b. Screening out unethical employees
c. Both a and b
d. None of the above
National Medical Enterprises, Inc. (NME) is a multinational health care enterprise with
143 hospitals on four continents. NME was started by Richard K. Eamer, a tax attorney,
in the 1960s. Eamer’s development of NME was possible because of the
implementation of the Medicare and Medicaid programs. He saw the programs as
opportunities for a virtual guarantee of profits.
He began by acquiring six hospitals. He paid for these hospitals with promises to the
physicians on staff of stock in his company. After the six hospitals were acquired,
Eamer did a $25 million national stock offering and gave the physicians shares of stock
in NME.
Eamer adopted a decentralized structure for the company. Hospital managers were
simply given a financial goal and complete autonomy in their operations. Eamer
traveled a great deal and used a company plane to get to NME-owned condominiums in
London and Aspen. While Eamer was not a hands-on manager, he set very clear goals
for NME managers. Achievement of established goals was rewarded. Under NME’s pay
structure, it was possible for managers to double their pay by meeting goals. Eamer was
harsh when goals were not met. In meetings he would refer to those executives who had
failed to meet established goals as “morons.”
Eamer’s managerial style paid off in the form of earnings growth of 15% per year
through 1985. But, in 1986, earnings growth was off, down to 3%.
When informed by his managers of the decline in earnings growth, Eamer announced
that NME would now focus on operating and acquiring psychiatric, substance-abuse
and rehabilitation hospitals. NME had 62 psychiatric hospitals in 1986, but by 1991,
that number had grown to 86. Further, NME occupancy rates for its psychiatric
hospitals were 25% higher than any of its competitors. NME maintained an occupancy
rate of 84%.
The director of NME’s Fair Oaks Hospital in New Jersey, testified at a Congressional
hearing that NME executives circulated information on how to maximize insurance
payments. Strategies included longer stays and additional tests.
NME’s intake manual specified as a goal that one of every two people who came to the