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Small Hospital, Huge Impact

When Steven Kelley arrived at Ellenville Regional in 2003, the hospital was already approaching bankruptcy. Today it’s a thriving critical access facility with countless awards to its credit. Learn how this CEO turned things around using data-driven methodologies and inspiration.

Steven Kelley is passionate about Ellenville Regional Hospital (ERH) and its impact on the community. With a background in health systems management, healthcare administration and IT, he took over the struggling hospital, ready to transform it into a flourishing medical resource for the community.

Paradigm Shift

One of Kelley’s first challenges was to clarify the hospital’s purpose and to make the right services accessible to the community. As a rural facility, ERH couldn’t compete with large medical centers, so Kelley instead fundamentally changed the way it delivered health care.

“We reconfigured ourselves from an inpatient model to an outpatient model, with 75% of our revenues today coming from outpatient services,” Kelley said. “Instead of being a competitor that other hospitals need to crush, they now look at us like a customer.”

As a referral source for larger facilities, ERH now sends patients with more serious conditions to upstream hospitals and focuses its own resources on providing primary healthcare services, like emergency medicine, outpatient surgery, diagnostics, and rehab.

Quest for Quality

ERH’s website provides an impressive list of recently-earned quality awards, including being named one of the nation’s top five critical care hospitals. A closer look at some of these quality initiatives illustrates how Kelley’s data-driven approach achieved remarkable results.

ER Wait Times

Using his background in analytics, Kelley applied industrial methodologies to conduct an interval study on wait times in the ER. For each touchpoint in the patient experience, Kelley and his team time stamped, measured, and shaved off seconds or minutes. The results were impressive, with wait times cut in half even as patient volume doubled.

Opiate Addiction

The opiate epidemic is considered the largest public health issue of our time, so ERH tackled the problem from the front lines: the ER.

“Seventy five percent of heroin addicts started out on prescription opiates,” he stated. “We decided to contribute to the solution instead of being part of the problem.”

Ellenville reduced opiate administration in its ER by 85% by engaging patients in primary care relationships, exercise and nutrition programs, and holistic care. The hugely successful program is well-received at conferences around the country and is being adapted for other hospitals.

Rehab Recovery

When Kelley began studying Ellenville’s rehab services, the program had a 79% return-to-home rate, meaning 21% of rehab patients moved into long-term care facilities. While an acceptable outcome by industry standards, Kelley knew they could do better. He directed his rehab staff to develop a measurement system for improving the functional outcomes of patients. After a year of implementing the new protocols, the return-to-home rate rose to 90%, and at least 11 other hospitals have implemented the program, including the University of Minnesota.

He stated, “Here’s a nationwide model for a project that improves outcomes and helps people with one of the most basic things a person could want—avoiding a nursing home—and it started here in Ellenville.”

Big Plans

Today Kelley is planning to build a replacement hospital to better house these exciting changes. Slightly bigger than its current facility, the new structure will have a layout more appropriate and efficient for an outpatient-based program. As he looks to the future, Kelley says Sterling National Bank will play a big role.

“We need a bank that will help us leverage all the opportunities that are available. Sterling is an innovative bank with qualities that are balanced in technology and leading-edge services. We consider them our partner for the future.”

Work Well: Boosting Your Corporate Wellness Program

More than half of employers that offer wellness programs report a marked decrease in absenteeism, a 66% improvement in productivity, and a 67% increase in employee satisfaction. Corporate wellness initiatives vary, but there are three components all programs should have:

> Feedback. Let your employees weigh in on the components of your wellness program.

> Participation. Employee enthusiasm for your program will improve if they see leadership participating, as well.

> Motivation. Structure your wellness program with periodic incentives and prizes for participants.

Healthcare Finance

At Sterling, our dedicated healthcare finance experts bring decades of experience navigating the ever-shifting healthcare marketplace.

We work with hospices, pharmacies, physician practices, outpatient and rehabilitation centers, healthcare product manufacturers, and more, providing high-level strategic thinking and thoughtful advice on the best solutions to help health businesses thrive.

In addition to our full range of banking solutions, our healthcare funding solutions include:

> Underwriting capacity in excess of $100MM, provided through Sterling’s Syndication Team

> Hold sizes up to $40MM

> Three- to five-year maturities

> Floating rates tied to LIBOR and fixed rates for some financing products

> ABL advance rates of up to 90% against eligible receivables and up to 60% against eligible inventory

> Cash flow senior secured debt leverage up to 3.75x and can arrange for junior/subordinated debt leverage up to 6.00x

> First mortgages for behavioral health, skilled nursing, and senior housing transactions

This is not a commitment to lend, all loans are subject to specific borrower qualifications as well as underwriting.

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