Hillsdale Hospital News

Episode 92: Leadership in Rural Health

Rural hospitals continue to face unprecedented challenges in todays environment with supply chain increases, workforce recruitment and retention, financial woes and more. And as staff burnout, leaders do too. This week, we welcome Sydney Grant, Director of Programming at the National Rural Health Association, to discuss how leaders can gain the education, support and fortitude to shepherd their organization for the years to come.


Center For Rural Health Leadership



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Audio Engineering & Original Music by Kenji Ulmer




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Rachel: Rural hospitals face unprecedented challenges in today’s environment, with supply chain increases, workforce recruitment and retention, financial woes, and more. And as staff burnout, leaders do too. So how do rural healthcare leaders gain the education, support, and fortitude to shepherd their organizations for years to come with.

JJ: Determination, education, and the support of their peers?

Rachel: I’m Rachel Lott.

JJ: And I’m JJ Hodshire.

Rachel: And this is Rural Health Rising.

JJ: Welcome to episode 92 of Rural Health Rising. I’m JJ Hodshire, president and chief executive officer of Hillsdale Hospital.

Rachel: And I’m Rachel Lott, chief communications officer.

JJ: So, Rachel. Wow. We know how challenging the job is here in Rural Health as rural Health leaders.

Rachel: Yes, we do.

JJ: Obviously, living that life each and every day. And it’s tough. We know that there are long hours. It’s a lot of hard work, many hats that we wear, in many cases six or seven titles to our name.

Rachel: Right now, that it’s consolidated and now it’s under one breath in the middle, which is great. So, I appreciate that.

JJ: You’re more than welcome. In a very different environment than health care in urban or suburban communities, it’s oftentimes lonely in rural healthcare, and the challenge has never been as real as it is today to push through in order to lead these hospitals, and especially in light of all of the changes in our environment. But a lot of rural hospital leaders, in particular, rules struggle to push through, and they burn out quickly. We see that whether it’s in the C suite, whether it’s the CEO level, it doesn’t matter what level it is typically at management, and you’re working long hours, you’re covering shifts. And when we think about our clinical managers, Rachel, we think about not only are they responsible for the day-to-day operation of their respective units, but also, they’re covering shifts when their nurse calls in. Right. That’s rural health. There’s no pool. There’s no opportunity to have a roving pool. And so, it is a tremendous amount of responsibility. And programs that help to build up these leaders and give them support are much needed, and they are critical to our rural healthcare framework.

Rachel: That’s right. And today we are talking with someone who leads the center for Rural Health Leaderships programs to do just that.

JJ: That’s right. Our guest today is Sydney Grant, director of programming for Rural Hospital certification programs at the center for Rural Health Leadership. And we welcome you to Rural Health Rising today, Sydney.

Sydney Grant: Thank you so much, JJ. And Rachel. I’m thrilled to be here.

Rachel: So, to start, Sydney, why don’t you tell us a little bit about yourself, your background and your work at the center for Rural Health Leadership?

Sydney Grant: Yes, I would be glad to. Thank you so much. Well, I’m not the usual person you would imagine getting into rural, so I like to call myself a rural transplant. So, I am a Florida girl. I am actually Tampa based, so not exactly the image of rural one thinks of. But I am a Florida girl through and through. So, I went to Florida State University for undergraduate, and I got my Masters in healthcare administration at the University of South Florida in 2020. And so, during my time getting my Masters, that’s when I got to step into rural and start working in this space, which was unknown to me to begin with. Healthcare administration was unknown to me. And once I stepped into that world, so much opened up. But then I realized there was rural health care. This was something we didn’t hardly talk about in grad school until the opportunity was presented to me to work as an intern for Dr. Bill Oxier’s Rural Health Leadership Radio podcast. And so that’s how I got my foot in the door into rural health care. I saw that opportunity, and it was different than all the rest of the opportunities. And I kind of love to go down that unmarked path. And that’s how I got started. And I like to say I kind of hitched myself to Bill, and he hasn’t been able to get rid of me yet. And so, we created the center for Rural Health Leadership, which does put on the Rural Hospital certification programs with the National Rural Health Association, or NRHA, as probably a lot of people have heard them called. So, in addition to that, I also cohost that podcast now with Bill. So, I get to be on the microphone side of things with Rural Health Leadership Radio, which is really fun. Nice. And then in addition to that, I’m also a board member and the communications director for my local American College of Healthcare Executives Board here, too. So, trying to bring the rural perspective everywhere I can go. So that’s just a little bit about me and how I found myself kind of going down this path and working on the certification programs.

