Visalia, California Leadership Profile Director of Procurement and Logistics CONFIDENTIAL Prepared by David Boggs Gwendolyn Jenkins June 2014 Overview of Kaweah Delta Health Care District Kaweah Delta Health Care District (KDHCD or the District), a local health care system formed in 1961, is comprised of a 581-bed hospital with eight campuses in Tulare and Kings counties serving the Central Valley of Visalia, California. It is a full service health system and services and the campuses are outlined below. Its campuses consist of: ∙ ∙ ∙ ∙ ∙ ∙ ∙ ∙ Kaweah Delta Medical Center Kaweah Delta South Campus Kaweah Delta West Campus Kaweah Delta Porterville Dialysis Kaweah Delta Woodlake Health Clinic Kaweah Delta Exeter Health Clinic Kaweah Delta Lindsay Health Clinic Sequoia Regional Cancer Center Radiation Oncology in Hanford The District’s main facility, Kaweah Delta Medical Center, is licensed for 403 acute care beds. It is the largest acute care medical facility between the cities of Bakersfield and Fresno and is the major referral center for Tulare and Kings Counties. The hospital campus is located in Visalia, California, approximately 45 miles south of Fresno, California, and approximately 60 miles due north of Bakersfield, California, just east of State Highway 99. Kaweah Delta Medical Center is situated on an 11-acre campus and consists of the original fivestory, approximate 309,000 square foot Mineral King Wing. The facilities provide a full range of primary and secondary acute care services (including specialized services in cardiology, cardiovascular surgery, radiation oncology, renal services, rehabilitation, orthopedic, neurological and spinal surgery), acute psychiatric, subacute, skilled nursing, trauma and comprehensive emergency, outpatient, laboratory, clinic and ambulatory care services. The main facility also houses the 229,000 square foot Acequia Wing. Completed in 2009, the Acequia Wing is home to a regional heart center, expanded maternity, emergency and cardiac services. Future developments for the Acequia Wing, include completion of the fifth and sixth floors to better serve the medical center’s patients. Facilities Growth and Expansion The District has steadily expanded its services over time. Kaweah Delta Medical Center was originally constructed as a 224-bed general acute care hospital in 1969; and since opening, its evolution has included expanding to 403 acute care beds as well as the following: 1 1976: Expansion of the emergency room and radiology department lobby.1982: Expansion and renovation of the labor and delivery department. 1983: Construction of the Special Services Center for outpatient surgery and outpatient diagnostic/treatment services, the construction of a cardiac catheterization laboratory, and the opening of a home health agency. 1986: A magnetic resonance imaging center opened, along with a sleep disorders lab, outpatient alcohol and chemical dependency program and an outpatient hemodialysis facility. 1987: A 46,000 square foot, three-story addition to the hospital provided a new 21-bed intensive care unit, as well as updated physical therapy, dietary, pharmacy, central supply and diagnostic service departments. 1989 and 1990: Further additions and improvements were made to the hospital to update the emergency department, birthing center, main hospital entrance, endoscopy, radiation therapy and skilled nursing areas. 1992: The new Kaweah Delta Rehabilitation Hospital was opened with 30 beds designated as acute rehabilitation beds and 31 beds licensed for skilled nursing care. At the same time, the 14-bed acute rehabilitation unit was converted to skilled nursing beds bringing the total skilled nursing bed complement to 32 at the hospital. A joint-venture with local surgeons to operate a freestanding ambulatory surgery center was begun (recently renamed “Sequoia Surgery Center” after merging with another local physician-owned ambulatory surgery center in August 2010). 1994: The District acquired Visalia Community Hospital (renamed “Kaweah Delta Skilled Nursing Center”) which is a general acute care hospital located approximately two miles south of the hospital in the City of Visalia. 1995 and 1996: The District completed several projects including the construction and equipping of a second cardiac catheterization laboratory, the construction and equipping of a new cardiac surgery facility and the completion of a new pediatrics unit at the hospital. The Kaweah Delta Skilled Nursing Center was redesigned to provide senior care services through the conversion of 19 existing medical/surgical beds to acute geropsychiatric beds. Construction of a two-story, 57,500 square foot health and wellness center (“The Lifestyle Center”) adjacent to Kaweah Delta Rehabilitation Hospital was completed during this same time. Upon closure of a former acquired hospital, the Exeter facility, the Exeter 46-bed subacute program was transferred to Kaweah Delta Skilled Nursing Center. Subsequent to the transfer, all 54 beds of Kaweah Delta Skilled Nursing Center were dually-licensed as skilled nursing and subacute beds. With this transfer and expansion, the District closed the 20-bed geropsychiatric unit previously operated at the Kaweah Delta Skilled Nursing Center campus. 