William Edward Deming, an American Statistician and one of the fathers of total quality management once said “It is not necessary to change, survival is not mandatory”. The aforementioned statement by Dr. Deming predicates one’s survival on their ability to change. The social, political, and economic landscape of today mandates that organizations be flexible and adaptive to change. How change is managed is extremely important. Successful Change Management efforts can lead and organization forward or be the cause for an organization’s demise. For over a decade, the University of Medicine and Dentistry of New Jersey has faced numerous internal and external problems; these problems have contributed to its persistent decline. Currently the organization is facing considerable pressure to divest successful assets such as the Robert Wood Johnson Medical School, The Cancer Institute of New Jersey, and the School of Public Health. These changes could potentially weaken an already volatile organization and have several implications for the UMDNJ system, medical care in New Jersey, and municipalities where the organization is located. A change management model proposed by two scholars Cummings and Worley will be used to analyze how UMDNJ should manage and transition through the changes they are facing.
Section 1
The University of Medicine and Dentistry of New Jersey—more familiarly UMDNJ—is a system of eight healthcare schools that serve approximately 6,000 students. (Stainton 2011) The eight healthcare schools include New Jersey Medical School, New Jersey Dental School, Graduate School of Biomedical Sciences, School of Health Related Professions, and School of Nursing, all of Newark, the School of Public Health and Robert Wood Johnson Medical School, both in New Brunswick, and the School of Osteopathic Medicine located in Stratford. UMDNJ also operates the University Hospital in Newark, while Hackensack University Medical Center in Hackensack, Robert Wood Johnson University Hospital in New Brunswick, and Cooper University Medical Center in Camden are all affiliates. UMDNJ is the nation’s largest healthcare college not associated with a larger, general-studies university. (Stainton 2011) With so many different pieces comprising UMDNJ, it has not been feasible for all the parts to be successful under the present and past leadership. Currently, different pieces of the UMDNJ campus are more successful than others making the merger between Rutgers and UMDNJ even more difficult. Today, the most successful pieces of UMDNJ are on the New Brunswick campus which includes the Robert Wood Johnson Medical School, the School of Public Health, and the Cancer Institute of New Jersey. Other pieces of UMDNJ, however, are not doing as well and are putting a strain on the merger. These pieces include the medical schools in Stratford and Newark as well as University Hospital in Newark. The status of these centers has many people worried as they provide healthcare to many residents who may not otherwise be able to afford it. For this reason, University Hospital in Newark drains a good deal of UMDNJ’s money, but still remains one of only three trauma centers in New Jersey.
Section 2
UMDNJ is the largest public university for health sciences in the country, with five regional campuses, more than 4500 students, and $1.6 billion in annual research grants. UMDNJ has suffered from numerous financial problems over the past decade. From 2001 – 2008 the average deficit for the university was $22 million. Under a slow and weakened economy, the organization has faced five years of decrease in government aid. The decreases in aid have continued amidst increased operational cost. During the 2009 fiscal year, there were $22.4 million dollars cut from the UMDNJ budget, $3 million increased energy cost, $4 million in higher interest payments on debt service. University Hospital paid a $9 million Medicaid fine in 2009. (William 2009) Even worse in FY2011, there was a 15% decrease in direct aid from government under the higher education budget cut policy and a $31 million “University Stabilization Fund” was cut as well. (William 2011) In 2009, UMDNJ had $46 million of state Medicaid debt and $23 million was owed.(Jojo 2011) In order to cover the deficit, UMDNJ issued $260 million NJEFA education bond that covers $23 million of their Medicaid debt and other $23million was put off until 2018. (NJEFA 2009) However, Student tuition/state aid/fees will pay off 7.47% interest of the bond for thirty years. It is no wonder tuition has been hiked last decade. 2008-2009 fiscal year witnessed a 9% was increased, and on 2010-2011, 18% was increased.(UMDNJ 2011) The state bails University Hospital out of that deficit every year so far; they had never let it shut down, as it would be a catastrophe. Even though University Hospital is nationwide recognized, its growing debt and constant tuition increase cannot continue.
