Job posting reveals CCMSD CEO change

A job posting for the administrator position within Crook County Medical Services District (CCMSD) was the first indication that the Board of Trustees is considering the removal of CEO Nathan Hough. According to its president, the company contracted to manage the district has been instructed to get rid of Hough – or face the axe itself.

At time of going to press, the only indication that Hough has been or will be removed is the existence of the online job ad. A listing for a “Chief Operating Officer” located in Sundance, Wyoming, appears to have been activated on indeed.com on Tuesday, February 11 and the contact associated with the listing is “Health Management Services, LLC”.

For legal reasons, board members are not at liberty to divulge the details of what was discussed during an executive session. When contacted for comment, Chairman Mark Erickson said he was surprised by the posting and felt he was only able to offer the following statement regarding CCMSD’s relationship with Health Management Services (HMS):

“The contract is up for renewal and we as a board have a fiduciary responsibility to the community to look at all options at how the hospital is run.”

A press release was later issued to explain that the contract with HMS will be expiring this year and it is a normal part of the board’s duties to “explore all options”. This, says the statement, will not affect the operations of CCMSD or continuity of care.

The person whose contract was under scrutiny, however, says he is under no such restrictions to remain silent about discussions regarding the contract.

“This was in executive session, which they can’t break – but I can. We were discussing my contract and I am not bound,” says Karl Rude, HMS President.

“The board has told me with no uncertainty that they wish that Nathan would not continue in the future. Under our contract, they can express those terms and I am obligated to try to find replacements. They have also put it as a contingency of the negotiation of the future contract, which they have in good faith been negotiating to extend for four years, and wanted to see if I could bring to bear candidates.”

Trustee Joey Kanode says he is aware of the situation regarding Hough and HMS, but does not agree with the idea of removing the current CEO.

“They want to get rid of him, I guess,” he says. “They are replacing Nathan because the board doesn’t want him in the hospital any more. That is a fact.”

Conversations within HMS have begun as to how best to remove Hough from the facility and bring in candidates, says Rude. The hope is to “find an admirable replacement that his team could gather around,” he states.

As to why the board has asked for Hough’s removal, “They have given me reasons…but I have never been able to substantiate those reasons – ever,” Rude says.

Certain trustees appear to have questions about Hough’s integrity, Rude says; for example, they question the fact that a member of Hough’s family was hired within the district. However, Rude says an investigation showed that Hough recused himself from the hiring process and three of the five people on the hiring panel were unaware the candidate had any relationship to Hough.

Board members also claimed they did not authorize Hough to bring his therapy dog to the hospital to work with patients, Rude says. However, he continues, the January, 2016 board minutes show that the dog’s presence was both authorized and encouraged.

“I cautioned the board about this for four-and-a-half months. We’ve talked and talked and talked,” Rude says. During those conversations, he continues, some board members have remained adamant that Hough cannot be trusted and has no integrity.

“I submit that there is not [a basis for the lack of trust],” Rude says. “It is nothing more than a personality conflict – and I can’t even find the origins of the personality conflict.”

Whatever his personal feelings, Rude says that he and Hough will endeavor to keep staff upheaval to a minimum. The board has requested a transition period to train Hough’s replacement followed by “clear line of separation” by which Hough would have nothing to do with the district, he says.

Rude also confirms that HMS placed the ad for Hough’s replacement on the afternoon of February 11.

“I’m reviewing the applicants and I’m going to be having a discussion with Nathan about those applicants because, according to what I know, they still don’t want him there, and if I want to continue to have a contract there, I need to have a replacement there and I’ll have to have Nathan be somewhere else,” he says.

Rude says he understands why there may be tensions due to the competing authority of the board versus its management company, and he also understands why the board would prefer not to pay money for his management services.

“I get that, but what they don’t realize is that, since we’ve showed up and Nathan has run that place, we have more than covered our costs in the increased growth in business. They were a $6.8 million-a-year hospital, now they are a $10 million-a-year hospital – your town is that much better off for having had us there,” he says.

“Of that $3.2 million a year of new money coming in, 70% of it is straight from the federal government. It’s entirely new money that your community didn’t have. [Certain trustees] don’t get how these things work and they’re willing to get rid of me as a result.”

For Kanode, a major sticking point is that the negotiations with HMS have taken place in executive session. Was that necessary? Kanode says he doesn’t think so and has voiced dissent several times.

“I can’t comment on any of the contract negotiations, but we could if they were in a public meeting and not executive session,” Kanode says. “I do feel it should be [in public session].”

Rude agrees that executive sessions are often utilized by the board for discussions of this nature and describes being “directly threatened with retaliation” during one such session by a board member.

“Right now, there are board members making decisions because they have a personal conflict with our administrator and they are not making, in my opinion, the best decisions for the residents or the employees of our facility,” Kanode says.

The board needs to remember who is important in this equation, Kanode says.

“There is no doubt in my mind that the board as a whole doesn’t look at the big picture and I think they truly do think they forget there are 30 people who live in that building all the time,” he says.

“Those are our primary residents. If we make the wrong decisions and that places closes, they have to move and the mortality rate goes plum through the roof.”

Kanode says he has already heard from citizens concerned that the CCMSD management team will quit if Nathan leaves – and if that happens, he notes, there will be nobody around with the licensing to run the place. Employees of the district are also voters, he comments, and have as much say in what happens in this county as anybody else.

“When they are raising alarm flags and telling us not to do something and we blatantly ignore it? This is why we’re a democracy, people have a say,” he says.

In fact, Kanode feels strongly that the board is not currently functioning as it should. He would like to campaign for change moving forward.

“I think they need to keep the special service district the way it us but they need to get a professional board to run the hospital and all the trustee board does is manage the mill levy money,” he says.

Negotiations with HMS regarding its overall contract with the district are ongoing.

CCMSD Statement

The Crook County Medical Services District (CCMSD) Board of Trustees would like to advise the residents of Crook County that CCMSD currently provides and will continue to provide around the clock medical services for our citizens and visitors.

For the last four and a half years, CCMSD has been using a medical services management company to oversee administration of CCMSD facilities. The district’s contract with the management company will be expiring this year and as part of its normal duties, the Board of Trustees is exploring all options to ensure CCMSD continues to provide high quality care for the residents of Crook County.

The board is tasked with ensuring the district continues to provide excellent health care and is also responsible for protecting and growing all district assets. Contract negotiations are part of this process and will not affect the operations of CCMSD or continuity of care.

CCMSD is fortunate to have a select team of highly skilled caregivers and staff that remain focused on the primary goal of patient care and safety. The Board of Trustees would like to thank everyone in the community for their continued support of all CCMSD locations and invite inquiries to be directed to [email protected].