JJ: Well, that is awesome. We love rule, don’t we? I mean, it’s quite rewarding. We’re going to talk about that today. Your experiences in working with Rule Hospital executives and the critical importance of making sure that they’re surrounded with education, training and support systems. But now that we’ve established who you are and what you do, let’s start with the why. And we do this on all of our episodes, so we get to know and our listeners, our guests, just a little bit better. So, what is your why, what motivates you, and what gets you up out of bed in the morning?

Sydney Grant: I love this question because I feel like it’s easy for me to answer now that I am in rural healthcare. So, part of my journey was that I really didn’t know what my passion was or what my journey was supposed to be. Like probably a lot of people starting their careers, it’s hard to know what step you want to take. Like I mentioned, when I was in grad school, I had the opportunity to work on that podcast. And like I said, when that opportunity came up, we got to do this little almost like career fair, but for internships. So, we had to have an internship. It was part of the degree. And so, we had our professors were nice enough to pull together some opportunities, and lots of great opportunities, for sure, but a lot of them were kind of the same, working on the payer side or interning at some type of small practice or something like that, which there’s huge value in that. Don’t get the wrong message, but bill’s opportunity came up to do this podcast about rural health leadership, and as soon as I saw that, I just knew it was the right thing for me to do. It was different. It was unlike any other opportunity that I had seen at all throughout graduate school, let alone during this really specific time to look for an internship. And so, if there is a path to pave, I will go down it. So that was really exciting for me. And like I said, rural was really unspoken. Rural healthcare was not a part of our curriculum per se in my master’s program, and we even had an opportunity to talk about it and ask a professor, what do you teach the students about critical access hospitals? And the response was, what’s a critical access hospital?

JJ: Oh, my goodness.

Sydney Grant: I knew that there was work to be done, and I love the challenge. I absolutely love a challenge and an opportunity to innovate and collaborate and do this creative problem solving, but on such a bigger, more impactful scale than a lot of people get to do. And that’s part of what motivates me every day, is that there are people out there that are, like you said, wearing 56789 different hats, and the least I can do is try to emulate them and wear maybe a quarter of those hats, but try to leave my mark and help along the way. So just knowing that there was an opportunity that’s so different from what a normal MHA candidate might go for, that’s speaking my language. If it’s different and it’s not what people might usually do, and there’s challenge involved, I am all in. So, getting to work with these amazing rural health leaders that do so much more with so much less. I mean, what could possibly motivate you more than that? So, it’s easy for me to want to get out of bed each morning knowing that I get to help these people help their communities. That’s essentially what it translates to. So that’s a pretty easy motivation, in my opinion.

JJ: Absolutely. Well, it’s a great why, and you’re doing some remarkable work, and I want to talk a little bit more about that work that you do. So, for our listeners, Rachel and I have had a chance to do a little background to learn more about the type of work that you do. But for our listeners, why don’t you tell us about the center for Rural Health Leadership? What is it? Why was it created? Maybe talk about some of the tenets of it.

