Gritman Medical Center Success Story
Expanding into outpatient facilities, this century old rural hospital leverages QHR’s strenght and savvy - and its own team’s determination - to improve access with outstanding service.
Dynamic Leadership
Joint venturing with physicians, winning national awards for customer service and running a level III trauma center, Gritman Medical Center doesn’t behave like a small rural hospital. Its range of specialists, construction projects and sharply rising volumes seem more likely in institutions ten times its size.
“We have to be creative to meet the needs of our community,”points out board chair B.J. Swanson. “QHR makes that possible. We don’t have the resources to go it alone. But we all have the same priority: what’s best for the community.”
It was the decision to convert to critical access that jumpstarted Gritman’s success. “Eight years ago,we were losing money,”says CFO Kara Besst. “Since then,a lot has happened.”
Like the arrival of Jeff Martin,CEO. “QHR brought us Jeff,with his Texas-friendly smile and get-it-done attitude,”Swanson remembers,“and things started looking up. People come to him with a problem,and he works on it until it’s fixed.”
Good Decisions
Martin describes his board as “progressive.” The loyal group is clearly not afraid to take a risk—a carefully calculated one.
Borrowing $18.5 million,the team effectively built a new hospital with 55,000 square feet of new patient care space,moving patient services out of the 1960s and 1970s section. “We were able to obtain low interest financing,”says CFO Besst,“because of the solid financial performance QHR helped us achieve.”The friendly new space, planned by QHR’s American Health Facilities Development,enhances both patients’ and staff’s experience.
Later,the team followed QHR’s advice to build an ambulatory surgery center in collaboration with Gritman’s surgeons. “It was a little unnerving to give up 40% of that business,” Martin admits. But the venture has benefited the hospital and the physicians— strengthening their relationship and escalating surgical volumes. “The market grew and we gained market share,paying big dividends— both literally and figuratively.”
Through these complex changes,Martin relied on QHR to help with proformas,facility planning—even program planning.
“The resources QHR offers are amazing and are not available in any other model that I’ve seen—from strategic and facility planning to very specific consulting projects, like billing, coding, compliance, mock Joint Commission surveys…and the networking aspects are tremendous. Even isolated out here, I can always get the help I need.”
Another recent expansion involved transforming a tire factory adjacent to the downtown Moscow hospital into Therapy Solutions, an inviting clinic housing physical, occupational, speech and massage therapies. “We put in a pediatric gym and a state-of-the-art therapy pool,” Martin beams. The innovative facility and the staff it attracts allow Gritman to serve more patients.
Staffing Up
Attracting staff is critical to the growing organization. “We host a physician reception every month,”Martin reports. “The whole town is invited. We try to help our physicians find partners long before they’re planning to retire.” It’s working:“We’ve added 15 physicians in the last 18 months,” smiles B.J.Swanson.
Dr.Matt Rice,chief of staff,believes doctors choose Gritman because of the natural beauty of the foothills of the Rockies and the stimulating academic milieu of the University of Idaho…but mostly,for the people. “There’s an amazing spirit of self sacrifice here,among employees, board, staff and management,” he says.
Martin encourages that attitude with the “Walk a Mile in My Shoes”program,which allows employees to experience each other’s jobs. “It helps create understanding,”Dr.Rice explains,“which is part of why Gritman is a great place to be.”
Top quality leadership helps too. “Jeff Martin is excellent—very approachable. He doesn’t favor one specialty over another. QHR gives us a broad base of expertise to be more innovative, creative and thrifty. We’re definitely getting our money’s worth.”
Creative Management
Delivering care for the bustling university town under CAH limitations is a challenge.“We’re constantly bumping up against the census limits,”Martin explains. “So we have to be efficient. QHR’s financial and operational reviews keep us sharp. ”With net days in AR averaging 62, days of cash on hand at 168, and salaries and supplies averaging 38% and 14% of net revenue,the hospital is indeed sharp.The last eight years’ solid management and growth yield an impressive trend:
- Outpatient surgeries jumped 156%,while inpatient surgeries climbed 33%
- Net patient revenue has more than doubled
- Operating margin is up from zero to a steady 5% - 6%
- Net assets climbed 82%,with net balance (cash and investments) up 75%
QHR continues to help the team excel in inventive ways:
The Blueprint for Nursing model helps CNO Sheryl Washburn enhance the work environment.
QHR Learning Institute programs,including webinars, make training and leadership development easily accessible.
QHR’s Health Financial Resources experts helped CFO Besst redesign charity care and counseling policies to ensure proper allocation of charity care expense.
Access to QHR’s group purchasing organization delivers serious buying power,for savings of $367,339 annually.
Strategic Planning experts helped hone six strategic priorities: quality & service, technology and people are the top three.
Sharing the Vision
Martin commissioned teams to work on the top goals. The People Team publishes an Employee Annual Report to salute achievements.And they’re significant: the hospital won three Avatar customer service awards, one for the 5th year in a row and employees vote Gritman a great
place to work.
Developing ways to be an even better employer,the hospital converted a nearby home into Charlie Bear’s Child Care Center for its employees. In the works are a technology upgrade to expedite workflows and a medical office building to support medical staff retention and growth.
What’s Next?
The newest project began when the county nursing home closed. Offering it to Gritman for $1, Moscow is hoping for great things. “QHR’s AHFD helped us decide how we can best use it,” says Swanson. “It will be our wellness center.” Dr. Rice is enthused. “That fits our vision. We want to lead the region in both prevention and cure, through wellness and genetics.”
"QHR is a very good foundation for us. We're basically a small rural hospital... but we want to do so much more for our community. When we get an idea, someone will say - let's run it by QHR. They've been there and done that!"
