Evans to step down from CEO role at Clinic

Alastair Baker
News Editor
Thursday, February 11, 2021
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Kristin Juliar, Director of Montana AHEC and Office of Rural Health, presents Beartooth Billings Clinic CEO Kelley Evans with the Dr. Frank Newman Rural Health Leadership Award in 2017.

After nearly 30 years serving the community by providing quality rural health care, Kelley Evans, CEO from Beartooth Billings Clinic, (BBC) is retiring.

Evans calls the decision to leave “bittersweet.”

In a public announcement she wrote, “Rarely does one's career provide an avenue where vocation and avocation come together in the manner it has for me.”

“It all went by so fast,” she said.  “And we’ve paid attention to hopefully the things that matter.”

“I have been super fortunate. The average tenure for a CEO in Montana is three years but between the intern admin, admin, and then CEO positions, it has been a good run,” said Evans.

Evans credits several things towards her long run; the board of directors, the volunteers, past board members like Rich Bruner and Jack Prather, and the current board led by Mitzi Vorachek

“They take on anything, and also make me feel very supported,” she said.

And, last but not least, the physicians.

“I’m so lucky to have strong leadership from the medical staff. At the end of the day as a CEO you can talk about quality, find ways to measure quality, you can make that part of the strategic plan and values but unless you have medical staff that is really buckling down and paying attention to the quality…they have to drive it at bedside… my job is to support the process,” she said.

Evans also added the local ties to the area have also helped with many at BBC being “vested in Red Lodge.”

“Red Lodge is a beautiful community, and this organization relatively new and off the Richter scale compared to other rural facilities,”

Evans said. “All the parts and pieces are in place.”

“It has been a team event especially when it comes to precision decision making. I can give them my perspective on it especially from the payer side, the financial side of the programs, and how rural health is reimbursed. I’ve always had a good handle on that and from that, I can see what is coming and when we need to be concerned,” said Evans.

It’s a tough role to balance and she always recalls Dr. Jim Kane telling her when Evans came on board as CEO, “Kelley you’ll have to run it lean and mean. There is nobody that is going to bail you out.”

“Hopefully I’ve run it lean but not so mean. I’ll never forget that advice,” she said.

 The CEO role is even more daunting because BBC isn’t supported as a tax entity and is a private not for profit 501 C3.

“There is no county or district money towards the operations. The County and the hospital enjoy a contract to oversee public health and that is the Carbon County Commissioners duty and we manage the contract; there is no passive revenue stream coming in for hospital operations,” explained Evans.

 “You learn pretty quickly when you are young when my budget was $7 million that I didn’t want to be in a position to take out loans to cover accounts payable or make payroll and fortunately never had to do this, despite lean times as the program for rural health evolved especially before the Critical Access Designation came into existence in 1997. That was a huge stabilizer for hospitals across the United States,” she said.

 Evans talked of the COVID Pandemic and how this blip has forced the BBC to change its business model.

 “We had some lean weeks during the shutdown, April 1 and middle of May, when we changed our business model to better cope with the Pandemic,” Evans explained. “I don’t know if additional expenses will go away or whether we will ever get away from full screenings for patients coming in. We’ve learned to live with it and keep our employees safe. We’ve been very diligent about the CDC guidelines.”

 Through it all Evans has spearheaded the drive to make hospitals in rural communities relevant.

 “Our mission statement is we save lives and really take that seriously and we literally save lives and do a good job in stabilization and transfer, so people have that chance of tertiary care centers that we work with to have a good outcome.

We have a great reputation with, thanks to nursing leadership and physicians’ leadership, of delivering on stabilization and transfers,” she said. “If you are coming here in an extreme condition, you have a pretty good chance of making it to the next level of care.”

 “I’ve tried to be transparent to the community and tried to encourage other hospitals to have open annual meetings and tell people what your story is. It helps people to understand it,” said Evans.

 Evans came from Harlowton where she was Director of Nursing at Wheatland Memorial and arrived in Red Lodge to take over the same position at the Carbon County Memorial Hospital and Nursing Home.

Events spiraled pretty quickly when LHS (Lutheran Health Systems), the company that owned the hospital, “abruptly left us, and fired the CFO and the CEO,” recalled Evans.

As she had a nursing home administrators’ license they asked her to step in as an interim. The plan was to put her in as intern administrator and close the organization.

“This led to a call to arms in the community led by Rich Bruner who pulled together a task force and said ‘we’re not ready to let this organization close’ and this started negotiations with Lutheran health systems,” said Kelley.

The learning curve in her new role was intense as she was flung into the world of figuring out 501 C3, articles, and bylaws.

“Honestly I didn’t know what an AR or an AP meant. I had to sit down with the finance guys and ask them to explain accounts receivable 101 and account payable.  And I thought ‘okay I can get this.’  It was trial by fire,” she said.

 More was to follow Evans' new found role as LHS let the old building fall into regulatory default so she inherited a 1950s HVAC (Heating, Ventilation, and Air Conditioning) system cited by the State, along with an outdated sewage system and a poor roof. Essentially the building wasn’t meeting safety criteria. It was also not ADA compliant and the boilers were pre- World War ll. She’d pray the old sewer lines wouldn’t erupt through the first floor.

  “I brought the President of the American Hospital Association and showed him the hospital to try and make a parallel to the national leaders that we were really operating out of a Third World facility,” recalled Evans. “It took years of strategic planning to move us from getting our arms around all the things wrong with Beartooth to making the decision to build a replacement, and laying the groundwork of us saying we need a partner.”

 In came Billings Clinic, who said Evans “wasn’t a partner that came in and said we’re going to subsidize you.  They have never subsidized us, but they did say ‘we will help you make important decisions.’ And part of that was rebuilding our scope of services. Sadly it lead to stopping obstetric and long-term care but we would not have been able to borrow the money for them.”

“We went into a fundraising phase, and Billings Clinic integrated the primary care physician’s clinic into the hospital and the new model. That put us where we are today,” said Evans.

They were “difficult times with a lot of meetings” Evans recalled.

“From 1997 to shovels in the ground in 2009 that was a push, a struggle, setbacks. But it was worth it,” she said.

Through that period she often wondered if the new hospital would ever come about.

“I used to drive passed it and see the sign saying future site of…, and it got to the point I couldn’t look at it. It made my heart sink…I don’t know if this is ever going to happen,” said Evans.

When the Beartooth Billings Clinic opened on Nov. 18, 2010, the impact of its presence was felt immediately as patient numbers went up and up.

Evans said she had read enough about replacement facilities and the public’s perception of something that is new and providing quality.

“I knew intake would be around 10 percent immediately with it rising to 15 percent after a few years. I expected it based on data to plateau around the 6th year, but we haven’t. We continue to grow,” she said.

Evans feels she has left the organization in a “good place” and “passing the baton at this time will provide a fantastic opportunity for a new leader to build on our strong foundation and lead Beartooth Billings Clinic to new levels of success and even greater service.”

A search committee has been established by the BBC Board of Directors with the intent to ensure the best candidate is found and have a new CEO placed by July. Evans has committed to staying on as long as the process takes.

“I have been truly honored to lead this incredible organization since 1991 and have always held at my core the belief that people who choose to live rurally should have the same access and quality of care as those who live in urban settings,” she said. “I hope I have delivered on that core belief to the thousands of people we have served over these many years.”

Evans and her husband, Dave, will remain in Red Lodge, and she will stay active in rural healthcare in some capacity.

“It has been a distinct privilege, and the honor of a lifetime to serve,” said Evans.