Photos by Lynn Janes; Article by Mary Alice Murphy

The Silver City-Grant County Chamber of Commerce monthly luncheon featured two speakers.

The first speaker, Grant County Community Foundation Director, Bernadette Smyth, talked about the importance of non-profits to the economy of the state and the country. "Non-profits are the best kept secret from an economic perspective. People think they are just touchy-feely and they do wonderful things, but they generate $4.22 billion in economic activity, which is 3.2 percent of New Mexico's gross product. Non-profits provide $2.85 billion in salaries and benefits, the third highest sector in the state. That grew 11 percent in the period between 2008 and 2018. Non-profits provide about 10 percent of the jobs in the private sector and bring in twice as many jobs as manufacturing."

The other thing that is different, she said, was that just over a quarter of the funds that non-profits bring in come from outside the state, from grants and fundraising, but the money is all spent in New Mexico.

She said the title non-profits is a misnomer. "Non-profits have to make a profit," Smyth said, "or they would go under. The profit goes back into the organization, not into anyone's pockets. Our board is completely local, and we are tax-exempt."

"We are a small foundation, and we are supported by local donors, as well as the larger foundations," Smyth continued.
"We have a strong community foundation here. The Grant County Community Foundation serves four counties, Grant, Hidalgo, Luna and Catron. We serve more than 100 non-profits, with support and help in their fundraising. We have one of the largest number of non-profits here per capita in New Mexico. We try to create a dialogue between the donors and the organizations. The best way to do that is with Give Grandly, which is coming up soon."

The event will take place at the Makers' Market in downtown Silver City from 9 a.m. to 2 p.m. where people can donate in person. The giving actually began online on April 20 and continues for a month at www.givegrandly.org .

She said for those, who might not know about Give Grandly, "it's basically a giving day. We do it bigger and better than anyone else, with a big party downtown, with music and fun. We have 65 non-profits participating in Give Grandly this year, which is the most we've ever had. We also try to give matching funds to every organization that takes in at least $500.00. We're a little short this year, so if any of you could donate, we would appreciate it."

Smyth noted that so far with the Give Grandly and other fundraising, over the past few years, the Grant County Community Foundation has raised more than $2 million and "that's just from Grant County, not including any outside grants."

The foundation can set up endowments that can become perpetual funds.

"We started a fund in the name of Alex Olson and Martin Pearson after they died in a car crash," Smyth said. "We have received more than $100,000, so it is now a perpetual fund. We will give out small grants from the interest on the fund."

She continued: "We also try to promote Silver City and Grant County throughout the state and elsewhere. Our priority is to support non-profits."

"When I first came here, I went to a conference in Albuquerque," Smyth said. "There were a lot of people who didn't know anything about Silver City. For those of you who know Hugh Epping, he, too, attended the conference and now everybody knows about Silver City."

She said the non-profits are always struggling to survive and do what their mission is. "They don't have a lot of time to fundraise to become sustainable. That's what we do. That's our purpose to help the community."

"We have a group called Community Architects that we ask to commit to giving $500 up to $3,000 or more every year for at least five years," Smyth said. "We hope to set up like an advisory board of community architects. We would love to have any of you there. It will be launching soon."

The first Give Grandly was statewide and was called Give Grande. Silver City raised more than any other community, raising $57,000 the first year. "The others decided they didn't want to do it anymore, but they wouldn't let us use Give Grande, so we changed it to Give Grandly and we've raised more each year. We invite the non-profits to work together each year to organize the event. We realized that as we enlarge the pie, it benefits each group even more. Last year, we raised $236,000 for our local non-profits. We're bringing in an average of about a quarter of a million dollars a year. That's amazing for a community of this size. It's because of the generosity of the people of this community."

Smyth then introduced Jamie Sechrist, who will replace her, as executive director of the Grant County Community Foundation.

