Jeri Nelson, who has faithfully served as Eastern Plumas Health Care\u2019s Chief Financial Officer for 23 years, retired Friday, June 15. She left behind a frighteningly neat and empty office as she hugged Katherine Pairish, the incoming CFO, and said, \u201cTake good care of it.\u201d Several of those who worked closest with Nelson went into her office after she went out the back door. One of them, Teri Becky, who had worked alongside her for that entire 23 year period, broke down and cried. CEO, Tom Hayes, called her, \u201cthe best CFO I\u2019ve worked with in my career. She\u2019s very honest and direct, which I really appreciate.\u201d<\/p>\n
What makes for that kind of response from fellow employees? A word that Nelson often used as a measure for what was right in guiding the hospital and her response to any given crisis was \u201cloyalty.\u201d Nelson embodied a sense of loyalty that meant putting the hospital\u2019s good front and center in everything she did. There was a great need for someone of Nelson\u2019s caliber when she arrived at EPHC. Shawna Leal, Clinic Back Office Supervisor, who has been at EPHC for 26 years said, \u201cHer determination and love for what she does is a huge part of why we are still here today. I truly believe that her drive was to help the hospital, but also to help employees and their families.\u201d<\/p>\n
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Taking a Look Back…<\/em><\/strong><\/p>\n As Nelson recalls, it was 1995 – she was \u201cmarried to a local guy\u201d and had recently relocated to Graeagle. She was looking forward to raising a family and riding her horses, but after a few months, she got bored. She looked in the local newspaper and saw an ad for an accountant. A CPA by trade, she thought, \u201cI can do that.\u201d<\/p>\n The hospital Board had recently fired Brim Healthcare, the management company that had been running EPHC. According to Teri Becky, she and Randi Collier, who were both working in the Finance Department, had discovered a drawer \u201cplumb full of checks that were not mailed and were being held by the CFO,\u201d because there was no money to pay the bills.<\/p>\n Becky and Collier told the Board, \u201cwe felt the CFO was cooking the books,\u201d adding that they \u201chad to race to be the first ones over the bridge to the bank to deposit our paychecks before they bounced.\u201d Becky stated they were spurred to action because they knew if they didn\u2019t, the hospital would close. \u201cIt was that bad.\u201d Luckily, the Board took them seriously and started looking into the hospital\u2019s finances, which resulted in the firing of Brim Healthcare, and their CEO and CFO.<\/p>\n When Nelson interviewed for the accounting position,, she met with Charles Guenther, who had been CEO for all of a week. He made it clear that \u201che needed some help rebuilding the organization from the top down,\u201d said Nelson. \u201cI didn\u2019t really want any responsibility at that time – I didn\u2019t want to be a CFO, but I knew I was up to the task . . . It\u2019s not in my nature to turn my back on things.\u201d<\/p>\n She paused and shook her head. \u201cI had no idea how bad it was.\u201d<\/p>\n They were still using paper ledgers, she said, which meant \u201cyou could create any financial record you wanted. They were one sided entries so they didn\u2019t have to balance, and they didn\u2019t balance. It was amazing.\u201d Records didn\u2019t match, they couldn\u2019t pay or get paid, the buildings were old and in ill repair, and all the equipment was old, she recalled.<\/p>\n About six months into the job, Nelson filed for bankruptcy on behalf of the hospital. \u201cWe owed about $850,000 that we couldn\u2019t pay,\u201d she said. The hospital wasn\u2019t making enough to survive given all the services they were trying to provide, so they had to cut some things, one of which was maternity. They couldn\u2019t afford to pay physicians 24\/7 on call for the small number of babies they were delivering, said Nelson.<\/p>\n \u201cThat was hard – a lot of people working here were born here,\u201d she said.<\/p>\n But, as she\u2019s had to do many times since, in concert with the CEO and the Board, \u201cWe needed to think about what to do to keep the whole hospital open. We still have to think that way,\u201d said Nelson.<\/p>\n The nurses had unionized, \u201cso one of the things we wanted to do was get them to trust administration and believe that we\u2019d follow through on commitments we made.\u201d She worked with the Board and the CEO to make things right with the doctors and nurses, who did agree to leave the union behind.<\/p>\n Next, they came up with a bankruptcy plan. They had to pay vendors a certain amount on the dollar. Some vendors refused to work with them, and others required cash payment. They tried to do right by local businesses as much as possible, Nelson said.