From Candy Striper to CEO: Melissa Hall on Rural Healthcare and Why It Matters | Ep 53

Hey guys, Sam McVey here with the Killer Hey guys, Sam McVey here with the Killer Growth podcast and today I have Melissa Growth podcast and today I have Melissa Growth podcast and today I have Melissa Hall, CEO of Susan B. Allen Memorial Hall, CEO of Susan B. Allen Memorial Hall, CEO of Susan B. Allen Memorial Hospital. Hospital. Hospital. » Hello. Thank you for having me today. » Hello. Thank you for having me today. » Hello. Thank you for having me today. » Of course. Been looking forward to it. » Of course. Been looking forward to it. » Of course. Been looking forward to it. » It's be fun. We don't know each other at » It's be fun. We don't know each other at » It's be fun. We don't know each other at all. We literally just shook hands and all. We literally just shook hands and all. We literally just shook hands and talked for 2 minutes. talked for 2 minutes. talked for 2 minutes. » We did. Yes. » We did. Yes. » We did. Yes. » That's about it. So, uh, but I've heard » That's about it. So, uh, but I've heard » That's about it. So, uh, but I've heard good things. good things. good things. » Thank you. » Thank you. » Thank you. » And excited to hang out and learn more » And excited to hang out and learn more » And excited to hang out and learn more about what it's like being a CEO of a about what it's like being a CEO of a about what it's like being a CEO of a hospital. hospital. hospital. » And how do you become a CEO of a » And how do you become a CEO of a » And how do you become a CEO of a hospital? hospital? hospital? » Oh my gosh. » Oh my gosh. » Oh my gosh. » That's where we're going to start. Okay. » That's where we're going to start. Okay. » That's where we're going to start. Okay. Well, Well, Well, » I think you obviously have some medical » I think you obviously have some medical » I think you obviously have some medical background I don't know about. background I don't know about. background I don't know about. » Yes, I do. Um, so, uh, fun fact, I'm a » Yes, I do. Um, so, uh, fun fact, I'm a » Yes, I do. Um, so, uh, fun fact, I'm a very goal- driven person. It was never very goal- driven person. It was never very goal- driven person. It was never my goal to be a CEO of a hospital. No my goal to be a CEO of a hospital. No my goal to be a CEO of a hospital. No joke. joke. joke. » That that they say is the recipe of a » That that they say is the recipe of a » That that they say is the recipe of a good CEO. good CEO. good CEO. » Oh, well, I I don't I'm I'm hoping. I'm » Oh, well, I I don't I'm I'm hoping. I'm » Oh, well, I I don't I'm I'm hoping. I'm trying. But, um, yeah. So, truly, my um trying. But, um, yeah. So, truly, my um trying. But, um, yeah. So, truly, my um my background is nursing. Um, I my background is nursing. Um, I my background is nursing. Um, I believe it or not, I actually started in believe it or not, I actually started in believe it or not, I actually started in the healthc care field when I was 14 as the healthc care field when I was 14 as the healthc care field when I was 14 as a candy striper back in the day. We used a candy striper back in the day. We used a candy striper back in the day. We used to have those. They were volunteers. Um, to have those. They were volunteers. Um, to have those. They were volunteers. Um, and we just went around and we just went around and we just went around and » built ice cups and that kind of stuff. » built ice cups and that kind of stuff. » built ice cups and that kind of stuff. Visited with patients. That that was our Visited with patients. That that was our Visited with patients. That that was our job. job. job. » Um, where was that at? » Um, where was that at? » Um, where was that at? » I did that at Newman in Emporia, Kansas. » I did that at Newman in Emporia, Kansas. » I did that at Newman in Emporia, Kansas. Um, my sister actually worked at Dolly Um, my sister actually worked at Dolly Um, my sister actually worked at Dolly Madison. So, I would ride to her she'd Madison. So, I would ride to her she'd Madison. So, I would ride to her she'd drop me off, she'd go to work, and then drop me off, she'd go to work, and then drop me off, she'd go to work, and then she'd pick me up. So, that's how my my she'd pick me up. So, that's how my my she'd pick me up. So, that's how my my summer days went. So, summer days went. So, summer days went. So, » cool. » cool. » cool. » Yeah. That's how it all kind of started. » Yeah. That's how it all kind of started. » Yeah. That's how it all kind of started. Yeah. And then um you know my my Yeah. And then um you know my my Yeah. And then um you know my my grandmother was actually a CNA at a grandmother was actually a CNA at a grandmother was actually a CNA at a hospital in Burlington, Kansas, which is hospital in Burlington, Kansas, which is hospital in Burlington, Kansas, which is where I was grew up. where I was grew up. where I was grew up. » Okay. » Okay. » Okay. » Born and raised there in a farming » Born and raised there in a farming » Born and raised there in a farming community, primarily farming community, primarily farming community, primarily farming community for a long time. Um so my grandma for a long time. Um so my grandma for a long time. Um so my grandma actually kind of instilled that just actually kind of instilled that just actually kind of instilled that just nurturing, giving. She was a farm wife nurturing, giving. She was a farm wife nurturing, giving. She was a farm wife for a lot of years. Um my grandfather for a lot of years. Um my grandfather for a lot of years. Um my grandfather ended up passing away and she had a lot ended up passing away and she had a lot ended up passing away and she had a lot of hospital debt. And um so true story, of hospital debt. And um so true story, of hospital debt. And um so true story, she walked in to the office to say, "I she walked in to the office to say, "I she walked in to the office to say, "I can't afford to pay my bill. What do I can't afford to pay my bill. What do I can't afford to pay my bill. What do I do?" And they said, "Well, do you want do?" And they said, "Well, do you want do?" And they said, "Well, do you want to work it off?" to work it off?" to work it off?" » Yeah. So they um at that point in time, » Yeah. So they um at that point in time, » Yeah. So they um at that point in time, they didn't actually have like CNA they didn't actually have like CNA they didn't actually have like CNA classes. It was just on the job classes. It was just on the job classes. It was just on the job training. And so she that's how she paid training. And so she that's how she paid training. And so she that's how she paid off her hospital bills. And that's how off her hospital bills. And that's how off her hospital bills. And that's how it all started. Wow. it all started. Wow. it all started. Wow. » Yeah. So, uh, my grandmother is probably » Yeah. So, uh, my grandmother is probably » Yeah. So, uh, my grandmother is probably one of the most influential people in my one of the most influential people in my one of the most influential people in my life. Um, you know, she just she just life. Um, you know, she just she just life. Um, you know, she just she just taught you from a very young age that if taught you from a very young age that if taught you from a very young age that if you just work hard and you just keep you just work hard and you just keep you just work hard and you just keep going, it's all going to work out, you going, it's all going to work out, you going, it's all going to work out, you know. Um, even the hard things in know. Um, even the hard things in know. Um, even the hard things in life, you can learn from. life, you can learn from. life, you can learn from. » And so, um, another fun fact, while I » And so, um, another fun fact, while I » And so, um, another fun fact, while I was in high school, um, I tried to get a was in high school, um, I tried to get a was in high school, um, I tried to get a job. I'm like, my mom and dad were like, job. I'm like, my mom and dad were like, job. I'm like, my mom and dad were like, you need to make your own money. you need to make your own money. you need to make your own money. » Um, and so we I was like, well, I don't » Um, and so we I was like, well, I don't » Um, and so we I was like, well, I don't know what to do really. I didn't really know what to do really. I didn't really know what to do really. I didn't really want to work in fast food, but I think want to work in fast food, but I think want to work in fast food, but I think it's like a passage of right, you know, it's like a passage of right, you know, it's like a passage of right, you know, you have to. And so I worked at Dairy you have to. And so I worked at Dairy you have to. And so I worked at Dairy Queen for a while. Um, and then, um, Queen for a while. Um, and then, um, Queen for a while. Um, and then, um, » I miss Dairy Queen. We had one here for » I miss Dairy Queen. We had one here for » I miss Dairy Queen. We had one here for a long time. a long time. a long time. » There's just It's just good ice cream. I » There's just It's just good ice cream. I » There's just It's just good ice cream. I mean, let's just be honest about that. mean, let's just be honest about that. mean, let's just be honest about that. » The chicken strips were fantastic. » The chicken strips were fantastic. » The chicken strips were fantastic. » And the dip them in gravy. It's perfect. » And the dip them in gravy. It's perfect. » And the dip them in gravy. It's perfect. » Exactly. Yeah. You only got the gravy. » Exactly. Yeah. You only got the gravy. » Exactly. Yeah. You only got the gravy. » Yeah. Yeah. Um, so my grandmother was » Yeah. Yeah. Um, so my grandmother was » Yeah. Yeah. Um, so my grandmother was like, "Hey, you should just try out like, "Hey, you should just try out like, "Hey, you should just try out being a CNA." And I'm like, "Yeah, okay. being a CNA." And I'm like, "Yeah, okay. being a CNA." And I'm like, "Yeah, okay. Like I could do that." So then I did the Like I could do that." So then I did the Like I could do that." So then I did the volunteer thing um at Newman's and then volunteer thing um at Newman's and then volunteer thing um at Newman's and then I'm like you know I could really like do I'm like you know I could really like do I'm like you know I could really like do this and so um I started working at the this and so um I started working at the this and so um I started working at the assisted living facility in Burlington assisted living facility in Burlington assisted living facility in Burlington and my grandmother's actually who and my grandmother's actually who and my grandmother's actually who trained me because trained me because trained me because » So were you still in high school at that » So were you still in high school at that » So were you still in high school at that point? point? point? » Yeah. Yeah. And so um I actually would » Yeah. Yeah. And so um I actually would » Yeah. Yeah. And so um I actually would go in before school and serve breakfast go in before school and serve breakfast go in before school and serve breakfast and then and then and then » help do as many dishes as I could before » help do as many dishes as I could before » help do as many dishes as I could before school and then I'd go to school and school and then I'd go to school and school and then I'd go to school and then usually then usually then usually » I was not that motivated in high school. » I was not that motivated in high school. » I was not that motivated in high school. I I would have not got up to do anything I I would have not got up to do anything I I would have not got up to do anything before school, like period. before school, like period. before school, like period. » So, honestly, I've always kind of been » So, honestly, I've always kind of been » So, honestly, I've always kind of been an early riser, so that part's not hard. an early riser, so that part's not hard. an early riser, so that part's not hard. But, um, but yeah, I mean, that's that's But, um, but yeah, I mean, that's that's But, um, but yeah, I mean, that's that's kind of how it all started. And then I kind of how it all started. And then I kind of how it all started. And then I actually, uh, my junior year of high actually, uh, my junior year of high actually, uh, my junior year of high school. Um, my, you know, my parents I school. Um, my, you know, my parents I school. Um, my, you know, my parents I grew up um, the typical farm family, grew up um, the typical farm family, grew up um, the typical farm family, right? like my dad I mean we ate so many right? like my dad I mean we ate so many right? like my dad I mean we ate so many family dinners in the field because family dinners in the field because family dinners in the field because that's where our dad was like you know that's where our dad was like you know that's where our dad was like you know and so my mom would cook dinner we'd and so my mom would cook dinner we'd and so my mom would cook dinner we'd pack it up pack it up pack it up » and she was very adamant that we all ate » and she was very adamant that we all ate » and she was very adamant that we all ate as a family together and so um we did as a family together and so um we did as a family together and so um we did that and so I think that's kind of where that and so I think that's kind of where that and so I think that's kind of where that just work ethic like you just got that just work ethic like you just got that just work ethic like you just got to do what it takes you know and so um I to do what it takes you know and so um I to do what it takes you know and so um I was going to be an a business I mean was going to be an a business I mean was going to be an a business I mean that's what I was going to do um kind of that's what I was going to do um kind of that's what I was going to do um kind of carry that torch but from another carry that torch but from another carry that torch but from another direction because I did not want to work direction because I did not want to work direction because I did not want to work in a field all day right that was in a field all day right that was in a field all day right that was not I bless them. not I bless them. not I bless them. They uh They uh They uh » Oh, yeah. Lots of summers on a haywagon » Oh, yeah. Lots of summers on a haywagon » Oh, yeah. Lots of summers on a haywagon for me and that was I don't want to do for me and that was I don't want to do for me and that was I don't want to do that forever. Yeah. All right. that forever. Yeah. All right. that forever. Yeah. All right. » Yeah. Um so, so then uh my sister » Yeah. Um so, so then uh my sister » Yeah. Um so, so then uh my sister actually ended up having her third actually ended up having her third actually ended up having her third child. Um he was a preeie, so he came child. Um he was a preeie, so he came child. Um he was a preeie, so he came three months early. Um he weighed 2 lb three months early. Um he weighed 2 lb three months early. Um he weighed 2 lb and 10 ounces, right? And so he was in and 10 ounces, right? And so he was in and 10 ounces, right? And so he was in the NICU for 14 weeks. The first 14 the NICU for 14 weeks. The first 14 the NICU for 14 weeks. The first 14 weeks of his life, that's where he weeks of his life, that's where he weeks of his life, that's where he lived. Um, and it was super impactful lived. Um, and it was super impactful lived. Um, and it was super impactful for me. Um, I had the opportunity I was for me. Um, I had the opportunity I was for me. Um, I had the opportunity I was the one that could kind of take my the one that could kind of take my the one that could kind of take my sister up in the evening, you know, so sister up in the evening, you know, so sister up in the evening, you know, so I'd get out of school and cuz she I'd get out of school and cuz she I'd get out of school and cuz she couldn't drive, she had some medical couldn't drive, she had some medical couldn't drive, she had some medical conditions going on. And so it was a lot conditions going on. And so it was a lot conditions going on. And so it was a lot of car time. Um, and we had the of car time. Um, and we had the of car time. Um, and we had the opportunity to just kind of feel and opportunity to just kind of feel and opportunity to just kind of feel and share that experience. And I'm like, share that experience. And I'm like, share that experience. And I'm like, wow, these people are really making a wow, these people are really making a wow, these people are really making a difference. I mean, my sister talked difference. I mean, my sister talked difference. I mean, my sister talked more about the people that helped her more about the people that helped her more about the people that helped her through that journey than the actual through that journey than the actual through that journey than the actual situation and the stress of all of it, situation and the stress of all of it, situation and the stress of all of it, right? right? right? » And so that's actually » And so that's actually » And so that's actually » they probably kind of become a family at » they probably kind of become a family at » they probably kind of become a family at that point. 14 weeks and they're kind of that point. 14 weeks and they're kind of that point. 14 weeks and they're kind of raising your kid. raising your kid. raising your kid. » Yes. And you know, there were days that » Yes. And you know, there were days that » Yes. And you know, there were days that um unfortunately, you know, she just um unfortunately, you know, she just um unfortunately, you know, she just couldn't get there every day. And so you couldn't get there every day. And so you couldn't get there every day. And so you kind of have to like have this sense of kind of have to like have this sense of kind of have to like have this sense of like, do I trust you? Right. And so I like, do I trust you? Right. And so I like, do I trust you? Right. And so I thought » that's kind of cool. Like I feel like I » that's kind of cool. Like I feel like I » that's kind of cool. Like I feel like I want to be a part of that. And so, uh, want to be a part of that. And so, uh, want to be a part of that. And so, uh, not my mom's favorite day of the world not my mom's favorite day of the world not my mom's favorite day of the world because I literally flipped everything because I literally flipped everything because I literally flipped everything up, right? I had my college picked. I up, right? I had my college picked. I up, right? I had my college picked. I had all this path and, um, she's like, had all this path and, um, she's like, had all this path and, um, she's like, "You want to do what?" I'm like, "Yeah, "You want to do what?" I'm like, "Yeah, "You want to do what?" I'm like, "Yeah, we got to start all over, right? We got we got to start all over, right? We got we got to start all over, right? We got to pick new colleges. We got like I to pick new colleges. We got like I to pick new colleges. We got like I don't know. We got to go see new don't know. We got to go see new don't know. We got to go see new programs." So, my senior year, that's programs." So, my senior year, that's programs." So, my senior year, that's what I what I spent my time doing was um what I what I spent my time doing was um what I what I spent my time doing was um finding the school that fit me. Um, I finding the school that fit me. Um, I finding the school that fit me. Um, I ended up going through an associates ended up going through an associates ended up going through an associates program. I was more of a, you know, it's program. I was more of a, you know, it's program. I was more of a, you know, it's just kind of how you're raised, right? just kind of how you're raised, right? just kind of how you're raised, right? Like like let's hit the ground for Like like let's hit the ground for Like like let's hit the ground for running, like hit the workforce, start running, like hit the workforce, start running, like hit the workforce, start your life kind of thing. Um, and well, I your life kind of thing. Um, and well, I your life kind of thing. Um, and well, I let me back up. I actually started at let me back up. I actually started at let me back up. I actually started at ESU. Um, I thought that's where I wanted ESU. Um, I thought that's where I wanted ESU. Um, I thought that's where I wanted to go. Um, to go. Um, to go. Um, » is that Emporia? » is that Emporia? » is that Emporia? » It is. Yeah. Yeah. And they have a » It is. Yeah. Yeah. And they have a » It is. Yeah. Yeah. And they have a nursing program I was super excited nursing program I was super excited nursing program I was super excited about. Um, about. Um, about. Um, » I started working for this gentleman and » I started working for this gentleman and » I started working for this gentleman and I ended up uh falling in love with his I ended up uh falling in love with his I ended up uh falling in love with his nephew. And so um my path changed a nephew. And so um my path changed a nephew. And so um my path changed a little. little. little. » Uh so met the love of my life. Truly » Uh so met the love of my life. Truly » Uh so met the love of my life. Truly mean that. Um Henry um mean that. Um Henry um mean that. Um Henry um » he is like my biggest supporter. I mean » he is like my biggest supporter. I mean » he is like my biggest supporter. I mean truly like when I say I didn't have the truly like when I say I didn't have the truly like when I say I didn't have the goal to be a CEO. Um but I definitely goal to be a CEO. Um but I definitely goal to be a CEO. Um but I definitely have the support at home that makes that have the support at home that makes that have the support at home that makes that an option. Right. So he does a lot of an option. Right. So he does a lot of an option. Right. So he does a lot of things that I don't think most husbands things that I don't think most husbands things that I don't think most husbands do and he just really just does them. do and he just really just does them. do and he just really just does them. Right. Right. Right. » Stop making us look bad, Henry. Okay. » Stop making us look bad, Henry. Okay. » Stop making us look bad, Henry. Okay. Stop setting the bar so high. Stop setting the bar so high. Stop setting the bar so high. » Yeah. » Yeah. » Yeah. Yeah. So we um so we we got married Yeah. So we um so we we got married Yeah. So we um so we we got married pretty young. I was 19 when we got pretty young. I was 19 when we got pretty young. I was 19 when we got married. Um married. Um married. Um » and how old was he? » and how old was he? » and how old was he? » Uh so we're three years apart. » Uh so we're three years apart. » Uh so we're three years apart. » Three years. Yeah. » Three years. Yeah. » Three years. Yeah. » Yeah. And so you know, but when you » Yeah. And so you know, but when you » Yeah. And so you know, but when you know, you know, you know, and so know, you know, you know, and so know, you know, you know, and so » so funny enough, my wife was 19, I was » so funny enough, my wife was 19, I was » so funny enough, my wife was 19, I was 21. 21. 21. » Okay. So yeah, very similar. » Okay. So yeah, very similar. » Okay. So yeah, very similar. » Yeah. So um and » Yeah. So um and » Yeah. So um and » lots of people are like, "Oh my gosh, » lots of people are like, "Oh my gosh, » lots of people are like, "Oh my gosh, you're 19. This will never work out." you're 19. This will never work out." you're 19. This will never work out." Well, 26 years later, we're still going, Well, 26 years later, we're still going, Well, 26 years later, we're still going, you know. Um and honestly I would say you know. Um and honestly I would say you know. Um and honestly I would say probably stronger today than any probably stronger today than any probably stronger today than any time, right? And so time, right? And so time, right? And so » it's that was truly a blessing. Thank » it's that was truly a blessing. Thank » it's that was truly a blessing. Thank thankfully God put us in the right paths thankfully God put us in the right paths thankfully God put us in the right paths and we crossed um but it did make me and we crossed um but it did make me and we crossed um but it did make me choose a new school for nursing. Um and choose a new school for nursing. Um and choose a new school for nursing. Um and so we I started an associates program so we I started an associates program so we I started an associates program through Ottawa and um you know we made through Ottawa and um you know we made through Ottawa and um you know we made it through nursing school which I don't it through nursing school which I don't it through nursing school which I don't know if anybody knows this but that's a know if anybody knows this but that's a know if anybody knows this but that's a hard degree that is um hard degree that is um hard degree that is um » it's challenging, it's intense, it's uh » it's challenging, it's intense, it's uh » it's challenging, it's intense, it's uh rapid fire all the time. And so a lot of rapid fire all the time. And so a lot of rapid fire all the time. And so a lot of stressors y stressors y stressors y » and but we made it. We made it through. » and but we made it. We made it through. » and but we made it. We made it through. And then um I started working at And then um I started working at And then um I started working at Stormmont Veil in the labor and delivery Stormmont Veil in the labor and delivery Stormmont Veil in the labor and delivery department. Um because you know my my department. Um because you know my my department. Um because you know my my calling I felt like was to be around calling I felt like was to be around calling I felt like was to be around these babies, right? And really be a these babies, right? And really be a these babies, right? And really be a part of that. Um and I got to experience part of that. Um and I got to experience part of that. Um and I got to experience firsthand to be on the nursing side of firsthand to be on the nursing side of firsthand to be on the nursing side of that care that my sister received all that care that my sister received all that care that my sister received all those years before that. So those years before that. So those years before that. So » that's cool. » that's cool. » that's cool. » Just really cool. Full circle. um that » Just really cool. Full circle. um that » Just really cool. Full circle. um that is truly is truly is truly it's just truly a passion of mine. it's just truly a passion of mine. it's just truly a passion of mine. There's just something amazing about There's just something amazing about There's just something amazing about bringing life into the world. Um so I bringing life into the world. Um so I bringing life into the world. Um so I got to be a part of that. Um and then my got to be a part of that. Um and then my got to be a part of that. Um and then my husband and I were blessed with our husband and I were blessed with our husband and I were blessed with our first one uh 3 years later and so we first one uh 3 years later and so we first one uh 3 years later and so we decided living that far away from our families living that far away from our families living that far away from our families doesn't really make sense. So we moved doesn't really make sense. So we moved doesn't really make sense. So we moved um to a small town, Lebo, Kansas. um to a small town, Lebo, Kansas. um to a small town, Lebo, Kansas. » Oh yeah. » Oh yeah. » Oh yeah. » Yeah. So um » Yeah. So um » Yeah. So um » Panasonic. » Panasonic. » Panasonic. » So we um we moved there. I started, » So we um we moved there. I started, » So we um we moved there. I started, which you know, I was commuting for a which you know, I was commuting for a which you know, I was commuting for a while back and forth to Topeka. Three while back and forth to Topeka. Three while back and forth to Topeka. Three days a week, it's not so bad. Um, but days a week, it's not so bad. Um, but days a week, it's not so bad. Um, but when you got a little baby at home, that when you got a little baby at home, that when you got a little baby at home, that gets harder and harder. gets harder and harder. gets harder and harder. » And so I actually reached out to the » And so I actually reached out to the » And so I actually reached out to the local hospital in Burlington, Kansas local hospital in Burlington, Kansas local hospital in Burlington, Kansas again, right? That's where I started all again, right? That's where I started all again, right? That's where I started all um well in high school. And so um I um well in high school. And so um I um well in high school. And so um I said, "Hey, I don't know if you guys said, "Hey, I don't know if you guys said, "Hey, I