KV Healthcare

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rural community

Can Rural Healthcare Deliver?

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Written by: Tricia Sinek, Strategic Projects Coordinator

In the US today, 55% of rural hospitals have closed their maternity units. Women in these communities must travel long distances to deliver their babies. Traveling during active labor increases the risks of complications for both mother and baby. Why is this happening? A perfect storm of conditions is leading to this trend.

The amount hospitals are paid to deliver babies is often lower than the cost of providing this care. To deliver babies safely in a rural setting requires several specialized team members, including maternity-trained RNs available 24/7/365 days a year, physicians available to deliver babies 24/7/365, anesthesiologists 24/7/365, and surgeons for OB emergencies 24/7/365. Additionally, you need specialists who can perform newborn resuscitation if needed. The cost of providing this expert care is huge. At KVH, this cost is over 7.5 million dollars a year. The reimbursement for delivering this care at KVH does not cover the cost of staffing. Because of this shortfall in reimbursement, KVH must make up for these losses with other services they provide. Hospitals that are losing money in their operations cannot pay for the high cost of maternity care. 

The second major force leading to the loss of maternity care in rural communities is the inability to recruit and retain OB/GYNs. Historically, OB/GYNs have worked in both the clinic setting and the hospital – frequently being called away from the clinic to deliver babies. This is a disruptive way to live and disruptive for women getting their in-clinic care. In a rural setting, typically three doctors would share the responsibility for 365 days a year of OB coverage plus see clinic patients Monday through Friday. Each doctor is on-call 24 hours straight to deliver babies, but they also have a full schedule of patients in the clinic Monday through Friday. Typically, an OB/GYN could work all day in the clinic seeing patients, cover OB deliveries all night, and then return to the clinic for another full day of appointments. Rural OB/GYNs working this schedule can conceivably work two to three 33-hour shifts per week, plus additional clinic days. A cultural shift in healthcare has led to providers seeking a better work-life balance, so hospitals are unable to recruit new Doctors for this type of schedule. It is incumbent upon healthcare systems that wish to continue delivering babies to find new staffing options.

KVH remains fully committed to being able to deliver the babies of Kittitas County. This requires us to do two things: first, find a model that works in the rural setting, and second, make enough money with the other services we provide to cover the unfunded costs of delivering babies. We have taken steps starting in 2023 to work with an expert partner in OB/GYN care to provide consistent OB/GYN coverage and separate clinic care from OB Call coverage. This will increase our capacity to serve individuals for all their women’s healthcare needs without interruption. It will also lead to a greatly improved work-life balance for our current and new providers. We believe this to be a win-win for KVH, our staff, and most importantly – our community. Bring on the babies! In the US today, 55% of rural hospitals have closed their maternity units. Women in these communities must travel long distances to deliver their babies. Traveling during active labor increases the risks of complications for both mother and baby. Why is this happening? A perfect storm of conditions is leading to this trend.

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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