[Editor's Note: This is part 2 and final of two articles on the Gila Regional Medical Center Board of Trustees meeting on Sept. 26, 2023. This one will continue with reports and updates.]

By Mary Alice Murphy

Reports at the Gila Regional Medical Center Board of Trustees meeting on Sept. 26, 2023 continued with an update from Human Resources Interim Director Dustin Knowles. "I've been here about six months now. I really enjoy the hospital and the community. We've had several opportunities to improve HR. One is looking at our turnover. Talking with the community and with the employees, many think we are short-staffed and we are turning over constantly. But if you look at the numbers, this quarter, we've lost 23 people, four of whom were terminated. That's only 5.1 percent for the quarter 20.4 percent annualized. We are doing better than the national average of hospitals. When we look at it from the years of service, it's two years and under years of service when most leave.

"When we looked at 18 of those who left, six found better employment. Maybe they found a position that was better for them. Four moved out of the area; four were personal or family-related; four were undisclosed; and one decided to pursue school full-time again. Those reasons are typical of what you see in the majority of the facilities. When you break it down by job type, nursing has the best and least turnover in the house, with only 2.6 percent in the last quarter. You tend to see clerical turn over quite frequently, as they make their way through their employment."

Board Chair Dr. Fred Fox said: "When you talk about years of experience, the national journals are talking a lot about the number of medical professionals who are leaving due to burnout because of Covid and other factors. But if you look at our situation, we are doing better, with the longer the person is here, the less the turnover. It's 8 percent for the short-timers and down to 2 percent of the ones with more years. It means we're doing something right here or those people are not leaving for other reasons."

Chief Financial Officer Patrick Banks said: "It's possible we saw some of that earlier, but if you walk the halls now, we have a lot of people who just want to take care of people. This is the place to be if you want to take care of people in a hospital situation."

Board Vice Chair Betty Vega asked which departments had the most people leaving.

Knowles said he grouped them by job type. "The departments themselves, when I say nursing for instance, that includes the nurses, the clerical, the MATCH (maternal and child), med surg." He mentioned other groups that had various types of jobs within the department.

Board Member Will Hawkins asked how many vacancies the hospital has.

"We have 68 positions posted currently," Knowles said. "In this quarter, we've hired 35 and only lost 23, so we're doing better."

Hawkins said: "This may not be connected, so forgive me for asking if it isn't, but last year we had a $1.4 million loss. Typically your greatest expense is your employees. Is there any correlation between the loss and this situation?"

Banks apologized for jumping into another report. "But to your question, yes, people are always the highest expenditure of a hospital. The most expensive are generally in contract labor and overtime. We are doing much better in staffing this year and this is showing up in the bottom line."

Vega had another question about the number of vacancies.

Interim Chief Executive Officer Margie Molitor noted that some of those vacancies are PRN (as needed) vacancies. "The vacancies are not 68 full-time positions. "

Board Member Seth Traeger asked how "our turnover within the first two years compares to national averages."

Knowles said among other hospitals across the country the average turnover of all hospital positions in the first year is 39 percent and for the second year 19 percent.

Health Tech Regional Vice President Scott Manis said the highest turnover is always in the first two years.

Molitor said the first two years the employee is figuring out what they want to do. "Sometimes, it's not a fit. and sometimes they decide it isn't what they want to do, especially for a young careerist. Our job is to onboard them and get them into the positions so they are not part of the statistics."

Knowles agreed that onboarding is a huge opportunity for the hospital to keep them. "Within the first several months, they know whether they want to stay. We're going to revamp our new employee orientation to be more interactive and to be proactive instead of reactive. This is all to identify training opportunities or discontent to make sure we are building up the person and assimilating them to our vision, mission and values. It's also up to leadership to have the training to make sure they hire the right candidates, making sure they have the right tools to coach the candidates. Margie started the leadership conference that we hold quarterly, and we are going to continue to invest in it heavily. It's good for all our directors to get together and learn different styles and grow as an organization together."

Fox noted that it might be good to give new nursing graduates the opportunity to shadow nurses in other departments.

Molitor said: "With our internship program, we interview them and hire them directly into a department. If they find it is not a good fit, we move them to another area. They pretty much know what's going on in the other departments."

Board Member Pat McIntire, a retired Western New Mexico University nursing professor, said: "Internships for new grads have been shown to increase retention and to help them get up to speed, because there's no way you can teach them everything in a school of nursing."

Molitor noted that nursing graduates from Western do their clinical rotations at Gila Regional."By the time we interview them, they've had experience in the different departments and they sort of know where they want to go."

Traeger asked for a breakout on why people are leaving in the first two years. Other board members concurred.

