Global Small Business Success: What Does It Take?

Small businesses are the backbone of our state and national economy.

According to the Small Business Administration, small business represents 99.7 percent of all employers, employ half of all private sector employees and pay 44.3 percent of total U.S. private payroll. Nearly 40 percent of these small businesses are in the technology fields and 53 percent of them are home-based.

Clearly, national and state policy-makers should be listening to what small business wants and needs to succeed in the global economy.

What do we need to push forward?

Read the opinion piece here but I think we need a lot more than this.

In-fighting in the Medical Community

Red River Valley Radiology Associates, one of the hospital's most consistant tenants, is being evicted, according to one of the radiologists.

They've not just said that they were not going to renew their lease, they are attempting to vacate it and the building of its tenants.

Possibly it's the pressure of competition, since RRVR has managed to keep fully qualified staff, while the hospital's radiology program has suffered an almost complete turnover since the purchase by Essent. Currently the hospital is desperately searching for a registered vascular sonographer, since their one and only has quit. Regulations require the hospital to have one on staff in order to bill for vascular exams, a large source of revenue for any hospital.

Since Essent has taken over, the hospital has lost their two main CT technicians, two nuclear medicine techs, two sono techs, and various other experienced x-ray personnel. They have replaced them with students fresh from classes, some not even registered to perform the exams that they attempt.

Red River, on the other hand, has maintained a consistancy that chacterizes a family business.

The hospital has recently established a policy of salary compression--essentially saying that a nurse with 20 years of experience has no more worth than that with 15...which caused another exodus of experienced nursing staff...driving some of the physicians to screaming fits during rounds. (Not quite screaming, medical professionals would never do that....)

Essent Drops One....

SSM Health Care Finalizes Purchase of Crossroads Regional Medical Center, Renames Facility SSM St. Joseph Health Center-Wentzville

SSM Health Care-St. Louis announced today that it has finalized the purchase of Crossroads Regional Medical Center (CRMC) in Wentzville and renamed the facility SSM St. Joseph Health Center-Wentzville.

Beginning today, SSM St. Joseph Health Center-Wentzville will offer patients in Wentzville and surrounding communities a 24-hour emergency department, as well as convenient access to outpatient programs, including diagnostic services such as radiology (MRI, CT and mammography), laboratory, cardiology and pulmonary services. Following some minor facility modifications slated for completion by December, the hospital also will offer inpatient and outpatient behavioral health services.

“Our primary goal has always been to deliver services that meet the community’s most critical needs, particularly emergency room and outpatient services. Today, we begin that journey,” said Ronald J. Levy, president and chief executive officer of SSM Health Care-St. Louis. “SSM St. Joseph Health Center-Wentzville will provide quick, convenient access to a variety of health care services while maintaining flexibility for future growth.”

Paul Convery, M.D., interim president of SSM St. Joseph Health Center, St. Charles, will oversee St. Joseph Health Center-Wentzville until Nov. 28. At that time, Sherlyn Hailstone will become president of St. Joseph Health Center, St. Charles; St. Joseph Health Center-Wentzville; and St. Joseph Medical Park. Hailstone, currently executive vice president/chief executive officer of Saint Francis Hospital, a 405-bed community teaching hospital in Evanston, Ill. was named president of St. Joseph Health Center, St. Charles, in October.

SSMHC-St. Louis announced in September that it had reached an agreement in principle with Essent Healthcare to purchase CRMC. The hospital, known as Doctor’s Hospital before being acquired by Essent in 2000, faced intense market pressures that threatened its future. Most notably, CRMC was located in a community with a relatively young population, which made it difficult to sustain a full-service hospital. Essent said in August that it was faced with two options for CRMC: Close the hospital, or find a new partner. SSMHC-St. Louis obtained in October the necessary zoning and regulatory approvals to finalize the purchase.

