Scott Webb (Host): On today's podcast, I'm joined by San Juan Regional Medical Center CEO, Jason Rounds, for a caregiver town hall that'll hopefully answer many of the questions and concerns that the valued caregivers of SJRMC have for Jason and the organization.

Welcome and thanks for joining me today. I'm Scott Webb. Jason, so nice to have you here today. It's time for another Town Hall Podcast from San Juan Regional Medical Center's President and CEO. That's you, Jason Rounds. So, let's just start here, easy one, how are things going? You know, I understand you have a lot of great things to share with your caregivers.

Jason Rounds: Absolutely. I think the biggest change in this town hall is we're trying out a new venue setting that I think overall worked well. We're anxious to see how our caregivers rate that when the survey comes out. But moving it from the Civic Center to on campus helps us be more flexible in providing probably more options in the future. So overall, I think it went pretty well. The turnout was okay. We weren't overly crowded in the space. The technology worked. And so, we're enthusiastic. We hope this could be a permanent setting for us going forward.

Host: That's great. And I remember from our conversation last time that it's important to you to Really listen to the caregivers, listen to the folks, you know, who work for you and keep trying things, keep throwing things out there, try it this way, try it that way until you find what works for everybody. So, great to hear that you're still pursuing those goals of trying to get this right for everybody. And I understand you've got some new members too on your senior leadership team. Maybe you can share.

Jason Rounds: We're thrilled to have some new folks that have joined senior leadership team. First is Neil Teatsorth. He is currently our interim Chief Human Resource officer. We're recruiting for a permanent placement where we hope he'll be a candidate in that. But his experience extends to the healthcare sector, serving as a senior HR leader for four health systems, including most recently, the Alaska Native Tribal Health Consortium, which is the nation's largest tribal health organization out of Anchorage, Alaska. He has roots in New Mexico. He was with Intel Corporation for a number of years in Albuquerque. He and his wife have family in the area up in Durango, for example. And he's also a graduate of the Miami University's Farmer School of Business out of Oxford, Ohio. He and his wife, Barbara, currently reside in Toledo, Ohio. We're actively trying to recruit him to our beautiful Four Corners area. And the proud parents of three, doting grandparents. And we're looking forward to continuing our journey of excellence in the HR department. He's done great things since he's been here in the last six months and we're looking forward to continuing to work with him.

Most recently, we've had a position, our Chief Information Officer that we've been recruiting for quite some time, and we're pleased to announce that John Gaede has accepted that position and is here on site with us now. He is an executive leader in healthcare informatics with 23 years of professional experience. He comes to us most recently from SkyLink Medical Center in Southern Oregon and Northern California. He served there as the Director of Information Systems since 2015. He has a broad background. He has a background in chemistry. He was medical technologist. He was also a registered medical laboratory scientist. He also has a Master's Degree in Theology. So, he's been married for 32 years, has six kiddos, loves everything that Farmington has to offer he and his family. And we're looking forward to getting him and his wife and family moved here this summer permanently. So, welcome to both those new leaders.

Host: Yeah, welcome for sure. And I know we talked about retention last time. Let's go into that. Let's roll up our sleeves a little bit here and go into that more in depth. It's something that folks are going to be interested in. So, how's the organization doing in terms of retention?

Jason Rounds: Sure. This was a top priority that our caregivers really wanted to hear more about. That became evident from our last town hall meetings as well as recent survey that we did on what was important to them. In addition to strategy and finance and the overall well-being of our organization, they really wanted to know what our plan was for retention strategically. So, it's a multifaceted approach really compensation is a big piece of that. It's something that we know that we need to focus on and make sure that we remain competitive in this market. We're undergoing a market survey right now. We're really trying to address the apples and oranges comparison that we got lost in in previous years. Our HR department has done a phenomenal job, and really boiling it down to actual job descriptions and comparing those across different markets.

Our ultimate goal is to really get a sense of what makes sense for Farmington, but also be able to respond and accept and adjust to what's going on in markets like Durango, or Shiprock, or Albuquerque, or Phoenix, or Denver, depending on the nature of the competitiveness for the positions that we're recruiting for, and actually what's going on in the compensation standpoint.