UMDNJ has been under microscope since it suffered a series of scandals, patronage and frauds. In recent times the scandals have been diminished but, the school is still under scrutiny due to its on-going talks of a merger with Rutgers University. The medical fraud probe at UMDNJ spawned more than a hundred investigations. One of them – the Bryant probe reveled what then U.S. Attorney Chris Christie called as “one of the most brazen example of public corruption he had ever prosecuted.” In March 2007, Christie indicted twenty count corruption charges against State Sen. Wayne Bryant and former Dean at UMDNJ Michael Gallagher, in which Gallagher created a bogus $38,200 a-year job for Bryant in return for using his role as State Senator to get money for the university. Bryant returned the favor by pushing Gallagher up among the high ranking New Jersey official resulting in nearly $99,000 in incentive bonuses in 2003 and 2004. The indictment said Bryant phony UMDNJ job as bribe.
The original UMDNJ medical fraud was estimated at $4.9 million, but investigation by Herbert Stern appointed as monitor by Attorney found evidence totaling the medical billing fraud about $70 million. Adam Henick, the former Vice President of ambulatory care at University Hospital, confronted UMDNJ official about rampant double billing of Medicaid by University hospital and university Physician Associates. Over a ten year period fraud Henick claims, the University overcharged Medicaid by as much as $ 2 million a year – a total of $ 10 to $ 20 million.
Henick says he made series of unsuccessful attempt to persuade the university legal and financial officers to stop the practice. The university recognized it mistake and tried to find solution to cover it up, but couldn’t find any. Henick then took this allegation to federal office of Inspector General in Washington, he claims his complaint ultimately lead to his firing in February 2007.
With a culture of corruption well-established at the administrative level, the school's students naturally followed suit. On the student front, revelations flowed from the federal monitor. Approximately twenty dental students were implicated in a cheating scheme in which they were given credit for course work not done. It is not known how long the scam involving false credits for learning how to do root canals, crowns, and extractions had been going on for at the dental school. In another instance, the associate dean for academic and student affairs at UMDNJ's Camden campus, Paul Mehne, pressured directors at the school to give passing grades to some medical students who failed standardized tests. Some of those students are now practicing doctors today.
The federal monitor, then targeted the heart unit. Stern found that the university, in violation of federal law, had offered high-paying faculty jobs to eighteen cardiologists in exchange for the doctors’ referring patients to a failing cardiac surgery program that the state was threatening to shut down because of poor performance. The monitor accused cardiologists with referring patients for nearly $36 million in illegal Medicare and Medicaid.
At a lower level, Michael Nappe, a billing manager at UMDNJ, said the University moved his office to lunchroom, demoted him and wouldn’t give him raises after he blew the whistle on a scheme to cover up more tham $ 25 million in padding bills. According to Nappe, he objected to an accounting system aimed at hiding the high cost of telecommunications contracts acquired illegally. Fake invoices billed university departments for services they never received to hide the inflated bills, including $301,660 to remove two computer viruses.
Governor Christie and former Governor Thomas H. Kean, recommend an overhaul of medical research and education across New Jersey. Some of their ideas include merging medical training with other higher education in the state. One major decision was reuniting Rutgers University with Robert Wood Johnson Medical School in New Brunswick and Piscataway. This will also help them achieve higher funding as most medical schools are affiliated with top research universities. Re uniting Rutgers and UMDNJ is critically important for medical education in the state.
Section 3
A culture of resistance has surfaced amid talks of a merger. Resistance has come from multiple stakeholders inclusive of; UMDNJ board of directors, members of the Newark Community, and UMDNJ staff to name a few. Two key problems in the merger of UMDNJ and Rutgers University, is UMDNJ’s board of directors’ attitudes toward the merger and their management of the change in general. When considering moving the organization forward we suggest the following measures be taken.
Motivate the Change
 UMDNJ’s board of directors need to understand the reality that they are undergoing major changes.
 The idea that UMDNJ will be weaker due to the loss of three successful assets, needs to be abandoned. A new proposed philosophy is that the change will create a more powerful, resourceful, and even better UMDNJ; due to the input of all stakeholders needs to be adopted.
 UMDNJ, needs to be transparent about the changes that are taking place. During this stage they get all stakeholders to understand the tough position that they are in and that these changes must take place. In this stage all stakeholders are included in making the decision.
 The stakeholders must be made aware of the challenges and understand that this organization cannot continue on a downward trend.
 Stakeholders will be informed that this change is not negative even though it is rooted out of the necessity to change.
 The workers must understand that the UMDNJ board of directors has them in mind. The board is concerned with their livelihood, their success, and the success of their family.
