By Ethan Nahté
A lot of exciting things have happened the past few days at Mena Regional Health System (MRHS). Michael Wood, who has been serving as the interim CEO for MRHS since September 2023, is now officially the Chief Executive Officer. He follows Robert Rupp as CEO, who took over for Jay Quebedeaux. Prior to that, Wood was the director of rehab for MRHS.
Wood said, “I’d actually applied when Jay was leaving, too. I was on Jay’s executive team — helped with some of their special projects. The Board went with Robert, who had a ton of experience. I spent quite a bit of time with Robert, as well. The last little bit I wasn’t. I don’t know if you remember, but after COVID when we reopened the rehab wing, I spent all my time getting that reopened.”
Being CEO in Mena seems to be a natural fit. “I was born and raised in Mena. I was actually born in this hospital. Then I went to UCA and got my bachelor’s in health science and minors in nutrition and in psychology.”
From there, Wood went to physical therapy (PT) school. “I got my doctorate in physical therapy in 2013 and then actually moved to Florida for almost five years. When I was in Florida I was with a private group. When I started, I was just a staff PT, but by time I left I was there a regional director. We had three clinics — a pain management clinic with a podiatrist on staff. I had done a couple other indie things.
“We had our first daughter and came back to Mena, and I started here in March 2017 and so I have been kind of worked my way up. I’ve spent my whole career in a progressive management type trajectory.”
When Wood first returned to Mena, he found that MRHS needed help with their outpatient therapy clinic. About three months later he took over all of their rehab services.
“A year after that is when I joined Jay’s leadership team. I got to learn a lot from him. Then Robert came along, and I got to learn a lot from him. That type of leadership has always been my goal, personally, is to move into this, as well as in private practice gave me opportunities to learn all of the facets of what it is that we do.”
As for some of the things MRHS does, there was an announcement this week that the hospital will be seeing a change thanks in part to a $2.7 million grant.
The Arkansas Legislative Council on Friday approved a $2.7 million grant for MRHS from federal American Rescue Plan funds. The Polk County hospital was one of four hospitals in Arkansas to be approved for funding Friday.
The Mena hospital has been experiencing staffing shortages requiring costly agency staff to fill 19 critical positions in 2022 and 2023. The staffing shortages have compromised management’s ability to operate several service lines at full capacity such as geriatric psychiatry and inpatient rehabilitation, which are major revenue producing units.
The Mena hospital has 65 beds. However, the hospital has chosen to convert to a Critical Access Hospital while working to improve service line revenue and improve revenue cycle management.
This reclassification and downsizing of Mena Regional’s beds to better match the hospital’s volumes will help to stabilize Mena Regional Health System’s financial position, maintain and enhance current service lines, reduce reliance on travel nursing staff, and allow the opportunity to add needed swing bed services to the hospital.
“They were working on it a little bit before I got here,” Wood said. “Since I got here, we’ve been working pretty diligently on the sustainability project with the state so the last little bit of the ARPA (‘American Rescue Plan Act’) money from COVID and everything that came out, the state decided they wanted to make sure they were giving it to the hospitals and that they actually had a plan to make sure that money was utilized appropriately and utilized in a way that allowed us to continue to operate into the future.”
Centers for Medicare & Medicaid Services
Part of that plan was reevaluating their status with Centers for Medicare & Medicaid Services (CMS).
“There’s three types of hospitals now,” Wood said. “There’s your PPS are prospective payment system, which is what we are now. You get paid for inpatient based on the diagnosis that the patient comes in with. It pays you roughly for 2 1/2 to 3 1/2 days’ worth of care no matter how long the patient stays.
“Then there’s critical access [hospital] (CAH), which is what we’re going to move toward. That status is, ‘Your hospital’s in an area that CMS, the state deem as critically necessary to healthcare in your region. They change how they pay you based on the cost to operate. We’re just speaking specifically about Medicare and Medicaid.”
Mena Mayor Seth Smith and the MRHS Board approved an official letter Wood had created to publicly announce the conversion of MRHS to a CAH.
What they do is they look at our cost over a year — a cost report — and then they break that out and we get a per day reimbursement as opposed to a per diagnosis biggest change.
“As far as the community goes, they won’t notice a whole lot different other than we’ll be able to offer what we currently offer without having to make difficult decisions about getting rid of service lines. Before the pandemic we were having staffing shortage issues, rising costs… obviously inflation has affected everybody, and through all of that the insurance companies really haven’t adjusted much in the way of our reimbursements.
“[CAH] is a program that will allow us to continue to operate that way. Our ARPA money was tied to making this conversion. The state liked our plan and they said they approved it last week, so we will get that funding in the coming months. We’ll get part of it up front and the rest of it after we finish with our conversion.
“Right now, we’re 65 beds. We’ll drop down to 45 beds, but the thing about that is in the last five years we have not had 45 patients, or even 40 patients in the hospital at one time. It sounds like a lot to say we’re losing 20 beds. We haven’t been using those 20 beds. It’s not going to affect the ability for us to care for the community at all and it’ll give us the opportunity to get paid closer to what we’re spending.
“One of the things that you see about rural healthcare is that our cost per patient day, which is a metric that a lot of health systems use, is significantly higher across the nation than what it is for your big systems in your metropolitan areas because of the economy of scale. We don’t have the ability to have a full row of 20 or 30 patients where we can spread our staffing out a little more economically viable. CMS recognizes that.
“There’s two types of stays when you come into a hospital,” Wood said. “There’s inpatient stay and then there’s an observation stay. We will repurpose a few of those beds for observation patients — somebody who comes in maybe later in the day who physicians feel like maybe we need to watch this patient overnight, and they’re likely going to go home the next morning. They may have had a little episode and we want to check labs and make sure that it was nothing more serious.
