Being a Finance Executive in Health Care during COVID-19

Kimberly McCarthy

VP of Financial Reporting & System Controller at Trinity Health

Learning Objectives

Please join the Vice President of Financial Reporting & System Controller from Trinity Health, Kimberly McCarthy in this Executive Interview where she will discuss the adaptations her team had to make to maintain a successful financial division during the pandemic.



  • How has COVID-19 impacted Trinity Health as an organization and its finance function?

  • How are you managing the team and keeping them engaged in a remote work environment?

  • How was your year-end audit different during COVID-19?


"The only way we've been able to get through this is by getting through it together."

Kimberly McCarthy

VP of Financial Reporting & System Controller at Trinity Health

Transcript

Hello, everyone. Welcome to the Connect Virtual CFO Leadership Summit hosted on Quartz Network. My name is Britt Erler, QN Executive Correspondent. Thank you so much for joining us. I would like to welcome our guest speaker here with us today, Kim McCarthy, VP of Financial Reporting and System Controller for Trinity Health. Welcome, Kim. Thank you so much for being here.


Thank you, Britt. So happy to be here.


Of course. I’m really excited to dive into this topic today to discuss finance in the healthcare sector, and also the changes that you’ve experienced during during this year of COVID-19. Before we do that, if you wouldn’t mind giving us a quick background about yourself and your current role with Trinity Health.


Sure. I’m the VP of Financial Reporting. My team has responsibility for all of the internal and external reporting across Trinity Health. We do the monthly consolidated financial statements, internal management, all of our external reporting to our bondholders. So really, in focusing on the policies and procedures across the organization.


Fantastic. As we discussed finance in the health care sector, how has this changed for you during COVID-19?


Well, Trinity Health is a healthcare organization providing patient services. So, it’s had a huge impact on our organization. We serve in 22 states across the United States. We are a large organization, Catholic base. We have about 92 hospitals, either owned or managed during a joint venture, about 100 continuing care locations, 120,000 employees. So, we’re very large—7000 associated physicians.


Our operations were significantly impacted by COVID-19. We had mandated shelter in place orders across most of our markets starting in mid March, and many of them lasted through June. Our operations and our volumes were hugely impacted. We immediately set up a FEMA format incident command center across the organization. Many groups of teams met daily for probably about the first two and a half months. Those have scaled back a bit now, but we really had a huge decrease in our patient volume, their inpatient admissions dropped about 20%, our surgeries dropped over a third in that four month period. We have bounced back and those volumes since June. We hit the real low peak in April. But it’s significant impact across our organization and cross functional teams meeting to make sure that we’re meeting our patient care need.


Exactly. I think a lot of companies are seeing that same influx from month to month as the industries are changing. In terms to your finance strategy, did you really have to rush to put something in place? Or was this something that you had prepared, kind of on the back end, for situations like these?


We had the incident command structure in place. We’ve never had to stand it up with this much breadth across the entire organization. We’ve used it before for locations with a hurricane, but being in 22 states, it has an impact of the entire organization at one time. So, it was a massive effort to quickly stand that up, so we could continue to provide patient care.


Of course. Moving forward, as obviously things have gone virtual for I’m sure many of your departments and across the board nationwide, do you think that some of the strategies you put in place will end up sticking moving forward? You’ve seen things that now work virtually that you may not have considered before.


Definitely. I think some of these will end up sticking. We had just started to roll out many new Microsoft tools like Microsoft Teams, One Note. Being in 22 states, we already used video conferencing extensively. Those have really helped us respond to this from an operational perspective. We immediately stood up telehealth visits or outpatient visits so that patients could still get those visits in without having to travel into their doctor’s offices. Much of that technology and operational changes will continue into the future after the pandemic.


Absolutely. I’m assuming that your team is working remotely. How have you managed that? What changes have you had to make from a managerial standpoint?


Yes, we’ve been working remotely since mid March. We are considered essential workers as finance colleagues. So, we can go into the office if we need to but we have mostly been working from home. Again, those tools and technologies has really helped us. We do an hour long team huddle on Monday mornings. The team helped develop the agenda for that. We tried to build into it many of the things we were doing in the office.


We have a long standing tradition of doing reflections at the beginning of a meeting, it’s to focus us, get us balanced and centered. It can be anything from a prayer to an inspirational quote. We start with that reflection. We then do a morning physical exercise routine. Just a little five minute morning stretches. We have team reminders. I give the team any key updates from my perspective, then we do a team building activity, so round robin and team building activity. So, that’s how we start our week off. We have rapid huddles then during the week, so just quicker phone calls. Again, the webcast tool we were using extensively before. In teams, we use the team’s chat feature all the time. I’m an avid team’s user now.


I know, so many people are. That and Zoom, I think, are the two most use platforms now. Now, as far as keeping your team engaged, a lot of members roles have expanded. What they’re working on has completely changed, and it will continue to change throughout this year and into next year. How do you manage to keep them on track? What motivational tactics you instill in them?


Sure, we’ve had to do a lot of juggling of activities. Our workload has changed. What we’re working on has changed. So, we do a lot of online training with each using the team technologies. To keep that link that we’re missing from being in the office together, we make sure that we do at least monthly team building activities. Most of those have been virtual happy hours. We share who gets to pick the cocktail for the meeting.


