Episode Transcript
[00:00:02] Speaker A: Welcome to PG Pulse Press Gainey's podcast on all things healthcare, tech and human experience. In this podcast, we'll be joined by some of the best and brightest minds in the industry to discuss challenges, share insights, and innovate the future of healthcare. Thanks for tuning in. We hope you enjoy the conversation.
[00:00:22] Speaker B: Good afternoon. Good morning, I guess here in Nashville at the Nashville Healthcare Center Sessions meeting. I'm here with David Dill, CEO of LifePoint. This is Pat Ryan, chairman and CEO of Press Ganey, and this is the PG Pulse. David, great to have you here this morning. You ready and raring to go for the meetings?
[00:00:42] Speaker C: Pat, it is great to be with you, as always. We saw each other not too long ago, and it's always good to be back here in this small little booth here in Nashville as we kick off sessions. It's going to be a great few days for Nashville, for the Nashville Healthcare Council, and hopefully for the broader healthcare community.
[00:00:58] Speaker B: Fantastic. Well, listen, I want to start out. It's Monday and we've got hurricanes approaching Florida, and I know that you and your associates were deeply impacted by Helene, and why don't you talk to us a little bit about that. And I know you've done some terrific things for your associates, so I'd like to hear about that.
[00:01:16] Speaker C: Well, I appreciate you starting with that at the top. It has been on our minds and in our prayers over the last week. Plus, we do have a network of hospitals in western North Carolina. And as the storm was barreling down, we positioned help and support where we thought we needed it the most. Little to find out by the time Friday evening got here of last week, that we had some of our support and help in the wrong places. And as we began to pivot that help and support to the places that was needed the most, we found ourselves in a place where some of the roads and bridges were unpassable and we couldn't get help as quickly as we wanted to. But help did arrive. The teams are doing great coming together. It's really one of the unique things, I think, about healthcare, and we're going to talk more about health care, but one of the unique things about healthcare and specifically in the communities that we operate in, where you have real family, taking care of family, and in your greatest time of need, I think you shine the brightest. And the teams have just come together in an incredible way to not only support each other and in whatever role we can play as a national support team to bring resources to bear, whether it was fuel trucks or water trucks or food or security Resources, communication, resources to do the very basic things that were needed during that point in time. So I think we should all keep the people of western North Carolina in our thoughts and prayers. I know HCA here in town has been impacted in Asheville and now we have another storm coming. So this is what companies do, it's what companies deal with. And teams come together to perform miraculous work. While they're taking care of each other, they're also taking care of the patients that are coming in their hospital every day that still need life saving help. So it's very inspiring work. I appreciate the question.
And our teams have done a great job. And the people in North Carolina know that you're in our thoughts and prayers.
[00:03:15] Speaker B: Well, you know, I want to follow up on that because you talk about that and you've created a culture at LifePoint that I think is unique. And during adversity like this, you see that culture, the light shines brightly on it. Talk about how you have continue to build that culture and what's important to you as the CEO of LifePoint.
[00:03:38] Speaker C: You know, we have a mission statement that we're driven by. And we are an investor owned provider of Healthcare Services, $10 billion company spread out in 30 states with over 50,000 employees. And as the company has grown, we've stayed really true to the roots and the things that are important to us. Our mission statement is very simple and it's the reason I like the mission statement so much. First of all, it's simple and I can remember it, but it's deeply meaningful and it's making communities healthier. And that doesn't just mean taking care of people in the greatest time of need, just like we're talking about in western North Carolina a moment ago. But what it really means is the role that we play in these communities. We are an engine of growth, an engine of prosperity for many of these communities that we operate in. We are the largest employer, we are a big taxpayer, we are making as big of capital investments as probably any of our communities are making on any given year. And so with that, we are an engine in the community. And that money stays in the community and it multiplies in the community and it grows in the community. So it's a very mission driven company that understands the role that we play not just in healthcare, but in the communities that we serve. And I think that has been a very important cultural touch point that we don't lose because we know we have people taking care of people, friends taking care of friends, people taking care of their Kids, teachers, in many cases, or in their community groups, in their church groups. So we've kept that and we've lived by that for the last 20 plus years that we've been in existence. And I remember having conversations with our executive team along the way that if we feel like as we grow we lose that, we've got to stop because this is the most important thing for us. So we center ourselves around our mission and our vision statement and our set of core values. That always starts with care at the bedside. Providing the most high quality care that we can and doing it together and doing it with compassion. Those are the cultural touch points of what it means to work at LifePoint Health. And as we've grown, it's been wonderful to see our team members, 50,000 people around the country.
