This week we’re having a conversation with Steve Tenhouse, CEO of Kirby Medical Center, a 16-bed independent not-for-profit critical access hospital located in Central Illinois. Prior to assuming the CEO role in 2004, Steve served as the hospital’s Chief Operating Officer and Chief Financial Officer. Kirby Medical Center was recognized by the National Rural Health Association as a 2017 Top 20 Critical Access Hospital Best Practice in Patient Satisfaction recipient.
“We have a saying that our culture doesn’t
hang on the walls, it walks the halls.”
Steve has worked in healthcare all his professional career and earned his Bachelors in Business in Accounting from Western Illinois University and his Masters in Health Administration from Ohio University. Steve is a certified public accountant and is a Fellow with both the American College of Healthcare Executives and the Healthcare Financial Management Association.
This week we celebrate National Rural Health Day by having a conversation with the person who invented it! Karen Madden is the Director of the Charles D. Cook Office of Rural Health (ORH) within the New York State Department of Health.
“National Rural Health Day began as a way to recognize and celebrate individuals and teams who give their best selves in the name of rural health. We wanted to focus on all of the very good things about rural communities on National Rural Health Day and all of that turned into the Power of Rural Movement because it’s not really about just one day.”
Karen currently serves on the Board of the National Organization of State Offices of Rural Health. She also has also served on the National Advisory Committee for Rural Health and Human Services and the National Rural Health Association Board of Trustees. Karen is a proud alumnus of the State University of New York and holds a Master of Arts in Public Policy from the University at Albany’s Rockefeller College of Public Affairs and a Bachelor of Arts in Political Science from the Oswego State.
This week we honor our veterans who have served our country, for which we are very thankful. We are fortunate to have two veterans as our guests today, Dale Gibbs and Dr. Tom Klobucar.
Dale Gibbs is an Army veteran who was wounded in Vietnam. His initial contact with the VA System after discharge was less than ideal, but he is now very proud of the care the VA provides. He is the Chairman of the Secretary of Veterans Affairs’ Veterans Rural Health Advisory Committee. He is also a current member of the National Rural Health Association Rural Health Congress and Rural Veterans Task Force.
Dale retired from a healthcare system in Nebraska and Iowa as the Director of Rural Health Services, where he worked to strengthen both owned and independent rural hospitals and providers. His background also includes long-time work in telemedicine services to rural populations, in order to expand access to care. Dale has served on various state and local boards, all related to improving access to quality healthcare.
A retired Air Force Senior Master Sergeant, Dr. Thomas F. Klobucar spent his military career first as a Cryptologic Russian Linguist and then as an Arms Control Inspector/Interpreter working on execution of the Intermediate Nuclear Forces (INF) Treaty of 1987 and the Treaty on Conventional Armed Forces in Europe (CFE) of 1990.
Tom was named Deputy Director of ORH in 2012 and Acting Director in 2016. His current work is focused on increasing access to health care for rural Veterans, providing opportunities for the delivery of virtual health care services into rural Veterans' homes, the expansion of health care provider virtual consultation services in underserved rural areas, and creating strong partnerships with local, state and national organizations to better serve Veterans, their families and the communities where they live. Dr. Klobucar oversees the day-to-day operations of ORH and the management of a broad portfolio, including rural health-focused studies and program assessments. He has overseen the transformation of the ORH electronic reporting system and directed the adoption of innovative and improved processes.
Under his leadership, ORH staff maintains relationships with local, state and federal entities with the goal of creating synergistic programs to enhance access to care and services for rural Veterans and their families. Tom came to VHA in 2010 as a Telehealth Research Associate in the Veterans Rural Health Resource Center, Iowa City, Iowa. Before that, he worked in commercial research and academe, holding faculty appointments at The University of Iowa College of Public Health and The Iowa State University Department of Political Science.
This week’s guest is Davis Patterson, PhD. Davis is a sociologist and a research assistant professor in the University of Washington Department of Family Medicine in Seattle, Washington. He is Director of the Collaborative for Rural Primary Care Research, Education, and Practice (Rural PREP), Deputy Director of the WWAMI Rural Health Research Center, and an investigator in the UW Center for Health Workforce Studies. Dr. Patterson’s research and evaluation activities seek to inform policy and improve rural and underserved populations’ access to healthcare, with a particular focus on the health workforce.