We have other things that we're focused on right now, is we are completing our Years of Service. We started this a number of years ago. We focused initially on nursing titles and other caregiver titles in that we are completing that process basically to bring everybody up to a competitive standpoint relative to their peers. So, doing some decompression in compensation ranges and that is a completion of a long project. We expect to have all of that completed by the end of April moving forward, really just to give everybody a sense that we're starting from the same foundational platform on compensation. We're in the process of preparing our budget for 2025. So, all of this is really timely as we're looking at how raises and compensation is going to work in the upcoming year.

We also have two key technology upgrades planned, one to workday and then one to our timekeeping technology, Kronos. Upgrading and making sure those systems are compatible and working together are absolutely paramount for us being able to do even more creative compensation plans in the future. For example, if we were moving toward a pay for performance methodology, we would really need these technologies in place, functioning, and tested before we were able to do that. So, we're looking forward to completing that project in FY25.

But beyond compensation, there's a lot to retention. In addition to that, work-life balance, making sure that we have programs that support our caregivers outside of work as well; our recognition and rewards beyond just compensation is what are we offering our caregivers in the form of holiday opportunities for bonuses, opportunities to get together. Last year, we had a really successful caregiver event up at our outdoor amphitheater where we hosted a showing of Into the Woods. And it was a great week of being able to do that for our caregivers. We're looking at other opportunities. We're looking at getting together for a family event with some DJ and some food and festivals in one of our area parks in the upcoming months for that. So, looking for better opportunities on what's important and what is really meaningful to our caregivers, all in the approach to really focus on a positive work environment here.

In addition to that, we're looking at re-imagining and relaunching our well-being strategy. Sandy Greenwald, who is up in Wisconsin now, but still very focused on that, has some bright ideas. We're planning on inviting Neil Teatsorth, our Chief Human Resource Officer, to the next town hall meeting to really expand more on some of these programs that will be rolling out for our caregivers.

And finally, we have lots of benefits now, but we are focused on professional growth and development of our caregivers. The programs that are available right now can help our caregivers, support them if they are pursuing certifications in their relevant field, are interested in furthering their education and things like that. These are programs that are available now. But as we are focused on our talent and learning aspect of it, we really want to make sure that we're focused on what is meaningful to our caregivers and will help our organization ultimately.

As I mentioned, Neil's going to be with us next time. We've done a lot of work in taking a look at our HR department and how to reorganize them to better support us and our caregivers going forward in the future. So, we look forward to inviting him to talk more about that.

Host: Sure. Well, I love hearing all of that. You know, obviously, compensation and titles are important when it comes to retention, but there's just so much more to it than really seeing the caregivers and your team, you know, and their entire lives, their families, what they do outside of work. And, you know, along with retention comes recruitment, so I know the healthcare industry always needs talented individuals, right? So, how are recruitment efforts going?

Jason Rounds: Our caregivers who are out there, who are on Facebook or LinkedIn or any of these other types of social media, as they see announcements that are coming out or positions that are available to help us by reposting those or sharing them or liking them just to help get the word out. Of course, we're an organization that is focused on our core values. We're interested in attracting the best and brightest, highest qualified applicants that we can find. Safety and quality remains absolutely our priority here especially as we focus on lifestyle balance and really attracting those folks to our community who would enjoy the kind of lifestyle that we have to offer here.

Interestingly enough, we have had an opportunity to engage our institutes of higher learning in a different way. For example, we've recently met with the senior leadership at San Juan College to really go and ask them to rethink how they attract the students to their programs and we've effectively challenged them to figure out ways to double their admissions. So right now, in their nursing program, for example, I believe that they are routinely turning down about half the total number of applicants, just because they don't have enough slots that are available. So, we look forward to being able to work with them now and in the future to find innovative and creative solutions where we can increase their capacity to really find those folks in our area that are interested in healthcare and get them into these programs and retain them in this market.

So, we know that those folks who do not have a chance to get in our program are probably not waiting around for the next opportunity. They're finding programs in other cities or other states, or choosing different fields. We think it's a real opportunity to be able to increase the number of caregivers that we can train locally here. We've started that conversation with our friends at San Juan College. There are probably seven or eight other institutes that we'll be having similar conversations with going forward.

Lots to work on, but workforce development, retention, and recruitment are going to be a top priority for us now and for the years to come.

Host: Definitely. And you mentioned that you're working on FY25, of course, and there's no way we could have this town hall and this conversation without talking about financials. So, what's the current financial status of the hospital?

