William Gilbert, the new CEO at Deaconess Medical Center, says he expects to follow up substantial quick fixes at Deaconess Medical Center with long-term improvements that will make consumers choose to come to Deaconess for hospital services.

Gilbert, a Northern California native, started work at Deaconess in late September, almost a year after Franklin, Tenn.-based Community Health Systems Inc. bought the assets of Empire Health Services, which operated Deaconess, on the lower South Hill, and Valley Hospital & Medical Center, in Spokane Valley.

Dennis Barts, who served as CEO at Deaconess initially after the ownership change, now is the CEO at Valley Hospital.

Gilbert is new to CHS, but he's no stranger to for-profit health-care operations or to competition among health-care systems.

He last served as CEO at the Regional Medical Center of San Jose, in Northern California, during its 12-year financial recovery. Regional Medical Center is owned by Nashville, Tenn.-based Hospital Corporation of America.

HCA, which owns 163 hospitals in the U.S. and England, bought the San Jose facility in 1996. Like Empire Health, Regional Medical Center "was a nonprofit in financial dire straits," Gilbert says.

That hospital, like Deaconess, is in a highly competitive market. Its main competition is Stanford University Medical Center, a world renowned teaching and research institution.

While Gilbert was heading up the California hospital, it expanded to 250 beds from 200. When he left there this year to take the helm at Deaconess, the San Jose hospital was enjoying record revenue and was completing a $150 million expansion due to growing demand for services, he says.

Gilbert sayspatients and the community are beneficiaries of competition.

"Competition makes us try a little harder," he says.

While he doesn't hesitate to point to Spokane-based Providence Health Care as CHS's main competition here, Gilbert says his strategy at Deaconess will be to collaborate in the development of an integrated health system here that CHS hopes people will choose first, rather than to focus on head-to-head competition. Providence Health Care operates Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital. Providence also operates Pathology Associates Medical Laboratories, a nursing home, an assisted-living facility, a visiting nurses program, and an adult day-care center here.

Gilbert says Deaconess already has a sturdy foundation for a financial rebuild. Since CHS took over operations at Deaconess, it has spent $17 million on capital improvements ranging from new beds to a fully equipped special-procedures catheterization lab, as part of a commitment to invest $100 million in capital improvements within five years, he says.

"CHS did some easy spends in the first year here on fundamental things the previous owner didn't have financial resources to address," Gilbert says.

Priorities are still being set on where to direct the next capital expenditures. "Now, we'll be looking to spend that money to create value to the patient," he says.

Also, through CHS resources, Deaconess has recruited 14 physicians in the past year, up from three or four a year earlier under Empire Health Services, Gilbert says.

Recruiting is ongoing, and the most pressing need for physicians here is for primary-care physicians who provide access to medical care and coordinate patients' needs, such as visits to specialists and hospitals, Gilbert says.

Deaconess recently opened Inland Family Medicine, a primary-care practice, in the Deaconess Medical Building near the hospital, and it's recruiting a physician to join two others there.

In addition to physicians, Gilbert says he's recruiting people to fill positions on his administrative team. Those positions include vice president of human resources, chief financial officer, and chief operating officer.

Deaconess is licensed for 388 beds and has an average occupancy of about 180 patients, Gilbert says.

Hospital admissions have been flat this year compared with last year, Gilbert says. He attributes that to many factors, including trends toward increased outpatient care and reduced length of hospital stays. For example, the hospital's new da Vinci surgical robot system allows increased use of minimally invasive surgeries with smaller incisions that heal faster than conventional surgical incisions.

"Technology and science help us reduce the length of stay or treat patients as outpatients with great outcomes," Gilbert says.

He predicts, though, that admissions will increase in the future.

"The population of the county continues to grow, and people are living longer, so demand will continue to grow," he says. "Deaconess' overriding growth strategy is to be the top-quality provider in the services we provide at the lowest possible cost."

Deaconess has about 1,600 employees, down from about 1,650 a year ago, but Gilbert says he expects the hospital's employment numbers to trend upward in coming years.

"If we achieve our goals, we'll create jobs," he says.

In the near term, Gilbert is looking to solidify Deaconess' relationship with Rockwood Clinic PS to provide integrated health-care services.

CHS announced plans in October to buy Rockwood, which operates 32 medical facilities here, including six primary-care locations in the Spokane-Coeur d'Alene area. The purchase, which is expected to be completed before year-end, pending approval by Rockwood's 133 member physicians, would help establish a continuum of primary, specialty, and hospital care, he says.

Gilbert says he would like to change the perception of "for-profit" in a positive way.

"Hospitals have to create a margin to remain financially viable," Gilbert says. "We're beholden to shareholders, and nonprofits are beholden to bondholders."

CHS hospitals also contribute to their respective communities, he says.

"Deaconess' commitment to the community is as strong, or stronger, than ever," Gilbert says.

During its first year under CHS's ownership, Deaconess provided $19 million in charity and uncompensated care. "We provide care through the emergency room no matter what the ability to pay," he says, adding, "Our charity-care policies empower us to do our share."