A Farmer, Teacher and the Consummate Trustee
Trustee Spotlight
Name: Edward Hatcher
Organization: Grinnell (Iowa) Regional Medical Center
Years on the board: 17
Board roles: President (1997, 1998), (2011, 2012); executive board member (1994–1999), (2009–current)
Profession: Grain and livestock agricultural operator
Best advice received for his role as a trustee: “Early in my trustee work at Grinnell Regional Medical Center, I was told that I should always do what my intellect tells me is the right thing to do both strategically and innovatively, but always make sure it agrees with our mission statement as it addresses the health care needs of the communities we serve.”
Over the years, Edward Hatcher has evolved from a high school science teacher to a farmer who raises crops and pigs in rural Grinnell, Iowa. However, his most enduring occupation has been as a trustee on the Grinnell Regional Medical Center board of directors.
Now in his 17th year of board service, Hatcher, 68, first served on the board of the 49-bed nonprofit hospital from 1990 to 1999. After the board reappointed him in 2007, he began serving his second term. Hatcher also has served as board president twice during both of his terms of service.
He says he enjoys serving on the board because it affords him an opportunity to “give back to my community or the communities served by the Grinnell Regional Medical Center … that’s fulfilling and gives me a great sense of pride to be able to do that,” Hatcher says, adding, “Hopefully, I’m benefiting the communities I serve and the health care needs that they have and, hopefully, we’re continually moving to improvement.”
A Commitment to Education
Hatcher’s dedication to education and learning still resonates in his role as a GRMC trustee.
Board members need “continuous trustee education and knowledge-building and they’ve got to be able to effectively communicate with communities they’re actually representing,” Hatcher says. “They also have to stay abreast of what’s changing as we go forward in health care.”
“That thirst for knowledge is one of Ed’s real hallmarks,” says Todd Linden, president and CEO of the medical center. “And I think he’s found an opportunity to really give back to his community through service to the hospital and the hospital board.”
Although Hatcher studied health care while attending Northeast Missouri State University (now Truman State University), where he earned two bachelor of science degrees — one in premedicine (zoology) and one in education — he pursued a career in education rather than health care after going on to receive a master’s in biology from the University of Northern Iowa and doing postgraduate work at the University of Iowa. After several years of teaching, Hatcher switched to farming when an opportunity arose to run his in-laws’ farm. Today, he and his wife Bev, and one of their two grown sons own a grain and livestock agricultural operation southeast of Grinnell.
Hatcher credits his current job as a farmer for allowing him the time he needs as a board member to stay informed.
As chair of the board’s trustee organization and education committee, known as the TOE committee, Hatcher aims to provide his fellow board members with educational experiences and articles.
“He likes to think of himself as the Big Toe,” Linden says, adding that Hatcher is “just excellent in that role because of his extensive knowledge about health care governance.”
Rural Hospital Challenges
As chair of the TOE committee, Hatcher also helps to vet incoming trustees.
Finding board members is particularly challenging in rural communities, which face a unique slew of problems, Hatcher notes.
As a “tweener” hospital — too large for critical access status and its cost-based reimbursement, but too small to thrive under Medicare’s prospective payment system — GRMC’s financial constraints challenge Hatcher and his fellow board members to do “what we can do to go down to bare bones in our basic operation and still maintain high quality and high safety … ,” he says.
The need to anticipate the direction in which health care is going has meant making sure “we constantly have great board membership … ,” Hatcher says. “You’re asking board members to give a lot more of themselves than they’ve been asked [to do] in the past, and when you’re looking at rural communities, you sometimes have to really … use up your leadership base … because of low populations,” he says.
Further, he and his other colleagues on the TOE committee recommended to the full board a couple of years ago that it require trustees to obtain certification from the Iowa Hospital Association, making GRMC the first hospital board in the state to make certification mandatory.
The certification program is designed to help hospitals adopt governance best practices, promote the coordination of care and use resources wisely.
“It’s a requirement now with zero tolerance,” Hatcher says, explaining that a trustee must leave the board if he or she doesn’t complete the certification in two years.