1999: The District acquired a 63-bed assisted living facility (now called Kaweah Delta Mental Health Hospital). Also during this year, the District transferred its 32-bed skilled nursing unit from the Hospital to the Kaweah Delta Skilled Nursing Center. Simultaneously with the transfer, the District increased the number of skilled nursing beds from 32 to 34 and increased the number of geropsychiatric beds from 19 to 20 bringing the total bed 2 complement to 54 beds. The vacated 32-bed skilled nursing unit at the Hospital was converted to general acute care beds and became licensed and available for use in 2003. 2000: The District entered into a jointventure agreement with Living Care Visalia, LLC, for the purpose of developing and operating an assisted living facility in Visalia, California. The facility, referred to as Quail Park Retirement Village, is comprised of 12 independent living units and 114 assisted living beds. The joint venture is owned 44% by the District and 56% by Living Care Visalia, LLC, and its affiliated investors. 2003: The District reconfigured Kaweah Delta Mental Health Hospital by increasing the number of acute psychiatric beds available from 28 to 47 beds and reduced the number of long-term psychiatric beds from 35 to 16 beds. In 2004, the District converted the remaining 16 long-term psychiatric beds to acute psychiatric beds. The aggregate number of licensed beds stayed the same at a total of 63 beds. The District commenced construction of Sequoia Regional Cancer Center and Kaweah Delta Imaging Center, a free-standing medical oncology, radiology oncology and outpatient imaging center. Construction of the 44,300 square foot Visalia facility was completed in 2004. Construction of a 6,600 square foot Hanford facility commenced in 2004 and was completed in 2005. 2004: The District increased the number of acute rehabilitation beds located at Kaweah Delta Rehabilitation Hospital from 30 to 45 and reduced the number of skilled nursing beds from 31 to 16. At the same time, the District converted 15 of its skilled nursing/subacute beds located at Kaweah Delta Skilled Nursing Center to dedicated skilled nursing beds thus maintaining a skilled nursing bed capacity of 31 across the two campuses. 2005: The District consolidated its two-site skilled nursing program into a single site located at Kaweah Delta Skilled Nursing Center. The 16 skilled nursing beds previously operated at Kaweah Delta Rehabilitation Hospital were placed into suspense. At the same time, the total number of skilled nursing beds operated at Community Health Center was increased from 15 to 24 and the remaining number of dually-licensed beds was reduced from 39 to 30, thus maintaining the total licensed beds at 54. 2007: The District completed construction of Kaweah Delta Visalia Dialysis Center, an 11,900 square foot outpatient chronic dialysis facility. The new facility replaced a previously leased facility and allowed for an additional 14 treatment stations. The District also operates a 6,500 square foot leased outpatient chronic dialysis facility located in Porterville, California. The District completed the remodel of its neonatal intensive care unit which expanded the unit from 10 to 15 beds. The unit is located on the second floor of the Mineral King Wing of the Hospital. 2008: The District removed the 16 skilled nursing beds at Kaweah Delta Rehabilitation Hospital from licensing suspense and placed them back into service. The skilled nursing 3 beds were developed as an orthopedic and general rehabilitation unit for orthopedic patients requiring post surgical skilled nursing care. 2009: The District completed construction of the North Expansion project that initially added 86 acute care beds and approximately 229,000 square feet of new space to the Hospital. The North Expansion project consisted of a six-story patient-care tower, referred to as the Acequia Wing. The Acequia Wing houses three dedicated cardiac surgery operating rooms, an endovascular operating suite equipped with endovascular robotic surgery equipment, four cardiac catheterization labs, including electrophysiology, with shelled space for a fifth lab, a 20-bed cardiac intensive care unit, a 42-bed maternity unit, a 24-bed cardiac telemetry unit, hospital supplies storage, sterile processing, and clinical engineering, as well as additional emergency department beds, non-invasive cardiology and other services. The fifth and sixth floors of the Acequia Wing were shelled in to allow for an additional 48 beds when demand dictated the completion of these two floors. 2010: The District opened the Kaweah Delta Lindsay Health Clinic. This new clinic facility is a hospital-based, federally qualified rural health clinic located in a leased building in Lindsay, California. The Lindsay Health Clinic provides outpatient primary care services in adult and pediatric medicine. 