Transparency not secrecy is needed on the EP Health board

There’s never a good time to experience emergency-turned-extended medical services. But when the triage team at a primary facility nearly two hours away demanded I report to the nearest emergency room in 15 minutes or call 911, there was no hesitation.

I did as I was instructed, and in the time it took to put on socks, shoes, and a coat I entered the sliding doors at Estes Park Health.

For the next three-plus days, I was cared for professionally, with compassion, kindness, and healing vibes.

No one mentioned the countless concerns raised over the past year by employees and former employees about how staff may feel mistreated by the administration.

No one brought up how the public views the administration’s exaggerations of financial strides made on the backs of now-missing healthcare programs. Over the past few years, the hospital’s nursing home, in-patient pediatric services, labor and delivery services, homecare, and in-home hospice have been eliminated.

No one said anything about the dozens upon dozens of behind-closed-door executive session meetings and the secret negotiations made about a taxpayer-funded organization.

The people who cared for me—beginning with the intake nurses and emergency room doctors to the radiology technicians, floor nurses, dietary employees, the hospitalist, and others behind the scenes whose faces I didn’t personally see—made sure my needs were met, and that my initial healing was swift enough for me to be discharged so I could continue healing in the comfort of my own home.

It didn’t matter that only two of the hands-on caregivers were Estes Park residents as opposed to the many others who were what are known as “travelers” – locum tenens healthcare professionals who take a contracted position for a period of several weeks to months to fill staffing gaps and then move on to another location.

I don’t think it mattered to them that I’m a full-time resident. I was a patient, not a number, who needed assistance. And those professionals provided what was needed. I am very grateful for their care and I wish to express my sincere thanks from the bottom of my heart.

From my personal experience, the hands-on, front-line staff are professional and respectful. It is beyond sad that the hospital board and the top administration do not show that same level of professionalism and respect for each one of us who supports our community hospital through our hard-earned property tax dollars.

I’m deeply concerned about the condescending attitude that we’ve seen by the members of the board toward the community over the past two years since the voters of the Park Hospital District were asked to give the board the go-ahead to seek a merger with a nonprofit healthcare institution. That approval was given on May 2, 2023.

Since then, the board has operated with an attitude that says don’t question us; we know exactly what you need; you can’t possibly understand the nuances and intricacies of the details of the deal.

It has indeed taken a great deal of work for the board to coordinate with UCHealth toward a merger, which we all hope will provide the community with some security for maintaining a local emergency room, primary care, and clinic system.

Whether or not the community can maintain an acute care hospital remains to be seen.

In an email from an Estes Park Health spokesperson in July, the Estes Valley Voice was told there are an average of 4.1 patients hospitalized at the facility. There are 23 beds in the hospital. That is an occupancy rate of less than 18%. From an economy-of-scale perspective, it is questionable if the community can support a 24/7 in-patient hospital.

The hospital is classified as a critical access hospital. A CAH is a hospital located in a rural area at least 35 miles from the nearest hospital that provides comparable services or 15 miles if the terrain is mountainous or secondary roads.

A CAH must have fewer than 25 acute care inpatient beds, have an emergency department, and have an average length of stay for acute inpatient care patients of 96 hours or less. 

Generally, a hospital needs to have an occupancy rate of 80% of its licensed beds to cover operational costs. While CAHs receive additional financial assistance because of their status, many have found it difficult, if not impossible, to keep their doors open due to high operational costs, low insurance reimbursement rates, and an aging population.

According to the University of North Carolina at Chapel Hill’s Cecil G. Sheps Center for Health Services Research, since 2005, 111 rural hospitals have closed completely, and 84 were converted, meaning they no longer provided in-patient care but continued to provide some healthcare services such as emergency and clinic care.

The Estes Valley needs a healthcare facility that can address the healthcare needs of its resident population, 40% of whom are 60 years of age or older, and its visiting population, which can swell to more than 125,000 people with visitors on a busy summer day.

And the community deserves to know what is being negotiated in their name with a facility bought and paid for over the past 50 years with their property tax dollars in much the same way the Patient’s Bill of Rights provides individuals with information about their care.

Transparency, accountability, and respect are essential for public trust in government institutions, and so far, the board has not provided those things.

And since the announcement was made in October that a deal was on the table to affiliate with UCHealth, that has not happened. That was four months ago.

The merger deal is not expected to be finalized until sometime this summer, and from what we have been told, we won’t know about any of the details until after the fact, and even then, we may not be given the full story.

In healthcare speak, that is not “informed consent.”

The Park Hospital District electorate deserves to know what is in the Letter of Intent and what is being negotiated behind closed doors about their community hospital.

What golden parachutes, if any, have been negotiated for the current administrators?

Has the Estes Park Health Foundation been offered up as a part of the deal?

How did forcing the removal of the Foundation’s president, Kevin Mullin, and the subsequent resignation of many of the Foundation’s board members in protest factor into the negotiations with UCHealth?

The voters of the Park Hospital District have a legitimate right to ask these questions of the EPH leadership and administration.

Obfuscation, exaggeration, and platitudes, and being told that the Letter of Intent is “privileged” and that the public will never see it has done nothing to assuage concerns for what is currently occurring and what the electorate may be facing in the near future.

The Estes Park electorate would not have given their approval to the board of directors to move forward with a merger that will bring us better care on more solid financial footings if they did not believe that such a deal was in the community’s best interest.

It’s why the board of directors was elected and why trust in the individuals was granted. But that trust has been tarnished by the way the board has treated the community.

We voted for neighbors to serve on the board to represent us and keep us informed. We asked to be part of the solution. We may not always agree on how to reach an equitable arrangement for all involved, but we sure as heck didn’t expect complete secrecy.

What we have gotten for the past two years are weekly work sessions masked as executive session meetings — more than 200 in the past two years — to discuss and decide how our assets would be divvied up.

The state’s open meetings laws demand that decisions are not made in executive session meetings, but when the Park Hospital District board meets for its monthly open board meetings, the board votes to approve the agenda, approve the minutes from the past meeting, and adjourn.

The directors sit on the dais and listen to performative reports. They do not enter into any deliberations and discuss the issues facing our community’s hospital. They do not raise questions. They do not dialogue. The board meetings are a carefully orchestrated show with all members in lockstep.

And now, it appears that the board meetings are no longer going to be held in person due to some unspecified threat. And unlike the transparency of the Estes Park Town Board meetings, which are held in person and can be both watched live or tuned into later to watch a recorded session via YouTube, a community member must register with the hospital to watch a meeting live or to see it after the fact.

Why does the hospital board need to know who is watching their meetings? It seems like a case of big-brother watching you, the citizen taxpayer. That is messed up.

We know that major changes will be forthcoming. We just want to be kept informed without having to seek legal redress to find out what those changes would entail and how our tax dollars would be spent.

We also want our front-line healthcare professionals to be respected by their employers as much as they respect their patients.

We do not want them to fear being fired or humiliated because of a supervisor or administrator’s rath.

We do not want them to fear recrimination. We have heard far too many accounts about those types of things being used to dismiss them as trivial complaints of a disgruntled or unprofessional employee.

As the merger takes place, we expect changes in how the board of directors will operate. Park Hospital District will remain a not-for-profit organization. The organization’s bylaws and operating directions will need to be revised and amended. That’s to be expected.

But, the community must be involved in knowing the details of what that means without being handed the decisions as if they are doled out in pauper Oliver Twist’s gruel bowl.