Jeanne Sager | Democrat Steve Ruwoldt

CEO Hopes to Turn Hospital Around

By Jeanne Sager
HARRIS — August 31, 2007 — He’s a turnaround type of guy.
A month into the job, the new head of Catskill Regional Medical Center says he’s found a place where he can make a difference.
Steve Ruwoldt has made a career at troubled hospitals.
“It seems that everywhere I’ve been was in some sort of financial trouble,” he said with a grin. “This is a turnaround situation… and I’ve got a lot of background there.”
Named chief executive officer of CRMC last month, Ruwoldt came from the Cleveland Clinic Health System in Ohio where he was president of the Lutheran Hospital in inner-city Cleveland.
There he helped improve a budgeted $2.3 million loss in 2000 to more than $1 million in profits each year since 2002.
Prior to his tenure in Cleveland, Ruwoldt was a hospital vice president in Harrisburg, Pa.
Born and raised in Detroit, Mich., Ruwoldt initially studied biology and pharmacy at Wayne State University.
Upon graduation, he went to work in a retail pharmacy, climbing the ladder to store manager.
But Ruwoldt missed the back-and-forth with colleagues that he’d experienced in school on a hospital setting.
“When you’re in a pharmacy, you’re the professional and you have clerks working with you,” he explained. “I missed the professional collaboration at the hospital.”
He returned to school, this time at the University of Michigan, where he eventually earned a master’s in hospital administration.
“When I went back to school, they told me, ‘Yes, you can become the director of pharmacy, but you could also become the head of the whole hospital’,” Ruwoldt recalled. “I never looked back.”
When a recruiter came knocking on his door with the CRMC job, Ruwoldt took a look around Cleveland and compared it to Sullivan County.
“It’s a growing community,” he said of Sullivan, “where Cleveland is starting to die.”
Lutheran Hospital was likely to be remissioned, and Ruwoldt said he’d done what he could do in Ohio. He decided it was time to find a new challenge.
“I think it’s a very interesting one,” Ruwoldt said of his new job. “The area and the dynamics that go on with the whole summer population coming in and trying to meld that … I’ve always been the one who looked at how can we make things better.
“What I do look for in a community is the attitude of the people, the opportunities in the community,” he said. “If I can turn this place around, we’ve got the opportunity to sustain it with the people coming in.”
As he’s dived into Sullivan County, Ruwoldt said he’s found a lot of people don’t use the hospital in town.
He wants to change that, tap into that patient base to increase the census and increase the revenues.
“Why should you feel you have to drive distances for basic care?” he asked.
Ruwoldt wants to work with what’s already there to improve the hospital – increasing people’s sense of security with the availability of the helicopter on premises in Harris and zeroing in on what the Grover Hermann Division in Callicoon can provide to the western end of Sullivan County.
“Grover Hermann is a critical hospital,” Ruwoldt said. “We’re seeing volume there, and we’re looking at what additional services we can provide.”
He’s also taking a look at the hospital’s many clinics not just for growth opportunities but places where CRMC can partner with other healthcare entities in the community to cut costs and reduce duplication of services.
The clinics could play a crucial role in getting people out of the emergency room, Ruwoldt said.
“There’s a number of people here who use the emergency room as their only method of healthcare,” he explained.
That doesn’t speak well for the health of the community where people are putting off care for so long that the emergency room remains their only option, he noted, and it bogs down the ER.
Ruwoldt is well aware that a lot of those who turn to the ER for basic healthcare are the lower income sector of the community, most without insurance.
At least 20 percent of the people who walk into CRMC for care are considered indigent, he said, and the non-profit hospital provides them care that is essentially free.
The hospital tries to recoup a portion of that money from the state, but Ruwoldt said what they get back is pennies on the dollar.
With that in mind, Ruwoldt has looked at the CRMC budget.
The census has spiked a little because of the influx of summer visitors, but it’s expected to drop off again as summer turns to fall.
Money is still tight.
The hospital is currently on track with the tight budget crafted last year, and Ruwoldt said there’s “no fat” to cut.
“I’m just trying to get my arms around it,” he said. “We’re struggling, but right now we are on target.
“I”m pretty encouraged,” he continued. “I’m not seeing a whole lot of fat; it’s more, how can we refocus?”
The return of Crystal Run Healthcare physicians to the ranks of CRMC – and with them their patients to the census – should help boost revenues, but Ruwoldt warns this is not a panacea.
“Crystal Run will augment the core services we already provide,” he said.
Still Ruwoldt is a step ahead of his predecessors – he’s already held three meetings with Crystal Run in the past month.
The for-profit healthcare group’s head Dr. Hal Teitelbaum has been vocal about former CRMC officials lack of communication and transparency.
“I’m a big advocate for communication,” Ruwoldt said.
That’s why he’ll be holding quarterly meetings with hospital staff – a first at CRMC.
“I think it’s important for the employees to hear directly from me,” he said.
The minutes of the monthly department head meetings will also be made available to every single staffer.
Ruwoldt is also setting up rounds of the hospital’s facilities, twice a week in alternative shifts so every employee will see him and he them over time.
He’s been pleased with the people he’s met so far – including the core group of administrators who kept the hospital going without a chief executive since late last year.
Chief Financial Officer Nick Lanza, Chief Nursing Officer Kate Thomas and Stuart Hirsch, director of critical operations have been “killing themselves for the past nine months,” Ruwoldt said.
He’s met twice with the medical staff – who he admits are uneasy about the future, and rightfully so.
“But after a lot of discussion and debate, I’m real pleased with the way the medical staff is giving us the benefit of the doubt,” he noted.
That’s all Ruwoldt can ask for – time and patience.
He’s found a house in Sullivan County, and wife Linda will be moving here with their son Peter as soon as their house is sold in Ohio.
Peter will go to school in the Monticello district, and the Ruwoldts will live in Rock Hill.
They’re in it for the long haul.
“It’s going to take some time,” Ruwoldt admitted. “I’d like to really focus on quality and growing – that’s the key to long-term success.
“Will there be changes still? Yes,” he said. “We need to be a little flexible – we can’t do things the way we’ve always done them.
“Change has to happen.”