2011: The District opened Sequoia Prompt Care, located a mile southeast of the Hospital, to alleviate pressure on the emergency department and urgent care center. 2012: The Kaweah Delta Woodlake Health Clinic opened. This clinic facility is a hospitalbased, federally qualified rural health clinic providing outpatient primary care services in Woodlake, California. Both Sequoia Prompt Care and the Woodlake Clinic are located in leased buildings. Additional projects currently underway include expansion of the Nuclear and CT Scan departments, Endoscopy Surgery Suites, and the remodel of the Obstetrics and Neonatal surgery areas. Sequoia Medical Building - In summer 2013, construction of a medical office building for orthopedics, vascular surgery, and general surgery including therapy services and a second Sequoia Prompt Care Center will be under construction. This building, on the corner of Akers and Cypress in Visalia, completes the West campus. Adjacent to the Sequoia Surgery Center and rehabilitation hospital provides an ideal setting for both patient and physician convenience. Helipad - In an effort to save critically injured patients by getting them care in the first 60 minutes of their injury, construction on a helipad at Kaweah Delta began in September 2012. By spring of 2013, the helipad was operational and ready for the rapid arrival and transfer of patients to and from Kaweah Delta. The bottom line: Emergency care has been improved and lives will be saved by having a helipad at the Medical Center. 4 Overview of Other District Facilities The District also owns and operates the following freestanding facilities, all located within the City of Visalia, except for Kaweah Delta Exeter Health Clinic. Kaweah Delta Rehabilitation Hospital Constructed by the District in 1992, this is a one-story, 69,000 square foot facility on a 22-acre campus located approximately four miles west of the Hospital. It is licensed for 61 beds, consisting of 45 general acute care rehabilitation beds and 16 skilled nursing beds. The Kaweah Delta Mental Hospital Constructed in 1989 and purchased by the District in 1999. It is a one-story, 48,900 square foot facility on a 9.5-acre campus located approximately four miles west of the main campus and is adjacent to Kaweah Delta Rehabilitation Hospital and The Lifestyle Center. It is licensed for 63 general acute psychiatric beds and currently operates/staffs 48 beds. Services focus on adults only and the volume has been growing over the last four years. At this time there is only inpatient services offered. Plans exist in 2014 to increase the staffed bed capacity by six more beds. The program is staffed by five full time psychiatrists and is the only behavioral health program in the region. Kaweah Delta Skilled Nursing Center Constructed in 1964 and purchased by the District in 1994, is a one-story, 49,600 square foot facility located approximately two miles south of the Hospital on a 5-acre campus. It is licensed for 54 beds, consisting of 30 beds dually-licensed for skilled nursing and subacute care and 24 beds dedicated to skilled nursing care. The Lifestyle Center Constructed in 1996, this facility provides outpatient physical therapy, pulmonary rehabilitation, and fitness services, among others. The Lifestyle Center is a two-story, 57,500 square foot medically based health and wellness center located on the same campus as Kaweah Delta Rehabilitation Hospital and Kaweah Delta Mental Health Hospital. Kaweah Delta Imaging Center and Sequoia Regional Cancer Center Radiation Oncology Opened in 2004, these are two hospital-based departments located within the same building. The Imaging Center provides a number of outpatient imaging services including radiography, magnetic resonance imaging, computed tomographic scanning, ultrasound, fluoroscopy, ultrasonography, and nuclear medicine. The District also acquired two digital mammography machines in connection with moving the District’s Women’s Imaging Services from the Kaweah Delta Skilled Nursing Center to the Kaweah Delta Imaging Center. 5 Kaweah Delta Visalia Dialysis Center Constructed in 2007, this center is an 11,900 square-foot outpatient chronic dialysis treatment facility located on the same campus as Kaweah Delta Rehabilitation Hospital, Kaweah Delta Mental Health Hospital, and The Lifestyle Center. The facility offers 26 patient treatment stations and replaced and expanded upon a previously leased dialysis facility. Kaweah Delta Exeter Health Clinic Acquired in 1998 in connection with the District’s purchase of Memorial Hospital at Exeter, this is a hospital-based, federally qualified rural health clinic located in Exeter, California. Through contracted physicians, supported by employed mid-level practitioners and clinical and administrative staff, the Exeter Health Clinic provides outpatient primary care services in adult and