[StBernard] Chalmette Medical Center CEO Lands on His Feet

[Westley Annis]

Starting Anew

(Las Vegas Review-Journal (KRT)) Dec. 25--Health-care executive Jon Sewell
couldn't pass up the opportunity to move to New Orleans.

He had never visited the city, but he and his wife, Debra, shared a love for
Creole cooking, and Sewell had amassed a collection of zydeco, an
accordion-based musical genre native to southern Louisiana.

So on April 1, Sewell left his post as chief executive officer at Banner
Health's North Colorado Medical Center in Greeley, Colo., to take over as
chief executive officer of Chalmette Medical Center, a Universal Health
Services hospital in New Orleans' St. Bernard Parish.

He had precisely five months to enjoy his Crescent City dream.

On Aug. 29, Hurricane Katrina strafed the Gulf Coast. Sewell watched from
his hospital as Katrina pounded New Orleans, where 40 nurses, four doctors
and a contingent of administrators tended 50 patients. Trees fell and
transformers blew, but Chalmette Medical Center came through: It lost just
two windows and a small portion of its roof during the storm.

Sewell, thinking the worst had passed, fell asleep in his first-floor
office. He woke a few minutes later to water lapping at his back.

Sewell jumped up and ran to the second floor, where the hospital's patients,
medical personnel and supplies were stowed. Within an hour, flood waters
from a nearby broken levee had risen to 10 feet inside the hospital; a few
hours later, the water peaked at 14 feet, gutting the hospital's first
floor.

Amid tending to employees and making sure they could care for their charges,
Sewell surveyed the destroyed Chalmette Medical Center and came to a stark
conclusion: "I was out of a job. Companies don't keep my kind of payroll to
be nice," he said.

But Universal Health Services had no plans to lay off Sewell -- or any other
employees. The Pennsylvania company, which owns Spring Valley, Desert
Springs, Valley and Summerlin hospitals in Las Vegas, has promised jobs to
any of its 2,800 Gulf Coast employees who are willing to relocate.

So Sewell made yet another cross-country move. On Nov. 1, he took over as
chief executive officer of Centennial Hills Hospital Medical Center, a
hospital Universal is building on Durango Drive near U.S. 95 and the Las
Vegas Beltway. Grading of the site began Dec. 5, and steel should come out
of the ground by early next year, Sewell said. The 171-bed hospital is
scheduled to open in late 2006 or early 2007 with about 500 employees. It
will have as many as 800 workers within three years of its opening.

It's not the opportunity he planned for, but Sewell said he is thrilled to
guide construction of a new hospital. Several corporate headhunters offered
him positions in other markets, but each job was at an existing medical
center "with intractable problems," he said.

"It's easier to build a culture than to rebuild it," he said. "I've always
moved into hospitals with cultures that have been developed by predecessors
with certain ways they want systems to work, and ways of dealing with
medical staff. It's hard to get past physicians' relationships when they
feel they've been wronged in the past. Here, I can develop relationships
from scratch based on how I want people to treat each other. (Coming to Las
Vegas) was a decision I didn't need to think about."

Now, Sewell's task is to convince other health-care professionals to
consider the same move.

Most of his Chalmette management team relocated to Universal Health's
633-bed McAllen Medical Center in McAllen, Texas; Sewell said they will
likely be too entrenched in their new jobs to consider moving to Las Vegas
when he starts hiring management and nurses in about a year. But because
hospitals have a longer lead time on hiring doctors, Sewell plans to speak
in coming weeks with physicians from Louisiana and other states such as
Colorado about relocating to the local market.

Larry Matheis, executive director of the Nevada State Medical Association,
said Sewell probably won't be the last of Southern Nevada's New Orleans
transplants.

Matheis said several doctors from New Orleans have contacted the association
about moving to Nevada to practice. He said a big part of Las Vegas' appeal,
aside from its arid climate, is its similarity to New Orleans as a tourism
destination.

"One of the problems we have when we try to recruit physicians is that their
families don't want the lifestyle of a resort city," Matheis said. "For
physicians who have already made a commitment to living in a community like
New Orleans, there's some transferability to Las Vegas in terms of
lifestyle."

Southern Nevada has other issues that have hindered health-care recruiting
efforts. The percentage of local residents covered via managed-care plans is
higher than that in most other markets -- about 60 percent here, compared
with roughly 40 percent in other cities -- and that squeezes doctor
compensation, Matheis said. And Nevada ranks among the states with the
lowest ratios of doctors and nurses to patients, so work loads are often
higher.

But Sewell doesn't see those problems as deal breakers. 

"Most people are fed up with their markets. There is no 'greener grass' in
health care these days," Sewell said. Nursing shortages are as bad in Denver
as they are in Las Vegas, he said, and both Denver and New Orleans have
bigger indigent patient loads than Las Vegas, in his experience.

So Sewell said he will pitch doctors on the opportunity to work at a new
hospital that gives them a role in administrative decisions. He'll also tell
prospects that "people pay for care here," and that growth in Las Vegas will
virtually assure the expansion of their practices. He'll even sell them on
quality of life, from recreation at Red Rock Canyon and Valley of Fire to
the four-star restaurants on the Strip.

He'll also apply lessons he learned at North Colorado Medical Center, where
the nursing staff had a 22 percent turnover and 17 percent vacancy rate when
he took over about five years ago. Once the hospital offered nurses flexible
shifts and gave them the "opportunity to be more engaged in leadership,"
turnover dropped to 10 percent and vacancies fell to 5 percent, Sewell said.

"We never used signing bonuses. People just heard it was a good place to
work," he said. "Patient ratios were not dangerous and doctors treated
nurses with respect.

"There's only so much stealing (of staff) you can do. You need to create an
environment people want to work in so you're not just competing with
paychecks."

In addition to lightening the patient load for local practitioners, Matheis
said health-care professionals who endured Katrina could bring valuable
experience in disaster planning to the market.

Sewell now knows all too well about dealing with calamity.

The flooding following Katrina knocked out ground-level emergency
generators, telephone land lines and cell-phone towers, leaving Chalmette
Medical Center without power and communication.

What's more, on top of the 50 patients checked into the hospital when
Katrina hit, more than 200 residents of the surrounding community took
shelter in the hospital. Underfoot were their pets -- 20 dogs, six cats and
two chickens. And once the flooding stopped, civilian rescuers began
bringing patients to the hospital via boat. A drowning victim, a
heart-attack sufferer and a diabetic in insulin shock were among the first
arrivals.

Doctors revived and saved all three, and also saved 46 of the hospital's 50
patients. It took about three days to evacuate everyone from the hospital.

Sewell has already shared his Katrina experiences with hospital operators in
other states. He said he expects new, Katrina-inspired federal regulations
to govern hospital readiness -- rules that could mandate reliable satellite
phones in addition to land lines, for example, and requirements that
emergency generators for hospitals in flood-prone areas be placed 15 feet or
more above the ground.

But Sewell said some of the most important lessons from Katrina involve
learning to think quickly when faced with unexpected catastrophe.

"People think that if you have a disaster, you pull out your red disaster
binder that shows a check list of how things are supposed to happen," Sewell
said. "But there are times when you just throw that binder out. No one was
prepared for (Katrina). There's no instruction manual to help you through
anything like that. We had to stay very flexible. We made decisions and had
to be ready to change those decisions within half an hour."