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A View From the Top: Life at a Top 20 Rural Community Hospital

Jun 20, 2019 07:00AM ● By MED Magazine

By Alex Strauss

This Spring, when the National Rural Health Association released its annual list of Top 20 Rural Community Hospitals, three South Dakota hospitals were on it. In fact, South Dakota was second only to Indiana - which had five - in the number of institutions on the list. In addition to Avera St. Mary’s in Pierre, the list included two independent hospitals - Brookings Health System in Brookings and Prairie Lakes Healthcare System in Watertown.

It was the third Top 20 designation in four years for PLHS and the second time in three for Brookings. What allows these small, independent rural hospitals to continue to thrive while so many others are forced to sell out or fold? For insights, we turned to two people who have made these hospitals their professional homes.

Investing Wisely

 Brookings Health System includes a 49-bed hospital, a nursing home, senior living apartments, an eye clinic, and medical clinics in Arlington, White, and Volga. Family medicine physician and Madison native Andrew Ellsworth, MD, has been with the system for the last seven years. As a member of the board of trustees, Dr. Ellsworth believes the hospital’s success has a lot to do with strategic investment - and good timing.

“The whole culture of the hospital is ‘we can do this and we are going to make it happen,’” says Ellsworth. “We invested in a major renovation at just the right time. We invested in the da Vinci and then the Mako robotic system, which helped bring in 3 more full time general surgeons and 2 full time orthopedic surgeons. We invested in hospitalists to take some of the burden off of primary care. We invested in becoming a ‘Baby Friendly Hospital’, the only one in the state outside of the IHS. Now we have four full time OBs.”

Ellsworth says investments like the 62,000 square foot expansion/renovation project in 2017 and the 30,000 square foot medical office building completed in 2016, boost both provider pride and patient confidence - both of which make it easier to attract new providers like himself and new patients. And the cycle of success continues.

“We have been able to recruit fairly easily whereas in some places it’s awfully hard,” says Ellsworth, He adds that a good school system and the city’s willingness to invest in projects like the Children’s Museum and the Hillcrest Aquatic Center are other draws for families like his.

Specializing in Specialists

 Situated about 100 miles from Sioux Falls, Prairie Lakes Healthcare System includes an 81-bed hospital, a cancer center, a surgical center, and dialysis units. It serves a patient base of 90,000 across a 10-county area. Like Brookings Health System, PLHS has invested heavily in infrastructure (like the new 68,000 square foot specialty clinic) and technology with the goal of enticing specialists and the patients who need them.

But nephrologist Tina Melanson, MD, says upgrades like new cath lab equipment and a therapy pool are only part of the attraction for providers. Melanson says she moved from a larger health system in Sioux Falls back to her hometown with her young family in 2011 for a more relaxed lifestyle.

“I moved here to be a ‘country nephrologist’,” says Dr. Melanson. “Because it is a much smaller facility, I thought it would be an opportunity to slow down for a little while and spend more time with family.”

But the demand for nephrology services - like the demand for so many other specialty services in Watertown - has grown steadily. The dialysis unit went from being open just three days a week to six and added an NP and a PA. Dr. Melanson now oversees additional PLHS dialysis units in Sisseton and Ortonville, Minnesota, and at Huron Regional Hospital.

While she is busier than she expected to be, Melanson repeats what so many providers say they value most about working at independent hospitals like PLHS.

“I love that I am in charge of my own ship,” she says. “They respect my opinion and that autonomy definitely impacts my practice. I used to have to schedule a meeting that would take a month to arrange. Now, I can literally walk down the hall and speak to administration any time.”

About the NRHA’s Top 20 Rural Community Hospital Award

The NRHA honors the 20 highest-ranked prospective payment system hospitals in the country based on an evaluation by The Chartis Center for Rural Health using iVantage Health Analytics’ Hospital Strength INDEX.

Now in its ninth year, the INDEX leverages 50 rural-relevant indicators across eight pillars of hospital strength (i.e. Inpatient Market Share, Outpatient Market Share, Cost, Charge, Quality, Outcomes, Patient Perspective and Financial Stability) to determine an overall score for each hospital. Each of the INDEX’s 50 indicators is culled from publicly-available data sources. NRHA’s Top 20 Rural Community Hospitals Winners are the highest ranked of the aggregate scores across these indices.

For more information about the Top 20 award and to see the other award winners, visit the NRHA website.

The ‘Secret’ to Top 20 Success

Wondering what the CEOs of these Top 20 hospitals credit with their Top 20 designations? Click here to read our exclusive interview with Prairie Lakes CEO K.C. DeBoer and Brookings Health CEO Jason Merkley.