When the baby boomer era had just begun, twenty-five people met in the auditorium of Methodist Hospital in Memphis, Tennessee on November 18, 1952. These individuals, employed by healthcare facilities in the area, were interested in forming a Chapter of the American Association of Hospital Accountants (AAHA). During this post war era of “I Like Ike,” “I Love Lucy,” and the McCarthy hearings, the financial concerns of the Fifties caused these few to recognize the need for affiliation with other hospital accountants. Although six of these individuals were already members of National AAHA, the remainder completed their application for membership. The application fees and the annual dues were $10.00 each for a grand total of $20.00 per person. As a matter of fact, each member was assessed an additional $2.00 to get the Chapter treasury off to a good start! A total of 22 new applications evolved from this initial gathering. Eighteen of the new applicants and four of the existing National members were from Memphis. Some of the institutions represented at this first meeting are familiar to us even now: Methodist Hospital, Memphis Eye Ear Nose and Throat Hospital, Gartly-Ramsey Hospital, Memphis Blue Cross, John Gaston Hospital, Obion County Hospital, Crittendon Memorial Hospital from West Memphis, Arkansas, Oakville Sanitarium, and LeBonheur Children’s Hospital.
On November 22, 1952, a letter was sent to Mr. Frederick C. Morgan, Secretary-Treasurer of The American Association of Hospital Accountants in Rochester, New York, on the formation of the new Chapter, the “Western Tennessee Chapter of the American Association of Hospital Accountants.” In its first meeting, the officers elected for this new Chapter were: C. Henry Hottum, Jr., President; William H. Bennett, Vice President; Ralph L. Roy, Secretary; and Robert M. Gleeson, Treasurer.
The twenty-two new applications stemming from this initial meeting brought the National membership total to 1,591 members, partially fulfilling National’s goal of 2,000 members by the end of 1953. In a December 22 meeting, the new Chapter adopted a constitution, bylaws, and petition for Charter, and forwarded these instruments to the National office.
By January 1, 1953, the Western Tennessee Chapter of AAHA’s membership was up to thirty-three. The first organizational dinner meeting of the Chapter was held on January 29, 1953 at 6:30 p.m. At that time, the officers decided to extend the geographical boundary of the Western Tennessee Chapter to include the middle Tennessee counties of Pickett, Fentress, Cumberland, Van Buren, Grundy and Franklin. In February of the same year, the new Chapter President, C. Henry Hottum, Jr. received a letter from John V. Fletcher of the Baroness Erlanger Hospital in Chattanooga requesting assistance in establishing their own Chapter. National AAHA was very pleased with the efforts and progress of the new Chapter. On February 2, 1953, the Western Tennessee Chapter of AAHA received notification that their petition for Charter had been accepted. The birth of a new Chapter was now complete.
Workshops were held in February and March with topics and papers presented by Chapter members with such titles as: “General Fund Income and Expense Accounts,” “Handbook on Accounting, Statistics and Business Office Procedures for Hospital,” and “Hospital Statistics and Definitions.” These subjects were discussed with twenty attending members. In April, the Chapter’s first survey was sent out to all hospital accountants statewide. Chapter membership at this time had risen to 38, and the Chapter treasury contained all of $66.00.
The formation and organization of the Chapter, and the Institute that followed a short six months later was truly a challenge, as personal letters and memos attest. Most of the communications between the Chapter and National fully describe the eagerness and pleas for help that later evolved into success.
The progress and achievements of the Tennessee Chapter were phenomenal, due largely to the efforts and involvement of the early members, help from National AAHA, everyone’s favorite National representative, Mr. Frederick C. Morgan, and the Tennessee Hospital Association. Perhaps the most difficult achievement of the year was holding a successful Institute within five months of receiving their charter. THA agreed to underwrite the first three day institute held in the event that any deficiency might be incurred. However, the first institute was self sufficient as was nearly every institute from then on.