Jason Rounds: We're entering the quarter in really very good shape. I'm still working on what is the most relevant financial metrics to share at town hall meetings and with our caregivers. But what I did share at the last one is the same dashboard indicator that we use for our Board of Directors and that we discuss in more detail at our finance committee. But it tends to look at the key indicators that are going to represent the overall financial health of the organization. So right now, we're in very good shape.

Our creditors, for example, when they are rating us, will look at things like our earnings before interest depreciation and taxes. And even though that we're a little bit short of this budget, we're really in a very strong financial position right now and well ahead of where we were this time last year. We also look at certain ratios, like the current ratio, the debt-services ratio, days cash on hand. And those are indicators that really demonstrate our ability to have access to cash, to be able to pay our bills, and how stable we are going into the future.

So for example, our days cash on hand right now is 263 days, which means that if revenue mysteriously just stopped coming in suddenly, how long could we keep the doors open paying our expenses? And that's 263 days. All of those indicators are in the green. And so, we're looking forward to our next round with the credit raters to see how we turn out. But right now, from a balance sheet perspective, we're absolutely in solid position. We have access to capital resources if we needed to borrow money for acquisition or large capital purchases, and the like. So like I said, we're entering the fourth quarter in very good financial position.

Host: Yeah. And when we talk financials, green is always good. That's a good color to be, right? What are some of the challenges and maybe contrasting that with what's going well, maybe you can take us through that?

Jason Rounds: I think the focus for the last quarter is really going to be on operational efficiency. We have identified some opportunities. We brought some consulting friends in to take a look at that. And we believe that there is, in addition to some low hanging fruit, some other structural things that we can do to help prove that efficiency, which, at the end of the day, will improve our bottom line, help with patient safety, and make this a more positive place to work.

We're also in growth mode. Regardless of anything that's happening in the future year that we're enthusiastic about, we are currently recruiting over 38 physicians right now to our market. We also are growing and expanding in our Durango area. Most recently, we've had the opportunity to acquire some new space. It's actually the old Mercy Hospital that's been kept up-to-date and is great clinic space now. So, we're enthusiastic that we're able to move our specialty clinic services into that building, which will allow for better efficiency off the bat, but also the ability to expand into that market even better than we have been. So, we're looking forward to growing in that area in the upcoming year.

Host: That's great. I'm wondering if you can crystal ball this for us a little bit, Jason, talk about opportunities that are on the horizon for SJRMC. I know there's some good news from recent legislative sessions. So, maybe you can share that with the caregivers.

Jason Rounds: So, the great news for us, the hospitals in New Mexico working collaboratively with the New Mexico Hospital Association, our advocates as well as our legislators really have put in place a substantial win for healthcare for the state of New Mexico. So, the program that we're able to leverage is through the Medicaid program. So, the way Medicaid works in very general terms is the state of New Mexico that has the program funds a certain amount of it. They get matching dollars from the federal government. And depending on what state you're in, that can range from a dollar match to a $4 match. For New Mexico right now, it's a $7.72 match up to a cap. And the state of New Mexico has traditionally not been able to afford the full amount of funding to be able to draw down the maximum amount from the federal government. We've put together, working collaboratively with all of the health systems across New Mexico to be able to fund the state to be able to maximize that match, for the state of New Mexico, it is potentially $1.3-billion additional funding from the federal government. For our state local area in the four corners, Farmington specifically, we're predicting that is going to be about an $80-million pickup for us, probably starting a year from July, FY26 for us. So, it is a game-changer for our community and our hospital system. And so, we're really quite enthusiastic as we rebase our strategy, working with local stakeholders to make sure that we are investing those dollars wisely and for programs that are going to have the most meaning for us.

But what does that mean? What are we going to be investing in? It's going to look very similar. We're going to invest in our caregivers and workforce development. We're going to invest in the infrastructure that we need, here in Farmington specifically. But we're also going to be able to invest in and growth strategies. We just want to make sure that we're being smart about how we go about that. So, that's coming, that's something to really look forward to in the upcoming years. Our next year, FY25, that starts in July, is going to have a lot of the same challenges that we've had in the previous years. But once again, we still have opportunity. We know that there's a potential pickup as we look at our efficiencies and we get our arms around length of stay and patient throughput and other opportunities in our organization.

Host: Well, Jason, it's always good to hear about the investments. And I know that talent and technology is something that organizations are really vested in. So, let's maybe underscore and underline some of the investments that you're making in those areas.

