in 90 days we can be free of this contract, without cause and without cost,” said Commissioner Smokey Parrish, in seconding the motion made by Commissioner Bert Boldt. “I don’t want to get into something you can’t get out of.”

In opening remarks, Allan Feifer, a critic of Weems in his role as president of the Concerned Citizens of Franklin Count6y, shared concerns that an online search of Alliant’s business history raised several potential red flags. While he was careful not to level charges of wrongdoing, he said the questions raised were significant to prompt a delay in the county’s approval of the deal.

In a stern response, Boldt, who represents the eastern Franklin County district where Feifer resides, dismissed the criticisms as lacking substance.

“This county commission is a gateway and we are open and receptive and welcome input on all county business,” he said.

But, Boldt continued, citing a review completed by county officials of the matters raised by Feifer, “I interpret more of these issues being more like a tattletale, as compared to a well-documented (analysis),” he said. “If you’re going to ask the county commission to respond to controversial (information), they need to be well-documented and well-researched, so that we can then get our teeth into it.

“These pepper balls that come through make me sad,” Boldt said. “Alliant has been very well vetted at many levels, from Tallahassee Memorial Hospital down to the history of the company itself.”

Commissioner Ricky Jones joined with Parrish in stressing the sustainability of the hospital was his paramount concern.

“This is a step in the right direction,” he said, noting that Alliant was the one company to come forward with a proposal that preserved the existence of the county’s lone acute care hospital.

“It might not work but if not, we have 90 days to get out,” Jones said.

Parrish said Alliant has a track record that includes managing 25 hospitals, as well as the blessing of TMH’s CEO Mark O’Bryant.

“He (Jim Coleman) is going to help Weems start collecting some of the money they’re billing for,” he said. “Let’s get this money back to Weems Memorial and raise the revenues at Weems Memorial.

“That’s a big selling point for me, to try to collect some of the money we’ve billed for and put it back in the revenue stream,” Parrish said.

Commission Chairman Noah Lockley, who has been a fierce advocate for Weems, sometimes locking horns with the Concerned Citizens, suggested the group was raising questions to force a delay in approving the deal.

“This commission is not playing games,” he said. “We’re doing business; don’t try to hold it up. It’s got to be done and it’s part of our job to do it.”

No financial risk, but buying power

The approved contract does not put Alliant at financial risk in the event increased revenue projections prove elusive. The company is guaranteed a little more than $200,000 per year in fees to run the facility, about 40 percent of which hospital officials say will be covered by additional revenues forthcoming from Medicare with critical access hospitals.

Jim Coleman Jr. Alliant’s chief executive officer, worked to put the deal together with Shuler and interim Weems CEO David Walker.

As part of accountability for the day-to-day operations of the hospital, Alliant representatives will attend all hospital board meetings, provide board education including strategic planning retreats, assist with the annual CEO evaluation including annual compensation review and host an annual governance retreat available to board members.

Coleman said Alliant would provide operations support to the CEO via the company's regional CEO/CFO positions, and establish bi-weekly calls and monthly meetings with Walker. Alliant would conduct monthly operations reviews with Weems senior leadership team, provide monthly operations reviews and conduct employee engagement surveys every other year.

Alliant proposed an array of financial management services, including monitoring monthly financial performance, analyzing accounts receivable analysis, performing interim cost reports and filing the annual cost report. The company will also perform a comprehensive hospital operations assessment and assist with Joint Commission or other accrediting assessment and preparation, as well as leadership development.

In terms of human resources, Alliant will analyze executive compensation, wage and salary administration and benefits, provide legal updates for senior leadership, and arrange for group purchasing services.

Coleman said Alliant offers $1.5 million in purchasing power, and that supply costs would likely drop 10 to 15 percent in the future for the 25-bed hospital.

One evidence of that power was Weems’ ability to use Alliant’s purchasing contract for a new inpatient and emergency department telemetry system that will allow remote patient monitoring for early detection of an ambulatory patient’s changing condition. All patients will be connected to the Passport 8 portable monitors so keep continuous track of their vital signs – such as blood pressure, oxygen saturation, and heart rate - during their stay, which will be viewed at the emergency room and by nurses.

Walker said the original quote for the system was about $178,000, but was lowered by about $24,000, to about $154,000 based on Alliant’s purchasing contract. The monies used for the 15 portable monitors, and four for the emergency department, comes from CARES Act funding.

The commissioners also approved the purchase of a new ambulance, as a cost of about $273,000. Walker said the vehicle will come equipped with updated patient care equipment, and no other purchases will be needed to outfit the vehicle when it is delivered.

Walker said the hospital had an impromptu visit from representatives of the Agency for Health Care Administration, and that while they found an emergency management plan that hadn’t been approved by the county’s emergency operations department, “they were complimentary of the facility’s look and offered great suggestions.

“We’re using it a teachable moment,” he said. “We want to invest in our equipment, our patients and our employees.”