Becker's Hospital Review

14 THOUGHT LEADERSHIP Cottage Hospital CEO shares 'growing our own' workforce strategy By Kelly Gooch H olly McCormack, DNP, RN, serves as CEO of Cottage Hospital, a 35- bed independent, nonprofit critical access hospital in Woodsville, N.H. She is well-versed in the unique challenges rural hospitals face, particularly in recruitment and retention. Dr. McCormack has led Cottage Hospital since April 2021, aer previously serving as its chief nursing officer and director of inpatient services. In a conversation with Becker's, Dr. McCormack highlighted the hospital's focus on fostering career growth through a leadership ladder and outlined plans to expand those efforts. She also shared insights on the hospital's capital investments, service expansions and community partnership strategies. Editor's note: Responses were lightly edited for length and clarity. Question: What do you expect to be the biggest financial challenge facing health systems in the coming year, and how are you preparing to address it? Dr. Holly McCormack: e challenges for us that continue are around the workforce, but we do see a rise in our expenses overall. We've realized about a 40% increase in our total expenses if you compare that back to 2019 or 2020, so pre-pandemic time. e workforce continues to be a struggle for us, and I think we have specific complications around being in a rural location — it's very hard to recruit to a rural location. e nursing shortage has really complicated the cost of what we pay for labor, and there are other associated factors, like a lack of housing in the area. When we recruit to our area, it's not only about recruiting somebody; we also have to find a place for them to live, and that's been a specific challenge for us. It's not something that, as a small, independent hospital, we can take on by ourselves. So we just need to focus on the things that we can control, and we realize there's not a silver bullet that's going to fix this. We have to try a lot of different things. Around the workforce, we're looking at different options. For instance, we've started internal travel contracts with our per diem staff to control expenses and also control quality. Employing our own staff in these per diem contracts helps us to know and be familiar with the people who will be working for us, maintain a level of quality, and still meet the demands of the workforce. e gig economy came about during the pandemic, and I think it's here to stay. We are working with other vendors — ShiMed is one of the vendors we're working with — that can help us fill staffing gaps. is helps decrease burnout by providing relief to our current staff and plugs gaps where we may not need a long-term travel contract but still have open shis that need coverage. So I would say our biggest financial challenge is still the workforce, but there are plenty of other contributing factors as well. Q: Given the current economic climate, how are you prioritizing capital investments for the upcoming year? In what specific areas do you see the highest ROI? HM: We are undergoing an infrastructure project related to an upgrade of our aging plant. Our sewer system needed an update, but we took that opportunity to also make improvements to our inpatient unit. Our unit was built in 1960, so these improvements allow us to have a more modern facility, which I think is more attractive for people to work in — and obviously, more attractive for patients, too. It also provides a quieter environment. Our older facility had Image Credit: NH Business Review

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