don't know if you guys have nursing. Like what I mean, you're a have nursing. Like what I mean, you're a have nursing. Like what I mean, you're a lot smaller than Stormmont, you know, lot smaller than Stormmont, you know, lot smaller than Stormmont, you know, that's been my exposure." and they that's been my exposure." and they that's been my exposure." and they were like, "Oh my gosh, yeah, we'd love were like, "Oh my gosh, yeah, we'd love were like, "Oh my gosh, yeah, we'd love to have you, but um probably in surgery, to have you, but um probably in surgery, to have you, but um probably in surgery, like that's where our opening is right like that's where our opening is right like that's where our opening is right now." And I'm like, "All right, let's now." And I'm like, "All right, let's now." And I'm like, "All right, let's learn surgery." So, u we did that. Um learn surgery." So, u we did that. Um learn surgery." So, u we did that. Um and then of course, because you have a and then of course, because you have a and then of course, because you have a skill set, um small hospitals are so skill set, um small hospitals are so skill set, um small hospitals are so very unique. Um very unique. Um very unique. Um it took me a little bit. I I actually uh it took me a little bit. I I actually uh it took me a little bit. I I actually uh jokingly but with all the love in my jokingly but with all the love in my jokingly but with all the love in my heart uh say I did go home about 3 heart uh say I did go home about 3 heart uh say I did go home about 3 months into working there and I told my months into working there and I told my months into working there and I told my husband I have committed career suicide, husband I have committed career suicide, husband I have committed career suicide, right? Like I mean I'm like oh my gosh right? Like I mean I'm like oh my gosh right? Like I mean I'm like oh my gosh like » okay but it's okay cuz I'm going to » okay but it's okay cuz I'm going to » okay but it's okay cuz I'm going to focus on our family and that's going to focus on our family and that's going to focus on our family and that's going to be okay. Um but actually what you what I be okay. Um but actually what you what I be okay. Um but actually what you what I didn't know then is what I know now and didn't know then is what I know now and didn't know then is what I know now and that is rural health has a just true that is rural health has a just true that is rural health has a just true um niche and you get to see all um niche and you get to see all um niche and you get to see all facets right like you yes um some days facets right like you yes um some days facets right like you yes um some days are hard because you truly have to are hard because you truly have to are hard because you truly have to figure out how to do things that at a figure out how to do things that at a figure out how to do things that at a big hospital you have every specialty big hospital you have every specialty big hospital you have every specialty for right I mean at a big hospital we for right I mean at a big hospital we for right I mean at a big hospital we had a team that came and started our IVs had a team that came and started our IVs had a team that came and started our IVs now all of a sudden I got to start all now all of a sudden I got to start all now all of a sudden I got to start all of my own you know it's just you of my own you know it's just you of my own you know it's just you know, it's just some things like that know, it's just some things like that know, it's just some things like that are you feel like they're that are you feel like they're that are you feel like they're backwards, but really as a nurse, my backwards, but really as a nurse, my backwards, but really as a nurse, my skill set grew so much. Um, the other skill set grew so much. Um, the other skill set grew so much. Um, the other thing about a small hospital is you kind thing about a small hospital is you kind thing about a small hospital is you kind of do whatever it takes. Um, so my of do whatever it takes. Um, so my of do whatever it takes. Um, so my director of nursing came to me one day. director of nursing came to me one day. director of nursing came to me one day. She's like, "We have all these gaps in She's like, "We have all these gaps in She's like, "We have all these gaps in our ER. Do you want to learn ER?" And our ER. Do you want to learn ER?" And our ER. Do you want to learn ER?" And I'm like, "Uh, I don't know." Like, and I'm like, "Uh, I don't know." Like, and I'm like, "Uh, I don't know." Like, and she's like, she's like, "It's not going she's like, she's like, "It's not going she's like, she's like, "It's not going to be that hard. Like, you'll be fine." to be that hard. Like, you'll be fine." to be that hard. Like, you'll be fine." And I'm like, she's like, "It's a lot And I'm like, she's like, "It's a lot And I'm like, she's like, "It's a lot like recovering a patient." I'm like, like recovering a patient." I'm like, like recovering a patient." I'm like, "Okay." She lied. It's not it's not it's "Okay." She lied. It's not it's not it's "Okay." She lied. It's not it's not it's different but um but it was still good. different but um but it was still good. different but um but it was still good. It's still a skill set that I you know It's still a skill set that I you know It's still a skill set that I you know got to learn and just be a part of. Um got to learn and just be a part of. Um got to learn and just be a part of. Um but the other part of that is you truly but the other part of that is you truly but the other part of that is you truly get to see how the whole hospital works. get to see how the whole hospital works. get to see how the whole hospital works. In a small hospital you have to In a small hospital you have to In a small hospital you have to » the correlation of like big business » the correlation of like big business » the correlation of like big business to a small business. Everything you're to a small business. Everything you're to a small business. Everything you're saying sounds like somebody that's, you saying sounds like somebody that's, you saying sounds like somebody that's, you know, starting a business and they have know, starting a business and they have know, starting a business and they have to do the bookkeeping and do the jobs to do the bookkeeping and do the jobs to do the bookkeeping and do the jobs and take the calls and take the calls and take the calls and » Yes. Like you don't just get to do your » Yes. Like you don't just get to do your » Yes. Like you don't just get to do your niche, you know? It's it's it's all of niche, you know? It's it's it's all of niche, you know? It's it's it's all of us together. Yeah. Yeah. us together. Yeah. Yeah. us together. Yeah. Yeah. » Um and then » Um and then » Um and then » so really that kind of progressed to um » so really that kind of progressed to um » so really that kind of progressed to um » I kind of like computers. Um I I you » I kind of like computers. Um I I you » I kind of like computers. Um I I you know I I don't know it's like never been know I I don't know it's like never been know I I don't know it's like never been a thing I'm like oh yes I want to learn a thing I'm like oh yes I want to learn a thing I'm like oh yes I want to learn IT stuff, right? But it kind of comes IT stuff, right? But it kind of comes IT stuff, right? But it kind of comes natural and I'm like I kind of get how natural and I'm like I kind of get how natural and I'm like I kind of get how things all work together. things all work together. things all work together. » And um so at the time the person that » And um so at the time the person that » And um so at the time the person that was over our IT department said, "Hey, was over our IT department said, "Hey, was over our IT department said, "Hey, we got to take this new update. um do we got to take this new update. um do we got to take this new update. um do you want to help us on the clinical side you want to help us on the clinical side you want to help us on the clinical side build the assessments? I'm like yeah build the assessments? I'm like yeah build the assessments? I'm like yeah because whoever built them to start with because whoever built them to start with because whoever built them to start with did them all wrong, right? Like I'm like did them all wrong, right? Like I'm like did them all wrong, right? Like I'm like I'm like let's build efficiency. And I'm like let's build efficiency. And I'm like let's build efficiency. And she's like well then come be your own she's like well then come be your own she's like well then come be your own voice. And I'm like okay. And so um that voice. And I'm like okay. And so um that voice. And I'm like okay. And so um that actually started me on a whole new path. actually started me on a whole new path. actually started me on a whole new path. And so then I I did end up leaving uh And so then I I did end up leaving uh And so then I I did end up leaving uh Burlington and I went to Newman's and I Burlington and I went to Newman's and I Burlington and I went to Newman's and I actually ran their clinical package in actually ran their clinical package in actually ran their clinical package in their IT department. their IT department. their IT department. » Oh wow. » Oh wow. » Oh wow. » Yeah. um » Yeah. um » Yeah. um » at the hospital in Newman. » at the hospital in Newman. » at the hospital in Newman. » At the hospital at Newman. Yeah. And so, » At the hospital at Newman. Yeah. And so, » At the hospital at Newman. Yeah. And so, but my main focus was the physician but my main focus was the physician but my main focus was the physician clinic offices. So, we had a surgical, clinic offices. So, we had a surgical, clinic offices. So, we had a surgical, pediatric, pediatric, pediatric, » uh orthopedic, and then just one primary » uh orthopedic, and then just one primary » uh orthopedic, and then just one primary care clinic. So, it was a whole care clinic. So, it was a whole care clinic. So, it was a whole conglomeration of things. Um conglomeration of things. Um conglomeration of things. Um I would say at that point, that's I would say at that point, that's I would say at that point, that's probably the most pivotal moment of my probably the most pivotal moment of my probably the most pivotal moment of my career because you truly learn every career because you truly learn every career because you truly learn every part of a hospital. You learn the part of a hospital. You learn the part of a hospital. You learn the billing part, right? because everything billing part, right? because everything billing part, right? because everything we do clinically we only get paid for if we do clinically we only get paid for if we do clinically we only get paid for if it drops to the bill, right? You know, it drops to the bill, right? You know, it drops to the bill, right? You know, and so and so and so » I learned all of that part. I learned » I learned all of that part. I learned » I learned all of that part. I learned how medical records works just from a how medical records works just from a how medical records works just from a » how do how are all these files stored » how do how are all these files stored » how do how are all these files stored and all the all of the pieces. Um, and all the all of the pieces. Um, and all the all of the pieces. Um, » you know, of course, just being involved » you know, of course, just being involved » you know, of course, just being involved in IT, there's a lot of security that in IT, there's a lot of security that in IT, there's a lot of security that comes with that. Um, definitely not my comes with that. Um, definitely not my comes with that. Um, definitely not my specialty, but specialty, but specialty, but » you have to learn some. » you have to learn some. » you have to learn some. » Yeah. And um so then randomly one day I » Yeah. And um so then randomly one day I » Yeah. And um so then randomly one day I got a phone call from the CEO at got a phone call from the CEO at got a phone call from the CEO at Burlington and she said, "Hey, we have Burlington and she said, "Hey, we have Burlington and she said, "Hey, we have this chief nursing office officer this chief nursing office officer this chief nursing office officer position open. What do you think?" And position open. What do you think?" And position open. What do you think?" And I'm like, "Oh, I I don't really know. I'm like, "Oh, I I don't really know. I'm like, "Oh, I I don't really know. I've really never thought about going I've really never thought about going I've really never thought about going into that like level of management." And into that like level of management." And into that like level of management." And she's like, "Oh, just come down and she's like, "Oh, just come down and she's like, "Oh, just come down and visit with us, you know." And I'm like, visit with us, you know." And I'm like, visit with us, you know." And I'm like, "Okay." And so um I went there and I'm "Okay." And so um I went there and I'm "Okay." And so um I went there and I'm like you know you have to find a like you know you have to find a like you know you have to find a different way to make a change right so different way to make a change right so different way to make a change right so » you know the whole reason I got into » you know the whole reason I got into » you know the whole reason I got into healthcare was cuz I wanted to be a part healthcare was cuz I wanted to be a part healthcare was cuz I wanted to be a part of something and you have this like of something and you have this like of something and you have this like almost instant gratitude and almost instant gratitude and almost instant gratitude and glorification of when you get to go home glorification of when you get to go home glorification of when you get to go home you know today you changed someone's you know today you changed someone's you know today you changed someone's life right like life right like life right like » they can have the worst day most of them » they can have the worst day most of them » they can have the worst day most of them are » they're in a hospital right but you can » they're in a hospital right but you can » they're in a hospital right but you can make it really good if you have the make it really good if you have the make it really good if you have the right mindset to do it. Um, you kind of right mindset to do it. Um, you kind of right mindset to do it. Um, you kind of walk away from that a little bit when walk away from that a little bit when walk away from that a little bit when you come to the management side. you come to the management side. you come to the management side. » Um, and so I had to find a new path, » Um, and so I had to find a new path, » Um, and so I had to find a new path, right? I had to find a new way of how do right? I had to find a new way of how do right? I had to find a new way of how do I still get my cup filled, I still get my cup filled, I still get my cup filled, » right? » right? » right? » And so, um, I really kind of took it » And so, um, I really kind of took it » And so, um, I really kind of took it from an approach of I'm probably not the from an approach of I'm probably not the from an approach of I'm probably not the one that's going to do it at the one that's going to do it at the one that's going to do it at the bedside, but I can help the next nurse bedside, but I can help the next nurse bedside, but I can help the next nurse do it and help her do it easier and do it and help her do it easier and do it and help her do it easier and better, right? And so that's really kind better, right? And so that's really kind better, right? And so that's really kind of became my focus. Um I still dabble, of became my focus. Um I still dabble, of became my focus. Um I still dabble, right? So I I won't lie. Um it's hard to right? So I I won't lie. Um it's hard to right? So I I won't lie. Um it's hard to just completely walk away from the just completely walk away from the just completely walk away from the clinical side of things. Um clinical side of things. Um clinical side of things. Um » so that's uh so I did that um for almost » so that's uh so I did that um for almost » so that's uh so I did that um for almost 10 years and it it was great like 10 years and it it was great like 10 years and it it was great like » learned a lot, ran a lot um again in a » learned a lot, ran a lot um again in a » learned a lot, ran a lot um again in a small hospital. So it wasn't like I was small hospital. So it wasn't like I was small hospital. So it wasn't like I was I mean my title was chief nursing I mean my title was chief nursing I mean my title was chief nursing officer but I was really over radiology officer but I was really over radiology officer but I was really over radiology and lab and respiratory. So, kind of and lab and respiratory. So, kind of and lab and respiratory. So, kind of learned everything um and just kind of learned everything um and just kind of learned everything um and just kind of how it all worked and then had the how it all worked and then had the how it all worked and then had the beautiful opportunity to come to El beautiful opportunity to come to El beautiful opportunity to come to El Dredo and be the operations officer. Um Dredo and be the operations officer. Um Dredo and be the operations officer. Um and I think it I think it's really and I think it I think it's really and I think it I think it's really powerful that I can sit in a meeting um powerful that I can sit in a meeting um powerful that I can sit in a meeting um even at that level, I could sit in a even at that level, I could sit in a even at that level, I could sit in a meeting and say, "Right, but the people meeting and say, "Right, but the people meeting and say, "Right, but the people that are doing the work that doesn't that are doing the work that doesn't that are doing the work that doesn't make sense for make sense for make sense for » Yeah. » Yeah. » Yeah. » Right. Like, so it's it's a little bit » Right. Like, so it's it's a little bit » Right. Like, so it's it's a little bit different." Like, I mean, different." Like, I mean, different." Like, I mean, » 100%. » 100%. » 100%. » It's Do you know what I'm saying? » It's Do you know what I'm saying? » It's Do you know what I'm saying? » Oh, yeah. Well, I think of uh so my » Oh, yeah. Well, I think of uh so my » Oh, yeah. Well, I think of uh so my wife's a educator at Butler. Okay. Uh in wife's a educator at Butler. Okay. Uh in wife's a educator at Butler. Okay. Uh in the nursing program, she went through the nursing program, she went through the nursing program, she went through the RN program at Butler and had two the RN program at Butler and had two the RN program at Butler and had two kids while she was going through it in kids while she was going through it in kids while she was going through it in the 2-year time period. So, you guys the 2-year time period. So, you guys the 2-year time period. So, you guys Yeah. married to 19. You guys have some Yeah. married to 19. You guys have some Yeah. married to 19. You guys have some similarities of that like uh similarities of that like uh similarities of that like uh » but yeah, that's that's a big » but yeah, that's that's a big » but yeah, that's that's a big frustration that top down model frustration that top down model frustration that top down model versus bottom up model. Um you know, I versus bottom up model. Um you know, I versus bottom up model. Um you know, I think of Walmart actually is famous for think of Walmart actually is famous for think of Walmart actually is famous for that. They're famous for promoting that. They're famous for promoting that. They're famous for promoting within, within, within, » you know, from you could be literally » you know, from you could be literally » you know, from you could be literally stocking shelves and be the president of stocking shelves and be the president of stocking shelves and be the president of a branch. Like that's how they're a branch. Like that's how they're a branch. Like that's how they're they're built because there's buyin and they're built because there's buyin and they're built because there's buyin and then there's empathy and then community then there's empathy and then community then there's empathy and then community grows. So 100%. I I'm everything you're grows. So 100%. I I'm everything you're grows. So 100%. I I'm everything you're saying is just cool that you were not saying is just cool that you were not saying is just cool that you were not only on the floor patient care. Then you only on the floor patient care. Then you only on the floor patient care. Then you went into the IT side to understand the went into the IT side to understand the went into the IT side to understand the back end, right? back end, right? back end, right? » And now you go to management like top of » And now you go to management like top of » And now you go to management like top of top of management. But top of management. But top of management. But » yeah, really cool. Um yeah. Uh, and I » yeah, really cool. Um yeah. Uh, and I » yeah, really cool. Um yeah. Uh, and I can feel your wife's pain. There's some can feel your wife's pain. There's some can feel your wife's pain. There's some true going through school. Um, I did go true going through school. Um, I did go true going through school. Um, I did go back to school and eventually get my back to school and eventually get my back to school and eventually get my bachelors and my masters. Um, did all bachelors and my masters. Um, did all bachelors and my masters. Um, did all that with a family. that with a family. that with a family. » Bless my husband, right? Like, let's » Bless my husband, right? Like, let's » Bless my husband, right? Like, let's just be honest. just be honest. just be honest. » She has a year left on her masters and » She has a year left on her masters and » She has a year left on her masters and we're dying on the inside. He's really we're dying on the inside. He's really we're dying on the inside. He's really dying. It's been tough because she dying. It's been tough because she dying. It's been tough because she stayed home for like 10 years and then stayed home for like 10 years and then stayed home for like 10 years and then went into the education role at went into the education role at went into the education role at Butler. And it's it's been a hard Butler. And it's it's been a hard Butler. And it's it's been a hard transition. And really, it's harder for transition. And really, it's harder for transition. And really, it's harder for her. But I'm a baby cuz I didn't realize her. But I'm a baby cuz I didn't realize her. But I'm a baby cuz I didn't realize how much she did, how much she did, how much she did, » you know? Let's be honest. It's like I » you know? Let's be honest. It's like I » you know? Let's be honest. It's like I just had no idea how much was going on just had no idea how much was going on just had no idea how much was going on behind the scenes in my own home. Yes. behind the scenes in my own home. Yes. behind the scenes in my own home. Yes. » Until I had to step up and do some » Until I had to step up and do some » Until I had to step up and do some things. So, but super proud of her and things. So, but super proud of her and things. So, but super proud of her and it's it's a big undertaking uh to do it's it's a big undertaking uh to do it's it's a big undertaking uh to do both sides of that. But like you said, both sides of that. But like you said, both sides of that. But like you said, it's been really fulfilling for her. it's been really fulfilling for her. it's been really fulfilling for her. » She's wanted to be a nurse since she was » She's wanted to be a nurse since she was » She's wanted to be a nurse since she was 6 years old. Her parents still remember 6 years old. Her parents still remember 6 years old. Her parents still remember like it's all she talked about. She was like it's all she talked about. She was like it's all she talked about. She was always going to go that direction and always going to go that direction and always going to go that direction and then chose to stay home and that worked then chose to stay home and that worked then chose to stay home and that worked out better for my career and then now out better for my career and then now out better for my career and then now got in a position where she can go back got in a position where she can go back got in a position where she can go back in. Um but yeah, you guys are like so in. Um but yeah, you guys are like so in. Um but yeah, you guys are like so similar. It's like you guys need to get similar. It's like you guys need to get similar. It's like you guys need to get together. together. together. » Yes, we should honestly. » Yes, we should honestly. » Yes, we should honestly. » Oh my god, this is » Oh my god, this is » Oh my god, this is » we can swap stories like listen. » we can swap stories like listen. » we can swap stories like listen. » Yeah. Anyway. » Yeah. Anyway. » Yeah. Anyway. » Yeah. But yeah, we um » Yeah. But yeah, we um » Yeah. But yeah, we um » so you're in uh so you go into the CEO » so you're in uh so you go into the CEO » so you're in uh so you go into the CEO role at SBA. role at SBA. role at SBA. » Yeah. Um and so really just kind of came » Yeah. Um and so really just kind of came » Yeah. Um and so really just kind of came with it with a little bit of, you know, with it with a little bit of, you know, with it with a little bit of, you know, fresh eyes, those types of things. Um fresh eyes, those types of things. Um fresh eyes, those types of things. Um you uh I kind of I chuckle inside a you uh I kind of I chuckle inside a you uh I kind of I chuckle inside a little bit because my team, I'm sure little bit because my team, I'm sure little bit because my team, I'm sure they get tired of hearing me. like they get tired of hearing me. like they get tired of hearing me. like just because we haven't done it doesn't just because we haven't done it doesn't just because we haven't done it doesn't mean we can't, right? And so um I mean we can't, right? And so um I mean we can't, right? And so um I brought you know just a sense of brought you know just a sense of brought you know just a sense of something different um to you know something different um to you know something different um to you know Burlington is a smaller scale but truly Burlington is a smaller scale but truly Burlington is a smaller scale but truly it really doesn't function a lot it really doesn't function a lot it really doesn't function a lot different than how we function at El different than how we function at El different than how we function at El Dredo. Dredo. Dredo. » Um there's just more volume here, right? » Um there's just more volume here, right? » Um there's just more volume here, right? And so um I challenge a lot from a And so um I challenge a lot from a And so um I challenge a lot from a perspective of but could we do it perspective of but could we do it perspective of but could we do it different, right? Like let's not just different, right? Like let's not just different, right? Like let's not just have the answer be no because we haven't have the answer be no because we haven't have the answer be no because we haven't done it in 20 years. let's just say what done it in 20 years. let's just say what done it in 20 years. let's just say what if we did it like let's let's really if we did it like let's let's really if we did it like let's let's really talk through it and so um so kind of did talk through it and so um so kind of did talk through it and so um so kind of did that and then again um our CEO at that and then again um our CEO at that and then again um our CEO at the time um had some health issues and the time um had some health issues and the time um had some health issues and uh ended up retiring a little earlier uh ended up retiring a little earlier uh ended up retiring a little earlier than he or I planned on um and so um than he or I planned on um and so um than he or I planned on um and so um kind of the CEO role just felt like the kind of the CEO role just felt like the kind of the CEO role just felt like the next thing right because I next thing right because I next thing right because I » I'm already » I'm already » I'm already » because you became interim automatically » because you became interim automatically » because you became interim automatically right as he with his health issues Um, right as he with his health issues Um, right as he with his health issues Um, and was that succession plan talked and was that succession plan talked and was that succession plan talked about at all prior or was that kind of a about at all prior or was that kind of a about at all prior or was that kind of a just, you