Jason Rounds: With due deference to our opportunities for the future, we have a lot going on right now at our facility and surrounding area. So, we're thrilled that our obstetrician-gynecologists have gotten into the the world of robotics. And we have recently started gynecology procedures with our da Vinci robot. Dr. Szekely began that most recently. The great news about our da Vinci robot, which we started just over a year ago, is that demand for it has really gone through the roof. So in a relatively short period of time, it has demonstrated its value to physicians who want to use it. And there's a long line waiting to get access to it.

So from an administrator standpoint, it's a good problem to have, but our doctors are a little bit bottleneck. So, we're looking at ways of improving the efficiency of that and how block time is going to work, but really thrilled for the success of that program. In addition to the OB or the gynecology procedures that are being done there, our urologists are using it routinely, our general surgeons are getting great use out of it for a variety of procedures, most specifically our bariatric services that we recently launched.

We continue to refine our ICU expansion. So, we have been re licensing a number of beds changing them from either progressive or med-surg into ICU. Why are we doing this? We're preparing for the future as healthcare continues to evolve and a lot of the procedures and care that was traditionally given in a hospital setting is moving increasingly to the outpatient setting. We want to make sure that we are appropriately investing in the resources necessary to take care of the sickest of the sick patients. So as we really looked at our complement of beds, we recognized that we were going to need more ICU and critical care capabilities in the future, and we wanted to be prepared for that. So, we're just waiting on final determination from the state of New Mexico to get that licensure set up and increase those numbers of beds.

We also have a wonderful joint venture with our nephrologist, Dr. Pandya, for kidney care. It has gotten off to a remarkable start over the last year and we're looking for further expansion opportunities throughout the Four Corners area. We're also looking at standing up an observation unit. This isn't your traditional observation unit necessarily. It's going to be a protocol-driven, run by our hospitalist, really focused on helping us manage efficient care and patient throughput through our organization. So, that, we're expecting to stand up early in FY24 at the latest.

I'm also happy to announce we've started the Intracept procedure at our San Juan Regional Medical Center Interventional Spine Clinic. It is a low-invasive procedure. It's outpatient based and usually our patients are going to see relief after one treatment. So, this is something that Dr. Jones and Dr. Garmaev and Eric Griffin up there are happy to be advocates for and provide to our patient base.

We're also opening a walk-in clinic in Aztec. This is going to be immediately adjacent to our existing clinic now. It's not shutting down or opening a new one. It's actually expansion of services for Aztec. They have a huge draw from not only in the Aztec area, but from Bloomfield, Flora Vista and parts of Farmington are getting their care up there. So, it's something that we're thrilled to be able to offer the community starting in April.

And also, I mentioned, I think, at the last town hall meeting that we're about ready to start bariatric services here. That has started. It's going really well. What I did not realize is we were the first in New Mexico for the fluorescent-guided bariatric surgery. So, thanks to Dr. Boyd and Dr. Ernest and Megan for all the work that they do in the Metabolic Center and to bring these valuable services to our patients.

Host: Yeah. It's all good stuff. And of course, I love robots. So, it's easy for me to say, "We'll just buy another da Vinci," you know, if it's getting used that much, but I know how expensive those robots are, so not quite that easy. So, glad that you're trying to figure out exactly how to make sure that everyone can use it and all the doctors and patients benefit, of course. Let's talk about your commitment as a community hospital to supporting the community through charitable giving.

Jason Rounds: Clearly, as a 501(c)(3) organization, we're not-for-profit. So, we are all about investing back into our community, and we have a number of ways that we do that through community health education, community-based clinic services, our healthcare support services in general, support of the community building. We're an active participant in the Sobering House. We support medical students, nursing students, other allied health professionals that rotate through our organization.

Obviously, our charitable care that we provide directly, the amount of charity care that we provide here, along with the uncompetitive care we're providing to this community to the tune of over $30 million a year at our cost. We also have an opportunity to make direct donations to other not-for-profits in our community. We promote and participate and support a number of these programs like Project Graduation; FAST, the Farmington Area Single Track System, I had a chance to meet the founder and one of the board members this week, a wonderful program promoting bicycle safety and use and getting outdoors to our kids. They're going very strong right now. We have a program we support, Don't Meth With Us, for addictive medicine. We also support a program called Inspire Art that offers support to our pediatric patients. I saw pictures just the other day of them rotating through our pediatric unit, supporting our kiddos that were up there in the hospital with art projects and other activities. And we also support community reinvestment funding.

