El Paso Children’s Hospital has had its ups and downs since opening six years ago: bankruptcy, a succession of six CEOs and some financial problems since emerging from bankruptcy that have unsettled taxpayers.
The previous CEO, Mark Amox, who lasted only 11 months, followed George Caralis, Mark Herbers, Ray Sexton, Ray Dziesinski and Larry Duncan.
So after six guys who were all from somewhere else, Children’s board of directors decided they’d had enough of that. They didn’t have to look far to find a homegrown overachiever.
She was right next door at University Medical Center – Cindy Stout, that hospital’s chief nursing officer and an Andress High graduate with a doctorate in nursing practice from Duke University.
In her 25 years in health care, Stout, 50, rose through the ranks to serve in top nursing and executive positions at Del Sol Medical Center, Las Palmas and University Medical Center.
“For many years, I was the person in charge if the CEO was out of the hospital,” she said.
In making the announcement last September, Children’s board chair Ted Houghton said, “We are welcoming a new CEO with hometown roots and exceptional business and health management skills.”
He disclosed that her salary is $295,000 and acknowledged that it’s $100,000 less than former CEO Larry Duncan’s salary in 2014 – the last year Children’s paid its CEO directly.
“We’re going to have to bring her up,” Houghton said. “She’s responsible for $13 million in new dollars coming into this organization. She’s going to be one of the bright stars in health care in El Paso. I’m just glad she’s committed to this community.
“It’s all about the leadership and the quality of leadership.”
Stout sat down with El Paso Inc. to talk about the changes she’s made over the past seven months, what it meant to receive the industry’s highest designation as a neonatal intensive care unit and the touchy subject of Children’s finances.
Email El Paso Inc. reporter David Crowder at firstname.lastname@example.org or call (915) 534-4422, ext. 122 and (915) 630-6622.
Q: Last September, you were chief of nursing at UMC when Ted Houghton, chairman of the Children’s board, asked if you’d be interested in being Children’s next president and CEO. Did you see that coming?
I’ve been in health care in El Paso for over 25 years, and I had been over at University Medical Center for about seven months as the chief nursing officer. Sometimes, when people think of the chief nursing officer aspect, they think you’re just overseeing all of nursing. But you’re also in charge of strategic planning. You’re in charge of physician satisfaction, employee engagement, quality and safety initiatives.
So I’ve had a lot of that experience through all of my years, and I think it was important. As I spoke with the board over here at El Paso Children’s, that was something they were really looking forward to — somebody who really understood the community, who had worked with pediatricians in the community in the past, and somebody that would be rooted here in order to help the hospital move in the right direction.
Q: How does this job compare to what you had been doing, and was running a hospital ever a goal of yours?
For many years, I was the person in charge if the CEO was out of the hospital. Individuals I’ve worked with in the past have always had that confidence in me. I’ve established relationships with the staff members as well as with the physicians and other community members. Having that experience, it was not that far of a jump in terms of coming here to El Paso Children’s Hospital.
Q: What are some of the changes you’ve made?
We’ve made a lot of changes. Obviously, the first thing is to make sure that we’re moving forward in a positive manner with our financials. So in the last seven months, I’ve been deeply involved with that. I have a strong administrative team, and there are a couple of different things we’ve worked on very heavily.
First, making sure that we’re capturing the revenues for the care that we provide. We’ve made a lot of internal changes related to that. We’ve also been renegotiating our Medicaid-managed care contracts, and I appreciate all of the MCOs (Managed Medicare Organizations) for being willing to sit with us and, in good faith, go through negotiations.
Q: Who are they?
Superior, Amerigroup and the MCOs. For the children’s hospital, those are all Medicaid plans that allow our children to partake and to have that coverage. We’ve been able to make a lot of those changes. We’ve also been working very closely with our partners at Texas Tech.
My goal is to make sure that, first of all, we’re a strong, sustainable organization. But I also want to make sure we’re looking at ways we can continue to provide the level of services here so that children are not leaving El Paso for care.
Q: Do you see this as a long-term thing for you here in El Paso?
Yes. I’m from El Paso. I’ve been here since first grade. My father was in the military. I graduated from Andress High School and went away for college, but I ended up coming back. This is my home. I have children here, so I want this hospital to do well. There are a lot of great programs in place, and we have a lot of opportunities to continue to grow those as well. So, yes. I plan on being here.
Q: Not that long ago, a woman CEO in charge of a major hospital was rare, and now there’s Sally Hurt-Deitch, the former CEO at Providence, and women are coming up fast in health care. Are there others in town we haven’t heard about?
Tenet has a couple of female CEOs here in town. To me, it really is about the person, not necessarily female or male. It’s about establishing relationships and making sure that you can build trust. That’s the biggest thing. That’s why it was important to me, in my journey through this as the CEO, to ensure that I established those relationships.
Q: How much has the number of children being taken out of town for specialized treatment declined because of the new levels of care available in El Paso?
In our estimates, since the hospital opened in 2012, we’ve been able to decrease that out-migration by about 80 percent. We still have a few more areas – the complex cardiac surgical procedures and neurosurgical procedures where patients still might be leaving our community. We’re working very closely with our partners to make sure we’re able to provide those services here in the near future.