know, just, you know, just, you know, » Yeah. » Yeah. » Yeah. » that's farther down the road. » that's farther down the road. » that's farther down the road. » Yes. Like nobody » Yes. Like nobody » Yes. Like nobody » people apply or whatever. » people apply or whatever. » people apply or whatever. » Exactly. You know, and I and honestly um » Exactly. You know, and I and honestly um » Exactly. You know, and I and honestly um at the time my youngest was I my oldest at the time my youngest was I my oldest at the time my youngest was I my oldest graduated, my youngest was still in um graduated, my youngest was still in um graduated, my youngest was still in um just middle schoolish, you know, and just middle schoolish, you know, and just middle schoolish, you know, and finishing up middle school. And I'm finishing up middle school. And I'm finishing up middle school. And I'm like, "Oh, you got to stay in like, "Oh, you got to stay in like, "Oh, you got to stay in Burlington, right?" Like I mean the Burlington, right?" Like I mean the Burlington, right?" Like I mean the thought of like moving your child when thought of like moving your child when thought of like moving your child when they've gone to school with their they've gone to school with their they've gone to school with their friends their entire life, you know, friends their entire life, you know, friends their entire life, you know, right? Like Burlington is small enough right? Like Burlington is small enough right? Like Burlington is small enough that you have that you have that you have » we met these kids in preschool, » we met these kids in preschool, » we met these kids in preschool, » right? And they've they've been in that » right? And they've they've been in that » right? And they've they've been in that journey together. Um and so honestly at journey together. Um and so honestly at journey together. Um and so honestly at home it was a lot of conversation of is home it was a lot of conversation of is home it was a lot of conversation of is it the right thing you know for our it the right thing you know for our it the right thing you know for our family and um we now I I would say I family and um we now I I would say I family and um we now I I would say I didn't let our son decide but I didn't let our son decide but I didn't let our son decide but I definitely he got a bigger voice than I definitely he got a bigger voice than I definitely he got a bigger voice than I would have normally thought you'd give a would have normally thought you'd give a would have normally thought you'd give a 14year-old. Um but just from a 14year-old. Um but just from a 14year-old. Um but just from a perspective of you know are you willing perspective of you know are you willing perspective of you know are you willing to pick up and move and you have to to pick up and move and you have to to pick up and move and you have to start all over and high school's hard. I start all over and high school's hard. I start all over and high school's hard. I mean, it's hard to walk in and not know mean, it's hard to walk in and not know mean, it's hard to walk in and not know anyone, you know, and so, anyone, you know, and so, anyone, you know, and so, » um, but he was up for a challenge. He's » um, but he was up for a challenge. He's » um, but he was up for a challenge. He's he just has that personality, which is he just has that personality, which is he just has that personality, which is pretty awesome. Um, so we decided I'm pretty awesome. Um, so we decided I'm pretty awesome. Um, so we decided I'm like, "Okay, I'm going to throw my hat like, "Okay, I'm going to throw my hat like, "Okay, I'm going to throw my hat in the ring, you know, and, um, the in the ring, you know, and, um, the in the ring, you know, and, um, the board was very supportive. They've been board was very supportive. They've been board was very supportive. They've been very supportive this entire time. I very supportive this entire time. I very supportive this entire time. I mean, truly, uh, I won't lie. I walked mean, truly, uh, I won't lie. I walked mean, truly, uh, I won't lie. I walked into I mean, it was kind of a mess. um into I mean, it was kind of a mess. um into I mean, it was kind of a mess. um you know they were even when I started you know they were even when I started you know they were even when I started as the COO financially things are not as the COO financially things are not as the COO financially things are not great um a little bit of upside down and great um a little bit of upside down and great um a little bit of upside down and so so so » you know we I'm like look we're going to » you know we I'm like look we're going to » you know we I'm like look we're going to have to hit the ground running like we have to hit the ground running like we have to hit the ground running like we can't survive this way and so um I can't survive this way and so um I can't survive this way and so um I really give a lot of that to our team really give a lot of that to our team really give a lot of that to our team our leadership team is phenomenal from a our leadership team is phenomenal from a our leadership team is phenomenal from a perspective of one they genuinely care perspective of one they genuinely care perspective of one they genuinely care about this community right I mean they about this community right I mean they about this community right I mean they that's what drives what they do um but that's what drives what they do um but that's what drives what they do um but they were very willing to okay we're they were very willing to okay we're they were very willing to okay we're going to do what it takes right um and going to do what it takes right um and going to do what it takes right um and if if I said hey we got to find a way to if if I said hey we got to find a way to if if I said hey we got to find a way to cut these expenses like what can we give cut these expenses like what can we give cut these expenses like what can we give what do we not need right even if what do we not need right even if what do we not need right even if we've done it for 20 years can we do it we've done it for 20 years can we do it we've done it for 20 years can we do it differently that's you know less differently that's you know less differently that's you know less expensive um expensive um expensive um » and you started having those » and you started having those » and you started having those conversations as COO before conversations as COO before conversations as COO before » a little bit yeah uh um you know as much » a little bit yeah uh um you know as much » a little bit yeah uh um you know as much as I could you know we don't as I could you know we don't as I could you know we don't » we get to do the work but we don't » we get to do the work but we don't » we get to do the work but we don't really get to control the path, right? really get to control the path, right? really get to control the path, right? Um, you know, we're kind of on the path Um, you know, we're kind of on the path Um, you know, we're kind of on the path that somebody sets us. And so, um, that somebody sets us. And so, um, that somebody sets us. And so, um, » and then when I became interim, I'm like » and then when I became interim, I'm like » and then when I became interim, I'm like I I really became very aware I I really became very aware I I really became very aware » of numbers and » of numbers and » of numbers and » really what it looked like. And it was, » really what it looked like. And it was, » really what it looked like. And it was, okay, now we have to, right? We we we've okay, now we have to, right? We we we've okay, now we have to, right? We we we've got to we got to fix some things. And got to we got to fix some things. And got to we got to fix some things. And that team has just been phenomenal from that team has just been phenomenal from that team has just been phenomenal from a perspective of, okay, let's do it, a perspective of, okay, let's do it, a perspective of, okay, let's do it, right? I mean, let's jump in. Let's right? I mean, let's jump in. Let's right? I mean, let's jump in. Let's » find the way. Um, and we've done a lot » find the way. Um, and we've done a lot » find the way. Um, and we've done a lot of great work. Um, the other side of of great work. Um, the other side of of great work. Um, the other side of that we really focused on, um, we that we really focused on, um, we that we really focused on, um, we we didn't have a great reputation for we didn't have a great reputation for we didn't have a great reputation for quality. Um, you know, unfortunately, we quality. Um, you know, unfortunately, we quality. Um, you know, unfortunately, we went through some things that went through some things that went through some things that prior administration um, some decisions prior administration um, some decisions prior administration um, some decisions that they made just kind of ruffled some that they made just kind of ruffled some that they made just kind of ruffled some feathers. We they changed some things, feathers. We they changed some things, feathers. We they changed some things, right? I wasn't in their shoes. I I'm right? I wasn't in their shoes. I I'm right? I wasn't in their shoes. I I'm not here to judge what they did or what not here to judge what they did or what not here to judge what they did or what they didn't do. um more of a I don't they didn't do. um more of a I don't they didn't do. um more of a I don't know what they were living in that know what they were living in that know what they were living in that moment. moment. moment. » Not not a judgment, just a time for a » Not not a judgment, just a time for a » Not not a judgment, just a time for a course correction though and course correction though and course correction though and acknowledging what's real. Yeah, that's acknowledging what's real. Yeah, that's acknowledging what's real. Yeah, that's okay. okay. okay. » Yeah. » Yeah. » Yeah. » And I I that was one of my questions. I » And I I that was one of my questions. I » And I I that was one of my questions. I was looking up image problem. How to ask was looking up image problem. How to ask was looking up image problem. How to ask you, okay, hey, is there an image you, okay, hey, is there an image you, okay, hey, is there an image problem or was there or is it current or problem or was there or is it current or problem or was there or is it current or what does that look like? Then I was what does that look like? Then I was what does that look like? Then I was looking at uh you know, in my world, I looking at uh you know, in my world, I looking at uh you know, in my world, I was looking at Google reviews and you was looking at Google reviews and you was looking at Google reviews and you know that's that's that's a tough know that's that's that's a tough know that's that's that's a tough anything that's public facing like that, anything that's public facing like that, anything that's public facing like that, right? is so hard. right? is so hard. right? is so hard. » Um, and I owning businesses like it » Um, and I owning businesses like it » Um, and I owning businesses like it sucks when I get a one-star review and I sucks when I get a one-star review and I sucks when I get a one-star review and I can't do anything about it and I'm like, can't do anything about it and I'm like, can't do anything about it and I'm like, "Oh, but I want to tell the other side "Oh, but I want to tell the other side "Oh, but I want to tell the other side of the story." of the story." of the story." » Um, but I was Yeah, you're at like that » Um, but I was Yeah, you're at like that » Um, but I was Yeah, you're at like that 2.5 which I think is a, 2.5 which I think is a, 2.5 which I think is a, » you know, a thing to look at from a » you know, a thing to look at from a » you know, a thing to look at from a public facing and it's only like 150 public facing and it's only like 150 public facing and it's only like 150 reviews. It's not, you guys see an reviews. It's not, you guys see an reviews. It's not, you guys see an insane amount of people, right? That's a insane amount of people, right? That's a insane amount of people, right? That's a small sample size. Um, but then I look small sample size. Um, but then I look small sample size. Um, but then I look at, you know, these other hospitals that at, you know, these other hospitals that at, you know, these other hospitals that probably have equivalent or more, but probably have equivalent or more, but probably have equivalent or more, but they have so many more ratings, right? they have so many more ratings, right? they have so many more ratings, right? So, like Wesley has thousands of So, like Wesley has thousands of So, like Wesley has thousands of » ratings. Uh, they're at a four or » ratings. Uh, they're at a four or » ratings. Uh, they're at a four or something like that, but they got way something like that, but they got way something like that, but they got way more. So, like they even have more bad more. So, like they even have more bad more. So, like they even have more bad reviews than you do, reviews than you do, reviews than you do, » but it's just a way bigger sample size. » but it's just a way bigger sample size. » but it's just a way bigger sample size. So, it's it's hard in a So, it's it's hard in a So, it's it's hard in a » that context. And I've had a lot of » that context. And I've had a lot of » that context. And I've had a lot of people bring that up to me before, like, people bring that up to me before, like, people bring that up to me before, like, well, did you look at this? So, well, did you look at this? So, well, did you look at this? So, » that's my question to you. uh as much as » that's my question to you. uh as much as » that's my question to you. uh as much as you want to talk about it, image you want to talk about it, image you want to talk about it, image problem, how is that being addressed? problem, how is that being addressed? problem, how is that being addressed? » Yeah. Yeah. Um so yeah, I mean I would » Yeah. Yeah. Um so yeah, I mean I would » Yeah. Yeah. Um so yeah, I mean I would say from an image perspective, a lot of say from an image perspective, a lot of say from an image perspective, a lot of a lot of just um you know, they don't a lot of just um you know, they don't a lot of just um you know, they don't keep anything. Everything gets keep anything. Everything gets keep anything. Everything gets transferred out. transferred out. transferred out. » Um I when I got there um as the COO, I'm » Um I when I got there um as the COO, I'm » Um I when I got there um as the COO, I'm like, we have to make a change in the like, we have to make a change in the like, we have to make a change in the ER. Um it it's not that the providers ER. Um it it's not that the providers ER. Um it it's not that the providers were bad. It really isn't. were bad. It really isn't. were bad. It really isn't. They didn't know how to manage the They didn't know how to manage the They didn't know how to manage the patient load that was coming through the patient load that was coming through the patient load that was coming through the door. Right? door. Right? door. Right? » Makes sense. » Makes sense. » Makes sense. » And so, um, we had a lot of people » And so, um, we had a lot of people » And so, um, we had a lot of people waiting in the waiting room for over two waiting in the waiting room for over two waiting in the waiting room for over two hours, right? We had a lot of people hours, right? We had a lot of people hours, right? We had a lot of people that wouldn't even wait that long, that wouldn't even wait that long, that wouldn't even wait that long, right? They checked in and then they're right? They checked in and then they're right? They checked in and then they're like, "Peace, I'm out." You know? Um, like, "Peace, I'm out." You know? Um, like, "Peace, I'm out." You know? Um, and so and so and so we we have to fix that, right? And so, we we have to fix that, right? And so, we we have to fix that, right? And so, um, one of the things that I did was I um, one of the things that I did was I um, one of the things that I did was I did actually bring in a new provider did actually bring in a new provider did actually bring in a new provider group. So, let me back up. The other group. So, let me back up. The other group. So, let me back up. The other side of that is why a lot of those side of that is why a lot of those side of that is why a lot of those transfers are happening, right? Is you transfers are happening, right? Is you transfers are happening, right? Is you have to have a a beautiful connection have to have a a beautiful connection have to have a a beautiful connection between your ER and your hospitalist, between your ER and your hospitalist, between your ER and your hospitalist, right? Because your ER can see people right? Because your ER can see people right? Because your ER can see people and they can say they need to be and they can say they need to be and they can say they need to be admitted, but if you have a hospitalist admitted, but if you have a hospitalist admitted, but if you have a hospitalist that's like, we can't keep that here, that's like, we can't keep that here, that's like, we can't keep that here, » right? Um, and so we tried to » right? Um, and so we tried to » right? Um, and so we tried to » and for those that are like me that » and for those that are like me that » and for those that are like me that don't understand hospitals, besides how don't understand hospitals, besides how don't understand hospitals, besides how to walk in the door and say, "I need to walk in the door and say, "I need to walk in the door and say, "I need help." Uh, the hospitalist is the final help." Uh, the hospitalist is the final help." Uh, the hospitalist is the final say in the ER. Are they stewarding the say in the ER. Are they stewarding the say in the ER. Are they stewarding the ER or are they the on call? What is ER or are they the on call? What is ER or are they the on call? What is that? that? that? » Okay. So, I'm sorry. Yes. Yeah. So, the » Okay. So, I'm sorry. Yes. Yeah. So, the » Okay. So, I'm sorry. Yes. Yeah. So, the act So, nope. The ER actually runs act So, nope. The ER actually runs act So, nope. The ER actually runs itself, right? Right. The provider itself, right? Right. The provider itself, right? Right. The provider that's down there um is who manages that's down there um is who manages that's down there um is who manages those patients. But that at that point, those patients. But that at that point, those patients. But that at that point, you make they make a determination of you make they make a determination of you make they make a determination of basically two things. You three things. basically two things. You three things. basically two things. You three things. One, you go home, right? We can One, you go home, right? We can One, you go home, right? We can stabilize you. We can stabilize you. We can stabilize you. We can » give you a prescription, whatever that » give you a prescription, whatever that » give you a prescription, whatever that looks like. um set your strain or looks like. um set your strain or looks like. um set your strain or whatever um and we send you home or we whatever um and we send you home or we whatever um and we send you home or we need to admit you to the hospital. need to admit you to the hospital. need to admit you to the hospital. Rather that's um as a Rather that's um as a Rather that's um as a » you're probably okay but we probably » you're probably okay but we probably » you're probably okay but we probably should keep you overnight should keep you overnight should keep you overnight » kind of look or » kind of look or » kind of look or » hey your blood sugars are so far out we » hey your blood sugars are so far out we » hey your blood sugars are so far out we we have to get those under control, we have to get those under control, we have to get those under control, right? We we have to put you in a bed. right? We we have to put you in a bed. right? We we have to put you in a bed. » Yeah, we're we're going to put you in a » Yeah, we're we're going to put you in a » Yeah, we're we're going to put you in a bed. Um and then the third one is um or bed. Um and then the third one is um or bed. Um and then the third one is um or do we just transfer you to another do we just transfer you to another do we just transfer you to another facility? Right? And there we definitely facility? Right? And there we definitely facility? Right? And there we definitely have limitations. We we can't do all the have limitations. We we can't do all the have limitations. We we can't do all the things that tertiary centers do. You things that tertiary centers do. You things that tertiary centers do. You know, the Wesley's of the world. They're know, the Wesley's of the world. They're know, the Wesley's of the world. They're they're meant to do those things. And so they're meant to do those things. And so they're meant to do those things. And so um you know, a lot of cardiology things. um you know, a lot of cardiology things. um you know, a lot of cardiology things. We we just don't have those. Um and so We we just don't have those. Um and so We we just don't have those. Um and so we we do have to transfer those out. we we do have to transfer those out. we we do have to transfer those out. » And so those three options, who's making » And so those three options, who's making » And so those three options, who's making that final call? So that's so the ER that final call? So that's so the ER that final call? So that's so the ER provider decides which one of those provider decides which one of those provider decides which one of those three from there if it's hey we need to three from there if it's hey we need to three from there if it's hey we need to tuck you in or we need to admit you and tuck you in or we need to admit you and tuck you in or we need to admit you and we think we can do it here at SBA that's we think we can do it here at SBA that's we think we can do it here at SBA that's when the hospitalist gets involved. So when the hospitalist gets involved. So when the hospitalist gets involved. So that's the provider on the actual that's the provider on the actual that's the provider on the actual » you're going to be in a bed at the » you're going to be in a bed at the » you're going to be in a bed at the hospital. Um and so there that's who's hospital. Um and so there that's who's hospital. Um and so there that's who's deciding that. And so if they don't deciding that. And so if they don't deciding that. And so if they don't » work beautifully together » work beautifully together » work beautifully together » there's a lot of » there's a lot of » there's a lot of » well I don't know they won't take » well I don't know they won't take » well I don't know they won't take anybody you know. Um anybody you know. Um anybody you know. Um » yeah, then that's frustrating for » yeah, then that's frustrating for » yeah, then that's frustrating for everyone. If a patient hears they're everyone. If a patient hears they're everyone. If a patient hears they're going to go, then they're told they're going to go, then they're told they're going to go, then they're told they're not. not. not. » Yeah, it's that'd be a bummer. And so, » Yeah, it's that'd be a bummer. And so, » Yeah, it's that'd be a bummer. And so, um so I a lot of that focus and shift um so I a lot of that focus and shift um so I a lot of that focus and shift came with our new provider group. Um we came with our new provider group. Um we came with our new provider group. Um we have oh my gosh, like our quality scores have oh my gosh, like our quality scores have oh my gosh, like our quality scores from a so from a federal CMS um we from a so from a federal CMS um we from a so from a federal CMS um we actually are required to submit data to actually are required to submit data to actually are required to submit data to them to prove to them that we're taking them to prove to them that we're taking them to prove to them that we're taking care of patients at a certain level. Um care of patients at a certain level. Um care of patients at a certain level. Um our all of our quality scores in the ER our all of our quality scores in the ER our all of our quality scores in the ER have improved. have improved. have improved. » Awesome. » Awesome. » Awesome. » Yeah. Um so our average just wait to be » Yeah. Um so our average just wait to be » Yeah. Um so our average just wait to be seen time used to be over two hours. seen time used to be over two hours. seen time used to be over two hours. It's now under 30 minutes. It's now under 30 minutes. It's now under 30 minutes. » Wow. » Wow. » Wow. » Right. Like you check in and you are in » Right. Like you check in and you are in » Right. Like you check in and you are in a room and average. Right. Average. a room and average. Right. Average. a room and average. Right. Average. » Average. But 30 minutes or less. » Average. But 30 minutes or less. » Average. But 30 minutes or less. » The person listening that had to wait an » The person listening that had to wait an » The person listening that had to wait an hour. It's an average. hour. It's an average. hour. It's an average. » It's an average. Yeah. Um but then you » It's an average. Yeah. Um but then you » It's an average. Yeah. Um but then you know um and then so even from that know um and then so even from that know um and then so even from that perspective just getting your hands on perspective just getting your hands on perspective just getting your hands on them that gets the process started you them that gets the process started you them that gets the process started you know that much sooner are left without know that much sooner are left without know that much sooner are left without being seen. So those are the patients being seen. So those are the patients being seen. So those are the patients that checked in and they were like I'm that checked in and they were like I'm that checked in and they were like I'm not hanging out until you have time to not hanging out until you have time to not hanging out until you have time to see me. Um that's reduced by almost 75%. see me. Um that's reduced by almost 75%. see me. Um that's reduced by almost 75%. » Right. » Right. » Right. » Yeah. I mean so just phenomenal things » Yeah. I mean so just phenomenal things » Yeah. I mean so just phenomenal things are going on. are going on. are going on. » Time frame of I mean 23 is when you So » Time frame of I mean 23 is when you So » Time frame of I mean 23 is when you So that's Yeah. We're talking that's Yeah. We're talking that's Yeah. We're talking » so » so » so » almost three right at the three year » almost three right at the three year » almost three right at the three year mark now. mark now. mark now. » Yeah. Um and I I didn't actually get » Yeah. Um and I I didn't actually get » Yeah. Um and I I didn't actually get » It's hard to target say interim though » It's hard to target say interim though » It's hard to target say interim though because interim you probably didn't have because interim you probably didn't have because interim you probably didn't have as much control as when you were as much control as when you were as much control as when you were » you know my my board actually um they » you know my my board actually um they » you know my my board actually um they gave me a lot of latitude right they're gave me a lot of latitude right they're gave me a lot of latitude right they're like you know what's here right I like you know what's here right I like you know what's here right I mean I' I'd been working in it and so mean I' I'd been working in it and so mean I' I'd been working in it and so they were like if you need to make a they were like if you need to make a they were like if you need to make a change you make a change. Um the change you make a change. Um the change you make a change. Um the problem is is you can't make things problem is is you can't make things problem is is you can't make things happen overnight, right? And so we we happen overnight, right? And so we we happen overnight, right? And so we we knew and identified we have to do knew and identified we have to do knew and identified we have to do something um in the ER in that something um in the ER in that something um in the ER in that hospitalist collaboration side. Um but hospitalist collaboration side. Um but hospitalist collaboration side. Um but we didn't actually get to make that we didn't actually get to make that we didn't actually get to make that change until February of 24. change until February of 24. change until February of 24. » Nice. » Nice. » Nice. » So um you know, so really we're just at » So um you know, so really we're just at » So um you know, so really we're just at two years and they've made