Vega asked if the hospital has a figure on how much turnover costs.

Banks said he would follow up on that.

Hawkins said the patients and the employees are the ones who take the narrative out into the community.

Knowles said recruitment has been successful in bringing in 35 new hires pretty even throughout the house, "but we've been passive with the jobs being mostly on the website. We've gone to a few career fairs, but we haven't pushed that since post-Covid. We have succeeded in hiring a talent acquisition specialist, which is HR speak for a recruiter. We promoted up our assistant. She is a Silver City native, and so I'm excited to see what she brings to the table. We're looking at social media. We have cell phones, looking at them constantly. We're going to be aggressive in getting our job notices out and attracting talent that we need. We are also looking at being aggressive toward career fairs. If we go to UTEP (University of Texas, El Paso) or to Arizona, we're not going to capture those grads straight out of school. Most have signed contracts with bonuses and incentives, but they will expire in one-to-two years. After they've been at a 300-400 bed facility, do they want to come to a town where they are a name, not just a number? There are resume databases, and we can cold call those within a certain radius of Silver City where we will have a huge talent pool that we can recruit."

Hawkins asked if Gila Regional has a sign-on bonus.

Knowles said the bonuses at Gila Regional are from $5,000 up to $15,000. Banks chimed in that those bonuses are for positions of critical need and the bonus is based on the position, not the candidate.

Traeger confirmed that the bonus has a requirement for a certain length of time the person must stay with the hospital.

Knowles said the hospital plans employee engagement events to help the employees become part of the organization. "We had a cookout at Penny Park. We will have a costume contest and a pumpkin carving contest, along with the Trunk or Treat coming up, and a Christmas party at the Flame."

He said open enrollment for benefits would take place Nov. 6-17. "I haven't gotten the final rates from our agents, such as Blue Cross and others. I am working with our brokers to make sure that they are all cost-effective and in line with the market. We're going to have teams on site with our vendors to help our employees with their insurance and even getting starting on their retirement plans. We have three plans and each has a deductible. We don't have a true high deductible. Copays are very reasonable. We always want to offer the best. We are asking our brokers to make sure our three are relevant for next year."

Banks said the discussion should take place in executive session. "If our employees are not using the benefits, then we need to determine if it's not what they want. Last year, we did a big change for a lower tier for a single parent and child."

"Lastly, one area that has been a huge question," Knowles said, "is am I being paid fairly. We will be working with PayFactors and they have industry-leading software with a large number of datasets and data points to review. They validate their data. These are validated professionals reviewing our pay scales."

Vega asked if the members would receive more information in executive session.

Banks said: "Yes, this is an investment in our people. We gave our nurses and CNAs well-deserved raises. An investment like this helps our employees stay. We want to set wage levels that help us be competitive."

Board Member Javier "Harvey" Salas came in late and asked if anyone at the hospital was paid less than $15 an hour."

Molitor replied: "Yes."

"Okay. That's one of the issues we had talked about as the Governing Board," Salas said. "No one should be working at this organization at less than $15 an hour."

Banks replied that it is a topic that should be discussed in executive session.

Molitor said the hospital starts with a pay survey to make sure it is competitive, as well as affordable for the organization. "We are paying someone else to determine what is best for us and not go in the hole. Yes, we have the goal of $15 an hour."

Salas asked why a survey is required. "Can't we get that from HR?"

Banks said they could agree that $15 is a goal. "But we have to be able to afford it. We can't just jump in and give a raise."

Salas: "I consider every position in the hospital critical. Why is a person making $13 not as important?"

Molitor said they are incredibly important, but with each raise, the hospital has to think about all the positions, so there is not compression. "This survey will look at everyone."

Salas persisted and said the people he has talked to who are in the lower groups feel like it's not fair that other groups have been looked at, while they've been denied any raises.

Banks replied: "We have looked at and we look at every position."

Molitor said: "We will come to you and say this is how much we can afford. I would love to pay everyone a ton of money, but we can't afford to. We have to do it systematically through this compensation study."

Banks said the hospital wants to be at market and be fair to everyone.

Salas said: "But you still have people working here who are under the $15."

Knowles said he has worked with PayFactors and they will present graphs and charts. "We are looking at having the benchmarking and forecasting done by the end of the calendar year."

Banks said it was too early in the process to know what the results will be, but "we can promise you and we promised the employees that we would keep everyone up-to-date as we go through the process. We will provide a plan to the organization."

Salas said there is noise from Santa Fe that they will require $15 an hour minimum.

"Then we'd have to do it," Molitor said.

