Annual Report

Contents


A Letter from our CEO


Doug McMillan, CEO (Left) & Dr. Lenox Baker, Board Chair (Right)
As we move into a New Year and decade at Cody Regional Health, I’m extremely grateful for the significant growth and accomplishments achieved at Cody Regional Health for the last decade.

These changes and accomplishments are a direct result of teamwork, compassion, commitment, and strong collaboration by all staff, physicians, and trustees working together to create a world-class rural health care system for Northwest Wyoming.

Every year, we are privileged to serve people from Northwest Wyoming, the United States, and even other countries who come to Cody Regional Health with all types of illnesses for treatment and services. Being trusted with the lives and health of so many is an honor and privilege that every Cody Regional Health employee takes seriously.

This past year was a monumental year for Cody Regional Health in service growth. Through our partnership with Billings Clinic, we opened the Cody Cardiology Center, recruited two full-time Interventional Cardiologists, and completed over 100 Cath procedures in our new Cath Lab. Cody Regional Health is the only Critical Access Hospital in Wyoming and one of seven in the United States to provide this level of Cardiology services.

We are proud to feature our CRH local women healthcare leaders, medical staff, and board of trustees. CRH workforce is comprised of greater than 80% women, many of whom are in leadership roles at Cody Regional Health. We are also excited to feature many other great changes that have occurred at CRH this last year including growth in our medical team, services lines, organizational awards, and more.

It is truly an honor and privilege to serve as CEO at Cody Regional Health. CRH is a special organization filled with people who have chosen the healthcare field because they want to make a positive difference in the lives of others. It is their commitment to making a difference in our patients and families’ lives that makes Cody Regional Health a special place.

Thank you for placing your trust in Cody Regional Health and for viewing our 2019 Report to the Community. We are proud to share how we are growing and making a positive difference in Northwest Wyoming.


Mission Vision & Values

Mission

To provide extraordinary healthcare to those we serve by people who care.

Vision

The first choice for those who aspire to heal, be healed & lead healthier lives.

Values

Compassion, Integrity, Excellence, Innovation & Collaboration.


Orthopedic Feature

Christopher Rice, M.D.

Orthopaedic Surgeon Specializing in Upper Extremities

We are excited to welcome Christopher Rice, MD to our Orthopaedic Family! Dr. Rice is Board-certified and achieved his hand surgery fellowship from HealthPartners Institute Regional Hospital in St. Paul, MN. He also completed his Orthopaedic surgery residency with the University of Wisconsin Department of Orthopaedics and Rehabilitation. Our patients benefit greatly by having a local upper extremity Orthopaedic surgeon and we are thankful to have him on the team.

View Dr. Rice's Profile

Specialties

Hand Surgery
Wrist Pain & Injuries
General Orthopaedic Care


Local Healthcare Women Leaders

Women Leading in Healthcare

  • ELISE LOWE, MD

    CRH Hospitalist

    What do you do to destress after work?
    My major stress relief comes through staying active and attempting to create boundaries between me and my work. I love hiking and paddle boarding and being involved in Search and Rescue. I value spending time with my family, friends and boyfriend. My dog, Watson, always lets me know when he needs more attention.

  • ANDREA MCKAY

    CRH Chief Ambulatory Officer

    Did you plan on becoming a leader in healthcare?
    I’ve served in some capacity in healthcare since 1984. My first position was as a cashier and patient registration clerk. I helped patients register for lab and X-ray services, billed insurance claims, and worked the switchboard when needed. I enjoyed the work helping people navigate through their financial aspect of healthcare. The more experience I gained in different areas of the hospital, the more intrigued I was about expanding my knowledge in healthcare. I grew into leadership having first served patients in a variety of positions, as a physician liaison, and then as an advocate for a team of healthcare providers and staff all in effort to bring the best patient care to the community.

  • BRANDI SHEPARD, AU.D.