[00:05:53] Speaker B: I mentioned that I was going to be interviewing you today and someone described you as an executive with heart.
And that's a nice thing to have said about you. How do you get that heart across to 50,000 teammates and step back for a second with me and talk about that? Why health care? Why did David Dill decide healthcare is his career and where you're going to spend your time?
[00:06:19] Speaker C: Well, I don't know which one to take first.
That's a great compliment, by the way, whoever said that.
There's days that I really believe I live that out and there's days that sometimes it gets hard but. And I've been called worse from other people, I can assure you over time. But it is really important to me that we keep this big company small. You know, we serve in a lot of small communities around the country and I want this big company that has a national reach and in some cases even a reach outside of the United States. When I think about our influence and people that we talk to and people that we can impact, but from our operations day to day in these 31 states, in these smaller communities, it's important to me that no matter how big this company gets, staying focused on our mission, the cultural touch points that we just spent a few minutes talking about and making this big company feel small. So later on this week, after we finish sessions, I'll be in a couple of our hospitals. I love going out to our hospitals because it keeps me close to really where the action is. But it's also an opportunity to make this big company feel a little bit smaller. So I do want our company to have a heart and we mean it when we say it. My journey to Health Care. I wish I had a great story on how I got into healthcare. I'm gonna count it by training. I grew up in a small community in western Kentucky. My father was a basketball coach. My team here in Nashville, our team probably gets tired of me talking about coaching analogies and coaching stories from my dad. We lost him a couple years ago, but he had a great impact on my life. And so many of the applications that he taught on the basketball court apply in business, and I bring many of those forward. So I left that little small town where I grew up in Western Kentucky, a town that reminds me of a lot of the communities that we serve at LifePoint. And it's one of the reasons I came to LifePoint because of the types of communities that we served. It reminds me of home. I've been able to travel like all your listeners, been fortunate enough to travel all over the place, all over the world. But when I go home and I hop on my couch at my mom's house, that's home for me. And it's a reminder of where we operate in our company. So I joined an accounting firm, had a degree in accounting, came to Nashville, packed up everything that I owned. I became an accountant with one of the big firms. Then I left public accounting and moved into Healthcare in 1996 to join a group of people that I thought were doing something pretty special. So my journey to healthcare was really not mission based, but it was following somebody in a group of people that I could trust and learn from.
That's where the career in healthcare started back in 1996. So here we are 28 years later. I've been at LifePoint now for 17 years and this is home for me. And it reminds me of my real home, which is at my mom's house.
[00:09:14] Speaker B: That's fantastic. I met you in that 1996 move when we were both in the dialysis industry, which was also critical industry to really serve patients who were going through very difficult times in their life. And talk to me a little bit about. You mentioned you love visiting the hospitals and have been books about management by walking around and we talk to our clients about rounding and constant rounding. And I know that's a passion for you. I think you're the case study for Press Ganey with regard to the effectiveness of rounding. I hope they've shared those charts with you, but it's quite impressive what you've done. Talk to me about how that feels for you, but also your team and how you draw them into the importance of that.
[00:09:59] Speaker C: Yeah, well, it's very important to model the behavior that you expect from your Leaders. And so carving out time and being in our hospitals is not just important for me to be there just because I can learn and see what's happening, but I can be a very powerful model for our CEOs.
It's very natural for our chief nursing officers to walk around the halls of a hospital.
