Lessons from the victory of a rural hospital over financial difficulties: 2 leaders intervene


St. Vincent Health, based in Leadville, Colo., Was on the brink of bankruptcy and closure seven years ago. But in September, he opened a brand new facility.

Leadville has the highest elevation in the United States, snows nine months a year, and drives mountains on all roads leading into the city. Becker spoke with Brand Manager Karen Onderdonk and CEO Brett Antczak about the methods the rural hospital uses to achieve this recovery and the advice they have for others in similar communities.

Editor’s Note: Answers have been edited slightly for style and clarity.

Question: What was the extent of Saint-Vincent’s financial struggle seven years ago?

Karen Onderdonk: Our primary struggles were with an aging facility (built in 1958) and fiscal support that had not seen an increase in factories since the formation of the hospital district in the late 1980s. The hospital no longer met physical demands. modern people safety code and part of the building was without heating.

The St. Vincent General Hospital District increased the levy rate on the Lake County ballot in 2014. The 2014 ballot initiative failed – and SVGHD’s board of directors announced it was shutting down hospital – then hired Centura to run St. Vincent Hospital. We have closed many services including home health, [extra care units] and physiotherapy during this time and became very tax-prudent.

In 2015, SVGHD returned to voters with a very clear message that the hospital would close if the District Factory Tax (5a) was not passed.

In the end, just under 60 percent of voters approved the factory tax increase on November 3, 2015. This gave the district a more solid foundation to operate and begin a financial turnaround while planning a new hospital.

Q: What strategies has the hospital implemented to prevent bankruptcy and closure and get it to where it is today?

KO: SVGHD signed a contract with Centura in 2015 to manage Saint-Vincent Hospital. They and their CEO-designate Gary Campbell were instrumental in the turnaround that took place by focusing on the services the community needed and were also income producers – such as increased hospital stays. , swivel beds and the reopening of physiotherapy services.

Towards the end of 2017, SVGHD’s board of directors and Centura mutually agreed to revert to a less formal affiliation relationship. Mr. Campbell was hired by SVGHD and the district has been managed independently since then. The hospital has now been under the management of a new CEO, Brett Antczak, since November 2020.

Q: How were you able financially to build this new facility?

KO: The new hospital cost around $ 26 million. The majority of its funding came from a very favorable USDA loan with an interest rate of 2.35%. The principal and interest on the financing during the loan repayment period is estimated to be between $ 1.6 million and $ 1.7 million per year. The term of the loan is 35 years. The remainder of the funding, about 20 percent, comes from private funding sources.

Two historic events led to the inauguration of the hospital in 2019:

  • Taxpayers voted to increase their support for the hospital and ambulance service in 2015, and this investment was fundamental to the work and planning that led to the construction of the new hospital today.
  • Since 2016, the Board of Directors and the management team have focused on increasing the services and inpatient capacity at St. Vincent Hospital, always striving to improve healthcare services. premises for Lake County.

Q: What challenges did COVID-19 pose financially to the hospital as you tried to bounce back and build this facility?

KO: Our small hospital has not experienced any service closures due to COVID-19. Our main challenges were the delays caused by COVID during the construction of the new facility. These were both supply chain delays and labor shortages among our construction suppliers. A very real and difficult outcome of COVID is the nursing shortage resulting from the exhaustion of COVID and the lucrative travel jobs available.

Q: What advice would you give to other hospital CEOs in rural communities facing financial difficulties?

Brett Antczak: My goal is always to remove barriers to health care. As a healthcare leader in a rural community, I study emigration data. We survey the community and stakeholders and take action to close the healthcare gaps we discover. Our goal is to become the best healthcare partner possible for the community we serve.

I think small hospitals need to focus on the unique needs of their communities, the niche markets they can be good at, and focus on adding “healthcare hospitality” to everything they do. .

For example, St. Vincent’s inpatient rooms are private and inspired by resort amenities such as high-end linens, 55-inch televisions, floor-to-ceiling windows with mountain views, and en-suite bathrooms. It creates a healing environment that is comfortable. Patients judge you on what they understand, such as a nice room to recuperate and recuperate.

We have recently added many visiting specialists, including general surgery. Now, people in our rural community can undergo colonoscopies and other general procedures without having to drive out of town on our high mountain roads.

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