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KVH Joins TeamBirth: Elevating Communication and Safety During Labor and Birth

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At Kittitas Valley Healthcare, we believe that every birth story deserves care that’s not only safe and skilled, but deeply personal because life’s most meaningful moments should be met with compassion, clarity, and connection. That’s why we’re proud to announce our participation in TeamBirth, a nationally recognized initiative designed to improve communication and safety during labor, delivery, and postpartum care.

What Is TeamBirth?
TeamBirth is a best-practices program developed by Ariadne Labs, a health systems innovation center at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. In collaboration with the Washington State Hospital Association (WSHA), the program is now being implemented in hospitals across the state, including here at KVH.

The core idea behind TeamBirth is simple yet transformative: make sure everyone involved in a birth, the patient, their support team, and clinical staff—is on the same page. The program formalizes “huddles” at key points during the hospital stay, such as admission, any significant changes in condition, or when important care decisions are being made. These huddles take place in the patient’s room and are anchored by a shared whiteboard that clearly outlines care plans, preferences, and updates.

Why This Matters
Childbirth is deeply personal. It’s also unpredictable. By implementing TeamBirth, we’re creating a system where patients are heard and supported, and where care teams are aligned every step of the way. The program promotes shared decision-making and empowers the person giving birth to be an informed, active participant in their care.

We’re excited to join 11 other hospitals across Washington in this latest rollout—representing the fourth cohort of hospitals bringing TeamBirth to our communities. Since the program’s introduction in 2023, 38 hospitals in Washington and Oregon have already adopted the model. The goal: to achieve 100% adoption across Washington’s birthing hospitals by the end of 2025.

Looking Ahead
KVH’s participation in TeamBirth underscores our long-standing commitment to high-quality, patient-centered maternity care. It’s a step forward in ensuring that every family we serve feels safe, respected, and supported from their first contraction to their baby’s first cry.

We are honored to be part of this movement and look forward to sharing more about the program’s impact in the months to come.

Reference: Fourth Cohort of Washington Hospitals launching TeamBirth to improve communication, safety throughout labor and birth (by: WHSA)

Farewell to KVH CEO Julie Petersen

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As Julie Petersen retires after eight and a half years as CEO of Kittitas Valley Healthcare, we should recognize the incredible work she’s done for the people of Kittitas County. When the Board hired Julie in 2016, we knew that she had a strong financial background, having served as CFO and CEO at Prosser, and she came highly recommended by other healthcare leaders. As a CWU graduate, it was also something of a homecoming for her. The Board was confident that we were hiring the right person for the job. But we couldn’t have anticipated just how much she would contribute to our community.

With the support of the Board, Julie’s primary goal has been to provide greater access to healthcare services in Kittitas County and to do so in a financially sustainable way, so that KVH can remain a locally controlled community hospital. Julie saw the growing demand for services here and vowed to keep care local, so people didn’t have to travel over a pass to get treatment. Under her leadership, KVH began to offer many new specialty services, including cardiology, neurology, vascular surgery, nephrology, maternal fetal medicine, pediatrics, otorhinolaryngology (ENT), workplace health, wound care, dermatology, and inpatient dialysis. KVH has also expanded existing services, including physical therapy, and now has a 24-hour outpatient pharmacy and a rapid access clinic. To handle our growth, KVH purchased and renovated the Medical Arts Center and the Radio Hill Annex. We are almost finished with the expansion of our operating rooms, which will greatly increase the number of surgeries our clinicians can perform. Because of physician shortages and low reimbursement rates, several hospitals in Washington state have had to close their OB/GYN practices, especially in rural areas. Julie has maintained those services here so residents don’t have to travel to Yakima to deliver their babies.

Since 2017, the population of Kittitas County has stayed roughly the same as it is now: about 46,000. Yet the number of patient encounters (appointments) has grown by 60 percent: from 67,757 in 2017 to 108,250 this year. The number of unique patients we serve has grown from 26,201 in 2018 to 38,105 in 2023. It can be frustrating when you have to wait weeks to see your doctor, but KVH is doing its best to keep up with patient demand.

