Listen to this post
Questioning of the Rangely District Hospital Board continued at their monthly meeting this past Thursday. Several business owners and Rangely residents attended the Aug. 29 public forum portion of the meeting which lasted more than two hours. Board members present were John Payne, Nathaniel Polley, Jason Kurrasch, Stephen Petersburg and Shad Peters. Rangely resident and town trustee Andy Key had presented a lengthy list of questions to the hospital administration prior to the meeting and was asking for clarification on several of the responses that were sent back to him. Many of Key’s questions were in regard to the mill levy presentation board members have been giving over the past several months.
Key: “In the presentation you say that Rangely is one of the few hospitals in Colorado that has doctors that live in the community. Why do you think that is? How much, in total benefits, are you paying annually to have local doctors versus traveling doctors?”
Hospital: “Most important, we treat them [the doctors] well. Work-life balance with scheduling which also helps in time of urgent coverage in case of illness or injury of other physicians or caregivers. Total benefits are between 1/2 and 2/3 of what our cheapest Locum coverage would be. Medical professionals like doctors spend more than a decade in school and have a great deal of cost in their education. They are in short supply and salaries will continue to rise. It is also important to note the single biggest complaint we have fielded over the years is we don’t have doctors committed to our community; they don’t live here.”
Key: (Regarding the hospital’s claim that they are not more expensive than other hospitals.) “I can go online and pull CPT codes and Rangely District Hospital is consistently more expensive than similar sized hospitals and larger hospitals.”
Hospital: Posted charges are not what insurance negotiates. You pay what your insurance negotiates and for the most part, you pay this from your deductible, which since Obamacare has likely tripled or more what you pay out-of-pocket. RDH receives less today than we did five years ago. Also we use the average when setting prices. Approximately 1/2 of the hospitals in the statistical area will be more than 1/2 less. But it’s true that no one pays the listed price.”
Key: Key also questioned the cut in the provider fee, unpaid services, the 340(b) program, and the per resident Electronic Medical Records (EMR) representation in the presentations. Key posed the question to the board members of how long a patient should wait for a pre-employment physical appointment? He was personally scheduled 18 days out after calling the clinic for an appointment. Polley, Kurrasch and Peters agreed it was unacceptable to wait that long and Payne said “it is something they need to address.”
Rangely resident Frank Huitt expressed his concerns that the board is “candy coating or misleading the public to pass this mill levy.” He wanted to know why the board’s presentation states employees hadn’t had a cost of living increase in four years but failed to disclose a 3% bonus given last fall. None of the board members could recall if the amount was budgeted or not.
Huitt read directly from the board’s January 2019 minutes: “Some of the larger variances for the budget are related to the decision in October to provide a 3% bonus to employees, this amounted to about $300,000 in unbudgeted cost. Payroll expenses were 3% below last year but 5% over budget due to the bonus mentioned above.”
“This is a pretty poor example of financial responsibility,” Huitt said.
After a brief silence, Payne said that they thought they were doing something right for the employees who work here, and agreed they should have shared that with the public.
on’s claim of not using scare tactics and cited the closing of the Leadville hospital as an example.
“If you get on their website they were absorbed by St. Vincent Hospital and they are building a new hospital supposedly this month, also you keep saying that CNCC will go away and move to Craig if the mill levy does not pass.” “There are parts of it, particularly the athletic programs,” Petersburg interjected.
Huitt asked if anyone had spoken to CNCC President Ron Granger, to which Payne said, “Yes, he told us that the thing that would be volatile would be the athletic programs needing to have a medical facility.”
“That is another fallacy that you guys are putting in this presentation that isn’t exactly the truth,” Huitt said.
“We are trying to present where we are at and what we need to sustain this place and we want to have the services that we have, that the community has asked for, the people have used and need. We have been told by many people, including experts, that this is what the plight of hospitals are for the next generation, and that is what we are trying to avoid. Rural hospitals all across the country are facing the same problems as we are,” Payne responded.
Huitt asked if the CNCC free student clinic—touted as a success—is “breaking even” financially. Petersburg explained the college provides a stipend to the hospital for that service, but he didn’t know if it generated a profit.
“How can you not know that?” Key asked.
Rangely resident Mary Dillon replied, “Who cares if it makes money if it’s providing a needed service?”
“The taxpayers do,” Huitt said.
Finally, Huitt asked if former CEO Nick Goshe and CNO Sharma Vaughn received any type of severance package when they resigned.
Chief Compliance Officer Bernie Rice explained that it is an industry standard to pay a severance package and that both former employees are tied to a lot of things that need to be transferred over.
Business owner and resident Brad Casto said, ”The hospital is an investment in our community, and it’s a great investment…but if you stick this up on a wall, this is an investment in my community but yet it has failed time and time again and we keep losing money. Why do I want to invest in that, it’s just like any other investment that I make. What are you going to do differently that is going to change where we are at? You haven’t come up with one single plan. How are you going to stop this bleeding? What are we going to fix?”
Payne said the hospital is being hurt by external things that need to be addressed. “We have made a lot of headway in my mind. We are trying to recruit new doctors, new nurses, and bring new services in here. We have been working on those things. What we are talking about are the things we can’t control like the Obamacare, mandates from the government, and the pressures from the community not trusting in what we have here so that they utilize it. I have been here for a long time, too, and I’ve seen doctors come and go over the years. I’ve seen good doctors here and I have seen bad doctors here. I think that in the last several years we have come to a place where we have some good doctors here. We have some providers who care about this community, who want to be here, and invest their lives in this community.”
Resident Joyce Key asked where can cuts be made (in regard to staffing). Payne explained they have been doing that by not replacing staff/ positions as they leave. “We look at that all the time. It takes a lot of people to run it. Everything is all interconnected to each other and it is a complicated thing.”
Resident Terry Smalec said the special districts have been meeting and trying to share services to save money and shared his disappointment that the hospital board only showed up twice. “It shows me that you don’t want to work with the other entities.”
Payne said that he couldn’t get away and “that is on him,” but after some discussion between Rice and Smalec it appears there was some miscommunication and the hospital was not informed of the meetings.
After the public forum, several important agenda items were addressed. The hospital has started to advertise for the recently vacated CEO and CNO positions. So far they have several internal and external applicants. Rice states that the vetting process will take place in the next 30 days.
As a way to generate more revenue and better serve the community, several months ago the board voted to facilitate the Senior Life Solutions program. The program kicked off at the end of August. Senior Life Solutions is an intensive outpatient group therapy targeting patients that are 65 years old and up who are struggling with symptoms of anxiety and depression often related to aging. The program is designed to meet the specific needs of rural hospitals. Referrals to the program can be made by anyone, including a patient’s physician, family member, the patient themselves, or another healthcare professional.
After taking the current year’s 20% assessed value increase into consideration and looking at graphed projections, the board voted unanimously to ask for an 8 mill increase on the November ballot. They discussed readdressing and reevaluating their operating budget needs in 2025.
Before adjourning Joyce Key thanked the board for their service to the community and their time. Andy Key said he appreciated their time and discussion. The Rangely District Hospital board meets on the last Thursday of the month at 6 p.m. in their executive boardroom.