Outsourcing rehab triggers controversy
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by Brenda Grose
Ringgold County Hospital’s board of trustees met Tuesday, May 27 in front of a packed room of concerned citizens in response to recent information expressed in a press release from RCH CEO Nicky Gilbertson. The topic of the press release was a newly signed contract with Inspire Rehab to provide rehabilitation services currently provided through the RCH Rehabilitation department headed by Jill Ehlen, PTA, Director of Rehabilitation. The meeting focused mostly on hearing from Ehlen, RCH occupational therapist Tess Shields, and Lynne Wallace, speaking as a community member.
Summarizing the press release dated May 27, Ringgold County Hospital and Inspire Rehab, an InReach Company, have entered into a partnership to provide rehabilitation services effective July 1. It states the decision to partner with Inspire Rehab is a way to “strengthen rehabilitation services for the community and surrounding areas, while maintaining current therapists” employed by RCH. The release further touched on access to “robust resources,” “expanded support,” opportunities to keep rehab staff “at the forefront of evidence-based care,” and the ability to “deliver exceptional care” and “meet the evolving needs” of patients.
Public comments regarding the new contract were limited to three minutes per speaker and 10 minutes in total.
Speaking on behalf of the Rehab Department, both Ehlen and Shields shared pieces of a prepared letter. As current Director of Rehab, Ehlen stated the entire rehab staff learned of this decision on May 23. She said she had concern for her staff and patients regarding this decision because it lacked “oversight, causing confusion and uncertainty with staff who are being asked to make life altering decisions.”
Addressing the potential impact for staff, Ehlen cited loss of vested IPERS retirement benefits for some, ineligibility for Public Service Loan forgiveness for some, potential for increased health insurance premiums and higher deductibles/out of pocket expenses, reductions in paid time off and salary decreases for some and the risk of staff turnover, as employees may seek other nonprofit organizations offering IPERS.
Also pointed out were the challenges and setbacks of both Cass County’s and Decatur County’s hospitals when choosing similar transitions and Creston’s Greater Regional Medical Center’s ultimate decision, after pursuing outsourcing, to retain their own rehab staff.
Wallace echoed concern that the current rehab department and board of trustees had “very little, if any input prior to the decision being made” and that a change to outsourcing rehab services might cause the loss of valued current rehab staff.
In response to the three speakers and a few comments from the crowd, board chair Mike Hopkins said the situation could not be discussed in the open meeting as it was not on the agenda. There was brief discussion from some board members as to whether the item was on the agenda, but it was not brought forward for discussion. Trustee Greg Jobe then called for a closed meeting with the board and the attorney for RCH to be held Wednesday, May 28 at 5:00 p.m. The request was approved by all board members present. Tessa Barnes, vice chair, then requested a second closed meeting without CEO Gilbertson to be held immediately following the first, also on May 28, and it was approved by the full board present.
Public notice of the closed meetings, as required, were posted at RCH at 6:15 p.m. following the regular board meeting on May 27, and the first closed session meeting was held at 5:00 p.m on May 28 with the second meeting following. Reasons for the closed meetings were not cited at the time the meetings were requested but the agenda for both meetings cited the first meeting was to discuss information falling under Iowa Code Chapter 21.5.1.l:
“To discuss patient care quality and process improvement initiatives in a meeting of a public hospital or to discuss marketing and pricing strategies or similar proprietary information in a meeting of a public hospital, where public disclosure of such information would harm such a hospital’s competitive position when no public purpose would be served by public disclosure. The minutes and audio recording shall be available for public inspection when the public disclosure would no longer harm the hospital’s competitive position.”
The second meeting was held in accordance with Iowa Code Chapter 21.5.1.c. for the following reason:
“To discuss strategy with counsel in matters that are presently in litigation or where litigation is imminent where its disclosure would be likely to prejudice or disadvantage the position of the governmental body in that litigation.”
Gilbertson confirmed no motions were made and no votes taken during either closed session.
On Monday morning Gilbertson released to the Record-News a prepared statement in response to questions regarding the transition for the rehabilitation services: “Change is never easy. We understand it can raise questions and concerns. When we do make changes, we do so with great care and thoughtful consideration of how they may impact our staff, our patients, and the community. Above all, we remain 100 percent committed to the quality of care our patients receive. That priority will never change.”