It's natural for a lot of our CEOs to do it, but it's unnatural for some of them, and it's unnatural for some of our CFOs to do it. But when we do our report outs, when we report our quality results internally, when we walk around the hospital, the CEOs. The expectation I have of our CEOs is they lead with quality. They don't just say, we're going to talk about quality and let me turn it over to my cno. It is, I'm going to talk about quality because I own it. And that begins with walking around and understanding what's happening at the bedside. So through some of the technology that you and your teams have built, through the adoption of that technology across our company, we have seen some remarkable results. But walking around the hospitals, making a big hospital feel small, just like making a big company feel small, I think that's where you learn. That's where you see, that's where you model that behavior and set those expectations and you learn. And I think one of the most effective parts of leadership is being that lifelong learner, committing to that understanding that you don't know everything. But by walking around, you see it, but then when you see it, you own it, you have to fix it. And that's where I think we continually get better as an organization.
[00:11:28] Speaker B: I love your humility. It's been there since the day I met you. And your organization breathes that same humility. So I appreciate it. And you talk about modeling the behavior. When you think of a board of directors, you've got a board, you've got a boss. Everyone has a boss.
The importance of quality and safety, I understand, goes to that level in your organization. Can you talk a little bit about that?
[00:11:54] Speaker C: Yeah. Well, I do think quality starts at the, you know, at the beginning of every one of our discussions, at the front of every one of our decks that we put together. We start with quality. We have a board committee, a quality committee of the board. We've had a quality committee of the board for many, many years. LifePoint was a public company for the first, almost 20 years of our company's life. And then about five years ago, five plus years ago, we took the company profit and it was important to me, and it was important to our owners at Apollo that we maintain that quality committee. So that's a standing committee of our board, and it's one of the most important committees that we have, that we take what's happening around the country, go through it in a small group, and then bring it forward into the board setting. But our quality journey really started in earnest probably 15 years ago.
And we were thinking about, how do we grow this company? There were opportunities to expand the network. We were honestly getting beat in different sales presentations. Some of it was because of cost, some of it was because of location perceptions, things like that. And we really decided that to be differentiated from the people that we're sitting across the table from and competing with, then we needed to do something different. And that led us into really two things that were very important inflection points for our company back 15 years ago. One was a commitment to partnerships. And we developed a very important partnership with Duke University. And Duke's been a fantastic partner for the better part of a decade and a half. And we really felt that we could bring a proven operator of community hospitals in community healthcare facilities with a brand, a high quality brand like Duke, and we could create a scenario where one plus one equals more than two. And so we started seeing that develop into something that was very attractive in the marketplace. And at the same time, we developed a national quality program. And our national quality program is really built on three things. It is empowering people, empowering leadership, expecting leadership. That's where CEOs lead from the front. It's not turn it over to the cno, the chief Nursing officer, and let them talk about quality. No, it starts at the very top of the organization. So empowering leadership using proven methods of continuous improvement. There's a lot of proven methods that are out there. Adopting those, assessing those, and then implementing those at scale, and then developing a company wide and a system wide and a hospital wide commitment to a quality of safety in the communities. And our quality program is really built on those pillars, leadership, continuous improvement, and culture of safety. And those two items really galvanized the company and galvanized our quality program for us to continue to grow and expand. And it's been powerful.
[00:14:48] Speaker B: Fantastic.
As you talk about safety at Press Gandy, we talk about the tip of the spear. You cannot have employee engagement without safety. You cannot have experience, patient experience without safety. The investments you have made there. Talk a little bit about that and the role Duke has played with you with regard to that.
[00:15:08] Speaker C: Yeah. So, I mean, Duke's been a great partner of ours.