And something I'm very excited about is the support of our health and healthy living. I hope you guys have probably seen the beginnings of our Choose Better campaign. But in October, we will be increasing our support of the Road Apple Rally with booths on Friday. We're going to have our San Juan Regional Medical Center team out there. We're going to have promotions at the race. And we hope to see you out there, and maybe you can join one of our teams to ride if that's up your alley as well. This mountain bike race is currently the longest standing mountain bike race in the U.S. So, something our community can be proud of and we're happy to support.

Host: Yeah, happy for sure. And I know there was a recent brand perception study. That sounds interesting to me. That sounds maybe a little over my head, but you're here to interpret it for all of us. What does that mean? And specifically, Jason, what does brand mean for you?

Jason Rounds: Brand is essentially our patient experience and how people view us. So, we do a perception survey every year. And it really kind of allows us to track how our brand or how we're doing in the community on a routine basis. And it helps us kind of adjust perspective-wise and how we may approach not only marketing, but also our services that we offer here.

So, this year we really settled in on four main themes. First, the good news our brand is trending up, although slowly. Our brand experience tends to lack consistency, so some of the answers to questions we were getting is, "Nope, we've had a great experience, loved our doctor, loved the caregiver, but we couldn't get a call back a couple of weeks later." So, really focusing on how we can take what we're doing well and make that consistent throughout our clinics and the total experience here will be a priority for us.

We also don't just take a look at what's going on with our brand. We also want to get a sense for what's going on with our competitor. And Durango is down. So, Mercy has had some challenges in the last year, seemingly around their corporate structure and some of the changes that are going on around that. So, I don't wish ill on anyone, but it is interesting to get a sense for what our competitor is dealing with in our surrounding markets as well.

The other key finding in that is the personalization of the care experience really resonates with our patients. And so, this is something that we know we have done really well in the past that we've been known for. Yet from our perception survey, it's an area that we know we can focus on and do even better. At the end of the day, our brand perception survey does give us a score. So, this year we scored a 12.5, which is up from a -7 in previous years. So, what does that mean relative to brand? A 12.5 is comparable to what a brand perception for Netflix would be. So if Starbucks, which is kind of at the top of the scale, Netflix is kind of comparable with us. And then, you have folks like Red Bull who may have right now a negative perception. So, that's where we were last year. So, a lot of good progress on that.

The other good news for this, as you look at how the score is generated, is our promoters are scoring us nine to 10. People who are neutral about it or passive are scoring us from 7 to 8. And then, our detractors are scoring us 6 or lower. The good news for us is there is a large number of folks that are in the passive category. So, we're not really going after our haters or detractors. We would love to improve their perception of us. But the folks who are neutral are a real opportunity. A few of those folks going from passive to promoters would really enhance our score in upcoming years.

So, we've got lots of initiatives underway. We'll be focused on our Choose Better campaign that we're rolling out in our market, as well as focusing on ways that we can improve that personalized care experience for our patients who choose us.

Host: Yeah, that's perfect. I want to, as we get close to wrapping up here, talk about the fourth quarter. What's your level of optimism for the fourth quarter?

Jason Rounds: We're entering the last quarter really on target and in good shape. Many of you may remember from last year that the fourth quarter was not. We were very financially challenged, we were coming out of COVID, our patient volumes were changing, and we were having a hard time keeping up with the cost structure and the change in volumes. But we are wrapping up the third quarter in good financials shape. We're a little bit short of our budget, but trending in the right direction. I think we've got a lot of opportunities on operational efficiencies.

As I mentioned before, we do have a consulting group who's going to be working with us. It's a seven-month engagement that we're going to have them on site over the upcoming nine months. So, looking at patient throughput, our ability to be more efficient in our procedural areas, helping us with block scheduling, but we think there's a tremendous opportunity for FY25, as well as the remainder of this quarter to really improve our efficiencies that will help our bottom line substantially.

And of course, we may focus on quality and safety. Some good news on quality, in February, Dr. Underwood reported for the first time that he says in the six and a half years that he's been here that we've actually had a month where we reported zero harms, which is the ultimate goal for our organization. So, it's a demonstration that we're trending in a very good direction with our quality scores. I also really want to give kudos to a wonderful program to help us manage pressure injuries better in our hospital. A couple years ago it was a critical initiative. We knew that we needed to do something different. We launched a program where we had four eyes and four hours on our patient, but also started using a new technology of using thermal scanners to help us identify areas of skin breakdown before they actually were problems in that. It was a remarkably successful program for that and we've recently been able to invest in replacement cameras and some additional resources to help our caregivers make sure that we manage that. But we went well over 400 days without a pressure injury. So really, two good examples of our focus on quality and having the ability to move in the right direction.

