Bruce Lamoureux
SAINT JOHNS — Emerging from the rubble after more than a decade of preparation, Saint Johns Health Care Center is ready to move into its next phase of life in Santa Monica.
And leading that effort is the hospital’s CEO, Bruce Lamoureux, as well as the Sisters of Charity of Leavenworth, who own the facility and the governing board and help guide the mission of providing health care while serving the poor and the underserved.
Lamoureux has been busy in recent weeks planning and celebrating the opening of the hospital’s new North Pavilion, a 200,000-square-foot facility that will serve as Saint Johns’ main inpatient hospital. The multi-million-dollar facility is a result of the catastrophic Northridge Earthquake, which forced the hospital to close for nine months in 1994. The rebuilding effort has taken a couple years longer than expected — the general contractor in charge of the project went bankrupt a few years ago.
But at last, the inpatient facility will open later this year. Two weeks ago, the facility was blessed by Cardinal Roger Mahony during a community mass that was attended by staff, hospital supporters and benefactors. This past Friday, an outdoor gala dinner was held at the base of the new facility to honor hospital employees and financial supporters. And on Oct. 7, an official dedication ceremony, at which California First Lady Maria Shriver will be the honored guest, will be held.
The second phase of the construction plan — a four-story, 275,000-square-foot diagnostic and treatment facility — will be built where the original hospital now sits. It’s scheduled to be completed in 2009. The entire rebuilding project is estimated to cost $314 million, raised through donations by hospital supporters and federal funds.
Lamoureux, who has been employed at Saint Johns for 26 years in a variety of roles, was chief operating officer at the time of the destruction. He found himself learning more about construction management than he ever dreamed of when he began his career as a respiratory therapist at Saint Johns in 1976.
As Lamoureux, 50, moved through the ranks at Saint Johns and eventually became the chief executive officer in 1997, he has gained a comprehensive understanding of the tumultuous and ever-changing health care industry. What he cherishes most are the relationships he’s built within the institution, which he describes as a “mini city.” Saint Johns has roughly 1,400 employees and is the second largest employer in Santa Monica, just behind City Hall.
And while Saint Johns embarks on an exciting time with its new facilities opening in the coming years, there are many challenges facing Lamoureux in the near future. Hospital administrators were forced last December to lay off 200 employees and eliminate more than a half dozen patient programs. The cost-saving measure, which was estimated to be about $10 million, was in response to the hospital’s declining revenues and increasing operating costs over the past year, administrators said. The lay-offs constituted 12 percent of the hospital’s workforce.
As costs continue to escalate, Lamoureux expects more lay-offs to occur while at the same time — like many hospitals in the country — Saint Johns is facing a nursing shortage and many other challenges.
The Montreal native who lives in Manhattan Beach with his high school sweetheart and their three children, recently sat down with the Daily Press to discuss the future of the hospital and the health care industry.
What’s fulfilled you the most in your 26 years at Saint Johns? “The relationships that I have been privileged to enjoy at Saint Johns from day one. The constituencies are so very broad. The gifts, the dedications, the humility people bring to their roles. It’s very humbling for me. I feel so very privileged to have had access to the people I’ve had access to. I truly mean people from every sector of the organization.
From watching someone in the environmental services department work hard at Saint Johns for 30 years, give lovingly, consistently with all of their ability and to do so with little recognition. Our entry level people are not in the limelight. They don’t get to enjoy the acknowledgment I that I get in my role.
“There’s also my relationships with physicians. I absolutely love to work with physicians. They are driven by their passion for excellence. They are highly competitive beings in terms of who they are as individuals. They come from a culture of patient advocacy and entrepreneurialism. The relationship in my mind, between the hospital and medical staff, is much like a good marriage. It requires equals. They don’t see the world, they don’t see what happens at Saint Johns in the same way that those of us who are in the hospital establishment. My relationships with physicians have been filled with learning.
“The Sisters of Charity, their drive as a constituency and as leaders. Sister Marie Madeleine as my mentor. Their devotion to God, their devotion to the poor, to the underserved. Their predominate impact on the organization in terms of making it as good of a place as it can be. Being able to advance in the organization has only been because of the Sisters of Charity. Without them, I don’t know that the opportunities would have been available to me.
“Our trustees, the members of the governing board. They are highly accomplished individuals. They give countless hours to Saint Johns in support of the institution. Our foundation trustees are volunteers who do the fundraising for the institution. Again, incredibly capable, talented and giving individuals.
“And last but not least amongst constituencies are all of the people who have been my peers along the way... each person has contributed something to my experience and learning.”
What is your biggest challenge or disappointment?