With 7 hospitals, nearly 2,000 staff physicians and 8,600 employees, SSM Health Care-St. Louis is committed to serving the comprehensive health needs of St. Louis area residents. Sponsored by the Franciscan Sisters of Mary, the health care network includes SSM Cardinal Glennon Children's Hospital, SSM DePaul Health Center, SSM St. Joseph Health Center, St. Charles, SSM St. Joseph Health Center-Wentzville, SSM St. Joseph Hospital West, SSM St. Joseph Hospital of Kirkwood, SSM St. Mary's Health Center and SSM Rehab, plus three medical groups: SSM St. Charles Clinic Medical Group, SSM Medical Group and SSM DePaul Medical Group. Its parent organization, SSM Health Care System, also based in St. Louis, in 2002 became the first health care recipient of the Malcolm Baldrige National Quality Award. The system owns, operates and manages hospitals and nursing homes in four states: Missouri, Illinois, Wisconsin and Oklahoma.

Well folks, in other related news, it was disclosed that they lost money in all but one year of ownership of Crossroads.

The Role of Small Businesses In Exports to China

In Export.Gov

Go here to download report.
Then click on "The Role of Small and Medium-Sized Enterprises in Exports to China: A Statistical Profile."

Get the scoop on what's really going on and then get going! The data represented is from 2002, the last year for which data are available. It's phenomenal! You won't want to miss it.

20 Women Exporters Take Part In Training

In IPPMedia

An institution dealing with women entrepreneurship development (WED) and the Small Industries Development Organisation (SIDO) have organized a five-day training session in Dar es Salaam to make women exporters in Tanzania become competitive in the global market and increase their capacity so that they can engage themselves effectively in international trade.

Read the article here.

A Global Checkup: Diagnosing the Health of Today's Organizations

In Strategy+Business

Nearly 50,000 profiles completed over two years by individuals around the world are consistent with one central hypothesis: Most organizations are unhealthy. Find out why here.

Global Business Columnist

In PRWEB

It's official!

CHICAGO, IL (PRWEB) November 11, 2005 – Laurel Delaney, an international entrepreneur and author, will become a global business columnist for Entrepreneur magazine on Nov. 1.

Read the release here.

I just hope I can follow through on my remarks: “There are just no more excuses on why companies aren’t going global,” Delaney says. “Rather, this is the beginning of a global small business revolution.”

Essent, on prowl for hospitals, hires 2 hunters

Roy Moore
Nashville Business Journal
Hud Connery is taking Essent Healthcare back into the hospital acquisition game, aided by a revamped development team.

The $340 million Nashville company has brought in Gregory Schonert and Austin Craun to find development opportunities.

CEO Connery's new executives have backgrounds in REIT financing and health care analysis. He'll need them both because, for every potential deal, the company has to look at a dozen others. "You've got to turn over a lot of stones," Connery says.

Earlier this month, Essent closed on its purchase of Greene County Memorial Hospital, a 54-bed facility near Pittsburgh that has since been renamed Southwest Regional Medical Center. Essent has also expressed interest in a North Carolina hospital HCA is leaving, putting the company in competition for the deal with other area providers.

Industry watchers shouldn't expect Essent Healthcare to morph into a fast-growth company that cobbles together properties across the country. Essent, whose five hospitals could grow Essent into a $400 million company by themselves, was in the running for another Pennsylvania hospital, but walked away because the deal didn't make any sense.

"We remain very deliberate. Some would call us cautious and deliberate, and I don't mind that label," says Connery, who earlier served as chief operating officer at HealthTrust, a Nashville chain that grew to 110 hospitals before merging with HCA.

Essent has garnered that label for adding only a few hospitals while others in Nashville went on spending sprees to piece together portfolios of hospitals. That cautiousness was highlighted in a decision to effectively shut down the acquisition pipeline after the sizable purchase of a hospital in Paris, Texas, nearly two years ago.

After that deal, which brought a lender and investor into Essent, Connery wanted to take a step back and integrate the facility into his company. With that point reached, Essent is returning to acquisitions, but officials aren't forecasting the number of centers they want to add.

The company is unique in the areas it targets. While most of the Nashville chains look for opportunities in the Sun Belt, Essent mostly has shunned those opportunities, believing the prices are too high. Instead, Connery treads into the Northeast and more mature communities, such as Paris, Texas, where the valuations are more reasonable and the returns are just as strong.