pediatric medicine as well as certain specialty services including adult and adolescent mental health, obstetrics, pediatric cardiology, neonatology, rheumatology, and neurology. The Exeter Health Clinic treats over 5,000 patients per month and helps reduce the number of nonemergency visits to the Hospital’s emergency room. Overview of Service Area and Market Share District management regards the District’s primary service area to include an area in northern Tulare County and southern Fresno County, encompassing the cities and communities of Visalia, Farmersville, Exeter, Lemon Cove, Three Rivers, Woodlake, Orosi, Ivanhoe, Goshen, Kaweah, Badger, Cutler, Yettem and Orange Cove. This primary service area accounted for approximately 81.4% of the Health Facilities’ calendar year 2010 inpatient discharges, a 2.8% gain from the its calendar year 2009 market share. Discharge data for the City of Visalia indicated that the District’s calendar year 2010 market share for the City of Visalia was approximately 85.2%, a 1.5% gain from its calendar year 2009 market share. The District’s primary service area includes a significant area outside of the District’s geographic boundary. Management estimates that most of the remaining acute care services are provided by smaller hospitals located in Tulare, Reedley, Hanford, Porterville, and Selma and hospitals located in Fresno and the San Francisco Bay area. Because the Health Facilities are geographically distant from the other major Fresno and Bakersfield area hospitals, management considers the District’s market to be distinct from that of such hospitals. Kaweah Delta operates as a non-profit hospital, with less than 1% of funding coming from taxpayers. The geographic area that incorporates the District (the voting residents who elect the District’s Board of Directors) encompasses approximately 183 square miles in northern Tulare County and includes the City of Visalia, as well as neighboring unincorporated areas. The 2012 estimated population of the City of Visalia and Tulare County was 126,864 and 450,840, respectively. Projections made by the Tulare County Association of Governments estimates the City of Visalia and Tulare County populations will reach approximately 163,000 and 566,000, respectively, by the year 2020, representing a compounded annual growth rate of approximately 2.6% and 2.4%, respectively. 6 Other Key Facts and Information ANCC’s Nursing Magnet designation and the only such facility in the Central Valley. Offering accredited Graduate Medical Education Programs in July 2013. The only Trauma Center in Tulare County. First to offer robotic surgery in Tulare County for gynecologic and urologic procedures. First hospital in California to install Artis Zeego advanced 3D imaging equipment in operating room. History of growth in net patient revenues with 2012 FY net revenues of nearly $450 million. FY 2012 operating margin of $19 million. Kaweah Delta Health Care District’s Mission, Vision and Values that drive the direction and culture follow: Mission: To provide high-quality, customer-oriented and financially strong healthcare services that meet the diverse needs of those we serve. Vision Delivering excellence. Together, Kaweah Delta and the Medical Staff will be recognized for consistently delivering a broad range of exceptional healthcare services, superior clinical quality and exemplary customer service. Values Integrity: We are completely honest, candid, and transparent in our dealings. Care: Our patients, their families, and the community must be at the center of all we do. Accountability: We are completely responsible to our patients, the community, and our colleagues for producing the best results possible. Respect: We collaborate effectively with others and are socially and interpersonally skilled. Excellence: We accept nothing less than our very best efforts, and through continual learning we are committed to achieving superior performance. For additional information, please access: http://www.kaweahdelta.org 7 The Role of the Director of Procurement and Logistics The Director of Procurement and Logistics will be responsible for all aspects of supply chain/materials management processes for Kaweah Delta Health District and related or affiliated entities. This includes the main hospital campus as well as all related offsite facilities and physician practice clinic sites. The Director of Procurement and Logistics integrates all aspects of the supply chain management processes throughout Kaweah Delta and has overall accountability for the centralized procurement, contract management and negotiation, inventory management, receiving, storage, distribution (Low Unit of Measure Area), the materials information system, and PAR stock replenishment. This position provides leadership in meeting operational and fiscal objectives as they relate to non-salary expenses, within Kaweah Delta Health Care District. This key leader identifies areas for service, quality and cost improvement