“Our biggest disappointment has been the delay in the construction of our facility. The biggest challenge? The health care environment and everything all health care providers are being asked to do in the face of often diminishing revenue and escalating costs. We enjoy the benefits of new pharmaceuticals, new technologies. We enjoy new facilities, in the case of Saint Johns. And all of those are expensive. And you and I have grown up as children of FedEx and Nordstrom and McDonalds. And we expect service, faster, better, cheaper. In health care, all of the costs are rising. The purchasers of health care, the employers generally, with the exception of the government, are stunned by the escalation of costs to cover their employees. Over the last 10 or 15 years, through the evolution of managed care and the continuing pressures on health care providers, we have seen that revenue has not kept pace with costs. So the biggest challenge we have is how to keep the organization sustainable and able to replenish it.”
And that’s why hundreds of people were laid off earlier this year? That couldn’t have been fun.
“No. And those challenges await us in the future as there is continued cost esca-lation. It’s not over with... Our challenge is that our revenue is diminishing whereas the expenses are increasing. Those lines have crossed, and in California 51 percent of hospitals are operating in the red. We are seeing the sale and/or the closure of an increasing number of hospitals...
“We are right now struggling with our current year. We are looking to do what we must to balance the budget again. We began with one picture. That picture has changed once again, and so we are revisiting that and adjusting. In this environment, the idea of a budget forecast that extends two and three years is a thing of the past. You are really looking at it from year to year and even within that year. We looked at the middle of last year’s budget because things had changed and we had to adjust. And we are looking at our budget again in the current fiscal year because already there are material changes from what we began with.
Are more budget cuts likely? “I believe so. I believe we will have to adjust methods of operating one more time. I don’t know when it’s going to stop in subsequent years. Again, we are seeing more and more mismatch between revenue and costs in health care. We need only look at the sale and closures of hospitals. It just doesn’t look good... At some point, there will be enough chaos that you and I will feel as though we’ve gotten run over by the health care bus and we will become outraged. When that outrage manifests within the middle class and there is enough of a nucleus of people who are adversely affected, then we will have that courageous conversation.”
When do you think that will be? “I would say five to 10 years out. There is insufficient pain right now. Forty-five million uninsured in our country, 7 million in California. It’s not enough pain.”
How long can hospitals operate in the red?
“They can’t. They absolutely will not. I can tell you our operating performance is diminishing. We are not going to run in the red. I can absolutely guarantee it. You can do that for a short period of time. You can tap into your reserves, if you even have any, which many hospitals do not. You can tap into the debt market, but at some point you have to pay the piper. Hospitals are not going to do it. There is insufficient outrage and pain resulting from the number of uninsured. There is, as of yet, insufficient pain and outrage in our ranks for the escalation in health premium costs. And there are too few people who are going without insurance getting caught in a terrible, catastrophic health circumstances and losing their assets, their home, whatever it may be, in order to pay for their health care. It’s happening in increasing numbers, but it’s not enough. Just as we’ve seen great societal movements in the past manifest when there is enough outrage, so too will we see something here...
“There are record-breaking profits being made by the health plans. And these times, where people are paying more out of pocket for their health care, employers are paying more than they ever have for basic, and in some cases, less health care coverage than they’ve gotten for premiums in times past. It’s a time when physicians are making less with more work than ever before, and the same is true for hospitals. Is there sufficient profit and waste in the system to make available for every Californian a basic health care package? Only time will tell. I think the possibility is there that it could.”
Has this issue been the most surprising to you in your career?
“Without a doubt. The economics of health care have just been wild. They are no less wild today than when we saw strong presence of managed care manifest in the early ’90s. No less than when we saw the federal government impose the prospective payment system for Medicare subscribers. No less surprising than when Medicare was established in the mid ’60s. So the industry has seen an absolute revolution in its economic models and structures over the decade. And today, it continues.”
What’s your main role as CEO at Saint Johns?
“It’s more the strategy and vision for the hospital. That is paramount in my role... Certainly, if you look at the constituencies and members of our governing board, they are very much involved in the vision Family: Wife, Nadia, a homemaker. Married for 26 years, “going steady” for 35 years. Three children: Tyson, 22, a senior at UCLA, studying mathematics; Sasha, 20, a student at Mount Saint Mary’s, studying nursing; and Chad, 13, a middle school student.
Lamoureux grew up in the suburbs of Montreal. His family immigrated to California in 1967 when he was 13 years old. He has six brothers and sisters. His father was a chef, and his mother was a homemaker.
Education: Master’s degree in business administration at USC. AA at El Camino College as a respiratory therapist.
Hobbies: Avid weight lifter; landscaping; mowing the lawn; gardening; spending time with family.
Originally published in the Santa Monica Daily Press print edition on October 4, 2004. Read the original PDF.