Managing cash flow, employee fatigue top priorities of Hackensack Meridian CFO in 2021

Alia Paavola -

Robert "Bob" Glenning serves as the president of the financial services division and CFO at Edison, N.J.-based Hackensack Meridian Health, an integrated system with 17 hospitals, 500 patient care locations and 36,000 employees. 

He has been in his current role since July 2016, when Hackensack Meridian Health was formed through the merger of Hackensack University Health Network and Meridian Health. 

Previously, Mr. Glenning was executive vice president and CFO of Hackensack University Health Network.

Here, Mr. Glenning describes how the resurgence of COVID-19 may affect finances at Hackensack Meridian, the motto that shapes his leadership and two of his top priorities heading into 2021.

Editor's Note: Responses were lightly edited for length and clarity.

Question: New Jersey is currently seeing a resurgence in COVID-19 cases and hospitalizations. Do you expect the rise in cases to affect finances at Hackensack Meridian?

Bob Glenning: I do. At its worst, the organization will largely be treating COVID patients and patients with other elective needs will be waiting. If that is the case, it will mean less revenue because COVID patients tend to stay and occupy beds longer.

There are also a lot more expenses. Personal protective equipment, like gloves, masks and gowns, are all difficult to get. Items we may have paid $1 for are now $11. PPE costs are going up by a factor of 10. We have seen an increase of $50 million in PPE expenses. Pre-pandemic the PPE would have cost us maybe $5 million to $7 million. 

We've been doing a significant amount of hiring to staff beds as well, and there is the ability to hire agency nurses who get trained by us to work in our facility. I envision it will become difficult to get agency nurses in the near future because COVID is everywhere. This spread has limited travel by these team members to us, and there are also needs for nurses in their own communities, so it will be harder to get those team members.

Q: Can you describe the most challenging decision you had to make as CFO?

BG: No particular decision comes to mind. When you look at the decisions we make, the logic behind them is really compelling. The decisions themselves aren't the hard part. The hard part is executing them.

There is a certain amount of expertise you garner from being a financial leader for a period of time. As CFO, you've sat in other roles at the health system or other organizations and earned that experience. You rely on your judgment and confirm it with facts and analysis. The thing to guard against is spending so much time analyzing a decision or reanalyzing that decision as it is not productive or useful to obsess over one once it's made. The decision is the start of the process, but not really where most of the difficulties lie. The known challenges or unknowns can be dealt with after the decision. 

Q: Based on your experiences, what is the best way to present a hospital's finances to the board, employees and public?

BG: You have to know your audience. Regardless of whether it's the board, the public or the team, you can't provide the information like they are knowledgeable about finance or accounting. You have to judge based on your audience and tailor the explanation so that it's clear to them. You can't talk over them, nor can you talk below them in a patronizing manner. 

Q: What are two of your top priorities as CFO heading into 2021?

BG: The first, likely the same for any CFO, is prioritizing cash flow. The second priority, but equal in importance to the first, is the team. The team that supports the organization in finance and IT, as well as the team that supports the community, has been working under extraordinary challenges. We have to be conscious that there is a fatigue factor that is unavoidable. There is also a certain amount of stress and anxiety of repeating the same thing that happened at the beginning of the year due to the pandemic. There are only so many hours of the week. We have a team I believe can do anything, but they can't do everything. 

Prior to the pandemic, we hired the network’s first chief wellness officer to help us address physician burnout and other important issues. The physician in this role and her team are already doing great work. They have launched new initiatives, including a program we call “Even Leaders Need to Recharge,’’ to encourage our teams to take some down time and to take care of themselves. Additionally, we have expanded employee assistance programs to help manage stress, which includes providing five free virtual counseling sessions for all team members.

Communication is also critical at this time. Our CEO holds an online town hall meeting monthly to provide updates and answer questions. I have weekly meetings with my team as well. I think the big thing is staying in touch and getting a pulse of things with my team, as they are largely working from home. Previously, they were working side by side at the office. Now it is important to hear from everyone because we don't want staff feeling lost or alone, especially with the remote work. We also host events for our team members to get them to have a little fun and relax for a moment. We also continue to assess pay and benefits to ensure we are paying people appropriately.

Q: What motto helps shape your leadership? 

BG: I picked up a quote that I now put at the bottom of my emails. I received it from another team member who emailed me one day to resolve a situation. It resulted in a phone call, and the person was so impressive to talk to, it made my day. The quote, though, which I asked if I could adopt, is from Maya Angelou, and it reads: "I do my best because I am counting on you counting on me." When you think about it, it means I am going to do my best because you need me to do the best. If I didn't think you thought I was important, would I do the job I am doing now?

Q: If you could pass along one piece of advice to another hospital CFO, what would it be and why?

BG: There are so many great CFOs out there. I wouldn't presume to give them advice. I would think that they already know what advice I might suggest or they wouldn't be in their roles. 

 

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