<\/p>\n The hospital didn\u2019t come out of bankruptcy until 2004 – nine years later. But, \u201cwe met the terms [of the bankruptcy]. Not too many small rural hospitals manage to survive that. A lot of them just closed their doors,\u201d said Nelson. \u201cWe were up against a lot of odds, but with our community, staff, and Board support, we made it. But, we never looked too far out – it was what can we do this week, this month.\u201d<\/p>\n The biggest frustration along the way was dealing with incessant additions and changes to government regulations. If they thought you were doing something wrong, Nelson said, they wouldn\u2019t tell you, they\u2019d just use it as an excuse not to pay you. \u201cAs soon as you got something fixed, something else would change\u2026these affected how we got paid, so you couldn\u2019t ever relax, we were always looking ahead, saying \u2018What\u2019s coming at us next?\u2019\u201d<\/p>\n Because, for example, Medi-Cal pays EPHC around twelve cents on the dollar, Nelson fills out a cost report at the end of the year. There are several federal and state programs she has researched and applied for that \u201cbackfill\u201d some of the money the hospital isn\u2019t paid by Medi-Cal and Medicare for services. Without those extra \u201cpots of money,\u201d as Nelson calls them, EPHC would likely have been forced to cut additional services.<\/p>\n Nelson also worked with the Board and CEO to get EPHC designated as a critical access hospital and its clinics designated as rural health clinics. These special categories are accorded to hospitals and clinics in rural areas, where access to care would be severely compromised if they were forced to close. These designations allowed EPHC to avoid some of the most draconian of the state and federal regulations.<\/p>\n In addition, she said, the hospital gradually added services that it felt the local community needed. One of the first things they did was to expand skilled nursing. \u201cThere was a huge waiting list and no other access to long term care,\u201d said Nelson. They added dental, which was vital because no other local provider would take Medi-Cal patients. \u201cThey had no place to go but the ER,\u201d Nelson said, \u201cso we did that.\u201d<\/p>\n Taking the risk and expanding services \u201cwas a team effort, involving a \u2018can do\u2019 spirit,\u201d said Nelson. \u201cI wouldn\u2019t have stayed otherwise.\u201d The Board had to trust that Nelson and current CEO Tom Hayes, who came in 2009, were telling them the truth when they pushed for an expansion of services. \u201cThe Board has been very supportive,\u201d she added.<\/p>\n Looking forward, she said, the hospital will continue to look to the community and the Board to determine what services are really important, and modify things accordingly. \u201cWe\u2019ve always been open to change,\u201d she said.<\/p>\n Asked what convinced her to stay through all the difficult times, Nelson didn\u2019t hesitate: \u201cI love what I do \u2013 always have . . . I knew how important [the hospital] was to the community. I wasn\u2019t going to let it go down if I could help it. With the added services, you can see we\u2019re helping kids, we\u2019re helping families, we\u2019re saving lives. I feel very fortunate. I did get the opportunity for all these years, to accomplish some good things, with the help of a lot of good people \u2013 too many to name.\u201d<\/p>\n Nelson is ready for a new chapter, however. \u201cI love the area very much. I have two dogs, two horses, and I want to be able to get out on these beautiful days – not sit in front of a computer, but enjoy my time in Graeagle. That\u2019s what I moved here for – it\u2019s only taken me 25 years!\u201d<\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Jeri Nelson, who has faithfully served as Eastern Plumas Health Care\u2019s Chief Financial Officer for 23 years, retired Friday, June 15. She left behind a frighteningly neat and empty office as she hugged Katherine Pairish, the incoming CFO, and said, \u201cTake good care of it.\u201d Several of those who worked closest with Nelson went into […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-411","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/posts\/411","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/comments?post=411"}],"version-history":[{"count":1,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/posts\/411\/revisions"}],"predecessor-version":[{"id":412,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/posts\/411\/revisions\/412"}],"wp:attachment":[{"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/media?parent=411"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/categories?post=411"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ephc.org\/blog\/wp-json\/wp\/v2\/tags?post=411"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}