‘Brand new day in healthcare’

Five months in, UnityPoint moves forward in Marshalltown

The main entrance to UnityPoint Health-Marshalltown’s downtown campus is flanked by the “Tribute to Caregivers” monument. Originally known in 1913 as The Evangelical Deaconess Hospital, it would acquire other names such as Marshalltown Area Community Hospital, Marshalltown Medical & Surgical Center, and Central Iowa Healthcare.

The main entrance to UnityPoint Health-Marshalltown’s downtown campus is flanked by the “Tribute to Caregivers” monument. Originally known in 1913 as The Evangelical Deaconess Hospital, it would acquire other names such as Marshalltown Area Community Hospital, Marshalltown Medical & Surgical Center, and Central Iowa Healthcare.

Editor’s Note: This is the first of a two-part series about UnityPoint Health-Marshalltown. On May I, it took over control of the former Central Iowa Healthcare’s assets. Today’s story identifies issues which led to the CIH bankruptcy, purchase of CIH assets by UnityPoint-Waterloo, and a new plan. Monday’s concluding story will focus on some of the changes made at UnityPoint-Marshalltown.

“It is a brand new day in healthcare in Marshalltown.”

Those were the words of UnityPoint Health-Waterloo Chief Executive Officer Pam Delagardelle on May 1, as she addressed a standing-room only crowd made up of former Central Iowa Healthcare employees, local elected officials, media, and more.

Delagardelle, a former nurse and 30-year veteran of the health care industry, was front and center along with other UnityPoint officials from several states at four sessions with UPH-Marshalltown employees.

Delagardelle’s mission: Acquaint employees with the new UnityPoint-Marshalltown executive team, and to explain that UnityPoint-Marshalltown was part UPH-Waterloo, with UnityPoint Health as the corporate umbrella.

It was a dramatic switch for former CIH employees, as CIH previously had been a 103-year old independent hospital (one of a few independent hospitals in Iowa). Importantly, CIH had declared bankruptcy in December, 2016, resulting in a significant reduction in force and other major changes.

Financial “distress”

CIH struggled to stay afloat after potential partners backed out of a plan to turn it into a for-profit venture in 2016.

CIH later dismissed Chief Executive Officer John Hughes, laid off 12 other employees and replaced emergency department physicians who resigned. At a public meeting in September, 2016, it was revealed CIH was $18 million in debt as of Aug. 31, 2016, according to financial reports disclosed at a special meeting.

“The hospital has suffered recurring losses from operations and has a rapidly declining net position that raise substantial doubt about its ability to continue as a going concern,” wrote auditors on another occasion.

Then board chairwoman Carol Hibbs used the word “distressed” to describe the condition. She said much of the trouble was due to a flawed 2015 shift to electronic medical records. Because of computer problems, CIH was unable to bill anyone for several months in 2015 and 2016, she said. “We just weren’t able to get cash in the door.”

In 2013, Medicaid required CIH to repay $2.5 million due to errors in processing.

New strategic plan

Delagardelle outlined her vision to prove it would be a “brand new day for health care in Marshalltown.”

“We have a strategic plan to deliver health care services in the area,” said Delagardelle. “Where do we go from here? It is simple. We know you are going to provide top patient care, experience, for the people you serve, your community. We are working to create a culture where leaders can lead, physicians can practice, staff have careers and patients have the best possible outcome every time.”

Jennifer Havens, CEO of Grundy County Memorial Hospital, was introduced as UPH-Marshalltown’s interim CEO.

Delagardelle said later in the month Dustin Wright, then of Summer Community Hospital in Sumner, would become president of UPH-Marshalltown, while Havens would be appointed vice-president of operations.

Finally, Delagardelle urged UPH-Marshalltown employees to promote the hospital, staff and services to friends and neighbors.

Dramatic improvement

After a whirlwind period of more than 100 days, Wright was able to speak with confidence and enthusiasm on Aug. 16 before a nearly full house at Elmwood Country Club about major changes implemented at the hospital. Increased employee morale was evident, efforts to regain the trust and confidence of Central Iowans patronizing the facility was paying dividends, and new hires emphasized a strategy of improving patient care.

Importantly, UnityPoint Health Marshalltown Foundation was back in action under its new name and new mission: raise $190,000 for a new ambulance. That night the Foundation publicly launched its 2017 annual campaign, “Lights and Sirens– Keep Them Rolling” with more than $70,000 in early commitments leading to a current total of $140,000 (Later, the fund-raising goal was increased to $400,000 when it was determined a second ambulance was needed. Due to UnityPoint Health-Waterloo’s purchase of CIH assets for $11.9 million earlier in the year, it was prohibitive for them to make two ambulance purchases in addition to other major hospital commitments).

Kathy McCune, Foundation President, welcomed UnityPoint Health to Marshalltown, and noted the healthcare opportunities it brought to the community. She introduced Lance Horbach, Chairman of the UnityPoint Health Marshalltown-Board of Directors.

Horbach introduced hospital board members, noting they were local individuals, and not UnityPoint Marshalltown employees.

“We prize our local hospital and it still is in our hands and your hands,” he said. “This is our Board, not a UnityPoint Health board. We need your engagement and will work to earn your respect, your trust and your care.”

Wright said: “Philanthropy support has never been more promising to insure we can deliver on our mission of improving the health of the people in the communities we serve. We are excited to have this relationship with UnityPoint Health-Marshalltown Foundation.”

Wright also announced the return of Dr. Lance VanGundy to the UnityPoint Marshalltown Emergency Department effective Oct. 1. Wright also stressed the high ambulance workload and dedication of the EMS staff under the direction of Steve Vannatta.

UnityPoint Marshalltown Auxiliary members Susan Eberhardt, Josette Peterson, and Peggy Schoer announced the Auxiliary gift of $50,000 to the ambulance campaign.

Bankruptcy process

Critical to the former CIH becoming UnityPoint Marshalltown was an asset purchase agreement agreed upon jointly. It was consistent with conditional approval filed in a March 16 hearing by the United States Bankruptcy Court for the Southern District of Iowa in Des Moines. At that hearing, the court identified UnityPoint Waterloo as the successful bidder in a bankruptcy auction process open to any qualified bidder.

CIH filed a petition for protection under Chapter 11 of the U.S. Bankruptcy Code Dec. 20, 2016. The bid submitted by UnityPoint-Waterloo included a commitment all CIH healthcare operations would continue without interruption during the bankruptcy proceedings and after the sales transaction was completed.

The assets included an acute care hospital emergency department, four primary care clinics (Conrad, State Center, Tama-Toledo and Marshalltown) and a $35 million outpatient center (opened in August 2015 across from Marshalltown Community College). Under the plan, high quality healthcare would continue in Marshalltown and surrounding communities as CIH assets would become owned by a new entity called UnityPoint Health-Marshalltown.

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Contact Mike Donahey at 641-753-6611 or mdonahey@timesrepublican.com