What is perhaps most impressive is that, under Petersen’s watch, KVH has done all this while remaining financially solvent. Rural hospitals confront unique financial challenges, which has led to the closure of 193 rural hospitals in the U.S. since 2005. Many others have merged with or been acquired by larger systems – 58 already this year. Unlike many other healthcare organizations in Washington and elsewhere, KVH has maintained a positive operating margin – this despite the fact that Kittitas County Public Hospital District 1 has the lowest tax levy of any other public hospital district in the state.

Julie is one of the most respected healthcare executives in the Northwest. She has had several leadership positions with the Washington State Hospital Association, the Association of Washington Public Hospital Districts, and the American Hospital Association. She has maintained positive relationships with our elected officials in both Olympia and Washington, DC. She received WSHA’s Joe Hopkins Award in 2022, “a lifetime achievement award for a health care leader who has made outstanding contributions to health care in the state, especially to rural health care.”

Behind the scenes, Julie has performed many acts of kindness and sacrifice that are too numerous to mention. Julie has always been transparent with and taken direction from the elected commissioners. She refused to be given a raise that was any higher than what the unions negotiated for themselves. When hospitals were losing revenue during the COVID pandemic because of freezes on non-emergency procedures (among other things), no employee was fired or had their pay cut. Julie has also promoted people from within. She has mentored the new CEO, Jason Adler, and the other members of the Senior Leadership Team to become excellent leaders in their own right – thus helping to make the organization strong beyond her tenure as CEO.

I can’t think of anyone who has had as much of a positive impact on Kittitas County over the last eight and a half years. On behalf of the Board, I want to thank her for her dedication to the well-being of the people of Kittitas County, both patients and KVH’s nearly 800 employees. Personally, I am grateful for her intelligence, her dry sense of humor, and her moral character. It’s been a pleasure to work with such a smart and savvy CEO who’s also always trying to do the right thing.

Matt Altman is President of the KVH Board of Commissioners and a professor at Central Washington University

Jason Adler appointed as next CEO of KVH

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We are pleased to announce the appointment of Jason Adler as the next Superintendent and Chief Executive Officer of Kittitas County Public Hospital District #1, dba Kittitas Valley Healthcare.  Jason will assume these responsibilities on December 12, upon the retirement of Julie Petersen, current CEO.

Jason has been with KVH since 2014, beginning his journey with us as a Financial Analyst and most recently serving as Chief Financial Officer. He brings extensive experience in healthcare finance and reimbursement and has played a pivotal role in our rural networks. Jason shares the Board’s vision of continued growth and expanded access to healthcare services. He and his family are deeply committed to Kittitas County, and they look forward to raising their children in this community. We are confident that Jason is the right person to lead KVH into the future.

We will celebrate this transition on December 10 at 3:00p.m. with a small reception in the KVH Hospital Café.   Please join us as we thank Julie for her years of service and welcome Jason into this new role.

KVH CEO to retire

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After over eight years of dedicated service to KVH and Hospital District #2, our CEO, Julie Petersen, has informed the Board of her intention to retire at the end of 2024. Julie first joined KVH as interim Chief Executive Officer in June 2016 and was appointed permanent CEO in March 2017.

During her time here, we have more than doubled the asset value of the Hospital District, bringing on more resources, equipment, and facilities to serve our county. Our Hospital services have expanded with the addition of a 24-hour outpatient retail pharmacy, the 4th Trimester Resource Center, in-patient dialysis, the “Ouchless” ER, and Digital Mammography. Many new clinic services have also opened during Julie’s tenure. These include the integration of behavioral health services in our primary care clinics, Cardiology, Dermatology, ENT & Allergy, expanded Physical Therapy, Neurology, Pediatrics, Vascular Surgery, Workplace Health, Wound Care, and the Rapid Access Clinic.

Despite declining payments, our operating revenue has increased by 87% and, in 2024, KVH will provide our communities with family wages and benefits totaling more than 79 million dollars. She was and is committed to maintaining a thriving health care system in our rural setting.