Sydney Grant: Sure, absolutely. So, the center for Rural Health Leadership is the entity that Dr. Bill Oxia and I work in to put on these certification programs. So, we partner with NRHA to put on our Rural Hospital certification program. So, we work with a few other NRHA Service Corps executives to bring all the brain power together to get this done, because I’m sure you all know it takes a village to get anything done. So, I work with some really amazing people to coordinate all these efforts, and Dr. Bill Oxygen and I put these programs on. So, we’ve created curriculums and gathered all of the, like I said, the brain power to get these programs off the ground, because we certainly couldn’t do it ourselves, just the two of us. We needed expertise and knowledge from the people that have lived it to make this happen. So, the center for Rural Health Leadership, between me and Bill, we put on these certification programs in partnership with NRHA, and we just knew that we’re going to talk about some more. There was a need for programs like these to help our rural hospital executives shore up their knowledge base and skills and all of those necessary things to be in rural healthcare successfully. So that was what inspired the creation of Crull. And interestingly enough, when I was an intern on the podcast, part of our degree work was to solve a problem with this organization that you’re interning for. And so part of what we wanted to address was the high rates of CEO turnover in rural hospitals. So, this is about 2018, 2019, so not yesterday, as much as I may feel like it is. And we had to come up with some solutions about what does a solution look like for this huge problem? And the certification programs. While they may not have been called the certification programs at the time, that was one of our big solutions, that we thought this would be really effective if we were able to implement something like this, like these programs that would really change the game for this CEO turnover rate, which has gotten so high, particularly in rural hospitals. And then we know that that rate is going to have a much more impactful, impact, for lack of a better word, on that community. So, it’s funny to look back and think that we’d hypothesize this many years ago, and then we’re able to make it a reality through the center for Rural Health Leadership with NRHA. So, a bit of an interesting story there, but between me and Bill and our partners with the NRHA Service Corps and NRHA as a whole, we’ve been putting on these certification programs since February 2020, right before COVID hit, which we also thought, what a time to start. But it’s truly taken off, and we’re excited to be a part of it. So that’s just a little bit about the center for Rural Health Leadership and how we kind of came to be.

Rachel: And for our listeners who have been with us for a while. You may remember we did have an episode with Dr. Bill Oxygen. He was on the podcast probably within our 1st 20 episodes. I think he was pretty early on. 20 episodes and early on. Yeah. It’s hard to really conceptualize how long it’s been since we started this. We were just talking about that earlier, but I just wanted to give that shout out. But you’ve been talking about these programs. You have several different programs that you guys run at the center for Rural Health Leadership. So, can you talk to us about what each of those are and how do they work? What’s the real structure and process and engagement for the people who are participating?

Sydney Grant: Yes, I would love to answer. This is what I do every day, so I’m more than happy to talk about this. So, yes, we have three main certification programs. So, we have our CEO certification program, our CNO for Chief Nursing Officers, and our CFO for Chief Financial Officers and Financial Leaders. Those are our three main programs. We’re planning to launch four additional programs this year. So, an HR, a CMO, or physician leader program, a board of trustee’s program, and a rural health nursing certification program to lay it all out there.

JJ: Goodness, yes. My goodness.

Sydney Grant: So, our three main programs, though, CEO, CNO, and CFO programs, like I mentioned, we launched our very first CEO Cohort in February 2020, which feels like it was yesterday, truly. So, we actually got to kind of celebrate that anniversary at the Policy Institute this past week, which was great through NRHA. So, with our programs, it’s a mix of self-guided and group learning structure. We realize the value in both of those. And part of our big goal with our programs is that, like we’ve said a few times, rural health leaders are wearing multiple hats. They have more tasks than time in the day, for sure. So, the last thing that we want to do is overhaul your schedule with all this extra work and things that are going to slam your agenda. So, we tried to create this program that’s pragmatic and efficient and effective. So, part of that equation is you’ve got your self-guided piece, you have your group learning. Once we’ve had this combination of that, you should be able to go out and implement that topic the next day if you wanted to. So, we want to be pragmatic and efficient because we know that not everyone might have the time for an intensive experience with education. So that’s part of our goal is being really pragmatic for these rural hospital leaders because we know there’s a lot to get done. We want to make that easier for them. And so, part of what we do, we have subject matter experts that are all rural hospital specific and specific to each of these program positions. So, they’ll be CEO specific content, CNO specific content and CFO specific content. All as it relates to the rural hospital landscape. So very, very specific information that we’re trying to provide for these leaders because we know that there’s tons of great learning opportunities out there and degrees you can get, programs you can participate in, but none of them, to our knowledge, are rural hospital and position specific. And so, we heard the need, we heard the demand. And once we had success with our CEO cohort, we were told we need to do this for CNOs and we need to do this for CFOs. So that’s what spurred us to kind of branch out just from the CEOs. But our structure, like I mentioned, a little bit of self-guided. So, participants get materials on the topic for that week, whether it’s videos and PowerPoints, PDFs, Word docs, you name it. We have our participants prepare to talk about those topics and then we all come together for a zoom call so that we can actually do some networking. And its really quite valuable time that gets spent on those zoom calls. So that’s our mix of that self-guided and group learning structure that gets to weave together some really fascinating and diverse perspectives. Our participants range from sea to shining sea, truly. And it’s quite a treasure trove of knowledge that we get that’s passed along through there. So, lots of networking, lots of best practice sharing and connecting with subject matter experts that are position and rural hospital specific. So, like I mentioned, we want to be really specific for our leaders because I know that’s what they’re looking for in the most pragmatic way possible. So that’s kind of how we carry out the day to day, week to week of our programs.

