Nanticoke Memorial administrator wants hospital to offer more services

By Lynn R. Parks

For the second year in a row, Nanticoke Memorial Hospital, Seaford, has posted a loss. The challenge of fixing the hospital's financial woes  of what he called "righting the ship"  is part of what attracted administrator Mark Rappaport to his new job. "We have our financial challenges," said Rappaport, who took the reins as hospital administrator October 29. "Fixing them will mean working together with the hospital staff, medical staff and hospital board." And, he said, he has no doubt that that process will succeed. "This hospital is in its adolescence, and it is going through some growing pains right now," he said. "Those pains are not pleasant. But the hospital will come out of it all as a solid hospital. If I didn't believe that, I would not be here. Closing down hospitals is not what I do." In June, at the close of its fiscal year, Nanticoke posted a loss of $1.8 million, 64 percent more than the $1.1 million loss it posted in June 2006. So far this fiscal year, Nanticoke "is doing better than the previous year," Rappaport said. "We are still running somewhat at a loss, but we are doing better." "Businesses go through cycles, and we are having a down cycle," added hospital spokesman Tom Brown. "But I would leave if I didn't think that we could make our way through this." Getting the hospital back on sound financial footing is "about growing our services," Rappaport said. That means providing medical care that attracts an increasing number of patients. "There are people leaving the area for services that we should provide," he said. "We need to bring new services here or expand the services we already provide." In particular, the hospital would like to hire at least one, maybe two, more orthopedic surgeons. In July, the hospital requested that the state downgrade its emergency department, after it could no longer guarantee that an orthopedic surgeon would be available to treat emergencies 24 hours a day. That means that patients needing emergency orthopedic care have to be taken to other hospitals in the area, including Kent General in Dover and Peninsula Regional Medical Center in Salisbury. Rappaport would also like to see Nanticoke get additional oncologists. Now, the hospital's Cancer Care Center has two doctors and two oncology radiologists. "We have a beautiful Cancer Care Center," Rappaport said. The hospital plans to do an analysis of the community's needs, including the types and incidence of cancers that occur in western Sussex, to determine how many doctors the care center needs. Brown admits that the hospital was "a little slow to respond to changing times" and "should have started 10 years ago" looking for the specialists that it needs today. "Maybe the hospital didn't start recruiting soon enough," agreed Rappaport. But, he added, fixing Nanticoke is "about looking forward. We want to be able to provide the services that the community needs and at the same time, pay our bills."

Doctors leaving
In addition to finding new specialists, Nanticoke also has to replace doctors who have left. Recently, hospital spokesman Tom Brown said, Nanticoke has seen an increase in the rate that it is losing physicians. Even so, the long-term physician loss rate is still 7 percent, the same as the national average.

Brown said that doctors are leaving for a number of reasons, including retirement and personal reasons. The hospital has 97 doctors, up from about 85 doctors two years ago, Brown added. Nanticoke has a new thoracic vascular surgeon, Nyen Chong, who is "fresh out of training" at the University of Pittsburgh, Brown said. It also has two new family practice physicians, who just opened an office in the former Trinity Transport building on U.S. 13 in Bridgeville, and has hired an obstetrician/gynecologist, expected to report to Seaford next summer. In addition to hiring new doctors, Nanticoke has been working to improve patient satisfaction. Recently, it was awarded the Compass Award, handed out by Press Ganey, a consulting firm that works with hospitals to measure and improve quality of care. The award recognizes health care facilities whose patient satisfaction scores have shown the greatest improvement over the past two years. Child-care center to be closed As part of its belt tightening, Nanticoke closed its Positive Steps exercise facility last month. Brown said at the time that the decision to close the facility was a financial one. "We were losing a considerable amount of money" with Positive Steps, Brown said then. "It was taking health-care dollars out of the budget, money that would be better spent on medical equipment and doctors." In February, Nanticoke will also close its Small Wonder day-care center, which opened about 20 years ago. As with Positive Steps, Brown said, the decision to close the program was financial. No decision has been made about the fate of the Small Wonder building, which is owned by the hospital. Rappaport said that the hospital is "always looking at real estate stuff," determining if it owns buildings that it should sell. But he does not anticipate that the cutting of programs will extend to any medical services. "We are focusing on how we can grow things, on how we can provide more medical care," he said.

Combining medicine with business
New Nanticoke Memorial Hospital administrator Mark Rappaport comes to Seaford from Lowville, N.Y., where he was chief economic officer of the Lewis County General Hospital. Before that, he was administrator at five hospitals in New Jersey and Pennsylvania in a career that spans 26 years. Rappaport, 59, grew up in Philadelphia and graduated from Cheltenham High School in 1968. He attended La Salle College (now University), Philadelphia, where he graduated in 1972 with a degree in pre-law. "For a while, I bounced back and forth between going to medical school and going to law schools," he said. "Then, I was introduced to a hospital administrator, and that seemed to me to be a great blend of what I wanted to do, work in the medical field and in the business field." He graduated from Temple University, Philadelphia, in 1981 with a master's of business administration with a concentration in health care administration. Rappaport and his wife, Marjorie, have three adult children and three grandchildren.

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