← Becker’s Healthcare Podcast
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. Looking forward to hosting you in Chicago.
- [00:33]
B
This is Laura Deardel with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Raymond Hino, Chief Executive Officer at Southern Coos Hospital and Health Center. Raymond, it's a pleasure to have you on the podcast today.
- [00:44]
A
Hi, good morning Laura. Great to be here.
- [00:48]
B
Absolutely. Well, thank you again for your time. I'm excited to dig deeper into some of the cool things that you've been doing in the last year as well as get your perspective on what's ahead. But before we do, I'm curious, can you tell us a little bit more about yourself in the hospital?
- [01:03]
A
Yes, absolutely. I am probably one of the the rare ones it seems that has never done anything but healthcare administration in my entire career. I am born and raised in Los Angeles, California, Southern California and got my my Bachelor's degree in Public administration, went to went on to get my Master's degree in healthcare Administration and started at the age of 24 working in healthcare administration, originally working in the investor owned for profit hospital sector. But my career has taken me from Southern California to working in Texas and New Mexico, Montana and now Oregon and I have tended to specialize in the smaller rural facilities. I really found a niche and in the small rural facilities. Enjoy it. A lot of experience with critical access hospitals which is where I find myself at this time. I am currently the CEO of the Southern Coos Hospital in Bandon, Oregon. As you mentioned previously, we are a 21 bed critical access hospital on the southern Oregon coast with beautiful area, beautiful beach, stunning beach views and world class golfing right here in our backyard. Our hospital is, is doing well during these challenging times, I'm proud to say, and a lot of growth going on. So it's exciting time and and happy to share with you what we're doing at Southern Coos Hospital today.
- [02:53]
B
That's fantastic to hear and you know, like you said, I mean it is really such a great thing to have a passion for the small rural and in critical access hospitals. Where do you think that comes from? What do you love so much about that type of space versus some of the bigger hospitals? And systems because I know some people, you know, might find it more challenging. So I was curious, what is really attractive to you about those small and critical access hospitals?
- [03:17]
A
Yeah, that's, that's, that's a really interesting question, Laura. I found, you know, I'm not from a rural area. I grew up in Los Angeles, California, so far from it. But when I started my career in healthcare administration, I started off working in, as I said, investor owned and urban facilities. But I was really, I was really passionate about getting my first hospital CEO position. And when I got, finally got my opportunity, got my chance, My first hospital CEO position was in a small rural hospital in Sun Valley, Idaho actually, of all places. And I, so I relocated my family from Southern California to Sun Valley, Idaho. Got used to working in a small town, small community. After that I actually went back to an urban facility. But, but I found over my career that, that I like working in the smaller communities and the smaller hospitals. Number one, it has such a personal family feel. I know everybody in our facility and I know their backstories and their family situation. I meet all of them at new employee orientation. I love the fact that I know everything quite a bit about almost everybody that works for me and also in the community as well. The hospital in a small rural community is so important, oftentimes the largest employer in the community, many, many times and of course so crucial for the health and well being of the local community. Taking care of being the only provider for emergency room care and obstetrics in many cases. And so the lifeblood of the community. And I just thrive and love that environment. And you're right, it is very challenging because in the smaller facilities we say often we have to wear many hats. We don't have large staffs to delegate to. We have to be able to do multiple tasks and responsibilities and I really thrive and enjoy that as well.
- [05:43]
B
That's great to hear. I love it. Now I think when you look back, especially on the last year or so, what was the most important initiative that you led and what did you do? What were the results?