Rachel: What’s the process to become a part of one of these programs for someone who is a CEO, a CFO, a CNO or a future, one of those things? If that’s the direction they’re headed in their career, how do they participate? Is it an application process? How does that situation work?

Sydney Grant: Yeah, great question. So, it’s a pretty simple application process. On our website, which I know will be linked in this episode, we’ve got our tabs for each of our programs where you can find more information, so there’s more information online if you want to peruse and review what’s available. But it’s a very simple application process. It’s free, super short and no commitment. So, you’re not bound to anything by applying. You just submit your short application and then we follow up with you with a flyer, some more details and information on next steps where we have all of our serious participants schedule an interview, just a short phone call interview. So, we can straighten out all the details and answer all of the questions, all that good stuff. So that’s our basic application process. If anybody is interested in enrolling. And we are enrolling for our upcoming Cohorts that we’re launching in March and are launching some cohorts later in the year as well. Around the fall.

JJ: We’ve already had a small discussion about how extremely busy executives are and a tremendous amount of work that is being done, especially in light of lost revenues, declining volumes, and truly, the need and demand for CEOs specifically to be all in fully engaged, keeping your board apprised of what’s going on, having a dialogue with your community and making sure that your rural hospital doesn’t close so you’re not added to that list of 140 since 2010. That’s closed. It’s a lot of responsibility. So, the question that I want to pose to you is knowing all of that with time being most precious, CFOs say cash is king. I say time is king.

Rachel: Because time is money and cash is king.

JJ: There you go. That is correct. Because truly, we are just in 18 different areas and a minute. Yeah, I guess my question is the programs that you have developed, let’s just talk about the CEO certification created, I would assume for maximum benefit for the members. Can you talk a little bit about the commitment that is required, let’s just say on a weekly basis? And then how do you as an organization say that is a focus area? That is something we need to talk about. That is something that’s going to take an hour of their time, that they’re going to have value added back on the other end. Because as a CEO, I’m listening and going, I’d love to do this, but you got to tell me what’s my value added? Can you help us understand that as CEOs are listening to this and CMOS and CFOs throughout the country?

