‘We’re the town at the end of the road’

ESTES PARK — When one thinks about everything Vern Carda has been through in his slightly more than three years as CEO of Estes Park Health, it’s a wonder he’s still there.

When he took the job in March 2020, the COVID-19 pandemic was just beginning to grip the nation. That fall, the East Troublesome Fire forced the hospital and the entire town of Estes Park to evacuate. Then add the issues gripping the health care industry across the nation: inflation, supply-chain issues, government bureaucracy and staffing shortages.

Finally, there’s the fact that the tourism-dependent high-country community at the gateway to Rocky Mountain National Park initially feels a bit isolated.

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“We’re the town at the end of the road,” Carda said. “Housing costs are higher. It’s a wonderful place to live, but the location and the housing sometimes offer more challenges than being down-valley.”

Carda sums it all up succinctly: “In retrospect, wow!”

But he’s still there. And along with his other responsibilities and duties, in recent months he’s also found himself having to be a bit of a campaigning politician as well, reaching out to voters in the Park Hospital District to urge support of Ballot Issue 8A in the May 2 municipal election

His efforts were successful. Voters gave 83% approval Tuesday to the ballot issue, which enables the district’s board of directors to enter into a multiyear financial agreement if it decides to affiliate with a larger nonprofit health-care services organization. The measure, which passed 2,228 to 453, does not impose new taxes or increase the tax rate that residents pay to support the hospital district that serves the Estes Valley.

“This is a great day for Estes Park Health,” Carda said after the results were finalized. “This decision can help in securing quality health care for our community members and visitors to the Estes Valley for decades to come.”

The board of directors unanimously supported the ballot measure, citing access to capital needed to stay current with evolving medical technology, important access to larger payor networks, and opportunities for financial savings that could come with affiliation with a larger health-care organization.

Such an affiliation, Carda said, “will make a significant contribution toward safeguarding the availability of excellent health-care services to meet the Estes Valley community’s health-care needs for many years into the future by ensuring there will be reliable and quality referral networks in place to provide services that EPH does not currently provide.”

The board has been in discussions with several major health care organizations to decide if affiliation with one of them could bring more advanced and varied medical care closer to home — and address  some of those issues that have forced many rural hospitals to close.

“Many if not all rural hospitals will be forced to consider partnerships in the future,” Carda said. “We’re small. We don’t have a large volume. If we’re not in network, our patients would have to pay more.”

He said increases in salaries, inflation-driven costs, and changes in health care’s budgeting model have forced small hospitals’ hands, he said, and “we’ve got to get out ahead of all these things.”

Besides the access to additional point-of-care resources, he said, “it would be nice to have a partner to help us make capital investments in our buildings.”

Carda emphasized, however, that the Estes Park hospital is not in peril.

“EPH has a strategic plan, trying to grow our revenue stream,” he said, adding that the hospital would like to add more robust mental-health services as well as enhancing its cardiac and pulmonary rehabilitation offerings and its surgical and urology capabilities. He’s also targeting expense reductions — not cutting any of the 350 staff members who work at EPH’s hospital, nursing facility and clinics but in terms of buying supplies.

“We have a great panel of physicians that deliver great quality care,” he said, adding that the problem has been with retaining a professional nursing staff as well as workers in ancillary areas such as housekeeping and laboratory duties.

“We’ve adjusted our salary scales, and it is making a difference, he said, “so we’re on par with other organizations in recruiting and retaining.

“We’re performing at budget this year,” Carda said. “Our cash on hand is stable. Our short-term future is secure — but 8A is about the long term.”

What if 8A had failed?

“We’d continue to work on our strategic plan and add revenue sources,” he said, but the board wouldn’t be able to negotiate a deal with a larger health system for enhanced affiliation, and “we’d have to come back eventually and seek approval.” Given that the ballot issue couldn’t be resubmitted before November, this year or next, the delay might have meant a lesser chance of closing on an affiliation deal.

“Our real job is to take care of the people,” he said. “That allows you to get through things like an 8A vote.”

A passion for providing health care helps as well, and Carda inherited it: His mother worked as a nurse for 42 years. He has passed on the inheritance; one of his daughters has chosen a nursing career and another wants to become a speech therapist.

Originally from Armour, South Dakota, Carda earned a bachelor’s degree in hospital administration from the University of South Dakota and a master’s in computer systems management from Creighton University in Omaha, Nebraska.

He came to Estes Park Health from Montana, where he had served as vice president for regional operations at the Billings Clinic, Montana’s largest health care organization, which serves much of the state as well as parts of northern Wyoming and the western Dakotas. After five years in that post, he was looking for a new job with less travel and more involvement in patient care. That’s when he discovered the opening in Estes Park, an exciting opportunity given that his family enjoyed all manner of outdoor sports. Carda was selected for the job from among three finalists.

No sooner had he taken the job than he was confronted with the pandemic and “so many unknowns,” he said, including “the scope and the depth of the challenges that COVID-19 would throw at us.”

However, he added, “EPH approached it like other challenges. The staff stepped into that problem really strong and finished it strongly.”

But then on top of the pandemic came the fire and the evacuation — “very unusual circumstances to start my first year of employment,” he said.

“That was traumatic. I still think about that — handing the hospital’s keys to a Denver fire chief and walking away, wondering if we’d have a building to come back to. The staff were some of the last to leave.”

He was used to a workplace that was open 24 hours a day, seven days a week and 365 days a year, Carda said, “but after we were evacuated, I thought, ‘What do I do now?’ It was the first time I didn’t have to be on call or wonder where the staff was.”

But Carda dealt with the fire just as he had dealt with the pandemic

“Sometimes when you find a job you know is right, you get through it,” he said. “The hospital is really crucial to the Estes Valley, so you forget about all the noise that’s going on and just take care of the hospital the best you can.”