The Estes Valley Voice sent six questions to the candidates standing for election for seats on the Park Hospital District Board of Directors. The questions and the answers provided by the candidates are published below.
Voting for the Park Hospital District will take place on election day, May 6. Electors will receive a ballot in the mail. It can be returned to the ballot drop box located inside the entrance at Estes Park Health, 555 Prospect Ave.
Two of the five Board positions are open. The candidates are Tim Cashman, Tom Leigh, Max Salfinager, Ralph Strickland, and Janet Zeschin. The candidates participated in a forum hosted by the Estes Park Rotary on April 3, and a forum hosted by the League of Women Voters of Estes Park on April 7.
Other than for some Associated Press style conventions, some formatting edits, and a few spelling catches, each candidate’s answers are published as submitted.
How long have you lived in Estes Park?
TIM CASHMAN: Lois and I moved to Estes Park in the spring of 2017, as I accepted the offer from Estes Park Health to serve as Chief Financial Officer.
TOM LEIGH: My wife Anna and I moved to Estes Park on June 8, 2015, so nearly 10 years.
MAX SALFINGER: Four years. I fell in love with Estes Park and the Rocky Mountain National Park when I was on sabbatical in the mid-eighties at National Jewish Health and at UCHealth in Denver, and my wife lived in Boulder as a child with Estes Park as the family weekend escape. More recently, I worked at National Jewish Health from 2012 to 2018, and my wife and I spent many weekends and vacations in Estes Park. In 2021, we retired and purchased a condo in April of the same year. We are year-round residents in Estes Park, are active in the community, and enjoy the beautiful surroundings.
RALPH STRICKLAND: I am about to begin my third full year of living in the Estes Valley, right outside the municipal limits of Estes Park. Prior to securing a transfer, I was visiting family up here for the past five years.
JANET ZESCHIN: My husband Larry and I have lived in Estes Park since 2011. Larry is a native of Colorado, and I moved to Colorado in 1980 when I separated from the US Air Force Nurse Corps as a Captain. We have two adult children, who, with their families, also live in Estes Park.
As a Board member, what would you expect your role to be?
TIM CASHMAN: I am expecting this role, as a Board Member, to be somewhat fluid. I am currently hearing that the plan is to move the official Board responsibility to a newly established Board of 7 appointed members from both EPH and UCHealth. This move would change the current Park Hospital District Board of Trustees to a sole function of approving the annual Mill Levy. That said, I would like to be one of the “appointees” to the new Operating Board. I believe this is not finalized; therefore, it would be presumptive to identify my projected role. Accordingly, it is my view that Trustees govern the organization, acting as one, with the specific role of overseeing the Chief Executive Officer. Most importantly, the Board should advocate function for the community. This should include communication and using available tools to understand community healthcare needs.
TOM LEIGH: Generally, as a PHD Board member, my role will be to oversee the CEO and overall hospital performance at Estes Park Health. All Board members are responsible for helping the hospital adhere to its mission, vision, and values in addition to providing financial oversight, strategic planning, policy development, and community engagement.
As elected members to the hospital Board, everyone needs to stay in contact with the community. We need to provide an informational conduit for constituents to and from the hospital administration. As a physician, I believe I can have a special role in strengthening cooperation with the medical staff leadership, providing clinical insight to the other four Board members, and helping oversee patient safety and quality of care. A critical duty of any healthcare organization is providing continuing education for hospital staff, the physician leadership, hospital administrators, and Board members, and I will advocate for that.
MAX SALFINGER: On May 2, 2023, a vast majority of the participating voters (80.3%) delegated authority to the Park Hospital District Board to enter an agreement with a larger entity with the goal that Estes Park has an excellent hospital for the residents and visitors for years to come. A recent press release from Estes Park Health and its elected Board of directors stated that the elected Board’s responsibilities may change after an affiliation agreement with UCHealth is signed. It stated that Estes Park Health would create its own nonprofit hospital Board of directors made up of community members, Board members nominated by the Park Hospital District Board, and UCHealth leaders. The new Board will help oversee the hospital’s operations, provider credentialing, quality, safety, and overall performance. The elected Park Hospital District Board members would oversee the special taxing district (which generates tax revenues to support local health care operations and improvements), with oversight of the hospital transferred to the new Board.