    CRH Audiologist

    How are you planning on helping other women progress in leadership roles?
    I have had so many wonderful women who helped shape me personally and professionally. I look forward to the time when I can be an influence to how another woman might practice. For now, as a mother of four young children, I am currently putting my efforts on raising them into being strong, independent individuals, who are open to new things, and not afraid to ask for help. I think there are many times we are helping women to be their best by being kind, supportive, and sharing our thoughts and experiences.

  • LISA WILLIAMS, MD

    Women's Health Provider at CRH

    What is your current leadership role in healthcare? I am currently the chair of the Ob/Peds committee and participate in other active hospital committees. As one of the two obstetricians in Cody, I work with Dr. Chisholm closely to grow and develop the obstetrical services at Cody Regional Health.

  • JEN TALICH

    CRH Board Member

    What do you do to destress after work?
    Sometimes I think the most stressful part of my day actually starts after work! I have five children from 1st grade up to a junior in high school and they are in all kinds of activities; just getting dinner on the table and sitting down together can be a small miracle! I think managing stress is very important though, I do workout four to five times per week and having a person in your life to confide in with your worries and cares helps relieve the burden of stress! And laundry—laundry causes me stress! Ha!

  • GRAHAM JACKSON

    CRH Board Member

    How are you planning on helping other women progress in leadership roles?
    I have been fortunate to be able to work and volunteer with amazing women through the years, and I see that continuing in the future! I try to be a positive role model and resource. It is always important to mentor others. Mentoring can look different based on career path and goals. Fundamental to mentoring is ensuring tools and training are in place to succeed; then encouraging women to keep moving forward and be confident in what they do best, while being available to cheer successes and coach when there are questions or opportunities.

  • KATHLEEN DIVINCENZO, MD

    CRH Hospitalist

    How are you planning on helping other women progress in leadership roles?
    I have always encouraged women to participate in the medical staff and its committees and have nominated them for positions. Offering advice when asked and encouragement when there is doubt.

  • COURTNEY SPENCE, DO

    CRH Internal Medicine Provider

    Did you plan on becoming a leader in healthcare?
    I did not intentionally plan on becoming a leader, but I have always taken pride in my job and strive to be the best I can be on a daily basis. When I started at CRH I was given an opportunity to further enhance patient care by becoming the quality champion and as such I have been able to make some exciting changes to better improve our patients’ overall health and quality of care.


Radiation Oncology Update

Bryce C. Lord, D.O., DABR

Radiation Oncologist

The Cody Regional Health’s Big Horn Basin Cancer Center is a joint project of Cody Regional Health and St. Vincent Healthcare in Billings, Montana to provide local radiation oncology and medical oncology.

Our Big Horn Basin Cancer Center caregivers provide advanced cancer treatments using the latest medical breakthroughs with a systematic approach to disease treatment. You’ll find the services you need in a caring, compassionate and hope filled atmosphere. Our commitment is to the whole person—to treat the body, calm the mind and uplift the spirit.

This year we were excited to welcome Board- Certified Bryce C. Lord, D.O. to our medical family! Dr. Lord, respects each patient’s hopes, values, personal experience, resources and treatment goals. Modern medical care is a human undertaking that’s complicated at times. He strives to educate patients and families about the diagnosis and process of treatment so the journey is understandable and less daunting. During a patient’s journey, his goal is to provide thoughtful and coordinated cancer care among all the medical specialists that comprise the care team so you receive the highest quality care.

As our radiation oncologist, Dr. Lord chooses the most appropriate technique to deliver therapeutic radiation to our patients. The process begins after diagnosis has been established with a plan recommended for radiation therapy by undergoing a simulation or mapping study. This involves a CT scan to create a 3D model of the body and target. Treatment planning then follows.