Julie’s commitment to the well-being of this community has been steadfast, and her leadership has left a lasting impact. Please join us in expressing our heartfelt gratitude to Julie for her years of dedication and service to KVH and Kittitas County.

As you know, KVH is a unique organization—publicly owned, rural, and proudly independent. Unlike many rural healthcare systems that have merged with or been acquired by larger systems, our mission remains solely to serve the people of Kittitas County. We are not beholden to outside investors, and the decisions that shape our future are made right here, by people who care deeply about the health and well-being of this community.

Being independent presents its own set of financial and regulatory challenges, particularly in a rural setting where patient volume is lower, costs can be higher, and reliance on government payers is significant. These challenges are impacting rural hospitals across the country, but we are confident in KVH’s future because of the strength and dedication of this team.
As we prepare for 2025 and beyond, we know that we need a leader with a deep understanding of healthcare finance, particularly in the context of critical access hospitals like ours. We are pleased to share that we have found that leader in Jason Adler and have entered negotiations with him to be our next Chief Executive Officer.

Jason has been with KVH since 2014, beginning his journey with us as a Financial Analyst and most recently serving as Chief Financial Officer. He brings extensive experience in healthcare finance and reimbursement and has played a pivotal role in our rural networks. Jason shares the Board’s vision of continued growth and expanded access to healthcare services. He and his family are deeply committed to Kittitas County, and they look forward to raising their children in this community. We are confident that Jason is the right person to lead KVH into the future.
We thank each of you for your continued hard work and dedication.

Sincerely,
Matt Altman, President
KVH Board of Commissioners

Meeting Essential Health Services And Reimagining Obstetrics In A Rural Community

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Case Study via AHA.org (American Hospital Association), Meeting Essential Health Services And Reimagining Obstetrics In A Rural Community (pdf), highlights women’s challenges in accessing healthcare services in rural areas like Kittitas County. It discusses the efforts made by KVH, a healthcare provider in the county, to improve women’s health services despite difficulties. The article emphasizes the importance of community support in providing quality healthcare to women in the region. It also encourages readers to join KVH in their efforts to support women’s health services in the community. The article calls for a collaborative effort to provide accessible and equitable healthcare services to women, particularly in rural areas.

Building a Workforce

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Kittitas Valley Healthcare (KVH) is leading the way to increase healthcare providers in Kittitas County.

The healthcare workforce shortage is not a new concern, but one that is on top of mind for our industry. Long before the COVID-19 pandemic, the expected number of nursing school graduates did not expect to exceed the number retiring. Add the stress of the pandemic and the emergency staffing needs for hospitals across the nation, and the problem has only been exasperated. Healthcare workers now have many options as healthcare systems across the country are desperate to fill staffing gaps. It is increasingly competitive to find and retain workers. KVH has worked hard on retention efforts for staff- offering free fitness and art classes, career development programs, decreasing benefits costs, and most recently implementing an $18 organizational minimum wage.

But is it enough to attract new healthcare professionals? In a rural community with limited education programs to develop healthcare workers, you aren’t just recruiting to your organization, you are recruiting to a new community or hoping people are willing to commute. This is why KVH took a different approach. Instead of waiting for applicants to happen to find us for opportunities, we are building our own workforce. This not only helps us recruit new staff but helps us develop and retain our own.

KVH now offers three apprentice programs with paid on the job training. The Medical Assistant program, which trains students to provide direct medical care in an outpatient clinic setting, is a year-long program where students work with a preceptor to provide supervised patient care with independent coursework. This has been a highly successful program that takes approximately one year to complete.  To date, 50 students have completed the program and are employed at KVH. The pharmacy tech program is a 520-hour clinical rotation. Actual completion time is dependent on the pace of the individual. And, most recently, KVH just got approved to be a training site for a Certified Nursing Assistant (CNA). KVH will be offering paid training for this six-week course to prepare trainees to apply for Patient Care Technician positions in our inpatient hospital units and Home Health.

We aren’t waiting. We are building our workforce, one employee at a time. Our patients need quality, trained healthcare professionals and our employees need an employer invested in their future.

