When Jody Jenner took the reins of Broadlawns Medical Center as CEO in 2006, Polk County’s public hospital was struggling financially and its reputation in the community had deteriorated as much as its long-neglected and aging facilities. 

Under Jenner’s leadership, Broadlawns has reinvented itself with a culture of excellence that has enabled it to recruit private physicians from across the community while significantly upgrading and adding to its facilities on its Hickman Avenue campus. 

The 113-year-old nonprofit hospital, which operates as a safety net for underinsured or uninsured patients, has dramatically increased its patient volume in the past decade by attracting more private-pay patients. That in turn has allowed the hospital to use that revenue to build its cash reserves while serving four times as many patients as it did in 2006. At the same time, Broadlawns has improved the level of its patient quality and reduced its per-patient costs by half, Jenner said. 

“Probably the most significant thing that led to a turnaround at Broadlawns is we just became more team-oriented,” he said. “We said, ‘Everybody’s important, and everybody’s got to work together and we have to start holding ourselves accountable.’ When I look back, it truly has been a team effort. We set metrics in place, and the staff responded beautifully.”

Jenner, who was 46 when he was hired as CEO by the Broadlawns board, attributes much of the leadership philosophy that he has applied at Broadlawns to 10 years spent in management and leadership positions with IBM Corp. 

“One of IBM’s basic tenets was excellence in everything they do,” he said. “Another was having the best customer satisfaction in the world. And expect a lot out of your employees, but take care of them, too. I think that’s a philosophy we’ve always tried to follow here.” 

A native of Aberdeen, S.D., Jenner grew up in a working-class family in which most of his five siblings had gone into health-related fields. Although he initially intended to pursue a clinical degree in health care, he became interested in business and earned bachelor’s and master’s degrees in business. After a decade at IBM, he grew tired of computers and went back to school to get a bachelor of nursing degree at Creighton University in Omaha, Neb. 

He initially worked as director of public health and nursing on a Native American reservation in Nebraska, and then worked at rural hospitals for Banner/Lutheran Health Systems before joining Broadlawns. 

“He’s got a lot of energy,” said Mary Krieg, current board chair of Broadlawns and a member of the board for the past six years. “He’s determined to have excellence, and he has a real passion for Broadlawns.”

A mission-driven leader, Jenner also listens to others’ ideas, Krieg said. “He knows how important it is for us to be the safety net and for us to care for other individuals who are challenged.” 

Early challenges 
Prior to Jenner’s arrival, the public hospital experienced multimillion-dollar losses each year between 2001 and 2006. 

“We were struggling financially in 2006,” Jenner recalled. “We were barely able to break even; we had maybe 20 days of cash on hand. Our facilities were aging. We didn’t have money to renovate the facilities. We had difficulty recruiting physicians. We heard folks in the community saying, ‘Maybe you aren’t accountable enough to the taxpayers.’ ”  

Even though 50 percent of Broadlawns’ revenues were coming from taxes, “we knew that we couldn’t raise taxes, so it was a real dilemma in trying to support the needs of our patients,” Jenner said. “I think also the public perception of Broadlawns had deteriorated over the years. And one thing you’re trying to do is attract insured patients — and when your facilities are old, the perceptions are not good; that’s a tough thing to do.” 

Part of the strategy for Broadlawns’ success going forward was the resolution to be the best at everything it does, Jenner said. 

“We want to have the best financials of a hospital in this industry; we want to be AA-rated. That seemed like a far-fetched goal when you’re sub-investment grade. We said we want the quality of our patient care second to no one. So when we measure our quality of care, we don’t measure it just against safety net hospitals around the country; we look at all hospitals. 

“We said we want our patient satisfaction to be second to none. And we wanted to be the employer of choice that would make us a fantastic organization. We also said we want to be good year in and year out, and that’s become part of our culture of excellence. That’s really what the staff here have bought into.”  

With operating costs that were out of line with expenditures, Jenner initially reduced staff through attrition as efforts were made to increase efficiency. 

“He started turning things around right away,” the board’s Krieg said. “We had a lot of inefficiencies that he addressed; we started automating. Streamlining things like clinic registration from what used to be a 20-minute process to two minutes, you can see a lot more people. And physicians can access that information and add their own quickly.”  

After about two years of improved bottom lines and cash position, “that was about the time we actually started thinking about investing in new facilities where we needed them most,” Jenner said. “There were always challenges along the way. As we were getting some momentum, we faced the recession of 2009. But like most organizations, we hunkered down and weathered through it.” 

Along with improvement in facilities and adding better technology, Broadlawns also began to successfully recruit private physicians from within the community. 

“They didn’t want to necessarily be with a large system, but they didn’t want their own clinics, either,” Jenner said. “They loved the mission, and I think they liked the fact that we tried to be a little bit more like a smaller community hospital where physicians were still at the forefront of making decisions. They could function autonomously, but still be part of a larger organization.” 

A key early recruit to Broadlawns was Dr. John Tentinger, who became chief of radiology and led the medical staff as its president. He was influential in bringing other well-known private doctors and their practices on board, among them Dr. Scott Neff, an orthopedist; Dr. Brad Lair, an oncologist; and Dr. Bob Bender, a geriatrician. 