all that two years and they've made all that two years and they've made all that progress. I mean it's it's really progress. I mean it's it's really progress. I mean it's it's really remarkable. remarkable. remarkable. » That's awesome. Yeah. Talk to me about » That's awesome. Yeah. Talk to me about » That's awesome. Yeah. Talk to me about the difference. How is Susan Valen the difference. How is Susan Valen the difference. How is Susan Valen Memorial Hospital different than other Memorial Hospital different than other Memorial Hospital different than other hospitals? Talk about, you know, like hospitals? Talk about, you know, like hospitals? Talk about, you know, like the difference from how it works from the difference from how it works from the difference from how it works from who runs it, who owns it who runs it, who owns it who runs it, who owns it » to like Wesley to, you know, I'm sure » to like Wesley to, you know, I'm sure » to like Wesley to, you know, I'm sure that it seems like there's a lot of that it seems like there's a lot of that it seems like there's a lot of different kinds of hospitals. different kinds of hospitals. different kinds of hospitals. » There is. Yeah. So, um so we are a a » There is. Yeah. So, um so we are a a » There is. Yeah. So, um so we are a a rural community independent PPS rural community independent PPS rural community independent PPS hospital. So, um hospital. So, um hospital. So, um » What's PPS? » What's PPS? » What's PPS? » Yep. So, PPS is how we get paid. So » Yep. So, PPS is how we get paid. So » Yep. So, PPS is how we get paid. So basically, um, insurance and CMS, basically, um, insurance and CMS, basically, um, insurance and CMS, Medicaid, Medicare, they say you get Medicaid, Medicare, they say you get Medicaid, Medicare, they say you get paid X dollars for this diagnosis and paid X dollars for this diagnosis and paid X dollars for this diagnosis and this problem, this problem, this problem, » the code. I had a direct primary » the code. I had a direct primary » the code. I had a direct primary care clinic owner on care clinic owner on care clinic owner on » and you talked about the codes like » and you talked about the codes like » and you talked about the codes like Yeah. Like you bill per code. Yeah. Like you bill per code. Yeah. Like you bill per code. » Yep. And so um they that determination » Yep. And so um they that determination » Yep. And so um they that determination comes off of they have this magical comes off of they have this magical comes off of they have this magical payer list, right? Well, Medicare does. payer list, right? Well, Medicare does. payer list, right? Well, Medicare does. And then And then And then » and it's already predetermined for the » and it's already predetermined for the » and it's already predetermined for the Interesting. Yeah. Yeah. Um so Interesting. Yeah. Yeah. Um so Interesting. Yeah. Yeah. Um so regardless of what it actually cost us regardless of what it actually cost us regardless of what it actually cost us to make that happen, right? to make that happen, right? to make that happen, right? » So um so uh so we're a perspective » So um so uh so we're a perspective » So um so uh so we're a perspective payment hospital which so comparatively payment hospital which so comparatively payment hospital which so comparatively that's like Wesley, right? That's how that's like Wesley, right? That's how that's like Wesley, right? That's how they get paid also. Um but we are they get paid also. Um but we are they get paid also. Um but we are nonfor-profit. Um and we are nonfor-profit. Um and we are nonfor-profit. Um and we are independently owned which means we're independently owned which means we're independently owned which means we're running ourselves, right? We have a running ourselves, right? We have a running ourselves, right? We have a board of directors. Um myself, we're our board of directors. Um myself, we're our board of directors. Um myself, we're our CFO, our CNO have fiduciary CFO, our CNO have fiduciary CFO, our CNO have fiduciary responsibility to ensure the hospital is responsibility to ensure the hospital is responsibility to ensure the hospital is » Yeah. Not nonprofit and not for aprofit » Yeah. Not nonprofit and not for aprofit » Yeah. Not nonprofit and not for aprofit are different things. are different things. are different things. » Uh so in our world they're the same. » Uh so in our world they're the same. » Uh so in our world they're the same. » They're the same thing. Okay. » They're the same thing. Okay. » They're the same thing. Okay. » Yeah. So » Yeah. So » Yeah. So » So you said independently owned. Who » So you said independently owned. Who » So you said independently owned. Who owns the hospital? owns the hospital? owns the hospital? » We own ourselves. » We own ourselves. » We own ourselves. » Okay. » Okay. » Okay. » So truly like no, there is no » So truly like no, there is no » So truly like no, there is no » mothership that owns us. Um » mothership that owns us. Um » mothership that owns us. Um » so is it like board members have stock? » so is it like board members have stock? » so is it like board members have stock? Does is there like none of that? It's Does is there like none of that? It's Does is there like none of that? It's just a 501c3 and there's a board that just a 501c3 and there's a board that just a 501c3 and there's a board that manages it. manages it. manages it. » Yeah. And there's there's truly I mean » Yeah. And there's there's truly I mean » Yeah. And there's there's truly I mean we have to we have to we have to » keep our own doors open, » keep our own doors open, » keep our own doors open, » right? » right? » right? » Yeah. Yeah. Um no stockholders. There » Yeah. Yeah. Um no stockholders. There » Yeah. Yeah. Um no stockholders. There are » there are hospitals around us that are » there are hospitals around us that are » there are hospitals around us that are privately owned. Um and they truly privately owned. Um and they truly privately owned. Um and they truly um I mean they have stock owners. Most um I mean they have stock owners. Most um I mean they have stock owners. Most of them are physician um ran and so of them are physician um ran and so of them are physician um ran and so they're they get a part of the profit they're they get a part of the profit they're they get a part of the profit that comes from it. Um that comes from it. Um that comes from it. Um » yeah, » yeah, » yeah, » that's that's not us. » that's that's not us. » that's that's not us. » Yeah. So, so board plays a big role in » Yeah. So, so board plays a big role in » Yeah. So, so board plays a big role in this obviously. Um, they have a lot of this obviously. Um, they have a lot of this obviously. Um, they have a lot of say there. Does the board and the say there. Does the board and the say there. Does the board and the committee » form a task force to find a CEO or on » form a task force to find a CEO or on » form a task force to find a CEO or on the executive side and then they're just the executive side and then they're just the executive side and then they're just you're reporting to them? Can you're reporting to them? Can you're reporting to them? Can you explain that relationship? explain that relationship? explain that relationship? » Sure. Sure. Yeah. Um, yeah. So that's » Sure. Sure. Yeah. Um, yeah. So that's » Sure. Sure. Yeah. Um, yeah. So that's that's really what happens is they um that's really what happens is they um that's really what happens is they um the board well in my case specifically the board well in my case specifically the board well in my case specifically um they did create a CEO search um they did create a CEO search um they did create a CEO search committee um and then they were in committee um and then they were in committee um and then they were in charge of hey you get us some charge of hey you get us some charge of hey you get us some candidates right and then I actually candidates right and then I actually candidates right and then I actually interviewed with the entire board and so interviewed with the entire board and so interviewed with the entire board and so um all of them had a say all the things um all of them had a say all the things um all of them had a say all the things um and so but from a operations um and so but from a operations um and so but from a operations perspective it is it is my job and my perspective it is it is my job and my perspective it is it is my job and my senior leaders job team's job to keep senior leaders job team's job to keep senior leaders job team's job to keep the hospital running and doing all the hospital running and doing all the hospital running and doing all the things that are appropriate. We things that are appropriate. We things that are appropriate. We definitely guide them. I, you know, we definitely guide them. I, you know, we definitely guide them. I, you know, we from a board perspective, a lot of from a board perspective, a lot of from a board perspective, a lot of conversation is, okay, here are here is conversation is, okay, here are here is conversation is, okay, here are here is where we're sitting. where we're sitting. where we're sitting. » Here are our options. Um, and I usually » Here are our options. Um, and I usually » Here are our options. Um, and I usually give my this is what I believe is the give my this is what I believe is the give my this is what I believe is the right choice, you know, and why. Um, but right choice, you know, and why. Um, but right choice, you know, and why. Um, but then but ultimately they then but ultimately they then but ultimately they » Yeah. » Yeah. » Yeah. » have to make some of those decisions if » have to make some of those decisions if » have to make some of those decisions if it's fundamentally structurally going to it's fundamentally structurally going to it's fundamentally structurally going to change how we function. Sure. Yeah. So, change how we function. Sure. Yeah. So, change how we function. Sure. Yeah. So, I'm sure there's certain decisions that I'm sure there's certain decisions that I'm sure there's certain decisions that go to a vote like any other board I've go to a vote like any other board I've go to a vote like any other board I've been on and certain decisions the been on and certain decisions the been on and certain decisions the executive director or CEO could make. executive director or CEO could make. executive director or CEO could make. Yep. You know, and then just report on Yep. You know, and then just report on Yep. You know, and then just report on » what they're doing. Yep. » what they're doing. Yep. » what they're doing. Yep. » Is that So, let's I think that's » Is that So, let's I think that's » Is that So, let's I think that's actually a actually a actually a » So, why is that better care » So, why is that better care » So, why is that better care potentially? Why is it better to be potentially? Why is it better to be potentially? Why is it better to be independent 501c3 versus why not just independent 501c3 versus why not just independent 501c3 versus why not just sell it? Why not let it turn into sell it? Why not let it turn into sell it? Why not let it turn into something else or partner? something else or partner? something else or partner? » Sure. So, there's a lot of um » Sure. So, there's a lot of um » Sure. So, there's a lot of um I'm going to start with probably one of I'm going to start with probably one of I'm going to start with probably one of my favorite things um is to hear the why my favorite things um is to hear the why my favorite things um is to hear the why people come to us, people come to us, people come to us, » right? Or after they've been a patient » right? Or after they've been a patient » right? Or after they've been a patient with us, most people don't plan to go to with us, most people don't plan to go to with us, most people don't plan to go to the hospital, right? Um but once they've the hospital, right? Um but once they've the hospital, right? Um but once they've had care here, what I hear the majority had care here, what I hear the majority had care here, what I hear the majority of the time is, "Oh my gosh, your of the time is, "Oh my gosh, your of the time is, "Oh my gosh, your nursing staff just took such good care nursing staff just took such good care nursing staff just took such good care of me." or you know the radiology of me." or you know the radiology of me." or you know the radiology tech that came to pick me up like they tech that came to pick me up like they tech that came to pick me up like they genuinely cared like why I was there and genuinely cared like why I was there and genuinely cared like why I was there and what was going on. Um that's what you what was going on. Um that's what you what was going on. Um that's what you get to do. That's what you get to bring, get to do. That's what you get to bring, get to do. That's what you get to bring, right? Um not that those nurses right? Um not that those nurses right? Um not that those nurses don't have the same compassion and care. don't have the same compassion and care. don't have the same compassion and care. They don't have the opportunity to have They don't have the opportunity to have They don't have the opportunity to have the time to actually take care of the time to actually take care of the time to actually take care of patients, right? Um the for-profit patients, right? Um the for-profit patients, right? Um the for-profit hospitals, they have to worry about hospitals, they have to worry about hospitals, they have to worry about the bottom line. Gotcha. A lot of the bottom line. Gotcha. A lot of the bottom line. Gotcha. A lot of dollars drive a lot of decisions. Uh dollars drive a lot of decisions. Uh dollars drive a lot of decisions. Uh regardless of what that truly from a regardless of what that truly from a regardless of what that truly from a care perspective means. Um here in an care perspective means. Um here in an care perspective means. Um here in an independent function I we have a independent function I we have a independent function I we have a committee that we have um two of our committee that we have um two of our committee that we have um two of our lead ER providers, our ER director, our lead ER providers, our ER director, our lead ER providers, our ER director, our med surge director and our lead med surge director and our lead med surge director and our lead hospitalist and myself and our quality hospitalist and myself and our quality hospitalist and myself and our quality and compliance person all sit in a room and compliance person all sit in a room and compliance person all sit in a room and we really talk about hey we had this and we really talk about hey we had this and we really talk about hey we had this situation. and how do we prevent this situation. and how do we prevent this situation. and how do we prevent this from happening? from happening? from happening? » Right? Those are those happen every » Right? Those are those happen every » Right? Those are those happen every month. Those are we're we're making month. Those are we're we're making month. Those are we're we're making change. We're improving things all the change. We're improving things all the change. We're improving things all the time. And we we get to just decide today time. And we we get to just decide today time. And we we get to just decide today we're going to make the change. Right? we're going to make the change. Right? we're going to make the change. Right? Those bigger hospitals, they're very Those bigger hospitals, they're very Those bigger hospitals, they're very formally driven. And a lot of those formally driven. And a lot of those formally driven. And a lot of those decisions don't get to get made at that decisions don't get to get made at that decisions don't get to get made at that table. They're they're made table. They're they're made table. They're they're made four levels up. And if the whoever's four levels up. And if the whoever's four levels up. And if the whoever's making the decision actually understands making the decision actually understands making the decision actually understands what that looks like. what that looks like. what that looks like. » Talk about nursing. How are you guys » Talk about nursing. How are you guys » Talk about nursing. How are you guys handling the nursing handling the nursing handling the nursing shortage? I mean, it's it seems like shortage? I mean, it's it seems like shortage? I mean, it's it seems like it's a mess like all around from I have it's a mess like all around from I have it's a mess like all around from I have I have several relatives that are in the I have several relatives that are in the I have several relatives that are in the medical industry and nursing and have medical industry and nursing and have medical industry and nursing and have hopped around and left it and then come hopped around and left it and then come hopped around and left it and then come back or didn't come back. back or didn't come back. back or didn't come back. » Sure. » Sure. » Sure. » Um how's that being addressed there in » Um how's that being addressed there in » Um how's that being addressed there in your background? Like I think you get your background? Like I think you get your background? Like I think you get it. So like it. So like it. So like » Yes. » Yes. » Yes. » Can you fix it? » Can you fix it? » Can you fix it? » Can I fix it? Oh my gosh, I'm trying. » Can I fix it? Oh my gosh, I'm trying. » Can I fix it? Oh my gosh, I'm trying. No. Um, you know, I No. Um, you know, I No. Um, you know, I » cuz I heard a stat too. Sorry to » cuz I heard a stat too. Sorry to » cuz I heard a stat too. Sorry to interrupt you. I heard a stat. It was interrupt you. I heard a stat. It was interrupt you. I heard a stat. It was something crazy like 50% of nursing something crazy like 50% of nursing something crazy like 50% of nursing students like after they graduate just students like after they graduate just students like after they graduate just don't go do nursing don't go do nursing don't go do nursing » or I don't know if it was if that's the » or I don't know if it was if that's the » or I don't know if it was if that's the right number, but I thought it was like right number, but I thought it was like right number, but I thought it was like a crazy a crazy a crazy » it's pretty significant. Um, yeah, it's » it's pretty significant. Um, yeah, it's » it's pretty significant. Um, yeah, it's it's um it just breaks your heart a it's um it just breaks your heart a it's um it just breaks your heart a little bit, right? Um so this is one of little bit, right? Um so this is one of little bit, right? Um so this is one of the things I just truly believe the things I just truly believe the things I just truly believe unfortunately how CO got handled we are now seeing the how CO got handled we are now seeing the how CO got handled we are now seeing the ramifications of it and I don't I don't ramifications of it and I don't I don't ramifications of it and I don't I don't mean that I'm not I'm not passing mean that I'm not I'm not passing mean that I'm not I'm not passing judgment right but at the end of the day judgment right but at the end of the day judgment right but at the end of the day we let political views decide we let political views decide we let political views decide care practice and model right and so it care practice and model right and so it care practice and model right and so it really pushed nursing really pushed nursing really pushed nursing to their limits to their limits to their limits um you we saw more nurses walk away from um you we saw more nurses walk away from um you we saw more nurses walk away from the career path of nursing in a two-year the career path of nursing in a two-year the career path of nursing in a two-year span than we had the five years prior to span than we had the five years prior to span than we had the five years prior to that. that. that. » That's that » That's that » That's that » geez » geez » geez » true stat. You can you can go look that » true stat. You can you can go look that » true stat. You can you can go look that up. So that I mean that's very up. So that I mean that's very up. So that I mean that's very impactful, right? And so then it also impactful, right? And so then it also impactful, right? And so then it also flipped everything upside down. Um and flipped everything upside down. Um and flipped everything upside down. Um and we also saw contract nursing become a we also saw contract nursing become a we also saw contract nursing become a thing. it is. You know, it's always been thing. it is. You know, it's always been thing. it is. You know, it's always been a thing, but there was always just this a thing, but there was always just this a thing, but there was always just this like 5% group of people that did it like 5% group of people that did it like 5% group of people that did it right now. It is a lot. Um I I actually right now. It is a lot. Um I I actually right now. It is a lot. Um I I actually just had the opportunity not very long just had the opportunity not very long just had the opportunity not very long ago to speak to a nursing group that's ago to speak to a nursing group that's ago to speak to a nursing group that's literally graduating in May, right? In a literally graduating in May, right? In a literally graduating in May, right? In a couple of weeks. Um and they couple of weeks. Um and they couple of weeks. Um and they um a good portion I mean I would I would um a good portion I mean I would I would um a good portion I mean I would I would say probably at least a third of the say probably at least a third of the say probably at least a third of the kids in that room were like, "Oh, I'm kids in that room were like, "Oh, I'm kids in that room were like, "Oh, I'm going to really just be travel nursing." going to really just be travel nursing." going to really just be travel nursing." » Yeah. And I'm like, "Oh, but do you » Yeah. And I'm like, "Oh, but do you » Yeah. And I'm like, "Oh, but do you understand what that really means?" understand what that really means?" understand what that really means?" Right? And that's that's really not how Right? And that's that's really not how Right? And that's that's really not how contract nursing was ever intended to contract nursing was ever intended to contract nursing was ever intended to be. It was it was intended to be just be. It was it was intended to be just be. It was it was intended to be just the hey, my regular routine nurse is the hey, my regular routine nurse is the hey, my regular routine nurse is going on maternity leave and so now I going on maternity leave and so now I going on maternity leave and so now I need somebody to fill her spot for 12 need somebody to fill her spot for 12 need somebody to fill her spot for 12 weeks, 13 weeks. Right. Right. weeks, 13 weeks. Right. Right. weeks, 13 weeks. Right. Right. » Um » Um » Um » but now it's turning into like » but now it's turning into like » but now it's turning into like » this is their profession. Yes. This is » this is their profession. Yes. This is » this is their profession. Yes. This is their career, you know? So um that's their career, you know? So um that's their career, you know? So um that's hard. Um we we even live at like 31% of hard. Um we we even live at like 31% of hard. Um we we even live at like 31% of our nursing staff is contracts nursing. our nursing staff is contracts nursing. our nursing staff is contracts nursing. » Um » Um » Um » which is hard. » which is hard. » which is hard. » Yeah. » Yeah. » Yeah. » And so » And so » And so » and the hard part that's interesting if » and the hard part that's interesting if » and the hard part that's interesting if you we can go as deep as you're you we can go as deep as you're you we can go as deep as you're comfortable talking about it. But I'm comfortable talking about it. But I'm comfortable talking about it. But I'm like I when you're working next to that like I when you're working next to that like I when you're working next to that nurse doing the same job and the pay is nurse doing the same job and the pay is nurse doing the same job and the pay is so substantially different. Right. so substantially different. Right. so substantially different. Right. Because that's how it works. Like they Because that's how it works. Like they Because that's how it works. Like they don't have benefits. They have no don't have benefits. They have no don't have benefits. They have no guarantee contract. Right. guarantee contract. Right. guarantee contract. Right. » Right. like it it does make sense, but » Right. like it it does make sense, but » Right. like it it does make sense, but it's also when it's that big of a it's also when it's that big of a it's also when it's that big of a percentage. And I never really thought percentage. And I never really thought percentage. And I never really thought about that being the shortage problem about that being the shortage problem about that being the shortage problem » and the demand problem. Um, so how many » and the demand problem. Um, so how many » and the demand problem. Um, so how many I there might not be a number, but I I there might not be a number, but I I there might not be a number, but I wonder how many people went to contract wonder how many people went to contract wonder how many people went to contract nursing um and then have stayed like nursing um and then have stayed like nursing um and then have stayed like what percent of all nursing is contract what percent of all nursing is contract what percent of all nursing is contract nursing if you guys are at 30. nursing if you guys are at 30. nursing if you guys are at 30. » Yeah, we're at 30. So I can't even » Yeah, we're at 30. So I can't even » Yeah, we're at 30. So I can't even imagine. imagine. imagine. » So it's probably 30 or more. Like that's » So it's probably 30 or more. Like that's » So it's probably 30 or more. Like that's crazy. It's I mean I I would venture to crazy. It's I mean I I would venture to crazy. It's I mean I I would venture to say we're not abnormal. I mean in fact I say we're not abnormal. I mean in fact I say we're not abnormal. I mean in fact I know we're not right. I mean we I have know we're not right. I mean we I have know we're not right. I mean we I have the opportunity through the Kansas the opportunity through the Kansas the opportunity through the Kansas Hospital Association. Hospital Association. Hospital Association. » I'm talking to other CNOs, CEOs » I'm talking to other CNOs, CEOs » I'm talking to other CNOs, CEOs » and we're all facing that problem. Um » and we're all facing that problem. Um » and we're all facing that problem. Um and you know some have truly had to just and you know some have truly had to just and you know some have truly had to just shut down units because shut down units because shut down units because we don't have you can't staff it with we don't have you can't staff it with we don't have you can't staff it with contract, right? You don't make enough contract, right? You don't make enough contract, right? You don't make enough » to staff it with contract and so you » to staff it with contract and so you » to staff it with contract and so you » choose to close it instead. » choose to close it instead. » choose to close it instead. » Yeah. Yeah. » Yeah. Yeah. » Yeah. Yeah. » Yeah. » Yeah. » Yeah. » So, » So, » So, » yeah. So, as the demand signal goes » yeah. So, as the demand signal goes » yeah. So, as the demand signal goes down, those, you know, I I just don't down, those, you know, I I just don't down, those, you know, I I just don't know how you balance that, though. It's know how you balance that, though. It's know how you balance that, though. It's hard. It's like, hard. It's like, hard. It's like, » yeah, once they get that experience and » yeah, once they get that experience and » yeah, once they get that experience and they figure out a lifestyle that works they figure out a lifestyle that works they figure out a lifestyle that works around that, then, around that, then, around that, then, » right, they're used to Yeah. I mean, » right, they're used to Yeah. I mean, » right, they're used to Yeah. I mean, they kind of have all the leverage cuz they kind of have all the leverage cuz they kind of have all the leverage cuz you need that skill set you need that skill set you need that skill set » in your hospital. And » in your hospital. And » in your hospital. And » if they say, "Well, this is I'm only » if they say, "Well, this is I'm only » if they say, "Well, this is I'm only going to do it this way." going to do it this way." going to do it this way." » And if enough of them say that, it's » And if enough of them say that, it's » And if enough of them say that, it's almost like a union thing, but it's not. almost like a