20 People Who Make Healthcare Better—2014

From HealthLeaders Media Staff , December 15, 2014

They are nurses and physicians. They are researchers and executives. They are providers and payers. They are watchdogs and innovators. And they are patients. They are this year's HealthLeaders 20 honorees, selected for their efforts to make a difference in healthcare. Their stories are sometimes tinged with struggles or challenges, but always, ultimately, with success.

Steve Simonin
President and CEO

Iowa Specialty Hospitals and Clinics            
Clarion, IA
Weekend barista Steve Simonin might not seem like your average high-ranking executive, but his other job is president and CEO of Iowa Specialty Hospitals and Clinics. His tireless work to take two struggling hospitals and combine them into one thriving system might be the biggest reason why the people in Clarion still have access to healthcare.


HL20: Steve Simonin—Turning It Around

Philip Betbeze, for HealthLeaders Media , December 4, 2014

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. They are making a difference in healthcare. This is the story of Steve Simonin.

This profile was published in the December, 2014 issue of HealthLeaders magazine.

"Because of our culture, we've never had to pay recruitment fees for physicians. They come to us, which is odd in rural Iowa where there are more pigs and chickens here than people."

Steve Simonin, president and CEO of Iowa Specialty Hospitals and Clinics in Clarion, slaves over a hot grill or espresso machine most Saturdays. It's not because he needs extra cash. He owns a small coffee shop and restaurant in the tiny town that still has a hospital thanks in part to his leadership. Appropriately for the kind of work Simonin does on Saturdays, the place is named "Grounded."

He calls it an "expensive hobby." Some hobby. But as the hospital CEO, he employs 500 people in a town of 2,800. What's a few more?

"It allows me to get out of the mold as just the CEO in town," he says. "Here, you employ most of the people and you're a neighbor to the rest, so it's kind of difficult for people to see me as anything other than the big boss."

That's the main reason that Simonin has held down this unpaid part-time position as a short-order cook for nearly three years—one where he wears a chef's hat and shorts to work instead of a suit. "I've been here 18 years and all I've done is hospital administration my whole adult life. I have a master's degree in hospital administration, so all I know is the corporate boardroom," he says.

He got a taste of a different perspective when one of his staff encouraged him to "take a walk in my shoes." That, coupled with an inability to sit still, led to opening Grounded. "Now that I do this every Saturday morning, I have a new respect for our support services," he says. "And I like to think they have more respect for me, as well."

Though Simonin himself would never characterize his leadership as having saved the town's hospital, there's a very good chance it's true. And if results equal respect, Simonin should have it. Those results—turning two struggling rural hospitals into one that's combined and thriving—represent one big reason he was named to the HealthLeaders 20 this year.

What makes the story all the more interesting is that Simonin was let go once—from this very same job.

At that time, Iowa Specialty Hospitals and Clinics (now two hospitals under the same corporate name) was just one hospital in Clarion, and it was called Wright Medical Center. Simonin managed it under a contract the board signed with a much bigger nonprofit hospital company that employed a large group of physicians who worked at Wright. Those physicians wanted to work for Simonin at Wright, and he wanted the same thing, but they were all employees of the managing health system. He hired them at Wright. The health system terminated Simonin's contract. The board at Wright terminated the management contract and hired Simonin back as the CEO.

"They called me up the day after Christmas and terminated my contract," Simonin says. "Best day of my life, but it was really just a transfer of employment."

Simonin didn't go off half-cocked by hiring the doctors. Months prior, he had decided, after leading Wright Medical for four years since 1996, that it was time to find a new job. But he was in the middle of a personal crisis, as his mother in Sioux City, Iowa, had been diagnosed with metastatic lung cancer. He spent many days and nights with her at the big hospital in town there.

"I had stayed the average amount of time for a CEO, and I figured I would wait out the year," he recalls of the idea to seek greener pastures. "But I had applied for jobs and got no attention. I started doing some life coaching, and realized with help that I really hadn't differentiated my hospital."

He had also suddenly been thrust into the role of patient advocate somewhere where he wasn't in charge. "I started seeing healthcare differently in Sioux City. I was wondering if my hospitals were loud, or dirty, or if the call button always brought someone quickly to the bedside. In my hospitals, can I go to the nurse's station? In my hospitals, do my patients lack a patient advocate? All of this started to resonate with me."

Simonin credits a consulting relationship with Quint Studer, founder of Studer Group, with focusing him on how to bring care and compassion back to the bedside.

In 2003, after Simonin hired that first group of physicians, word got out. By 2005, more specialists wanted Iowa Specialty to hire them.

One of Simonin's biggest risks since his new tenure began was taking another struggling critical access hospital into the fold. When the former Belmond Medical Center was absorbed, the two became Iowa Specialty Hospital. "I think they were getting ready to close it," Simonin recalls. "They had zero debt, but had a census of 0.8 and 50-some employees. Yet people were using it less than a Band-Aid station at the time."

Now boasting a bariatric surgery center as well as numerous specialty services, the Belmond hospital is in a new facility built with funding from the USDA. "It's only 15 miles away, so this was a very risky thing for us to do. It would have been easier to walk away, but we've built a new hospital, the employee base has doubled, and a bariatric center of excellence went there. Docs started coming back and patients started coming back."

Above all else, Simonin credits the system's success for making it a preferred practice location for physicians, despite the obvious disadvantages of its location and size. "Because of our culture, we've never had to pay recruitment fees for physicians. They come to us, which is odd in rural Iowa where there are more pigs and chickens here than people. There's not a lot in this county, but docs are driving up from Des Moines to work here. I'm not saying we're Mayo, but we're a destination."

Perhaps not surprisingly, both campuses are in the 95th percentile for patient satisfaction, physician engagement, and clinical quality performance, according to Press Ganey. "Our vision is to be the benchmark for all rural healthcare. We pride ourselves in getting calls from other rural healthcare organizations around the country, and we think we're setting the bar for them. It's a huge point of pride for all of us."

Simonin has a positive message for all his fellow rural CEOs who are struggling: Innovate. "There's opportunity out there. Don't see doom and gloom in your future," he cautions. "Whether it's merging with another community or bringing on some interesting services, we're interested in showing them that path. People come to visit to learn from us."

And they just might be asked to flip a burger or two while they're there.



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