David Jahn Gives an Update on Eastern UP Healthcare

David Haynes sits down for another conversation with David Jahn, President and CEO of Chippewa County War Memorial Hospital. Jahn has been with War Memorial for 15 years, and prior to that he was CEO and CFO at Schoolcraft Memorial Hospital in Manistique (his hometown) for 22 years.

David has his undergraduate degree in Business Administration from Michigan Technological University and an MBA from Lake Superior State University. He is currently a member of the Michigan Health and Hospital Association Board of Directors and the Vice-Chairman of the Michigan Center for Rural Health Board of Directors.

In this episode we learn about David’s new affiliation with My Michigan Health, what the agreement will mean for healthcare in the Eastern UP, and also the details on the healthcare challenges the Eastern UP is facing right now and the efforts that are taking place to address those challenges.

Transcript

David Haynes:

Good day, everybody. Welcome to Rural Insights Podcast series. And today we’re, again, pleased, he’s been with us before is David Jahn. Who is the President and CEO of War Memorial Hospital over in the Eastern UP in Sioux Saint Marie and serves a good chunk of the Upper Peninsula. And we’re going to get some updates from him on a number of what’s going on. Welcome, David. Good to see you again.

David Jahn:

Thanks, David. Good to see you as well.

David Haynes:

So, tell us about, you have a new affiliation. What’s that all about?

David Jahn:

Yes. We just signed a definitive agreement with their new name now is called My Michigan Health. It was Mid-Michigan, but since our signing the agreement, they’re no longer mid. They’re all over Michigan. So, they just changed their name to MyMichigan Health. And we’ve been at this process of looking for a potential partner for probably 10 plus years, but we’ve been able to survive as an independent hospital for a long time.

And back in 2018, 2019, we had some struggles financially. And at that point we thought maybe this is a time to look for a partner. And we sent out RFP’s to six different hospital systems and over the course of time, widdled it down to a couple and then chose MyMichigan. And that should be a beneficial thing for the Eastern UP for sure. I know MyMichigan is now also a partner with Mackinaw Straits Hospital in St. Ignace. And I’m pretty sure they’re looking to partner with Helen Newberry Joy Hospital in Newberry with their electronic health record. And it’d be nice to have all three hospitals in the Eastern UP working together to provide as much care as possible in the Eastern UP.

David Haynes:

So MyMichigan is M-Y Michigan or M-I Michigan?

David Jahn:

M-Y Michigan, all one word.

David Haynes:

MyMichigan.

David Jahn:

Yep.

David Haynes:

Okay. And so, tell us, so patients that come to you, the advantage to being part of this, you’re part of the University of Michigan Health System, right?

David Jahn:

Correct.

David Haynes:

What it give you?

David Jahn:

Well, from a patient perspective, patients won’t see a huge difference. We hear right now, well I don’t want to go to Midland when I could go someplace closer. Well, as you know with the [inaudible 00:03:04] laws and other things, we have to send any emergency to the closest, most appropriate facility. And we’re not going to change geography. So, McLaren Northern Michigan in Petoskey is still going to be the closest, most appropriate. So, patients will go there a lot of the time. But, in our ER, there are times where McLaren Northern Michigan can’t provide the service that’s needed and needs a higher level of care. And a lot of times we’ll try to transfer to University of Michigan Health System and they won’t have any beds. But, because MyMichigan is part of University of Michigan Health System, we’ll have the bat phone or whatever, the hotline, and we’re told we’ll have much easier access to get an open bed at the University of Michigan Health System for those patients that can’t be treated locally or in Petoskey, Traverse City or Marquette.

David Haynes:

Would there be University of Michigan Health System physicians coming up occasionally to War Memorial.

David Jahn:

There may be. More than anything, we may have access via telemedicine to some of their specialists. And there’s a conditions of use agreement where we’re allowed to use the block M on our signage and things, but we have to meet the same quality standards as University of Michigan Health Systems. So, we think we provide high quality care here. And lot of times when you’re in a small community, the grass seems to always be greener on the other side. And people don’t think that you do a good job in the small local community. And so, just to have that behind us. To say, we’re meeting the same standards as Michigan Medicine, that’s going to be beneficial to us.