“Our work really gives leaders at all levels, local, state, federal, the information they need to advocate for change.”
His current research includes studies examining the commitment of health professions schools to produce rural practitioners, graduate medical education for rural practice, rural emergency medical services, workforce solutions to ensure patient access to oral health care, and factors affecting provision of home health services to rural patients.
He is a member of the advisory committee of AcademyHealth’s Health Workforce Interest Group and the Joint Committee on Rural Emergency Care (of the National Association of State EMS Officials and the National Organization of State Offices of Rural Health). He is an avid traveler and fluent in Spanish.
This week’s guest is Leslie Hall, the Executive Director of the Michigan Rural EMS Network (MiREMS). Leslie has been the Executive Director since the organization was created in 2011. Prior to that, she was the Executive Director of the Huron-Sanilac EMS Network. Leslie actively initiated the organizational structure and expansion of MiREMS from a two-county initiative to a statewide network.
“Leadership is really having a vision that you can clearly communicate and then having the passion to translate that vision into reality.”
Leslie led the organization as Project Director during the implementation of six separate multi-year federal grant programs. At the same time she created a foundation of connections and relationships throughout Michigan and across the country with EMS leaders, medical control authorities, hospital CEOs, legislators, healthcare professionals, and organizations which serve the unique healthcare needs of rural populations.
As Executive Director, Leslie has initiated and supported collaborative networking efforts of EMS services, EMS professionals, and stakeholders.
She graduated from Central Michigan University with Master of Applied Arts degree in Public Health Education.
This week’s guest is Roger Wells, Physician Assistant at Howard County Medical Center. Roger grew up in Central Nebraska on a farm raising hogs and cattle, and is proud to have been a farm kid. Growing up he attended school with a total of 17 people in his class. He learned about what devotion is to his farm and family and got up in the morning with his dad to do the necessary farm chores.
“Leadership occurs when someone who has passion about an issue develops influence and impacts others to establish the coordination of efforts to accomplish a common goal.”
Roger went on to college earning degrees to become an athletic trainer, continuing his education to earn a master’s degree. After helping care for an automobile accident victim, he realized his passion for healthcare and went back to school to become a physician assistant.
Roger is active in with the National Advisory Commission on Rural Health and Human Services/Federal Office of Rural Public Policy, the National Rural Health Association, the Nebraska Governor’s Rural Health Advisory Commission, the President’s Advisory Council at the University of Nebraska and the Nebraska Rural Health Association.
Awards he has received include:
This week’s guest is Amanda Basso, President of CSuite Consulting. Amanda is an experienced, adaptable healthcare CEO, accustomed to the integration of new healthcare delivery systems and restructuring of work in an increasingly complex regulatory environment. Amanda enjoys using her skills at communicating, organizing and solving problems to raise the stature and rankings of healthcare facilities. She is an accomplished CEO who proudly maintains a highly productive, efficient and quality driven environment.
“Leadership is the act of leading others by providing vision and direction so that they’re really inspired to follow.”
Amanda is a Registered Nurse with an MSN and MBA, who has served in healthcare leadership roles for over 18 years. Before becoming a hospital CEO, Amanda worked her way up hospital leadership ranks as Nursing Department Director and then a Chief Nursing Officer (CNO). Amanda loves Healthcare Leadership and has a passion for operations.
Amanda is President of CSuite Consulting, a leadership consulting company where the mission is to bring the passion for leadership alive into organizations by igniting a spark or fanning the flame so that exceptional leadership is the true cornerstone in those served.
Amanda is a Certified Professional in Healthcare Quality (CPHQ), Certified John Maxwell Speaker, Trainer, and Coach, and Certified DiSC Administrator.
This week’s guest is Dr. Tim Putnam, CEO of Margaret Mary Health. Tim began his career in healthcare in 1983 working in clinical laser and minimally invasive surgery research. For the last fifteen years he has worked exclusively in rural healthcare leadership and is currently CEO of Margaret Mary Health, a Critical Access Hospital in Batesville, Indiana.
Tim currently chairs the National Rural Health Association’s Policy Congress:
“The Rural Health Congress… (is about) making sure we get everybody’s voice heard and presented in a way that people understand… the more good people we have on Policy Congress, the more robust the policy positions are and the better we can tell our story.”