The highlight of the first Chapter year occurred on May 4, 5, and 6, 1953, when the Western Tennessee Chapter of AAHA held their first three day “Accounting Institute” at the Andrew Jackson Hotel in Nashville, Tennessee. The Chapter’s goal of forty attendees was well realized with registrations of forty-six hospital accountants. National AAHA notified the Chapter that its funds were “extremely limited” at the time, so that only the travel expenses could be paid for one National representative to attend the Institute. Luncheon at the hotel was $1.50 per person. Dr. T. LeRoy Martin of Northwestern University in Chicago, Illinois, conducted the Institute. One of the great highlights of the Institute was the musical ability of the National Representative, Mr. Frederick C. Morgan, Secretary-Treasurer and Piano Player Extraordinaire, at the Institute’s social gatherings.
The Tennessee Chapter’s constitution and bylaws were amended on June 23, 1953 and by July, Tennessee’s first president, C. Henry Hottum, Jr. had been appointed a director of National AAHA. In August of the same year, the first Chapter newsletter was mailed out to a total of 59 members.
In that same year, National AAHA established the Graham L. Davis Award for Chapter Achievement. The GLD Award, which at the time was based on attendance, increase in membership and the number of papers published, was founded in memory of National AAHA founder Graham L. Davis’ recent death. The brand new Tennessee Chapter won the first GLD Award, receiving it in January of 1954. The Tennessee Chapter’s first year was nothing less than an overwhelming success.
In 1954, the Chapter’s second year, National AAHA surpassed their original goal of 2,000 members. National had a total of 33 Chapters, with eight more in progress. Tennessee Chapter members attended the five day National Institute held at Indiana University. C. Henry Hottum, Jr. presided over the National Chapter Presidents Meeting during that institute and was nominated by the Tennessee Chapter later in the year for a National Vice Presidency position for 1956. Chapter attendance for each regional meeting ranged between 71-82 under the Chapter’s second president, Mr. John Blend. The Tennessee Chapter submitted 17 papers towards the GLD Award, one paper over the maximum, at two points each. Tennessee came in third behind Mississippi for the 1954 GLD Award. The biggest industry issue of the year concerned the fact that insurance companies raised their premium rates by 15%.
The highlight of this Chapter year was the Second Annual Accounting Institute held in Gatlinburg, Tennessee. The four day institute was held at the Mountain View Hotel from Sunday, May 16, through Wednesday, May 19, 1954. Sixty-four registrants paid the $20.00 registration fee to attend the two sessions presented. Registrants came from as far away as Georgia, South Carolina, Florida, Alabama, North Carolina, Virginia, Kentucky and Maryland. Forty-two of the registrants were from Tennessee, and 54 registrants were employed by hospitals.
Daily Mass was arranged for the Sisters in attendance and a sight-seeing trip through the Great Smokies was available at $3.00 per person. The Mountain View Hotel served excellent food, and lodging per night for a single room was only $10.00 on the “American Plan.” Additional entertainment was provided at the Sunday evening social by Fred “Play in again, Sam” Morgan on the piano.
The first session was titled “A Workshop on Hospital Accounting Principles and Practice” by Dr. T. LeRoy Martin, and an advanced presentation of formal and informal papers with round table discussions made up the second session. The president of National AAHA, Sister M. Gerald attended; along with Frederick C. Morgan, National Secretary/Treasurer, both serving as faculty. Stanley Pressler, CPA, professor of Accounting at Indiana University; Harold Prather, President of THA; C. Henry Hottum, Jr; Chapter President John Blend; and First Vice President Billy Bartley made up the remaining faculty staff at the institute. The Tennessee Chapter provided textbooks and practice sets to each registrant free of charge. The institute was considered “excellent’ by 80% of the surveys submitted, (Yes, they had to fill them out then, too.) and the remainder rated the institute as “good.” Mr. Frederick C. Morgan stated, “The institute was an excellent success in every way, as far as I could see. You certainly are to be congratulated on having developed such a fine ‘team’…”
By January of 1955, the Tennessee Chapter of AAHA had 67 members. Fifty-eight of these members attended the third Accounting Institute held at the Lookout Mountain Hotel in Chattanooga, from May 16 through May 18, 1955. The registration fee of $20.00 was decreased to $10.00 by Chapter President Billy Bartley in the hopes of attracting more registrants, and the Chapter treasury still showed a healthy balance of $946.84 after institute expenses. Dr. Rufus Rorem, Ph.D., CPA and Ron Jydstrup from AHA were the principal speakers, during this institute. Tennessee came in third for the GLD Award for 1955.