After the affiliation document has been signed, the Park Hospital District Board will enter unchartered territories. It is important that this Board continues to have members with experience in healthcare systems, an open mind, and a commitment to create a meaningful working relationship with hospital leadership and the new hospital Board. The appointed community members of the new Board and the elected Park Hospital District Board members should form a coalition and will need to seek consensus to benefit the Estes Valley community. I am very committed to this novel and exciting task.
RALPH STRICKLAND: As I understand the current role of the Board member, it is to contribute and collaborate with hospital leadership as it relates to finding a way forward for the future of Estes Park Health. To do so, I believe that fostering clear communication regarding the hospital’s intent to proceed towards a partnership with UCHealth, to Estes Valley residents and business owners will be a large part of my responsibilities to my family, friends, and neighbors who depend on the services offered.
JANET ZESCHIN: Running for the Board was a decision made after feeling personally and professionally compelled to do so. I am a service-oriented individual, and with my healthcare knowledge and experience, I feel I can be a voice for the community, EPH staff, and the facility in the Board’s oversight of operations, finances, quality initiatives, and the potential partnership with UCHealth. The EPH Board, its functions, and its processes/procedures are familiar to me from my previous employment at EPH as the Director of Quality and Risk Management, as well as my experience at other hospitals, both critical access and large metropolitan. I know that if the possible partnership with UCH goes through, the role of this Board will be more focused and limited. My role on the Board will be to bring my knowledge and experience to supplement the perspectives represented by other Board members in discussions and decision-making that are in the best interest of the facility and community, as well as fair and beneficial to all involved. I hope my knowledge and experience will qualify me to serve on the joint EPH/UCHealth Board.
What skills, expertise, and perspectives would you bring to the Board?
TIM CASHMAN: My career included 35 years in Hospitals, principally as Chief Financial Officer, in 3 communities in Colorado. This includes 4 years as CFO at Estes Park Hospital. I am very familiar with the operations, especially the finances. We have had many successes in my tenure, including conversion of the computer systems, development of our local Urgent Care, upgrades in equipment, and profitability, etc. I am currently retired after a successful series of rural hospital Interim CFO projects. I understand the language, the workload, and the challenges of these important community assets.
TOM LEIGH: What I think I uniquely bring to the Board are the skills of an emergency physician, the ability to quickly acquire important information, assess the situation, diagnose the problems, and suggest reasonable solutions to the issues at hand. I have worked in over 25 hospital emergency departments over the course of my education, training, primary jobs and a variety of moonlighting; from CU to the University of Michigan, to Denver General Hospital, Providence Alaska Medical Center, Alaska Regional Hospital and critical access hospitals in Seward, Wrangell and Cordova, Alaska. I have seen firsthand how important critical access hospitals are to the communities they serve. I have been a Board member for 12 years at a community mental health center in Wasilla, AK, and served as Chief of Staff for two terms at Valley Hospital (now Mat-Su Regional Hospital in Palmer, Alaska. As a voting Board member, I was involved in the formation of a merger between our hospitals. The last nine years of my career were here at Estes Park Health, and I know our hospital very well.
MAX SALFINGER: My career has been built on working as a team player, improving public health systems, ensuring accurate and timely diagnostics, and leading teams toward innovation. Now, I want to apply that experience to ensure Estes Park Health remains a trusted, high-quality resource for our community.
My experience serving on the Estes Park Health Foundation Board since December 2023 has enabled me to develop relationships with management and hospital staff as well as gain an understanding of the Estes Park Health needs and operations.
Before coming to the United States, I was a state legislator in Switzerland and the chair of the legislative personnel committee. When I was appointed as the state public health laboratory director in Florida, the leadership of the state health department asked me to join a working group charged with re-organizing the Florida Department of Health. Also, they asked me to serve in the role of an interim tuberculosis controller for almost 2 years.
