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About Heppner gazette-times. (Heppner, Or.) 1925-current | View Entire Issue (March 19, 2025)
EIGHT - Heppner Gazette-Times, Heppner, Oregon Wednesday, March 19, 2025 Community meeting concerns over hospital and MCHD response -Continued from PAGE THREE especially true in the nurs- ing department at PMH. With regard to our staff- ing approach, we prefer to employ local staff rather than rely on traveling staff. We have been working hard over the past few years to create a culture that peo- ple want to work in. The Oregon Center for Nursing cites workplace culture as a primary factor in recruit- ment and retention and notes that 30% of nurses nationally leave their job in the first year. According to Gallup, an employee’s direct supervisor and their peers have the most impact on their job satisfaction, which means that it takes everyone participating in building a positive culture to actually achieve it. In 2022, MCHD en- gaged in a salary review process, which ultimately encompassed all positions. The decision to engage in a salary review process was made by the executive team in an effort to ensure that all employees are fairly com- pensated and the district is competitive in the labor market. The first group to have their pay scales eval- uated were the nurses and those pay increases ranged from 9% to 40% depending on years of experience. MCHD is committed to fostering an environment that is positive, profes- sional, and healing for our patients. It takes everyone to make this happen. Financial Management As much as we have followed best practices to mitigate this problem, delays in claims billing processes are guaranteed when new patient account- ing systems are implement- ed. The District converted twice in the span of 13 months in 2023 and 2024 due to a substandard elec- tronic health record system. This has resulted in staff having to work accounts in three separate billing systems while training for and learning the newest one at the same time. The billing delays increase the length accounts that stay in accounts receivable, mea- sured as Days in AR, and the delays further decrease operational cash on hand, tracked as Days Cash on Hand. Both metrics are best practice financial monitor- ing tools and are reported monthly on the dashboard in each board packet. These are being monitored closely by MCHD executive lead- ership, the Revenue Cycle Director, and board mem- bers. District revenue cycle committees and department teams, all patient business office staff, electronic med- ical records committee, and all finance staff are working diligently to resolve and remove any barriers that are causing any claim billing delays. Staff are all 110% committed to achieving our goals of 60 Days in AR and 90 Days Cash on Hand, which are industry best-practice levels, but this will take time. The District’s Chief Operating Officer presents monthly interim financial statements at each board meeting, and they are avail- able on the website. The district’s current operating losses are entirely a result of lower than budgeted utilization and revenue as well as decreased levels of government reimburse- ments. Management and staff have diligently been holding expenses under budget by over $1 million dollars as of January 31, 2025. Spending on tempo- rary staff is budget neutral as compared to employees with taxes and full benefits including health and life in- surance, retirement contri- butions, and paid vacation and sick leave. The final operating position will not be available until the audit is complete and financial statements and the final cost report are issued in October of this year. The district’s current financial condition is close- ly monitored by MCHD executive leadership in connection with the dis- trict’s contracted account- ing firm, WIPFLI. They consistently analyze ways to take advantage of every opportunity to increase revenue. During WIPFLI’s 2024 audit presentation to the Board, they affirmed that MCHD’s current op- erating expense increases, and revenue decline is what every entity is struggling with across the entire rural healthcare landscape na- tionally. Leadership and Ser- vice Quality Without context it is difficult to understand what you’re asking here. Can you provide additional in- formation? What led to this phy- sician’s termination? With respect to a dis- closure of details associated with employee departures, the policy of MCHD is to respect employee pri- vacy and confidentiality. Without commenting on any particular employee’s departure, employees in certain positions are subject to contractual obligations that require compliance. A failure to comply with the terms of any employ- ment contract can result in a termination of that contract, depending on the circumstances. Retaliation is not something the district condones. MCHD strives to foster an environment that is free of negativity, toxicity and conflict. When the working environment becomes toxic, steps are taken to investigate the source and take whatever action is required to correct issues staff and patients re- port to administration and the Board. For instance, suggesting that the staff at MCHD do not “understand medicine,” would tend to undermine staff, negatively impact morale and deval- ue the contributions all employees working hard within the district to pro- vide care to the best of their ability. These types of statements are counter- productive to our commu- nity goal to provide safe, high-quality medical care to our patients and provide a respectful and positive workplace for all staff. How do you