Host: Well, Jason, this has been really educational and fun. I'm sure caregivers agree. I want to finish the conversation today with some positive takeaways, things that are happening on the horizon, times of celebration at the hospital. I know you've got Nurses Week and Hospital Week. Share all that with us.

Jason Rounds: Before I jump into that, just a couple of information pieces for our folks. Back in mid-March from the 13th to 17th, our WebTPA friends had a system hiccup. So, some of you may have experienced some problems if you were getting prescriptions filled or accessing healthcare during those days. I think we've identified most of the people that were impacted and worked through that. If anybody out there is still having problems with that, please don't hesitate to contact our Total Rewards folks and we can help you manage that. Also, our friends at WebTPA during that same hiccup sent out new ID cards that had incorrect information on them, so wrong out of pocket expenses, deductibles, all of that. They have sent out new cards, so you may want to compare the two if you're getting some of these in mail. Just dispose of the ones that are inaccurate and keep your new ones. But if any of you guys continue to have problems with that, please don't hesitate to contact our Total Rewards folks in HR and we can help you through that.

Since our last town hall meeting, we're acting on some feedback. We knew we had some traffic issues on our Pinon Street and Lake area from the parking lot crossing over to our main campus. Our leaders were able to work with the city manager and traffic engineers, and we've made some improvements recently over there. So if you're on Pinon Street, you'll notice these changes. One of them, we do have a radar-activated your speed indicator. So, it will identify the speed that anybody is going, driving on that street, just to raise the awareness of the drivers that you're in a, high pedestrian zone. We've improved the signage and we've also reduced the speed from 30 miles per hour to 20 miles per hour. We've put in some reflective cones that will help narrow the lanes and identify for the drivers in a physical way that they're entering a high pedestrian area. And we put in a new crosswalk, where if you activate it, lights go on, it activates the signs, just an additional alert for those drivers going through there. Always be aware of your surroundings when you're crossing that street. It's a high traffic area, but we really do appreciate our friends at the city working with us to help improve safety for you guys over there.

On to some good news, of course, we were recently awarded the Education Support Special Designation of the Family Friendly Business Award. So, this is an organization or an award in collaboration with the United Way of North Central New Mexico. What they recognize for us is our dedication to investing in our own caregivers through development and support for increasing their education, their advancement through certifications, and the like. We're not chasing awards, but it was a nice validation that some of the benefits that we do offer here are well received and on the right track and support our caregivers in a very meaningful way. So, there is going to be a special luncheon that we're going to send a group down to Albuquerque and accept that award in the upcoming weeks.

And for Nurses Week, we have a lot of great things coming up in May, certainly starting with National Nurses Week, which will be May 6th through the 12th. You guys make a difference, so we'll be recognizing three of our nurses with the Suzanne Smith Nursing Excellence Award. That event's going to be in the Healing Garden at 10 a.m. on May 5th. And once again, this recognizes nurses who have demonstrated excellence in their area of service.

Right after that, we roll into National Hospital Week that's going to run from May 12th through the 18th. We have a number of events and programs scheduled, including our brick celebration, recognizing our caregivers with over 30 years of experience. We're going to have luncheons and department caterings. At the department levels, we're going to recognize our honorees from five to 35 years. We also have our Future is So Bright education breakfast. And all of this will be capped off with our service awards dinner celebration, May 15th at the Civic Center. It is by invitation, and you do need to RSVP by April 26th. So, lots of fun activities coming up in May.

Host: Yeah, definitely. I'm so glad to hear about these opportunities for the organization to celebrate caregivers. They do amazing work every day, and I know the community is grateful for the care your hospital provides, Jason. I look forward to these town halls. You've got a lot on your plate finishing off 2024, planning for '25, '26. You've got so many stakeholders. I don't know how you do it. But I'm sure, the caregivers especially appreciate hearing from you. So, thank you so much.

Jason Rounds: Oh, my pleasure. And thank you for your time this morning.

Host: That's San Juan Regional Medical Center CEO, Jason Rounds. And thanks for joining us for our caregiver town hall. I'm Scott Webb. Stay well.