RALPH STRICKLAND: Throughout the past (nearly) 40 years of employment, I have developed my communication skills to work effectively with a wide variety of audiences – from health insurance policyholders to corporate senior executives… from mental health patients to state legislators… from veteran patients to Veteran Service Officers. Although I do not have the recognized expertise that medical licensure affords some, my expertise was developed through process improvement, where I would identify a problem (i.e., a lack of transparency or ensuring confidentiality) and develop ways that all stakeholders within a particular process could live with the solution brokered. And, I believe I bring a unique perspective, when compared to most of the points-of-view of others seeking one of the two vacant Board seats, in that my present and past experiences working in public health, the corporate sector, for public agencies, and closely collaborating with non-profit organizations and building rapport with private citizen stakeholders make me a well-rounded candidate for a seat at PHD’s Board, as I am not beholden to nor have a singular worldview gained through a specific industry or interest group.
JANET ZESCHIN: I retired in 2020 after a 46-year professional nursing career. My education includes an RN diploma from a hospital-based nursing program and an undergraduate degree in sociology, as well as a master’s degree in health services administration from Regis University. My career included almost 20 years in critical care nursing and then a transition into healthcare quality. The remaining years were spent in hospital and medical staff quality, patient safety, patient experience, risk management, utilization review, and infection prevention, as well as federal and state accreditation and regulatory compliance. This work included a leadership role working with hospital administration, medical staff, and hospital staff at all levels and in most departments, as well as the Colorado Hospital Association, Colorado Rural Health Center, and regulatory and quality improvement organizations. I worked as Estes Park Health’s Director of Quality and Patient Safety from 2011-2016 and then again from 2019-2020 until my retirement. The intervening years were spent in a national consulting role. During my tenure, I regularly attended and provided reports to the Park Hospital District Board of Trustees. I have served on Rotary Club Governing Boards for 10+ years and have been on the Estes Valley Library Friends of the Foundation Board since 2024. On other Boards that I serve, I am effective by being able to comprehensively summarize discussions, keep conversations on track, engage nonparticipants, and focus on collaborative dialogues.
What are the most important challenges and opportunities facing the organization?
TIM CASHMAN: Regarding the current challenges, I think we need an experienced voice at the table. I believe we need a deep understanding of the hospital’s operations and fiscal responsibility. This includes the willingness to collaborate and advocate for our community.
It is true that the industry is greatly challenged in many areas, including staffing, recruitment, billing and reimbursement, equipment complexity, Medicare/Medicaid, changing regulations, etc. It is a very difficult industry.
TOM LEIGH: From my perspective, the biggest challenge at EPH is the loss of services and the shrinking market share that are causing our friends and neighbors to seek care elsewhere. The hospital has lost money for the last four to five years, and that is not sustainable. The biggest opportunity we have right now is a possible affiliation with UCHealth, but the devil is in the details, and we have no details. I think it is possible that this hospital could operate independently and profitably for the time being if we can increase our market share and maximize the services we currently offer, such as primary care, general surgery, orthopedic surgery, diagnostic imaging, physical therapy, and infusion therapy.
We also have to attract and retain permanent primary care physicians, hospital nurses, and ancillary personnel. The expense of travelers and the need for continuous retraining of new hires are two of the main financial drags on this hospital. Our dependence on traveling nurses eliminates the institutional memory necessary for a smoothly functioning hospital.
Also of concern is the toxic, threatening work environment at the hospital and the pervasive, persistent low morale of essentially everyone who works there. There is a feeling by many that there is always a target on their backs. This is no way to treat dedicated, highly trained, intelligent, hardworking staff, and it makes recruiting permanent full-time employees difficult.
MAX SALFINGER: Successful Affiliation with UC Health – Completing the affiliation with UCHealth is the number one priority. This will provide sustainable long-term healthcare for the Estes Valley for the foreseeable future.
Representing Community Interests – According to a recent press release from Estes Park Health, the Park Health District Board will have different responsibilities after affiliation with UCHealth. I will make sure that the healthcare needs of the Estes Valley community are heard and considered by the new UCHealth Board.