Sydney Grant: Yeah, absolutely. So, for one, when we created these programs, like I mentioned before, this wasn’t something that Bill and I, while we did say, yes, this is a great idea, we need to do this, we did not come up with these curriculums, this content, on our own. We truly sought out the people who have lived the experience. So, for example, for our CEO certification program, we got together a group of tenured successful rural hospital CEOs. Majority of these CEOs had 20 plus years’ experience and tenure in their rural hospital CEO position and considered very successful in their careers and got them all together. Granted, this was pre COVID times. Even during COVID times, there’s nothing like a good zoom call. But got them all together and asked what I like to say is probably our favorite question ever in which we ask this question for our CNOs, our CFOs, and so on and so forth. We ask them, what do you know now that you wish you’d known? Then one of our favorite questions ever. And I’m sure, as you might imagine, pages and pages and pages and pages of notes later from all the input we got from that question, that’s truly what helped shape our curriculum. So, for one, when we wanted to create a program that was specifically for Rural Hospital CEOs, we got the Rural Hospital CEOs and said, what do these people need to know? Those people that are new in this position, continuous learners aspiring towards that goal, whatever spot you might be in. We asked these Rural Hospital executives, what do you know now that you wish you would have known that when you first stepped into this role or first started seeking out more information? And so that valuable knowledge that we got is what we shaped into our curriculum. For each of our programs, we go back and forth with ours. We like to call them our advisory board. We go back and forth with them many times to refine and make sure that curriculum is exactly right for this program. So, we use building blocks and modules in our program to make things again efficient and pragmatic. So, like you were saying, time commitment. We never ask for more than an hour and a half of time per week across our programs for those that are participating, because we do understand sometimes that’s all you may have been an extra 90 minutes in your schedule. And so, part of making things easy for people is just that, making sure the time commitment is reasonable and feasible for everyone because they have so many things going on. But I think in addition to that, we create this nationwide network for these leaders. They can have access to any time of the day. Granted, some people are in different time zones, so that is what it is. But we create this structure for them, whether it’s via email, a phone call, or through the platforms that we use, they can reach out to each other anytime they want. So, if Joe from Oregon is suddenly hit with the need for an example policy, or maybe has to close down OB and wants to know who’s done this, what were some of the common obstacles that you ran into? Maybe it can be avoided, anything like that. We’ve created this network for them so that even if it’s something outside of those hot topics that we made sure we wanted to cover when we talked to our experienced, successful executives, we can still reach out to each other any time of the day, and we can create this network of best practice sharing. And next thing you know, there’s three different policies flying between people and all these different resources that are being connected. So even outside of that potential 90 minutes of your time per week that might be needed, you have the flexibility to contact and reach out to not only your colleagues in the cohort, but those subject matter experts that teach the modules in our program, they are committed to reaching out. And if you want to reach out to them, they’re available now or five years from now, whatever the case may be. That’s part of the deal with them is that they offer their contact information to you as well. So, I think part of the flexibility and the return is that you have this network now and forever. As I like to say, when our participants are graduating, we’re really just getting started on our journey together. And that’s been true ever since February 2020, when we launched our very first CEO cohort and have been in touch with that group ever since. So, I think that network structure we create, because truly they are participants, carry it on their own so well, so easily, because it’s that desire to be in touch, to not feel alone, right? To know. For one, I’m not the only person that’s dealing with this problem, which is great. But two, you come to find there’s lots of different perspectives on how to approach this. You may have never even considered Joe and Oregon’s perspective because you’ve only known what gets passed around to you in Kansas or any number of issues like that. So, I think that too, is part of the return, is that you have this network that you can bounce questions and ideas off of, not just while you’re enrolled, but forever into the future. So, it’s almost, as I like to say, limitless return there with that network you’ve created. In addition to it’s not just your network of colleagues, it’s your network of subject matter experts. It’s all the content from your program that you’ve learned and everything that you learn in between from sharing stories and resources. So quite a lot of return for not too much of your time per week for program participation.

Rachel: So, what have you seen as far as the results of participation in this program? How has this impacted the success or the longevity of the rural healthcare leaders who have participated? I know you guys have only been doing it for a couple of years, so you clearly don’t have any long-term data on it, but what type of results have you seen? And even Anecdotally, what have you heard from the people who’ve completed the programs?

Sydney Grant: I love this question because we do have some data, which I love when data is really positive.

Rachel: I knew you would have some data.

Sydney Grant: Yes, of course. So, part of our measurement, because we of course want to measure growth, we’ll do pre and post assessments for all of our cohorts in our programs. So, these are self-assessments. So, it’s about how they’re perceiving their confidence levels, not only in all of the modules, but also their confidence as a leader in a rural hospital. So, we ask them to assess themselves on all of those competencies as well as their confidence in a pre and post assessment. So, it’s truly coming from their perception of themselves.

JJ: Good.