Vega said she would like to see a plan on how to pay everyone in the hospital a livable wage. "If we have that as a target, I think we will see a lot of improvement in the hospital. However, we have to work it into the budget."

Salas said: "It has been brought up previously and it fell through the cracks and is not being addressed."

"If it's something we can't do in a year, we will make progress," Banks said. "And as we make progress, we will provide the plan to you."

'That will take months, and I bet we're still talking about this six months from now," Salas said.

Molitor said that's the reason they want the information in December, is "so we can do something in January."

Hawkins said: "There's your answer right there."

Molitor said; "We will come to you and say this is what it's going to cost us."

Hawkins said he didn't believe the board meant to make the issue confrontations. And others agreed, with Vega saying: "We just want the information."

"I also have a question about the Trunk or Treat," Hawkins said. "Which department does that?"

The reply was Marketing.

Hawkins said he would like a presentation on marketing.

"We've made an effort to be in the community," Molitor said. "We did buy a pig at the Fair."

Chief of Staff Dr. Colicia Meyerowitz said she would give her report in executive session.

Molitor presented her Interim CEO report. "We had great participation of our directors, trustees and medical staff.with our three candidates for CEO."

[Editor's Note: Please visit https://www.grantcountybeat.com/news/news-articles/80581-breaking-news-gila-regional-medical-center-appoints-new-ceo to see who the trustees chose.]

She noted that newly appointed Chief Nursing Officer Ron Green has worked his way up at the hospital.

A new Lab Director Steven Duncan was to start on Oct. 15.

The hospital will complete its annual employee engagement survey between Oct. 19 and Nov. 11. A planned second quarterly leadership development institute was scheduled for Sept. 18.

The new emergency department provider group, ESS, was to start Oct. 1.

"We continue to wait on the operating room air handler replacement," Molitor said. "Trane visited the facility in July and again in August, but has not yet provided the scope of work."

She said the MATCH (maternal and child labor and delivery department) plans were submitted, with the only approval pending was the electrical. Subcontractors were expected on site on Sept. 27.

The hospital has finalized the nurse call light replacement project details and hoped to submit them to the state the week of the meeting. It will be funded by a grant.

The Meditech Expanse is on track, with testing being done regularly. She said Banks has brought in people to keep the hospital on track for go live on Nov. 7.

The hospital is also working on a interior renovation to place the orthopedic clinic in the at present unused Pod 3.

An appreciation luncheon for auxiliary members took place on Sept. 26. "They are a small but mighty group," Molitor said. "During the past year, they have donated 7,635 hours for the value of $92,620. Lifetime hours by current active members total 100,963, for a value of $1,211,559."

Under recruitment, she said pediatrician Dr. Herr will begin his service to the hospital in January. "He will also provide pediatric hospitalist coverage about one week a month. We plan to request to utilize funds from SB7 for the start-up costs of this practice."

"We are still hopeful that federal funding for a new MRI is on track," Molitor said. "Don't forget to buy tickets for the hospital's 40th anniversary celebration. Ruby and Scrubs Gala on Oct. 27."

Vega said she didn't think the hospital was promoting women's care as much as it should. "We have excellent staff all over the hospital, but women need to know they can get all the services they need here, without going out of town.

Banks noted a video on women's services for marketing purposes had just been finalized and would be showing in October.

Molitor said it would air on Facebook.

"When I came here I asked what the hospital was doing on marketing," she continued. " We didn't have anyone doing marketing, so we started creating short videos. We are doing better now that we have more money that we can put toward marketing."

Banks noted that the Marketing Director Julissa Alaniz is working on redoing the website to make sure it is patient friendly.

Vega said she has heard several talking points, including the volunteer hours, the 3D mammograms. "Can we get a list of the talking point so we're all on the same page?"

Manis gave his Health Tech report. He noted that Carolyn St. Charles, the organization's chief clinical officer, will work with Green to make sure he has the resources he needs. "HealthTech is also happy to provide sponsorships for hospital events, such as the Ruby and Scrubs gala, although I will not be able to be here. We started the process of weekly cash calls with Gila Regional. Now they are every other week. Patrick is putting together a report on the cash and what needs to be done from here. We also need to look at grants for many expenses and equipment. We have our finger on the pulse of the finances here. It is helpful for the leadership team and the folks here to make sure what we're doing has purpose. It's all happening in the background. Finally, when you have a new CEO, we will be bringing them all together in Illinois for training and networking."

The trustees went into executive session and adjourned from the closed session.

To view the preceding article, please visit https://www.grantcountybeat.com/news/news-articles/80791-grmc-board-of-trustees-held-regular-meeting-102723-part-1