union thing, but it's not. almost like a union thing, but it's not. You know what I mean? It kind of feels You know what I mean? It kind of feels You know what I mean? It kind of feels like that. like they're forming this like that. like they're forming this like that. like they're forming this union that doesn't exist. Yeah. No. And union that doesn't exist. Yeah. No. And union that doesn't exist. Yeah. No. And it's but you know I do think you know it's but you know I do think you know it's but you know I do think you know part of that is we do just across the part of that is we do just across the part of that is we do just across the board » um » um » um » you have to give nurses it's not always » you have to give nurses it's not always » you have to give nurses it's not always I'm going to back up. Sorry. I would say I'm going to back up. Sorry. I would say I'm going to back up. Sorry. I would say the average nurse does not go into the average nurse does not go into the average nurse does not go into nursing for the dollars. nursing for the dollars. nursing for the dollars. » Sure. » Sure. » Sure. » Right. they go in because they want to » Right. they go in because they want to » Right. they go in because they want to care for something drove them to care for something drove them to care for something drove them to that or they've just always had like that or they've just always had like that or they've just always had like your wife since right the third grade your wife since right the third grade your wife since right the third grade like she's like I just need to do this like she's like I just need to do this like she's like I just need to do this job. job. job. » Um and so I think I think that's what » Um and so I think I think that's what » Um and so I think I think that's what really drives them and so yes from a pay really drives them and so yes from a pay really drives them and so yes from a pay perspective you can't compete with perspective you can't compete with perspective you can't compete with contract pay. I mean just on a contract pay. I mean just on a contract pay. I mean just on a » routine full-time position. Um but what » routine full-time position. Um but what » routine full-time position. Um but what you can give them is an opportunity to you can give them is an opportunity to you can give them is an opportunity to truly get to care for patients the way truly get to care for patients the way truly get to care for patients the way they want to care for patients. they can they want to care for patients. they can they want to care for patients. they can be a part of that. Um, the other thing be a part of that. Um, the other thing be a part of that. Um, the other thing that I really love about a small that I really love about a small that I really love about a small hospital is you will never see a hospital is you will never see a hospital is you will never see a group of people that will rally together group of people that will rally together group of people that will rally together so that a mom can make it to a so that a mom can make it to a so that a mom can make it to a Valentine's party more than that group, Valentine's party more than that group, Valentine's party more than that group, right? Um, I'm telling you, um, I've right? Um, I'm telling you, um, I've right? Um, I'm telling you, um, I've seen so many seen so many seen so many » shift that they've came in and just » shift that they've came in and just » shift that they've came in and just covered for two hours so that she can go covered for two hours so that she can go covered for two hours so that she can go and do that because we all want to be and do that because we all want to be and do that because we all want to be all the things, right? We want to have all the things, right? We want to have all the things, right? We want to have we want to work. We want to provide for we want to work. We want to provide for we want to work. We want to provide for our family, but we also want to be the our family, but we also want to be the our family, but we also want to be the mom that's or dad mom that's or dad mom that's or dad » that's there and that shows up and we're » that's there and that shows up and we're » that's there and that shows up and we're present. present. present. » So, the contract nurse is a little » So, the contract nurse is a little » So, the contract nurse is a little alienated from that community. alienated from that community. alienated from that community. » Yeah, they really are. Um, you know, » Yeah, they really are. Um, you know, » Yeah, they really are. Um, you know, people don't tend to bend over backwards people don't tend to bend over backwards people don't tend to bend over backwards to help that. So, um, to help that. So, um, to help that. So, um, » uh, bed like nurse ratio to bed ratio or » uh, bed like nurse ratio to bed ratio or » uh, bed like nurse ratio to bed ratio or care to bed ratio. Is there any benefit care to bed ratio. Is there any benefit care to bed ratio. Is there any benefit at at at » Susan Bellen? Yeah. versus some others. » Susan Bellen? Yeah. versus some others. » Susan Bellen? Yeah. versus some others. » Yeah, I would I definitely say so. Um, » Yeah, I would I definitely say so. Um, » Yeah, I would I definitely say so. Um, we on average sit about four, sometimes we on average sit about four, sometimes we on average sit about four, sometimes 5 to one. 5 to one. 5 to one. » Okay. » Okay. » Okay. » Um, you're going to go to Witchaw and » Um, you're going to go to Witchaw and » Um, you're going to go to Witchaw and those are mostly six or seven to one. those are mostly six or seven to one. those are mostly six or seven to one. » Okay. » Okay. » Okay. » Um, and » Um, and » Um, and » you know that's and they're sicker, » you know that's and they're sicker, » you know that's and they're sicker, right? I mean it's it's not just that right? I mean it's it's not just that right? I mean it's it's not just that there's more of them. They are sicker there's more of them. They are sicker there's more of them. They are sicker patients because the hospitals our size patients because the hospitals our size patients because the hospitals our size couldn't keep them, couldn't keep them, couldn't keep them, » right? Or I mean they never even came » right? Or I mean they never even came » right? Or I mean they never even came here to start with, but But for the most here to start with, but But for the most here to start with, but But for the most part, they're they're a lot more acute. part, they're they're a lot more acute. part, they're they're a lot more acute. And that's And that's And that's » Yeah. » Yeah. » Yeah. » Yeah. So » Yeah. So » Yeah. So » yeah, that's interesting. Yeah. I did it » yeah, that's interesting. Yeah. I did it » yeah, that's interesting. Yeah. I did it used to be like one to one like way back used to be like one to one like way back used to be like one to one like way back in the day or one to two like what in the day or one to two like what in the day or one to two like what did it used? did it used? did it used? » Yeah. You know, I mean » Yeah. You know, I mean » Yeah. You know, I mean » or is the one to four pretty been » or is the one to four pretty been » or is the one to four pretty been normal? normal? normal? » I mean I would say it probably was. I » I mean I would say it probably was. I » I mean I would say it probably was. I mean there's there's different phases of there's there's different phases of there's there's different phases of healthcare, right? And so when healthcare, right? And so when healthcare, right? And so when everything transitioned to this concept everything transitioned to this concept everything transitioned to this concept of valuebased care um all of a sudden of valuebased care um all of a sudden of valuebased care um all of a sudden the G the we call them DRGs that's the G the we call them DRGs that's the G the we call them DRGs that's the payment that you get for this diagnosis payment that you get for this diagnosis payment that you get for this diagnosis for this duration right for this duration right for this duration right » um that whole concept now we then added » um that whole concept now we then added » um that whole concept now we then added an element of and you have to score this an element of and you have to score this an element of and you have to score this high on quality scores to get your full high on quality scores to get your full high on quality scores to get your full payment » right which um I truly believe this I » right which um I truly believe this I » right which um I truly believe this I don't think hospitals weren't doing it don't think hospitals weren't doing it don't think hospitals weren't doing it before Somebody just wanted it to be on before Somebody just wanted it to be on before Somebody just wanted it to be on a piece of paper, right? Um they wanted a piece of paper, right? Um they wanted a piece of paper, right? Um they wanted a statistic to show for it. Um but what a statistic to show for it. Um but what a statistic to show for it. Um but what that made the nursing person do is now that made the nursing person do is now that made the nursing person do is now my time can't be just all at the my time can't be just all at the my time can't be just all at the bedside. We transition to now we have to bedside. We transition to now we have to bedside. We transition to now we have to do all these documentation things to do all these documentation things to do all these documentation things to meet those requirements to actually get meet those requirements to actually get meet those requirements to actually get the full payment at the hospital level the full payment at the hospital level the full payment at the hospital level if that makes sense. if that makes sense. if that makes sense. » Yes. And I really enjoy the series PIT » Yes. And I really enjoy the series PIT » Yes. And I really enjoy the series PIT uh the show the TV show about the ER. uh the show the TV show about the ER. uh the show the TV show about the ER. » Yes. and they're always complaining » Yes. and they're always complaining » Yes. and they're always complaining about that. They always have to go over about that. They always have to go over about that. They always have to go over there and do their thing. So they there and do their thing. So they there and do their thing. So they » Yeah. Yeah. Yeah. And so and that's » Yeah. Yeah. Yeah. And so and that's » Yeah. Yeah. Yeah. And so and that's that's the part that's um you know when that's the part that's um you know when that's the part that's um you know when I got into it that's no joke. I was I got into it that's no joke. I was I got into it that's no joke. I was like » whoever created this documentation style » whoever created this documentation style » whoever created this documentation style wrong, right? Like so we we got to make wrong, right? Like so we we got to make wrong, right? Like so we we got to make it so that it's easier for them to do it so that it's easier for them to do it so that it's easier for them to do that. But so I would actually say the that. But so I would actually say the that. But so I would actually say the nursing ratio nursing ratio nursing ratio » nurse to patient ratio actually probably » nurse to patient ratio actually probably » nurse to patient ratio actually probably was a little bit higher. But we didn't was a little bit higher. But we didn't was a little bit higher. But we didn't ask them to do near as what we're asking ask them to do near as what we're asking ask them to do near as what we're asking them to do today. them to do today. them to do today. » Right. » Right. » Right. » Makes sense. » Makes sense. » Makes sense. » So, um, and I would say those bigger » So, um, and I would say those bigger » So, um, and I would say those bigger hospitals haven't really changed that. hospitals haven't really changed that. hospitals haven't really changed that. They just expect you to They just expect you to They just expect you to » literally do it all. » literally do it all. » literally do it all. » Do it all. Yeah. And at a high level, » Do it all. Yeah. And at a high level, » Do it all. Yeah. And at a high level, then they get burned out and tired and then they get burned out and tired and then they get burned out and tired and Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. » Uh, ransomware attack. What a what a » Uh, ransomware attack. What a what a » Uh, ransomware attack. What a what a deal. Right. You talk about if you're deal. Right. You talk about if you're deal. Right. You talk about if you're researching like that obviously made the researching like that obviously made the researching like that obviously made the news. Yep. uh July of 2025. I've I've news. Yep. uh July of 2025. I've I've news. Yep. uh July of 2025. I've I've never experienced that and I think it never experienced that and I think it never experienced that and I think it would actually be really insightful to would actually be really insightful to would actually be really insightful to any business owners, any organizational any business owners, any organizational any business owners, any organizational people listening. Anything you want to people listening. Anything you want to people listening. Anything you want to share on that experience and share on that experience and share on that experience and » anything learn from it or » anything learn from it or » anything learn from it or » Sure. Yeah. Yeah. Um one, never live » Sure. Yeah. Yeah. Um one, never live » Sure. Yeah. Yeah. Um one, never live through it if you don't have to through it if you don't have to through it if you don't have to just FYI, you will lose sleep. Um just FYI, you will lose sleep. Um just FYI, you will lose sleep. Um » you know, two truly I have actually » you know, two truly I have actually » you know, two truly I have actually named that the event. all of the staff named that the event. all of the staff named that the event. all of the staff at the hospital, we actually refer to it at the hospital, we actually refer to it at the hospital, we actually refer to it as the event of 2025. as the event of 2025. as the event of 2025. » Um, that is that is a horrible » Um, that is that is a horrible » Um, that is that is a horrible experience. Um, it, you know, we went experience. Um, it, you know, we went experience. Um, it, you know, we went from everything's working fine at 2 a.m. from everything's working fine at 2 a.m. from everything's working fine at 2 a.m. and all of a sudden at 3:00 a.m. one of and all of a sudden at 3:00 a.m. one of and all of a sudden at 3:00 a.m. one of the nurses calls the IT guy on to call the nurses calls the IT guy on to call the nurses calls the IT guy on to call and says, "My computer doesn't work. I and says, "My computer doesn't work. I and says, "My computer doesn't work. I don't know what's happening." Uh, and don't know what's happening." Uh, and don't know what's happening." Uh, and you know, a lot of it is done remotely you know, a lot of it is done remotely you know, a lot of it is done remotely and so he's like, "Oh, let me remote in and so he's like, "Oh, let me remote in and so he's like, "Oh, let me remote in and see what we He couldn't get in, and see what we He couldn't get in, and see what we He couldn't get in, right?" And so immediately his bells and right?" And so immediately his bells and right?" And so immediately his bells and whistles are going off. Um comes in and whistles are going off. Um comes in and whistles are going off. Um comes in and discovers all the admin is not discovers all the admin is not discovers all the admin is not accessible. And so you know he just accessible. And so you know he just accessible. And so you know he just turns it all off. I mean literally like turns it all off. I mean literally like turns it all off. I mean literally like you literally unplug the server, right? you literally unplug the server, right? you literally unplug the server, right? Like I mean it is you just turn it off Like I mean it is you just turn it off Like I mean it is you just turn it off and » okay now what's the next step? Um so you » okay now what's the next step? Um so you » okay now what's the next step? Um so you know hospitals from a a perspective know hospitals from a a perspective know hospitals from a a perspective » Oh sorry I thought it was me because my » Oh sorry I thought it was me because my » Oh sorry I thought it was me because my phone was buzzing a second ago. My I'm phone was buzzing a second ago. My I'm phone was buzzing a second ago. My I'm in a I'm in a podcast. in a I'm in a podcast. in a I'm in a podcast. » Yeah. » Yeah. » Yeah. » Yeah. We um so so to go through » Yeah. We um so so to go through » Yeah. We um so so to go through something like that, you know, we we something like that, you know, we we something like that, you know, we we obviously have fail safes, there's obviously have fail safes, there's obviously have fail safes, there's firewalls, we have all of these firewalls, we have all of these firewalls, we have all of these regulations to keeping data safe. regulations to keeping data safe. regulations to keeping data safe. » Sure. » Sure. » Sure. » Um and I can I can honestly say » Um and I can I can honestly say » Um and I can I can honestly say thankfully they couldn't actually get thankfully they couldn't actually get thankfully they couldn't actually get into our EMR system. into our EMR system. into our EMR system. » Um but unfortunately they did deploy and » Um but unfortunately they did deploy and » Um but unfortunately they did deploy and encrypt all of our other servers. Yeah. encrypt all of our other servers. Yeah. encrypt all of our other servers. Yeah. Right. I mean, we couldn't get to our Right. I mean, we couldn't get to our Right. I mean, we couldn't get to our EMR system, but what was on our actual EMR system, but what was on our actual EMR system, but what was on our actual patient records, patient records, patient records, » they couldn't get into. » they couldn't get into. » they couldn't get into. » Um, but unfortunately, you have lots of » Um, but unfortunately, you have lots of » Um, but unfortunately, you have lots of other servers that do a lot of other servers that do a lot of other servers that do a lot of other things. Um, and that stuff was on things. Um, and that stuff was on things. Um, and that stuff was on there. And so, there. And so, there. And so, » it truly uh thankfully we actually have » it truly uh thankfully we actually have » it truly uh thankfully we actually have a recovery a recovery a recovery » program that we pay for uh every month. » program that we pay for uh every month. » program that we pay for uh every month. I mean, we had for several years, I mean, we had for several years, I mean, we had for several years, » almost like you're insured for that » almost like you're insured for that » almost like you're insured for that event. Well, um, so it's basically a event. Well, um, so it's basically a event. Well, um, so it's basically a safety net. Like, so everything that we safety net. Like, so everything that we safety net. Like, so everything that we have on our system, like all of our have on our system, like all of our have on our system, like all of our servers are actually replicated servers are actually replicated servers are actually replicated » somewhere else, » somewhere else, » somewhere else, » in a data center, believe it or not, in » in a data center, believe it or not, in » in a data center, believe it or not, in Iowa. But listen, I'm not like stirring Iowa. But listen, I'm not like stirring Iowa. But listen, I'm not like stirring up a topic. I'm not taking a position, up a topic. I'm not taking a position, up a topic. I'm not taking a position, but um, they are actually very useful but um, they are actually very useful but um, they are actually very useful and helpful from a perspective of what and helpful from a perspective of what and helpful from a perspective of what they do. Um, so ours was housed in, they do. Um, so ours was housed in, they do. Um, so ours was housed in, um, Iowa, and so it was a matter of, um, Iowa, and so it was a matter of, um, Iowa, and so it was a matter of, okay, I guess we spin that up, right? Um okay, I guess we spin that up, right? Um okay, I guess we spin that up, right? Um that actually takes 4 days to do. that actually takes 4 days to do. that actually takes 4 days to do. » Wow. » Wow. » Wow. » That is not a I really thought that was » That is not a I really thought that was » That is not a I really thought that was like 4 hour job. like 4 hour job. like 4 hour job. » That sounds complicated. » That sounds complicated. » That sounds complicated. » It's not. Yeah, it's 4 days. Um we were » It's not. Yeah, it's 4 days. Um we were » It's not. Yeah, it's 4 days. Um we were truly » everything was done by paper. Um which » everything was done by paper. Um which » everything was done by paper. Um which you know unfortunately then meant we you know unfortunately then meant we you know unfortunately then meant we truly couldn't serve some of our truly couldn't serve some of our truly couldn't serve some of our patients, right? patients, right? patients, right? » Um » Um » Um » and that's that event has just been » and that's that event has just been » and that's that event has just been truly detrimental to the hospital. I truly detrimental to the hospital. I truly detrimental to the hospital. I mean we went um mean we went um mean we went um 45 days and couldn't charge we couldn't 45 days and couldn't charge we couldn't 45 days and couldn't charge we couldn't even create a bill even create a bill even create a bill » right and so from uh you're already » right and so from uh you're already » right and so from uh you're already struggling financially I mean all struggling financially I mean all struggling financially I mean all healthcare is not just Susan Bon but healthcare is not just Susan Bon but healthcare is not just Susan Bon but healthcare in general healthcare in general healthcare in general » most people don't have a heavy cash flow » most people don't have a heavy cash flow » most people don't have a heavy cash flow » sitting around um to then we couldn't » sitting around um to then we couldn't » sitting around um to then we couldn't bill we couldn't we couldn't even see bill we couldn't we couldn't even see bill we couldn't we couldn't even see some patients in our ER because I didn't some patients in our ER because I didn't some patients in our ER because I didn't have a way to get images to our after have a way to get images to our after have a way to get images to our after hours people you Gosh, hours people you Gosh, hours people you Gosh, » you don't really think about it, but » you don't really think about it, but » you don't really think about it, but we have really we have really we have really » just transitioned to like all things are » just transitioned to like all things are » just transitioned to like all things are electronic. electronic. electronic. » Um, which is beautiful when you want it » Um, which is beautiful when you want it » Um, which is beautiful when you want it to be, but when you don't have it all of to be, but when you don't have it all of to be, but when you don't have it all of a sudden, it's really hard. a sudden, it's really hard. a sudden, it's really hard. » Yeah. So, so the rans So, it you shut » Yeah. So, so the rans So, it you shut » Yeah. So, so the rans So, it you shut the system down, right? Unplug it. the system down, right? Unplug it. the system down, right? Unplug it. » Yeah. » Yeah. » Yeah. » Start bringing in onto like new » Start bringing in onto like new » Start bringing in onto like new hardware. hardware. hardware. » So, it's actually it's all housed there. » So, it's actually it's all housed there. » So, it's actually it's all housed there. That's what the data center does. That's what the data center does. That's what the data center does. » Oh, sorry. So, the you essentially just » Oh, sorry. So, the you essentially just » Oh, sorry. So, the you essentially just transition servers. The hardware stayed transition servers. The hardware stayed transition servers. The hardware stayed the same. the same. the same. » Yeah. So, well, um, so what happens » Yeah. So, well, um, so what happens » Yeah. So, well, um, so what happens is they have an identical server rack in is they have an identical server rack in is they have an identical server rack in Iowa all set up, right? And now we just Iowa all set up, right? And now we just Iowa all set up, right? And now we just have to make our computers talk to that. have to make our computers talk to that. have to make our computers talk to that. » Uh, the fun thing that I really » Uh, the fun thing that I really » Uh, the fun thing that I really never thought about, um, when you have never thought about, um, when you have never thought about, um, when you have something like that, it touches all the something like that, it touches all the something like that, it touches all the computers that are on your network also. computers that are on your network also. computers that are on your network also. » So, not only can you not access your » So, not only can you not access your » So, not only can you not access your servers, you can't even use the hardware servers, you can't even use the hardware servers, you can't even use the hardware that's sitting on everybody's desk, that's sitting on everybody's desk, that's sitting on everybody's desk, » you know. So, it was um I bought out » you know. So, it was um I bought out » you know. So, it was um I bought out bought by um Best Buy um you know, some bought by um Best Buy um you know, some bought by um Best Buy um you know, some of their laptops, you know, I'm like I'm of their laptops, you know, I'm like I'm of their laptops, you know, I'm like I'm like I'm like what's the best deal? How like I'm like what's the best deal? How like I'm like what's the best deal? How does this work? You know, um we I think does this work? You know, um we I think does this work? You know, um we I think ended up having to buy like 40omeish ended up having to buy like 40omeish ended up having to buy like 40omeish computers to truly I mean I'm like computers to truly I mean I'm like computers to truly I mean I'm like » obviously not everybody got a computer, » obviously not everybody got a computer, » obviously not everybody got a computer, right? I mean, but we had at least one right? I mean, but we had at least one right? I mean, but we had at least one in every department so that somebody in every department so that somebody in every department so that somebody could access it, get patients taken care could access it, get patients taken care could access it, get patients taken care of, do their thing of, do their thing of, do their thing » and move forward while our own internal » and move forward while our own internal » and move forward while our own internal IT team. So all that's functioning and IT team. So all that's functioning and IT team. So all that's functioning and then they truly had to I mean after then they truly had to I mean after then they truly had to I mean after the audit's done, right? So you even have audit's done, right? So you even have audit's done, right? So you even have these forensics teams that come through these forensics teams that come through these forensics teams that come through and they're like finding all the and they're like finding all the and they're like finding all the ransomware and what does it mean and ransomware and what does it mean and ransomware and what does it mean and what does it look like and what at all what does it look like and what at all what does it look like and what at all did it touch, you know? did it touch, you know? did it touch, you know? » Yeah. » Yeah. » Yeah. » And then they have to literally wipe » And then they have to literally wipe » And then they have to literally wipe everything and rebuild our everything and rebuild our everything and rebuild our infrastructure again. infrastructure again. infrastructure again. » I mean it's just it » I mean it's just it » I mean it's just it » seriously don't live through it if you » seriously don't live through it if you » seriously don't live through it if you don't have to. Right. Like I mean sounds don't have to. Right. Like I mean sounds don't have to. Right. Like I mean sounds awesome. awesome. awesome. » So I think from uh if I could give » So I think from uh if I could give » So I think from uh if I could give anybody advice actually I told just a anybody advice actually I told just a anybody advice actually I told just a CEO the other day. She was like, "Oh, I CEO the other day. She was like, "Oh, I CEO the other day. She was like, "Oh, I mean, we're so small, they're not going mean, we're