Stormont Vail stabilizes failing Junction City hospital, keeping health care close to home

Kourtney Brown, a nursing manager at Stormont Vail Health Flint Hills campus, relates the stress of working at the failing Geary Community Hospital before Stormont Vail took ownership. (Sherman Smith/Kansas Reflector)

JUNCTION CITY — In 2021, employees at the county-owned Geary Community Hospital wondered every week if they would get a paycheck.

The downhill spiral of the facility was coming to a critical point.

Layoffs of certified nursing assistants. Staff hoarding supplies because they weren’t sure when, or even if, new ones would arrive. Increasing numbers of contract employees as local people left for more stable jobs. Broken equipment.

Even today, three years after Topeka-based Stormont Vail Health took over and began turning around the failing hospital, staff still hoard supplies, said Kourtney Brown, a nursing manager at the renamed Stormont Vail Health Flint Hills campus.

“It’s just one of those things where, every day, not knowing if the lights were going to be turned on — we were worried about our electricity bills,” she said. “We were worried about our food bills.”

The worries were legitimate. Geary County Commissioner Trish Giordano said the hospital at one point had two days of operating cash on hand.

“Our doors were ready to close,” she said. “I took office in January of 2021, and it was obvious that we had to do something.”

 

Geary County Commissioner Trish Giordano shares the importance of keeping health care local by keeping the hospital open so Junction City residents don’t have to travel for health care. (Sherman Smith/Kansas Reflector)

County decisions

Pinpointing exactly how the hospital got into such bad financial straits is difficult, Giordano said. A 15-member Board of Trustees ran the facility but had somehow missed red flags as the hospital began floundering, she said. 

County officials fielded constant constituent complaints about the hospital, and the situation was critical by 2020, Giordano said.

Giordano believed the county’s lack of a finance officer contributed to problems because commissioners didn’t have good oversight of how the money collected from a six-mill tax levy was being used.

“We had deferred maintenance of $20 million, operating in the red all the time. It was just a bad situation,” she said.

A long-time community member, Giordano served as a police officer in Junction City for 28 years. She campaigned for county commissioner on two issues: addressing the hospital’s poor performance and hiring a first-ever county finance officer.

One thing affected the other, Giordano said. 

When the county hired an experienced finance director in 2021, she helped the commission revamp the budget and use a $32 million bond to save the hospital “with no impact to our taxpayers,” Giordano said.

The county is using the six-mill levy that was already in place to repay the bond debt.

“If we had had a finance person before, they would have seen those red flags years ago and would have saved us a lot of money,” Giordano said.

As county officials scrambled in 2021 to resuscitate the hospital, commissioners spoke with one organization interested in taking over. They wanted to eliminate services, such as inpatient care and delivering babies, Giordano said, leaving only clinics and an emergency room.

“Our community deserves better than that,” she said. “We deliver 300 babies a year here.”

At the end of 2021, Giordano and a governing board member reached out to Stormont Vail’s CEO. The hospital system was in the midst of dealing with COVID-19 but indicated interest in talking with them, Giordano said.

The idea of taking over a hospital in Junction city wasn’t in Stormont’s long-term plan, said Anita Fry, vice president for marketing and communications, and it’s the first hospital Stormont has acquired. But the process has been successful in ways Stormont didn’t expect, including how the Flint Hills campus blends with Stormont services offered in nearby Manhattan, she said.

“The synergy between Manhattan and Junction City can just continue to grow,” Fry said. “Having this whole operation gives us a different perspective now. We understand some of the smaller hospitals that feed into us in Topeka. It gives us a nice perspective to be able to think with a different lens.”

 

Tracy Duran, administrator at Stormont Vail Health Flint Hills campus, said she’s pleased the facility is operating in the black, and she’s hopeful to expand services. (Sherman Smith/Kansas Reflector)

Logistics

The rebuilding process has not been an easy one, but Tracy Duran, Flint Hills campus administrator, lights up when she talks about where the hospital is now.

A 19-year Stormont employee, Duran joined the Junction City operation as director of nursing before becoming the administrator.

Stormont began managing the hospital in July 2022 and took full ownership on Jan. 1, 2023, she said. One of the first steps was putting an electronic medical record system into place.