When we first built our quality program with Duke, we took a lot of the principles that worked inside of Duke and at the academic medical center level. But we also knew that those same type of processes just will not work. It'll break, it'll crush under its own weight when you get it to a small community hospital that has 100 beds and limited resources compared to a large, complex academic medical center. So we spent a year developing a program that we thought could work in our size hospitals, and then we began to rapidly deploy that. And as the company has grown, we've now deployed that national quality program through all of our acute care hospitals. And the company has changed and evolved. And in addition to a network of community hospitals that now make up 75% or so of the company, the other 25% of the company is a network of rehabilitation hospitals and behavioral hospitals. And we're beginning to customize our quality program to overlay on top of our rehabilitation network of hospitals and also our behavioral network of hospitals. And through our rehab business, we're in partnership with some of the largest brands, largest names of healthcare. And it's largely because of the focus on quality and the commitment to partnerships. We're going to be talking tomorrow and we're doing a panel discussion tomorrow here at Sessions on the power of partnerships. Not just what partnerships mean to LifePoint, but what partnerships mean to broader healthcare and how we get better together. Because I know we're better with you as our partner to drive the things that you and your company are really good at and the richness of the data and the resources to give us those proven methods of continuous improvement that then we can deploy and make healthcare better. And so we need partners to make that happen.
[00:16:55] Speaker B: You know, interestingly enough, we've been talking a lot about quality. And the data will demonstrate that the highest quality organizations also have the highest financial margins. And that's nonprofit, for profit. And for years, as a for profit operator myself, several companies, I've always said if you don't have quality, you don't have margin. And talk to me because there's issues in the industry with regard to profit and private investment. I've always found my private investors to want quality at the highest standard. Talk to me a little bit about that.
[00:17:30] Speaker C: Yeah. So this national discussion of for profit healthcare and not for profit health care, most of the nation's hospitals are not for profit hospitals. So we deal with this all the time.
I remember a story of we were looking at a hospital actually in western North Carolina. I'm sitting here, reminded of this story right now. We're sitting in a community in western North Carolina back in 2014 or 2015, and we were at a council meeting and the council members were up on a little bit of a stage and I was sitting there with the executive vice president from Duke. And the question came from one of the council members, why would we want to sell our hospital and partner with a for profit operator of hospitals? It's a question that I have received hundreds and thousands of times. And I leaned up into my chair and I was ready to answer it. I knew exactly what I was going to say because I knew the question would probably come. And I felt this hand on my forearm and it was my partner at Duke and Dr. Bill Fulkerson, I'll never forget it, became a really good friend and just an incredible leader for that, for that institution. He said, he looked at me, kind of winked at me, said, david, I've got this one. And he looked at that council member and said, let me tell you why we chose them as our partner and we chose them as our partner because of quality. Because of what you just mentioned, the commitment at the top of the organization and all the way down the organization of a commitment to quality and this notion that you have to be not for profit to drive quality. The data just doesn't flat out doesn't support it. So I don't think about it as for profit, not for profit. I think about it as tax paying versus not tax paying. In fact, as we've acquired and partnered with communities and hospitals around the country, one of the first slides we put together is we take our mission statement and take their mission statement and show where it overlaps and you'll be. You probably won't be surprised. Your listeners probably won't be surprised, but it's amazing how consistent they really are. So we're so much more alike than we are different. And we have proven over 25 years, like many others in for profit healthcare, that you can do both if you stay focused on quality. I do believe that the financial results will follow and you can build a successful company focused on the things that matter most.
[00:19:40] Speaker B: Fantastic. Well, you've done a fantastic job with it now. You've done a lot of things for the organization and it has transformed over a period of time. Talk to me a little bit about how you drive change, transformation, keep the team moving forward, because it's not always easy and change is not always something people want to see.
[00:20:00] Speaker C: You know, I've been with this company since 2007. And from the company's beginning, we were kind of birthed out of HCA back in 1999. And so the company was really eight years old by the time I got to it. And I was the CFO of the company when I first got here. And you know, we were, we were growing, we developed a partnership with Duke, we grew a network of hospitals from 40 hospitals to 70 hospitals. But it was doing a lot of the same things in the same type of communities. And then in 2020, in March of 2020, Covid hit. And in many ways I felt like there's, what can I do to add the most value for the company? So I was able to step back. I couldn't travel to hospitals. I felt like I was going to be in the way. There was too much important work to happen. So I stayed away and allocated resources, directed resources, tried to advocate best I could for not only our company, but for our industry.
