Published in the Pagosa Sun
PagosaSUN.com staff

The dream began 30 years ago with the formation of the Upper San Juan Health Service District (USJHSD).

Just three years ago, the Pagosa Springs Critical Access Hospital was built, complete with an operating and procedure room. Until this month, though, neither of those rooms had been used for their intended purposes.

On Monday, Aug. 1, for the first time in its history, surgery was performed at the local hospital.

Dr. Dave Shaeffer, the new general surgeon at the Pagosa Springs Medical Center (PSMC), performed the first surgery at the facility — a hernia repair. He was assisted in the operating room by his wife, Dr. Amber Reiss-Holt.

Judy Cole, director of surgical services at PSMC, said that, “As prepared as we were, I was still a little nervous.” However, she continued, “The team was very prepared and works very well together. We were very pleased.”

Cole was not the only one who thought the surgery went well.

Dr. Shaeffer was extremely satisfied with how the surgery was performed and was satisfied with the subsequent five surgeries that he and the PSMC surgical team have performed. As of publication date, Shaeffer has completed three hernia repairs, a bowel resection and removed a gall bladder using a laparoscope.

“We are very excited to offer this service to the community,” PSMC CEO Brad Cochennet said. “We are excited to get some basic needs addressed here so people don’t have to drive so far away.”

There are more hernia repairs scheduled at the center this month, and the PSMC staff anticipates appendectomies to be scheduled in the future as patients’ needs are served.

lindsey@pagosasun.com

Pagosa Springs will soon be the only hospital in Southern Colorado to have an advanced 128-slice CT machine. Starting in late August, patients who need a CT scan for internal injuries, cardiac scans, brain profusions or other types of trauma will be able to be scanned right here in Archuleta County.

Currently, the Pagosa Springs Medical Center has a 4-slice CT machine that they purchased when opening in January 2008. At a recent board meeting, the Upper San Juan Health District approved the replacement of the hospital’s CT machine. When researching options and talking with vendors, staff realized they could acquire a state-of-the-art, 128-slice machine at a comparable price to a 64-slice machine.

Over the past three years, the development of faster and better CT equipment has made the 4-slice CT nearly obsolete. Many Archuleta County citizens have been directed to drive to Mercy in Durango for a higher quality scan on their 64-slice CT. Due to vendors being motivated to open up the 128-slice equipment market, General Electric Medical Systems has allowed Pagosa Springs Medical Center to purchase the latest technology at a competitive cost to a 64-slice machine.

“We are fortunate to be able to provide the latest technology to our community at a reasonable cost, help patients get the best diagnostic screens close to home, and allow an equipment vendor to showcase their latest technology,” expressed Brad Cochennet, CEO of Pagosa Springs Medical Center.

The GE GoldSeal Certified Lightspeed technology provides greater detail with much faster processing speed. Pagosa Springs Medical Center will now be able to perform coronary artery scans or brain profusions. In addition, the high-end machine gives patients a less expensive and less invasive option to evaluate cardiac issues.

“If a patient presents chest pains and EKG irregularities, most other hospitals need to perform a heart catheter procedure to determine diagnosis. However, the 128-slice CT allows doctors to scan the heart without a heart catheter. This saves the patient money, time and radiation exposure,” said Chris Savoy, Director of Ancillary Services at Pagosa Springs Medical Center.

In the 128-slice machine, patients are scanned in only 3 seconds. The films are then sent to Denver to be read by a radiologist within 5 minutes, and read within 15 minutes. With the hospital’s current CT machine, this process takes more than an hour.
The 128-slice machine will also help with early detection by offering a quality screening tool. The advanced CT machine is scheduled for delivery in early August and will perform their first scan in late August.

Brad concluded, “Our new CT machine is just another step in our mission to become a sustainable integrated health care resource system though service, leadership and community partnership. We take great pride in our part of health service district, and strive to help people with their health needs. “

By Brad Cochennet — CEO, Pagosa Springs Medical Center

Originally published in the PagosaSun on Friday, July 8, 2011

In February 2011, the Upper San Juan Health Services District board approved a multi-year strategic plan which established a frame work for our future.

Since then, strategic plan tactics are continually being indentified, evaluated and selected by management, and then presented to the board for approval. Our community’s dynamic health care environment not only requires an active management/governance process between the board and staff, but it also demands a vigilant eye to determine the best new ideas for our health district. The goal of being the finest health care provider for the community today, while establishing a sustainable foundation for tomorrow, continues to be the focus.

