By Anna Jauhola
Kittson Healthcare is entering Phase II of its strategic planning process on several positive notes.
At the facility’s annual meeting in February, stockholders learned the cost reports had not been filed, which reduced Medicaid and Medicare income until that process was completed. The facility had also not filed its 990 tax return.
“We have since caught up and filed our cost report for fiscal year 2022, so there are no restrictions on our CMS (Centers for Medicaid and Medicare Services) billing compliance issues,” said Chief Financial Officer Curtis Bach in an interview at the end of June. “That actually involves completing and reconciling the monthly financial process. … We are reconciled up through the fiscal year.”
Bach added the board of directors had not received a monthly financial statement since July or August 2022. He began his position with the facility in March 2023 and said they are now in the process of running monthly financials, allowing them to use that data to move forward with the strategic plan.
“On a monthly basis, we are really running all financial processes in a normal fashion, which basically means accounts payable and everything is being inputted, just having the infrastructure needed to answer any questions, and being able to monitor the expenses in an effective way,” Bach said. “We are really getting very close to almost getting caught up.”
Bach said Kittson Healthcare “is really in a very good position, considering what it’s been through the last X number of years.”
Chief Executive Officer Andrea Swenson agreed and said the facility is moving in a positive direction. Bach added they have addressed several issues and the public can be assured “there are no real surprises” financially because leadership has a good handle on the finances.
“It’s now just organizing and starting the planning process and moving forward,” Bach said.
In February, the Kittson Healthcare Board of Directors announced it hired Eide Bailly of Fargo to help the facility create a strategic plan. In March, Adam Strom visited Kittson County and conducted six public meetings and several internal meetings to begin his work on laying out a basic strategic plan for Kittson Healthcare. He presented this plan to the board in May, which completed Phase I.
In recent weeks, Swenson said they officially partnered with Eide Bailly to begin Phase II of the strategic plan. Swenson, Bach and former interim CEO Everett Butler, acting as a consultant, met with Strom to discuss the next steps.
“We spent time talking about the pillars because ultimately he wants the board to make the decision on Mission, Vision, Values and Purpose, and help identify those focus areas,” Swenson said. “We decided we want to add another pillar more related to governance and stockholder communication, and financial transparency.”
Swenson noted this will take time, not only on a leadership level but on an internal level creating teams to brainstorm details for each pillar. Swenson and Bach will be on each team, but involve different leaders from certain departments. For example, nursing managers will work on what services are offered. There will also be teams that work on human resources, public relations and so on.
“We’re trying to gauge right now how best to make sure we’re still involving input from staff and the community, but you can’t have a group of 100 people coming up with action steps,” Swenson said. “We’re looking for the right representation from each of those areas.”
The strategic plan currently has four pillars – Health Needs of the Community; Marketing and Communications; People; and Viability. Each of these has goals attached such as maintaining trusted leadership and regular employees, maintaining current services, ensuring industry standard labor costs, operating at optimal rural provider structure, demonstrating financial transparency and maintaining a skilled governing board.
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“I think this is going to be the actual action path,” Swenson said. “It’s been a lot of planning, a lot of thinking and a lot of gathering. Now it’ll be where people actually get it on the table and say, ‘OK, what are the steps of what we’re going to do.”
Strom has not yet provided a basic timeline for this phase. However, Swenson believes it could be a several-year process including re-evaluation to ensure plans and goals are being met.
As the facility enters Phase II of the strategic plan, Swenson said they haven’t implemented many changes. However, she feels the few changes taking place are improving the overall mood within the building.
“I feel that the general sense of the facility is that people want to be here. People want to provide healthcare services to the community and people want to see it improve,” she said. “I think as long as we have the commitment of people willing to work with us to make it better, I feel good about it.”
She said the executive team is working to remain transparent and open to ideas from staff and the community. One minor but important change that has made a positive impact recently is an email every two weeks to each department relaying new staff, celebrations, new activities, thanking someone.
“We’ve had good feedback from something as easy as that,” Swenson said.
Staffing remains a concern as several traveling CNAs and nurses are employed in the nursing home and hospital. She said this is not an abnormal challenge on a national scale, and Kittson Healthcare is actively trying to recruit permanent staff.
Kittson Healthcare is advertising for several other positions, including a human resources director. Swenson said this department needs two people, not just one person who is already handling other responsibilities. Human resources handles recruitment, retention, compensation, benefits, morale and more.
“To try to ask somebody, ‘Please, maintain all your daily duties you’re doing now, but now we’re going to assign all these new projects for you’ – that’s a lot,” Swenson said. “We want to have a strong human resources department for our staff, but also to support the facility and make a more manageable situation.”
As for physical improvements, the current project is to remodel the former upstairs nursing home space for physical and occupational therapy services. They are working on a budget and getting a quote from Krause Anderson for their portion of the work. Swenson said Kittson Healthcare employees can do much of the work, like painting, moving equipment and waxing the floors. Krause Anderson will have to handle portions such as building a privacy wall for the therapy area and installing sinks in some of the outpatient rooms. They will be doing a site visit soon to create an official quote.
“We’re just excited for accessibility for our patients,” Swenson said. “We don’t have to send people down to the basement to take a right and then a left. I think it’ll be a really good utilization of space.”
The nursing home continues to see a steady census between 39 and 41 residents. The facility is still licensed for 60 residents, but 10 of those spots are on hold, Swenson said. As staffing remains a challenge, the facility staffs for the number of residents.
“I think we just continue to really need support from the community in every aspect,” she said. “We need people to come work for us, or point people to us. We have so many opportunities here for employment. And we need patients to support all the services we’re trying to offer. We’re trying to be open to what the community wants and needs as well. We want to be a partner to stay here and need people to work with us.”
By Anna Jauhola