The Tennessee Chapter continued to expand and grow increasingly aware of the financial needs of the healthcare industry. TCHFMA now has a confident voice that is being heard as we make our views on current issues in the healthcare field known. The excitement and eagerness felt by the founding members of our Chapter, and their enthusiasm and wholehearted involvement in striving for the fulfillment of Chapter goals should encourage us as present day members.
They saw with clear vision, the future and the possibilities that lay ahead of this Chapter. We need to keep the same vision before us and apply the same determination and involvement towards achieving our goals today.
When the American Association of Hospital Accountants was founded in 1946 by William G. Follmer, Graham L. Davis, Frederick T. Muncie, and Robert H. Reeves, they had no idea that their association would have such an impact on healthcare financial management. The steady growth and influence of AAHA over the years has been mirrored in the Tennessee Chapter as well. We have much to be inspired and encouraged by, after many years as a Chapter of this organization.
AAHA’s first official journal entitled “Hospital Accounting” was printed in 1947. By 1948, the first AAHA Chapter was formed in Illinois, and in 1949, the association’s first Annual Accounting Institute was held at Indiana University with 80 registrants. The American Association of Hospital Accountants was on its way. However, tragedy struck in the early 1950’s. William G. Follmer was killed, and Frederick T. Muncie and Graham L. Davis both unexpectedly passed away. These tragedies formed the basis for the Founder’s Award Series and Graham L. Davis Award established in their memory.
In 1956, Tennessee past President C. Henry Hottum, Jr. served as Chairman of the Board of Examiners presiding over the formation of the Fellowship Examination. National AAHA hired its first salaried Executive Director and his secretary, moved its headquarters from Rochester, New York to Chicago, Illinois and became a not-for-profit association. The Tennessee Chapter formed a Past Presidents Council which later evolved into the present day Council on Organization and Liaison. Tennessee’s annual institute was held at the Claridge Hotel in Memphis in June of that year. The next year, Tennessee returned to the Mountain View Hotel in Gatlinburg, for their three day institute, meeting in May, 1957. C. Henry Hottum, Jr. served as National AAHA president for a term of 17 months. During his term in office, Mr. Hottum set up the fellowship exam to promote professionalism, revised the Constitution and By-Laws, upgraded the journal, “Hospital Accounting,” developed hospital accounting correspondence courses and textbooks in conjunction with Indiana University, and revised the AAHA seal.
The seal is made up of three parts. The golden STAFF of Aesculapius, the Roman god of medicine is entwined with a single serpent in the green color of the medical cross. Aesculapius was the mythological son of Apollo and the nymph Coronis. One myth states that a daughter of Aesculapius was Hygeia, the goddess of health. The main section of the SHIELD is given to the principal part of the United States’ coat of arms. The top section bears three green leaves representing the Dominion of Canada. The quill pens symbolize the efforts of hospital accountants and bespeaks the office and Purpose of AAHA. The MOTTO is translated “Render an accounting of stewardship,” taken from the Gospel of Luke, Chapter 16, verse 2. This motto is appropriate to the purpose of AAHA and all hospital accountants, which is to make an accounting of the stewardship of the hospital regarding income and expense.
Two years later, in 1958, the Tennessee Chapter returned to the site of their first institute and met at the Andrew Jackson Hotel in Nashville from May 24 through May 27. That year, National AAHA established the Frederick C. Morgan Award for Outstanding Individual Achievement, held its first fellowship exam, and created a permanent Board of Examiners to insure fellowship examination each year.
In 1960, the Tennessee Chapter held its annual institute at the Peabody Hotel in Memphis. National AAHA started the Founders Award Series with the William G. Follmer Award, and set up the 90 Point Club in recognition of points earned towards the annual GLD Award. National also started its AAHA Reference Library with 2767 papers donated by its Secretary/Treasurer Frederick C. Morgan, and adopted a national Code of Ethics.
