These are critical days in the life of St. Lukes Hospital, according to the new administrator Ken Shull.
Shull arrived last November as the first, full-time administrator for St. Lukes under the hospitals new management contract with Carolinas HealthCare System. He brings 37 years of experience in running small-to-large hospitals.
After just three months on the job, he looks at a four-month string of profits and expresses the hope that St. Lukes has turned the corner financially.
“It is still fragile, but changes were made,” he said. “Without them, we might not have survived last year.”
Of course, asking if a hospital is struggling financially is like asking if the sun came up. Hospital finances in the world today are difficult, Shull said, and likely always will be.
But Shull likes what he sees at St. Lukes. The board is respectful, and the medical staff is supportive and open to communicating.
Shull said he has visited in every doctors office in the area and has found the physicians welcoming, willing to share concerns, and each and every one to be a quality practitioner.
“Sometimes you find in a rural area one or two poor doctors who are hiding,” Shull said. “None are hiding here.
“I feel good about the quality here,” Shull said. “We (at St. Lukes) want to do things that we can do as well as anybody who does it. If we cannot do it as well here, well get you there. In-depth cardiac work, neurology we wont do things like that often enough to do it well.”
However, Shull said he has found that more than 90 percent of those who come to St. Lukes emergency department can be treated in St. Lukes.
“We can be a portal for the other 10 percent,” he said.
The biggest challenge for St. Lukes today, Shull said, is recruiting primary care physicians. Primary care physicians feed specialists, and with that specialists working at St. Lukes can expand their hours.
“We want to capture market share, not drive it out for lack of doctors,” Shull said. “As a hospital, youre not going anywhere without doctors.”
In the longer range, a huge challenge for St. Lukes is the age of the hospital building.
“This building is 40 years old. It operates with 40-year-old boilers. I am impressed with how they have kept it going,” Shull said.
However, he knows the board is looking at the appropriate time to replace the facility.
“You cant put a band aid on a band aid on a band aid,” he said. “We will need to do something phased, reasonable. We have enough land on the current site to handle that.”
The first step will be to show more successful financial results, to raise the communitys faith in the hospital, Shull said.
His board and staff will also need to go through a planning process. Shull said he believes in designing facilities by putting function first.
“We need time to show what is working, what is needed,” he said.
St. Lukes is showing some real strengths now. Shull mentioned orthopedics, geriatric psychiatric care and wound care as “financial positives.”
He plans to work on the community awareness and support by being open with real information, and available.
As for patients, he said, “We want to be viewed as easy-to-use, 1/2 hour versus a half a day. Minimum administrative hassle. Warm, friendly, and professional.”
Shull said he plans to formalize the hospitals service excellence program, with the goal of giving patients and visitors the “Wow! experience.”
“You are a person here, rather than a number,” he said.
Susan S. McHugh, chairman of the St. Lukes board of trustees, said the board worked from last May to November, interviewing candidates, before settling on Shull.
“We looked for a proactive, visionary leader; strong communicator; and someone who would work closely with the physicians, the board, the staff and the community,” McHugh said.
McHugh said the board wanted someone to focus on critical access hospital operations, finances, capital needs planning, and someone who could move the hospitals surgical and orthopedic initiatives forward.
“The board is pleased with the leadership, energy and vision he is providing,” she said.
Shull was born on the West Coast, in Modesto, Cal. His father was a chemical engineer doing sales and marketing for FMC Corp.
The Shull family moved when Ken was young to Ossining, N.Y., home of Sing Sing Correctional Facility, the prison 30 miles from New York City on the Hudson which spawned the slang for incarceration, “Going up the river.”
Shull attended high school in Ossining and then attended Denison University in Granville, OH where he earned his bachelor of arts in biology.
His goal in life at that point was to become an Air Force pilot. He had trained with the Air Force Reserve Officer Training Corps (ROTC) at Denison. After college, he joined the Air Force in 1969 and was sent to flight school in Arizona.
But he was too tall.
He is a big man, at 6-foot-5. He calls his wife, Heidi, by the nickname, “Killer.” The Shulls new landlord in Tryon calls his tenants, “Big Guy and Killer.” The pair have two married children, Lindsey and Drew, and five grandchildren.
While his size gives him immediate recognition and presence in any room, on the occasion of his application for flight school, it was a problem.
“My sitting height was too tall for one of the planes they were flying at the time,” he recalled, noting the disappointment. “That was the goal of my life.” The plane in question, a T33, was on the way out, but the rule was sitting height could not be more than 38 inches. Shull’s sitting height is 41 inches, so he was out of flight school.
