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This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Regina Foley, president of specialty hospitals and clinical
services as well as chief nurse executive at
Hackensack Meridian Health. Regina, it's a pleasure to
have you on the podcast today. Good to
talk to you too, Laura, and all your
all your listeners.
Awesome. Well, thank you so much for being
here. I'm excited to have you because I
know Hackensack Meridian Health is on the forefront
of a lot of amazing things in the
clinical care space, and especially thinking about nursing.
You know? You're really, really interesting,
ways that you've been adapting to the current
environment and building on the ecosystem. But before
we dig into that, can you tell us
a little bit more about yourself and the
organization?
Sure.
So I,
Hackensack Meridian Health located in New Jersey.
38,000
team members strong,
recover about eight counties in the state of
New Jersey, 18 hospitals, about 500 locations.
I'm a career
HMH'er. I've been in our company for thirty
nine years as we roll into twenty six
years, thirty nine years.
Different places, different roles. You know, it's been
part of the
the gift of being a nurse, whether it
be, you know, nurse at the bedside, a
chief nurse
at, one of our hospitals or hospital president
or leading transformation efforts, which is all the
change,
or even landing to the to the enrollment
today.
I, you know, have certainly have a lot
of longevity
within Hackensack Meridian Health. I would say I
don't I'm not alone, though. We have many
nurses that have been promoted from within
and, or or say a career,
within our company.
Certainly proud
of,
of the organization.
We had a recent restructuring
in '26 where,
we were divided in or or segregated kind
of in a regional role within the within
our our state.
And,
our CEO and board,
thought let's you know, we need to get
a little bit more provocative thinking and forward
thinking here.
So we actually eliminated,
a regional structure
and,
which was north, central, and south.
And then,
we eliminated those roles,
in that kind of although care is very
local. And, you know, we keep care as
local to the patient as possible or or
community as possible. Administratively,
now we've
organized that our acute care hospitals are kind
of one side of the house, and then
areas like specialty hospitals or clinical services,
that's what I have the responsibility of. So
it's really allowed for a lot of, further
integration,
further continuity,
you know, transparency
of information, timeliness,
which certainly, at the end of it all,
helps us with, caring for our patients. So
this kind of recent reorganization we did, in
the in the kinda latter half of '25
certainly, I think, turned out to be beneficial
for the company.
That's great to hear. And, you know, certainly,
always a lot goes into those kind of
restructures and reorganization,
but I love that goal of, you know,
making sure care is local and, putting the
right people in the right places to,
transform that care experience.
Now when you think about the last year,
what was the most important initiative that you
led? What did you do, and what were
the results?
I think the top one of the top
three priorities,
would be,
strengthening
and supporting
the workforce, the nursing workforce.
I would say stabilization
of the workforce.
You know, the
the pandemic really took its toll on the
work on the health care workforce,
globally.
We also were part of certainly a part
of that.
So recently, I would say the most important
initiative that we tackled in '25
was stabilization of the workforce, which has led
to we have a very low vacancy rate
today,
just about 4%. Actually, we have two of
our hospitals that have below the four vacancy
rate. Retention is extremely strong.
We also were able to reduce,
contracted labor agency utilization,
by,
about,
gosh, dollars 41,000,000
last year, which is not insignificant.
So I would say making significant strides in,
stabilization
of the workforce and making sure that we
have, very strong
retention efforts,
which is really is led from culture, you
know, in the organization. So it's not just
about recruiting
net new. We want those nurses to stay
in the organization, you know, just like me.
You know, here he is a few years
later. So,
that I would say there's many priorities, but
I can tell you that's one standout or
important initiative for '25,
was,
the, you know, stabilization
of the work environment. I gave you some
stats. Vacancy, retention,
agency utilization,
and,
you know, behind the scenes of all of
that, there's different kind of unique programs
to help on the retentions on the recruitment
side
because many you know, our care is local.
Our team members are local. We're very community
based. So our our
our physicians,
team members, and patients are living within the
communities that they're practicing in. So we have
different programs in place to ensure that if
somebody wants to go to school as a
second career choice, how do we support them
to do that? They always wanted to be
a nurse. We we kinda mentor and figure
out different ways, whether it be tuition reimbursement,
scholarships, or things that we're bonusing.
So a lot of detail there. There's a
lot to unpack.
But I I can say that probably stabilization
of the work environment was a key initiative
that we had success with, last year.
Sounds amazing to hear. And, you know, definitely
something that a lot of hospitals and systems
are are trying to achieve. And so when
you think about, you know, reaching those goals
being,
such a low vacancy rate and truly, truly,
having that kind of retention that you need
and then the savings as well by reducing
the contract labor. I know, you know, there's
a lot of components that go into being
a great place to work and,
you know,
setting that right type of culture that people
wanna be at. So, you know, when you
look at that differentiating factor, what did it
take to,
achieve these these results and really transform the
way you were thinking about the workforce?
Yeah. I I first think
nurses
and it's more just that it's not just
nursing, but, you know, we're on that topic
right now. But the workforce wants to feel
respected, appreciated, and that their opinion counts.
