The president of MedWest-Haywood hospital suddenly stepped down this week after three-and-a-half years on the job.
Mike Poore’s tenure at the helm of MedWest-Haywood was marked by an aggressive strategy to restore a crisis of community confidence, rebuild plummeting finances and compete head-to-head with the much-larger neighboring Mission Hospital in Asheville.
The news that Poore was resigning came as a surprise to the medical community and hospital’s board of directors, who met for two-hours Monday to digest the news.
Dr. Benny Sharpton, a long-time surgeon in Haywood County, said the medical community is going to be disappointed at the loss.
“The medical staff was not only comfortable but optimistic with his leadership,” Sharpton said. “He opened up lines of communication that had been broken it he past. He had an open door policy. Not all CEO’s have good rapport with their medical staff.”
Poore will be best known for rescuing the hospital after a tumultuous period when it failed federal inspections and was forced to essentially shut its doors for four months in 2008. The previous CEO, David Rice, who had become a lightning rod of controversy even prior to that crisis, stepped down and Poore stepped in — not only filling a leadership void but also putting the hospital on a path to recovery.
“Within a relatively short period of time, we had regained the market share we had lost. That is not a small feat,” said Dr. David Markoff, an ophthalmologist in Haywood County. “I have enjoyed working with Mike. I am sorry to see him leaving.”
Poore’s family man persona and regular presence at civic and social functions not only built rapport for the hospital but made him generally well-liked around town as well.
“Mr. Poore is one of the finest men I have ever known,” said Dr. Charles Thomas, an oncologist in Haywood County and a hospital board member. “He has done us a wonderful job. We accepted his resignation with deep regret and lots and lots and lots of thanks and platitudes.”
While Poore’s departure seems amicable, many in the medical community are left asking “why now?”
Poore, 47, does not have another job lined up. Depending on where he goes next, his family may stay in Haywood a while before joining him to avoid being uprooted. His son, a football player for Tuscola High School, will be a senior year next year, while his daughter will be a sophomore. His wife is involved in various community civic groups.
Poore is receiving a severance package but the terms aren’t public for now.
Poore said he will look for another hospital CEO position.
“I am a hospital administrator. That is my animal,” Poore said.
There wasn’t any detectable tension between Poore and the Haywood medical community or hospital board.
But, Poore technically had another boss as well. He answered to Carolinas HealthCare System, a network of 34 hospitals based in Charlotte that MedWest joined two years ago.
Carolinas didn’t have a problem with his performance either, according to John Young, the vice president for Carolinas HealthCare’s western region who Poore reported to.
“This moment is Mike’s choice. This is not because of anything,” Young said. “It is just a certain period of time when it is time for somebody else to come in.”
By all accounts, Poore was dealt a difficult hand when he took the job.
“We will always remember his great leadership in getting Haywood Regional Medical Center back up and running,” said Fred Alexander, the chairman of the full MedWest board of directors.
With no patients to speak of, the hospital’s cash reserves had plunged so low that it had less than a month of operating revenue left when it reopened its doors. Patients who had turned elsewhere for medical care during the closure had to be lured back. And, the historically robust medical community in Haywood County, which had rallied around the hospital, needed reassurance they still had a future in Haywood County.
“He has worked so hard in the past several years to bring this entity, our hospital, upright again,” said Jean Burton, chair of the MedWest-Haywood board and a Cooperative Service agent in family and consumer sciences. “We were so knocked down a few years ago, and Mike worked tirelessly around the clock and has really stuck to the priorities he set.”
With the crisis in the rearview mirror, Poore led the hospital into a new partnership with neighboring hospitals in Jackson and Swain counties. The three hospitals formed a joint venture under the new MedWest banner. At the same time, MedWest joined the Carolinas HealthCare Network.
“I came to the hospital at a time of transition. We have gone through that transition during the last three-and-a-half years. It is just time for me to move on to other things,” Poore said.
Poore’s tenure isn’t uncharacteristically short for a hospital CEO. While the average time at one hospital for a CEO in North Carolina is longer, nationally it is 3.8 years, Poore said. Poore’s time at Haywood was just under that.
“It is not unusual for that turnover, but especially in a circumstance where you have a transition of bringing two organizations together to form MedWest,” Poore said.
There are always rivalries, even if friendly ones, between neighboring hospitals, Poore said. Bringing together two medical communities to act and think like a single entity can be difficult and challenging, he said.
As is sometimes the case in corporate mergers or turn-arounds, the person to affect change does not stay on as the long-term leader, Young said.
“Mike was the man to move the ball,” Young said of Poore’s role during the past three years.