Typical radiation treatment times are scheduled in 15 minute blocks with most of that time being used for alignment and imaging as applicable. Radiation treatment is painless and lasts much less than 1 minute for a typical treatment. After treatment is completed, a course of surveillance and follow-up is recommended which may include imaging and labs as appropriate for the diagnosis. Understanding the treatment process in radiation oncology is the first step to minimize some of the confusion that patients experience during their journey.


Opioids, Mental Health and Zero Suicide Update

ZERO Suicide Initiative Update

“Since November 2017 CRH has had 209 referrals that would have otherwise fallen through the cracks in our community.”

Last year Cody Regional Health reported on our efforts to implement a new process throughout our organization called ZERO Suicide. We are so excited to report this process has begun saving lives in our community.

The goal of the Zero Suicide Initiative was to prevent ALL death by suicide, and the only acceptable number for death by suicide is ZERO. This is important for Cody Regional Health because as a health system we are at the center of the community, and we have the ability to prevent people from falling through the cracks by using and incorporating a hospital wide protocol involving each patient in every office from the Emergency Department to our Pediatrics Clinic.

Currently we are in an operational phase within our system, where all departments that provide direct patient care are administering a PHQ-2/PHQ-9 questionnaire. There is a scoring system where if a person scores in a mild depressive symptoms they are provided with a list of therapists in the area and information on counseling if they are accepting and willing to do this. If a patient scores moderate to moderately high on the depressive symptom inventory, the patient is asked if they would be willing to have a referral made to our Behavioral Health clinic.

Once this referral is made, the patient is contacted to offer any services CRH provides in house or to establish a more appropriate referral in the community, if needed. If a person scores severely high on the PHQ- 9, CRH is contracted with Yellowstone Behavioral Health to provide in house crisis intervention therapy services. Since November 2017 CRH has had 209 referrals that would have otherwise fallen through the cracks in our community.

The future of this program will be to fully integrate this system within the community, providing the PHQ-2/PHQ-9 questionnaire in more than just medical offices within the community. Depressive symptoms are vital signs and they are difficult to measure and are often not discussed. As a society, there is a lot of stigma placed on mental health issues, making it difficult for people to speak openly and honestly about the challenges they face in their lives. The Zero Suicide Initiative, as it grows, will diminish this stigma and help normalize discussions between patients and their medical providers when they need help w/mental health challenges.

Wyoming State Opioid Grant

In response to the national opioid crisis, the federal government has directed grant money to all 50 states for establishing Medication Assisted Treatment (MAT) programs for clients with Opioid Use Disorder.

This grant opportunity was a perfect fit for Cody Regional Health (CRH). Cody Regional Health’s Behavioral Health department is home to Wyoming’s oldest MAT program. Our MAT program started in January 2012 and has continued to grow with Psychiatrist, Scott Pollard, MD and his team. Everyone brings a unique experience that has helped this program to expand and now start new programs.

CRH was awarded a State Opioid Response grant in February 2019 with the goal of making Medication Assisted Treatment available in all four counties of the Big Horn Basin. We are now partnering with Big Horn Basin Counseling Services to offer MAT programs in Basin and Lovell, Wyoming.

We have also been able to work with Yellowstone Behavioral Health and Cloud Peak Counseling in providing medication management for their program through our Nurse Practitioners.

We recently launched an integrated marketing campaign to address the stigma of opioid addiction, and the stigma of treatment throughout the Big Horn Basin Region in Wyoming. There is much work to be done, but we are on the way to achieving our grant expectations and making this life-saving treatment available throughout our service area in Northwest Wyoming.


Cody Cardiology Center Update

Retired Powell High School Educator and IT Director, Terry Foley, was Cody Cardiology Center’s 104th heart cath patient since November 2019. Terry and his wife, Trisch Foley, have been residents of Powell, Wyoming, for the past 46 years. Now in retirement, the couple enjoys camping and spending time with their four children and grandchildren. Terry was looking for answers and he found them at CRH’s Cody Cardiology Center (CCC). He was short of breath and had various heart tests but wanted to rule out any blockages to his heart. As a candidate for a heart cath procedure, Terry chose CCC because of the advanced technology and the providers conducting the procedure, and being close to home. Soon after his procedure, interventional cardiologist, Dr. Thomas Wolford, found Terry had no severe blockages. Terry now has peace of mind, knowing the results of the procedure.