Tim also chairs the National Rural Accountable Care Consortium and the Indiana Board of Graduate Medical Education. Additionally, he serves on several other regional and national healthcare boards.
In 2015, he was certified as an Emergency Medical Technician and serves in that capacity with Batesville Fire and EMS.
Tim has degrees from Vincennes University, Oakland City University, University of Southern Indiana and received his Doctorate in Health Administration from the Medical University of South Carolina.
This week’s guest is Pamela Tripp, Chief Executive Officer of CommWell Health, who often uses Chief Encouragement Officer as her title. Ms. Tripp is passionate about rural healthcare in NC and America. She and her team of colleagues at CWH have raised the profile of Health Centers as credible and invaluable providers of primary, high quality multidisciplinary, integrated care in NC and across the nation.
CommWell Health is a thriving healthcare organization receiving national recognition for service excellence and patient integrated care, offering medical, dental, behavioral health services, HIV/AIDS among 16 office locations spanning 6 counties in southeastern North Carolina.
“…the most pivotal thing in a turnaround is being able to change your culture.”
Pamela has been active in the NC legislative branches, and at the national congressional level advocating for rural community health centers vital mission, as long-standing member of the NC Community Health Center and the National Associations of Community Health Centers.
CommWell Health was the first community Health Center in the nation (2016) to receive the Governor McCrory’s Milestone One Malcolm Baldrige National Quality Award. In 2017, CommWell Health was awarded the Most Outstanding Rural Health Organization, the by the National Rural Health Association (NRHA), for excellence in areas of Culture, Quality, Finance and Governance as a safety net for the multiple southeast counties served by Medical, Dental, Behavioral Health, and HIV/AIDS services. Ms. Tripp recently received the BCBS Robert Gretzen Jr. Healthcare Leadership award, which came with an unrestricted donation of $25,000 to her organization.
Pamela is the author of “The Culture Cure: Transforming the Modern Healthcare System”, and to accompany her book a Master Mind Guide that will be released late summer 2017. Over 25 years Pamela Tripp also developed a Transformational Blueprint for healthcare organizations titled Corporate Transcendence. Ms. Tripp has been a returning speaker/panelist for the American College of Healthcare Executives (ACHE) supporting
healthcare leadership in NC and beyond. She is on social media, where she blogs on healthcare transformation and leadership. firstname.lastname@example.org.
This week’s guest is Dr. Mark Lindsay, an Assistant Professor of Medicine at Mayo Clinic College of Medicine. He has practiced at Mayo Clinic Health System Eau Claire since 1997 and has served as Quality Officer for Mayo Clinic Health System from 2006-2010 supporting Quality, Patient Safety and Service Excellence for 19 hospitals and 70 clinics in Minnesota, Wisconsin, and Iowa.
“We support critical access hospitals and urban hospitals in creating these models that benefit not only the acute care hospital but the critical access hospital and most importantly, the patients.”
Dr. Lindsay received his Master’s in Medical Management in 2004 from the USC School of Business. His Master’s project was development of 11 Transitional Care programs in Minnesota, Wisconsin and Iowa. He presently serves as Medical Director for Allevant supporting rural healthcare post-acute pathways.
This week’s guest is Christian Curtis with the Fort Peck Tribes Health Promotion Disease Prevention program (HPDP). Christian is a registered nurse who started working with the Tribes in August 2015. Her plan to continue to work for this program to assist in providing medical services to children on the Fort Peck Indian Reservation.
“Anytime you work with a cultural group or a native population, it’s important to know their history and what they’ve gone through as a people.”
Christian grew up on the Fort Peck Reservation and is an enrolled member of the Tribe. She graduated from one of the High Schools on the reservation in 2011 and continued her education at the Fort Peck Community College. While a student there, she was given several opportunities to pursue a nursing career. In August 2012, she continued her undergraduate studies at Crown College in St. Bonifacius, MN, where she graduated in May 2015, with dual degrees: a Bachelor of Science in Nursing and Christian Studies.
Christian chose to work for the HPDP program because of the unique opportunities to expand in providing services on the reservation. She loves the work and hopes to continue on this path in providing and enhancing healthcare for her community.
