Becker's Hospital Review

Hospital Review July 2015 • Vol. 2015 No. 7 Behind Closed Doors: The Lesser-Known Details of Mergers of Equals By Tamara Rosin A merger of equals does not follow a traditional merger or acquisition model where there is a perceived "winner" or "loser." One system does not simply hand over its keys to the other. These types of deals start with a small group of decision- makers and they demand a unique due diligence process. We spoke to some insiders who discussed the pace and challenges of these transformational relationships. The Modern Definition of a Community Hospital By Heather Punke Depending on whom you ask, a community hospital could be defined in a number of different ways. That problem arose in an editorial team meeting in the Becker's office earlier this year, as we were planning for this very issue of our magazine — the "Commu- nity Hospitals Issue." As we sat discussing the articles that follow on subsequent pages, one of my colleagues spoke up and asked a deceivingly difficult question: What makes a hospital a community hospital? The team struggled to provide solid definition for her. And that got us thinking. The Community Hospital Survival Guide By Ayla Ellison Community hospitals across the nation are facing a myriad of financial challenges, causing some fa- cilities to file for bankruptcy or close their doors for good. The financial struggles these hospitals are encountering are apparent, as 50 rural hospitals have closed since 2010 — and there may be many more headed down the same path. There are 283 rural hospitals across 39 states that are vulnerable to closure, according to a report from iVantage Health Analytics, a firm that compiles a hospital strength index based on data about financial stability, patients and qual- ity indicators. In 2013, more than one-third of rural hospitals were operating at a deficit, according to the National Rural Health Association. continued on page 12 continued on page 14 continued on page 8 Inside: 100 Great Community Hospitals p. 27 SAVE THE DATE! Becker's Hospital Review CEO Roundtable + CFO/CIO Roundtable November 18-19, 2015 Ritz Carlton - Chicago, Illinois 44 Leading Hospital & Health System CEOs 33 CFOs & CIOs & 100 Hospital Executives Total Speaking • 5 Tracks & 74 Sessions To learn more visit www.BeckersHospitalReview.com To register, visit www.regonline.com/ceoroundtable2015 INDEX Table of Contents p. 6 Financial Management p. 14 Leadership & Strategy p. 40 Revenue Cycle p. 62 Physician Affairs p. 70 Health IT p. 78 Opinion p. 85 Thought Leadership p. 86 Thoughts on Healthcare From 3 Physicians in America's Tiniest Towns Three family physicians from towns of 4,000 people or less weigh in on the industry. p. 70 The Woman Who Runs the Oldest Hospital in America Meet Theresa Larivee, executive director of the 264-year-old Pennsylvania Hospital. p. 42 15 Hard-to-Forget Quotes From Hospital Leaders Hospital and health system leaders share concise ideas about the big world of healthcare. p. 40

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