Manda Scott, SPHR, MAOL, joined KVH in December 2019 as the Chief Human Resources Officer. With a background in healthcare and nonprofit, Manda’s focus at KVH includes communication, culture, and talent development. She oversees all HR functions for KVH staff, including recruiting and employment, benefits, wellness, labor negotiations, and staff development.

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National Doctors Day

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By Dr. Kevin Martin, Chief Medical Officer KVH

March 30 will mark the 182nd anniversary of the first use of anesthesia in surgery by Dr. Crawford Williamson Long, and so that is the day we celebrate National Doctors Day. At Kittitas Valley Healthcare, we take that as an opportunity to celebrate all of our providers and thank them for their commitment to our health and our community.

All the healing professions have an oath, pledge, or declaration that promises to respect and serve people.  Mine, The Declaration of Geneva – 1994, started, “I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity.”  Osteopathic physicians, physicians’ assistants, and nurse practitioners make similar promises.

Healing work, our service, takes many forms. It might be fixing a surgical problem, or diagnosing a medical one, or facilitating life’s inevitable transitions. It was the latter that drew me to family medicine, delivering babies and providing hospice care. Each of us finds the work that fulfills us, but that work is always about humanity.

When I started in private practice in 1998, probably 90% of my time at work was spent in the exam room with patients and families.  I would come out of a room, spend a couple of minutes with a Dictaphone, and head to the next room. If I had someone in the hospital, I would make rounds at 7:00, at lunch, and at 5:30.  I routinely saw 25-30 patients a day and was home for dinner or a kid’s game or recital. Primary care providers (PCPs) in a mature practice would have up to 3,000 people in their care. A workforce of 20 PCPs and a handful of surgeons, gynecologists, and other specialists could easily care for today’s population of Kittitas County.

That is not the work today. There is much more that we are expected to document at every visit. Some of the requirements come from the government and many more from insurers. Typing at a computer is slower than dictating. Studies and procedures need prior authorization from payers. Studies have shown that today’s primary care doctors spend 1-2 hours outside the exam room for every hour they spend in it, and the same is true to some extent across all specialties. High functioning primary care providers see 16-18 patients a day, frequently work into the night from home, and can only care for perhaps 1,500 people; 1,250 is probably a better number. The care that 20 PCPs could do before 2000 now needs at least 40, probably closer to 45.

Many providers are retiring earlier, especially since 2021, and we are not graduating new doctors fast enough to keep up. In 2023, the American Association of Medical Colleges (AAMC) reported that 83% of practicing physicians are over 40 and 23% are over 65.  Nationally, some estimate we are short up to 30,000 providers, and AAMC expects that shortage to grow to as much as 139,000 by 2036. The shortage hit rural areas in the South and West hardest, and we feel it.

Every year at KVH, we put a table in the lobby for the month March with note cards and pens. If a provider has helped you, has impressed you, please share that. We share the cards with each provider. It’s a little thing, but it helps remind us why we do this work and for whom we do it. You can also thank your provider by visiting: https://qrco.de/drday24.

A Message from the Board of Commissioners Regarding the Future of OB Care at KVH

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Early today, KVH received a resignation letter from KVH Women’s Health provider Holly Dawson, DO, effective October 12, 2023. In true accordance with our value of Transparency, we want to take this opportunity to be open and honest with you on the current status, and future plans of KVH Women’s Health and the KVH Family Birthing Place.

At KVH, we talk a lot about our strategies and how they shape the work we do. When you look at the KVH strategies, Access is at the top of the list. For us, Access means that KVH is intentional in providing the needed services in our community and we work to anticipate the resources needed to serve our community.

In April 2022, the Women’s Health Clinic was staffed with four OB/GYN or FPOB physicians and two advanced practice providers. These staff shared the responsibility of OB/GYN care at KVH Women’s Health and OB call and deliveries at KVH Hospital. KVH providers were supported by staff at Community Health of Central Washington (CHCW), however their call coverage has been significantly hampered due to their own staffing issues. Since then, three physicians and one advanced practice provider have left the practice for issues around work-life balance and professional burnout. We have been actively recruiting OB/GYN and FPOB candidates since the Fall of 2022 and have seen some success with the arrivals of Dr. Wageneck and Anna Phillips.

