Just who are Karp, Carris?
Bob Karp and Jim Carris sit in a large, sunlit office at Aspen Valley Hospital. It’s taken an hour of conversation, but the two have finally relaxed. Karp has his legs up on the desk. Carris has slouched comfortably in his chair.
These are the two men who were hired to clean up the mess at AVH. Karp, a semi-retired heart surgeon, joined the hospital in January as the hospital’s interim CEO. Shortly thereafter, Carris, an independent financial expert, was brought in as his right-hand man.
Their investigation process was intensive – thousands of financial statements to sort through – and the fallout was painful – controversy, accusations, 34 employees laid off.
But now, say Karp and Carris, they are through the worst of it. Their body language indicates two men at the helm of a ship that was at one point dangerously close to going under.
“Were it not for some of the actions of some of our board members, this hospital had a real chance of being lost to this community,” Karp says.
“I wouldn’t say we were hired in the ‘nick of time,’ but it is true that we didn’t have a whole lot of time to turn this around,” Carris adds.
Four days, thousands of documents
The investigation process began when Karp hired Carris on a four-day contract to examine the hospital’s billing flaws. As Karp tells it, Carris set up his computer in his office in January and emerged four days later with news of an impending crisis.
With the permission of the board, Carris’ contract was extended until May and the two men dived in, ferreting out and fixing long-standing billing problems, addressing hospital efficiency, and ultimately calling for an aggressive, controversial reduction of more than 10 percent of the AVH work force.
The two men acted as a team; they could not have done it alone. The medically minded Karp has only a tenuous grasp of hospital finances. But with Carris’ help, he assembles graphs, charts and other cheat sheets to help him understand and explain billing complexities.
Carris, a fix-it man used to behind-the-scenes tinkering, was totally unprepared for the public scrutiny accompanying the overhaul of a public hospital. He defers often to Karp, a retired surgeon who still has a knack for reporting bad news to anxious ears. Carris refused to be photographed for this article, saying “you don’t need a picture. I’m just the worker bee.”
The problems and inefficiencies found by the pair had been overlooked for years by the former AVH management, but reporting the bad news didn’t exactly make Karp and Carris into community heroes. They’ve also been reluctant to assign blame for the billing problem that led to a $7 million shortfall in last year’s budget, and that hasn’t helped their image.
After the March resignation of CFO Verna Bartlett, who oversaw the hospital’s finances as they plunged into the red, Karp referred to her in a press release as “the linchpin of the hospital’s success in recent years.”
Still, the two men remain stubbornly forward-looking.
“Everyone’s looking for a magic bullet. There is no magic bullet,” says Carris. “Our job is to right the ship, not to court-martial people.”
“If all we did was focus on who caused the problem, we wouldn’t have time to fix the problem,” Karp adds.
When Carris was brought in, his description as an “efficiency expert” and his reluctance to step into the spotlight led many to believe he was a big-business hatchet man, hired to slash the hospital’s work force.
And although Karp and Carris claim the recent firings occurred with input from many different sources, the “reduction in force” was ultimately their responsibility. Among fired employees, the handling of the layoffs had a cold, big-business feel. One fired employee said the layoffs were sudden, impersonal and against the principles of a community hospital.
Karp, especially, has had his share of criticism. He is currently negotiating an affiliation with a huge, New York orthopedic center that would brand AVH with the New York name. There have been whispers that Karp is trying to sell out local orthopedists and doesn’t appreciate AVH’s importance as a community institution.
But the New York affiliation wasn’t his idea. Current board members John Jellinek and Bob D’Alessio made the first overtures to the Hospital for Special Surgery, and Karp has taken over from there. He also claims that during the talks he has been working to defend local surgeons and Aspen’s community.
“Yes, we are the little guy,” Karp said in an interview in March. “But does that mean we can’t learn from the big guy? I live here in Aspen, too. I want the best possible hospital for this community.”
Karp and Carris’ term will soon be up. Within the next three months, the AVH board plans to replace Karp with a full-time CEO. Carris will return to his home in Rhode Island and seek out his next contract.
They wear grim faces, but there is a palpable sense of accomplishment in the two men.
“We can now assure patients they will get a timely bill and that the hospital will be able to function on revenue gained from their care,” Karp says. “It’s not much, but it’s something to be proud of.”
Eben Harrell’s e-mail address is email@example.com