Jim Kenyon: Dartmouth Health budget cuts come from afar after executives’ pricey office move

Valley News Columnist
Published: 2/4/2023 10:50:35 PM
Modified: 2/10/2023 7:06:32 PM

In an “internal” message sent out to thousands of employees last month, Dartmouth Health declared belt-tightening measures were a must as it tries to close a $120 million budget gap by the end of September.

In other words, most workers shouldn’t expect much in the way of pay raises or promotions in the foreseeable future.

Edicts from DH’s executive suite might be easier to accept for workers who mop floors and empty bedpans if CEO Joanne Conroy and her top lieutenants were not so far removed from the trenches.

But it’s difficult to create an all-for-one, one-for-all culture when the big bosses are holed up in new digs a safe distance from the front lines.

Last year, Conroy moved her office from Dartmouth Hitchcock Medical Center’s fifth floor to newly renovated quarters in a low-slung office building that DH owns on nearby Mount Support Road. To keep her company, Conroy brought along about a dozen members of her leadership team and administrative staff.

Tucked off on the same dead-end road as David’s House, the unmarked building in the Colburn Hill complex is an ideal hideaway.

With many DHMC employees who aren’t involved in patient care still working remotely, Colburn Hill features plenty of conveniently located parking spaces. And if Conroy ever feels a need to mingle with the masses, she’s only a Segway ride away from the mother ship. Yes, that’s really how the big boss makes the trip.

Audra Burns, DH’s chief spokeswoman, told me that I’ve got the reasons for the move all wrong.

“It is important to first understand that the reason for the move of our executive officers was to create more space within the Medical Center,” she emailed. “Most of the space formerly occupied by our executives is now devoted to space for our caregivers who, by necessity, need to be close to our patients.”

Oh, the sacrifices that some folks earning $500,000 a year and up are willing to make just so doctors and nurses can do their jobs.

The “Colburn Hill Leadership Relocation Project,” the operation’s code name, didn’t come cheap. In a building permit application submitted to Lebanon’s planning department in June 2021, DH wrote that it expected to sink $853,000 into upgrading the accommodations.

In her email, Burns tried to sell me on the notion that Colburn Hill Leadership Relocation Project is in “reality, a much more multifaceted project than that name implies.”

The largest share of the cost, by far, was replacing the “outdated and no longer fully functioning HVAC system,” she wrote, referring to heating, ventilation and air conditioning upgrades performed in the circa-2000 building.

In the course of reporting this column, I obtained internal DH documents that showed the project’s scope went far beyond what was detailed in the building permit application filed with the city.

Apparently, the space — roughly 10% of the 55,000-square-foot building — didn’t meet DH leadership team standards. Before anyone moved in, the offices were outfitted with new doors ($12,282), flooring ($8,150), cabinets and countertops ($6,913) and a fresh coat of paint ($5,258).

Next up, redecorating.

A Boston-based “workplace solution and design firm” was hired to complete the makeover. I’m not sure exactly how much the finishing touches cost. I stopped adding up the bills for furniture and design services when the total passed north of $50,000, which included redesigning the former executive offices at DHMC for current use, Burns said.

(I asked her if I could get a peek at the new digs, but the request fell on deaf ears.)

The project ended up costing $1.126 million — $273,000 more than DH wrote in its building permit application.

“As has been the case for most construction projects around the nation over the past few years, COVID, inflation, rising material costs and labor shortages forced our costs beyond our initial budget estimates after the project began,” Burns told me.

Still, it wasn’t a big-ticket item for a mega health care system with an annual operating budget of close to $3 billion.

But it does make me wonder if DH’s leadership team has its priorities misplaced. Couldn’t the team live without new flooring ($1,700) in Colburn Hill’s kitchen? Or $720 roller shades? And why was it necessary to rack up $18,500 in moving company expenses?

Two weeks ago, Valley News staff writer Nora Doyle-Burr reported that DHMC and DH’s satellite clinics had about 800 job openings listed online. The majority of openings were for nursing or allied health positions.

A lack of physicians in the DH system, which consists of DHMC and three smaller hospitals, has resulted in “pausing” the acceptance of new primary care patients in some locations for almost a year.

In November, Chief Financial Officer Dan Jantzen informed bondholders that DH was “curtailing capital spending as much as possible to improve liquidity.”

And to think, it was just last April when DH launched its grand “rebranding” plan that I think it’s safe to say will cost the organization millions. (DH refuses to tell the public how much it’s spending.)

Last week, I talked with John Wasson, professor emeritus at Geisel School of Medicine at Dartmouth and a founding member of the Dartmouth Institute for Health Policy and Clinical Practice.

When I told Wasson about DH spending more than a million bucks on its “leadership relocation” project, he didn’t seem surprised. For decades, he’s been researching and writing about the waste brought on by the consolidation in U.S. health care that DH and its bigger-is-better strategy epitomize.

In a large health system, often the “goal is to sidestep personal and corporate accountability,” he said.

For Conroy & Co., the move out of DHMC means less contact with everyday workers. Which, I imagine, was another goal all along.

Jim Kenyon can be reached at jkenyon@vnews.com.

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