We are very proud of our Women’s Health teams in the clinic and the hospital and we want to support them. As KVH Women’s Health began to experience the provider departures felt throughout the country, leadership began exploring new options to support this service. The key to any service line offered is that it must be RELIABLE for our community and SUSTAINABLE for our providers and staff. Women’s health has faced unprecedented challenges in 2023, and we are committed to addressing them. Due to staff shortages, we have been forced to limit the number of new OB and GYN patients we can accept. We’ve had to reach into our Family Medicine providers to assist with newborn call coverage. We can no longer depend on the traditional model of single clinic physician coverage and must think deeper and broader.

Eight months ago, leadership brought forth a new model of obstetrics care for our KVH provider team to consider. This model is similar to the models we are using in MedSurg/CCU, the Emergency Department, and Anesthesia where dedicated, professional teams with significant bench strength are brought in to provide services for our patients in our facility. At that time, our providers felt they could still meet the needs of our community and asked that we continue to put our efforts into recruiting new KVH-employed providers. This has not worked. Today, our providers are leaving for opportunities to work in the very models we were bringing forward.

Across the state and throughout the country, OB programs are closing. We only expect to see this trend continue. We know that rural OB programs are fragile everywhere. KVH is committed to finding a reliable and sustainable OB program for our community and welcomes the involvement of our community partners. We will be holding a special board meeting on Thursday, July 20 at 5:00 p.m. to discuss our efforts and next steps. In the meantime, please be assured that we are committed to a full-service women’s health program at Kittitas Valley Healthcare.

Matt Altman

President, KVH Board of Commissioners

KVH Chief Ancillary Officer and Roslyn community member Rhonda Holden named to new Federal Advisory Committee

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On Tuesday, December 13 the Biden-Harris Administration announced that local resident Rhonda Holden, RN, BSN, MSN was one of 17 individuals throughout the country selected to join the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. This new federal advisory committee was created in November of 2021 to improve the disclosure of charges and fees for ground ambulance services and to better inform consumers of insurance options for such services and protect consumers from balance billing.

Ms. Holden will provide the committee with insight into the unique needs of rural communities that rely on ground ambulance services, not only to respond to accidents and emergencies but also to transport patients long distances to a higher level of care. “I believe we can work together to revise the payment structure for ground ambulance transports which will ultimately alleviate burdensome financial challenges for consumers. Financial concerns should not be a barrier to access life-saving care for any American,” states Holden.

Rhonda’s career as a registered nurse has been spent largely serving rural communities. She is a long time resident of Roslyn with an in-depth experience in advisory roles. She currently serves as the Chief Ancillary Officer at Kittitas Valley Healthcare (KVH) and is the Director of Strategic Initiatives for Kittitas County Public Hospital District #2, which operates Medic One, the only advanced life support (ALS) ambulance service in Upper County.

“Ms. Holden is well qualified to articulate the unique challenges that rural ground ambulance consumers and providers experience and will represent the rural perspective,” stated KVH Commissioner Robert Davis in her nomination letter. Ms. Holden’s nomination was supported by Kittitas County Hospital District 1 and 2’s Boards of Commissioners, the Legislators of Washington State’s 13th District, the Washington State Hospital Association, the Washington State EMS and Trauma Steering Committee, the Washington State Emergency Cardiac and Stroke Technical Advisory Committee and the American Hospital Association’s Rural Health Services.

For more information on the Ground Ambulance and Patient Billing Advisory Committee appointments see Members of New Federal Advisory Committee Named to Help Improve Ground Ambulance Disclosure and Billing Practices for Consumers | CMS and 2022-27263.pdf (federalregister.gov).

For information on the GAPB committee and charter see Advisory Committee on Ground Ambulance and Patient Billing (GAPB) | CMS

For inquiries on the GAPB please contact press@cms.hhs.gov