About Phelps Health
Phelps Health serves over 200,000 residents in south-central Missouri. Phelps Health is county-owned, non-tax supported and is overseen by a five-member elected board. Phelps Health employs more than 1,900 people with 100-plus providers. Phelps Health, which includes a hospital licensed for 240 patient beds, serves a six-county area, with its main campus and several clinics in Rolla. Phelps Health also has clinics in Salem, St. James, Vienna and Waynesville. For more information, visit phelpshealth.org.
About Salem Memorial Hospital
Salem Memorial District Hospital is a 25-bed Critical Access Hospital located in Salem. SMH, a tax supported entity, offers the following services: a rural health clinic, an emergency room with a Level 4 Stroke and STEMI Center, an 18-bed long-term care facility, an ambulance service and an Air-Evac Life team on site. SMH employs more than 200 people and serves Dent County and portions of Shannon, Crawford and Iron counties. For more information, visit smdh.net.
Phelps Health and Salem Memorial Hospital announced Aug. 28 the two hospital entities were entering into a process to work toward affiliation.
That’s great news. Why?
Earlier this year at a Phelps Health board of directors meeting it was announced that the hospital system had $169.3 million in the bank and cash on hand for 207.2 days. Its debt was half of the benchmark rate, meaning the hospital was financially secure. About the same time Phelps Health was glowing in that financial news, it became apparent that Salem Memorial Hospital was not only nearly broke, but there was concern that bankruptcy was one of the options to get out of the financial mess.
So, the question a lot of people started to ask was, could affiliation with Phelps Health or another health care entity help Salem and Dent County keep a hospital in the community?
The answer is yes, and over the next weeks and months – and maybe even years – Phelps Health and Salem Memorial Hospital are going to work together to see that the affiliation is “a significant step forward on our shared mission to provide quality healthcare for years to come.”
Those are the words of Brooke Bollman, chief executive officer of SMH, who has been on the job since July and attended her first board meeting July 30.
It didn’t take Bollman long to see the best path forward for health care in Dent County. The SMH board had been working with Phelps Health on this for some time, and unanimously voted to move forward with a nonbinding, confidential letter of intent. Phelps Health’s leadership and board also look at the partnership favorably.
Where do we go from here?
First, end the negativity. Yes, the recent history of SMH has been wrought with controversy and poor financial performance, to the point of a very real possibility of the hospital closing. But luckily the SMH board persevered, and leadership saw this through and selected the best path forward. To be fair, odds are there is nothing SMH could have done to survive going it alone, so the board and leadership should be applauded for making the tough decision of working toward affiliation. The process will not be without its heartbreak and angst.
Secondly, focus on the future. Much of the leadership from Phelps Health and SMH met Sept. 4 in the SMH library meeting room to start answering the question of where we go from here. Bollman was there, along with Phelps Health CEO Jason Shenefield, the two key figures in making this affiliation work.
Right now, the questions far outweigh the answers. But what we do know is that we need to put the past in the past and approach the affiliation with a clean slate. Affiliation is really the only viable option on the table.
It won’t be easy combining the staffs and services. There is a reason SMH is in financial trouble, and the only way to make this work is for the Salem facility to stay in the black, financially. This will be accomplished by elimination of duplicate services and yes, duplicate personnel. (This is a good time to reflect on the definition of insanity, which is doing the same thing over and over and expecting a different result.)
This is also a time for patience. As Phelps Health and Salem Memorial Hospital work toward viability in Salem, it will take a combination of what’s best for health care and the bottom line. It will be a process.
Says Shenefield: “The collaboration between Phelps Health and SMH is driven by a shared commitment to improving community health. Together, we can significantly benefit the individuals we care for and allow our mutual communities to continue to thrive.”
Luckily, months of board closed session discussion resulted in a confidential letter of intent that frames what a collaboration might look like. As meetings such as the one Sept. 4 are held, the affiliation will begin to take shape. The group has a lofty goal of accomplishing most of this by sometime in early 2025.
Among the items that have been addressed in the letter of intent are:
• leasing of SMH buildings to Phelps Health and the terms of that lease
• transfer of assets, books and contracts
• role of SMH board going forward
• realignment of current employees of SMH
• general integration of SMH into Phelps Health systems, including the Phelps Health clinic already in Salem
• maintenance and repair of facility and equipment
• taxes received from the SMH district
Wow. There is a lot more in the 19-page proposal, but those are some of the key items for discussion and then agreement.
Managing editor Catherine Wynn and I also met with Bollman and Shenefield Sept. 4 during their break from the meeting with Phelps Health and SMH leadership. We discussed the complexity of the affiliation and all four agreed on the need for transparency as the public is made aware of decisions and what to expect when it comes to health care in not only Salem and Dent County, but any impact on the main Phelps Health facility in Rolla and its clinics in Salem, St. James, Vienna and Waynesville.
Bollman set up the meeting, and both her and Shenefield want to not only work toward the agreement, but they want the public to be aware of the process. How effectively the public is informed will go a long way in confidence when it comes to the quality of health care in all of the communities served.
Phelps Health and SMH plan to issue joint updates through the Phelps Health marketing department when there is news to share. Salem Publishing, through The Salem News, Phelps County Focus and Pulaski County Weekly and their websites will share those updates and regularly report on the process.
A few years ago, I wrote that keeping a hospital in Salem is a matter of life and death. The same holds true today, as when it comes to emergency care, seconds and minutes matter. Other factors that impact quality of life and economic development in Dent County – and anywhere else for that matter – are convenience of routine health-care procedures and tests, a hospital bed that is close to home, access to doctors and health professionals and an ambulance or helicopter ride that is minutes away.
I have confidence that Phelps Health and Salem Memorial Hospital are on the verge of ensuring that will be the case in Salem and Dent County and communities to the south and east of them for a long time to come. You can have that confidence, too.