The following Code of Ethics was established by the American Association of Hospital Accountants to set the proper guidelines for the behavior of each member of AAHA. Each member was to seriously consider these ethical statements as a measure of their professional integrity.
Code of Ethics
I acknowledge that my primary responsibility as a member of the American Association of Hospital Accountants (Healthcare Financial Management Association), regardless of my official title, is to safeguard the organization’s assets and to furnish management with accurate and timely financial and statistical information. While performing my duties, I will be guided by the following principles:
In 1961, the Tennessee Chapter held its annual institute at the Patten Hotel in Chattanooga, and C. Henry Hottum, Jr. received the Frederick C. Morgan Award for Outstanding Individual Achievement. In the next year, National AAHA had over 4,000 members and 63 Chapters. The Tennessee Chapter, under the guidance of Chapter President Fay Lancaster, won the GLD Award for 1962, and established the Henry Hottum Award for Outstanding Achievement. The Tennessee Chapter held their 16th Annual Accounting Institute at the Andrew Jackson Hotel in Nashville, the site of their first institute.
In 1963, at the Tennessee Chapter’s 11th Annual Accounting Institute, the first Henry Hottum Award was presented to James F. Hampton, CMPA. National AAHA celebrated its 15th anniversary and held its first self sponsored Annual Institute. AAHA started the first studies on changing its name to the Hospital Financial Management Association, and formed the AAHA Education Institute which later evolved into HFMEF. One year later, the Tennessee Chapter again won the GLD Award for 1964 under Chapter President Robert R. Gregg, FHFMA. The annual institute was held once again at the Mountain View Hotel in Gatlinburg with the theme of “Learning From Each Other.” The institute emphasized collections and charged a $7.00 registration fee.
By 1966, National AAHA had 68 Chapters, over 6,000 members, and celebrated its 20th anniversary, but perhaps the most significant occurrence of that year was the implementation of MEDICARE. In 1967, AAHA expanded its Founders Award Series with the Robert H. Reeves Award, and one year later, in 1968, changed its name from the American Association of Hospital Accountants to the Hospital Financial Management Association. The new HFMA formed the first Matrix Organization in that year. In 1969, the Frederick T. Muncie Award was added to the Founders Series and HFMA received its first Kellogg’s grant for financial research. The Certified Manager of Patient Accounts exam was established as HFMA’s second professional examination offered to its membership. Boulder, Colorado was chosen as the first Western site for a very successful Annual Institute that year, with 530 attendees.
In 1970, the “Hospital Financial Management Magazine” began being published on a monthly basis and once again the Tennessee Chapter, under Chapter President Sister Mary Placide, was awarded the GLD Award for the year. The next year, the 1971 GLD Award also went to the Tennessee Chapter under the direction of Eleanor T. Dougherty, CMPA, as its President. National HFMA at this time had over 9,500 members, 72 Chapters, and celebrated its Silver Anniversary for 25 years of service in hospital accounting and financial management. A year later, HFMA added 3 new Chapters and had all its membership records computerized. 1973 saw the opening of an additional office in Washington, D.C., with Ronald R. Kovener, FHFMA as Executive Director. In 1976, HFMA celebrated its 30th anniversary with over 15,000 members nationwide.
In 1977, the Tennessee Chapter celebrated its Silver anniversary using the theme “Financial Excellence Through Performance” at its annual institute, with 160 registrants. In the next year, National HFMA hired its first salaried President. By 1980, HFMA established the Robert M. Shelton Award for Sustained Chapter Excellence, moved its headquarters to Oak Brook, Illinois and revised the Graham L. Davis Award’s scoring system to cover separate regions based on membership size. These were named in honor of three outstanding HFMA members: Sister Mary Gerald, Charles F. Mehler, and John M. Stagl. The next year, HFMA had over 20,000 members and Tennessee won the GLD Award 1981 under Chapter President Roger H. Kishman, CMPA. In 1982, Tennessee won the GLD Award for the seventh time, under Chapter President Robert H. Needham, and was also presented the Robert M. Shelton Award for Sustained Chapter Excellence. In the same year, HFMA changed its name to Healthcare Financial Management Association.
