New EARH CEO brings 'critical' experience

Ritzville’s East Adams Rural Healthcare has been under new leadership for the past several weeks, as it welcomed a new CEO who has almost two decades of experience in a variety of different types and sizes of hospitals, including critical access hospitals like EARH.

Corey Fedie was hired by the Adams County Public Hospital District No. 2 Board of Commissioners in April and started at the hospital in mid-June.

Most recently, Fedie was the Chief Operating Officer and interim CEO at the Kit Carson County Memorial Hospital in Burlington, Colorado from 2016-19. That hospital, like EARH, is a critical access hospital. He’s also been a director of facilities at hospitals in Wisconsin, Minnesota and Texas since graduating from the University of Wisconsin—Stout in 2000 with a Bachelor of Science degree in Facilities/Engineering/Management.

Fedie said he’s grown in both large and small organizations over the last two decades. “I’m proud to say I started as a working-class guy in healthcare, a working supervisor and I was promoted multiple times.”

After receiving a Master of Business Administration in Business Administration and Management from the University of Wisconsin—Eau Claire in 2015, Fedie was hired the following year at Kit Carson County Memorial Hospital. Fedie was initially hired just as the hospital’s COO, but soon into his tenure was named interim CEO, a title he held until that board finally recruited a new CEO some three years later.

With no longer being responsible for the duties tasked to the CEO, Fedie said he realized he missed all of what he was doing in that role.

Like Ritzville, Burlington is the seat of a small, rural county. He also described Burlington—which is close to the Colorado-Kansas border—as a wheat community similar to Ritzville.

“Critical access hospitals are what I love, and my family and I are rural folks with horses and cows and chickens,” said Fedie. “We love the community ... the dry climate, you still get four seasons, it’s wonderful.”

As Fedie steps into his new position at EARH, he understands the challenges facing the hospital, as well as the rural health industry as a whole. He says the industry can get a bad rap from larger hospitals that make more money, but noted that critical access hospitals such as EARH have to deal with slim margins. Across the country, he said, critical access hospitals usually have a margin between 1.5 and 3%, while large systems are sometimes making anywhere from 7 to 12% margins.

One of the hurdles facing the rural health industry is Medicare and Medicaid reimbursements that continue to get less and less. “The reality really is that what’s ‘actual cost’ that politicians keep talking about vs. the ‘true cost’ are different numbers. So we really are struggling just to make ends meet,” Fedie said.

For Fedie, the struggle is part of what he really enjoys about his job.

“When I worked for a large, 450-bed hospital, it was all about making sure we hit our benchmarks but more importantly that we were making a lot of money,” said Fedie. “At rural hospitals, it’s about making sure the doors are open for the public. And that’s more important for me. I want to take care of my community because it’s our friends, our neighbors, my family that are here.”

Fedie added though that hospitals do need to make money, whether nonprofit or not, to invest and survive in the healthcare industry. He said that he’s not concerned with the financial liability of the hospital, but noted that “the public certainly knows that we have billing challenges.”

Any time a hospital loses a provider—such as doctors, mid-level practitioners, physician assistants and nurse practitioners—or sees a reduction in hours worked by a provider like EARH has experienced recently, a hospital loses that chunk of revenue. Providers, Fedie said, are the starting point. “You see the doctor and that’s how we generate our revenue.”

“So [EARH] got really down there, right? So we’re rebuilding the business and it’s probably 6-12 months to get a good swing,” said Fedie. He noted that PA-C Juiletta Shapiro—who joined EARH earlier this year—has been quickly growing her clientele base, while Dr. Anthony Anderson is so new that he’s still undergoing the credentialing phase and needs more time going through the long process.

The credentialing process is one of the things that Fedie would like to work on to make it faster. “We’ve got to get good at making sure we do everything right so that we shorten that timeline up. So it’s going to affect how [the providers] ramp up their business and how many patients they can see and the types of patients they can see. But we’re on a good path right now,” Fedie said.

EARH, he said, is looking at new service opportunities and what they can provide for the community. One of his first goals is to reach out and receive feedback from the community and determine how EARH can partner with other hospitals in the Grand Columbia Health Alliance and the big hospital systems in the region to be a vibrant community hospital.

In his first few weeks on the job, Fedie’s gotten to know and connect with the hospital staff, as well as receive feedback from them on what opportunities EARH should pursue. “I’ve been meeting with a lot of folks from the public just to get a feel for things. I need to understand a whole environment before we can move forward,” Fedie said.

Along with reimbursements, another issue facing the rural health industry is recruiting providers to the rural market. In rural critical access hospitals, providers often aren’t able to specialize in just one area.

“Some folks love the rural market because they get to do a lot of things,” said Fedie. “A lot of people don’t. So it’s challenging enough when you have a shortage of a certain field, like nurses and official RN’s that maybe don’t want to do ER, or they just like med-surg or they just like ER.”

It’s also important for hospitals to stay in tune with public policy and where the healthcare industry is going. EARH can impact that, he said, by staying in touch with the community and making sure the hospital is providing all of the things they possibly can. “It’s hard to be all things when you’re small, so we have to carve out the ones that are most important to the community and try and do those really well.”

Fedie is married and has seven kids. He said he had a great family life growing up with two older sisters, and that his parents still live in Wisconsin, where Fedie was born and raised. He said his upbringing helped him understand what it’s like to work hard, and although he grew up in town, he has a farming background. A lot of his relatives run farms, and he’d spend summers laboring on them. “It helped me understand what blood, sweat and tears really is about.”

Fedie described he and his family as classic outdoors folks, and said they have already gotten to experience some of what the region and Washington state has to offer in regards to canoeing and fishing. They also enjoy camping and hunting when they get the opportunity.

“We’ve got a challenge, so let’s fix it … this hospital is my hospital. It’s not just because I work here, it’s because I’ve got eight other members of my family that need care here,” said Fedie. “So I’m going to make this hospital the best it can be for my family, which means it should be awesome for your family.”