But I gave a lot of thought to what does this company, how do we make this company better, stronger, more durable on the other side of this, and through our ownership group, we sat down and really thought about does diversification make sense? And if so, what type of diversification makes sense? What are the most important parts of our company that we can replicate in another part of health care? And the rehabilitation business that was owned by a company in Louisville, Kindred was the name of the company owned the rehabilitation business, largely in partnership. Kind of checked that box with partnership. So there was some commonality and a common thread. So as our teams around the country dealt with two years of really an uncertain environment, I gave a lot of thought to how does the company look over the next decade? Because we will come out of this, this will end, we'll move into a new phase, and when we do, we need to be ready for it. And so we embarked on a strategy of diversifying our business, maintaining the parts that were non negotiable and important, quality at the front, mission driven at the front, commitment to partnerships at the very top. And we decided that we were going to diversify the company. And that took a lot of communication with our team. Imagine me explaining to our acute care team that instead of 100% of the focus on this, the pie is going to get bigger, we think over time. But you will be a fraction of the pie, probably the largest fraction of the pie, but you won't be 100% of it. But we need to take the great things that you've done and represent and then bring new organizations, new businesses, into this company to expand it. And that's what we did with the rehabilitation business. And then about a year later, we had the opportunity to partner and acquire Springstone, which was a behavioral health company. And the reason we did that is there were behavioral health needs in every one of our communities. And we had a choice to make. Do we get out of it because we just don't have that expertise, or do we lean into it in a big way? And so as we decided to lean in to making behavioral the thing third very important business line that we support.
It was really fulfilling the commitment that we made to all those communities around the country because our employees needed help, the community needed help. And we had one resource within the company focused on behavioral health services. And it just wasn't enough, given where healthcare was and given where our people were and needed help. So we acquired Springsteen, and now we have a very important acute care business, a very important, second largest rehabilitation business in the country. And I'm very excited. It's a hard business, but I'm very excited about the behavioral business. And we can take that structure that we brought in, and now we have many more resources to help support our entire company and our people solve very complex problems that are happening inside of our emergency departments. Even sitting here right now, today, I.
[00:23:56] Speaker B: Have to tell you, I applaud you on that move.
It's not the easiest decision to make. There is a crisis in this country with regard to adolescence in particular, that has. The advent of social media we could go on for forever has created. And I appreciate you doing that with the communities that you represent. It's not a straight line to that decision.
[00:24:17] Speaker C: Yeah. And the change management, explaining that inside the company and getting the alignment behind that, and it never ends. It's not like we can just go have one meeting and all of a sudden everybody jumps in line. But we are continually focused on that, explaining why, bringing people along. And that's a big part of my job. You know, before we leave this topic this summer, I was able to go visit some of our larger partners that we work with. I know you do a lot of that with people that you work with. And so I spent time on the west coast with one of our big partners, and we were talking, and I just said, what are the things when you think about our company? Just tell me what you think about when you think about our company. And he says, I think about you as not for profit healthcare. That was the farthest thing away from his mind. It was a company committed to partnerships, focused on quality. Every day. But here's what got me the most. And you do the hard stuff like your company does the hard stuff. You're operating hospitals in small communities that would fail if they didn't have you. You're operating in a behavioral health part of the business that we all need it, but it's just hard and you're stepping into that. And of all the things that have been said about our company, whether it's a company that has a heart, whether it's a company that focuses on partnerships, all those things are really important to me. But when he said that, it really resonated with me is that's what our company does. We do the hard stuff and we do it with a heart. And I think that's what differentiates LifePoint Health.