Obtaining trustee certification “forces them to have skin in the game, so to speak, and say they’re working toward becoming more knowledgeable and helping as a team [to] move forward,” Hatcher says.
A Partnership for the Future
To tackle the challenges posed by GRMC’s status as a tweener hospital, and other challenges that small, rural hospitals face, such as an increasingly aged population and human resource shortages, GRMC in 2009 entered into an affiliate partnership with Mercy Medical Centers in Des Moines, Iowa, to become part of the Mercy Health Network — a clinically integrated network that can share data, resources and knowledge.
Hatcher was part of the board leadership team when GRMC underwent a yearlong process to identify the advantages and disadvantages of forming a relationship with a larger hospital system, Linden explains.
“Ultimately, we decided there were more advantages to having an affiliation, and Ed helped lead that effort to get good communication with our full board, our medical staff and our community as we were really contemplating that change,” he says.
“Ed did a really fine job of helping to put us in a good position to study the issue, get lots of input from our stakeholders and, ultimately, make a decision that has brought a great deal of value to our hospital and our community. And that’s just an example of the kind of leadership that Ed’s helped to provide,” Linden adds.
Additionally, GRMC became a member of the Mercy accountable care organization in January through a federal grant program. As a participation site for the Mercy ACO, GRMC will receive funding as it makes the transition to value-based care and helps to create delivery models for the future, according to a GRMC statement.
A National Platform
Hatcher is able to bring the concerns of rural hospitals to the national level through his membership on two American Hospital Association committees: the Committee on Research, which he joined in March 2014, and the Committee on Governance, which he joined in January 2014.
The Committee on Governance provides input on policy issues to be considered by the AHA board of trustees, among other responsibilities, and the Committee on Research focuses on developing the association’s research agenda.
“I’m privileged to be on two of the American Hospital Association committees,” Hatcher says. “You’re learning a lot at these meetings, but you’re also getting a chance to meet with and have discussions with board members across the United States and you find out the problems I’m telling you about with Grinnell Regional are typical of most other hospital association groups.
“That’s not encouraging, it’s scary,” Hatcher says, noting that he appreciates the opportunity to share experiences with other organizations and to try different solutions. “From my standpoint, that is excellent experiential stuff.”
John Combes, M.D., chief medical officer and senior vice president of the AHA and president of the AHA’s Center for Healthcare Governance, worked with Hatcher on the Committee on Research. “Ed is the consummate trustee. He is very articulate, very thoughtful; he can put issues into perspective for you,” he says.
Hatcher “brought the perspective of a small and somewhat rural hospital in their role in this whole transformational episode that we’re going through right now,” Combes says. “He was a very articulate voice for their needs and concerns, and kept us grounded in the fact that a lot of what we’re talking about may not be as applicable to small and rural hospitals. But it was a path they could take that he wanted us to recognize to make sure we incorporated that perspective into our reports.”
Combes credits Hatcher’s experience as a teacher with his dedication to continuing education and appreciation that trustees “have to be continuously educated and developed.” Further, Combes says Hatcher’s experience leading a small business lends to his understanding of the “fragility of the economic situation and how you have to conserve resources and use them appropriately … .”
Linden supports Hatcher’s participation on the AHA committees, saying that his involvement with the Committee on Governance in particular has afforded him “the opportunity to represent hospitals our size and, I think, be a strong voice with the AHA on what being a trustee in rural hospitals is all about.”
During his remaining time on GRMC’s board, Hatcher hopes that the organization can “remain a community health care provider.”
Despite the successful partnership between GRMC and the Mercy affiliate network, Hatcher says the board has to decide: “Can we keep going along as a stand-alone nonprofit, private institution?
“It would be devastating to have to close our doors for some reason that is outside the realm of health care quality and service to meeting the health care needs of communities,” he says.
Hatcher seems confident, however, that financial problems won’t be an issue for GRMC because it has already aligned itself with the Mercy Health Network.
“If the name has to change, so be it, but as long as we can maintain what we’re doing and maintain doing it well, which we do, that’s good.”
Lea Radick is a staff writer for Trustee, Chicago.