so small, they're not going mean, we're so small, they're not going to care." And I'm like, "Oh, listen. to care." And I'm like, "Oh, listen. to care." And I'm like, "Oh, listen. » Listen, we're small, right? Like, we » Listen, we're small, right? Like, we » Listen, we're small, right? Like, we we're we should have not been on we're we should have not been on we're we should have not been on anybody's radar, right? We're um it can anybody's radar, right? We're um it can anybody's radar, right? We're um it can happen. It can really happen." happen. It can really happen." happen. It can really happen." » And did the ransom actually come » And did the ransom actually come » And did the ransom actually come through? Like, was there any like email through? Like, was there any like email through? Like, was there any like email or something that had like a number? or something that had like a number? or something that had like a number? » So, there it it there really was, but » So, there it it there really was, but » So, there it it there really was, but never like a dollar amount was never like a dollar amount was never like a dollar amount was never even disclosed. Like, so it never even disclosed. Like, so it never even disclosed. Like, so it never even got deployed the whole way, which Okay. got deployed the whole way, which Okay. got deployed the whole way, which Okay. » Thankfully, right? Like I mean we got » Thankfully, right? Like I mean we got » Thankfully, right? Like I mean we got some things turned off but unfortunately some things turned off but unfortunately some things turned off but unfortunately they did lock everything down they did lock everything down they did lock everything down » they still got the full ramification of » they still got the full ramification of » they still got the full ramification of it but it but it but » that's crazy. » that's crazy. » that's crazy. » Yeah. Yeah. » Yeah. Yeah. » Yeah. Yeah. » Yeah. Thanks for sharing that. That's a » Yeah. Thanks for sharing that. That's a » Yeah. Thanks for sharing that. That's a good thing to think about and good thing to think about and good thing to think about and something I think about all the time something I think about all the time something I think about all the time whenever I find out another password is whenever I find out another password is whenever I find out another password is put in not inside our password put in not inside our password put in not inside our password protection system. protection system. protection system. » Yes. Like oh that's probably » Yes. Like oh that's probably » Yes. Like oh that's probably » and access to other things. » and access to other things. » and access to other things. » Um let's talk about the 1% sales tax. um » Um let's talk about the 1% sales tax. um » Um let's talk about the 1% sales tax. um if you're good with jumping into that. if you're good with jumping into that. if you're good with jumping into that. Um Um Um » sure, » sure, » sure, » you know, from my research the you guys » you know, from my research the you guys » you know, from my research the you guys and I don't know if this is about right, and I don't know if this is about right, and I don't know if this is about right, but for about 40 million a year is about but for about 40 million a year is about but for about 40 million a year is about what the hospital overall billables can what the hospital overall billables can what the hospital overall billables can hit. Um or has hit. I don't know. Um hit. Um or has hit. I don't know. Um hit. Um or has hit. I don't know. Um that's, you know, at the best I could that's, you know, at the best I could that's, you know, at the best I could find. Yeah. find. Yeah. find. Yeah. » Um and then talking about a 1% sales tax » Um and then talking about a 1% sales tax » Um and then talking about a 1% sales tax from the city. from the city. from the city. » Mhm. » Mhm. » Mhm. » Uh that would go on a ballot in August. » Uh that would go on a ballot in August. » Uh that would go on a ballot in August. » Yeah. Yeah. The August ballot. » Yeah. Yeah. The August ballot. » Yeah. Yeah. The August ballot. » Um so yeah, take us through that » Um so yeah, take us through that » Um so yeah, take us through that processing. how you guys came to processing. how you guys came to processing. how you guys came to that conclusion, what that communication that conclusion, what that communication that conclusion, what that communication looked like with the city. looked like with the city. looked like with the city. » Sure. Yeah. So, we um Yeah. So, the » Sure. Yeah. So, we um Yeah. So, the » Sure. Yeah. So, we um Yeah. So, the biggest piece of that puzzle is, you biggest piece of that puzzle is, you biggest piece of that puzzle is, you know, we we've done a lot of work from know, we we've done a lot of work from know, we we've done a lot of work from 23. I mean, even before 23, right? Um 23. I mean, even before 23, right? Um 23. I mean, even before 23, right? Um » we did a lot of work to try to get our » we did a lot of work to try to get our » we did a lot of work to try to get our ship rided, you know, um on the right ship rided, you know, um on the right ship rided, you know, um on the right path. And so, um as we worked through path. And so, um as we worked through path. And so, um as we worked through that, it's still at the end of the day, that, it's still at the end of the day, that, it's still at the end of the day, we still came in at a negative operating we still came in at a negative operating we still came in at a negative operating margin. Um, and you can, you know, you margin. Um, and you can, you know, you margin. Um, and you can, you know, you can do that for a while. You can you can do that for a while. You can you can do that for a while. You can you can have a negative operating, but your cash have a negative operating, but your cash have a negative operating, but your cash is okay. Um, the cyber event, I would is okay. Um, the cyber event, I would is okay. Um, the cyber event, I would say, is probably the thing that just say, is probably the thing that just say, is probably the thing that just really put it over the edge because we really put it over the edge because we really put it over the edge because we depleted our cash. depleted our cash. depleted our cash. » Yeah. » Yeah. » Yeah. » I mean, truly any we didn't have a lot » I mean, truly any we didn't have a lot » I mean, truly any we didn't have a lot of reserve, don't get me wrong, but of reserve, don't get me wrong, but of reserve, don't get me wrong, but what we did have, you know, so then what we did have, you know, so then what we did have, you know, so then we're really pushing our AP vendors out we're really pushing our AP vendors out we're really pushing our AP vendors out as far as humanly possible, and we're as far as humanly possible, and we're as far as humanly possible, and we're we're making all those things happen. we're making all those things happen. we're making all those things happen. And so and then plus you're not billing And so and then plus you're not billing And so and then plus you're not billing for services or you can't even provide for services or you can't even provide for services or you can't even provide services, right? So income you're used services, right? So income you're used services, right? So income you're used to having you don't even have. Um so to having you don't even have. Um so to having you don't even have. Um so from that perspective it's just like a from that perspective it's just like a from that perspective it's just like a double whammy. double whammy. double whammy. » Yeah. » Yeah. » Yeah. » Um but on a bigger scale it's it's » Um but on a bigger scale it's it's » Um but on a bigger scale it's it's nothing. You know, our service lines are nothing. You know, our service lines are nothing. You know, our service lines are everything's back up. Um our cancer everything's back up. Um our cancer everything's back up. Um our cancer center was the last thing the last piece center was the last thing the last piece center was the last thing the last piece of the puzzle to come back. Um and we're of the puzzle to come back. Um and we're of the puzzle to come back. Um and we're not even at full capacity yet. not even at full capacity yet. not even at full capacity yet. » Right. And so that was last July. I » Right. And so that was last July. I » Right. And so that was last July. I mean, that's that's a long time. mean, that's that's a long time. mean, that's that's a long time. » Um, but that's really kind of what led » Um, but that's really kind of what led » Um, but that's really kind of what led to the sales tax right now, right? Um, to the sales tax right now, right? Um, to the sales tax right now, right? Um, » I won't lie, it was actually a » I won't lie, it was actually a » I won't lie, it was actually a consideration when I was interim. I consideration when I was interim. I consideration when I was interim. I mean, it was like, should we, mean, it was like, should we, mean, it was like, should we, right? Cuz I mean, right? Cuz I mean, right? Cuz I mean, » when you become very aware of the » when you become very aware of the » when you become very aware of the numbers, you kind of go, whoa, right. numbers, you kind of go, whoa, right. numbers, you kind of go, whoa, right. Um, Um, Um, » but it really wasn't the right time » but it really wasn't the right time » but it really wasn't the right time for a couple of things. One, I still for a couple of things. One, I still for a couple of things. One, I still thought there was things we could do. thought there was things we could do. thought there was things we could do. » Yeah. to to get us on the right path. » Yeah. to to get us on the right path. » Yeah. to to get us on the right path. Um, but the other side of that is we had Um, but the other side of that is we had Um, but the other side of that is we had those quality issues and we had some those quality issues and we had some those quality issues and we had some image things that we had to get taken image things that we had to get taken image things that we had to get taken care of. You can't go ask for something care of. You can't go ask for something care of. You can't go ask for something if you're not running your ship if you're not running your ship if you're not running your ship efficiently anyways, right? So, um, you efficiently anyways, right? So, um, you efficiently anyways, right? So, um, you know, from that perspective, we we know, from that perspective, we we know, from that perspective, we we really did I mean, so in from 23 to 24, really did I mean, so in from 23 to 24, really did I mean, so in from 23 to 24, we made a $3 million shift. we made a $3 million shift. we made a $3 million shift. » Wow. » Wow. » Wow. » Right. So, I mean, » Right. So, I mean, » Right. So, I mean, » it's not a lack of effort. Um, we're » it's not a lack of effort. Um, we're » it's not a lack of effort. Um, we're we're riding the ship and in from 24 to we're riding the ship and in from 24 to we're riding the ship and in from 24 to 25, we should have we've actually should 25, we should have we've actually should 25, we should have we've actually should have seen almost the same. We still have seen almost the same. We still have seen almost the same. We still would have came in would have came in would have came in » projected if you take everything before » projected if you take everything before » projected if you take everything before the event the event the event » um of 25, we should have seen that same. » um of 25, we should have seen that same. » um of 25, we should have seen that same. I mean, not to that magnitude I mean, not to that magnitude I mean, not to that magnitude because right, you can only reduce because right, you can only reduce because right, you can only reduce expenses so so much, right? expenses so so much, right? expenses so so much, right? » But, um, » But, um, » But, um, » we were really running very efficient » we were really running very efficient » we were really running very efficient and successful with what we were and successful with what we were and successful with what we were doing. And then that just kind of doing. And then that just kind of doing. And then that just kind of » blew everything out of the water, » blew everything out of the water, » blew everything out of the water, » you know. And so um but » you know. And so um but » you know. And so um but » well and it's hard to find a baseline » well and it's hard to find a baseline » well and it's hard to find a baseline anymore and it's hard to probably even anymore and it's hard to probably even anymore and it's hard to probably even project anything until that's all project anything until that's all project anything until that's all squared away and recovered. squared away and recovered. squared away and recovered. » Yeah. Yeah. Yeah. And so um so kind of » Yeah. Yeah. Yeah. And so um so kind of » Yeah. Yeah. Yeah. And so um so kind of worked through you know that perspective worked through you know that perspective worked through you know that perspective and it's it's really we also then of and it's it's really we also then of and it's it's really we also then of course got the announcement from um the course got the announcement from um the course got the announcement from um the federal government that hey we're going federal government that hey we're going federal government that hey we're going to initiate this rural health to initiate this rural health to initiate this rural health transformation program. Right. So they transformation program. Right. So they transformation program. Right. So they said each state's going to be in they said each state's going to be in they said each state's going to be in charge of their own dollars. You find a charge of their own dollars. You find a charge of their own dollars. You find a way to reduce your health care cost way to reduce your health care cost way to reduce your health care cost because in 2028 we're going to start because in 2028 we're going to start because in 2028 we're going to start paying you less. paying you less. paying you less. » Right? So Medicare and Medicaid are » Right? So Medicare and Medicaid are » Right? So Medicare and Medicaid are going to pay even less than going to pay even less than going to pay even less than » they do today and they already don't » they do today and they already don't » they do today and they already don't pay. pay. pay. » That was my one of my questions. How » That was my one of my questions. How » That was my one of my questions. How much does the federal government affect much does the federal government affect much does the federal government affect Susan B. Allen? Susan B. Allen? Susan B. Allen? » A lot. A lot. » A lot. A lot. » A lot. A lot. » A lot. Yeah. Um, and so, so truly for us » A lot. Yeah. Um, and so, so truly for us » A lot. Yeah. Um, and so, so truly for us to be able to make decisions that are to be able to make decisions that are to be able to make decisions that are sound, that are strong to keep this sound, that are strong to keep this sound, that are strong to keep this hospital here for years and years to hospital here for years and years to hospital here for years and years to come, we need a little help to get us come, we need a little help to get us come, we need a little help to get us through that window, right? Um, you through that window, right? Um, you through that window, right? Um, you know, at the end of the day, if it's a know, at the end of the day, if it's a know, at the end of the day, if it's a no vote in August, um, point blank, no vote in August, um, point blank, no vote in August, um, point blank, someone asked me, "Does the hospital someone asked me, "Does the hospital someone asked me, "Does the hospital close in September then?" Right? And I close in September then?" Right? And I close in September then?" Right? And I said, said, said, » "No, the hospital doesn't close in » "No, the hospital doesn't close in » "No, the hospital doesn't close in September." But what it does is it makes September." But what it does is it makes September." But what it does is it makes us make decisions that are to fix the us make decisions that are to fix the us make decisions that are to fix the now instead of now instead of now instead of » how can we just make it better, right? » how can we just make it better, right? » how can we just make it better, right? How do we get through it? Maybe there's How do we get through it? Maybe there's How do we get through it? Maybe there's a well there's there's different a well there's there's different a well there's there's different classifications of hospitals, right? classifications of hospitals, right? classifications of hospitals, right? There's um hospitals that get reimbured There's um hospitals that get reimbured There's um hospitals that get reimbured like we do PPS. There are hospitals that like we do PPS. There are hospitals that like we do PPS. There are hospitals that are called critical access hospitals. are called critical access hospitals. are called critical access hospitals. they get reimbursed on like a actual they get reimbursed on like a actual they get reimbursed on like a actual cost base, cost base, cost base, » but they you can't have more than 25 » but they you can't have more than 25 » but they you can't have more than 25 beds. beds. beds. » But we don't we don't already we already » But we don't we don't already we already » But we don't we don't already we already don't staff for 25 beds. don't staff for 25 beds. don't staff for 25 beds. » Oh, interesting. » Oh, interesting. » Oh, interesting. » Yeah. So, for us, like we actually fit » Yeah. So, for us, like we actually fit » Yeah. So, for us, like we actually fit every component of that criteria except every component of that criteria except every component of that criteria except » there are two hospitals that are too » there are two hospitals that are too » there are two hospitals that are too close to us. They have to be the 35 close to us. They have to be the 35 close to us. They have to be the 35 mile. mile. mile. » 35 miles. » 35 miles. » 35 miles. » That's all there was. 35 miles, 25 beds. » That's all there was. 35 miles, 25 beds. » That's all there was. 35 miles, 25 beds. » Yes. So unfortunately um KMC and Eureka » Yes. So unfortunately um KMC and Eureka » Yes. So unfortunately um KMC and Eureka are just too close to us, right? But we are just too close to us, right? But we are just too close to us, right? But we serve completely different populations, serve completely different populations, serve completely different populations, right? And so um right? And so um right? And so um » so there's some of that » so there's some of that » so there's some of that » truly could still work » truly could still work » truly could still work » if some legislation would change. » if some legislation would change. » if some legislation would change. » Yeah. » Yeah. » Yeah. » Right. But that also doesn't happen » Right. But that also doesn't happen » Right. But that also doesn't happen overnight. overnight. overnight. » Sure. » Sure. » Sure. » Um I will tell you I have learned I have » Um I will tell you I have learned I have » Um I will tell you I have learned I have had to be in the political world more had to be in the political world more had to be in the political world more than I have ever I don't even like than I have ever I don't even like than I have ever I don't even like politics. Like I'm not like I I I really politics. Like I'm not like I I I really politics. Like I'm not like I I I really just kind of just try to keep to my own, just kind of just try to keep to my own, just kind of just try to keep to my own, right? Like I have my thoughts, I have right? Like I have my thoughts, I have right? Like I have my thoughts, I have my opinions, and I just keep them to my opinions, and I just keep them to my opinions, and I just keep them to myself. But myself. But myself. But » the reality is is these lawmakers make » the reality is is these lawmakers make » the reality is is these lawmakers make decisions that affect hospitals and they don't that affect hospitals and they don't that affect hospitals and they don't necessarily know what that full impact necessarily know what that full impact necessarily know what that full impact looks like. looks like. looks like. » Well, and when you drop the payout for » Well, and when you drop the payout for » Well, and when you drop the payout for Medicaid and Medicare, knowing the Medicaid and Medicare, knowing the Medicaid and Medicare, knowing the inflation that you caused, inflation that you caused, inflation that you caused, » right? » right? » right? » It's interesting. I mean, it kind of » It's interesting. I mean, it kind of » It's interesting. I mean, it kind of seems like life's more expensive and I seems like life's more expensive and I seems like life's more expensive and I don't understand how the payout works. don't understand how the payout works. don't understand how the payout works. Is it already too much? Is it, you know, Is it already too much? Is it, you know, Is it already too much? Is it, you know, I don't know that side of it, but I don't know that side of it, but I don't know that side of it, but » Sure. » Sure. » Sure. » It seems like all healthcare on the » It seems like all healthcare on the » It seems like all healthcare on the fulfillment side or the services side is fulfillment side or the services side is fulfillment side or the services side is struggling. struggling. struggling. » Yeah. Yeah. » Yeah. Yeah. » Yeah. Yeah. » So, I would assume it's not paying too » So, I would assume it's not paying too » So, I would assume it's not paying too much. much. much. » Yeah, it's not. Well, and I think it's I » Yeah, it's not. Well, and I think it's I » Yeah, it's not. Well, and I think it's I think it's interesting there's um I'm think it's interesting there's um I'm think it's interesting there's um I'm going to going to go on a tangent here going to going to go on a tangent here going to going to go on a tangent here if that's okay. A little side note long if that's okay. A little side note long if that's okay. A little side note long format. format. format. » Yeah. Um, so healthcare in general from » Yeah. Um, so healthcare in general from » Yeah. Um, so healthcare in general from a how they get paid, how we get paid to a how they get paid, how we get paid to a how they get paid, how we get paid to do business is so different than the do business is so different than the do business is so different than the average service industry, right? So a average service industry, right? So a average service industry, right? So a typical business owner, right? If it if typical business owner, right? If it if typical business owner, right? If it if it cost you $5 in labor, it cost you $5 in labor, it cost you $5 in labor, » $5 in supply, so it cost you $10, you » $5 in supply, so it cost you $10, you » $5 in supply, so it cost you $10, you want to make $5, you charge 15 and the want to make $5, you charge 15 and the want to make $5, you charge 15 and the customer pays you 15. customer pays you 15. customer pays you 15. » Right. » Right. » Right. » Right. » Right. » Right. In our business, In our business, In our business, our charge actually doesn't matter our charge actually doesn't matter our charge actually doesn't matter because Medicare has already all payers because Medicare has already all payers because Medicare has already all payers have already decided we're going to pay have already decided we're going to pay have already decided we're going to pay you X for this diagnosis regardless of you X for this diagnosis regardless of you X for this diagnosis regardless of how long the patient's there, what other how long the patient's there, what other how long the patient's there, what other coorbidities that they have that make coorbidities that they have that make coorbidities that they have that make them more complex, them more complex, them more complex, » regardless of how many visits under that » regardless of how many visits under that » regardless of how many visits under that same » Yep. They don't it doesn't matter. Yeah. » Yep. They don't it doesn't matter. Yeah. » Yep. They don't it doesn't matter. Yeah. And so it it's truly there are things And so it it's truly there are things And so it it's truly there are things that um that um that um » Yeah. So it's essentially like a set » Yeah. So it's essentially like a set » Yeah. So it's essentially like a set it's a flat it's a flat rate. Yep. it's a flat it's a flat rate. Yep. it's a flat it's a flat rate. Yep. » And so if you're and certain service » And so if you're and certain service » And so if you're and certain service companies have that, right? They'll have companies have that, right? They'll have companies have that, right? They'll have a flat rate, but they've they have a a flat rate, but they've they have a a flat rate, but they've they have a little more control and they can up little more control and they can up little more control and they can up their own rates at any point. Right. their own rates at any point. Right. their own rates at any point. Right. » Sure. Yeah. Yeah. And they just charge » Sure. Yeah. Yeah. And they just charge » Sure. Yeah. Yeah. And they just charge more per hour if it takes them longer. more per hour if it takes them longer. more per hour if it takes them longer. Right. Right. Right. » If you clean carpet and you charge per » If you clean carpet and you charge per » If you clean carpet and you charge per room, room, room, » flat rate, then eventually when it's not » flat rate, then eventually when it's not » flat rate, then eventually when it's not working out, you can just raise your working out, you can just raise your working out, you can just raise your rate per room. rate per room. rate per room. » Right. Right. » Right. Right. » Right. Right. » But you can't. and we can't. Um, and the » But you can't. and we can't. Um, and the » But you can't. and we can't. Um, and the other side of that is we other side of that is we other side of that is we » we provide service to anyone, » we provide service to anyone, » we provide service to anyone, » right? If you come in through the ER, » right? If you come in through the ER, » right? If you come in through the ER, we're going to take care of you. we're going to take care of you. we're going to take care of you. » Yeah. » Yeah. » Yeah. » Um, we don't want to, nor would we ever, » Um, we don't want to, nor would we ever, » Um, we don't want to, nor would we ever, but there are actual laws that prevent but there are actual laws that prevent but there are actual laws that prevent us from saying us from saying us from saying » you can't come here. Right. So, if you » you can't come here. Right. So, if you » you can't come here. Right. So, if you if someone hasn't paid their bill for 15 if someone hasn't paid their bill for 15 if someone hasn't paid their bill for 15 years, years, years, » they can't come in. So, talk about why » they can't come in. So, talk about why » they can't come in. So, talk about why it's so hard to get paid. That's a it's so hard to get paid. That's a it's so hard to get paid. That's a perfect Yeah. perfect Yeah. perfect Yeah. » It's one thing I was talking to someone » It's one thing I was talking to someone » It's one thing I was talking to someone about a very large amount of about a very large amount of about a very large amount of receivables and I assume every hospital receivables and I assume every hospital receivables and I assume every hospital has huge receivables. has huge receivables. has huge receivables. » Sure. » Sure. » Sure. » What does that look like? Why is it » What does that look like? Why is it » What does that look like? Why is it hard? hard? hard? » Yeah. Well, » Yeah. Well, » Yeah. Well, » you just had the core of it, I think, » you just had the core of it, I think, » you just had the core of it, I think, right? There like we can't refuse right? There like we can't refuse right? There like we can't refuse service, service, service, » right? Yeah. I mean, part of it is just » right? Yeah. I mean, part of it is just » right? Yeah. I mean, part of it is just um it it doesn't actually matter at the um it it doesn't actually matter at the um it it doesn't actually matter at the end of the day, right now. There are end of the day, right now. There are end of the day, right now. There are » So, I think I think two things. one, » So, I think I think two things. one, » So, I think I think two things. one, whoever decided to use this insurance whoever decided to use this insurance whoever decided to use this insurance payout plan made it way more complex payout plan made it way more complex payout plan made it way more complex