Cath Lab

Since opening our new Cody Cardiology Clinic in partnership with Billings Clinic, we have been able to serve over 900 patients and out of these, over 100 patients have had a heart Cath procedure in our Cardiac Cath Lab. Cody Regional Health is the only Critical Access Hospital in Wyoming and one of only a few in the United States to provide this level of Cardiology services.

We now offer cardiology services once a week at Powell Valley Healthcare and in Worland to better meet the needs of our patients throughout Northwest Wyoming.

Your heart health matters and it is our goal to offer the best localized care available to our patients. With preventive care, you can enjoy a healthy, active lifestyle with your friends and family. For patients who require treatment and rehabilitation, our cardiologists work with our dedicated team of professionals to provide you personalized care.

You are in good hands with our cardiologists and you can trust our comprehensive diagnosis, treatment and rehabilitation care.


Awards

2019 AHA Rural Hospital Leadership Team Award

The Rural Hospital Leadership Team Award from the American Hospital Association (AHA) Section for Small or Rural Hospitals recently honored the Leadership Team of Cody Regional Health for guiding our health system and community through transformational change on the road to health care reform. The CRH leadership team displayed outstanding leadership and responsiveness to the community’s health needs and demonstrated a collaborative community process to lead to measurable outcomes. The innovation and leadership in working with Billings Clinic and Helmsley Charitable Trust to establish the Cody Cardiology Center is only one of many major projects accomplished over the past year and has received national recognition.

2019 Hospital Quality Excellence Award

Mountain-Pacific Quality Health recognized Cody Regional Health with a 2019 Hospital Quality Excellence Award for outstanding performance in effectively using quality assurance performance improvement methodologies to improve care practices. Cody Regional Health is one of eight hospitals honored during this year’s Wyoming Quality Health Care Conference held in Cheyenne.

Jeff Martin Award for Excellence

For 10 consecutive years, Cody Regional Health has received the Jeff Martin Award. The Jeff Martin Award for Excellence is given only to select hospitals for exemplary performance in the area of patient safety and risk management

Center for Medicare & Medicaid Services

Cody Regional Health continues to be rated as a top 4-star rated facility. The star ratings are based off of 64 different healthcare measures, such as infection rates or emergency room wait times. These measurements are then grouped into broader categories, and weighted differently to provide the different star ratings. Hospitals have to meet minimum reporting requirements in order to be eligible to receive a star rating.

HomeCare Elite

Cody Regional Health was named a Top Agency of the 2019 HomeCare Elite®, a recognition of the top-performing home health agencies in the United States. Cody Regional’s Home Health has received this award for the past four years. The ranking is developed by ABILITY® Network, a leading information technology company helping providers and payers simplify the administrative and clinical complexities of healthcare.

Becker’s Healthcare

Cody Regional Health’s CEO, Doug McMillan, was recognized this year by Becker’s Healthcare as one of the top critical access hospital CEO’s across the nation. As CEO, Mr. McMillan has grown Cody Regional Health into a regional critical access hospital with expanded services not typically found in this size of facility. He leads recruitment efforts and doubled Cody Regional’s primary care and specialist physician teams during his tenure. In recent years, Mr. McMillan oversaw the hospital’s efforts to open a Wound Care Center with hyperbaric chambers, establish ENT, Allergy and Orthopaedic clinics, negotiate a joint venture for a cath lab and expand its cancer center which includes radiation and medical oncology under one roof.