We actually get a bingo night, a couple weeks ago as well. We had like fancy tropical cocktails involved. It’s just nice. It’s a nice refresher.


It is. We’ve played the game Taboo online, which is kind of challenging but fun. So, just really staying in touch, continually staying in touch. If we have younger team members that are newer, we’re making sure we’re meeting their needs. Understanding what we need to still complete all the tasks that we have to do with so many more tasks that have been added to our plate.


Of course, and even just things being added to your plate. I understand you guys also have a June 30 year end. How was your yearly audit different this year with everything COVID-19 related?


Well, first of all, it was completely remote. But I was pleasantly surprised at how well it went in 100% remote environment. We have Deloitte Touche as our auditor. They already had a tool that we use to upload our work papers online. That was mandatory this year, we had to use it. We’re done with our financial statement audit.


The biggest change that we’ve encountered right now that’s kind of got us in a holding pattern. We did receive several millions of dollars worth of funding from both the Cares Act and Paycheck Protection Act. Some of those funds are considered federal grants. Well, the grant guidance, we’re usually done with our grant audit towards the end of October, that grant guidance hasn’t even been published yet by the federal government. So, they were really focused on trying to get healthcare entities cash fast so that we could keep serving our patients. But with that, there’s been a lot of confusion, a lot of lack of clarity. They publish Frequently Asked Questions almost daily that we have to keep up with. It’s really just been a huge added workload, balancing those federal changes in that federal funding, and kind of trying to keep track of it all.


Right. Knowing that these changes are occurring now, and that the federal government is still unsure of how to make sure things go smoothly. Are you still preparing that this may be an issue going into 2021 as well?


Absolutely. Some of the federal grant funding that we have extends. We have up until June of next year to use those funds. The first mandatory reporting period starts in January, and they don’t have the guidance published for that yet either. There’s just a lot of uncertainty. It’s been the year of change, change, change. Huge teamwork is helping us to get through this all together.


Right. I think everyone’s in the same boat. Tthere’s so much change. People still don’t know what to expect for next year. I think finance is honestly the trickiest department, because so much relies on the finance of an organization. Are you guys able to put together accurate forecasts for next year or are you really taking it day by day?


Forecasts are definitely challenging right now. It’s very hard to predict volume. We have had a couple of locations that have surged later or gone through second surges of the pandemic and the virus itself. So, we changed from doing an annual budget instead of doing a 12 month budget. We’re doing quarterly forecasts, so breaking it down into smaller components, and then we actually do a rolling forecast each month.


Okay. Yeah, that makes sense. I think that’s actually what I’ve heard a lot of companies are doing as well, and they’re hoping to eventually switch back. But right now, as you mentioned, there’s so much uncertainty. As far as being a leader in your position, what changes have you seen in your role? What changes have you had to make when managing your staff?


Well, I’ve definitely had to be more flexible. Before COVID, we pretty much had a work in the office policy full time. We work from home a couple of days, but the majority of all of our time was spent in the office together as a team. It’s just really helping the team focus on priorities, and making sure that they understand the key deadlines and the key priorities. Then make making sure they have the right tools, and that we’re communicating constantly to make sure that we’re meeting all those deadlines.


Absolutely. As far as any just best practices, tips that you have for finance executives going through this time. I’m sure they’re all experiencing very similar things that you are right now. Any pieces of advice that you would give them?


I guess the biggest piece of advice I have is embrace the new technology that’s out there. I’m an old dog. I can learn new tricks. I let the young kids on my team learn all the new tricks, and then they teach me those things. I teach them some of the technical aspects of health care and the experience that I’ve had over the 26 years here at Trinity, and they teach me the new stuff. So, it’s a two way street. I’d say I guess I’d say the key, Britt, is really that strong focus on teamwork. The only way we’ve been able to get through this as getting through it together.


I completely agree. As far as hiring for Trinity Health, have you guys brought anyone new on board or have you seen pretty consistent with everything going on?


We had one new team member that started the day before we all got sent home to shelter in place in Michigan. It’s been interesting, how do you train remotely, especially she doesn’t know any of us and doesn’t know the organization. But again, with those teams and tools, we’ve been able to successfully onboard her. I’s worked out really well. As far as any future hiring, we’re kind of in a holding pattern right now, since there’s so much uncertainty,


Of course. We’re in the same place, too. We’ve been hiring a lot of brand new people, trying to figure out the best way to train them, but also getting them excited about our culture, which is very hard to do virtually. But it sounds like all of the practices and the meeting that you have in place have been really successful at doing that. So, congratulations. I will definitely be taking some of those tips myself for my weekly meetings for our content team. Before I let you go back to your busy schedule, any final words that you would like to say to the audience about Trinity Health for yourself as an executive?


Again, I think that key for me in this whole environment has been that strong sense of teamwork. So, teamwork, and just we need to be flexible. There’s so much unknown, so many uncertainties. You can either be flexible or drive yourself crazy worrying about things that we can’t control.


I couldn’t agree more. Well, thank you so much, Kim, for taking the time. I really appreciate it. It has been fantastic to have you here. I’m sure our audience picked up some really great insights and tips that they can use moving forward. For everyone that joined us today, thank you as well. If you have any questions for Kim, please do not forget to make comments in the discussion forum below. Please enjoy the rest of the summit and have a wonderful rest of your week.


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