David Haynes:

So, let me switch over to some of the rural issues. We’re hearing all across the country, talk about staff shortages and healthcare professions and clinics, hospitals all across the board. And I know you’ve served on national boards dealing with rural healthcare and are a national expert. Can you talk a little bit of about it globally, but also what’s happening in places like the upper peninsula with the labor shortage or the shortage of trained professionals?

David Jahn:

Sure. And it’s not just the shortage of trained professionals. It’s throughout probably most organizations. Just trying to find enough people to work, but we’re struggling. A lot of hospitals are struggling. Right now, we’re at capacity and just like other Michigan hospitals. And we’ve had to delay some surgeries because there’s just not enough staff to take care of them. We have patients, we call ED-overs where patients have to stay in the ED until we can get them up to a bed in our medical, surgical floor. Or until they can be transferred somewhere else. But, other hospitals can’t accept them either because they’re full. And we have 49 beds, but if you only have staff to have 30 open or 35 or 36 open, you can’t accept anymore.

And then when you have ED-overs, that stresses the emergency department nurses because they’re not only having to take care of patients who should be up on the medical floor. They’re taking care of emergencies. And I just read an article today from, actually, University of Michigan Health System, where there’s people in the community that are not COVID related, that are dying because they can’t get into the ER, can’t get in to see people, can’t get transferred to the appropriate facilities. Because we’re also stressed because of staffing. And it’s nurses, it’s certified nurse aids, it’s phlebotomists, it’s housekeepers, it’s food, nutrition workers. Just this week, actually Monday, yesterday, we had to close down our cafeteria for staff breakfast and dinner because we can’t find cooks.

And we have to focus our efforts on serving meals to the patients and residents here. And if we can’t find cooks to cook the food, then it’s not good for our employees because it’s nice to come to work and be able to grab a bite to eat before you start your 12 hour shift. And when you have to bring it in yourself or not have breakfast, it’s not good. And that’s throughout the country. And I really don’t know when it’s going to end. It’s not all COVID related, but obviously, there’s nobody in the workforce these days and how do we get more people into the workforce?

David Haynes:

And you’re right. That’s facing every sector of the economy right now. And I think for people it’s even scarier when they hear they can’t get into a hospital and they can’t get this and they can’t get that, related to their healthcare. What’s your COVID situation like over in the Eastern UP? I know it’s the numbers for the statewide and I’ve heard some of the other regions of the UP. What’s the situation in the Eastern UP?

David Jahn:

Yeah. What most people don’t realize is that we’re worse now, from a state perspective, than we were at the peak of the pandemic almost two years ago. And nobody’s really talking about it. But, inside healthcare institutions, we’re talking about it every day and we’re not at our max. Our max that we had at one time was last year about this time and we had 23 COVID patients. But, at that time we had more staff, too, to take care of them. And a lot of those COVID patients were from the Department of Corrections because we have two very large prisons here that had an outbreak at that time. And the Department of Corrections has done a great job of managing that internally. So, they’re not coming to our facility. But, right now, currently we have two in ICU and eight in the med, surge floor. So, 10. It’s manageable, but again, when you have less staff, if we didn’t have those 10 patients there, the COVID patients, we could take care of more patients that are sitting in the ER and those type of things.

And so, it is a challenge. And as statistics bear out to somewhere between 75 and 80% of the people getting admitted to the hospital are unvaccinated, and the only way we’re going to get out of this is to get people vaccinated.

Now, I don’t want it to be all doom and gloom about that, but we did have a success story, which was really good. I feel for the patient, but there was a 39 year old that was in here and had been in here for 35 days and for two weeks was on the ventilator. And then you can’t keep somebody past two weeks on a ventilator and you had to do a tracheostomy and I really thought, boy, the prognosis for this person is not good. Yet, somehow the lungs healed and the patient was discharged on home oxygen yesterday. So, not everybody perishes that gets that sick, but that’s the type of thing you can get into where, how many of us would want to sit in the hospital bed for 40 days and be at the edge of life and death? I would hope most people wouldn’t want to endure that and that they would really think again about whether they should be vaccinated or not.

David Haynes:

What’s your vaccination rate over in the Eastern end?