This week’s guest is Don Kelso, the Executive Director of the Indiana Rural Health Association (IRHA). Don has been with IRHA since 2008. Previously, he served as Vice President of Operations at Daviess Community Hospital in Washington, Indiana from 2008-1998, and from 1994-1998, he served as Vice President of Human Resources. Don was also Director of Human Resources at Jasper Memorial Hospital in Jasper, IN, from 1991 to 1993.
“If I could change one thing in rural health, we would have many more psychiatrist and social workers.”
With a staff of 18, Don leads the largest state rural health organization in the United States. With over 3000 members, IRHA has demonstrated success and leadership in many rural health initiatives, such as: broadband connectivity through fiber construction, rural hospital networking, Telehealth adoption for mental health and stroke care services, Rural Health Clinic disaster preparedness/education and support, tobacco cessation education, E-Learning/education, and annually hosts one of the largest state rural association annual conference’s in the country. Don is also responsible for the management of $1,500,000 in federal grants from HRSA and ORHP (Office of Rural Health Policy).
Lara Brooks serves as a Rural Health Analyst with the Oklahoma Office of Rural Health, and Dr. Brian Whitacre is a Professor and Extension Economist in Agricultural Economics at Oklahoma State University. Lara and Brian have been working together since 2008 on increasing community and hospital engagement in rural areas. They focus on things like funding and grants, quality of life and technological advancements.
“I like to think of leadership as the x-factor and it’s something that’s not necessarily tangible, it’s not equipment that you can purchase or hardware or software. But it’s the x-factor that can really make the best of an organization, business or even government.”
Lara primarily works with Oklahoma Critical Access Hospitals within the Flex program, the Medicare Rural Hospital Flexibility Grant program. Brian generally works in the area of rural economic development, and also teaches an undergraduate class on rural development. Together they both work to help improve the quality of quality of life for people in rural America.
Brian Bauer is an attorney for Hall, Render, Killian, Heath and Lyman, PLLC, and works extensively in rural health. He has been an attorney practicing in the rural health field for around 25 years. He has served as general counsel to a number of hospitals, advising them on a wide range of legal, business and ethical issues. He also has experience in addressing medical staff, credentialing and peer review issues, including medical staff disciplinary actions and corrective action hearings.
“A thing that a lot of people especially in more urban areas don’t fully understand is that rural hospitals have all the same legal issues, all the same challenges, all the same need that a large system has without the resources.”
Brian earned his law degree from Valparaiso University School of Law in 1987. He has worked with over 40 ACOs and CINs across the country. The ACO/CIN clients include very large single system CINs that consist of medical centers and their physician groups, as well as ACOs that consist of a combination of hospitals, independent physician groups, federally qualified health centers and rural health clinics.
Michelle Mills serves as the Chief Executive Officer of the Colorado Rural Health Center, which is the State Office of Rural Health and Rural Health Association in Colorado. Colorado is a state that expanded Medicaid and has not had any rural hospital closures.
Michelle has a passion for quality improvement and collaboration, and won the Patient Safety Leadership Award in 2009. The Colorado Rural Health Center is set up as a non-profit, giving the organization flexibility in allocating resources and manpower to reach rural populations with education and tools for better health. Through her organization, Michelle and her team conduct healthy clinic assessments, which help rural health clinics to ensure they are foundationally sound.
“If you have a healthy foundation, then you’re able to build upon that foundation by adding in things like quality improvement and population health.”
Michelle is also a graduate of NORSORH’s Leadership Institute. Additionally, she serves in a number of advisory boards, including the NRHA Board of Trustees, NRHA Rural Health Congress and the RHC Consistency Group.
Tim Size has been the Executive Director of the Rural Wisconsin Health Cooperative since helping found the organization in 1979. The Rural Wisconsin Health Cooperative is owned and operated by forty rural acute, medical-surgical hospitals with the twin mission of shared services and advocacy. The organization focuses on building a collaborative network among freestanding hospitals and system affiliated rural hospitals, distinguishing it from other programs that utilize alternative approaches. Tim works to advocate for rural people and emphasizes the importance of good physician to population relationships.
“Rural Health is as important to the economy and the development of the local community as any other major economic sector.”
