1. Can we expect to get written responses to prior comments/questions submitted? I emailed you about this already and did not get a response from you.

Answer: Because so many questions are duplicative, we generally will respond to thematic questions.

2. Can the board please explain how the online price estimation tool works? I have used it to attempt to calculate services in the past and it never even comes close to what the hospital charges patients.

Answer: This is a complex tool that RMCHCS did not create; CMS designed it. If you have a sample service you would like to calculate, please let us know, and we will assist you. Otherwise, if you intend to price compare against multiple institutions, we suggest you contact CMS for an expert who works regularly with the tool.

3. Can the board please explain why the cost of services are more expensive at this hospital, compared to other hospitals around the state that have higher ratings and perceived higher quality of care? Given the median income of this community, the cost of services at RMCH are completely egregious.

Answer: We appreciate your opinion. We strive to maintain market-sensitive pricing. We are in the midst of updating our charge master. Moreover, pricing is often a function of realistic reimbursement rates from insurance companies and government programs, and regrettably, the system is not always sensitive to local economic factors.

4. Can the board please speak to the recent public announcement that only one support person is allowed in labor and delivery? Doulas should be seen as part of the professional care team, not a support person. I would like to see the guidance updated to include that language. Now that the state mask mandate has been updated, I recommend RMCH immediately update their visitation policy.

Answer: This is a personnel matter, and we never discuss it publicly, especially when litigation is involved.

5. Would like a detailed answer: Why was Dr. Lauber not allowed to enter the hospital for the last board meeting, a public meeting and he was escorted out of the building. Why did this happen?

Answer: This is a personnel matter and we never discuss such publically, especially when a litigation is involved.

6.  Patients and community members are frustrated, dismayed, concerned, and scared by RMCHCS leadership’s response to the issues at College Clinic and other serious patient safety issues and healthcare inequities. CHAG is submitting the following suggestions to the Board of Trustees to help strengthen communication and rebuild trust between RMCHCS and the community it serves.

• RMCHCS has an obligation to alert patients and community members to hospital system breakdowns.
• Infrastructure improvements must include plans to avoid or mitigate disruptions to hospital services. It is unacceptable for a planned phone system upgrade to result in two months or more of non-functioning phones at a family medicine and pediatric clinic.
• Communication about either planned infrastructure improvements or unplanned infrastructure issues needs to include more than a minimal explanation and a concrete timeline for resolution.
• More importantly, temporary workarounds and/or stopgap measures need to be implemented immediately when unforeseen issues arise, and those solutions need to be shared immediately with patients and community members.
• Temporary workarounds or stopgap measures need to include a way for patients with urgent issues or for whom those measures fail to escalate their issues.
• Communication requires consideration of accessibility for vulnerable patients, including those who live far away, who do not speak English as a first language, and who are elderly or who do not have reliable internet service.

CHAG would be happy to facilitate a small focus group of patients to troubleshoot communication and work with RMCHCS administration to find patient-centered solutions to issues.

Moreover, we believe that RMCHCS could remedy its relationship with the community and position itself for success by implementing formal mechanisms for community accountability and input. So far, CHAG has routinely invited hospital leadership to engage with the community with openness, honesty, and transparency through hosting town halls, submitting comments and questions to the Board in advance of Board meetings, and emailing administrators and Board members. Yet the administration and Board have not responded in kind.

CHAG would be happy to support the Board in improving public relations by:

• Making regular public reports about issues of relevance to the community, as Mr. McKernan proposed in The New Mexico Source in October.
• Answering questions submitted to the Board at Board meetings.
• Reorganizing the Board of Trustees to represent local interests and reflect the diversity of our community with a transparent process for Trustee selection that includes meaningful opportunities for community input, including a presentation of candidates with an opportunity for questions and input by the public.
• Forming a Community or Patient Advisory Board, which can bring community concerns directly to hospital leadership, can provide patient perspectives and inform solutions, and can provide the community accountability necessary for the equitable provision of health care.
• Enabling access to members of the Board of Trustees, whose contact information should be made publicly available, would allow for open dialogue with the community.

We hope you will take CHAG up on its offer to facilitate dialogue, which will benefit the hospital and the entire community.

Respectfully,

CHAG Core Committee

Answer: While we are not familiar with who the Community Health Action Group is in terms of a local authority, we appreciate some of the ideas proposed in the commentary.

7. Concerned of the retention of physicians and nurses for RMCHCS.

Answer: The turnover rate at RMCHCS is comparable to that of general hospitals during the pandemic.

8. Personal Experience:

•  Community member complaints:
• They have had 3-4 different primary care doctors since she left. (high turnover)
• Some have not seen a provider at all since she left.

Previous board meeting questions that have not been answered: 

9. Did we find out why nurses have left?

Answer: We offer exit interviews for all existing employees.

10. What is the progress for the 2022 Implementation Plan for RMCHCS?

Answer: If you are referring to the Community Health Needs Assessment, we are in the process of updating a new one given various complex issues such as the pandemic and staff shortages.

11. What is the progress for the 2022 Implementation Plan for RMCHCS?

Answer: If you are referring to the Community Health Needs Assessment, we are in the process of updating a new one given various complex issues such as the pandemic and staff shortages. Current and former employees have experienced retaliation (based on her community survey).

• Current and former employees have experience retaliation (based on her community survey).

12. “The community built this hospital. We own this hospital. We’ve subsidized the operations of this hospital to the tune of tens of millions of dollars. CHC was hired to manage the hospital and rebuild trust between the community and the hospital. Yet it has done the exact opposite. The hospital is being mismanaged, wrecked, and made into a target for a cheap takeover. The phones at College Clinic didn’t work for at least two months, and that’s just the tip of the iceberg. CHG operates the hospital without a working code button on the Med Surge Peds floor. Doctors have been harassed out of their jobs, and entire departments and units have been gutted. The hospital had a positive cash flow of $4.5M in 2020. CHG announced a $9M loss just a month or two ago. That’s a change in financial condition in the scope of just one year of $14M. The hospital is falling apart in front of your eyes and around your ears. The Board owes the community not just an explanation but an immediate halt of the wreckage and reversal of this catastrophe.”


Answer: We value your opinions, but the facts do not support your assertions. But thank you for your views.