David Jahn:

Well, I know for our employees, it’s about 80%. I think in the Eastern end, it’s somewhere in the mid-50’s to maybe 60%. When it was only 65 and over, I think we’re 70 plus percent, but then they added on the younger people and now the kids and it takes time to get everybody vaccinated.

So, those percentages come down. But, I know that the vaccine mandate, which is on hold right now, was worrisome because we can’t afford to lose two employees, let alone, 30 or 40 employees., And we’ve gone through that. And we’ve had, I think 100 and some people file religious exceptions and maybe 15 or 20 file medical exceptions. But, when you look at it right now, everybody in our organization, but maybe 10 people have either picked one or the other. So, if that vaccine mandate comes back. If the courts say it is constitutional or legal, we’ll still have to deal with those 10 people and make a choice, but it’s better than we thought.

David Haynes:

So, when you were thinking, sort of wrapping up, what are the next two years? I know that seems like 100 years right now in the middle of all this in the pandemic. What are the things you’re thinking about that you got to keep your priority and focus on for War Memorial as the president and CEO? What for the next year or two years?

David Jahn:

Well, the shoe hasn’t fallen yet, but the whole financial piece of this pandemic has to fall at some time because when you’re short staffed and you want to retain your employees, you’re usually giving them additional income. Giving them additional sign on bonuses and things like that. And if you can’t, then you’re paying pretty exorbitant rates for travelers. And we used to pay somewhere in $70 to $80 an hour for a traveling nurse, and now it’s $200 an hour. And I know the state and federal government are looking into those traveling nurse companies saying, are they taking advantage of the times? But, we’re not getting any more additional revenue from Medicare or Medicaid or Blue Cross. And when you’re paying that much more to your workforce, somewhere there’s got to be a financial shoe that has to drop. And it’s going to hit mostly in rural areas first because we’re much smaller and don’t have the depth and breadth of an organization that some larger ones do, but also, just getting enough people in the healthcare workforce.

I think what this pandemic has shown is that, healthcare is one of the toughest jobs in around and it’s not only physically tough, it’s mentally tough. And in the past, you saw death and it was usually at the end of life when somebody was elderly or somebody that had a medical emergency or got an accident or whatever. And now, you’re seeing death from people who walked in and have their mind yet. And they just can’t breathe. And it’s really tough on a nurse when that patient said, I can’t live like this, and you got to take this high flow oxygen off me. And within 15 minutes, they’re gone. Yet, they had all their faculties and had no other comorbid conditions or that sort of thing.

So, how do we get people into healthcare and how do we get the education system to make sure we’re training enough of these healthcare professionals? Because it’s very difficult. I know it’s hard for the universities to have the curriculum and follow all the criteria that they need to follow. And for them to hire nursing instructors who, in order to be accredited, you have to have certain level of nursing instructors, but at the same time, we need to produce more nurses and more nurse aids and more LPN’s and those type of things to be able to survive in the healthcare of the future.

David Haynes:

David, just before we wrap up, can you tell our listeners what a traveling nurse is?

David Jahn:

Well, a traveling nurse is somebody who basically is for hire through a travel company. So, we’ve actually lost probably 10 of our nurses to who travel companies lately. What happens, if you’re young or if you’re older and have already raised your kids and have the flexibility, a company will hire you for a three month stint or a six month stint somewhere. And you’ll probably make twice as much money as you would working for your local hospital. And then there’s a fee that the traveling nurse companies put on top of that. So, they might be billing us $200 an hour, but the nurse is probably getting maybe $70 or $80 an hour and the company’s making the other 120 an hour. And just for arranging for them to be there. And for young nurses, once they get some experience, they’re thinking, hey, I want to go out and see the world instead of staying in Sioux Saint Marie in January and February and March, I could go and get a travel job in Arizona or Florida or California. And since I can come back in the summer and enjoy the warm weather, I can create my own little perfect scenario where I never have to see snow again. But, it really puts small, rural hospitals, especially hospitals in the northern climate at a disadvantage.

David Haynes:

Well, David, thank you for spending this time with us. That’s been really informative and the challenges are immense. And it’s good to know there are leaders like you out there helping us through this in the rural areas and all the added challenges that we have. So, David Jahn, President and CEO of War Memorial hospital and Sioux Saint Marie. Thank you, my friend, very much.

David Jahn:

Thank you, David.