MEEKER | The Eastern Rio Blanco County Health Service District (Pioneers Medical Center) Board of Directors held its regular monthly meeting for September last week.
Chief Financial Officer John Nadone provided updates on the facility’s operations and outlook. He noted a minor downturn in August due to wildfire-related postponements, but said most canceled procedures have been rescheduled and retail pharmacy sales have remained strong. Overall, the hospital reported a near break-even performance year to date, with an $8,000 net loss after accounting for depreciation and amortization.
The board also discussed national trends affecting rural hospitals, including the potential loss of Affordable Care Act subsidies and ongoing Big Pharma lawsuits over 340B drug rebates. Several large insurers — including Anthem, Humana, UnitedHealthcare and Aetna — are pulling out of Medicare Advantage markets nationwide, which could limit options for patients.
To help the community navigate these changes, the hospital will offer educational sessions on Medicare Advantage and supplemental plans beginning Oct. 14 at 9:30 a.m., with staff available to guide participants through their options.
During the finance meeting, board secretary and treasurer Sherri Halandras raised a question about whether hospital employees who traveled with residents during the wildfire evacuation were compensated.
“Were they really compensated for time away from their family, were they given some kind of bonus, but were they paid mileage for travel?” Halandras asked.
Hospital leadership responded that employees affected by wildfire evacuations were compensated for their time, travel, hotel stays and meals. Payroll and staffing costs, they said, remain largely fixed. Looking ahead, the 2026 budget projects growth in orthopedic services with the addition of a second surgeon, which will increase surgical volume and support staff costs. The budget also anticipates a slight decrease in the county mill levy — about $460,000 — as well as increases in contract labor and service fees.
Despite tight margins and mostly fixed expenses, Nadone said the hospital remains financially strong, with a cash position of roughly $13 million, and expects a modest positive margin next year. He said the hospital will continue close expense monitoring early in 2026 to stay on track financially.
After the finance meeting, the board moved into the regular session. Halandras raised the issue of whether minutes should include detailed narratives or remain a concise record of actions taken in accordance with Robert’s Rules of Order, rather than a transcript of discussions.
“The minutes should focus on motions, votes and decisions made, not on individual opinions or debates,” Halandras said. “They should also include the names of those who make the motions. The first one was regarding the apartments. There was quite the discussion regarding apartments, but one board member was quoted. I don’t think you can pick and choose who is quoted — I really think you should stick with actions taken and discussion items that were discussed.”
Executive Assistant Natalie Scritchfield responded, saying, “I think it’s really important that the minutes offer a fuller picture than ‘apartments were discussed, no decisions were made,’” she said. “I do think there are a lot of special community members who rely on the minutes to understand what we speak about. I think that there is always opportunity to be more objective, and I am happy to take that feedback.”
The board ultimately approved the minutes as presented and agreed to meet separately to establish a consistent format for future records. Before moving into reports, members confirmed updated committee designations, with Halandras appointed to the Finance Committee and Jean Gianinetti to the Quality Committee.
CEO Liz Sellers reported that remodeling work on the hospital’s employee housing units is nearly complete, with two apartments currently being renovated and expected to be finished this week. Once seasonal Bureau of Land Management tenants vacate their units later this fall, three additional apartments will become available, bringing the total to five completed units, with the potential for three more to be added as needed.
Sellers said the housing program continues to support traveling medical staff, including CRNAs and emergency room physicians, while the hospital works to hire three permanent CRNAs. One unit will be reserved during the winter months to accommodate traveling ER providers affected by weather.
Chief Nursing Officer Janelle Borchard expressed appreciation for continued collaboration among hospital staff and first responders, noting how valuable those partnerships have been. She said revisions to the hospital’s staffing plan will be presented to the board in November to account for growth in surgical services and the addition of new providers. Borchard said the changes are necessary to ensure adequate coverage and meet reporting requirements.
Later in the meeting, representatives from Ovation provided an update on statewide funding and education opportunities for rural hospitals. They noted that hospitals, federally qualified health centers, and behavioral health providers are all competing for limited federal dollars. The organization encouraged board members to participate in ongoing Ovation training sessions — which count toward board certification — and invited them to attend the annual meeting in February. Ovation also announced a cost report “boot camp” in October and shared that a financial operations review for Pioneers Medical Center is underway, with results expected at the next board meeting.
The board then reviewed the hospital’s August financial report, noting lower surgical volume due to wildfire-related disruptions but stable payer mix and strong pharmacy revenue. Members approved both the August financials and the preliminary 2026 budget as presented by the Finance Committee.
Near the end of the meeting, Pioneers Medical Center released information regarding an incident earlier this year in the Walbridge Wing. In response to the situation, the hospital took immediate action — including removing implicated staff members, notifying the Office of the Inspector General, conducting a comprehensive review of resident care and medical records, and providing staff training focused on resident rights, documentation accuracy and quality measures. The hospital also implemented stronger oversight and accountability procedures to prevent future occurrences.
Following these actions, the Colorado Department of Public Health and Environment (CDPHE) conducted a thorough investigation. The agency found that Pioneers Medical Center “acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence.” The investigation confirmed that four employees engaged in unprofessional conduct, including failure to perform mental health evaluations, inadequate safety monitoring and falsification of medical records. While no physical harm to residents was found, the event caused emotional distress, and the hospital’s report of neglect was substantiated. CDPHE commended the facility for ensuring client safety and well-being during the investigation and for taking corrective steps to address the issues.
After hearing the report, the board voted to enter executive session with legal counsel to discuss pending matters. The session was held under Colorado Revised Statutes §24-6-402(4), including subsection (b) for receiving legal advice on ongoing litigation, subsection (c) for matters required to be kept confidential under federal or state law — specifically Federal Regulation 45 Parts 160 and 164 governing the privacy of individually identifiable health information — and subsection (f) concerning personnel matters and special instructions.
The next board meeting is scheduled for Oct. 28, 2025, with the finance meeting beginning at 9:30 a.m., followed by the regular meeting at 10 a.m. at Pioneers Medical Center.