"I'll be going home to Ireland to enjoy some rain, actually," Smyth said. "We have the same sort of sharing of giving in Ireland. Silver City is the place I've lived that feels most like Ireland, except for the weather, because of the community and the friendliness and the acceptance of one another. I will be back. When you come to Ireland, look me up."

Chamber Director Romeo Cruz thanked Smyth for speaking. "You will truly be missed."

The next speaker was Gila Regional Medical Center Chief Executive Officer Robert Whitaker.

"I was just noticing the plaques on the wall behind me," Whitaker said, "especially the Marine Corps one honoring my fellow Marines. Semper Fidelis means forever faithful, but being Marines we modified that to Semper Gumby, meaning always flexible. [Editor's note: This is fake Latin. True Latin would say Semper Flexibilis.]"

He said the hospital has put out its first annual community benefit report. "We wanted to show what impact we have on the community."

Whitaker went through some of the statistics for fiscal year 2023. "We had almost 82,000 patient encounters, which includes the clinic visits, admissions and any sort of patient encounter. That's a lot of folks we see. That year we had a $1.7 million profit. We spent about $3.3 million in capital expenditures on equipment costing $5,000 or greater. For fiscal year 2024, we will spend just about $3 million on capital expenditures. So over $6 million in two years.As an example, in our operating rooms, we call them towers, which have shelves, monitors, scopes, we just replaced, using our group purchasing plan, three of them for about $600,000. We have to keep reinvesting in our facility."

He noted for fiscal year 2023, which ended June 30, 2023, the hospital spent $900,000 on charity care. For salaries and benefits in that same year, the hospital spent $34.2 million. "That's not contract workers or our physicians, just our employees."

"We're going to go through a website design pretty quick," he said. "But the community benefit report is on the website."

Because the hospital has a 501c3 status, CMS (Centers for Medicare and Medicaid) require a community needs assessment. "We're getting ready to start that. We expect it to come out in the September or October time frame."

The Gila Regional Medical Center Foundation plans to take over a wall in the hospital to create a donor wall. "We received a $3,000 donation to renovate the chapel, paint it and put in art and new furniture."

Whitaker announced the next townhall would take place at the Grant County Veterans Memorial Business and Conference Center on Tuesday, May 28, 2024 from 5-7 p.m. "A big focus will be on the transfers we do and why. I hear a lot about the helicopters flying. I want to provide some myth busters."

He referred to a couple of construction projects going on at the facility. The labor and delivery area is being consolidated into one section and the completion is expected by the end of May. "We plan an open house to show it to people, and then we will add some security measures."

Another big project, funded with EDA (Economic Development Administration) grant money, Whitaker said has been challenging with paperwork and getting estimates from a contractor. The project will be to fix HVAC issues in 2 of the larger operating rooms. The hospital has six operating rooms, but only two will be addressed in this project.

"I've also been working on affiliations with the schools and the university," Whitaker said. "We're working on a high school internship for the next school year, with up to 10 students who may be interested in nursing, radiology or internet technology."

He said the ER (emergency room/department) is truly the "front door to the hospital. The majority of our admissions to the hospital come in through the ER. We have had challenges with it. When people come to the ER, it's usually for a bad thing. They have fears and anxieties. The challenge is to manage to help them with high quality and comprehensive clinical care and with compassion. We are changing how we staff the ER. In the past, we had a physician doing a 12-hour shift during the day, and the same physician would be on an on call 12-hour shift the same evening. And during that time, we would have a nurse practitioner or physician's assistant in the ER. We are switching that. We've changed the contracting company. We will still have the daytime physician from 7 a.m. to 7 p.m. and then a different physician on from 7 p.m. to 7 a.m., with the nurse practitioner or PA coming on a mid-shift from about 10-10. Inevitably, under the old system, the physician would get called back in during the evening shift."

One of the things every hospital worries about is workplace violence. "We want to protect our staff and our patients.Its's just a part of what we're calling de-escalation. We're doing training on how to help things stay calm in the ER."

