Kootenai Hospital District Board of Trustees Discussion with Chris Nordstrom

Show Notes

Candidate interview with Chris Nordstrom, running for Kootenai Hospital District Board of Trustees.

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It costs millions of dollars to
do that certification to ramp up

the hospital with all the
physicians and all that. So I

would I wanted to ask questions
and I didn't hear the board

asked questions. How many times?
Does that happen in a given

here? How many patients have to
be transferred to another

facility? Because of that
situation? They there was no

answers, no questions. And of
course, as a civilian member of,

you know, just viewing the board
meeting, I can't ask questions.

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tune in each week to hear local
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voter. Idaho speaks where issues
take shape. Welcome to Idaho

speaks. Again, we're continuing
our interview of candidates

running for local office. And
with me in studio today, I have

the pleasure of sitting down
with Chris Nordstrom. Chris,

thank you so much for coming in
studio today. Thank you, man.

Appreciate it. Now you're
running for the kidney hospital

District Board of Trustees.
That's correct. Without going

into qualifications just yet.
I'll save that for a little bit.

Tell the listeners of Idaho
speaks about you, your your

background, how long you've
lived in Idaho, etc.

Okay, well, my wife and I moved
here from Texas after I retired.

We came up here about seven
years ago, actually from a red

state to another red state. But
I I was a refugee from Southern

California in 2005, or my
company offered a transfer to

San Antonio, which was really a
pleasure. My background is not

in medical, I don't have a lot
of MDS or degrees or letters

after my name. My background was
actually Business Administration

and information technology. I
did a stint in the Air Force for

six years where I did f 16
avionics, which was I didn't

actually work on the airplanes I
worked on the back side, where

we repaired equipment that was
on the airplane computers,

mostly it was almost all
computer driven the aircraft

was. And so that's where I got
my first taste of computers and

digital technology. I was a
trainer, I became what they call

a seven level which is the
highest expertise. And I enjoyed

it. I loved serving my country
for seven years. And I think it

was a fair trade, I got a great
technology boost. And Uncle Sam

got me for six years. So worked
out really well. After that I

went to work for Wang
laboratories, which is now

defunct, but believe it or not,
at one time, they had more CRTs

on desktops than IBM did. I
remember when 1982. And then

then I got into Information
Technology positions at various

banks in Southern California,
ending up at a big investment

firm, about 22 years, 21 years
plus with them. They were

investment management of about
$1.5 trillion of other people's

money. So at that position I was
I had a lot of experience

explaining highly technical
projects, multimillion dollar

projects, participating in what
they used to call, RFI is where

you you create a request for
information or quotation and you

send that out to the various
vendors, helping board members

executives to make decisions to
draft strategic plans for the

enterprise. This was an
enterprise of about 10,000

employees in 22 cities around
the world. And I got to visit

each one of them and assess
their their infrastructure for

information technology. I put
most of them on the network back

in the early 90s. So I have a
lot of experience dealing with

large enterprises, large
executive boards, large budget

projects, that sort of thing.

When did you move to Coeur
d'Alene,

we live in Post Falls. Okay. We
did that in 2013. I was still

working for the company at the
time and I was telecommuting,

essentially they I told them,
they wanted me to extend and

stay longer. I said, No, I want
to I want to get out of here

while the getting's good, so I
they they agreed I could come

here and work for like six or
seven months, telecommuting

while I trained my replacement
and that sort of thing. And so

that was in 2013. And we bought
a place actually contributed

with my daughter and her husband
and we bought five acres in post

falls outside of post fall city,
county county and built a place

there for retirement and it's
been great ever since we love it

up here in Idaho.

So why quarterly or excuse me
why Post Falls

primarily because of the church.
There's a weird Traditional

Catholic and there's a good
traditional Catholic Church in

Post Falls very large one.
There's many of them around the

country. But this was one that
my daughter and son in law had

already found in, I think they
moved here in 2006 2005, or six.

And so we decided that this was
we'd always wanted to retire

into the Northwest, the Pacific
Northwest was I mean, northern

Utah, potentially Idaho, even
potentially Northern California

in the right place. But then it
became clear that that wasn't

going to work out too well. So
my daughter and son in law found

the place up here in Post Falls,
and it just made sense for us to

help invest in it with them and
then expand it when it's time

for me to retire.