So our you know, myself, our CEO,
our COO,
are very
grassroots
oriented that we're at you know, as I
talked to you today, I'm at one of
our hospitals
where we're very we have a lot of
visibility.
I mean, you you're never as visible as
the team members want, but,
we definitely are at the site
routinely to keeping things very real.
And that that's that's I feel very symbolic
on where culture begins.
Our CEO
was a hospital executive or CEO at one
of our hospitals.
Our leadership team, our executive leadership team for
our company network,
all have come from a hospital environment.
And that really pays dividends because the team
members,
they I'll say they I feel like that
they always know a faker. Right? Like, they
can feel like, what are you talking about?
You're saying this, but did you really live
it? And in, you know, truth be told,
myself, the COO, the CEO have done that.
You know, clinicians by background have have literally
rendered patient care and came from very humble
beginnings. So I think culture begins there because
we it is very family oriented. I I
don't just say it to resonate like, oh,
Virginia, you gotta be kidding me. You know,
again, I'm in our company for thirty nine
years.
It is an extension of my house. I
I, you know, have three kids. They're adult
children now, but they they know
where where I practice and what what I
do for a living is extremely important even
to our family.
And so, therefore, that is that translates
because of,
I would say, style and type of communication
being authentic.
Team members know that they're cared for. They
know that they're respected.
We want nurses to work at full scope
of practice and full license.
We partner with our medical community to ensure
that that happens for potentially advanced practice providers.
So, again, culture, it's not I mean, it
could probably be a whole other podcast is
culture really sets the tone of
how you're able to really move the needle
in your in your organization,
whether it be workforce, whether it be financial
results,
god forbid, a situational issue.
You're able to see very,
very clearly in a quick period of time
when everybody's on the same sheet sheet of
music and moving in the same direction, how
you can really make things happen in a
very short short,
and very timely. And I I would say
the definition of that is having a healthy
culture. So I I
appreciate you bringing it up because very often,
when health care executives are asked, you know,
it's about margin and volume,
and we don't necessarily think that way. I
mean, yes, it's those are important,
but at the at the beginning of it,
you know, quality is at the bedside.
How do we make sure that the quality
that we're rendering
you know, how do we make sure the
individuals rendering that care
know you know, are we listening to them?
And that's, again, where it begins with culture.
So probably a long way of answering it,
but that I mean, that's just from, you
know, my heart sharing that with you.
I really appreciate it. And then and such
an important thing to to to share, and
I can tell your passion for what you're
doing and everything that goes into,
the organization there in HMH,
is really shining through. So,
that's amazing. I think when you look ahead
to 2026, are there any other priorities you're
looking at or headwinds that you're focused on,
right now?
Easy answer is yes.
One is,
how and where we can leverage technology.
We we did launch virtual nursing
in the last two years, and we have
a 147
beds,
activated with virtual nursing. So it's a nursing
partner. It's somebody else taking care of the
administrative burden
of caring for the patient. And we are
you know, we'll monitor it for a solid
year to make sure to just to say
it's it's for those 147
beds in four different hospitals, a unit in
all in four different hospitals.
And we're in the process now of evaluating
to see if that's something that should be
expanded
or not.
So I I think leveraging
technology
to lighten the load
for
individuals that are patient facing.
It could be a doctor, could be a
nurse, it could be a PCT. Right? And,
you know, a partner, right, a partner
in care.
So
I would say our one of the biggest
priority or headwind
would be,
leveraging technology
and advancing technology we have in place
as we're monitoring it and, you know, we're
measuring it, what are the benefits, and is
it something that could be expanded?
You know, we can't underestimate the power of
AI.
We we are at Hackstack Meridian, we do
utilize and leverage the EPIC platform,
And we have some generative,
AI that are helping,
nurses with,
notes, you know, end of shift notes to
help,
that,
change a shift,
time to you know, could we
reduce that in any way and can we
be more,
comprehensive?
So, you know, if you would have said
five years ago, we were gonna be leveraging
AI at the bedside, I'd say, I don't
know. I'm not quite there. Now
early adopter, and the answer is yes because
AI can really be another partner
in helping that nurse or clinician care for
the patient. So those are two, I would
say, big priorities for us this year.
Got it. I love that.
Fantastic. Thank you so much for for sharing.
Now what do you think the hardest thing
you're gonna have to do will be in
the next year?
I would say continuing to innovate, you know,
because our our our teams are not,
they're not complacent and just same old, same
old. They're always looking to challenge. There's you
know, with the all the smart scientists and
things that are happening on the technology side,
how can we how can we afford to
be early adopters
when we see benefits of patient? You know,
robotic surgery comes to mind. You know, if
if I mean, you can't argue with the
technology in robotic surgery.
Patients are you know, they're back to work
quicker. They're back to their regular activities of
daily living. They're able to travel quicker.
They have less complications. They have less time,
you know, in the Operating Room. They have
less time in the hospital, meaning more time
with their families.
So, again, that's where technology has really advanced.
So I would just say that one of
the hardest thing is can continuing to innovate
and be early adopters of the technology
as it, you know, as it evolves. Certainly,
I shared on the AI front
or virtual. We have those 147
beds that we have activated.