“Ultimately, they talk with each other,” Jenner said. “It wasn’t the C-suite recruiting these doctors; they recruited each other.” 

Facilities expansion  
In 2008 Broadlawns launched a capital campaign to partially fund a three-phase, $45 million expansion project, which it completed in 2012. That project included construction of a new state-of-the-art emergency department, a new 40,000-square-foot medical office building, a revamp of the surgical suites and a renovated front entrance and lobby for the hospital.

“That was a big thing for us; we did that without going to the taxpayers for additional funding,” Jenner said. About $30 million of the funds was borrowed through issuing bonds. Broadlawns will be able to begin retiring that debt next year using its its cash reserves, Jenner said. 

Broadlawns’ current facilities expansion campaign is based on a facility master plan completed at the end of the initial capital projects that year. “At the time, we determined that mental health was the biggest priority, just given the shortages within this community,” he said. That plan includes approximately $60 million in capital outlays for facility remodeling and construction. 

The first phase, a remodeling of the 30-bed behavioral health inpatient unit, the first update made in 35 years, was completed on March 31. 

The second phase, which includes construction of a new $22 million medical offices building on the southeast side of the campus, is underway. The new building will house all of Broadlawns’ family medicine residency programs as well as all outpatient behavioral health services. When Broadlawns launches its psychiatric residency program in mid-2018, in partnership program with UnityPoint Health – Des Moines, it also will function out of the building. The building will also house Broadlawns’ dental program, which is going to significantly expand, Jenner said. 

“The building is also going to allow us to accommodate up to 40 percent growth in our outpatient behavioral health services,” he said. “We’re also designing space for our interventional pain program.” The medical offices building is expected to be completed in March 2017. 

To the east of the new medical offices building, Broadlawns is also constructing new housing for its medical residency program. The approximately $3.8 million housing will accommodate about 15 Broadlawns residents. 

Directly across Hickman from the campus, Broadlawns has purchased several lots that it is now converting into green space, which gives the hospital room for future expansion.  

Broadlawns also recently announced that it will open an off-site family medicine clinic at 2508 E. University Ave. The 10,000-square-foot clinic will be staffed by about six physicians and will increase east-side residents’ access to medical care.

Notably, Broadlawns will be able to finance the entire expansion out of its reserves, Jenner said. 

Cash reserves 
In contrast with the approximately 20 days of cash reserves on hand when Jenner became CEO, Broadlawns now has enough cash to fund 250 days of operations, or $92 million in unrestricted cash reserves.  

“That is the level that a financially solid, well-run hospital or hospital system would maintain,” Jenner said. 

“Being in a position of strength over time is going to allow us to actually reduce taxation. We’ll be able to make investments in new services and community needs as they arise, and not have to run to the taxpayers for more money. We’ll be able to maintain our facilities consistently, rather than being in catch-up mode like we are right now.” 

Last year, Broadlawns was able for the first time to reduce the amount of property tax revenue it receives from Polk County. The hospital will receive 15 percent less in tax revenue, or about $5.5 million less. In the past decade, the tax receipts had largely gone toward paying the hospital’s operating deficit, but in the past fiscal year, a majority of the tax receipts — about $45 million — represented a net surplus for the hospital. The Taxpayers Association of Central Iowa would like to see further reductions in Broadlawns’ levy, but Jenner favors a conservative approach. 

“Obviously our cash reserves right now are very strong and we’re doing well,” he said. “But there are so many uncertainties in this health care environment that we’re in right now. Plus there are additional needs in this community. We’ll be expanding our inpatient beds by 14 beds next year; expanding outpatient behavioral health service; psychiatry residency; expanding dental program for the poor. All of those programs are going to cost substantial money. So we’re trying to balance those community needs with any tax relief.” 

One significant uncertainty for Broadlawns is the Medicaid modernization that began this year. Medicaid and charity care patients make up about 45 percent of Broadlawns’ patient population. 

“We’re very concerned about the privatization of Medicaid,” Jenner said. “We forecast that will have about a $12 million a year negative impact to our financial results (due to Medicaid cost control measures designed to reduce use of services). It’s just too soon to tell. The thing that concerns us is we have some of the lowest costs in the state, and we think we treat patients very efficiently now. For us, it’s a little bit of ‘Can you cut costs any further?’ ”

In 2006 Broadlawns’ cost per adjusted patient day — a benchmark of how much it cost to treat each patient — was just under $2,900. Currently that cost is less than half that, about $1,425, which is 36 percent less than the state average of $2,221 per day. 

“We’re going to be very responsible with the funds we have,” Jenner said. “I think we’ve demonstrated that over the last 10 years.”  

Polk County Supervisor Angela Connolly said she agrees with Jenner’s approach on reserves. 

“Not knowing what’s going to happen with Obamacare and Medicaid, I think they need to hang on to that money,” she said. “No one has asked me what’s happening with the tax dollars.” 

Connolly said she believes Jenner and his team are doing “great work.” 

“They’ve come a long way,” she said. “They’ve always been the county hospital — but more and more I’m hearing from people that their doctors are over there. They really are the preferred hospital for many in the community. … Just driving by you can see all the progress they’re making. For us, the addition of mental health beds they’re making will make a huge difference.”

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Broadlawns at a glance