Well, it is a beautiful area,
that's for sure. So let's talk a

little bit about the role of the
Board of Trustees. So what is

the role of the kootenay?
hospital District Board of

Trustee how to how do they serve
the citizens of kooten? County?

Okay, well, there's a it's a
nine member board. seven members

are elected to members are
appointed after the board is is

situated, they can elect two
members. Originally, it was two

year terms now they just
recently last month change the

bylaws to make that six year
terms. And they immediately

reappointed the two appointed
members, to those turn to those

two terms to a four and a five
year term, because they knew the

election was coming up, I'm
pretty sure. I mean, I suppose

that's probably not a bad thing,
particularly since they want to

keep continuity expertise
continuity within the board,

which that kind of makes sense.
If the two incumbents should

lose the election. And of
course, the third guy that's up

for election re election decided
not to run so that's why there's

three positions open. The Board
of Trustees provides oversight

and business acumen and and
community representation to the

hospital executives. The
executives run the physical

operation, they run the physical
plant, they do the

administrative stuff, HR and all
that and and when they want

money, they have to go to a
board of trustees who are

looking out for the taxpayers
resources. Cooney hospital was

originally founded in 1956 as a
community hospital, a public

hospital. At the time the
community was underserved at you

know, up here in North Idaho.
Now, you can see that it's not

any more underserved. Courtney
has grown tremendously in the

past. Well, probably since the
current CEOs tenure, which I

think is about 10 years, not
positive exactly when he started

but that they've grown by
expansion by acquisitions, and

they've become the largest. And
I think the Board of Trustees

does a little bit too much. Yes,
and not enough No. In some of

the oversight positions, they're
supposed to be kind of a

gatekeeper to keep the thing in
check. And it's become way more

than I think it was ever
originally intended to be. It's

it's got it's become the
recommendations from the

executive administration are
what's good for the hospital and

us not necessarily what's good
for Cooney County. Recently

they've purchased a lots of
specialty practices in North

Idaho and even in Spokane. And
by doing that they're

effectively reducing choice by
eliminating competition. And and

so they've created this offshoot
called kidney clinics. And and

I'm not sure exactly how that
fits into the mission, it was

originally a hospital that was
supposed to provide beds,

emergency room and surgical
operations for the for the

population and became expanded
into now creating actual doctor

practices. And there that that
was not in short supply up here.

At least I don't believe it was
my statistics indicate that it

wasn't. And yet they've expanded
in that area and they are

gobbling up a lot of family and
specialty practices. About seven

or eight years ago, they bought
a one in Spokane, they thought

they were going to be able to
expand into Spokane Valley but

Spokane heart clinics from I
think it was from multi care.

And in just last year, I think
it was February of 2020. They

had to dissolve it because it
wasn't doing well. They

dissolved it they had to lay
everybody off and sell

everything and they have they
have given no accounting for how

much money was lost. How much
did that cost the hospital

district. they've purchased a
couple of hospitals in north

central Idaho. St. Mary's and
cottonwood and Clearwater Valley

clinics and hospital in orofino.
And those are already draining

funds away from Cooney County,
from the from the hospital

district itself because they
were I don't know exactly

whether they were
underperforming or poorly

managed, I'm not sure but they I
guess needed something to get

them to keep them buoyant and so
Courtney stepped in. And I don't

know if they approach scrutiny
or the other way around, I

haven't been able to you have to
do individual information

records requests to the, to the
board, or to the Secretary of

the board for everything. And
you have to be very specific. So

it's been like pulling nails to
get data and statistics out of

these people. Which is, which is
kind of a problem, because it's

a lack of transparency that I
see that's going on right now.

That's the problem with the
current board.

So with that, okay, so let me
back up just a little bit,

folks. So this is an elected
position, the citizens of

kootenay County are going to
elect it does go round on May

18. Three people to the board
correct. And there's no

visibility without a FOIA
request of what the board is

doing.

Well, yeah, they don't publish
their minutes or their agenda.

Well, they do publish the
agenda. They published the

agenda about two days before the
meeting, the meeting is always

on a Tuesday. And I think it's
available on the website, either

late Friday, or maybe sometimes
Sunday. I've found it both ways.