than it needed to be, than it needed to be, than it needed to be, » right? So, the average person does not » right? So, the average person does not » right? So, the average person does not actually understand how their insurance actually understand how their insurance actually understand how their insurance even works, right? So, in their in your even works, right? So, in their in your even works, right? So, in their in your mind, I'm I'm not really any different. mind, I'm I'm not really any different. mind, I'm I'm not really any different. I'm like, I've paid my insurance I'm like, I've paid my insurance I'm like, I've paid my insurance premium, I should get a service. premium, I should get a service. premium, I should get a service. » Um, it doesn't happen that way, right? » Um, it doesn't happen that way, right? » Um, it doesn't happen that way, right? So, uh, in healthcare, you have to jump So, uh, in healthcare, you have to jump So, uh, in healthcare, you have to jump through a lot of hoops even to get through a lot of hoops even to get through a lot of hoops even to get approved to to even have that service done, to to even have that service done, to to even have that service done, right? And so, so some people don't um right? And so, so some people don't um right? And so, so some people don't um understand that I'm paying an insurance understand that I'm paying an insurance understand that I'm paying an insurance premium. Why isn't my insurance paying premium. Why isn't my insurance paying premium. Why isn't my insurance paying the whole cost of it? You does that make the whole cost of it? You does that make the whole cost of it? You does that make sense? sense? sense? » Y » Y » Y » um so then the other piece is is you » um so then the other piece is is you » um so then the other piece is is you have a lot of insurance. Well, all of have a lot of insurance. Well, all of have a lot of insurance. Well, all of them have like, you know, you're going them have like, you know, you're going them have like, you know, you're going to pay your deductible and then that's a to pay your deductible and then that's a to pay your deductible and then that's a flat fee usually, right? So maybe 2500, flat fee usually, right? So maybe 2500, flat fee usually, right? So maybe 2500, maybe 3,000. And then on top of that, maybe 3,000. And then on top of that, maybe 3,000. And then on top of that, you also then they're still not going to you also then they're still not going to you also then they're still not going to pay the whole thing. They're going to pay the whole thing. They're going to pay the whole thing. They're going to pay 80% of it. And you still have to pay 80% of it. And you still have to pay 80% of it. And you still have to cover this other 20% cover this other 20% cover this other 20% » up to another sizable » up to another sizable » up to another sizable » 5,000 or whatever that looks like, » 5,000 or whatever that looks like, » 5,000 or whatever that looks like, right? And so for the average person, right? And so for the average person, right? And so for the average person, unless you understand how that really unless you understand how that really unless you understand how that really works, you're like, I am double paying works, you're like, I am double paying works, you're like, I am double paying for this. I'm paying for this. I'm paying for this. I'm paying for » my insurance premium and I'm have the » my insurance premium and I'm have the » my insurance premium and I'm have the hospital's charging me in in addition to hospital's charging me in in addition to hospital's charging me in in addition to it, right? Um, so a lot of people just it, right? Um, so a lot of people just it, right? Um, so a lot of people just don't believe they owe it, don't believe they owe it, don't believe they owe it, » right? And so a lot of times it's a » right? And so a lot of times it's a » right? And so a lot of times it's a » we have to talk through it. Like we we » we have to talk through it. Like we we » we have to talk through it. Like we we really have to walk through their plan really have to walk through their plan really have to walk through their plan with them. And with them. And with them. And » you know, it's a it's a way of how you » you know, it's a it's a way of how you » you know, it's a it's a way of how you have to do life sometimes, right? I have to do life sometimes, right? I have to do life sometimes, right? I mean, obviously all of us would love the mean, obviously all of us would love the mean, obviously all of us would love the premium insurance package that you premium insurance package that you premium insurance package that you » have to pay $1,000 deductible and then » have to pay $1,000 deductible and then » have to pay $1,000 deductible and then you're done and everything's covered. you're done and everything's covered. you're done and everything's covered. The reality is is most of us can't The reality is is most of us can't The reality is is most of us can't afford that, right? I mean, so it's it's afford that, right? I mean, so it's it's afford that, right? I mean, so it's it's a matter of you make decisions based on a matter of you make decisions based on a matter of you make decisions based on what your means are. And so some have what your means are. And so some have what your means are. And so some have had to because insurance premiums just had to because insurance premiums just had to because insurance premiums just kind of get going up and up. Um, some kind of get going up and up. Um, some kind of get going up and up. Um, some have had to pick deductibles that are have had to pick deductibles that are have had to pick deductibles that are really high. really high. really high. » So, you know, um, there's a couple » So, you know, um, there's a couple » So, you know, um, there's a couple around town that are real common, but around town that are real common, but around town that are real common, but their deductible, so just out the gate, their deductible, so just out the gate, their deductible, so just out the gate, they have to pay $7,000 they have to pay $7,000 they have to pay $7,000 before insurance will even pick anything before insurance will even pick anything before insurance will even pick anything up. up. up. » So, if they don't pay that, you don't » So, if they don't pay that, you don't » So, if they don't pay that, you don't get paid. Correct. get paid. Correct. get paid. Correct. » Wow. » Wow. » Wow. » Yeah. Because insurance won't give me » Yeah. Because insurance won't give me » Yeah. Because insurance won't give me anything until they've paid my anything until they've paid my anything until they've paid my deductible met. deductible met. deductible met. » Yes. » Yes. » Yes. » And the deductible goes to the insurance » And the deductible goes to the insurance » And the deductible goes to the insurance company. company. company. » To us. » To us. » To us. » Oh, the deductible does go to » Oh, the deductible does go to » Oh, the deductible does go to you. Yeah. But then you. Yeah. But then you. Yeah. But then » that's right. I guess like the co-pays » that's right. I guess like the co-pays » that's right. I guess like the co-pays that I Yeah. that I Yeah. that I Yeah. » Yeah. Yeah. So, it would come to us, but » Yeah. Yeah. So, it would come to us, but » Yeah. Yeah. So, it would come to us, but then and then we tell the insurance then and then we tell the insurance then and then we tell the insurance company, okay, they've paid the rest company, okay, they've paid the rest company, okay, they've paid the rest though. They've paid their $7,000, though. They've paid their $7,000, though. They've paid their $7,000, » you know. Um, but whatever and however, » you know. Um, but whatever and however, » you know. Um, but whatever and however, and there's a lot, right? It'd be a big and there's a lot, right? It'd be a big and there's a lot, right? It'd be a big deal if someone comes in with a $5,000 deal if someone comes in with a $5,000 deal if someone comes in with a $5,000 deductible and you perform a $20,000 deductible and you perform a $20,000 deductible and you perform a $20,000 operation. Then operation. Then operation. Then » sure » sure » sure » you're sitting on that other 15 until » you're sitting on that other 15 until » you're sitting on that other 15 until they Yeah. And then what's the delay? So they Yeah. And then what's the delay? So they Yeah. And then what's the delay? So they pay their deductible. they pay their deductible. they pay their deductible. » How long till you get the other 15k of » How long till you get the other 15k of » How long till you get the other 15k of that $20,000 scenario? that $20,000 scenario? that $20,000 scenario? » So So first we don't ever get the 20 » So So first we don't ever get the 20 » So So first we don't ever get the 20 because right um what we bill to the because right um what we bill to the because right um what we bill to the insurance again they don't care. insurance again they don't care. insurance again they don't care. » They're going to pay us the flat fee to » They're going to pay us the flat fee to » They're going to pay us the flat fee to start with, right? So they're probably start with, right? So they're probably start with, right? So they're probably only going to pay us 10. only going to pay us 10. only going to pay us 10. » Sure. Anyways, but of the 10 that we » Sure. Anyways, but of the 10 that we » Sure. Anyways, but of the 10 that we could have collected, we got the five could have collected, we got the five could have collected, we got the five from the patient and then we have to from the patient and then we have to from the patient and then we have to then tell the insurance company, okay, then tell the insurance company, okay, then tell the insurance company, okay, we've collected our five from the we've collected our five from the we've collected our five from the patient's responsibility, so now it's patient's responsibility, so now it's patient's responsibility, so now it's your turn to pay. It's about a 45day your turn to pay. It's about a 45day your turn to pay. It's about a 45day payout. payout. payout. » Some payers are sooner. I mean, I I want » Some payers are sooner. I mean, I I want » Some payers are sooner. I mean, I I want to give credit where the where it's due. to give credit where the where it's due. to give credit where the where it's due. Um but for the majority of time, it's Um but for the majority of time, it's Um but for the majority of time, it's about a 45day delay before you see it. about a 45day delay before you see it. about a 45day delay before you see it. » Deductables met. » Deductables met. » Deductables met. » Um is is that a real thing? billing. » Um is is that a real thing? billing. » Um is is that a real thing? billing. Like we see a bill that never actually Like we see a bill that never actually Like we see a bill that never actually transacted. Like we see a bill on some transacted. Like we see a bill on some transacted. Like we see a bill on some statement of like, oh, this birth cost X statement of like, oh, this birth cost X statement of like, oh, this birth cost X and you only pay this. Is that number and you only pay this. Is that number and you only pay this. Is that number real? real? real? » Like like » Like like » Like like » my first daughter was a she came » my first daughter was a she came » my first daughter was a she came premature 6 weeks early. premature 6 weeks early. premature 6 weeks early. » Um they sent in the NICU unit, didn't » Um they sent in the NICU unit, didn't » Um they sent in the NICU unit, didn't need it. She was six pounds. She was need it. She was six pounds. She was need it. She was six pounds. She was great. No problem. They walked right great. No problem. They walked right great. No problem. They walked right out, right? But we were there for cuz out, right? But we were there for cuz out, right? But we were there for cuz she had jaundice. So, we were there for she had jaundice. So, we were there for she had jaundice. So, we were there for probably like 5 days. Bill comes in, probably like 5 days. Bill comes in, probably like 5 days. Bill comes in, it's like $45,000 it's like $45,000 it's like $45,000 or something like that. And we had good or something like that. And we had good or something like that. And we had good insurance at the time. So, we did our insurance at the time. So, we did our insurance at the time. So, we did our $1,500 deductible. $1,500 deductible. $1,500 deductible. » And I was like, man, that's crazy that » And I was like, man, that's crazy that » And I was like, man, that's crazy that they had to insurance paid the rest of they had to insurance paid the rest of they had to insurance paid the rest of that. What did insurance really pay? that. What did insurance really pay? that. What did insurance really pay? » Yeah. They didn't » Yeah. They didn't » Yeah. They didn't » to Wesley. That was at Wesley. Gosh, 12 » to Wesley. That was at Wesley. Gosh, 12 » to Wesley. That was at Wesley. Gosh, 12 years ago. years ago. years ago. » Sure. Yeah. No, no, they didn't pay » Sure. Yeah. No, no, they didn't pay » Sure. Yeah. No, no, they didn't pay 40,000, right? And so, 40,000, right? And so, 40,000, right? And so, » but why is that posted? Well, so we » but why is that posted? Well, so we » but why is that posted? Well, so we every hospital um well every entity so every hospital um well every entity so every hospital um well every entity so clinic, physician clinic, hospital, you clinic, physician clinic, hospital, you clinic, physician clinic, hospital, you have to have these codes, right? And you have to have these codes, right? And you have to have these codes, right? And you create a um charge and it's truly a create a um charge and it's truly a create a um charge and it's truly a comeration of everything. So a lot of comeration of everything. So a lot of comeration of everything. So a lot of things drive the charge. So one just a things drive the charge. So one just a things drive the charge. So one just a bed rate, right? That's just bed rate, right? That's just bed rate, right? That's just » and I'm not even questioning the amount. » and I'm not even questioning the amount. » and I'm not even questioning the amount. » No, no, no. But this is just » No, no, no. But this is just » No, no, no. But this is just fundamentally. I'm just trying to kind fundamentally. I'm just trying to kind fundamentally. I'm just trying to kind of like so fundamentally and then every of like so fundamentally and then every of like so fundamentally and then every piece of supply that they used is also a piece of supply that they used is also a piece of supply that they used is also a charge, right? charge, right? charge, right? » Um » Um » Um » we base those charges. We typically you » we base those charges. We typically you » we base those charges. We typically you create a charge. Most hospitals pick create a charge. Most hospitals pick create a charge. Most hospitals pick kind of a concept that they want to kind of a concept that they want to kind of a concept that they want to choose their charges off of. And here's choose their charges off of. And here's choose their charges off of. And here's what kind of drives it. You always what kind of drives it. You always what kind of drives it. You always insurance companies, this is the best insurance companies, this is the best insurance companies, this is the best part, you'll love this. Um not only do part, you'll love this. Um not only do part, you'll love this. Um not only do they have a flat fee that they're going, they have a flat fee that they're going, they have a flat fee that they're going, this is all they're going to pay you this is all they're going to pay you this is all they're going to pay you regardless of what you charge. Also, if regardless of what you charge. Also, if regardless of what you charge. Also, if you charge less than that flat fee, they you charge less than that flat fee, they you charge less than that flat fee, they will just pay you less. will just pay you less. will just pay you less. » No joke. Interesting. » No joke. Interesting. » No joke. Interesting. » Yes. So, it's the lesser of the two and » Yes. So, it's the lesser of the two and » Yes. So, it's the lesser of the two and that's what you're going to get paid. that's what you're going to get paid. that's what you're going to get paid. Right. Right. Right. » So, you have to create a charge that is » So, you have to create a charge that is » So, you have to create a charge that is » enough over what their flat rate is. » enough over what their flat rate is. » enough over what their flat rate is. » Yeah. » Yeah. » Yeah. » Right. So, we we typically pick like 10 » Right. So, we we typically pick like 10 » Right. So, we we typically pick like 10 to 15% over the majority of our payer. to 15% over the majority of our payer. to 15% over the majority of our payer. Right. So, we pick a commercial payer, Right. So, we pick a commercial payer, Right. So, we pick a commercial payer, our highest commercial payer our highest commercial payer our highest commercial payer » um from a volume perspective, right? We » um from a volume perspective, right? We » um from a volume perspective, right? We kind of use that number and then we add kind of use that number and then we add kind of use that number and then we add 10 to 15% based on the procedure just so 10 to 15% based on the procedure just so 10 to 15% based on the procedure just so that we can ensure they're not going to that we can ensure they're not going to that we can ensure they're not going to pay us less. pay us less. pay us less. » Got interesting. » Got interesting. » Got interesting. » Than what we're charging. » Than what we're charging. » Than what we're charging. » Yeah. » Yeah. » Yeah. » Yeah. Okay. » Yeah. Okay. » Yeah. Okay. » Yeah. » Yeah. » Yeah. » And that just creates it and they still » And that just creates it and they still » And that just creates it and they still always short you 10 or 15 always short you 10 or 15 always short you 10 or 15 » basically every time. Or more. » basically every time. Or more. » basically every time. Or more. » If or more. So it is it's just literally » If or more. So it is it's just literally » If or more. So it is it's just literally a a a » So there's there's actually this is um » So there's there's actually this is um » So there's there's actually this is um this is no joke um several actually this is no joke um several actually this is no joke um several actually outpatient infusions. So there's people outpatient infusions. So there's people outpatient infusions. So there's people that just need medication on a weekly, that just need medication on a weekly, that just need medication on a weekly, monthly, some daily regimen, right? To monthly, some daily regimen, right? To monthly, some daily regimen, right? To sustain life. sustain life. sustain life. » Sure. » Sure. » Sure. » Not not a joke. This is this is truly » Not not a joke. This is this is truly » Not not a joke. This is this is truly what keeps them alive is their monthly what keeps them alive is their monthly what keeps them alive is their monthly infusions that they get, right? um and infusions that they get, right? um and infusions that they get, right? um and to have any quality of life. to have any quality of life. to have any quality of life. The insurance companies, there's two of The insurance companies, there's two of The insurance companies, there's two of them that are that we've had to work them that are that we've had to work them that are that we've had to work through at the hospital. The insurance through at the hospital. The insurance through at the hospital. The insurance company would reimburse us $2,000. company would reimburse us $2,000. company would reimburse us $2,000. The medication to buy it from our The medication to buy it from our The medication to buy it from our dealer, like our wholesale dealer, dealer, like our wholesale dealer, dealer, like our wholesale dealer, » was $4,000. and we can't and we can't charge the and we can't and we can't charge the patient the difference because we've patient the difference because we've patient the difference because we've said to the insurance company, we'll said to the insurance company, we'll said to the insurance company, we'll we'll we'll take your negotiation. We we'll we'll take your negotiation. We we'll we'll take your negotiation. We don't we don't actually get a choice. don't we don't actually get a choice. don't we don't actually get a choice. Here's the problem. We're not big enough Here's the problem. We're not big enough Here's the problem. We're not big enough to actually have a voice in that game. to actually have a voice in that game. to actually have a voice in that game. » Yeah. » Yeah. » Yeah. » Right. » Right. » Right. » Um » Um » Um » I do try to negotiate with insurance » I do try to negotiate with insurance » I do try to negotiate with insurance companies all the time. In fact, we um companies all the time. In fact, we um companies all the time. In fact, we um » we worked really hard. Um Am is an » we worked really hard. Um Am is an » we worked really hard. Um Am is an insurance that is used a lot throughout insurance that is used a lot throughout insurance that is used a lot throughout this community and for a lot of years this community and for a lot of years this community and for a lot of years SBA didn't even take it. M SBA didn't even take it. M SBA didn't even take it. M » um and so I'm like we need to fix that. » um and so I'm like we need to fix that. » um and so I'm like we need to fix that. Like they need to be able to come here. Like they need to be able to come here. Like they need to be able to come here. They live here. Like all the things. And They live here. Like all the things. And They live here. Like all the things. And so um our revenue cycle director and I so um our revenue cycle director and I so um our revenue cycle director and I like really worked through this. They like really worked through this. They like really worked through this. They came back. They wanted to pay us less came back. They wanted to pay us less came back. They wanted to pay us less than Medicaid, which than Medicaid, which than Medicaid, which » is typically um about 50 » is typically um about 50 » is typically um about 50 to 60% less than it actually cost you to to 60% less than it actually cost you to to 60% less than it actually cost you to do the business. do the business. do the business. » It's not those are real numbers for » It's not those are real numbers for » It's not those are real numbers for the majority of things that they're the majority of things that they're the majority of things that they're doing. Um, and so we're like, we we doing. Um, and so we're like, we we doing. Um, and so we're like, we we can't do that. Like, you have to come in can't do that. Like, you have to come in can't do that. Like, you have to come in a little bit higher. And so we finally a little bit higher. And so we finally a little bit higher. And so we finally did get some negotiation done with that. did get some negotiation done with that. did get some negotiation done with that. But typically we're not big enough to But typically we're not big enough to But typically we're not big enough to have a voice like right like Blue Cross have a voice like right like Blue Cross have a voice like right like Blue Cross and Blue Shield does not care and Blue Shield does not care and Blue Shield does not care » what I'm doing here in Elorado, Kansas. » what I'm doing here in Elorado, Kansas. » what I'm doing here in Elorado, Kansas. I mean, I mean, I mean, » it doesn't move the needle for them. » it doesn't move the needle for them. » it doesn't move the needle for them. » They Yeah. You know, they're we don't » They Yeah. You know, they're we don't » They Yeah. You know, they're we don't have enough volume for them to if I have enough volume for them to if I have enough volume for them to if I said, "Well, we're going to stop taking said, "Well, we're going to stop taking said, "Well, we're going to stop taking Blue Cross." They'd say, "Okay." Like, Blue Cross." They'd say, "Okay." Like, Blue Cross." They'd say, "Okay." Like, » it'll go down the street. » it'll go down the street. » it'll go down the street. » It'll go down the street. Right. like so » It'll go down the street. Right. like so » It'll go down the street. Right. like so they, you know, that's that's they, you know, that's that's they, you know, that's that's unfortunately kind of where we live and unfortunately kind of where we live and unfortunately kind of where we live and every » I will tell you small hospitals across » I will tell you small hospitals across » I will tell you small hospitals across the state of Kansas are struggling with the state of Kansas are struggling with the state of Kansas are struggling with that. Um the Kansas Hospital that. Um the Kansas Hospital that. Um the Kansas Hospital Association, I kind of referenced them Association, I kind of referenced them Association, I kind of referenced them before, but they're kind of a before, but they're kind of a before, but they're kind of a » they're a really unique association that » they're a really unique association that » they're a really unique association that help a lot of these smaller hospitals help a lot of these smaller hospitals help a lot of these smaller hospitals and big ones, but really these smaller and big ones, but really these smaller and big ones, but really these smaller hospitals come together and have a voice hospitals come together and have a voice hospitals come together and have a voice together. And so we're trying to create together. And so we're trying to create together. And so we're trying to create things at the state level of things at the state level of things at the state level of » how can we all work together to get a » how can we all work together to get a » how can we all work together to get a better price. better price. better price. » Yeah. » Yeah. » Yeah. » Right. Because if we're all united, we » Right. Because if we're all united, we » Right. Because if we're all united, we have a much bigger voice. have a much bigger voice. have a much bigger voice. » Yeah. Kind of like a co-op, farmers » Yeah. Kind of like a co-op, farmers » Yeah. Kind of like a co-op, farmers co-op, like Yeah. Get together and co-op, like Yeah. Get together and co-op, like Yeah. Get together and » Yep. » Yep. » Yep. » get some buy down deals. Get some » get some buy down deals. Get some » get some buy down deals. Get some medication buy down deals. Right. medication buy down deals. Right. medication buy down deals. Right. » Exactly. Yeah. Yeah. » Exactly. Yeah. Yeah. » Exactly. Yeah. Yeah. » Yeah. That's that's really interesting. » Yeah. That's that's really interesting. » Yeah. That's that's really interesting. » Um let's jump into the board. I' » Um let's jump into the board. I' » Um let's jump into the board. I' I've got two questions on board and the I've got two questions on board and the I've got two questions on board and the 1%. Uh and I got some questions just 1%. Uh and I got some questions just 1%. Uh and I got some questions just from some uh people I know that are from some uh people I know that are from some uh people I know that are really engaged in the community. really engaged in the community. really engaged in the community. » Sure. some ideas to form a couple of » Sure. some ideas to form a couple of » Sure. some ideas to form a couple of these questions. And the one that I these questions. And the one that I these questions. And the one that I think was really interesting was I think was really interesting was I think was really interesting was I think the public anybody that's going to the public anybody that's going to the public anybody that's going to probably vote no, they're going to probably vote no, they're going to probably vote no, they're going to probably be in two camps uh for the probably be in two camps uh for the probably be in two camps uh for the sales tax. I mean, there's going to be sales tax. I mean, there's going to be sales tax. I mean, there's going to be one that they just they don't like you, one that they just they don't like you, one that they just they don't like you, right? Like that's we all have those. right? Like that's we all have those. right? Like that's we all have those. And then you have the other one that's And then you have the other one that's And then you have the other one that's like transparency. Well, I don't like transparency. Well, I don't like transparency. Well, I don't want that money to go there. I want it want that money to go there. I want it want that money to go there. I want it to go somewhere else. or it's just more to go somewhere else. or it's just more to go somewhere