“Another thing we want to do is we currently offer infusion services on an outpatient basis.” For MRHS, there’s a list of more than two dozen such services that require IV therapy for the management of chronic and acute illnesses, covering a wide range of therapies and disorders.
“We’ll be looking to enhance that a little bit with some of those beds, try to get more people utilizing us so they’re not going out of town to get their monthly or quarterly injection or infusion services. That’s two of the things that we’re gonna do with that.”
“In our general surgery, Dr. [Thomas C.] Sullivan — a great surgeon — has been here a long time.
“We hired in October Dr. [Kennan J.] Buechter, also a general surgeon, which has allowed us to have 24/7 coverage in general surgery, which is not something that we’ve had in a very long time. When it was just Dr. Sullivan, we had about 21 days worth of coverage. We increased that by seven days, which is huge.
“We recently hired Dr. [Enes] Kanlic. He’s an orthopedic surgeon. He’s going to be starting with us on February 26th. He’s spent most of his career in level one trauma. He’s an orthopedic trauma surgeon. When you look at our population and then the type of injuries we have, we get a lot of hip fractures and other long bone fractures that come through our ER. Lately, we’ve been having to ship all those out of town. With him coming on board, we will be able to keep the majority of those here. He’s excited to get here. He’s coming from Arizona.
“We’re excited to have those guys. The surgery department is looking really strong,” Wood said.
“We’ve blessed with a core group of staff that loves the community and then was willing to roll up their sleeves and be creative, innovative and lean into modern healthcare. We don’t all necessarily agree with all of them or enjoy all of the changes that the regulatory bodies are forcing upon us, but they’ve done an exceptional job of being willing to navigate that and make sure that we continue to offer all the things that we can for our community. When you look at the growth potential for our area with the potential bike trails, and the college has grown exponentially over the last five years with their sports and everything, you look at our industry, this hospital is a paramount piece of the puzzle. The staff recognizes that.”
Moving on up
Wood mentioned that MRHS is moving up to the next level for this region. Location and the general population’s age are contributing factors.
Wood said, “Being remote obviously makes us unique even to the rest the state. Even though they consider most of Arkansas to be rural, most of them have a metropolitan area relatively close. We’re unique in that it’s 90 miles in any direction, and you’ve got to consider Oklahoma in that kind of southeast corner of Oklahoma doesn’t really have services either. We get a lot of patients from over there that are also isolated.”
New technology and services
MRHS announced in July 2023 that they were installing the world’s first deep-learning reconstruction MRI. The Orian 11.5T MRI helps the hospital obtain critical patient information for enhanced diagnoses faster, generally in less than 15 minutes.
“State of the art, first one of its kind,” Wood said. “The other thing we’ve done with our radiology techs is we’ve expanded. For the longest time they were only offering MRIs four days a week. We’re expanding to five days a week. I think our wait times are under a week to get a MRI scheduled, which is incredible.
“One of the things that we’re going to roll out next month at the clinic over at Mena Medical Associates is something called chronic care management. It’s a program again through CMS, a Medicare program, that basically your older population who have chronic conditions like diabetes, hypertension, COPD, CHF… those big things that tend to kind of cycle through and cause disruption in people’s lives.
“What will happen is if you choose to sign up, w’ll have somebody that will reach out at least once a month if not a couple of times a month, check on you to make sure that all of your prescriptions are getting filled, that you’re checking those vitals and if anything’s awry or you start to see a trend, they help you get scheduled to get into the clinic with the goal of trying to prevent you from getting so sick that you end up in the hospital.
“One of the things when you look forward over the next five years that you’re going to see more and more of is this idea of population health management. The hospital’s kind of being that central beacon of making sure their communities are healthy and in providing resources in education to get them there. Given the fact where we live — the difficulties, the poverty, the lack of public transportation — that will be a big lift force for us but an important one. Chronic care management is the first step in and connecting more with a patient so that it’s not three or six months before you see your provider again. There’s somebody in contact with you every month to make sure that you’re doing okay.”
“We have a couple of programs with UAMS in our ER: The Stroke Program where if you’re connected, you come in with stroke-like symptoms we activate the stroke protocol and you’re connected with a neurologist at UAMS. They’re able to do an exam with the help of our staff here on the ground and then determine the best course of treatment for you.”
MRHS has several other programs through the trauma network, being connected as they can be with the other systems in that regard.
“Speaking of UAMS,” Wood added, “we recently opened that breastmilk donation center. That’s really huge to be able to have a place where people who are lucky enough to have a surplus can donate that, then UAMS can take it, process it and be able to redistribute it out to mothers who aren’t so lucky.”
Wood said the program is getting a good response and doing good.
“I’m excited, honored, blessed. To be able to come back home and serve the people who poured so much into me as I grew up in the mentorship and in the love the community gave to me. It’s just a dream come true. There’s not a better job in the world than to serve the people who served you. This community has a good heart. There’s churches and civic organizations all over our community that people don’t even know about that are doing tons of things because they don’t need the recognition. When the ice and the weather all came, we had staff that spent the night here to make sure that they didn’t miss work. The dedication to taking care of their neighbors, their friends and their family… just just blessed to be able to serve alongside those people.
“I think it’s important to mention that I couldn’t do any of this without my wife Jennifer. I’ve got three beautiful daughters that keep me on my toes. Family is so important to so many people in our community.
“That’s our goal every day at Mena Regional is our patients come first. We do our best to treat people like family. We’re not perfect. Obviously, we have bad days, but we always strive to to be fair, to be reasonable, to make sure that we’re doing everything we can to support the community — always open for suggestions and ideas. We believe in an open-door policy. There are so many things changing in healthcare right now.”