Sydney Grant: And so, we’ve measured growth by cohort and cumulatively with all of our cohorts across all of our programs. And so, the confidence numbers, all of the numbers have been extremely just. Wow. I’ve been stunned by the growth we see in each individual, as we like to call building blocks. So, we have leadership, financial operations, and clinical building blocks in each of our three programs, and there’s been massive growth in all of those building blocks. But the confidence numbers with our CEOs across all of our cohorts, we’ve seen a 38% increase in their confidence as a leader. With our CNO, we’ve seen a 51% increase in their confidence. And with our CFO, a 39% increase in their overall confidence as a leader in their rural hospital. So, I mean, that in addition to the growth percentage growth we see in the building blocks. That’s quite a recipe for success. We can finally say not a recipe for disaster, but a recipe for success. So, we’ve seen that the numbers are heartwarming, to say the least. But the anecdotal stories, like you’ve said, we’ve heard great feedback from participants. You know, for example, we’ve had one CEO graduate who found like hundreds of thousands of dollars in revenue for their facility based on this one piece of a module that we were talking about, about HPSA, which I think is Health Professional Shortage Area.

JJ: Shortage Area.

Sydney Grant: They were able to realize that they had all of this money that they could get from and you’ll forgive me for not being well versed in that, but from participating or taking advantage of something with the HIPAA, they were able to find all this revenue for years and years and years to come that they got directly from sitting in on one of our sessions. That’s great to hear. We hear lots of stories also about how culture has changed in an organization, how communities become engaged. We’ve heard about people who have been able to work with their communities to put up baseball fields, and from baseball fields to cancer screenings, to drive through COVID testing pop up tents that were drawing attention from states all around, not just in their rural area. But those little success stories, they’re not so little. As we know in these rural communities, that impact is amplified far more than what we often see in an urban setting. So, whether it’s in financial gains, cultural gains, community engagement, we see it all. And we see it all across our programs. And we hear it from our guests on our podcast too, which is exactly what we’re hoping to see in rural and hoping to keep up. So just a little bit about our growth and we’ve got so much more growth to make. I’m very excited for that and looking forward to sharing more numbers with you guys in the future, hopefully.

JJ: So, you know, Sydney, at some level, several years ago, you. Had to look at Bill and go, we have to pitch this to the National World Health Association for sponsorship or for partnership. You had to do that. And so, I guess I want to know what makes this program. I’m sure NRHA gets hit up all the time for sponsor this, do that, authorize this, recognize us, and they’re very limited in the amount of programs that they sponsor. So, what makes these programs that you offer, the tracks that you offer for executives a priority in your mind for NRHA? And I guess I would imagine the impact is not just as individuals who participate, but the organization and the industry as a whole. Right. So, could you talk to us about that two-part question?

Sydney Grant: Yeah, absolutely. So, kind of like how I hinted at before when I was explaining how the certification programs were a part of my internship that we never even thought would be a real time thing for us. So, the origin of this problem, and I think what NRHA is also aiming to do is keep our rural hospitals open. If I can be as broad speaking as possible, we want to keep our rural hospitals open. And so, to quote Alan Morgan, the CEO of the National Rural Health Association, he’s been quoted many times saying leadership is the single biggest predictor of success for a rural hospital. And so, if you couldn’t tell, I couldn’t agree more. And so that was the basis of our move and NRA’s move into creating and putting on these programs, was we wanted to figure out a way to address this high CEO turnover rate in rural hospitals, which we know is far more impactful on the community than in an urban setting per se. But we knew there was a lack of qualified candidates. We really don’t necessarily have a pool of qualified candidates for whether it’s the CEO, the CNO, the CFO role in a rural hospital. We just simply know that it’s different. It’s not the same as being in an urban setting. So that was, I believe, our shared mission between us and NRHA was we wanted to figure out how to keep these rural hospitals open and how we were going to do that. And so that’s how the certification programs began to take on their light, was to address that massive turnover rate. And we know that that can inevitably cause other executives to leave. It can certainly put a stop on any initiatives or projects that are going on in the hospital and can, unfortunately, be a huge factor for closures, which we’re trying to avoid that. And so, in an effort to keep those hospitals open through leadership, that’s what that shared mission is between us, is keeping rural hospitals open by preparing our leaders to effectively lead rural hospitals and be successful and not just survive, but thrive, we want to get past the survival stage. So that was our way of trying to tip things in the odds, in their favor. And I think that kind of speaks to it. As you were saying, the impact on rural health care as a whole, I can’t say it enough. We want to keep rural hospitals open. We know how incredibly valuable and critical they are to the survival of a community. I think that’s something as a convert, as a rural transplant and convert, I can say with full certainty that most people in the urban areas have no idea that a rural hospital closes and then the entire community can crumble if they’re the largest provider of jobs. Or imagine not having a hospital in your community. It’s hard to imagine. As a person that’s surrounded by hospitals everywhere in Tampa, Florida, it’s hard to imagine. So, I can say with all certainty that it’s an issue that needs to be brought to light, because even just knowing about it makes a difference, which I think is part of my job as a person in urban areas, is to make everybody around me a rural advocate. I like to say that if you make contact with me, I’m going to turn you into a rural advocate one way or another. So, I think that’s part of impacting the industry as a whole. But if we can provide that strong leadership, we can have such a positive impact on rural health care as a whole. You know, not just the Singular people, but their communities. And then we can have an entire network of thriving rural communities. So hopefully that answered your two-pronged question there.

