'Never Waste a Crisis'
"What we needed was the right strings pulled administratively to not only stop the bleeding that happened in the past, but to determine how to grow going forward," he says.
Migoya's new COO and CSO found other attractive, experienced hospital executives to join the senior leadership team, and all recruited heavily from for-profit hospitals. Ultimately three-fourths of the senior administrative staff was turned over, Migoya says. By the end of the 2012 fiscal year, the first for which Migoya and his team were responsible, they had turned a predicted $400 million annual loss into an $8 million profit just by implementing and holding managers accountable for basic business best practices, he says.
"Never waste a crisis," Migoya says. "Jackson was literally about to close its doors if we didn't do this transformation," he says. "Our days cash on hand were in the single digits and we had over 120 days in accounts payable. We had to make some radical changes."
Migoya says his most important duty during this time was making the case to county commissioners and unions that difficult choices had to be made in the restructuring.
"That was difficult for unions to understand and difficult for the commissioners," he says. "But over time, we delivered on our words and we've built much better relationship with both county commissioners and the unions."