initiatives. This position serves as a resource to KDHCD entities for process improvement and business reengineering activities related to supply chain processes; and participates in management and negotiations of contracts and capital equipment purchases. The Director is responsible for ensuring organizational compliance with legislation and regulations that impact the supply chain operations within the health system. This position has discretion to establish plans and recommend policies and priorities that support and are consistent with KDHCD objectives, operating policies and precedents. He/she will report directly to the Director of Finance and Logistical Planning. Reports to the Director of Procurement and Logistics include: Clinical Materials Manager Purchasing (4 Buyers) Central Logistics Manager KDHCD utilizes Lawson’s financial/AP/supply chain software enterprise wide with the GHX electronic ordering interface. They are running at approximately 75% electronic purchase orders at this time. Premier is their primary GPO and Cardinal is their distribution partner. The below table contains some operational statistics for Kaweah Delta’s supply chain function. Kaweah Delta Supply Chain Information Supply Costs Annually Supply Costs as a Perct of Net Revenue Supply Costs per Adjusted Discharge Supply Costs per Adjusted Patient Day Total FTEs - Purchasing (Materials Management) - Central Logistics Annual Budget Materials Dept. Current FY $60,164,000 17.10% $1,212 $232 6.00 25.00 $1,474,000.00 8 Below are the key duties and responsibilities for this position: Responsible for supply chain management for the hospital including continuous evaluation and implementation of best practice standards. Acts as a resource to all clinical and non-clinical staff regarding non-salary expense management by actively communicating contract or purchasing opportunities. Develops and maintains good working relationships with customer departments, the management team, and medical staff. Develops and articulates a clear vision of Supply Chain Management operations. Responsible for all related external materials management factors; including Group Purchasing Organization (GPO) relationships and services, supplier capabilities and advanced supply delivery programs. Maintains a professional environment in interactions with vendors. Utilizes financial data and other benchmarks to monitor costs. Oversees cost benefit analyses to substantiate decisions in product selection. Keeps informed of all new developments relative to materials and supplies, and makes recommendations designed to reduce costs and improve methods. Responsible for contract management. Develops, maintains, and coordinates a system for regularly scheduling contract reviews. Routinely reviews purchasing practices to assure that Purchasing staff are procuring and utilizing appropriate contracts and tiers. Oversees the purchasing function utilizing acceptable purchasing practices. Develops purchasing plans and programs to implement overall objectives. Works with the hospital management staff to procure the appropriate supplies and equipment within agreed upon time frames. Directs the activities of the Value Analysis Committee in an effort to foster a spirit of teamwork, cooperation and communication. Oversees the use of information technology in the purchasing and distribution process. Coordinates upgrades to the system and use of new software applications. Coordinates the standardization of supplies and equipment within the organization. Acts as Chairperson of the Value Analysis Committee. Directs all processes for the Value Analysis Committee to include development of appropriate financial targets and performance benchmarks. Directs the activities of the Value Analysis Committee in an effort to foster a spirit of teamwork, cooperation and communication. Assists in the preparation of the annual departmental operating budgets; operates each function within the approved budget. Applies cost-effective measures in department operations and keeps abreast of all product changes, recalls and industry trends. 9 Qualifications and Personal Qualities The section below outlines the qualifications and selection criteria for the ideal candidate for the Director of Procurement and Logistics. Education, Licensures & Certifications Bachelor’s degree will be required and a Master’s Degree preferred. This could include business, healthcare, economics or related degree from an accredited college or university. Association for Healthcare Resource and Materials Management (CMRP) or the National Association of Purchasing Managers (CPM) certification strongly preferred. Experience Minimum of five to seven years of experience with progressive responsibility in a supply chain/materials management setting required; must have experience as a director (number one) in a similarly sized or smaller supply chain department or as an assistant director (number two) in a larger healthcare supply chain department. Experience in successfully