In addition to serving as the Executive Director of the Rural Wisconsin Health Cooperative, Tim is also co-chair of the National Health Association Foundation. Prior to his current roles, Tim worked in administration at both the University of Wisconsin Hospital and Clinics and the Hospital Metodista in La Paz, Bolivia.
Andy Fosmire serves as the Vice President for Rural Health for the Oklahoma Hospital Association. He has worked through cuts in the state of Oklahoma, as it was not an extension state with the Affordable Care Act, and discusses difficulties that they’ve had as a result.
“I look at leadership as being a person that is skilled at getting a team of people to move in the same direction and accomplish a mission, a vision as a group, not necessarily being out in front of that group, but working together with a team, and trying to accomplish the mission of the entity.”
Healthcare was a natural fit for Andy, and he earned a Master’s Degree in Therapeutic Recreation. Prior to working for the Oklahoma Hospital Association, Andy was Executive Director for Rural Health Projects, a nonprofit, and was also a Managing Director for the Rural Health Association of Oklahoma.
This week’s episode of Rural Health Leadership Radio is a special episode celebrating the program’s one-year anniversary. In this special episode, guest host Elise Auxier interviews the creator and regular host of Rural Health Leadership Radio, Dr. Bill Auxier. Bill shares his definition of leadership, how Rural Health Leadership Radio began, and lessons he has learned as a leader.
Coming from humble beginnings in Southern Illinois, Bill’s first job in healthcare was that of a nurse’s aide at a small rural hospital, Hamilton Memorial Hospital in McLeansboro, IL. From there he has had a successful career on the industry side of healthcare, working his way up to become the CEO of a surgical device company with a global presence. In addition to the real-life experience in healthcare leadership, Bill also continued his education, receiving a bachelor’s degree in business, a master’s degree in communication, and a doctorate in leadership. Bill likes to combine what he learned about leadership in the real world with what he learned about leadership in the academic world.
Rural Health leadership continues to grow. From a beginning one year ago of 24 downloads (download equals listener) in the month of July, Rural Health Leadership Radio has now surpassed 7,000 downloads, and this growth has been without promotion. While most listeners are in the United States, Rural Health Leadership Radio also has listeners in 22 other countries. Those countries include:
Thank you to all of Rural Health Leadership Radio guests, past and future, and all Rural Health Leadership Radio listeners!
Bill Finerfrock is one of the co-founders of the National Association of Rural Health Clinics (NARHC), and currently serves as the Executive Director. He also serves as the President of Capital Associates, a bipartisan government relations firm that specializes in health policy.
The NARHC has helped healthcare providers navigate Medicare and billing, among many other things, allowing them to help more people. They advocated for one PA in Michigan, who was having trouble gaining rural certification for his clinic, and as a result, started a conversation among government officials about empowering healthcare providers who are providing greater access to care by going into communities where others won’t to provide care.
“It’s not a national thing. It’s not a huge thing. But to look and know that one community was able to have healthcare because we’re able to intercede and help folks out. I think it was really kind of a neat experience.”
Bill became familiar with rural health while working with the American Academy of Physician Assistants in the late 1980s. Several PAs working in rural health would contact Bill with issues they were facing, and Bill realized how difficult it was to get information and answers. He worked closely with PA Ron Nelson, who was Chairman of the Government Relations Committee for the American Academy of Physician Assistants at the time, and together they formed the NARHC to address this issue.
The 2017 Minnesota Rural Health Conference, Shaping Sustainable Solutions, was held June 19 and 20, at the Duluth Entertainment and Convention Center in Duluth, MN. The annual event was hosted by the National Rural Health Resource Center, the Minnesota Rural Health Association and the Minnesota Department of Health Office of Rural Health and Primary Care. The conference objectives was to share and discuss innovative local and state solutions to challenges while encouraging informed and visionary collaborations for the future.
The conference provided the opportunity to:
Keynote speakers included:
Arne Vainio, MD
Family Physician, Min No Aya Win Human Services Center
Edward Ehlinger, MD, MSPH
Minnesota Commissioner of Health
Alana d. Knudson, PhD, EdM
Program Area Director and Co-Director of the NORC Walsh Center for Rural Health Analysis
Senior Vice-President for Member Services, National Rural Health Association
Raz Cook serves as administrator for two hospitals: East Texas Medical Center Trinity and East Texas Medical Center Jacksonville. Raz has been a registered nurse for 35 years, and a hospital administrator for 18.