And so you don't know what
they're going to talk about

until two days before. But yet
the board has a rule that if you

want to make public comments at
the meeting, you have to give

them notice a week in advance
and give them a sample of what

it is you want to talk about. So
how are you supposed to do that

when you don't get the agenda
until two days before the

meeting?

Now, I assumed that the hospital
District Board of Trustees has

to follow public meetings laws,
they

absolutely do have to follow all
of the same open meetings and

public meetings laws. By law,
they have a bus set of bylaws

which they've published, which
they haven't published, they've

made available to me by request,
because you have to request

everything. The only thing
that's available directly is the

agenda. It's on their website
two days before but everything

else, you have to be very
specific, you have to know what

it is you're looking for. You
have to give them the dates and

specific concepts or content of
the documents that you're

looking for. And and then they
take you know, they I guess by

law, they're allowed to take up
to 10 days, but they're

typically it's three, four days
turnaround time. And sometimes

they they redact certain things,
so it's not transparent. And I

don't know why. I don't know
that there's any shenanigans

going on. But it's just puzzling
to me why they aren't more open

to the to the taxpayers and the
and the residents of Cooney

County.

Well, you know, I noticed when I
was doing my research for these

interviews, I got three of the
candidates coming in Idaho

speaks to talk. I found it very
difficult to even find out what

the board does. Because there is
no bylaws listed. There's no

mission statement. There's no
vision statement. There. There's

no order of operation. There's
no operating procedures

guideline. There's no past
meeting minutes. There's no

information with regards to how
this body operates. And I've

been an elected official and the
ESOP for the city council that I

served on in Fairview, Oregon.
It was 900 pages long. Wow. And

I had to read that before I
became a city councilor. Well,

actually, I read it before I
even decided I wanted to become

a city councilor. And I was just
surprised that here's a public

board that is supposed to adhere
to the public meetings, laws

that go to the voters during a
time and election when

traditionally, there's only
about 12 to 18% of the

electorate that turns out to
vote for them. It just seems

like there's something there.

Yeah. Well, first of all, if you
go to the kuti Health website,

kh.org. There is a mission
statement, you can find it it's

not. I think there's a couple of
pages, but that's

for the hospital, correct?

Well, yeah, well, it's the same
for the Board of Trustees. They

consider themselves one in the
same. That's another thing that

I find very puzzling. There are
two lawyers, at least two

lawyers that work for the
hospital administration, they

essentially report to the CEO,
but they're the same lawyers

that give the board of directors
Board of Trustees technical,

legal advice. And the one of
them that's bleeds right into my

one of my first efforts is going
to be to find out why the Board

of Trustees does not have its
own, at least available

independent counsel, when it
comes to legal issues and

doesn't have to rely on
employees of the hospital, there

seems to be almost a conflict of
interest there. I don't know

that. I mean, maybe not an
illegal technical definition of

conflict of interest, but
certainly one that doesn't look

right. At least on many issues.
There are some issues,

obviously, where they would be,
you know, there wouldn't be any

conflict at all, and they could
give some advice. But when it

comes to the board's operations
and how they do things, it seems

to me the board needs to have
its own legal counsel.

Well, since you opened the door,
let's jump into if elected, what

would be your top two or three
goals for your six year term?

Sounds like one is to secure
independent legal counsel for

the Board of Trustees.

That's one. Another one that
I've developed since I've been

getting some I've been asking
for Dr. Duke and I have both

been asking for records. And
we've gotten some minutes from

last year and we've gone through
them and figured out what

they've been up to one of my
First initiatives is our, I

guess, they'll be prioritized
somehow I haven't figured out

yet exactly how but
transparency, I would, you know,

even post fall school district
has a website that you can go to

and by yourself, you can find
meeting minutes, you can find

agendas, you can find all kinds
of documents, any document that

submitted to the board of
directors of the of the district

are available on that website,
almost everything that I've been

able to look for, there may be a
few things missing. But anyway,

I would like to see kidney
health, the hospital boards

website do the same, I would
like to see it have up page set

up where you can work
individually. citizens can log

in, or just go to the website
and pick and choose what

documents they'd like to see

kind of like they do at the City
Council.

Here you go kind of a school
board. And I don't understand

why they don't do it. Now, there
are obviously some

confidentiality issues as Bart
as far as the like when the

trustees deal with personnel
issues. But those are going to

be Executive Session anyway.

