A View from the Top

BY ALEX STRAUSS

Life at a Top 20 Rural Community Hospital

THIS SPRING, WHEN the National Rural Health Association released its annual list of Top 20 Rural Community Hospitals, three South Dakota hospitals were on it. In fact, South Dakota was second only to Indiana — which had five — in the number of institutions on the list. In addition to Avera St. Mary’s in Pierre, the list included two independent hospitals — Brookings Health System in Brookings and Prairie Lakes Healthcare System in Watertown.

It was the third Top 20 designation in four years for PLHS and the second time in three for Brookings. What allows these small, independent rural hospitals to continue to thrive while so many others are forced to sell out or fold? For insights, we turned to two people who have made these hospitals their professional homes.

INVESTING WISELY

Brookings Health System includes a49-bed hospital, a nursing home, seniorliving apartments, an eye clinic, andmedical clinics in Arlington, White, andVolga. Family medicine physician andMadison native Andrew Ellsworth, MD,has been with the system for the lastseven years. As a member of the boardof trustees, Dr. Ellsworth believes the hospital’s success has a lot to dowith strategic investment — and goodtiming.

Prairie Lakes Healthcare System in Watertown includes an 81-bed acute care hospital. They have made the Top 20 List for three out of the last four years.

Photo courtesy PLHS.

“The whole culture of the hospitalis ‘we can do this and we are goingto make it happen,’” says Ellsworth.“We invested in a major renovationat just the right time. We investedin the da Vinci and then the Makorobotic system, which helped bringin 3 more full time general surgeonsand 2 full time orthopedic surgeons.We invested in hospitalists to takesome of the burden off of primarycare. We invested in becoming a ‘BabyFriendly Hospital’, the only one inthe state outside of the IHS. Now wehave four full time OBs.”

Ellsworth says investments likethe 62,000 square foot expansion/renovation project in 2017 and the30,000 square foot medical officebuilding completed in 2016, boostboth provider pride and patientconfidence — both of which make iteasier to attract new providers likehimself and new patients. And thecycle of success continues.

“We have been able to recruitfairly easily whereas in some placesit’s awfully hard,” says Ellsworth. Headds that a good school system andthe city’s willingness to invest inprojects like the Children’s Museumand the Hillcrest Aquatic Center areother draws for families like his.

Brookings Health System’s 49-bed hospital was named a Top 20 Rural Community Hospital in 2017 and 2019 and has made the Top 100 list since 2016.

Photo courtesy Brookings Health.

SPECIALIZING IN SPECIALISTS

Situated about 100 miles from SiouxFalls, Prairie Lakes Healthcare Systemincludes an 81-bed hospital, a cancercenter, a surgical center, and dialysisunits. It serves a patient base of 90,000

across a 10-county area. Like Brookings Health System, PLHS has invested heavily in infrastructure (like the new 68,000 square foot specialty clinic) and technology with the goal of enticing specialists and the patients who need them.

But nephrologist Tina Melanson, MD, says upgrades like new cath lab equipment and a therapy pool are only part of the attraction for providers. Melanson says she moved from a larger health system in Sioux Falls back to her hometown with her young family in 2011 for a more relaxed lifestyle.

“I moved here to be a ‘country nephrologist’,” says Dr. Melanson. “Because it is a much smaller facility, I thought it would be an opportunity to slow down for a little while and spend more time with family.”

But the demand for nephrology services — like the demand for so many other specialty services in Watertown — has grown steadily. The dialysis unit went from being open just three days a week to six and added an NP and a PA. Dr. Melanson now oversees additional PLHS dialysis units in Sisseton and Ortonville, Minnesota, and at Huron Regional Hospital.

While she is busier than she expected to be, Melanson repeats what so many providers say they value most about working at independent hospitals like PLHS.

“I love that I am in charge of my own ship,” she says. “They respect my opinion and that autonomy definitely impacts my practice. I used to have to schedule a meeting that would take a month to arrange. Now, I can

literally walk down the hall and speakto administration any time.”

THE ‘SECRET’ TO TOP 20 SUCCESS

Wondering what the CEOs of these Top 20 hospitals credit with their Top 20 designations? We have exclusive and extensive interviews with Prairie Lakes CEO K.C. DeBoer and Brookings Health CEO Jason Merkley online. You can find their thoughts and more about the NRHA’s Top 20 Rural Community Hospital award on our website.