Porter Hospital CEO Resigns Amidst Budget Crisis

On Friday, March 18, Lynn Boggs resigned from her position as CEO of Porter Hospital in Middlebury. After just eight months on the job, Boggs will be replaced by Fred Kniffin, whom the board of directors has chosen to serve as Acting President and CEO.

“Thank you for the opportunity to serve as President and CEO of this great institution,” Boggs said in a press release at her resignation. “I wish the Porter community well as they contin- ue the important work of providing exceptional patient-centered care in our community.”

Maureen McLaughlin, the chair of the board of directors, thanked Boggs for her leadership in a press release.

“Lynn has led the organization at a time of great change for small community hospitals like Porter,” McLaughlin said. “We appreciate her dedication and commitment to the organization.”

Boggs’ resignation comes during a difficult time for the organization. Porter
Hospital, Porter Health Care and Rehabilitation Center and 12 physicians practices have collectively lost 1.6 million dollars in the previous fiscal year. In all, the organization has lost 12 million dollars since 2012.

Earlier in February, the hospital also laid off eight nurses in an effort to balance its budget, in addition to nine other employees. The nurses respond ed by posting a flyer at a Middlebury town hall meeting accusing the hospital of sacrificing patient care to budgetary concerns.

n an interview with Vermont Public Radio (VPR), the President of the Porter Federation of Nurses and Health Professionals, Alice Leo, said that the firings were misguided.

“I think the focus was in the wrong place. Taking away nurses that do the hands-on care probably isn’t the best place to do cutbacks.”

Ron Hallman, the Porter Medical Center Vice President for development and public relations, defended the cuts.

“[Porter staff] is a team that is comprised of nurses and physicians and medical assistants and therapists, and I think we allowed our team to get a little too much of one type of provider. The losses were unsustainable. Our clinical leaders in our practices did assess the team according to various standards, or benchmarks around the country, and have recalibrated each practice according to those benchmarks.”

“The analogy is, it’s like you inherited a baseball team with nine pitchers. And you realize you need four infielders and three outfielders, and you need a catcher. It doesn’t mean you don’t like your pitchers,”
added Hallman.

Leo countered that the cuts would reduce the quality of patient care.

“We belive that our community shouldn’t have to drive to Burlington for their care, and that they should be able to receive high-quality care in Addison County. And having a registered nurse is really necessary for quality care.”

She was also critical of the way in which the management at Porter handled the cuts, which she belived was in an opaque way.

“No one asked us,” Leo said. Dr. Jean Anderson Swayze, a partner at Middlebury Family Health and an affiliated member of the medical staff at Porter Hospital, agreed that communication between the staff and the management at Porter was poor.

“With no sense of partnership or collaboration, there have been a wave of providers who have either left or tendered their resignations in the past six
months,” Swayze said. “I believe there have been seven. And the more concerning thing is that I know of other providers who are thinking about leaving.”

Budget issues are not unique to Porter Hospital, as many rural hospitals in Vermont have been plagued by budget issues in recent years. Roughly a third of all rural hospitals in the nation run at a deficit.

One federal program, known as the 340b Drug Pricing Program, allows small hospitals to purchase prescription drugs at a discounted price. Hallman said that the program, which is part of a broader strategy at cutting costs at Porter, is critical in keeping the organization afloat.

“We have a short-term one-year plan,” Hallmann said, “that involves a number of steps. The first is to integrate all of our overhead departments, which we’ve done ... We’ve improved our supply chain by some group purchasing arrangements ... We’ve also included, on the revenue side, a brand new infusion center, which is providing necessary services here in our community to folks who would otherwise have to drive to Burlington or Rutland for infusion care, as well as some cardiology services.”

However, many health care professionals are unsure whether these structural changes will be enough.

“The root of [the problem],” Swayze explained, “is that primary care is underfunded and under-appreciated, and in this current health care world, the bigger you are the more health care dollars you bring in.” Ultimately, Swayze argued that a radical change in the way health care is provided would allow smaller hospitals like Porter to remain open.

“We need a new system that values primary care, where there is complete transparency and pay parity,” Swayze insisted. “Not one that burns millions of dollars in creating a new health care bureaucracy.”

Without serious reform, Swayze claimed, small hospitals like Porter might continue to hemorrhage money and unfairly lay off health care providers. Yet for the employees at Porter that already lost their jobs, these changes come too little, too late.