"I was in a hospital in Kansas," Whitaker said. "Have you ever heard about the show about the 600-pound patient? Well, the person had moved near us and the show contacted us, because he needed a follow up surgery. 'We're going to bring in a camera crew,' they said. What was interesting was throughout the process, they referred to this person as a cast member. It gave me a different perspective.

"In the hospital industry, we call those people patients, but they are really our customers," he continued. "So, we have to provide good customer service. We are grateful to those who come to Gila Regional."

Another concern the hospital has is cybersecurity. A company called Optimum deals with the hospital billing. Hospital finances are complicated. "Our billing to insurance has to go through a process. A few months ago, one of the channels, called Change Healthcare, which is a clearing house, was cyber-attacked. It shut down payments to clinics and health systems overnight. "We use this firm. But our payments did keep coming through. I was talking to a hospital yesterday and 50 percent of their payments had stopped coming through. They're stressed out. For us 50 percent of our revenue would be about $4 million. Hackers like health systems and health care in general, because they can threaten us, by saying 'we'll charge you $500,000 to give you back your records. Otherwise CMS and other agencies will fine you even larger amounts.' So cybersecurity is a major concern for us."

He mentioned several legislative items. The hospital in the most recent session received $5.7 million to be reimbursed for costs over two years. "We call it a bridge bill. It will allocate up to that amount over the two years for ER labor and delivery, family practice. We are also working with the Rural Hospital Association, and we have to show our costs and apply for the funding."

Whitaker noted another hot topic is medical and professional liability. "Our prior ER group left New Mexico because of the liability issues. Some things have to change. We have to talk to the legislators about the malpractice amounts at the next 60-day session. It's difficult to recruit physicians. When I was in Gallup, we got dropped by our insurance company. They told us New Mexico is the No. 1 worst state for malpractice insurance. We've seen in the past couple of years a $400,000 premium for malpractice insurance. Now it's more like $1.2 million for the premium. The state took the caps off the amount that people can receive in lawsuits and other issues are the frequency of claims."

He asked if anyone had questions.

Rudy Martinez asked about the mental health that is provided by the hospital.

Whitaker said a few years back, when the hospital was in bad financial shape, the inpatient behavioral health unit was losing about $1.2 million every year, so the decision was made to close the department. "The department has to have staff, and when staff left, they had to close it. We continue to have discussions on the issue. We are meeting with HMS (Hidalgo Medical Services) about the potential of a short-term stay. It all feels a bit fragmented, so we're trying to pull it altogether. We want to be part of the conversation about how we can help. We see a lot in the ER."

Bruce Ashburn said it's nice to the the $5.7 million, but the hospital has to incur the costs and then apply for it. "Small hospitals are always facing a cash crunch. I'm interested to hear your thought process and how are your Medicare/Medicaid payments."

Whitaker said almost everything has to have to expenditures first and then apply for the state funding. "We have conversations every month with other rural hospitals. Last legislative session, they worked on the Medicaid payments and they have improved. About 40 percent of patients in New Mexico are on Medicaid."

Ashburn asked if the payments are coming in a timely manner.

Whitaker said if everything is perfect then the payments are timely, but sometimes "we or the payor makes an error. The biggest challenge we have is Medicare Advantage. Many of our payments are directly from Medicare. But Medicare Advantage is insurance companies that contract with Medicare, and often that's a problem getting the payments. And we see only about 20 percent of what we billed. A lot of hospitals have stopped contracting with Medicare Advantage."

Cruz told attendees that Whitaker was very accessible and if they had questions to give him a call.

Cruz also announced the Fourth of July festivities coming up. "Our theme for the parade is 'This Land belongs to you and me.' It also coincides with the 100th anniversary of the Wilderness Act, with the Gila Wilderness being the first one designated."

He also noted that the county was working on correcting the name of the facility and putting the full name Grant County Veterans Memorial Business and Conference Center on the outside wall.

Cruz presented a new membership certificate to Mark Speirs of the Small Business Development Center.

Ashburn announced the PNM grant applications would be available April 8, and could be found on the PNM.com website.