At a recent board meeting, the board approved the replacement of the hospital’s CT machine. When the hospital opened in January 2008, a used, GE 4-slice CT was purchased from Mercy Regional Medical Center. The original purchase was funded by a grant from the Caring for Colorado Foundation. Now, Pagosa Springs Medical Center can provide more comprehensive scans for patients with an advanced machine.

Over the past three years, the development of faster and better CT equipment has made the 4-slice CT nearly obsolete. Many Archuleta County citizens have been directed to drive to Mercy in Durango for a higher quality scan on their 64-slice CT. However, the board of the Upper San Juan Health Services District approved the acquisition of a 128-slice CT for Pagosa Springs Medical Center!

Better yet, three equipment vendors have made the latest technology available for us to acquire at the same cost as a 64-slice CT. The vendors are motivated to open up the 128-slice equipment market with their new tool, and have selected us (and only a few other smaller markets) to introduce these machines. We are fortunate to be able to provide the latest technology to our community at a reasonable cost, help patients get the best diagnostic screens close to home, and allow an equipment vendor to showcase their latest technology.

By keeping our equipment up to date and offering a quality screening tool, the strategic plan vision to become an integrated delivery system is being successfully met.

Pagosa Springs Medical Center will continue to provide services locally that are clinically sound and convenient for our population. Our new CT machine is just another step in our mission to become a sustainable integrated health care resource system though service, leadership and community partnership.

We take great pride in our part of health service district, and strive to help people with their health needs. Thank you for the opportunity to serve!

Click on the link below to find out more about our Mayo Clinic Diet workshops!

Success stories from participants of the Mayo Clinic Diet workshops

Click below to find out more information about our sports physical day, coming soon!

Sports Physicals

By Brad Cochennet — Pagosa Springs Medical Center

Published in the PagosaSun.com on Thursday, June 23, 2011

The Upper San Juan Health Services District’s vision is to become an integrated delivery system in order to provide health services to our community. We know that a community of 12,000-plus people will have specific demands on the health care system, so we try to provide people with services to get well and take control of their health. We also align ourselves with other providers and entities that will do more than we can to assure that a complete continuum of care will be available.

The Emergency Room door is often called the most expensive door to enter in the health care delivery system. Individuals end up there due to an accident or some degree of poor health that requires an emergency visit. By having a staff of medical personnel literally standing by waiting, we are able to respond to those emergencies with appropriate episodic care. There is a sign I see above some people’s desk that reads, “failure to plan on your part does not constitute an emergency on my part.” I am fairly certain that some of our emergency room patients had a degree of lack of planning in their part, but regardless it does create an emergency on our part. We respond, no matter what!

Having services available in the emergency room, or elsewhere on our campus, starts with the building, equipment and personnel. However, it certainly doesn’t end there. In the process of selecting our personnel, we work very hard to find people with the right attitude and disposition for our district’s provision of services. Often, we have people technically qualified for various roles in our facility, but we don’t invite them into our organization to work because their attitude isn’t what we believe will be the most conducive to the health and well being of our patients. Our providers’ positive attitude helps lift others up, whereas a negative attitude brings negative energy that drains others.

Taking this thought process deeper into the organization, the individual belief system that people bring to the workplace will impact others in specific ways. We want to do what we can to be sure the influence on others is helpful and positive for their health. We talk to people everyday about their health and we want to take the opportunity to assist them in as many positive ways as possible. By listening, understanding who they are and their individual struggles, and helping them focus on solutions, we hope to be able to make a difference. We believe we have a great team of individuals who have the right attitude and spirit and find ways to make things happen for themselves and others. Because of who they are and how they live, these providers improve the health of others and leave the world a better place.

By Brad Cochennet — CEO, Pagosa Springs Medical Center

Published on Pagosasun.com - Friday, May 20, 2011

Since the community started the hospital district in 1981, there have been many who have participated in the struggle to bring a hospital to Pagosa Springs. Board members, employees, and volunteers have all helped carry the load.

I often meet people in the community who tell me stories about their part of the history and their role in taking steps toward better health facilities in our community. Most of these folks did their part and then stepped back and let new volunteers take the responsibility for the next phase.

Our current board is figuratively standing on the shoulders of many who went before them, and they will provide the next leadership a higher level of activity to govern and direct. When someone sets out to do good, the ramifications are many and usually far beyond what was originally dreamed. I believe this is true with our community’s effort to improve health care; much good was intended and much more has happened as a result.

The new hospital opening in 2008 was a defining moment for those who worked so hard for so many years. A $12,000,000 facility using tax money to back the bonds for the capital was quite an accomplishment. Improved ability to serve the population with many services never available in our community had arrived.

Since then, new participants have come into the limelight to help take the district into the future. One of the ways the district has benefited from new talent is increased donations and grants.