Because these areas don't have the growth rates of the Sun Belt, they've been passed over. Plus, there are the high regulatory hurdles that lie in New England. Essent's Sharon hospital became the first for-profit medical center in Connecticut and required the approval of the state's attorney general.

But Schonert, Essent's senior vice president of development, sees opportunities in these areas. They have a good payer mix, a large population and a high number of older residents. In Haverhill, Mass., where Essent owns Merrimack Valley Hospital, there are only four community hospitals for an area the size of Nashville, and Connery brags about transforming Merrimack into a top 100 hospital nationally.

Moving into older areas does bring its challenges, however. All of Essent's hospitals are more than 100 years old and the communities there tend to have a strong attachment to them. Because of their age, these hospitals need a capital infusion to end their runs of losses. "Rarely is a hospital put on the market for sale that's doing well," Connery says.

For these communities, the goal is to keep the hospital open. Don Headlee, chairman of the Greene County hospital board of trustees, says the deal with Essent allowed the community to keep its hospital and benefit from the sale's proceeds. Tough measures were needed to turn the hospital around, including union agreements with the nurses, 50 of whom left on the first day.

"This is a marathon. This isn't a 100-yard sprint," Connery says. "These hospitals are in pretty bad shape. It doesn't get done in a day."

Abridged Borderbuster 11/4/05

CONTENTS

If you are not a subscriber to Borderbuster, here's a glimpse of what you missed this month:

1. Welcome From The Publisher
2. Feedback From Our Readers
3. U.S. Must Help Iraq Obtain Wealth Quickly*
4. Business and Cultural Tips: Have Some Fun!*
5. Foreign Shopping Sites Cater to U.S. Customers*
6. How I Went Global: Ongoing Series // GlobeTrade.com
7. A Reader Asks: Q&A*
8. Everybody Loves a Freebie -- repeat: FREE OFFER*
9. Expanding Internationally: Grow As You Go*
10. The Importance of Developing An International Strategy*
11. Executive Planet*
12. Blog World: A Feature On Wal-Mart*
13. Laurel’s New e-Book Is Ready: “GODZILLA Global Marketing!”
14. Take A Walk On The Wild Side (TAWOTWS)*
15. Wind Behind Your Sail*
16. Miscellany*
|||||||||||||||||||||||||||||||||||||||||

Published in Chicago – “Home of The World Series Champion White Sox!” – Congratulations!

*Indicates exclusive to Borderbuster subscribers only.

Sample section:

9. EXPANDING INTERNATIONALLY: GROW AS YOU GO
*Subscriber Exclusive*

Large companies routinely take advantage of the enormous potential of international markets. They simply budget for the expansion, spending whatever it takes to build the infrastructure to support future revenue. Entrepreneurs, on the other hand, have limited resources, few connections, and tight budgets. When they go global, they need to be convinced that they are doing the right thing.

To read the balance of the article, visit:
EntreWorld

###

To subscribe to Borderbuster, visit:
Sign Up For Borderbuster!

Going Global: Help For Small Manufacturers

In Industry Week

Despite the criticism of the federal government's trade policies that some say have effectively allowed foreign competitors to gain unfair advantages against U.S. makers of goods, at least one Commerce Department program is aimed specifically at helping small and midsize manufacturers to thrive in the same big pond with the sharks.

Read the article here.

The Three Hurdles Of Global Web Sites

In Optimize

One of the most difficult issues companies are dealing with in the new global economy is thinking locally and managing globally. Sure, companies have always had international divisions and subsidiaries, but they tended to be isolated fiefdoms. Now the global economy requires that companies use their Web site to provide a consistent image to customers, no matter where they are. But companies can't just impose a one-size-fits-all view on their Web site.

Here's what they have to look out for:
http://www.optimizemag.com/article/showArticle.jhtml?articleId=171200563

Going Global: Can You Afford It?

In WorldWIT

Determining how much you can afford to invest in your international expansion efforts can be a tricky proposition. Will it be based on ten percent of your domestic business profits or on a pay-as-you-can-afford process? That’s an excellent question. And my answer is: It depends.

Read more here.

And a big thank you to our favorite webinar place -- shhhhhhhh ... a best-kept secret -- for letting us know the article was published.