“We had to get all of the policies and education to staff,” she said. “They learned like 13 different processes and new applications in that six months, so they were really drinking from a fire hose.”

Brown, the nursing manager, said it was difficult to keep up with all the changes at first but seeing the infusion of energy and money into the hospital made up for it.

“It was not Stormont coming in and just taking over and changing everything about us,” she said. “We still got to be us in our community. But then we had a different name, and then we started getting a different reputation. You don’t realize how bad your reputation was until it starts getting better.”

Employees welcomed the stability Stormont brought, Brown said. 

“None of us knew how to accept things,” she said. “I remember something broke and Tracy was like, ‘OK. We’ll just call Topeka and see if they have one or we’ll just buy one.’ ”

Brown shook her head at the memory, still amazed at the idea they didn’t have to make do anymore. On another occasion, a Topeka unit got new recliners and she asked for their old ones. 

“They’re like, ‘You’re not going to like them,’ ” Brown said. “Excuse me. A patient’s using a trash can for a footstool. I got them and they’re beautiful. Just to be able to have supplies for our patients, be able to have equipment that works, that’s trustworthy … to be able to start slowly hiring different staff and these different specialties and these different services that we could provide to our community — you started to see our community coming more and trusting us more.”

 

A sign is covered in employee signatures in the lobby of Stormont Vail Health Flint Hills campus, a visible reflection of the work Stormont is doing to support employees and expand the workforce. (Sherman Smith/Kansas Reflector)

Proof in the numbers

Duran said that when Stormont came in, the hospital was losing $1 million to $1.5 million per month. Now the hospital is in the black.

“Over these last six months, it’s a baby profit, but it’s a profit,” Duran said. “It’s a positive sign.”

They did not expect to see positive revenue that quickly, she said.

“I think we’ve gained a lot of respect back from the community,” Duran said. “They’re coming. You can see that in our emergency room numbers. They’re growing every month.”

When Stormont Vail took over, there were 175 employees, Fry said. Today, there are 250 plus an additional 85 contract employees who work mostly in nutritional services or on an as-needed basis.

One of the first moves was to stabilize the emergency department staff by hiring new physicians and stopping the use of traveling doctors and nurses. They also hired physicians for the hospitalist program, which had been run by one doctor, Duran said.

Jimmy Jenkins was in primary care — though Duran pauses to say he first started at Geary Community Hospital doing lawn care — but when he saw that primary care doctors were stressed by running a clinic all day and then taking calls in their off hours, he started the hospitalist program.

“He was really doing it 24/7 and was worn out with that,” she said. “We hired two internist-trained physicians and now Dr. Jenkins is back in our rural health clinic,” she said.

Challenges remain, but Duran said she believes those are no longer about stabilizing the hospital as much as they are the standard difficulties facing most medical facilities.

“The landscape of how we’re going to be reimbursed is going to be huge for us,” she said. “We have a high volume of self-pay (patients) and a high volume of marketplace insurances.”

Staffing is always a challenge, she said. 

“We are really in a pattern of growing, and how do we grow and be a western hub for a hospital?” she said. “To do that, it’s going to take a lot of recruitment, a lot of marketing of what we need, and making sure that we’re balancing that with community resources.”

 

The courtyard at Junction City’s Stormont Vail Health Flint Hills campus is a peaceful place to take a break outside, for patients, visitors and employees. (Sherman Smith/Kansas Reflector)

Keeping care local

Cindy Samuelson, spokesperson for the Kansas Hospital Association, said she appreciates the collaboration that saved Junction City’s hospital.

Times may be difficult for hospitals with financial and workforce issues — 67% of Kansas hospitals are running in the red — but the Flint Hills campus is an example of how community care can survive, she said.

“There’s a lot happening to help keep health care local, and a number of things happening in regards to the model of care being provided,” Samuelson said. “Our state is unique in that we have many independent hospitals. Many states have a lot more systems, where all their hospitals in their state are connected to some big system.”

Partnerships, whether through mergers or collaborations, throughout the Kansas medical system strengthens care and opportunities, she said.

Samuelson listed multiple examples of how communities are addressing medical needs, including two struggling critical access hospitals in Harper and Anthony that merged together to create the Patterson Health Center, a public-private partnership. 

“We are trying to sustain health care in our state close to home,” she said.