else. or it's just more of a money thing like if we're going to of a money thing like if we're going to of a money thing like if we're going to do this, I want it somewhere else and do this, I want it somewhere else and do this, I want it somewhere else and not maybe believing that's where the not maybe believing that's where the not maybe believing that's where the money should go. money should go. money should go. » Sure. » Sure. » Sure. » Um, so I should say three actually » Um, so I should say three actually » Um, so I should say three actually because then the other one was the because then the other one was the because then the other one was the transparency side of it, right? So we transparency side of it, right? So we transparency side of it, right? So we can't uh the community even if this goes can't uh the community even if this goes can't uh the community even if this goes through, right? They can't see board through, right? They can't see board through, right? They can't see board minutes. They can't see like this minutes. They can't see like this minutes. They can't see like this because this is a 501c3. It's not a because this is a 501c3. It's not a because this is a 501c3. It's not a right. And so this public partnership, right. And so this public partnership, right. And so this public partnership, I'm not sure how that'll I'm not sure how that'll I'm not sure how that'll » be construed or whatever. Um, but talk » be construed or whatever. Um, but talk » be construed or whatever. Um, but talk to those fears of how are you to those fears of how are you to those fears of how are you actually going to stop the bleeding even actually going to stop the bleeding even actually going to stop the bleeding even after this amount of money that gets after this amount of money that gets after this amount of money that gets infused. And I I think that's like the infused. And I I think that's like the infused. And I I think that's like the ultimate summary is like, well, will it ultimate summary is like, well, will it ultimate summary is like, well, will it stop? Will it still after 10 years? Will stop? Will it still after 10 years? Will stop? Will it still after 10 years? Will it just go back to where it was? And it just go back to where it was? And it just go back to where it was? And you've already talked about some of the you've already talked about some of the you've already talked about some of the bleeding you've stopped, bleeding you've stopped, bleeding you've stopped, » right? Yeah. » right? Yeah. » right? Yeah. » But just speak on that. » But just speak on that. » But just speak on that. » Yeah. So, so some of that, like I said, » Yeah. So, so some of that, like I said, » Yeah. So, so some of that, like I said, it this kind of gives us the time to it this kind of gives us the time to it this kind of gives us the time to explore those like how what part of the explore those like how what part of the explore those like how what part of the legislation, right? Well, I already know legislation, right? Well, I already know legislation, right? Well, I already know what part, but how do I make it happen what part, but how do I make it happen what part, but how do I make it happen so that we can become a critical access so that we can become a critical access so that we can become a critical access or we can become a rural emergency or we can become a rural emergency or we can become a rural emergency hospital? What does that look like? You hospital? What does that look like? You hospital? What does that look like? You know, we can explore some of those. So, know, we can explore some of those. So, know, we can explore some of those. So, » so it's not a time for us to just sit » so it's not a time for us to just sit » so it's not a time for us to just sit back and go, okay, well, we got an back and go, okay, well, we got an back and go, okay, well, we got an additional 3 million. We're done. additional 3 million. We're done. additional 3 million. We're done. » Like that's that's not it. » Like that's that's not it. » Like that's that's not it. » Yeah. You know, we're we're really » Yeah. You know, we're we're really » Yeah. You know, we're we're really taking that sales tax as this just buys taking that sales tax as this just buys taking that sales tax as this just buys us time us time us time » to really get us set and our get our » to really get us set and our get our » to really get us set and our get our footing correct. footing correct. footing correct. » Correct. » Correct. » Correct. » Right. Um so from So that's one piece. » Right. Um so from So that's one piece. » Right. Um so from So that's one piece. The other piece of the transparency The other piece of the transparency The other piece of the transparency piece um so that you are correct like it piece um so that you are correct like it piece um so that you are correct like it is a it is a private board and so um we is a it is a private board and so um we is a it is a private board and so um we don't have to share our minutes but I don't have to share our minutes but I don't have to share our minutes but I did assure um the city commission when did assure um the city commission when did assure um the city commission when we took the very first work session was we took the very first work session was we took the very first work session was well how's the dollars going to be used well how's the dollars going to be used well how's the dollars going to be used and I'm like here's here's what we're and I'm like here's here's what we're and I'm like here's here's what we're looking at right it's it's capital looking at right it's it's capital looking at right it's it's capital equipment we're we're really behind um equipment we're we're really behind um equipment we're we're really behind um you know it's not it's not that things you know it's not it's not that things you know it's not it's not that things aren't working today it's they're at the aren't working today it's they're at the aren't working today it's they're at the end of life they're really old right And end of life they're really old right And end of life they're really old right And so if they break tomorrow, most pieces so if they break tomorrow, most pieces so if they break tomorrow, most pieces of equipment in healthcare are like a of equipment in healthcare are like a of equipment in healthcare are like a million dollars, right? Like a CT million dollars, right? Like a CT million dollars, right? Like a CT machine is a million dollars. So, um, so machine is a million dollars. So, um, so machine is a million dollars. So, um, so those things add up pretty quickly. And those things add up pretty quickly. And those things add up pretty quickly. And so, and we have, um, we, you know, our so, and we have, um, we, you know, our so, and we have, um, we, you know, our senior team, this is this is our job. senior team, this is this is our job. senior team, this is this is our job. And so we went through and our critical And so we went through and our critical And so we went through and our critical like this is not the fluff. This is not like this is not the fluff. This is not like this is not the fluff. This is not the, oh, it'd be nice if we had that. the, oh, it'd be nice if we had that. the, oh, it'd be nice if we had that. It's the It's the It's the » right » right » right » if it breaks tomorrow, how do we come up » if it breaks tomorrow, how do we come up » if it breaks tomorrow, how do we come up with these dollars? And we have about with these dollars? And we have about with these dollars? And we have about 2.6 6 million 2.6 6 million 2.6 6 million » of critical equipment needs, right? And » of critical equipment needs, right? And » of critical equipment needs, right? And so, so, so, » so it helps that it it buys you that » so it helps that it it buys you that » so it helps that it it buys you that time. It helps you find the funnel of time. It helps you find the funnel of time. It helps you find the funnel of somewhere else, right? There there are somewhere else, right? There there are somewhere else, right? There there are grants. grants. grants. » Trust me, we're really good at writing » Trust me, we're really good at writing » Trust me, we're really good at writing grants now. Um we're we're getting grants now. Um we're we're getting grants now. Um we're we're getting better and better. Um but you know, better and better. Um but you know, better and better. Um but you know, there's some of those avenues and we there's some of those avenues and we there's some of those avenues and we will still explore those. So will still explore those. So will still explore those. So » So I think that comes from that. But the » So I think that comes from that. But the » So I think that comes from that. But the other part of that is at the work other part of that is at the work other part of that is at the work session meeting um session meeting um session meeting um » they just point blank. They were like, » they just point blank. They were like, » they just point blank. They were like, "So, will you come back and share your "So, will you come back and share your "So, will you come back and share your financials?" And I'm like, "Absolutely." financials?" And I'm like, "Absolutely." financials?" And I'm like, "Absolutely." Right. Um, even at one of the work Right. Um, even at one of the work Right. Um, even at one of the work session, the very first work session, the very first work session, the very first work session meeting, actually, meeting, actually, meeting, actually, » I shared our profit and loss for the » I shared our profit and loss for the » I shared our profit and loss for the last since 2017, last since 2017, last since 2017, » right? And that's hard to share. I'm » right? And that's hard to share. I'm » right? And that's hard to share. I'm just going to be honest, like we we went just going to be honest, like we we went just going to be honest, like we we went through some times um like we kind of through some times um like we kind of through some times um like we kind of talked about early on that talked about early on that talked about early on that » administration spent a lot of money. Um, » administration spent a lot of money. Um, » administration spent a lot of money. Um, and that's that is what it is. You know, and that's that is what it is. You know, and that's that is what it is. You know, I I can't fix that. All I can do is move I I can't fix that. All I can do is move I I can't fix that. All I can do is move forward from it forward from it forward from it » and we can show you that in the last » and we can show you that in the last » and we can show you that in the last » two and a half years we've made a lot of » two and a half years we've made a lot of » two and a half years we've made a lot of stride and we'll continue to make that stride and we'll continue to make that stride and we'll continue to make that stride. Um and we'll we'll be open with stride. Um and we'll we'll be open with stride. Um and we'll we'll be open with that. I'm I'm happy to give you a list that. I'm I'm happy to give you a list that. I'm I'm happy to give you a list of you know there's there we don't have of you know there's there we don't have of you know there's there we don't have anything to hide. anything to hide. anything to hide. » Sure. » Sure. » Sure. » Really? » Really? » Really? » So so that I love that answer. So there » So so that I love that answer. So there » So so that I love that answer. So there is a place where you've provided some is a place where you've provided some is a place where you've provided some transparency specifically with the transparency specifically with the transparency specifically with the commission which our community has commission which our community has commission which our community has elected. Yeah, they're there for a elected. Yeah, they're there for a elected. Yeah, they're there for a reason. And I'm appreciate you reason. And I'm appreciate you reason. And I'm appreciate you partnering with them on that. That's partnering with them on that. That's partnering with them on that. That's great. great. great. » I think that really squashes some fears » I think that really squashes some fears » I think that really squashes some fears of people that I've talked to of like is of people that I've talked to of like is of people that I've talked to of like is there going to be any type of there going to be any type of there going to be any type of » Yeah. » Yeah. » Yeah. » uh partnership or collective, right, of » uh partnership or collective, right, of » uh partnership or collective, right, of like this is our money and what like this is our money and what like this is our money and what does that look like? So that's great. Um does that look like? So that's great. Um does that look like? So that's great. Um so talk about the uh the business so talk about the uh the business so talk about the uh the business unit itself is a hospital. Um, it unit itself is a hospital. Um, it unit itself is a hospital. Um, it employs a lot of people, but what is it employs a lot of people, but what is it employs a lot of people, but what is it to our community? Like, it's not just a to our community? Like, it's not just a to our community? Like, it's not just a hospital. What do you think SBA is hospital. What do you think SBA is hospital. What do you think SBA is to our community outside of just to our community outside of just to our community outside of just healthcare? healthcare? healthcare? » Sure. Yeah. Um, so it's the cornerstone. » Sure. Yeah. Um, so it's the cornerstone. » Sure. Yeah. Um, so it's the cornerstone. It's one of the cornerstones of El It's one of the cornerstones of El It's one of the cornerstones of El Dredo, right? Um, I hear a lot of I I Dredo, right? Um, I hear a lot of I I Dredo, right? Um, I hear a lot of I I have the opportunity to get to sit on, have the opportunity to get to sit on, have the opportunity to get to sit on, you know, several different meetings you know, several different meetings you know, several different meetings throughout the community and it's a lot throughout the community and it's a lot throughout the community and it's a lot of like, how are we going to grow? How of like, how are we going to grow? How of like, how are we going to grow? How do we keep jobs here? How do how do we do we keep jobs here? How do how do we do we keep jobs here? How do how do we keep people living here in El Dredo? Um keep people living here in El Dredo? Um keep people living here in El Dredo? Um and without a hospital, and without a hospital, and without a hospital, » that's really hard to keep. » that's really hard to keep. » that's really hard to keep. » Yeah. » Yeah. » Yeah. » Right. Um I actually had a great » Right. Um I actually had a great » Right. Um I actually had a great conversation with um Sarah at Elorado, conversation with um Sarah at Elorado, conversation with um Sarah at Elorado, Inc. and Inc. and Inc. and » I said, you know what? What does it mean » I said, you know what? What does it mean » I said, you know what? What does it mean for you if we don't have a hospital? And for you if we don't have a hospital? And for you if we don't have a hospital? And she was like, listen, I I don't know, she was like, listen, I I don't know, she was like, listen, I I don't know, but every paper that I usually have to but every paper that I usually have to but every paper that I usually have to fill out from a what do we have to offer fill out from a what do we have to offer fill out from a what do we have to offer here, one of the questions is is there here, one of the questions is is there here, one of the questions is is there health care in your community? And so, health care in your community? And so, health care in your community? And so, um, she's like, I I don't know. I can't um, she's like, I I don't know. I can't um, she's like, I I don't know. I can't specifically tell you, but I'd say I'd specifically tell you, but I'd say I'd specifically tell you, but I'd say I'd hate to mark the box no. hate to mark the box no. hate to mark the box no. » Yeah. » Yeah. » Yeah. » You know, and so I think that's that's » You know, and so I think that's that's » You know, and so I think that's that's pretty impactful. We, you know, we pretty impactful. We, you know, we pretty impactful. We, you know, we employ um we have about 293 positions employ um we have about 293 positions employ um we have about 293 positions throughout our organization. throughout our organization. throughout our organization. » Um, which so last year we paid 16.4 » Um, which so last year we paid 16.4 » Um, which so last year we paid 16.4 million in wages, right? So if million in wages, right? So if million in wages, right? So if » and most of those people are they » and most of those people are they » and most of those people are they don't just work here, right? They're don't just work here, right? They're don't just work here, right? They're shopping here. They're going to shopping here. They're going to shopping here. They're going to Dillan's. They're going to Walmart. Dillan's. They're going to Walmart. Dillan's. They're going to Walmart. They're doing all their grocery stuff, They're doing all their grocery stuff, They're doing all their grocery stuff, you know, they're doing all the things you know, they're doing all the things you know, they're doing all the things um right here. And so that's those um right here. And so that's those um right here. And so that's those dollars will go somewhere else. Um and I dollars will go somewhere else. Um and I dollars will go somewhere else. Um and I think, you know, it's it's not about think, you know, it's it's not about think, you know, it's it's not about just the hospital being gone, but truly just the hospital being gone, but truly just the hospital being gone, but truly you will lose you will lose you will lose the care that is provided. So, I mean, the care that is provided. So, I mean, the care that is provided. So, I mean, I'm listen, I'm not here to like talk I'm listen, I'm not here to like talk I'm listen, I'm not here to like talk bad about the big hospitals. They have bad about the big hospitals. They have bad about the big hospitals. They have their own their own their own » things to worry about. Um, but what I » things to worry about. Um, but what I » things to worry about. Um, but what I can tell you is we I hear over and over can tell you is we I hear over and over can tell you is we I hear over and over the patients that go there, in fact, I I the patients that go there, in fact, I I the patients that go there, in fact, I I know some of the providers that work in know some of the providers that work in know some of the providers that work in that ER and they really struggle with that ER and they really struggle with that ER and they really struggle with the fact that the fact that the fact that » Yeah. like you wait in the ER waiting » Yeah. like you wait in the ER waiting » Yeah. like you wait in the ER waiting room for four or five hours, right? And room for four or five hours, right? And room for four or five hours, right? And then even if you need to get admitted, then even if you need to get admitted, then even if you need to get admitted, you literally sit in a hallway waiting you literally sit in a hallway waiting you literally sit in a hallway waiting for a bed to open up. for a bed to open up. for a bed to open up. » Um, if we're not here, that's even more » Um, if we're not here, that's even more » Um, if we're not here, that's even more of that. of that. of that. » Yeah. Add a half hour drive plus. » Yeah. Add a half hour drive plus. » Yeah. Add a half hour drive plus. » Yeah. And it's yeah, » Yeah. And it's yeah, » Yeah. And it's yeah, » you know, it's I understand if if » you know, it's I understand if if » you know, it's I understand if if » if you had a bad experience with us one » if you had a bad experience with us one » if you had a bad experience with us one time, right? I I I understand that's time, right? I I I understand that's time, right? I I I understand that's hard to let go of, but the reality hard to let go of, but the reality hard to let go of, but the reality of it is is if we're not here when you of it is is if we're not here when you of it is is if we're not here when you really need us, really need us, really need us, it can be detrimental to not have it it can be detrimental to not have it it can be detrimental to not have it here, here, here, » you know. Um any » you know. Um any » you know. Um any » Yeah. Well, my grandma needs you guys » Yeah. Well, my grandma needs you guys » Yeah. Well, my grandma needs you guys here. There's been multiple situations here. There's been multiple situations here. There's been multiple situations where that would have not worked to go where that would have not worked to go where that would have not worked to go to Witchah, right? So to Witchah, right? So to Witchah, right? So » yeah, » yeah, » yeah, » that's the part that I at my core the » that's the part that I at my core the » that's the part that I at my core the fear I have right of something like this fear I have right of something like this fear I have right of something like this not going through regardless of it like not going through regardless of it like not going through regardless of it like and I appreciate your answer like we'll and I appreciate your answer like we'll and I appreciate your answer like we'll continue to exist but we probably won't continue to exist but we probably won't continue to exist but we probably won't be able to improve at the rate we could be able to improve at the rate we could be able to improve at the rate we could for the community right like that's like for the community right like that's like for the community right like that's like where could we invest 2 to four million where could we invest 2 to four million where could we invest 2 to four million a year on that 1% and also the cool a year on that 1% and also the cool a year on that 1% and also the cool thing if you guys are let's just I'm thing if you guys are let's just I'm thing if you guys are let's just I'm throwing out a number that I might have throwing out a number that I might have throwing out a number that I might have found uh Melissa's not saying this found uh Melissa's not saying this found uh Melissa's not saying this around 40 million a year you're talking around 40 million a year you're talking around 40 million a year you're talking about a five potentially 5 to 10% about a five potentially 5 to 10% about a five potentially 5 to 10% revenue increase that's got no overhead revenue increase that's got no overhead revenue increase that's got no overhead against it and complication in billing against it and complication in billing against it and complication in billing right that can come in and direct I mean right that can come in and direct I mean right that can come in and direct I mean affect change quickly affect change quickly affect change quickly » and I love that free and clear cash » and I love that free and clear cash » and I love that free and clear cash can solve problems really quick y can solve problems really quick y can solve problems really quick y » and everything you're saying in your » and everything you're saying in your » and everything you're saying in your vision I think is going to be attack vision I think is going to be attack vision I think is going to be attack those improvements show off those improvements show off those improvements show off those improvements and make sure the community improvements and make sure the community improvements and make sure the community feels it right y feels it right y feels it right y » and with that at its core I think that's » and with that at its core I think that's » and with that at its core I think that's exciting um and that's something I can exciting um and that's something I can exciting um and that's something I can get behind on a 1% sales tax. And get behind on a 1% sales tax. And get behind on a 1% sales tax. And there's been other ideas for this 1% there's been other ideas for this 1% there's been other ideas for this 1% sales tax, but I don't think there's sales tax, but I don't think there's sales tax, but I don't think there's been anything as meaningful as this and been anything as meaningful as this and been anything as meaningful as this and what the hospital means for the what the hospital means for the what the hospital means for the community. Not to try and influence community. Not to try and influence community. Not to try and influence people because I have been accused of people because I have been accused of people because I have been accused of that before, but if you can't tell, I'm that before, but if you can't tell, I'm that before, but if you can't tell, I'm going to vote yes. And uh I I hope going to vote yes. And uh I I hope going to vote yes. And uh I I hope others vote yes as well. And I that is others vote yes as well. And I that is others vote yes as well. And I that is the vibe I'm getting, by the way. I the vibe I'm getting, by the way. I the vibe I'm getting, by the way. I think the vibe I'm getting within think the vibe I'm getting within think the vibe I'm getting within the people I'm talking to is the people I'm talking to is the people I'm talking to is the majority are yes. So majority are yes. So majority are yes. So » yeah, » yeah, » yeah, » any final words for you? I'm going to » any final words for you? I'm going to » any final words for you? I'm going to let you go, but let you go, but let you go, but » Oh gosh. Um, yeah. I mean, I just I hope » Oh gosh. Um, yeah. I mean, I just I hope » Oh gosh. Um, yeah. I mean, I just I hope that um people in the community just in that um people in the community just in that um people in the community just in general understand general understand general understand how valuable and what they really have how valuable and what they really have how valuable and what they really have in their back door. I mean, to just be in their back door. I mean, to just be in their back door. I mean, to just be honest. Um, and we have a we have an honest. Um, and we have a we have an honest. Um, and we have a we have an entire team of people entire team of people entire team of people that are so passionate about just making that are so passionate about just making that are so passionate about just making sure that their loved ones that live sure that their loved ones that live sure that their loved ones that live right here have somewhere to be cared right here have somewhere to be cared right here have somewhere to be cared for at the level that they want them for at the level that they want them for at the level that they want them cared for, cared for, cared for, » you know. And so, um, that's what SBA » you know. And so, um, that's what SBA » you know. And so, um, that's what SBA can bring. can bring. can bring. » Yeah. Yeah, that's good. Appreciate you » Yeah. Yeah, that's good. Appreciate you » Yeah. Yeah, that's good. Appreciate you coming on. You're awesome. Glad we met. coming on. You're awesome. Glad we met. coming on. You're awesome. Glad we met. So much. This was a blast. So much. This was a blast. So much. This was a blast. » Our stories of of life are really in » Our stories of of life are really in » Our stories of of life are really in line. line. line. » I'm excited. You and my wife need to get » I'm excited. You and my wife need to get » I'm excited. You and my wife need to get lunch sometime. I think uh she could not lunch sometime. I think uh she could not lunch sometime. I think uh she could not only learn a lot from you, but you also only learn a lot from you, but you also only learn a lot from you, but you also have shared experiences. My gosh. Yes. have shared experiences. My gosh. Yes. have shared experiences. My gosh. Yes. But she's just starting her career, so But she's just starting her career, so But she's just starting her career, so she's she's enjoying it. And also, it's she's she's enjoying it. And also, it's she's she's enjoying it. And also, it's a lot. a lot. a lot. » Yeah. Healthcare's changed a lot. » Yeah. Healthcare's changed a lot. » Yeah. Healthcare's changed a lot. » It is. Yes, for sure. So, thank you so » It is. Yes, for sure. So, thank you so » It is. Yes, for sure. So, thank you so much for having me. This is my first much for having me. This is my first much for having me. This is my first podcast. This is great. podcast. This is great. podcast. This is great. » First, man, you're awesome. You're » First, man, you're awesome. You're » First, man, you're awesome. You're You're natural. Thank you. You're natural. Thank you. You're natural. Thank you. » That was good. Thank you so much for » That was good. Thank you so much for » That was good. Thank you so much for your time. your time. your time. » Yeah. ---