In 1985, the Tennessee Chapter established the Director’s Meritorious Service Award, based on sustained service to the Tennessee Chapter, HFMA, aiding in the professional development and advancement of the Chapter membership, improving the public image of the healthcare industry, and is given in recognition of contributions to the achievement of the Chapter’s goals and objectives. The Director’s Award was first awarded that year to Jack J. Fletcher. In 1986, HFMA reached a membership count of over 25,000 members in 75 Chapters, and established the fourth level of the Founders Award Series, the Founders Medal of Honor.
In 1989 in response to increasingly large disparity in the numbers of members in Chapters, a fourth GLD league was formed. The Tennessee Chapter was greatly honored in the naming of this league for our first president, C. Henry Hottum, Jr. This new league would serve for those Chapters with the largest membership of which Tennessee was one of the initial Chapters.
In January of 1991, the first Winter Institute was held at the Sheraton Music City Hotel. In the past a Matrix and Board Meeting had often been scheduled for this time of year and it was felt that by adding educational sessions it would increase participation. The meeting was viewed as a success and it was decided to make this an annual event.
In 1992, the Tennessee Chapter, under the leadership of President Pace Porter and ANI Host Committee Chairman Bob Harriman, was the Host Chapter for the Annual National Institute which was held in June at the Opryland Hotel in Nashville. There were over 1500 in attendance and this Chapter set a new level of excellence for “volunteerism” in helping to make the ANI a tremendous success. Also that year by vote of the Board of Directors the name of the Director’s Meritorious Service Award was changed to the Ira M. Lane Award for Meritorious Service in honor of the recently retired Chairman of the Tennessee Hospital Association for his unfailing support to HFMA over this 33 year tenure.
In 1995, national HFMA in response to a growing population of Managed Care professional established a new Certification Exam. It was first given in June and those members passing the exam and gaining certification were acknowledged with the designation of Certified Managed Care Professional (CMCP).
The Tennessee Chapter has had its first Chapter President, C. Henry Hottum, Jr., held the office of National President, has been a member of the 90 Point Club, received the Robert M. Shelton Award for Sustained Chapter Excellence, and has received the Graham L. Davis Award for Chapter Achievement seven times! In addition, Tennessee has nurtured Certified Manager of Patient Accounts and Fellows.Tennessee has had one national life membership conferred to C. Henry Hottum, Jr., and has conferred Chapter life memberships to outstanding individual members. Tennessee has grown from 22 members to over 850 members in three regions, covering the entire state.
Tennessee shares in the national HFMA purpose of improving the financial management of the delivery of healthcare services and in providing service to and representing our own members. Tennessee Chapter HFMA’s objectives are being met through the efforts of its officers, Board of Directors and involved members by: fostering proficiency in financial management through education and information; providing opportunities for professional development and growth; influencing public policy; communicating information; strengthening cooperation among financial disciplines; joining in common endeavors with other organization and agencies; establishing financial management principles; upholding ethical standards; and undertaking research.
Throughout the years of existence we can be sure that ours is not an ordinary history, and that the Tennessee Chapter has not had an insignificant role in national achievement. Perhaps we can be challenged to greater heights of success and achievement with anticipation and pride. Knowing that our Chapter has had its share of trials as well as successes should make us even more aware of the firm foundation that Tennessee members have built over the years. The past achievements of our Chapter provide a standard with which we can compare and improve upon. However, a Chapter can only be as successful as its most improved members. We must continue to get involved and improve the services we offer not only to our members but also to our patients and our communities. We must not rely on “Somebody Else” to get involved for us. Success will fall into the hands of those who reach for it.