Poore’s total compensation package was $444,000 a year.
Bumps in the road
Poore’s tenure wasn’t without snags, however. His honeymoon period began to fade in recent months, as the financial recovery initially witnessed under Poore began to backslide.
Despite a workforce reduction of 52 employees last year, MedWest has embarked on another round of cuts — 120 positions will be eliminated by July 1.
“It is what we need to do to right-size our organization with the reality of the revenue coming in today,” Poore said. Poore said MedWest is operating under austerity measures until the tide turns.
The layoffs amount to about 5 percent of the 2,100 employees across MedWest, including all three hospitals plus the 16 doctor practices now owned by MedWest.
In the midst of the financial troubles, MedWest-Haywood has seemingly been on a building and spending spree during the past year — from the very necessary replacement of a broken down generator to the very optional construction of a new surgery center.
In the end, MedWest-Haywood saw its cash-on-hand dip so low it had to turn to Carolinas HealthCare for an emergency $10 million line of credit. It was the first time Carolinas has ever loaned money to any of the 34 hospitals in its network.
While Poore defended the loan as no big deal, as Haywood has no other debt on its books, getting bailed of a cash-flow crunch by Carolinas clearly wasn’t ideal.
The loan was precipitated by a series of unexpected costs. Namely, MedWest-Haywood spent more than $10 million to replace a broken generator, upgrade its electronic medical records system and pay out judgments in two lawsuits dating to the previous administration.
Like Poore, Young characterized MedWest-Haywood as a victim of circumstances. Nonetheless, it revealed just how critical the financial status had become.
Build and they will come
While some costs indeed couldn’t be helped, Poore also oversaw an expansion campaign far more voluntary in nature.
A hospice center, a new surgery center and a new urgent care center are in various stages of construction, costing MedWest-Haywood a total of $2.35 million. The amount put up by the hospital is a fraction of the total cost — the lion’s share was paid for by the non-profit hospital foundation and a private group of physician investors.
MedWest also has new MRIs, a new diagnostic lab and new heart catheterization services.
“The hospital is very well positioned to serve patient needs and to grow and to prosper,” said Dr. Charles Thomas, an oncologist in Haywood County and former chief of staff of the hospital.
“Mike started us down a track. A lot is already in place,” Young said.
The attention Poore gave to MedWest-Haywood didn’t sit well with some doctors in Jackson County, who felt their hospital was being slighted in favor of making Haywood the flagship of the MedWest system, another bump in the road for Poore in recent months. Disatisfaction among the Jackson medical community led to Poore being replaced as CEO of MedWest-Harris and relegated to being over MedWest-Haywood only.
Perhaps the most expensive piece of Poore’s expansion campaign was buying out several Haywood doctors’ practices. The exact cost of the private transactions are not known, but up-front costs aside, the newly bought doctor’s practices will continue to be a drain on the bottom line for another year or two before turning the corner. The hospital has to foot the bill for salaries, equipment, and overhead before the billing for patients begins to pay off.
While costly and perhaps outside the hospital’s realistic budget, it had to be done, according to Dr. Benny Sharpton, a long-time surgeon.
Mission Hospital in Asheville was courting the same physician practices, and Haywood had to make a competing offer. So Poore acted swiftly despite perhaps not having the money to do so.
“It was done in an extremely short period of time primarily due to outside threats from Mission hospital trying to siphon the loyalty of our doctors off,” Sharpton said. “He took that on in a difficult time. It needed to be done. It had to be done.”
While Poore has taken criticism from some for overspending or failing to enact austerity measures sooner, others disagree. When faced with embattled finances and dwindling market share, MedWest-Haywood had a choice. It could retrench and scale back. Or it could move forward with guns blazing.
Rather than resigning Haywood to being a rural second-fiddle hospital in Mission’s shadow, Poore chose to push Haywood onto a bigger stage.
“He has already laid the foundation,” said Cliff Stovall, a MedWest-Haywood board member. “The person that does all the spade work doesn’t always get to enjoy all the glory.”
The track set in motion by Poore will hopefully continue by the leadership team still in place, said Stovall.
“As much as I hate to see Mike ago, we are glad to have the people he put in place,” said Stovall, a retired army colonel who now works in tax preparation.
Poore assembled a nearly all-new management team for the hospital after he was hired, bringing on board more than a dozen vice presidents and department heads within his first two years.
Poore gives credit to the entire team for the advances that have been made.
“I am so proud of the accomplishments the team has made,” Poore said. “I feel like I am leaving this in good hands on a go-forward basis.”