And those are already covered by

public meeting. Exactly. They
are covered. And they're already

confidential. And what they can
discuss in those meetings is

already defined. So that's not
what we're talking about. We're

going

I don't imagine the Board of
Trustees talks about patient

care. So there's a don't there's
no hip? Well,

they do actually, they don't
talk about individual patients,

they do talk about patient care,
because the board sets, goals

and objectives for the hospital.
That Are they call it patient

experience, patient safety and
experience. There's actually a

subcommittee that deals with it.
Now, I have no doubt that a lot

of these things are proposed by
the executive ministration.

They're not they didn't, the
trustees didn't dream a lot of

these things up because these
are things are way too

complicated. I think in most
cases, even though there are a

few doctors, as trustees now,
and probably who know how to

operate a hospital, a lot of
this stuff is proposed and

recommended by the executive
administration. And so far, from

what I've seen in every single
agenda, there's never been an

instance where they've said no
to the executives, no matter

what they want to do. Last year,
they they went on a building

binge to build a cafe, they
wanted to call it a five star

eating experience. Now, of
course, COVID got in the way of

that. So they haven't been able
to let the public in yet, but

it's from what all and I haven't
been able to see it because you

got to be an insider to see it.
But from the descriptions of it

and the cost, it was pretty
substantial. And I don't

understand what I mean, sure you
want to feed the doctors well,

so they're, you know, stay close
by when it's lunchtime or

whatever. But it seems to me
this was a bit extreme, they

currently have a new mission
statement that talks about being

a premier medical destination,
they want to be the premier

medical destination for the
North Idaho region and expanding

out, sideways, east and west, to
try to get a lot of this, you

know, paint a lot of patients
wanting to come here. And

they've been working on that for
quite some time. And they've

also done a lot of hiring of
specialty physicians and so

forth. And then today in the
meeting, they're complaining

that they don't have enough
operating rooms. And they said

it's not because of the
population growth, we're keeping

up with that this or it's not
because we didn't anticipate it,

we're trying to keep up with it.
But the problem is, is that

they're at the same time using
all of these resources around

them to force more surgeries
and, and procedures into the

hospital. And then they run out
of hospital space. And and I'm

trying to figure out what
exactly is it Why is it the

public hospitals responsibility
to bail out physician practices

and in some cases, diagnostic
facilities, pharmacies, whatever

and other hospitals who are
either underperforming or or

poorly managed. Why is it a
public hospitals responsibility

to do this? That's where it
comes down to the fact that it

seems like the executive
administration, the hospital is,

is trying to make things bigger
for itself. They're trying to do

things that are good for it good
for the hospital, good for the

executives and that sort of
thing. And not necessarily

what's good for Cooney county
residents and patients.

Well, okay, but let me play
devil's advocate just a little

bit here. And I, I shared this
with my first interview, I'll

share this with my third
interview. We've had an amazing

experience at kidney hospital.
It really is a fantastic

facility. When my wife went in
the level of care that she got

was top notch. Could it be that
the executive folks are trying

to expand the services so that
people don't have to travel to

places like Spokane or Portland
or beyond to get those high

level specialty cares,

they are, that's part of their,
their goal is to in fact,

they're they're working right
now on what they call a level

twos trauma certification
because they don't want to have

to do transfers. So when a
patient comes into the hospital

emergency room, and their level
of care is beyond the level

three or two that they have, or
the level three that they have.

Now they have to transfer them
to a level two facility, they

don't want to do that. Now. And
I would agree with that for the

most part, except that it costs
millions of dollars to do that

certification to ramp up the
hospital with all the physicians

and all that. So I would I
wanted to ask questions, and I

didn't hear the board asked
questions. How many times? Does

that happen in a given year? How
many patients have to be

transferred to another facility?
Because of that situation? They

there was no answers, no
questions. And of course, as a

civilian member of, you know,
just viewing the board meeting,

I can't ask questions. But that
would have been my number one

question, well, what is this
costing the hospital? And what

are the what is the downside?
How many patients are being

transferred out? And they there
was no answer to that question.

Okay, so for my last question
here, this is kind of an odd

question. But because you would
think on a hospital District

Board, you kind of alluded to
it, there's there's a few

doctors on there. But one might
think that you really have to be

a doctor to serve on this board.
But what are your qualifications

for the position that you're
currently running for?