Strengthening Financial Stability – A financially strong hospital is essential for maintaining high-quality care. I will work with UC Health to advocate for sustainable financial strategies that prioritize patient care, staff retention, and smart resource allocation.
Community Health Needs Assessment – Inspired by the Rocky Mountain National Park, the Estes Park Valley community is unique in various aspects – an older community and many of us are living here because of the hospital; a seasonal economy; a needed workforce which has difficulty finding housing.
What is missing is a holistic approach for the well-being and health of our entire community – a community health needs assessment is a must which should not only include the hospital but also the health needs for less fortunate ones, mental health, dental screening in the school, pharmacy services, and home and hospice care.
Employee Satisfaction Survey – Staff turnover in any organization is very costly, especially in healthcare. As part of quality management, top healthcare organizations periodically perform employee satisfaction surveys among all staff. Employee satisfaction surveys are anonymous, and staff can be frank with their answers without fearing retribution from supervisors or managers.
Employee retention is an essential element in healthcare for many reasons, including employee satisfaction, motivation, and financial outcomes. The use of employee surveys and acting on the feedback that is received works towards employee retention. Engaging employees fosters a culture of mutual respect, open communication, and employee buy-in to their workplace.
RALPH STRICKLAND: I think it’s clear – to not only the slate of candidates vying for the two Board seats, but also to the full-time residents and business owners living, working, and receiving healthcare in the Estes Valley – that the most important challenges and opportunities facing Estes Park are tied to what would become of our cornerstone hospital.
It’s been my personal (e.g., as a patient) experience that such ‘joining’ always results in some things ‘lost’ and other things ‘gained.’ Do we need more services? Yes, but at what frequencies such specialists can be retained is going to require proper assessments and more than surveys tossed at us.
The challenges are going to be in what we may lose. Will we lose seasoned staff who may be backfilled with UCHealth clinicians? And the opportunities will be defined through what we gain. Will the proposed partnership require tax increases to/for the Estes Valley citizen-stakeholders? That will largely depend on what we could expect to get for the taxes we currently provide, but, with no accounting of where our tax dollars go, it’s been difficult (thus far).
JANET ZESCHIN: The challenges and opportunities facing the Park Hospital District include financial stewardship, the possible partnership with UCHealth, and its relationships with the Estes Park Health medical staff, hospital staff, and the community. The current Board should continue its difficult and challenging path to keep finances on the upward trajectory. Through painful decisions, EPH is now in a favorable financial position to tenuously sustain on its own, or partner with a larger organization. The community has historically insisted on an independent community facility, which is not tenable in today’s healthcare environment. The partnership with UCHealth has the potential to provide EPH with resources (staff and leadership training, purchasing economies of scale, potential new service lines, etc.), and “lessons learned” from their small, rural facilities.
How should a Board balance transparency with confidentiality?
TIM CASHMAN: Balancing transparency and confidentiality are very difficult. This requires an understanding of federal and state laws, HIPAA, and compliance rules. During my career, I also had the responsibility of developing and managing the initial compliance policies and programs for two facilities.
Transparency at the Board level requires consideration and likely good counsel from our legal team. That said, I do believe that in order to establish Trust with the community, Transparency is required. There should be careful consideration of existing laws, rules, and policies.
TOM LEIGH: With regard to the transparency vs confidentiality question, the hospital Board is elected, and that implies, even demands, that we try to err on the side of transparency for our constituents, of course, within the boundaries of the law. Along with that goes a need for Board members to be available and accessible to the people in this district.
MAX SALFINGER: Follow the Colorado Open Records Act (CORA). If a situation is new or ambiguous, seek counsel interpretation. If it is still not clear, opt for open records or open meetings. New Board directors should be onboarded, and this topic should be addressed.
RALPH STRICKLAND: Balancing transparency with confidentiality is the proverbial elephant in the room. There’s widespread dissatisfaction with transparency with our families, friends, and neighbors in the Estes Valley. Does anyone outside of the C-suite executives know what’s going on (and even more so…)? Can the situation be fully explained so that the ‘taxed masses’ can throw their support behind it or oppose it with ‘eyes wide open’? The rule of thumb for every Board, non-profit, and ministry I’ve been involved with was simply this: unless it pertained to an employee’s contract or a disciplinary process, everything is an official record and should be placed well within the stakeholders’ line-of-sight. To balance both will require a resolve to reaffirm what is (and what is not) confident.