gaining buy-in among physicians and clinical staff to standardize products in multiple service lines. Someone who has successfully lowered supply and/or other controllable expenses within a hospital or health system setting. Candidates with experience in an organization, where patient/customer satisfaction is considered a very high priority and a part of the culture is a must. The successful candidate will have experience in the entire supply chain process within the healthcare organization. This must include value/clinical product analysis, contracting, order placement, acquisition, distribution, and disposition of all supplies, equipment, and purchased services. Experience with the use of material management related information systems as well as a commitment to the use of technology to increase efficiency. Proficiency in Microsoft Office Applications such as Word and Excel. Someone with experience in putting in place systems to better manage utilization of products in the key service lines (such as interventional radiology, cath lab, surgical services, orthopedics, etc.) is a plus. 10 Personal Characteristics Someone with absolutely solid values, who is honest, loyal and sincere. Must be service oriented and embrace the reason for Kaweah Delta Health Care District’s existence which is to serve patients and their families. The successful candidate will have excellent listening skills. He/she will listen well to his or her constituents and provide feedback to them. Must have a positive and can-do approach to their role and the role that their department fits into the healthcare system. This candidate must be comfortable and be able to work closely with physicians, clinical staff, hospital administration, and other constituents. Someone who is excited about the materials management/supply chain function and the key role that it plays in a hospital or health system’s future success. He/she will be someone who has a high level of ‘personal ownership’ in the future success of the organization in which they belong. Someone who is energetic, enjoys working with people at all levels of the organization, and has a good sense of humor. An uncompromising commitment to the value of staff involvement in decision making and finding solutions to future challenges. Excellent written and verbal communication skills and the confidence to sell his or her ideas in the hospitals and within the system. He/she will also have excellent oral presentation skills. The successful candidate will value relationships and be a committed team member with the KDHCD leadership teams. The successful candidate will set the standard for performance for both his/her employees and other hospital associates through a willingness to do themselves what they would ask others to do. Opportunities and Expectations for Leadership During the first 12 to 18 months of his/her tenure, the Director of Procurement and Logistics will be expected to achieve the following: Establish credibility and solidify working relationships with staff, management, administration and physicians by being visible, aware and proactive. Ensure that operational statistics/metrics relating to the supply chain process are at or better than the established goals for the organization. Ideally this new leader will look at existing measures as well as develop new measures that will enable the department to enhance service and efficiency. Evaluate practices and processes within the departmental areas and identify potential opportunities for utilization of information technology to improve efficiency. 11 Gain in depth knowledge of the Premier purchasing program and solid knowledge of other GPO product category programs. Ensure that Kaweah Delta is maximizing savings with regard to GPO contract opportunities Earn the trust and respect of the departmental employees, the senior leadership team, the managers/directors, and physicians within KDHCD. Develop a strong working relationship with all department heads, nursing staff, and physicians. Serving as a consultant, the director will assist the department heads in reducing their supply costs. Become an integral part of the Kaweah Delta management/leadership team; develop a sense of personal ownership for the future success of the organization while demonstrating a ‘can-do’ and proactive approach. Evaluate the value analysis process and make improvements to ensure that the process is effective and efficient. Gain an understanding of the product utilization processes and practices in the operating room environment. Identify and implement opportunities for product standardization that demonstrate cost savings. Serve as the hospital champion for the Premier GPO program. Procedure for Candidacy Please direct all nominations and resumes to Gwendolyn Jenkins, preferably via e-mail to: [email protected] Gwendolyn Jenkins WK Advisors 2000 Warrington Way, Suite 200 Louisville, KY 40222 Phone: 502-228-4030 Fax: 502-426-2719 12
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