Q: One of Children’s big advances was being designated a Level 4 neonatal intensive care facility in December – the highest designation possible. How big was that and what did it take to get to that level?
This hospital had all the elements in place – all the subspecialists, all the 24/7 coverage that was required of it and all of the quality outcomes. We didn’t have to make any huge tweaks to the program to meet that designation. And, again, it’s the level of commitment that our hospital has.
Q: Providence Children’s Hospital achieved that Level 4 designation earlier in 2017. What does it mean having two hospitals offering that level of care in El Paso, and is there a high demand for it here?
There absolutely is that level of demand. It’s allowing us to really determine where the hospitals that have those levels of specialty, that should be the hub for care.
Q: Are you all keeping everybody busy? There’s still talk of highly paid doctors sitting down in the lunch area with not much to do.
No, not true. In fact, we’re looking at ways, whether it’s employment through the hospital or through partnership with Texas Tech, to determine what additional specialists we need to bring here in town. So part of our strategic plan going into this next year is to really try to close a few more of those gaps that we’re seeing.
The physicians are very busy. El Paso is a city that when you bring a physician in, they have to be able to tell you when they’ve reached their max load, and they reach it very quickly.
Q: I understand Providence Children’s flies doctors in. They’re from Dallas and other places, and they come in and work shifts here during the week. Then, they go home for the weekend. Is that less expensive than bringing doctors to El Paso who will live here?
Not always. Sometimes it is. My understanding is that they are. For us, it’s important enough to get individuals that will be rooted in the community. It doesn’t help to have an individual who comes a couple of days every month to see patients. This city deserves a higher level of care for children.
Q: And you also offer new special cranial and facial clinic services. Would you tell us about that?
We do. Dr. David Yates is our medical director for the cranial/facial program. Phenomenal results. We have a group of physicians that are fellowship-trained, which is very hard to come by throughout the United States. We’ve got some great stories.
Q: What else is there in the way of new and higher levels of care at Children’s?
We have the children’s oncology group with the clinical trials. We have an outpatient hematology/oncology clinic as well that’s here on-site in which the physicians are here while their patients are being treated. Those patients may be on clinical trials, or they may be on already approved regimens for treatment.
Again, those really in-depth services are important. We also have, of course, different specialists – everything from urology to GI to endocrine that’s solely dedicated to our facility.
Q: In 2012 when Children’s opened, there were concerns expressed that the hospital didn’t have a big, well-endowed foundation to start with that would raise large amounts of money. Today, there’s the El Paso Children’s Foundation, which is connected to the UMC Foundation. Would you explain that relationship and tell us how much the foundation has raised so far?
The El Paso Children’s Hospital Foundation has raised over $15 million. All of those funds obviously stay here, and they’re dedicated strictly for use here at our El Paso Children’s Hospital. University Medical Center has a separate foundation. Those two monies, they don’t get mixed.
Q: What should people know about Children’s support?
I think some people don’t understand El Paso Children’s Hospital is not tax-funded. We’re a not-for-profit organization. That’s why we have to make sure that, again, we’ve got a strong foundation.
Q: Who are some of your biggest donors?
We’ve had a number of really great donations over this last year. Southwest University gave a $1.5 million donation. We named our blood and cancer center the Southwest University Blood and Cancer Center at El Paso Children’s Hospital. We also have the Children’s Miracle Network, Walmart, Sam’s, and other organizations that participated with, I believe, over $432,000 this last year. Again, all of those funds are staying here.
The Bowlings – we just named our Zach Bowling Outpatient Diabetes Education Center. Every child that leaves our facility is equipped with what we call a “Zach Pack,” and it has the medications, it has the tools and equipment needed for children who are newly diagnosed with diabetes for them to be able to care for themselves and a very robust ongoing education program.
Q: It’s been reported that Children’s revenues are declining. The hospital expected more than $21 million in revenue during the first quarter of the fiscal year that began in October but took in $17.8 million – $3.8 million less than you expected.
For last fiscal year, when we closed out that year, we had a huge deficit. This year, we’ve been able to expect, as the year comes to a close, to be able to close that gap by 33 percent.
Q: Is there a break-even point in the near future?
2019 we’re going to be pretty close. 2020 should be when we get there for sure.
Q: There were concerns raised recently about a possible $5 million reduction in state uncompensated care funding to Children’s and that other children’s hospitals in Texas would be hit by similar reductions. Does the state understand the impact that would have?
You know, I think the state understands it, and I believe that our legislators understand it. I think they see the difference between a truly dedicated children’s hospital versus an adult hospital that has a pediatric wing.
With that being said, they understand that that’s where the depth of services really are. Every big city in Texas has a children’s hospital. All of them have been able to be successful as a young hospital. We’re the youngest one in the state of Texas. This hospital really wasn’t expected to get anywhere close to breaking even, I think, until year seven or year eight.
Q: A UMC board member told me a couple of years ago that the addition of 25 patients a day would make a world of difference for Children’s. Have you been able to increase your patient load over last year?
We’re doing well. This last year, we saw over 22,000 visits. This year, we’re seeing over a nine percent increase in the emergency department, so we anticipate that that number this year is going be a big increase from the prior year.