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.
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