Nearly 20 years after leaving Rehoboth McKinley Christian Health Care Services (RMCHCS) to pursue a career opportunity in Texas, David Conejo returned to find a much different healthcare system than the one he remembered. RMCHCS had become a shrinking organization between 2008 to 2014 and started to slide towards bankruptcy.
“Starting in 2008, RMCHCS had seven administrators in six years and that’s when the decline started,” Conejo says. “Even if you have the best administrator each time, when someone new comes in they want to do things differently. After a while, you have chaos and no structure.”
From 1984 through 1995, Conejo led a growing healthcare system. In his first year, the two hospitals in Gallup – Rehoboth Christian Hospital and McKinley General – merged and the services were consolidated into the former McKinley General Hospital. Vacating the Rehoboth Christian Hospital allowed the healthcare system to create a behavioral health program with 20 beds. In addition, RMCHCS acquired a physician’s clinic and developed three dialysis centers and three home health units.
In 2014, RMCHCS closed the behavioral health service, sold the dialysis units and allowed a number of practices such as sleep labs and physical therapy to drift away onto other providers. “They started a bid process to find someone to take over the hospital in 2013, but there were no takers,” Conejo remembers. “In early 2014, they came up with another plan to turn the hospital over to someone or an organization that will either purchase the hospital or assume all its liabilities.”
RehobothConejo visited RMCHCS in February 2014 and signed an agreement that July to perform four months of due diligence to fully assess the situation. “My offer was to assume the liabilities, building in the option to buy,” he explains. “It was a sinking ship. I think I can come in and pump the water out and get the ship right, and if I can do that, I’ll buy it. That was my approach and I signed in September 2014.”
At that time, Conejo became the CEO and brought with him NewLight Healthcare, an Austin, Texas-based hospital management and consulting company, to manage RMCHCS for two years. In 2016, he took over as the hospital manager and president.
Back on Track
Reducing expenses was vital when Conejo came aboard to turn RMCHCS around. Rather than letting go 40 people from the 400-person staff, everyone from the leadership down took a 10 percent reduction in pay. “All our employees went along with it and no one lost their jobs,” he remembers. “I worked for $1 a month between September and December, and eliminated high priced executives who were payed way above market, which cut about $500,000. The immediate move was to rightsize everything.”
RMCHCS also had about $5 million in unbilled charges to Medicare and Medicaid, which pays out in two weeks. Conejo brought in a team to oversee the billing and focused on getting those out to get money in while looking for other services to provide.
The healthcare system added physical therapy back to its service offerings. RMCHCS raised $1.5 million within the community to build a wellness center across the street from the hospital that includes 8,300 square feet of physical therapy space. The DeVoss Foundation donated $400,000 worth of equipment for the wellness center.
“There is tremendous community support and these combined efforts began to grow,” Conejo says. “When I got here, RMCHCS was down to two days cash on hand and now we have $7 million in reserves.” We also replaced all of the radiology, CT, and MRI equipment. We purchased all new lab analyzers and 460 new computers.
RMCHCS also added a behavioral health unit, beginning with three patients in 2015. Over the course of one year, the unit had 69 patients and contributed $1 million to the bottom line. It has also established a medical residency program.
RMCHCS this year is hosting a fund-raiser to expand its women’s health unit to create rooms with combined delivery and postpartum.
The organization is looking to partner with Loveless Medical Center to provide oversight on more critical cases. It also is looking into partnering with a group in Denver that would use its facility to establishing a screening clinic to look for patients where the fetus needs surgical intervention in the womb.
Moving forward, RMCHCS will focus on creating a new long-term strategic plan that will highlight its priorities for the future to remain a strong healthcare system for the communities it serves. +