JANET ZESCHIN: Lastly, relationships require repair. Monthly Board meetings are open to all, and town hall meetings with specific groups can be organized to address concerns. Issues identified should be directly addressed. I am aware of the number of executive sessions that have been held by the Board in 2024. The sitting Board certainly felt the discussions should be confidential. In my limited merger experience, the foundation for a merger is confidential between the two business partners until the negations are complete. I do not know what was discussed in those meetings, but I believe transparency is a best practice. while acknowledging that some issues are confidential. Whether these concerns are protected by healthcare privacy statutes or business contractual clauses, shared information and assurances should be provided when and as soon as possible with an understanding that decisions are made in good faith, fairly, and for the benefit of all involved.
Do you have any other statement you would like to make to Estes Valley Voters?
TIM CASHMAN: Estes Park Health is a very important asset to our community and a major economic engine. It is one of the top three employers and generates millions of dollars for our economy. Year-round services are required for all ages. It is important to understand the demographics and be a partner in growth.
TOM LEIGH: And finally, for now, given the confines of this format, I know how important this hospital is to this community, especially when our average age is right around 60 years old. This hospital is also critically important to all of our visitors. The continued diminution of our capabilities at EPH is unacceptable and must be reversed. I promise that I will work as hard as I can to do that. I promise to be serious, available, honest, straightforward, and transparent. My phone number is (907) 232-3976, and my email is akleigh@mtaonline.net. I welcome your input and questions.
MAX SALFINGER: I worked most of my entire professional career on tuberculosis control, first in Switzerland and from 1992 in the United States (I became a naturalized citizen) and globally. Lifetime Achievement Award for outstanding contributions to TB care and prevention, International Union Against Tuberculosis and Lung Disease – North American Region, Vancouver (2023). Honorary Professor, Kazakh National Medical University, Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan (2003). Hiking and wildlife photography in my spare time.
RALPH STRICKLAND: Simply put, I chose to run for the Park Hospital District (PHD) Board out of a desire to continue to serve my community. I think there is value in what I can contribute – and it helps that I am a bit of a non-conformist, a free thinker, and a simple man at heart. I know finding consensus can be challenging in times of change – like with this possible UCHealth partnership – but I can foster some genuine (and when necessary ‘blunt’) communication, as well as engage with my fellow Estes Valley stakeholders to broker some much-needed transparency, if extended the gift of your vote to be selected.
JANET ZESCHIN: I am committed to contributing to the sustainability and growth of Estes Park Health, ensuring it remains a vital part of our community. My extensive experience in healthcare quality, patient safety, and regulatory compliance, combined with my service-oriented approach, uniquely positions me to be an effective advocate and leader. I am dedicated to working collaboratively with the Board, Medical Staff, EPH staff, and the entire Estes Park community to address current challenges and seize opportunities for improvement. Together, we can ensure that Estes Park Health continues to provide exceptional care and service for years to come.
I believe that it is imperative that all of the candidates answer 3 questions before the election: 1) Where do they stand on affiliation and 2/3) Do they suport finding a new CEO and CNO?
Pulling no punches: What we have seen Donald Trump do the last 3 days happens every week with Vern. It is WILD how similar the two are. Vern has absolutley idiotic ideas that reuslt in the hospital losing money every single time he decides to actually show up to work and attempt to do something other than get a free meal. We point htis out to him nicely, and he loses his damn mind and digs the whole deeper. No one can talk him down from his horrific decision because his feelings are hurt. America is the laughing stock of the world right now because of Trump. EPH is the laughingstock of CO healthcare because of Vern.
What about Pat, you ask?… Stephen Miller
I want to reiterate my message so that it comes across without distortion or mixed messaging. No hyperbole, Vern is the least useful coworker I have ever worked with. It is a travesty that that man is in charge of anything in any professional field.