SHS systems reports stronger staffing, stable cash position and rural policy push at county workshop

Joe Thine, a representative of SHS systems, told the Montezuma County Board of County Commissioners at a workshop update that the hospital has made substantial progress on physician recruiting and employee retention while maintaining a cash position sufficient to meet bond‑holder covenants.

Thine said the recruiting effort yielded six candidates who expressed interest, with five active prospects, 29 interviews scheduled, 28 completed, 18 offers made and 17 accepted. “Weve been really busy on the physician provider recruiting front,” Thine told the board. He said most specialties the hospital targeted are now under contract and that "all but 1 of the physicians has already started their practice." He previewed welcoming Dr. Brunaud as a third general surgeon in early 2025 and named recent hires including Jocelyn Hirschman, Dr. Bernard, Dr. Vikas, Jamieson Laubbs and podiatrist Dr. Jeter.

Thine said nurse retention has improved: the hospital at one point had about 25 nurse vacancies and, as of the November report he cited, had about four vacancies remaining. He described employee engagement and retention as a priority.

On finances, Thine said the hospital has managed cash and its relationship with the hospital district and bondholders to create headroom for capital work. He described a prior 80‑day cash‑on‑hand covenant that banks reduced to 60 after the hospital moved restricted monies and created an infrastructure fund that could be counted toward the covenant. Thine said the hospital currently has about 74 days cash on hand outside capital and reserve accounts.

Thine described capital spending as deliberately restrained in 2024 (he said the hospital spent less than half of its capital budget from operating funds), noting some capital infrastructure work already completed (a roof) and HVAC work planned for late spring. He said most operational revenue will continue to come from services provided inside the hospital: the hospital expects roughly $80 million in revenue in the planning period, with about 17% coming from Medicaid. "If that got restructured in a meaningful way to decrease the Medicaid dollars flowing into this community, we would not be able to provide all the services we do today," Thine said, urging attention from elected officials.

Thine also described the hospital's participation in an informal Colorado Rural Futures group of rural hospitals that funded policy research through the Farley Center at the University of Colorado. The group has identified three policy priorities: improving financial viability for low‑volume providers, access to capital (including asking the legislature to sponsor a study of capital needs across rural hospitals), and leadership/governance support tailored to independent rural hospitals.

He also reported attention to how Medicare Advantage plans affect patient access and hospital finances, and noted that some insurers are leaving the region: Cigna Choice was reported as exiting and Humana is exiting the five counties of Southwest Colorado in 2025. Thine said the hospital would collect plan‑level data into early next year to guide contracting decisions.

Thine highlighted patient experience results and national recognition. He said the hospital ranked in the 90th percentile on the HCAHPS question asking whether patients would recommend the hospital, and that the hospital earned a five‑star rating from the National Rural Health Association's rural rating system.

Commissioners asked follow‑up questions about staffing levels and survey sample sizes; Thine said sampling for the HCAHPS question involved fewer than 100 respondents in a quarter and that small sample sizes make small percentile changes statistically insignificant.

Thine closed by saying the hospital recently completed a strategic objectives process with its board and will return with updates on capital and service expansion priorities in 2025. "We believe that we've got to have the right people ... to be delivering care on our walls," he said, describing staff recruitment and retention as central to improving safety, quality and service availability.

Ending: Thine invited questions and said he would return with further updates to the commissioners as the hospital implements its 1–3 year objectives.