Well, how do we how do we quantify
the benefits of that? Hard savings. It can't
just be soft. I can't just say to
CEO, oh, so we're retaining nurses longer,
or
we have less incidental
overtime because the the change of shift time
is is quicker. I I need to quantify
with hard savings.
So that's what we're in the process to
do now, and that's hard. Because there's a
lot of soft savings associated with,
virtual nursing.
But, you know, our CEO and board are
gonna look for some hard savings. So those
are,
tough because it's a delicate balance of to
be innovative,
to bring technology to the bedside. But now
that we have it, how do we expand
it? And I'm gonna have to quantify that
with, hard savings. So that's certainly
a that's a it's a big nut to
crack for this year.
Absolutely.
That that sounds like a huge, huge challenge.
And, you know, I appreciate all the dynamics
that go into trying to,
be that innovative
and tech forward organization while at the same
time making sure that you've got,
quality, safety, everything else there, and it can
really prove,
the results coming from those different initiatives. So,
I I love that, you know, kind of
talking about those soft savings, especially in virtual
nursing, and then trying to continue to to
transfer that into the hard savings as well.
Before we wrap up here, I'm curious. How
do you see growth and development over the
next year? Where do you see the best
opportunities to continue growing?
Well, I guess two two things.
We've
had a pretty significant appetite the last couple
of years to expand our ambulatory footprint. You
know, patients that are in hospitals are so
acute. Right? They're really acute. They're the acuity
is high.
They're very sick. Patients are very sick. We
wanna keep people certainly, if they need to
come to us, we we're the we're the
guy to take care of them. I have
no problem with that. We wanna keep people
healthy and happy in their local community environment.
So we've placed ambulatory
locations
peppered throughout the state. As I mentioned in
the outset, we have about 500 locations.
But,
even today, I think there's about 14 or
15 shovels on the ground, different different areas
in New Jersey, building an ambulatory
environment
so that patients can go to to see
their primary care doc, go to a pharmacy,
get a CAT scan, or or an image
done for something. So that's one. The other
is, you know, as we roll into '26,
we really can't talk about health care in
New Jersey with Hackensack Meridian Health without talking
about the FIFA World Cup.
We this global
this global you know, these games are gonna
be played here in New Jersey at MetLife
Stadium beginning this summer July June into July.
And our quaternary facility,
Hackensack University Medical Center,
will be on the world stage. I know
that is this that that our hospital will
be the hometown hospital,
for New Jersey, New York hosting this global,
this global,
game, so to speak. So that on top
of the two hundred fiftieth anniversary of our
country, obviously, we're booked down between New York
and, Philadelphia.
A lot of activity happening in the Philadelphia
market, certainly in the New York market, but
right across the river here in New Jersey,
we'll be hosting the, the FIFA World Cup.
So
that certainly is something it certainly it's a
tremendous opportunity for us, but then it's on
you're on the global world stage of, rendering
care.
God forbid, you know, somebody gets hurt. But
in the world we live in on,
you know, mitigating risk and
protecting those,
making sure that when they go to an
event, it's as safe, right, as safe as
possible, and that they're going to have a
good time. So we'll we're gonna be part
we're,
you know, very much early adoption in the
you know, this plans have been going on
for more over more than a year.
But, certainly, as we get into this year
and opportunities
on the growth side,
you know, we're we're gonna be hosting or
we're we're sponsoring the FIFA, World Cup. I
believe that, you know, New Jersey, it's very
highly diverse,
diverse state.
The post of it as as this the
attention
is on New Jersey for this,
to be, you know, to be shown for
a month, you know, June into July. We're
also gonna build, these, I think, what they're
called, like, legacy fields. So in communities that
need additional fields where kids need, you know,
get away from technology, get outside,
you know, team sport,
be with your friends. Right? Get out in,
get out in the environment.
We're gonna build three three, fields,
in our state so that kids could, you
know, get excited about it as much as
we are, but keeping them more, you know,
in their community. So,
certainly a global platform,
that we'll be able to share, well, things
that are important to us, tackle kids' cancer.
You know, we do have two children's hospitals,
and they're doing a lot of cancer care
with children.
And we have you know, we we wanna
fundraise as much as we can for that
because, I mean, nobody should be nobody should
feel sick or or feel badly. But let
me tell you, when a kid has cancer,
it is, really it's a very pivotal thing
for the those that are caring for the
child as well as the family. So we
have a lot of initiatives behind the scenes
on that. So those are another areas of
growth for us on the philanthropy side.
That's amazing to hear. Wow. A lot of
great opportunities coming up this year. Regina, thank
you so much for joining us on the
podcast today. I really appreciate your time, and
has been a great conversation. I look forward
to seeing you at our annual meeting as
well coming up here. I know you'll be
speaking on a panel, and we'll continue to
to deepen,
some of the themes we talked about here.
And this will be a great opportunity to
connect with all those, from across the country
leading very similar health care challenges as well
as initiatives moving forward.
Sounds good, Laura. You know, flattered to be
asked and, happy to partner with any of
my friends and colleagues throughout our country.