- [05:54]
A
Yeah, I can think of two, Laura, and the two major initiatives over the last year that I'm particularly proud of and have been so important for us. One was the conversion of our electronic health record system. We converted to the epic electronic health record system, which is huge, of course, a huge undertaking and huge for a small facility such as ours, but really connects us to other healthcare and really the world. But I think the one that I want to talk to you about today is another initiative that we undertook, which was opening a retail pharmacy at our hospital and in our community. And the reason that it's so important is listeners may be able to identify there's so much change and upheaval going on right now in the pharmacy industry. And earlier this year, for example, Rite Aid, national chain, with almost very little notice, closed their doors. Rite Aid was the only, the only retail pharmacy, only major retail pharmacy in our small town abandoned. Fortunately, about 12 months before the Rite Aid closed, we had identified a need for more retail pharmacy support in our community. People, people are complaining about long lines at Rite Aid. There's only one other retail pharmacy in our community. It was owned by a federally qualified health center. So we felt like there was a need in our community for more pharmacy and an opportunity for a new revenue stream for our facility. So we undertook the project of creating a pharmacy in, in June of 2024, not knowing that when we eventually actually opened our pharmacy In June of 2025, we were going to be replacing Rite Aid, which closed their doors just 30 days before we opened our pharmacy. And it was a tremendous undertaking. We were fortunate that we had some internal resources, a CFO on our staff who had previous experience opening a pharmacy. We enlisted the support of national companies. Cardinal Health was a huge help to us. We identified space in our clinic. We had to go through the whole construction project of constructing space for a pharmacy, hiring a staff from scratch, new director, pharmacy. You know, we were, we were participating in 340B previously in our hospital, but never on the outpatient side. So learning 340B on the outpatient retail side and hiring a 340B coordinator has been a tremendously challenging, but also rewarding. On June, I think it was, June 17th of this year, 2025, we opened our retail pharmacy. And it's been a huge success. Because of the closure of Rite Aid, our statistics, our utilization numbers have been much higher than what we initially anticipated. We thought we were going to have a gradual ramp up over six to nine months, but we got fairly busy pretty quickly with the shortages of pharmacy services in our area.
- [09:41]
B
That's amazing to hear and, you know, really, really important, as you mentioned, to have that type of retail pharmacy and pharmaceutical opportunities for the community. It seems like, you know, very fortuitous that you had those plans in place and then the team that was able to get things executed and built up for the hospital. Now, looking ahead, what are some of your big priorities and headwinds that you're focused on today?
- [10:06]
A
Yes. So looking ahead, looking to 2026. Of course, the HR1 and the Healthcare Transformation Program is certainly weighing heavily on us. We are heavily impacted by Medicare and Medicaid utilization of our facility in a rural community. And we trend higher on Medicare in our area. We're, we're kind of a retirement area and with the resources and amenities that we provide in our area, very popular for retirees. So we're watching the changes at the federal level and how that's going to affect us. We're obviously concerned about protecting our Medicaid utilization to the extent that we can. And, and we're encouraged by the Health Transformation, the Rural Health Transformation Program and the dollars that have been granted to our state of Oregon. We're working closely with the state of Oregon on how those funds are going to be utilized in our facility and other rural facilities around the state. It's. And so of course, I think it's so important at this time because even before HR1, the Oregon hospitals really have been struggling for several years. Oregon Hospital association put out a report earlier this year on hospitals on the brink and reported out that over 50% of Oregon hospitals have had negative margins for the last couple of years. And really only 25% of Oregon hospitals are experiencing relatively healthy margins at this time. So I think in answer to your question, that was a lot of background detail. I guess financial success, sustainability for our facility are going to be. Be our number one challenge. And the way that we're addressing that is through, is through looking at the potential for new services, new service lines that make sense for a small facility in our community. And I mentioned already the retail pharmacy. And we believe that that's going to be an important new revenue stream for, for our hospital in 2026. We also in the past year have revitalized our surgery department in our surgery program. We've recently onboarded a general surgeon. The surgery department at our hospital was closed during the pandemic, and it's taken us several years to get the surgery department back up and running. When we began the process of reopening a year ago, we discovered that our sterile processing department was out of date and no longer current with current codes. So we invested about $800,000 earlier this year in renovating, remodeling our sterile processing department so we can bring surgery back. And our goal is to build up our surgery department that year. We're also starting a new service that we're excited about serving the Medicare senior population for psychiatric care. Working partnering with a company called Senior Life Solutions, we're going to be providing group Therapy for senior adults that may be struggling with some psychiatric and emotional issues such as loneliness, such as depression. One of the things that we've noticed that we've discovered is that there's a lot of seniors in our community that are caring for loved ones and spouses and that can be an emotional drain. And so this is a new service that we think is going to be very important to provide support for our caregivers and our seniors in our community.
- [14:40]
B
Got it. That sounds amazing. And you know, certainly being able to have those additional revenue streams coming in and planning ahead, it seems like it'll be a great foundation to continue building on no matter what happens in the coming year with some of the legislation and different funding priorities now. Absolutely. I know it's, you know, will be helpful, but not overall like 100% solution or fix. And so when you look into the next year, what do you think the hardest thing that you'll have to do will be?