[00:25:40] Speaker B: That's fantastic. I love that comment. And I'm going to make sure that is spread throughout the industry as I travel and talk to people. I think it's fantastic. Well, as we wrap up a little bit here, I want to ask you a few questions as you look at the industry going forward. And you could snap your fingers. There's a lot of challenges out there, but I give you the power for the day to snap your fingers. Maybe you're in the White House and you have total control.
No, as a visitor, maybe.
We'll see. You never know. You could be drafted into the process. But if you had total control and you could snap your fingers, what would you do?
[00:26:23] Speaker C: You know, access to care is so important and, you know, creating the tracks, if you will, it feels like there's just. I was in San Francisco last week and meeting with some people talking about artificial intelligence and half of what they talked about I'm not sure I fully understood. But I really appreciated that we're building these high speed trains that are moving and have the potential of moving so fast. But the train tracks that we're trying to run it across are still the old train tracks that we've had for 100 years and longer in some cases. And so making sure that we are building tracks that can help accelerate all the change that is going to happen in our country and certainly in healthcare. And when I think about access to care, when I think about using technology to expand more access to care, sometimes our regulations don't really support that. And so I would really take a hard look at the regulations around how do we ensure that we can secure the most access to the most people as possible? Because in the communities that we serve, and we see it now, just what's happening in western North Carolina, you know, people that live out by themselves, we need to reach them a different way. And there's just not enough financial or human manpower to reach all those individuals. We need to reach them different ways. And technology will play a very important role. But we've got to make sure the tracks can run these high speed trains across them.
[00:27:53] Speaker B: Yeah, you know, you bring that up. Patients, our data will tell you. Our patients loved telemedicine.
They love access through their devices. You'll hear people talk about folks over 65 don't use devices or technology. That's not true. I even know a couple people over 65 who do. I'm not going to mention their names. So the ability to use technology to allow patients access through technology is going to be critical going forward. And as you start to think about engaging your workforce and retaining your workforce and you cannot recruit enough nurses or doctors, technology is going to play a critical role. So I guess one of your challenges is to get to Washington and make sure people understand it. Our data is available for you when you're there. Patients really do like the use of technology, no question. Well, I appreciate that. I want to end on this. You know, we've had a conversation about leadership and change and character, integrity and hard work. Throughout your discussion, what advice would you give executives who they don't get to come to the C suite a lot or chat with the CEO? What advice would you give them for their careers?
[00:29:07] Speaker C: You know, when I think about, you asked the question 30 minutes ago or so around, you know, why don't you get into healthcare?
And I didn't get into healthcare because my dad was a doctor or my mom was a doctor or a nurse or any a supplier, nothing attached to healthcare at all. I got into healthcare because I trusted some people. And so I would encourage, especially I have a son who's 25 years old, daughter who's a couple years older than him. And I tell them all the time, like, find people that you can learn from and that you can trust. And if you find people that you can learn from and you can trust and you submit yourself to that, then the sky's the limit. So I would encourage people don't feel like you have all the answers because you don't, don't feel like you can solve all this because you can't. But what you can do is surround yourself with some really good people and follow some really good people and learn and listen. And once you do that, you'll be equipped, the money will be there to go do things. There's all kind of opportunities to improve healthcare, but start with getting around the right people that you trust. This is a very local business. Healthcare is very local. It's very personal. That relationship between a doctor and a patient, between a nurse and a patient is one of the most trusted relationships that you can find. So this is all a people driven business. So search for those people, surround yourself with good people and the sky's the limit.
[00:30:34] Speaker B: David on behalf of Press Gainy Forsta, I want to thank you for everything you do in your communities, for your patients. And I want to also thank you for the friendship. We've been friends now for almost 20.
[00:30:45] Speaker C: Easy, easy now.
[00:30:47] Speaker B: So we're both young men still, though. So great to see you. Thank you.
[00:30:51] Speaker C: Thank you. Thank you, Pat.
[00:30:52] Speaker A: That's a wrap. Thank you for joining us today and special thanks to our guests for sharing their time and insights. Stay tuned for our next episode which will be released soon. In the meantime, visit our website where you'll find more information on the human experience and a lot.