address the concerns about retal- iation and the need for medically knowledgeable leadership? MCHD has a uniformly enforced non-retaliation policy for concerns reported in good faith. Concerns can be reported to the Compli- MCHD CEO Emily Roberts ance Officer, HR Director, a member of management, or anonymously through the District’s Compliance Hotline. All reports are in- vestigated, and legal coun- sel is consulted as necessary to ensure that all concerns are addressed appropriately. MCHD has four phy- sician leaders serving in Medical Directorships; Dr. Metzler has served as the Trauma / Emergency De- partment Medical Director since 2022 and the EMS Medical Director since 2023, Dr. Seals has served as the Hospice Medical Director since 2021 and the Clinic Medical Director since 2024, Dr. Cheeney has served as the Labo- ratory Medical Director since 2025, and Dr. Wheir has served as the Radiolo- gy Medical Director since 2022. These physicians are solid leaders who help us to ensure that we provide safe and high-quality care. Emily Roberts wanted to share her perspective I do have a perspective I would like to share, and I think it is one the commu- nity needs to hear. I start- ed with Morrow County Health District at the end of 2018 as the Compliance Officer. I was the first person to fill that role on a full-time basis, though Fed- eral law has long required that healthcare providers employ a Compliance Of- ficer who reports directly to the Board of Directors. In my first couple of years in that role, we did sig- nificant work to establish a functional compliance program for the district, in- cluding fully implementing an anonymous reporting hotline, which is required by law. We also established policies and protocols for responding to staff concerns and patient complaints, which did not exist previ- ously. In June of 2021, the Board hired me as the Inter- im CEO. I was the fourth CEO to serve in a very short span of time. Upon hire, the Board specifically tasked me with correcting a toxic workplace culture and implementing accountabili- ty. That’s a huge ask and it does not happen overnight, and it does not happen without a commitment from the Board and the executive leadership team. To that end, the Board engaged Impact Communications to conduct a leadership assessment of the district’s executive team to ensure the team was capable of implementing positive culture change. We each completed assessments and spent time with a leader- ship coach individually and as a group. At the end of a 6-month assessment period, Impact Communi- cations recommended that the Board retain me as the permanent CEO. At the same time, we started work with Custom Learning Sys- tems, an organization that helps healthcare systems to affect culture change to improve patient satisfaction and employee engagement. Among other things, CLS is responsible for the creation of our service recovery policy (a method we use to make it right when we have failed to live up to a patient’s expectations), our Service Excellence Council (a group of staff and managers who meet to address patient satisfaction and employee engagement initiatives), our employ- ee engagement survey (a survey conducted every 6 months, which drives man- agement goals to improve the workplace), and the regular review of patient satisfaction scores by man- agement and the Board. To improve transparency, we began posting Board packets to our website and created the dashboard in- cluded at the front of every Board packet with informa- tion about human resourc- es, financial, and patient satisfaction metrics. We are not required to measure and report that information, but we do so because we think it is important, and it demonstrates our commit- ment to improvement in those areas. Culture change is hard, and it takes a sustained ef- fort and commitment even in the face of adversity. Our culture change initiative has resulted in some staff turnover in the last few years - some people did not wish to participate in the new culture, and they chose to leave or were asked to leave. The details of spe- cific staff departures will never be something that the district can comment on. On the other hand, some people have found that they thrive in the new culture, and they appreciate having mechanisms to report con- cerns and ensure that those concerns are addressed and that all staff are held to the same standards of conduct. I believe in the mission of the health district, and I believe in our staff. I made the choice to move here and raise my children in Morrow County because I know this is an amazing place to live and work. We can do so much when we work together. Mor- row County Health District is a public non-profit. It belongs to the people of Morrow County, and it cannot succeed without the support of the people. If someone has an idea to improve MCHD, we want to hear it. We welcome attendance at our Board meetings, and we welcome phone calls or emails (com- munity@mocohd.org) from anyone who has a question or a comment they want to share. Healthcare entities in Oregon and across our country are in trouble; there are countless news articles outlining the issues. If we want to preserve and ex- pand the services we have here, it’s time to look to the future and work together. WWW.HEPPNER.NET Submit News, Advertising & Announcements Letters To The Editor Send Us Photos Start A New Subscription 177 N. Main P.O. Box 337 Heppner, OR 97836 Chris@sykesrealestate.net Broker Chris Sykes 541-215-2274 2 Lots Approx 38 acres Price Reduced $170,000 Bare land to build! 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