Okay, let me back up real quick.
Just one thing I want to

mention. Your right kidney
health is a stellar hospital,

there's no doubt about it, they
have made it the best. My

question is, why does it have to
be the biggest, it can be the

best without having to be the
biggest Chinese building in

town? That's, that's my, that's
my question for them. And when

what I want to dig into, as far
as qualifications, I don't have

I said earlier, I don't have any
medical degrees. But it's

because I don't think the
trustees provide hospital advice

or medical advice to the
hospital, they are not allowed

to give any medical advice. Even
doctors on the board are not

allowed to give medical advice
to the hospital. But the

hospital has its own physicians
and experts in residence and on

staff as managers and department
heads that provide plenty of

that. The trustees position is
to oversee the executives to

make sure they aren't going
overboard, that they're not

overspending that they're that
now the hospital does have the

capability that the district has
the capability to levy taxes. So

part of that responsibility of
the trustees is to make sure

that that's being done wisely.
And whether they've done that or

not, they haven't actually done
a levy since 1995. So they've

been doing pretty well. And
that's because they end up with

what they call positive marginal
operating margins every year

since somewhere around the late
90s, mid mid to late 90s, which

means they're essentially making
a profit. Of course, it's not

called a profit, because they're
a nonprofit organization. So

they put that money into
reserves in order to buy new

buildings, or revamp operating
theatres, or whatever it might

be. And and I'm presume they
also use some of that money to

provide bonuses to the
executives and the management,

so forth, which would be kind of
common, I don't think that's

uncommon. And I'm not suggesting
that there's anything shady

going on, I just wish that they
could be a lot more transparent

about what they are doing with
this money, and why they're

making these decisions. Why are
they you know, why do they have

to be a premier medical
destination, when what they

really need to be is provide the
best medical care they can feed

and they do need to expand a
little bit the hospital itself

is gonna need more rooms,
there's no doubt about it. The

population in Cooney county is
expanding at three and a half 4%

a year. At some point we're
going to outstrip the capacity

again, it's not quite there yet.
And so they'll need to have some

expansion for the hospital.
Makes sense. But why do they

need to be acquiring? why did
why do they need to operate a

clinic, there was never, as far
as I know, any shortage of

Doctor practices, professionals,
skilled professionals like heart

surgeons and, and cardiovascular
and all the other specialty

disciplines. There was there's
lots of those around, and they

go around buying them or or
those practices, plead to the

hospital to take them over
because they don't want to deal

with all the insurance or
whatever. You know, I don't know

the details of why because it's
hard to find that information

just from the meeting agendas
and the meeting minutes. So I

plan to dig into that if I get
elected so I can really

understand and convey that to
the residents and patients of

county. What exactly is going on
what's driving these decisions?

So like I say the hospital
expansion is necessary in some

ways because they need to be
able to take care of capacity.

But all these other expansions
Why are they buying big

pharmacies, for instance? I
mean, sure, they probably need

some mechanisms for, you know,
providing medications, less

expensive, but there's no
indication that that's happening

and the pharmacies that they're
acquiring or not even in the

hospital, they're elsewhere. And
why are they buying hospitals

and other counties, it kind of
fits into their overall plan of

this thing called kootenay
health care network, which is

almost statewide, from well,
north central Idaho all the way

up to North Idaho. And it all
feeds into providing patients

referral patients into the
kootenay surgery centers. But

then again, that's also driving
the cost up because they have to

build new surgery centers that
expand capacity. And so it's

kind of a, I don't want to use
the vicious cycle isn't the

right word but, but it's
something similar to that where

they're they're, they're
creating this increased demand,

and then they have to keep up
the capacity in order to meet

the demand.

Perfect. Anything else you want
to share with the listeners?

No, I can't think of a whole
lot. I mean, there's there are

other things that I'd like to
talk about, but probably it

would be better at in a personal
face to face kind of dialogue

with with voters if I get the
opportunity to do that. And I

plan to do that with you know,
every way that I can I plan to

push for openness and
transparency of the board's

decisions, plans, expansion, all
that kind of stuff. That's my

goal.

Well, Chris, thank you so much
for coming in and talking with

the listeners of Idaho speaks
Thank you very much.

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