JJ: It did, yeah. I firmly believe that our mandate is to tell our story in rural health. And it’s a remarkable story, very successful story. It encompasses several areas, as you know. Number one, high quality. A lot of individuals want to argue that if you go to a bigger facility, it’s better quality. It’s not the case. Lower cost. We often find that. And then when you have the atmosphere that we do, you look at the economic impact of those rural hospitals on their respective communities. And for those reasons are why we fight for rural healthcare. But the biggest reason that we fight is to provide services in the backyard, local and close to home in rural America, where we know transportation is a major concern and a barrier, where we know that individuals to get good health care, to travel 45 minutes, is not an option. And so, we’re fighting for the patients. This isn’t just to keep you and me and Rachel employed and looking at our jobs, but it is the backbone of health care. Rural healthcare is. We send out very ill, sick patients who need significant care. But we triage them first here. And we keep those patients. And we administer the TPA for stroke. And we’re stabilizing that patient, getting them ready. Whether it’s here in the Er, or if it is in the field or wherever it is on the floor. If they crash. The reality of it is that I feel we are the gatekeepers of all healthcare, local, rural healthcare. We’re the gatekeepers. And so, our story has to be told. And I think that is in part, the partnership that we’ve had with an RHA. And I’ve been a guest on your program before, Bill’s program, and really enjoyed my time there. But we tell the story. And it’s amazing to me the number of people that respond back. I did not know that. I did not realize that. Just the volume of people that don’t understand that I don’t have negotiating power with Blue Cross Blue Shield, and that I don’t get paid the same rates as this person, and just the challenges of rural health care. And so, I think what is critical is that we tell the story. And I think what you’re doing is you’re preparing a generation of leaders to be able to tell that story, to give them the framework, and I’m going to encourage you to keep that work up. I know for one of our staff, Megan Campbell, our chief nursing officer, who started her career here and worked up the ranks, and it’s a success story. It’s a story of determination and hope and leadership. And she completed this program at my request. I encouraged her after I received Bill’s, I think, 12th email about the certification class. And I said, Megan time isn’t available for me now. I will go through this program, but I want you to go through the program. And she’s going to actually update and give a summary to our management council and to our board of trustees about her experience in the certification program, which I think is very important. But I want to thank you for what you’re doing to raise up, to train, to educate this next generation of leaders in some of the most tumultuous times that we’ve ever experienced in healthcare, ever in our history. And it is going to take tenacity hard work. But the most important thing that I heard you talk about today was the cohort, the collaboration. It’s the opportunity to not feel like we’re an island, because there are days I wake up and I feel that way. There are days I go to bed at night going, I’m alone. And I know it’s not right, but I do. And I feel like, man, I’m in the fight alone. And we have to be reminded that there are other leaders throughout this country who are in the exact same, if not worse, condition than myself or other peer hospitals. And so, I think one of the things that’s so encouraging about your program is the access to peers across the country. And so, if you’re listening today, as a senior executive in healthcare, I would encourage you to look at this program as an opportunity for you to build, a great opportunity for you to learn, a great opportunity for you to connect. And I think for all of those reasons, it would make this a worthwhile program for an executive. And the work that the NRHA is doing, the work that you are doing, Sydney, is so important to the long-term viability of healthcare. We have to tell our story. We have to have a voice. And oftentimes we just get into our little narrow Hillsdale, name the community, and we just stay there. And when they don’t hear our story, congressional leaders, obviously politicians who have ability to change a lot, they don’t know that story exists, and we’re not telling it. Healthcare will begin to look much different into the future unless we do something radical involved with changing payer mix, changing how payment structures work, and the list goes on and on. But in order to do that, they have to be trained well, and that’s what you and your program do. So, I want to thank you for joining us again today. It has been an absolute pleasure to have you on our podcast, and we hope that you will take the opportunity to come visit Hillsdale and not only that, but also maybe be a return guest for us here on Rural Health Rising. So, thank you so much for joining us today.

