Spencer Hospital: Profile of a Top 100 Rural Hospital

By Alex Strauss

Spencer Hospital hospital has a long and proud history of doing what current hospital President Bill Bumgarner calls "taking the long view".  

"When you look at the hospital and the medical community over a period of time, you see how our medical staff, healthcare team, and governing board have always worked together to both ensure access to high quality services and to engage around business opportunities," says Bumgarner. "That has been key over many decades, long preceding my tenure." 

Established by a volunteer association with community donations in 1914, the hospital stood on the same spot for 20 years until the town's residents approved a bond issue to construct a new 'modern' hospital. The new municipal facility opened its doors in 1935 and has continued to grow and expand in the same location ever since. 

Today, Spencer Hospital is staffed for 64 beds - 49 acute care (medical/surgical, the ICU, and a birthing center) and 15 beds in an inpatient behavioral health unit. It has eight locations in four counties, including rural family medicine clinics in Hartley, Milford, and Sioux Rapids, and is accredited by the Center for Improvement in Healthcare Quality. 

Recently, the hospital was named a Top 100 Rural & Community Hospital by Chartis Health for the eighth time. It is the only mid-sized Iowa hospital - and one of only 17 nationally - to have received the award every year since its inception. With more than 500 employees, Spencer Hospital is also the largest employer in Clay County and maintains strong relationships with a number of business partners, including Avera Health.

"I think the Top 100 award shows that from a service, outcome, and business aspect, we do a lot of things really well," says Bumgarner. 

Bumgarner has been Spencer Hospital's President for 14 years, but his history with the hospital goes back to the very beginning of his career. Fresh out of the University of Iowa with a business degree, Bumgarner served as the hospital's human resources director. He went on to earn his MBA from Iowa State University and, although his work would eventually take him elsewhere, including a brief stint in Arizona, all but 2.5 years of his 41-year career have been spent in Iowa.

"I think the thing that so many of us value about being part of the Spencer medical community is that, at one level, we are a traditional community hospital where it's not unusual to see your friends and neighbors," says Bumgarner. "But on another level, we are also a regional medical center for about nine counties in Iowa."

"I think we are a very progressive hospital," says Brenda Tiefenthaler, RN, Senior Vice President of Patient Care and Operations. "We are constantly looking at what services are needed and then doing the legwork we need to bring them here. We also have strong community support, which allows us to do this and maintain our independence."

Small Hospital, Big Services

It is easy to see why Spencer Hospital has become an important regional referral center. It offers a wide range of services not often seen in smaller rural facilities. 

At the hospital's Abben Cancer Center, patients can get a diagnosis and access comprehensive therapies including surgery, radiation therapy, and medical oncology. Spencer Hospital is the only center in the region to offer eight modalities accredited through the American College of Radiology plus two distinctions - a Breast Imaging Center of Excellence and a Lung Cancer Screening Center. 

"I don't think that you should have to travel for healthcare," says Tiefenthaler, a former oncology nurse and past Director of the Abben Cancer Center. "We believe that you should be able to get your care closer to home from people that you know and trust. It's hard enough when you have a health problem. You should be able to feel safe getting your care locally." 

Also notable for a rural hospital is the Behavioral Health Center, including both outpatient and inpatient care, two freestanding dialysis centers (Spencer and Spirit Lake), and a 

Wound Center with not one but two hyperbaric oxygen therapy chambers. 

A construction project is underway to expand and update the emergency department. In addition to a larger, more comfortable waiting area, the enhancements include more privacy, larger rooms, a temperature-controlled attached ambulance garage, and an area reserved for behavioral health patients. The surgical center recently got a similar upgrade.

"When we have physician recruits visit, they are sometimes taken aback by how our hospital and our systems and processes compare to even larger facilities," says Bumgarner. "We have been fortunate because of the success of our hospital and medical community."

Culture of Cooperation

Bumgarner says investments like the ED and surgery center projects are not only important to meet the needs of local patients, but are also part of fostering relationships and forming partnerships that can help sustain their services for the long haul. 

A variety of specialists offer regular clinics at the hospital, which also offers specialty care through Avera Medical Group Spencer: Advanced Gynecology & Surgery, Iowa Spine Care of Spencer Hospital, Northwest Iowa Ear, Nose & Throat Specialists, behavioral health and oncology services, and provider-based relationships with orthopedic and general surgery clinics. 

"One thing we have been doing a lot is joining into relationships with physician practices," says Bumgarner. "It's so competitive to recruit and retain good quality surgeons. Lately, we have entered into joint business arrangements instead, so that we are all succeeding together."

Just as important as their outside partnerships are the ones that form within their own ranks. Tiefenthaler says being a tight-knit community has helped Spencer Hospital "think outside the box" to manage post-pandemic labor shortages. 

"We are moving our RNs, LPNs, and patient care techs around, as needed, and looking at all kinds of disciplines to accommodate staffing," she says. "Fortunately, everyone knows what our mission and purpose is and we work together as a team to accomplish it, whether you are a member of the medical staff or an entity in the community. It's why people want to get their care here."

Which is not to say it has been easy. "We've had to do some good old-fashioned belt tightening," says Bumgarner. "The hiring process is more challenging, the supply chain can be inefficient. Then there are inflationary problems. But we have always prided ourselves on being very efficient."

Despite the challenges of the last three years, Spencer Hospital has not limited services and has maintained the job security of its healthcare team. Tiefenthaler says it has only made them stronger. 

"I have worked at big and small hospitals and the atmosphere, the people, and the culture here is amazing," she says. "I still like to wake up and come to work. You would have to tug on me hard to get me to go anywhere else."