Finances

West Park Hospital District
Combined statements of net position June 30, 2019 and 2018

CURRENT ASSETS 2018 2019
Cash and Investments $45,865,538 $51,821,810
Patient and Resident Accounts Receivable, Net $19,332,423 $18,344,949
Other Current Assets $4,738,758 $4,663,403
Capital Assets, Net $82,490,536 $76,681,271
Noncurrent Cash and Investments $19,320,259 $19,752,317
Other Noncurrent Assets $1,879,736 $2,061,780
TOTAL CURRENT ASSETS $173,627,250 $173,325,530
LIABILITIES 2018 2019
Current Liabilities $14,259,461 $13,830,538
Long-Term Liabilities $36,539,052 $35,595,656
TOTAL LIABILITIES $50,798,513 $49,426,194
NET POSITION 2018 2019
Net Investment in Capital Assets $43,478,507 $38,699,147
Restricted $5,020,367 $5,128,544
Unrestricted $74,329,863 $80,071,645
TOTAL NET POSITION $122,828,737 $123,899,336
TOTAL LIABILITIES AND NET POSITION $173,627,250 $173,325,530

Foundation & Community Benefits

3 Reasons To Give To Cody Regional Health Foundation

To Commemorate Love
Donating can provide an opportunity to remember or honor special people; while also raising much needed funds to support those without an ability to pay or provide special patient needs.

To Reflect Inner Values
Your passions can drive your giving. If you have an interest in a particular area such as cancer support, elder care, hospice, heart health, women and children, and first responders we have a variety of ways you can make an impact.

Help Improve Our Community
With the support of donors such as you, Cody Regional Health Foundation has obtained funding for an allergy clinic, a new pediatric clinic, cancer center, state-of-the-art diagnostic equipment, cardiac cath lab, and much more.

Donations from the heart boost sense of community and inspire others to give. Gifts large and small, make a difference in helping us deliver exceptional care to all who enter our doors and support immediate and emerging needs. The Cody Regional Health Foundation is an organization committed to supporting Cody Regional Health through philanthropic support. All gifts are tax deductible and offer an opportunity for you to invest in your community and future generations. With the help of our generous donors we have been able to help provide so many additional important programs, technologies, and services. All along positively impacting our patients, their families and our community.


How Gifts To Cody Regional Health Foundation Have Made A Difference

Hospice Memorials
Spirit Mountain Hospice is dedicated to providing for the physical, emotional and spiritual needs of the terminally ill and their loved ones. Hospice Memorials provide an opportunity to remember or honor special loved ones; while raising funds for Hospice. Donations are used to support hospice care for those with an inability to pay.

3D Mammography
3D mammography is an FDAapproved advanced technology that supports early breast cancer detection with fewer call backs and improves the health of women in our community. 3D mammograms allow more accuracy to detect and diagnose cancers.

Big Horn Basin Cancer Center
Our cancer center provides residents throughout Northern Wyoming access to some of the nation’s leading oncologists and cutting-edge technology— right here at home. This center was established so local patients can receive exceptional care without having to travel great distances.

Hand Held Ultrasound
Hand held ultrasound can be extremely important in addressing very serious situations. These portable devices will cut out time needed to set up a traditional scan and allow a physician or a paramedic to identify something like a sudden and life-threatening hemorrhage in a patient much more quickly.

Stop The Bleed Program
This is a free education program that focuses on recognizing lifethreatening bleeding and the ability to intervene effectively to save a person’s life. For someone who is seriously bleeding, one person who is on the scene, at the right time, and who has the right skills can make a life or death difference until emergency professionals arrive.

Community EMS
The Community Emergency Medical Services (EMS) program is an emerging healthcare profession that is helping close the gap by expanding the role of EMS personnel. Our EMS program allows paramedics and emergency medical technicians to provide routine healthcare services to under-served populations, and helps to improve transition of care after hospital discharge.