“I think that leadership is artfully influencing people to do work for a common purpose. I think it has both quantitative and qualitative aspects to it. At its best, it's an effective symbiosis that accomplishes great goals. It's rather like being the director of a symphony of different voices and talents, and it creates beautiful music when it's done right.”
She has had a variety of roles throughout her career, including solid organ transplant, critical care nursing, academic nursing instructor and administrative leadership. Her experience took her from the bedside to the C-suite. Additionally, Raz has also served on multiple boards, including the Texas Hospital Association Executive Board, and is currently a non-trustee member on the Texas Healthcare Trustees board of directors.
Randy Dauby serves as the CEO of the Pickneyville Community Hospital District in Pinckneyville, IL. Prior to that, he was CFO then CEO at Hamilton Memorial Hospital in Illinois. His leadership style is authoritative, mixed with kindness and compassion, which trickles down throughout the organization among staff members and patient care.
“I think as a leader, we can tell people that respect, dignity, courtesy is something we need to have as managers. We've got to be authoritative, we've got to expect our managers to do their jobs, but also have a caring and concern for your employees, just as you should have that caring concern for their patients and visitors that come to the hospital.”
Randy started working in healthcare as a teenager, then went on to get a CPA degree and became CFO of Hamilton Memorial Hospital. He transitioned to become a CEO in 1999 and has held the role ever since.
Tune in to hear our conversation on leadership in healthcare and the thoughts on the current state of healthcare policy.
Marybeth Peña is the Nurse Program Specialist for the Florida Department of Health in Marin County. She is a registered nurse and a certified diabetes educator, and was recognized at the 2017 Rural Health Symposium for the work that she does with underserved populations. Currently, she oversees “The Program for Chronic Disease,” a preventative initiative designed to fight chronic conditions such as the obesity epidemic.
“I spent a lot of time just kind of observing, and looking, and listening, and using the model of knowledge, attitude, practice, and belief. So you kind of look at what the community has, what they're willing to change, what their belief systems are, and then work with the people who are already leaders, and the organizations that already have an impact in the community.”
Marybeth’s rural health journey began when she joined the Peace Corps, and worked in a small orphanage in Nicaragua. That experience is what sparked her passion for working with underserved populations in rural areas.
John Gill serves as President of the National Association of Rural Health Clinics. He received the Ron Nelson Award in 2014, presented by his peers; in honor of the positive impact John’s efforts have on the lives of the community that he serves. In this episode, John discusses the importance of connecting with the community, understanding the issues they face and promoting rural hospitals and clinics.
“[Rural is] a silent left out majority of our nation that, unfortunately, has been poorly focused on, because the louder voices, and certainly the majority of voices that are heard, tend to come from urbanized areas.”
John has been a Physician’s Assistant since 1974, and also served as a member of the United States Army for 40 years. He has worn many hats in rural health, as do many rural health leaders, and shares his knowledge and expertise with us in episode 46 of Rural Health Leadership Radio.
This week’s guest is Carolyn Bruce, Chief Executive Officer of Western Healthcare Alliance and Healthcare Management and the Executive Director for the California Critical Access Hospital Network, and Network to Network Strategies. A native of San Diego, CA, Carolyn started her career in healthcare in 1989 after attending San Diego State University and earning a Master of Business Administration Degree from Western State Colorado University. She worked for a 350-bed tertiary hospital as the Director of Planning and Community Health before taking her current position with WHA 20 years ago (this year!).
When we look at those successful CEOs, they've actually gone past and beyond looking for cost savings.
Carolyn currently manages a portfolio of consulting, programs and services designed to assist rural providers in reducing costs through their combined volume and purchasing power, while creating sustainability in their communities. She is a licensed Colorado Insurance Producer and currently serves on the advisory committees for the National Rural Health Association ACO Leadership Committee, Rural Health Center Health Information Informant Group, Rural Health Innovations with the National Rural Health Resource Center, the Mayo Clinic National Symposium of Healthcare Reform, Mesa County Community Health Assessment Taskforce, and the Community Board for the CU School of Medicine Clinical Campus Expansion. She has served as the President of the National Cooperative of Health Networks (NCHN). She was recognized as “2011 Network Director of the Year” by NCHN.