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St. Luke’s replaces top hospital leaders with nurses — and it’s got more job changes ahead

St. Luke’s says ‘value-based’ pay will work

St. Luke's executives Jeff Taylor and Dave Self talk about the benefit for a pay for value health care model.
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St. Luke's executives Jeff Taylor and Dave Self talk about the benefit for a pay for value health care model.

The hospital leaders in charge of St. Luke’s Health System facilities in Nampa, McCall, Mountain Home, Ketchum and Jerome have been replaced as part of a restructuring.

The former site administrators’ jobs were eliminated, according to a memo St. Luke’s CEO David Pate sent out to staff this month. In their place, chief nursing officers will take on dual roles as chief operating officers and run the hospitals.

The CNO-COOs “will be assuming interim responsibility for day-to-day operations, reporting to population health vice presidents Mike Fenello, Dave McFadyen and Dennis Mesaros,” the memo said.

St. Luke’s operations in Boise will be an exception and will have split leadership, the memo said. That hospital is much larger and more complex compared with the others.

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Why St. Luke’s is restructuring

The traditional structure of payment for health care is changing, and St. Luke’s is going through “a huge transformation,” Pate said.

“It means looking at components of the health system as cost centers, instead of profit centers as they have existed under fee for service,” he said. “Additionally, we must move from a hospital-centric model and structure to a population health model that focuses on trying to prevent avoidable hospital admissions and emergency visits and on coordinating their care more efficiently and effectively.”

The memo suggested more changes are coming for St. Luke’s employees.

“Beginning this month and over the next few weeks, leaders will be meeting with team members to share information regarding the new organization design structure and any related changes for team members,” Pate wrote. “We will be moving quickly to share information, and meetings and conversations will be sequenced and will be happening through the remainder of November and the first week of December. We anticipate the majority of adjustments will be complete by the end of January, and refining and fine-tuning our new structures will continue through the spring.”

The site administrators who were laid off can apply for new jobs in the organization, a St. Luke’s spokewoman said.

St. Luke’s Nampa’s former administrator, Ed Castledine, left the health system earlier this month, according to the spokeswoman. Castledine took a job at Boise businessman Tommy Ahlquist’s company, BVA Development.

Some of the administrators were fairly new to their jobs. The Mountain Home administrator started in May 2015. Castledine was promoted to administrator in 2015 as well. McCall’s administrator started in March 2016.

Audrey Dutton is an investigative reporter for the Statesman. Contact her at (208) 377-6448 or adutton@idahostatesman.com.
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