- [15:12]
A
Yes, that's a great question. And I think the hardest thing for us is going to be to manage that road back to profitability for our facility and sustainability. We've been fortunate as a district hospital, we do receive tax support, which helps us and we've typically been a break even facility. Our goal really is to get to be a sustainable and profitable facility. And that is a challenge for us. But we believe that with the new programs that we're creating and being very careful and also looking at, you know, where we can be more efficient in the coming years and we've got some opportunities up the road as well for that. But I think the, the answer to your question is the, the hardest thing that we're going to be able to do is, is to move the needle as far as getting over the hump from basically a, a break even over to a, a profitable, sustainable facility that is going to be here to serve this community for the next 50 years.
- [16:40]
B
That makes a lot of sense and great to understand a little bit more on how you're thinking about that sustainability and profitability. I know you've outlined some of the different tactics in ways that have really been transformative in the last year to support that vision of profitability. Is there anything else that you're doing, whether it's with your teams or kind of the organizational strategy that will lead to this type of profitability and financial success?
- [17:09]
A
Yes, there is and I'm excited to talk about it. In partnering with the state of Oregon and the Rural Health Transformation Program. One of the things that we're very excited about is creating a clinically integrated network amongst the rural independent hospitals in our state of Oregon. There are several, I'll say successful clinically integrated networks in many states that are largely rural. North Dakota has a very successful one, Colorado, other states as well. Montana I'm aware of. So we have, we're working with our state to obtain funding through the Rural Health Transformation Fund to create a clinically integrated network. We've identified 13 rural independent hospitals that is hospitals. They're not part of large systems. Many of these 13 hospitals or critical access hospitals, but not all. There are some PPS hospitals that fall into that category. Not part of a system serving a rural area. And so we're starting to think about how can we band together. Using the power of larger numbers for negotiation of payer contracting is one of the major opportunities. Value based care another opportunity that we're looking at. Working with a group of hospitals and then some efficiencies possibility for shared services among the hospitals group purchasing opportunities. I'm very, very excited to, to create our Oregon clinically integrated network this year. I believe we're going to do it with the support of the federal government and the state of Oregon. We have several very excited and motivated hospitals that are excited about partnering together and we believe that through this partnership that we're going to be able to create some new efficiencies and create some new more beneficial payer contracting for our facility which, which would be so important for our facility. That's, that's I think the, one of the, the most exciting opportunities that, that I'm looking forward to in the upcoming new year.
- [20:01]
B
Wow, that's amazing. What a huge feat. But a necessary and important aspect of growth and development. And I. Very exciting as you said.
- [20:11]
A
Yes, we're, you know what, I think we're in a good place. I mean it's, it's challenging times but you know, we're not, we're not thinking of it in, in terms of, of devastation and, and we're, we're thinking in terms of, you know, where can we grow, where can we build, where can we create new new systems that are going to benefit our community and support our facility. I guess one last thing that I'll add and throw out there. We've also started planning for expansion of facilities in the future. We received a grant from the largest employer in our area which happens to be a nationally renowned golf course, the Abandoned Dunes Golf Resort right in our backyard yard. They have a charitable foundation and they're very, very supportive of non profits and critical infrastructure in our community and they granted our facility $171,000 last year to fund a master facility plan so that we're now working with architects in planning for expansion and potentially replacement of facilities for the future. Future. I like to tell people that Last year in 2024, we celebrated our 25th year of service in our current hospital facility, which we outgrew long ago. And now we're planning for the next 25 years. So a lot of optimism and excitement about what we're doing and love the partnerships, which is so key. Partnerships with local employers, with local government, and with other hospitals and healthcare providers. I think that's the key for us.
- [22:06]
B
Absolutely. I love it. Raymond, thank you so much for joining us on the podcast today. This has been such an inspiring conversation and a great way to think about the coming year. And, you know, I look forward to connecting with you at the annual meeting coming up here in April. I know you'll be speaking on some of the topics we talked about today, as well as just sharing your perspective on how things are going. And again, you know, being able to dig a bit deeper into how you've been able to build all the things that you've done, whether it's looking at the retail pharmacy, I'm sure, you know, we'll get into some of the clinically integrated network in other aspects of our conversation today as well. So thank you again for your time and I look forward to seeing you then.
- [22:44]
A
Thank you, Laura. I'm looking forward to it as well. Happy holidays and Happy New Year to you. And in the end, entire Becker's Healthcare organization.