Understanding the need for grants and donations, we have an EMT named Joe Bigley who has written most of our grant requests. He began on his own time and volition, identified several sources of potential funding for our district, and wrote grant applications. He started with a specific focus… help our EMS group receive money for equipment, training and programs. His success with EMS funding soon allowed the word to spread that Joe could find money, and he expanded his grant writing to include hospital, clinic and EMS. The most recent list totals over $1,000,000 of grants received, and he continues his work looking for the next grant with more potentiating coming. He is certainly an example of new talent who has stepped forward and helped the district move forward.

Getting the grant funders engaged in our community efforts to improve our health and welfare has much more impact than the actual cash we receive. Joe knows this, so in his grant application, he is able to describe the very heart and soul of who we are. Therefore, the funders have insight and a deeper connection to us. We believe we are doing some great things for our community. As a result, our drive and belief also add members to our loyal group of followers and volunteers. By reaching out, telling our story and asking for help, we discover those that have a heart to give of themselves, their talents and support in our health care operation. We certainly appreciate it when they do.

Published on PagosaDailyPost.com - May 10, 2011
By Sandy Artzberger

Brad Cochennet CEO since 2008 of Pagosa Springs Medical Center (Pagosa Mountain Hospital, ambulance service, and Primary Care Rural Clinic) will be the featured speaker at the May 10th Archuleta County Republican Women’s meeting to be held at Boss Hogg’s Restaurant from noon to 1:30pm.

Brad will be discussing the impact on tax payers of hospital growth as well as the impact of recent government health care initiatives. Everyone is welcome to attend.

During Brad’s tenure since 2008, we have seen the hospital stabilize financially, the addition of the Primary Care Rural Clinic, development of the Wellness Program, plus the addition of several very qualified physicians and physician assistants, expansion of existing services and growth of additional services such as gastroenterology and in June of 2011 a surgeon will come on staff. These are only a few of the various obvious changes that have taken place.

Community support continues to grow for the medical center under Mr. Cochennet’s direction.

Brad has obviously integrated himself into the community seeing the specific medical needs relative to the demographics of Pagosa and seeks to obtain the needed services. After reading Mr. Cochennet’s resume it becomes apparent how past experiences have enabled him to accomplish so much here in Pagosa.

Brad humbly summarizes his qualifications as: “multi career experiences for the past 30 plus years with advancing business responsibilities, social concerns and impact on society.” During his career he has been involved in at least 12 different organizations and/or boards in various capacities ranging from business leadership, church, hospital boards, community service groups such as a re-start homeless shelter and a domestic violence shelter, education, finance, and since 2010 has been a member of the San Juan Basin Health Board, just to mention a few.

His professional career has been equally diverse ranging from accounting (CPA), part of the executive team of Ferrellgas taking it public as an MLP on the NYSE in 1994, chairman of the board of Kearney Commercial Bank MO, Chief Financial Officer and Chief Operating Officer 2000-2006 for Mercy Regional Medical Center (senior Executive for $100 million dollar new regional hospital and medical office building), led the financial turn around for a failing Cardiology clinic, plus owned and operated a business consulting firm.

What is the vision for the Pagosa Springs Medical Center in the future and how will government mandates and growth affect tax payers?

Come to the meeting to hear and discuss.

By Brad Cochennet — Pagosa Springs Medical Center
Published on PagosaSun.com - Friday, May 6, 2011

Our recently approved Strategic Plan is a plan balanced with current issues as well as forecasted future demands.

When the plan was developed for the Upper San Juan Health Service District, the need for strategic guidance for quality decision making for short term decisions was balanced with the requirement to look into the future to meet unknown but somewhat predictable issues coming our way longer term. Financial stability was one of the first strategic goals identified as most of us have experienced well intended organizations with missions that were unable to be completed because of the lack of financial resources. Our board of directors thoughtfully included the idea that we should “maintain a strong financial position and be good stewards of our community’s resources to allow us to offer services at the right time and for the right reasons. The plan went on to state that we rely on funds from the county mill levy, patient services, donations and grants. These are the sources we include with the income from our operations to balance out our cash flow annually and to accumulate funds for capital expenditures. The need to balance our short term financial challenges with our longer term projections requires balance.

