‘This is a draft’ – Kittson Healthcare shares goals for strategic plan

By Anna Jauhola
Kittson Healthcare has a draft of Phase I of its strategic plan and will be working toward refining goals and initiatives. During its regular meeting, the Kittson Healthcare Governing Board met with Adam Strom of Eide Bailly who conducted community and internal meetings in March. Strom gathered that data and constructed the plan he presented. Strom appeared virtually and presented a slideshow.
“Throughout my visit (in Kittson County), no one called into question the quality of care,” Strom said. “I thought that was really fantastic. But for everything else, people shared input.”
Strom identified four pillars by which Kittson Healthcare operates, or key components of the organization’s commitment to the community – Health needs of the community; People; Marketing and Communication; and Viability.
Under each of these pillars are goals Strom suggested Kittson Healthcare strive to achieve to create a better, more cohesive organization.
“I want to remind you, this is a draft. The board owns the strategy and this is for your review, revision and approval,” Strom emphasized. “This is not me prescribing what to do. These are draft initiatives.”
Under each pillar, there can be several initiatives attached to each goal.
For Health Needs of the Community, Strom said the goal is to review facility equipment assessments and update or execute new assessments, depending on critical need. He said through leadership turnover, “there’s been a loss of momentum on different things.”
For People, goals include: maintaining sustainable and consistent trusted leadership; building trust and positive workplace culture, engagement and satisfaction; consistently recruit and retain skilled and engaged providers and staff; and fully embrace Kittson Healthcare’s mission, vision and values.
Strom said staff reported in March that they need to be more positive.
“It was really beautiful. They said, ‘We need to be the best advertisement in the community. If we’ve got a bone to pick with one another, let’s deal with it internally and not spread that around the community, because that just makes us look bad,’” he said.
Building trust within the workplace and within the community will be important.
“It’s a hard needle to move, but it can be done,” Strom said. “You’ve already begun doing it with the strategic plan, with finding a good CEO, a person known in the community and who doesn’t have the word interim attached. So you’re on a good course.”
To consistently recruit and retain staff, as well as increase board members’ skill and knowledge, Strom suggested membership with the National Rural Recruitment and Retention Network as well as consulting the National Rural Health Resource Center in Duluth.
“You are not alone in any way with challenges of recruiting and retaining employees,” he said. “And there is actually a board of trustee group certification process the Minnesota Hospital Association offers. There is also support from the National Rural Health Resource Center.”
One consideration is some of the training and certification comes at an expense, such as $1,250 per person for the Board of Trustee certification.
“It’s a lot of education about the roles and responsibilities and healthcare industry knowledge,” Strom said. “That includes registration for the MHA summer trustee conference at Alexandria. It would strengthen your board.”
Marketing and communication was a big issue for people at internal and public meetings in March. Transparency will be key in educating everyone on how upper management works as the perception has been that Kittson Healthcare’s is top heavy. Showing employees and the public the approach to staffing, including contract labor, as well as the cost by disseminating quarterly or monthly financials.
“Now, I know your board meetings are open, but in the spirit of increased accountability and transparency, you may want to make that more deliberate,” Strom said. “I think your CFO can play a greater role in the financial report-outs.”
Strom also addressed the need for better communication of services provided, including a need to review and revise past marketing plans, or create a new one.
For Viability, he said the board needs to continually revisit several labor costs, a proactive plan for safe, modern and effective facilities, and offering services that are financially sustainable and/or support other critical services; explore reimbursement opportunities for staff credentialing.
The final goal is dual – operate in an optimal rural provider structure and maximize use of assistance or credit programs. Strom said Kittson Healthcare may already operate optimally, considering the services – hospital, clinic, nursing home, assisted living and specialty services.
But, the question of switching to a Rural Emergency Hospital (REH) format may come into question. Kittson Healthcare is a Critical Access Hospital (CAH), but could operate as an REH if deemed necessary.

Strom said the Minnesota Department of Health has preliminarily released they will approve the REH designation. While this designation would allow for a $3 million stipend each year for the facility, there is no guarantee it would increase the facility’s revenue.
This led Strom to his point of Kittson Healthcare maximizing its use of assistance and credit programs. There is a possibility Kittson Healthcare can recoup money through the Employee Retention Credit for three quarters of 2021 and possibly some in 2020. Eide Bailly can do the study in two phases – the first to gather information to confirm qualification at no cost to Kittson Healthcare; the second is to calculate and review, as well as amend and file paperwork, which comes at a hefty cost between $100,000 and $200,000. This can be paid for through the money received from the Employee Retention Credit, Strom added.
Kittson Healthcare Board President Bob Jaszczak asked whether there’s any risk in starting the process of looking into the REH designation, to which Strom said there is no risk in a study. He noted that the Minnesota Hospital Association said there’s the possibility once a facility has switched to REH, it may not be able to go back to Critical Access Hospital designation.
Board member Janelle Craigmile asked whether REH designation would allow for swing beds, as it’s important for people to recover near home. Strom said REH allows for that type of program, but it would likely be called a rehabilitation stay.
He said the board’s homework is to revisit Kittson Healthcare’s mission, vision and value statements. These may need revising to better align with the strategic plan.
The next steps the board and staff will take include building work sessions with different groups, which Strom will facilitate, to handle each goal. They will determine when to next update the public and employees regarding draft changes. The board will also further discuss REH designation and applying for the Employee Retention Credit.
“Refining goals and initiatives with a timeframe and accountable party, that’s what makes this a complete strategic plan,” he said. “It’ll take time, but we’ll get it done and I’ll finalize it into a format that fits in with the goals. I believe you are on the right track.”