Sydney Grant: Well, thank you so much. And truly, we don’t exist without people like you and Rachel and Megan and everybody else out there in rural hospitals fighting the good fight. So, we’re nothing without you all. Truly, you all are the reason we’re even here to try to make things better. So, thank you for all that you all are doing, too.

JJ: And before we close, we like to do a fun segment with each of our guests. We want to know now, you’re not born in a rural community and you didn’t spend all of your childhood in rural, but we want to know what is your most unique rural experience or one of your favorite memories that’s unique to rural life?

Sydney Grant: Yes, this is a great question. So, you’re absolutely right. While I am not a rural native and I don’t currently live in rural, I will say I absolutely adore visiting rural areas. That’s been the places that my parents and I have vacationed ever since I was a child. So, we certainly have had a love for rural areas since the beginning. But I hear lots of very interesting stories, whether it’s between program participants or podcast guests and things like that. One of my favorite stories that we’ve heard so not a personal story, but I’ll share it for this person. One of our favorite stories that we heard was from one of our participants and a podcast guest, and he shared with us how he was literally born and raised in the hospital that he’s currently the CEO of. So, his mother was the CEO there first. He was born there, lived in the hospital. They had an apartment in the hospital.

JJ: That they actually lived in.

Sydney Grant: Used to ride his little trike down the hallways in the hospital and now he is the CEO of that hospital. So that’s one of my favorite stories.

Rachel: Cool.

Sydney Grant: Yeah, that’s a pretty cool story. So, I love to share that.

JJ: That’s pretty rural.

Rachel: Talk about being rooted and dedicated to your community and your hospital.

Sydney Grant: Yes.

JJ: That’s an amazing history. Wow.

Sydney Grant: Yes.

JJ: Tell that story wherever you go.

Sydney Grant: I think that has to be my favorite story so far. But I know the stories are going to grow, so we have lots of opportunities. They are the next time I’m on here to share some more.

JJ: That’s right. Yes, absolutely. Well, once again, thanks for joining us today.

Sydney Grant: Thank you so much for having me.

JJ: Next time on Rural Health Rising, we’ll have another great conversation with another great guest, so be sure to tune in.

Rachel: And with that, don’t forget to subscribe. Wherever you get your podcast. And if you like what you hear, leave us a five-star review on Apple podcasts and tell others why they should listen to your feedback helps more listeners find Rural Health Rising.

JJ: And you can now find us on Twitter. I’m @hillsdaleCEOJJ Rachel is @RuralHealthRach, and you can also follow the podcast at @ruralhealthpod. Until next time, stay safe, stay healthy, and stay strong.

Rachel: Rural Health Rising is a production of Hillsdale Hospital in Hillsdale, Michigan and a proud member of the Health Podcast network hosted by JJ Hodshire and Rachel Lott. Audio engineering and original music by Kenji Olmer. For more episodes, interviews, and more information, visit rural healthrising.com.