2019 Classes & Events

  • Stop the Bleed Classes
  • Hands Only CPR Classes
  • Reach Healthcare Camp
  • SpinCody
  • Cancer Survivor Ice Cream Social
  • Community Thanksgiving Dinner
  • Hospice Lovelights & Celebration of Life
  • Annual Holiday Helpers
  • Barn Dance
  • Lunch & Learn: Cardiology
  • Lunch & Learn: Orthopaedics
  • Lunch & Learn: Advanced Directives
  • Lunch & Learn: Women’s Health
  • Lunch & Learn: Food Prep
  • Guns & Roses Event

COMMUNITY EVENTS

Community health partnerships are a key pillar at Cody Regional Health. One of the major ways we work to improve overall health in our communities is by hosting multiple health events and classes covering a variety of topics.

We would like to give a big thank you to our team members for sharing their knowledge during these events and classes. All events and classes are supported by Cody Regional Health’s Foundation to keep everything free of charge to the public. We look forward to a full year of events in 2020. Please review some of the events and classes Cody Regional Health hosted in 2019!


Our Physicians

Theodore Ajax, MD
Anesthesia

Patrick Allen, DO
Internal Medicine

Lael Beachler, DPM
Podiatry

Jimmie Biles, Jr., MD
Orthopedic Surgery

Kirk Bollinger, MD
Emergency Medicine

Ryan Bower, MD
Hospitalist

Adair Bowlby, MD
Family Medicine

Andrea Chisholm, MD
Obstetrics & Gynecology

Gregory Cross Jr., MD
Radiology

Kathleen DiVincenzo, MD
Hospitalist

Thomas Edwards, MD
Cardiology

Stephen Emery, MD
Orthopedic Surgery

Thomas Etter, DO
General Surgery

Randy Folker, MD
Otolaryngology

Duncan Fraser, DPM
Podiatry

Allen Gee, MD
Neurology

Travis Graham, MD
Radiology

Gary Hart, MD
Wound Care

Lisa Harvey, MD
Family Medicine

Andrew Hoene, MD
Emergency Medicine

Aaron Killpack, DO
Family Medicine

Stephanie Knodel, MD
Emergency Medicine

Judd LaRowe, MD
Internal Medicine

Jared Lee, MD
Orthopedic Surgery

Bryce C. Lord, DO
Radiation Oncology

Elise Lowe, MD
Hospitalist

Bradley Low, DO
Anesthesia

Stephen Mainini, MD
Wound Care & Pulmonary
Medicine

Gregory McCue, MD
Hospitalist

David Mills, MD
Family Medicine

Douglas Morton, MD
Family Medicine

Dale Myers, MD
Gynecology

John Murray, MD
Emergency Medicine

Jeffery Poffenbarger, MD
Neurosurgery

Sandra Nelson, MD
Child & Adolescent Psychiatry

Scott Pollard, MD
Psychiatry

Adam Peters, MD
Family Medicine

Scott Polley, MD
Emergency Medicine

Chris Robertson, FM
Family Medicine

Mark Ryzewicz, MD
Orthopaedic Surgery

Catherine Schmidt, MD
Anesthesia

Frank Schmidt, MD
Orthopaedic Surgery

Tanya D. Schnel, DO
Anesthesia

Peter Sidor, MD
Pediatrics

Kim Slight, MD
Hospitalist

Courtney Spence, DO
Internal Medicine

Gregory Stewart, MD
Urology

Christopher Rice, MD
Orthopaedic Surgery

Barry Welch, MD
Ophthalmology

Charles Welch, MD
General Surgery

Lisa Williams, MD
Obstetrics & Gynecology

Thomas Wolford, MD
Cardiology

Derek Paul Wille, FM
Family Medicine

  • Mission

    To provide extraordinary healthcare to those we serve by people who care.

  • Vision

    The first choice for those who aspire to heal, be healed and lead healthier lives.

  • Key Values

    Compassion, Integrity, Excellence, Innovation and Collaboration.