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Activists see RMCHCS changes as positive, but just a start

Changes are in the works at Rehoboth McKinley Christian Health Care Services in response to community protests and the threat of losing the hospital’s lease with McKinley County.

One change that may help is that the federal Centers for Medicare and Medicaid Services (CMS) has designated RMCHCS’s College Clinic as a Rural Health Clinic facility, which is intended to make healthcare more accessible in areas where medical care is in short supply. CMS also reimburses RHCs at higher rates than non-RHC providers.

CMS has clout because it is not only a regulator, but also the single largest payer for health care in the U.S., covering nearly half of Americans.

The designation could be a big step, because RHCs are required to provide outpatient primary care services and basic laboratory services, and to use a team approach of physicians working with non-physician providers such as nurse practitioners, physician assistants and certified nurse midwives.

A month ago, the McKinley County Board of Commissioners gave RMCHCS management 180 days to respond to community and board concerns – including finding a permanent CEO – or risk losing their lease.

RMCHCS brought on new CEO Robert Whittaker April 15 to replace interim CEO Don Smithburg, and added interim CFO Chantelle Venter, who specializes in hospital turnarounds. Venter outlined her “100-Day Financial Improvement Plan” in a presentation to the hospital Board of Trustees April 20. That plan aims to stabilize and improve the hospital’s finances.

Problems arose last year when RMCHCS hired Community Hospital Corporation of Plano, Texas, to take over management. A few months later,  about two dozen physicians voted to form a union which has yet to negotiate contracts. Some other staff quit or were let go.

Community Health Action Group attributes the turnover to the CHC management, which the group claims is putting technology and money ahead of staff and services. The grassroots group began a campaign of town meetings, online activism and protests outside the hospital demanding change.

Now CHAG is shifting its focus to circulating a petition. Constance Liu, CHAG co-founder and spokesperson, said her organization has gained 2,000 signatures, calling for a new RMCHCS board of trustees composed entirely of members of the community.

 

CAUTIOUS OPTIMISM

McKinley County Attorney Doug Decker said RMCHCS has taken steps in response to the commission’s edict to improve communication and transparency, but there is still work to do.

“There is the communication with the county that has been improving but can still be even better, he said. “We do not want it to close and that’s why we are willing to work with RMCHCS, because they are communicating better with us now.”

Another positive sign is placing one county representative on the board as a voting member, which was the case before CHC took over.

“That’s a change from the lease. They can do that, and they chose to do that,” Decker said.

Activists are also guardedly optimistic about the moves, but keeping the pressure on. CHAG is also concerned about what it calls a lack of permanent nurses in labor and delivery. Liu claims most nurses working at RMCHCS now are temporary hires – costing two to three times more than a permanent nurse – but that some former staff members would come back if they were comfortable with new leadership.

“From the pattern of testimony that has come out at several public forums over the course of several months,  there was, under the prior management, a pattern of retaliation and toxic work culture that was making it difficult for permanent employees to remain at the hospital,” said Liu, who is also an OB-GYN at Indian Health Services.

“I work in McKinley County because I always intended to serve an area that needs doctors and I am involved in this issue because I believe that our community deserves excellent health care,” she said. “I will continue to be involved because I see that they are willing to speak up and organize to get it, and that is inspiring.”

As for CHAG, she said, “Our interest is really to build a strong relationship between hospital leadership and the community, because we want this to be a true community hospital, one that serves community interest and puts the community in the center of its decision making in the interest of a long-term resolution.”

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