Shull instead went to work at the Air Training Command center at Chanute Air Force Base in Illinois, about 130 miles south of Chicago. He worked as a student squadron commander for students in avionics and maintenance. He also was in charge of discipline for half of a 1,000-man barracks.
It was about this time he started thinking of a career in hospital administration. He applied to enter the Medical Service Corps, but his application was not accepted, so he began taking courses for a Masters in Business Administration, going to school every third weekend.
When he left the Air Force, he enrolled in the Masters of Hospital Administration program at the Medical College of Virginia (MCV) in Richmond.
“I had three criteria for my career,” he recalled. “I wanted to make a difference, to work with people and to hold a job that had no routine.”
Hospital administration certainly has no daily routine. Anything can happen and usually does, Shull said.
Shulls second year in the MCV program was a residency at Community Hospital, a 400-bed teaching hospital in Roanoke, Va.
“I attended all the 7 a.m. meetings there with the medical staff,” he recalled. “Weekends I was on administrative call. I went through a Joint Commission survey there.”
The Joint Commission is the national accreditation agency that ensures hospitals meet standards set by the Centers for Medicare/Medicaid (CMS) as a condition of licensure and the receipt of Medicare and Medicaid reimbursement. Rigorous onsite surveys are done every three years.
Shull said as an assistant administrator in the residency program, he handled medical records reviews, ensuring no mistakes in medical records go forward in processing, and also worked on new concepts, such as outpatient surgery.
“I worked all three shifts, meeting different people at different times,” he said. “It was a great experience.”
It was 1975, and he was ready to begin his career.
Shulls first job came in Western North Carolina, in the 98-bed Charles A. Cannon Hospital in Banner Elk, N.C., not far from Boone. He was the assistant to the administrator, a woman, with 36 years tenure. All departments reported to Shull.
One of Shulls first jobs was to perform a work load analysis.
“We were a small hospital with 242 employees and I told her we needed 192,” Shull said. “She agreed and we cut 50 positions. It was extremely tough sitting in church Sunday mornings with people who had just lost their jobs.
“But she said “we” had decided to do this. She got on the hook with me, and she was raised in that community. She had the courage and the backbone.”
After three years in Banner Elk, Shull took a position as administrator of Cannon Memorial, a 56-bed hospital in Pickens, S.C.
“The hospital board there was planning a new hospital building on 2.3 acres,” he recalled. “I had to tell them it was not going to happen. They needed 15 acres minimum, but didnt want to leave downtown.”
Two years later, Cannon Memorial did build a new hospital building on 23 acres just outside downtown. Shull stayed there six years total and led the construction effort and established the hospital in its new facility.
In 1984, he moved to Stanly Medical Center in Albermarle, N.C., a 132-bed hospital. He oversaw the addition of a psychiatric unit at Stanly and worked to build support in the community and medical staff.
Shull was moving up, and would land next in a big hospital in West Columbia, S.C. He went to the 292-bed Lexington Medical Center in 1988 as an assistant administrator. Eight months after he arrived, he was made the chief executive officer.
In addition to the hospital, the Lexington Medical Center ran a 354-bed nursing home and several outpatient centers.
During his eight year term there, Lexington undertook a major expansion with $62 million in bonds, They added services, housed an MRI operation and expanded out-patient services.
Shull, while working in West Columbia, was a natural to work closely with the South Carolina Hospital Association housed just across the street in West Columbia.
He chaired the hospital association board and served on committees, and in 1996, he agreed to become the association president.
During his eight years with the hospital association, Shull did lots of educational work, primarily focused on managed care and community health issues, as well as a lot of lobbying at the state and federal levels.
However, when the association board decided to focus almost exclusively on lobbying, Shull said he decided to go back into hospital administration.
He took over at the Highlands-Cashiers Hospital in 2005.
“I wanted back in a hospital and I liked rural hospitals. We enjoyed rural life,” he said. “I had chaired the North Carolina Hospital Association section for small, rural hospitals.”
The Highland-Cashiers hospital was just 24 beds, but operated on a different kind of economics. It offered plastic surgery, dermatology, gastroenterology, orthopedics and an on-site radiologist.
“That hospital very much depends upon the support of philanthropy,” Shull said. The wealthy settlers in the mountains there simply want, and are willing to pay for, a hospital with more services than a business case can support, Shull explained. There are 9,000 winter residents in the area, 33,000 in the summers.
Like St. Lukes, Highlands-Cashiers is designated a “critical access” hospital. Shull said, in addition to the financial challenges, he spent much of his time at Highlands-Cashiers recruiting physicians and building relationships with the community and the medical staff.
Now, in Polk County, he begins anew meeting the challenges of running a small, rural hospital.