Rehoboth McKinley Hospital: Chuck Wright, CEO

by HCE Exchange on August 19, 2010

In November 1983, Rehoboth Christian Hospital and McKinley General Hospital, two independent healthcare organizations, merged together to form the Rehoboth McKinley Christian Hospital. “This later became the Rehoboth McKinley Christian Health Care Services (RMCHCS),” says Chuck Wright, the Chief Executive Officer. This community-owned, not-for-profit healthcare corporation caters mainly to Northwestern New Mexico and Northeastern Arizona.

Wright describes RMCHCS as a combination of hospital and multi-specialty group practice integrated health delivery system. “At present RMCHCS is an 89-bed facility with a 20-bed behavioral health unit, a 69-bed acute care general hospital and multi-specialty group with 50 providers,” says Wright.

The behavioral health unit offers a unique traditional health program combining the best practices of western knowledge and Native American healing methods. This integrated healthcare system also has three outpatient dialysis clinics covering a geographic area over 100 miles in distance from the Zuni Pueblo to Gallup and Crowpoint on the Eastern Navajo Reservation.

Financial Challenges

When Wright joined RMCHCS in December 2005, an audit identified several loopholes in the accounts receivable department. The hospital’s losses amounted close to $1 million every month in the fiscal year which had just ended in August 2005.

“The billing system,” says Wright, “was in a horrible condition. Just two years ago, the firm had lost close to $13 million. This was more than 10% of the total budget for operations at RMCHCS.”

Chuck Wright brought with him 21 years of experience from the Providence Health System, which has its headquarters at Seattle and Spokane and a background as a Regular Army officer for 7 years. This prepared him to take up the challenging task of turning an unprofitable organization into a profit-making one, in little more than a year’s time.

The Right Steps

The hospital’s financial situation is quite different today. “Financially, we are in a significantly better shape,” said Wright. The hospital earned a record $72.6 million in the fiscal year 2005 ending in August 2006, making a net income of $2.8 million. Though this may not seem like much in comparison to many other hospitals, it was a big comeback from the financial crunch the hospital had faced a couple of years ago.

RMCHCS has adopted quite a few measures to enable it to reach this position. “We brought in outside consultants to help us analyze the existing billing system and suggest modifications. We’ve used ACS Healthcare Solutions extensively in a number of areas with a very high level of satisfaction including fixing revenue cycle problems.” explains Wright. In retrospect, this seems to have been a wise decision made at the right point of time. In 2005 the hospital had to write off over $2.5 million, simply because it had not kept the billing records straight. Today, the registration, billing, and collection processes have been redesigned for better efficacy.  Under the leadership of CFO Deb Mohesky, an excellent training program for Patient Financial Services staff is improving morale and producing excellent results.

The hospital undertook significant cost-cutting measures. Operating expenses were reduced by around $4.5 million and top management was restructured.  While deciding which positions to cut, Wright did not consider job performance as the only factor. Nine management and administrative staff reductions were made and care was taken to see that it was as far removed from “front line” patient care as possible.

“ACS Healthcare Solutions deserves significant credit in helping us to fix hundreds of IT and systems problems over the last two years which have been a major contributor to our financial recovery, resulting in a $2.8 million bottom line in the fiscal year ending in August 2007”, says Wright.

Current Initiatives

Having learned how to manage their finances more efficiently Wright explains that their primary focus is currently on providing service excellence, which includes customer service as well as healthcare quality.

About 60% of the occupancy at RMCHCS is by those covered under Medicare and Medicaid. Like any other rural hospital, reimbursement of healthcare services is an important concern at RMCHCS. “One of the unusual characteristic of this organization is that 40% of our patients and employees are Native Americans.  This number is very high for a non-Indian health service hospital,” says Wright.

Future Plans

Wright looks forward to building a strong management team and having all the organization’s elements working together as a team. His aim is for RMCHCS to be in the top 25% nationally in patient satisfaction and clinical outcomes.

RMCHCS is presently in the process of restructuring their analog imaging services into digitalized facilities. According to Wright, McKinley County, NM has one of the highest incidence per capita of end stage renal disease (ESRD) patients in the country. Presently the hospital runs three outpatient dialysis centers for these patients. It is “in the design stage” of building a $3.5 million dialysis-care facility with 45 stations to replace the 28 station facility in Gallup.

Though RMCHCS plans to develop a new medical office building in the future to consolidate their physicians in a modern facility, their focus will remain on building up the capital needed to help keep the organization’s financial status stable, concludes Wright.

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