What’s the Plan? Succession Management in a Critical Access Hospital Camper Community Hospital is a small, critical access hospital in a small, rural town in the Midwest. The county has a population of 6256, not including the livestock. Camper County is in an area of nearly 1900 square miles that consists of farming and agriculture, which is the main livelihood and source of jobs for the residents. In addition to the livestock farms, the main crops include corn, wheat and soybeans. The town of camper has a unique geographic position and attractions. It lies along Interstate 80, approximately 56 miles from the next largest urban city. A major attraction for visitors is the world’s largest hay bale and a small chocolate factory that employees some of the citizens of camper. If you ask people why they live in camper, they will tell you that the town is family-oriented, quiet, has minimal traffic and plenty of parks and recreation activities. Camper also has a grocery store that hosts local farmers’ markets from May until the end of September. The rural high school is the Camper Chargers. The town seems to shut down every Friday night in the Fall. Camper also comes with plenty of challenges that many small, rural towns are faced with. Many of the residents are older and there is generally a lower education level, lower income, and fewer healthy lifestyles. Other issues affecting the wellness of camper residents include the occasional drought, farming accidents, large numbers of Camper residents who are underinsured or uninsured, limited business growth, as well as high occurrences of diabetes, congestive heart failure and chronic obstructive pulmonary disease (COPD). Camper Community Hospital opened in 1975 but has a long history dating back to the early 1900s when doctors Smith and Jones partnered to form the first hospital known as the Camper Sanitarium. The current hospital has 25 beds and offers services in ancillary care, emergency care, home health, diagnostics, surgical services, lab services, and hospice. An additional 25 bed long-term care facility is also associated with the hospital. There are 100 full-time staff and approximately 125 employees working at the hospital. This includes seven staff physicians, one certified registered nurse anesthetist (CRNA), one surgeon and one physician assistant. It also has an interim CNO. On occasion, Camper Community Hospital is also able to offer satellite specialty clinics such as orthopedics or obstetrics. In addition, Camper Community Hospital is one of the base sites for the countywide emergency medical service EMS. The hospital averages 125 admissions and around 110 emergency room visits per month. It has approximately 5000 outpatient visits per year. As previously mentioned, in 2019, a long-term care facility, the Whispering Winds, was built directly west of the hospital. Whispering Winds has three senior administrators including an interim CEO, a chief financial officer (CFO), and a part-time chief nursing officer (CNO). There are 12 managers within the hospital for the various departments and service areas. Their average tenure is approximately 10 years. Up until 2017, the hospital had very stable senior administrative staff. The CEO and the CFO had been with the hospital for nearly 20 years. The CNO had been with the hospital for almost 30 years. Due to unexpected health concerns, the CEO was forced to immediately retire. Since his departure, Camper Community Hospital has had two other CEOs, neither lasting more than seven months. The first CEO quit because his wife did not like the rural lifestyle and a second was fired due to unethical workings within the hospital. The other members of the senior team, the CFO and CNO, retired. Plans are currently underway to promote the interim CNO to full-time. Camper Committee Hospital did not have a succession plan in place to address the current situation with the leadership executive team. It didn’t seem necessary since those employees had been with the hospital for so long. It was assumed that the clinical and administrative leaders would continue in their roles. In fact, the hospital’s cofounder, Dr. Jones’ great-great grandson, recently retired as a general surgeon, ending 100 years of legacy of physicians at Camper Community Hospital. The Camper Board of Directors, which has always been comprised of six community leaders and volunteers, never thought that they would need to plan for replacing these positions. The Board is currently comprised of five males and one female. The men age in range from 56 to 75 and the female board member is 32 years old. Occupationally, the board has a range of experience, however, only one of them has a clinical background. The other members are community leaders including a high school teacher, funeral home director, grocery store owner, state roads employee, and a vice president of the bank. Many things have changed since the hospital was built. There is a lot of uncertainty surrounding the changes at the executive leadership level. The goal of succession management is to ensure that there is an appropriate pipeline and development program for advancing other employees and preparing them to assume a higher level of responsibility and leadership as they move up the executive chain. Camper Community Hospital is learning an important lesson. Although it was not initially prepared to address resignations, firings and retirements, the Board has hired you as its consultant to create a succession plan that focuses on these key administrative positions. In order to make recommendations to the Board regarding how to plan for and eventually fill these positions, what are the next steps that you recommend the hospital take to help prepare for filling these positions? 1. How would you describe the current situation at Camper Community Hospital? What are the key succession issues that the organization is facing? Do you have any initial recommendations based on the scenario? 2. How would you describe the current situation at Camper Community Hospital? 3. What are three main issues affecting succession at the hospital? 4. What are Camper Community Hospital’s strengths? What are its weaknesses? 5. Are there any short-term recommendations that you can make to help address some of the responsibilities for the available positions? Do you think promoting from within will help the situation? Or, are there other temporary solutions? 6. What recommendations are necessary to facilitate a long-term plan for continued succession? How might you educate the Board regarding this process?
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