In our daily operations, financial challenges enter into the health care decision process at most all levels of activity except one: delivering quality patient care. Providers are charged with taking care of all patients regardless of their ability to pay and when providers make decisions to help a patient in need, they make those decisions for the best outcome for the patient. We in turn charge the patient directly or their insurance company, Medicare or Medicaid or other government insurance plans, or utilize any grant or donated money we have accumulated for the patient care provided. If none of the sources are available, we “cross subsidize” the costs of services proved from funds received from other transactions. The resources to balance the costs of care provided for those who can’t pay for the care received falls on the shoulders of the rest of the payers and the hospital. In reality, those that do pay, pay for themselves and for the others who don’t pay. Thus, we need to continue to look at the mix of patients in our community we serve to assure the mix of payers will allow for the services provided to be in balance.

When we look at the mix of services we provide and we strategically think about what we would like to provide to the community, we evaluate the costs associated with the new proposed service and estimate if it will add to the district or will determine if the service not be self sustaining. Not unlike the balancing act we do with the mix of patients who pay and those who don’t, the mix of services provided must also have a mix of services that make money along with those that don’t in order to balance out and we have the ability to pay all of our obligations. Some of our services are known to not “make money”, but we provide them anyway because of regulatory requirements or community need to assure a basic level of services for everyone. Our EMS ambulance service and our Emergency department are two services that we currently provide that on their own, do not provide any excess operational funds. There are a number of support services we provide as a result of being in the ambulance and emergency room business that make money like diagnostic imaging (X-ray, CT, ultrasound) and laboratory services (blood work and other analysis).

On the whole, there is balance achieved when all services are included. Our inpatient beds and skilled nursing services also are services that we provide as a basic level of service and often time they do not “make money”. Due to their demand for diagnostic imaging and laboratory services, on the whole they will provide excess funds when all the services are included. What future services we decide to provide will draw a mix of patients from various payor groups and will allow us to charge for services rendered that will result in a mix of services that make money and those that do not. To complicate things further, reimbursement for various services changes over time so those services that provide excess funds today might not in the future. We must be careful to not assume current revenue streams will continue unadjusted into the future.

The other source of funds for our health care district is from a county mill levy, donations and grants. As we have worked with our strategic plan assumptions for the future, we know there will be less money coming from our county mill levy and we have already seen a drop in donations and grants. With these passive sources of funds in decline, at least for the near future, we need to find other ways to replace the those sources of money with new ways to at maintain if not increase our funds to reach the strategic goal of financial security. We will continue to look for what services the community will benefit from and what the resulting financial impact will be as a result. You can count on a lively debate by your seven member elected board to assure the best decisions are made taking into account all the issues in play as described above for the desired result of financial stability.

Brad Cochennet, CEO, Pagosa Springs Medical Center
Published in the Pagosa Sun, Friday, April 22, 2011

One of our health care provider’s biggest challenges is to help people to stay well and not get sick.

Our industry is organized primarily to take care of people when they are sick, and not when they are well. Most of us have grown up in an environment where we go to the doctor only because of illness or something required, like the dreaded school physical. Although we learned that an ounce of prevention is worth a pound of cure, the health care industry has not been designed for quality interactions with health care providers. Since one of our goals is to create one of the healthiest communities in Colorado, we have some work to do!

Issues regarding how to stay healthy are boiled down to two basic facts… the challenge to exercise regularly and eat healthy. No matter how we try to make things more complicated, it comes down to those two steps. Yet, what a challenge they seem to be for us to implement in our lives! Because our own life experiences have formed many habits of behavior, our expectations translate into ingrained behaviors we own and are very hard to change.

I am struck by how specific patterns of behaviors by our primary role model, our parents, are mimicked by family members. What we learned as children from our parents is deeply ingrained in our life expectations and very difficult for us to see, let alone change. If Grandma always made fried chicken for Sunday dinner, and Mom followed Grandma’s lead, guess what will probably bring comfort to our lives when Sunday dinner rolls around? However, good habits could also have been formed in our lives as well. As an example, if our parents exercised regularly, their good behaviors probably helped form patterns of behavior us that are good for us.

To address this issue, Pagosa Springs Medical Center has developed several early detection programs to allow people to find out information about their health before they are sick. With their health information in hand, they are able to make appropriate lifestyle changes as needed. Sometimes people get their screening scores and they are marched directly to our emergency room for care! Most of the time, however, individuals get their information and support from our wellness team. In addition, they receive coaching to understand what individual choices are to get healthy and stay there. Utilizing personal trainers as coaches in our clinic allows us to help individuals change their habitual behaviors in favor of better health. Our success has led to the development of a Wellness Club with organized activities to help people find out about their health, get healthy and stay fit.

Your Pagosa Springs Medical Center team is here to serve you — sick or well. As information and understanding about what are the best practices for care and health improvement are developed, you can bet we will be in the front row learning about what we can do to continue our pursuit to make Pagosa Springs a healthy community … one person at a time.