 Get everyone excited about building a new UMDNJ and the opportunity to transform the organization, the community, and their lives through these changes. Everyone has to feel and know that the board of directors has everyone’s best interest is in mind.
Create a Vision
 Everyone should unify behind one purpose making a tough decision and managing the downside.
 UMDNJ shows the students, employees, and the community the possibility of how great it can be in the future.
 A plan is created to make the failing units to self sustaining.
 A plan is demonstrated that will ensure that debts are paid off and that the organization is fiscally sound.
 Everyone will know their role in rebuilding the organization and how to make this transition work. In this step UMDNJ Board of Directors prove to the employees, students, and the community that it will emerge as an innovative and powerful force in medical care and education.
 All stakeholders should know that they are a part of the team which will drive the organization forward.
 Employees should know that UMDNJ is making a plan to minimize the amount of job loss and ensure job placement for downsized employees or they can get a new position within the new system
 UMDNJ researches best practices which will cut their cost
 UMDNJ will innovate and create new business by expanding into markets in which they have core competencies or ability to meet a need thereby generating more revenue
 Finally rebuilding the organization’s reputation and viability.

Develop Political Support
 Internally UMDNJ Board of Directors Need to get everyone on board with the changes starting with the Deans. Garnering the support of the deans will help to get each department onboard with the changes.
 Externally UMDNJ Board of Directors should seek to get the support of community leaders and educate them.
 At the lowest level of the organization students need to be informed of the changes and support the changes.
Manage the transition
 As the merger takes place it is important that they stay consistent with the promises made earlier.
 It is important that the leadership communicates with everyone and does so in a sincere way
 The expectations of stakeholders should be managed
 All parties involved with the change should continue to communicate why these changes must take place, how instrumental everyone is in this change, and the benefits of the change.
Sustain the momentum
 Now that the changes have taken place it is important that everyone not abandon the operations. It is extremely important that everyone continues to do their best to fulfill the plans and ensure the continuity of the newly formed UMDNJ.
 Review committees should monitor the changes taking place and make sure that all the plans are being executed correctly.

As the merger pushes forward, there are still some obstacles that can possibly stand in the way. First of all, it is unknown what will happen to all of the pieces of UMDNJ. One question the government will have to answer regarding the merger is what to do with the failing pieces of UMDNJ. Another obstacle stopping the merger may be UMDNJ itself. There are many administrators and employees of UMDNJ who do not want to see the merger go through and that must deal with the uncertainty that comes along with the merger. Finally, one of the biggest threats to the Rutgers-UMDNJ merger is the money that is needed. The merger will not come at a small cost and could be a difficult endeavor looking at the state of New Jersey’s economy. In order for this merger to be successful and produce a cohesive unit, there are a number of processes that must be put into place. First of all, we believe that it will be beneficial for all parts of UMDNJ, even the failing ones, to merge with Rutgers. Rutgers is a successful university with rich tradition that should be able to help some of the struggling parts of UMDNJ. Also, we believe that the change associated with this merger should be instituted from the top down starting with the administration. If the administration is not able to successfully manage the change, how can they expect other employees to? Finally, communication is extremely important when it comes to change. Rutgers administrators must communicate effectively with UMDNJ administrators as well as other employees in order to ensure that the change is working properly and continuing to move in the right direction. The successful implementation of this change will make other changes easier in the future. For over a decade now UMDNJ has been trying to resolve the problems they faced. Unfortunately for them, with every passing year their financial burdens seem to be getting worse. Lack of grants from the state has added to their woes. The doctors, staff and students will have to accept the transition which is almost certain now. The citizens of New Jersey who depend on the medical care provided by UMDNJ will also be hoping for a smooth and quick transition. Changes are never easy and for an organization as large as UMDNJ it is going to be harder. Cummings and Worley change model suggests how UMDNJ can ensure an efficient transition.

References:
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Joan Whitlow, November 25, 2011 The Future of UMDNJ in Newark: What’s behind curtain number three? Retrieved on December 10, 2011 from http://blog.nj.com/njv_joan_whitlow/2011/11/the_future_of_the_umdnj_in_new.html

Lilo H. Stainton, May 3, 2011 Medical History: UMDNJ’s Long path to Reform Retrieved on December 10, 2011 from http://www.njspotlight.com/stories/11/0502/2224/