In the last 50 years, the Tennessee Chapter has proven itself to be team oriented one of the attributes most important to successfully pooling talents and energy. The achievements of a Chapter not only involve the “high” moments of being in he spotlight, but also those times when service has been quietly performed without applause for the good of all concerned. The Tennessee Chapter has proven itself to be dedicated to the causes of healthcare financial management regardless of whether appreciation or attention has been received. The Tennessee Chapter membership can be assured that they have performed the purest form of service. Its membership has served it well.
In 1997-98, HFMA National discounted the GLD awards to provide focus of achievement awards for any and all Chapters deserving recognition for meritorious activity.
The awards and recognition program is designed to provide incentives and recognition program is designed to provide incentives and recognition of Chapter activities to achieve results as defined by the Davis Chapter Management System policy. The Awards and Recognition Program of the Davis Chapter Management System should:
The 1998-1999 Chapter year was a year of successes and awards for the Chapter. For the second time in seven years the Tennessee Chapter was host to the HFMA Annual National Institute. A Chapter web site was established, the CPAR program completed, and a comprehensive Chapter survey was conducted. Chapter finances were increased to record levels with net assets and net income at all time highs for the organization.
The Chapter received the Sister Mary Gerald Bronze Award of Excellence for outstanding performance in education and programming by providing 11,746 hours of education during the 1998-1999 Chapter year. Also, the Chapter was the recipient of the C. Henry Hottom Award for Significant Improvement in Educational Performance for its’ efforts in increasing education hours by 28.2% over the previous year. In addition, the Tennessee Chapter won four (4) Helen M. Yerger Awards for Outstanding Effort and Excellence In Improvement and Innovation for programs and projects completed during the year.
Richard Henley, HFMA’s 1999-2000 National Chairman selected the theme “Leading with Integrity – The Bottom Line” as the association’s theme during his term. He chose this theme to raise the credibility of the profession and the industry in the eyes of the public. Healthcare finance professionals must have the necessary information to recognize skills and ethical threats while serving as the advocate for organizational integrity. HFMA’s leadership is steeped in integrity. The Tennessee Chapter adopted this theme to promote Chapter activities to encourage members to embrace integrity leadership both personally and professionally.
The Tennessee Chapter submitted an aggressive Strategic Plan to address service to members, quality service, Chapter growth, and Chapter leadership. The reporting year experienced strong participation by members who had previously been involved; it also experienced growth in leadership through new members and members who had not previously been involved. The volunteer commitments of Chapter members provided the source to meet many of these goals and achieve the successful year recognized by National. The success story includes:
The Chapter collaborated in the academic environment with Vol State Community College for education courses offered to patient accounts representatives and medical record coders.
Forty-one new CPAR’s passed the CPAR exam.
A membership survey was conducted. Incorporated in the Strategic Planning for future activity is the result of a membership survey to identify member needs and desires.
The Tennessee Chapter of HFMA received seven National awards. Three awards were Davis Chapter Management recognition. The John M. Stagl Silver Award recognized the average number of 13.63 education hours per member. Total education hours increased from 12,900 to 13,200 to merit the C. Henry Hottum Award for Education Performance Improvement of 9.93%. National offered its first award for number of certified members. The Tennessee Chapter received the bronze award for the Awards of Excellence for Certification. Certified members in the Chapter represent 7.39% of the Chapter’s membership.
Additionally the Tennessee Chapter won four (4) Helen M. Yerger Awards.
Tennessee Regional Concept
Because of the size and shape of Tennessee, the Tennessee Chapter of HFMA is an example of a successful regional organization. Two advantages of a regional concept are: (1) the reduction of distance in traveling to meetings, and (2) the ability to concentrate on programs, ideas, and context pertinent to local interest. Two (2) regional meetings (in each area) plus three (3) statewide Chapter Institutes are scheduled each year.
In 1952, the Western Tennessee Chapter was chartered and discussion with interested hospital accountants across the state resulted in forming a statewide Chapter with three (3) regions – Eastern, Middle and Western.
The three (3) region concept utilized by the Tennessee Chapter has added strength to the Chapter, created additional leaders and encouraged membership from all of the healthcare organizations in the state. The Tennessee Chapter has created an atmosphere of competition among the regions, yet retained its oneness of purpose.