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, thanks so much for your time today. I know this is your first town hall as CEO of San Juan Regional Medical Center. So, how'd you get to this format with the in-person meetings you held and this podcast you were recording? I know it's been a bit of a process.

Jason Rounds: It has been a process so we're really thrilled to bring back kind of the live town hall meetings. This is the first one that I think we've had the opportunity to do since COVID, so it was important to me and our team that we at least had an in-person version of that. But the other key thing we wanted to make sure that we do is answer and address questions that are important to our caregivers. So, it was a process. It took us about three months from start to finish to really orchestrate this to get to a return to this type of format.

And during that process, many of our caregivers will remember a survey that went out and that ran between July 30th and August 4th. And we had a really good response rate for that. We have about 403 people that had some comments about the structure, what their preferences would be as well as the focus of conversation. So, we took that all into account. We didn't do just a carbon copy of what we were doing before. We really did try to address the needs that we were hearing from the caregivers directly.

Host: Yeah. So, let's talk about that a little bit. Talk about the caregivers. What are some of the topics that caregivers said they wanted you to address from the survey?

Jason Rounds: There were a consistent number of themes that came out of that survey. We heard loud and clear that they wanted more information about the financial stability of our organization, the future of San Juan Regional Medical Center, a strategic plan for growth and challenges, how we are involved in our community and some of the partnership initiatives that may be ongoing with our organization; retention, how we're treating our current caregivers to keep them in our system. There were questions about pay and PTO and sick leave. And I recently had sent out a memo about the PTO buyback that that program was being discontinued. And within that memo, I addressed some other programs that we had implemented and there was some confusion around that as well. So, it was an opportunity to clarify some of those points.

We also heard loud and clear, we got some really good feedback about the format or what would work best as far as a town hall meeting. So, the general themes along those lines from our caregivers is they wanted it to be one hour or less, at least as far as content went. They liked the concept of in-person. They were also open to Webex meetings. And as we went through our process, we're trying to balance through this. So, the podcast, this podcast is part of us trying to be creative in how we record and share information with a broader audience. On the timing, they were really looking for these maybe on a quarterly basis. And what I had promised people during the town halls was largely, we would see what we could do on that, but given that it took about three months to get the content, the space identified, notices out and kind of fine tune our town halls. Four maybe a lot, but we are currently setting up a cadence to have these types of forums at least three times a year. And they like generally the morning and afternoon sessions. So here, I'm very sensitive to the fact that we do not have an on site or on-campus auditorium in a convenient place to gather and that people are having to leave this area, drive someplace else, park and all that. So, we're trying to find that right balance in that. But overall, great comments. Once again, it's an experiment. So, this was the format that we chose. At the Civic Center, we were going to have a total of four sessions, one in the morning, one in the afternoon over two days, and then follow up with this podcast.

Host: Yeah. And you've obviously been listening. You and I, before we got rolling here, you said the PowerPoint is about 55 minutes and they had expressed that they wanted it less than an hour. So, 55 minutes sounds pretty good. Let's talk about the organization's core values. I know you have five of them, but one in particular resonated with the presentation. Maybe you can tell us what that was.

Jason Rounds: As we kind of reflect on the core values, and I've been here five months, so am still learning some of the nuances in this. But as we were preparing for the town hall meetings, our core value of creative vitality really seemed to resonate with the team. And as a reminder, that core value is it allows us to look at things in new and energetic ways, looking for new approaches to meeting our community needs with enthusiasm, discipline, we find creative solutions.

And certainly, the challenges in healthcare today, which are not unique to Farmington, New Mexico or San Juan Regional Medical Center really do inspire that type of creative problem-solving. So, I was happy to do that. This core value also reflected as we were trying to address some of the topics that came up during the survey. And Scott, there are a few of them that I'd probably like to go into a little bit more detail about.

Within those common themes that we heard, I wanted to specifically address some of them. So within the construct of talent management, there were questions around pay disparities. And so in this memo that I had sent out, I had talked about completing a two-year process to adjust our pay ranges to be fair. And so, there were some questions about that. And I did remind our caregivers that. Last year, we did go through a process that was focused on mostly nursing titles to address the fact that we don't want to hire new caregivers into our system at rates that are higher than our experienced staff that are already here. So, we wanted to make sure that those pay ranges were appropriate. So, there was a significant adjustment that was made to that pay range to make sure that we were not compressing those pay grades at those upper levels. We're completing that process for the remainder of our caregivers. So, we're going through that same exercise to make sure that those ranges are fair. And also acknowledging that we're not in a static environment, so it's not one fix fixes it permanently. We need to keep up to speed on that and making sure that we're addressing those ranges as salaries continue to compress in our market.

There were also some questions about PTO, specifically the PTO buyback, which I did address in our memo about the rationale behind that. And it is a program that we had been doing at San Juan Regional for a number of years. It is discretionary. And so last year, our caregivers did not get it because of the financial situation that we were in. We did not hit that trigger. And so, what I was getting mostly from our leadership and our caregivers directly is just tell us what the answer is so we can plan accordingly. So, knowing how the fourth quarter ended last year, finishing our budget process and projecting forward, we knew that we were not going to be able to offer that program any longer. So, I just wanted to make sure that everybody knew that that is the plan going forward.

And there's been a lot of questions about our sick leave program. The state of New Mexico put in new legislation that required everyone, employers essentially, to have a sick leave bank. And there were some guidance and guidelines around that were fairly restrictive. So once again, it's a great program. I think the state of New Mexico was focused on the right thing, but it really was not designed necessarily for healthcare organizations or organizations that had pretty robust paid time off programs already. So, fitting that into our existing program was challenging and fitting that into our program to ensure that our caregivers were not losing anything in part of that process has been challenging. So, there are some specifics around that make this program remarkably complicated. I compared it at the town hall meetings to a 1973 Fiat. It looks good, but when you pull out the dashboard, you could never describe accurately the wiring harness behind it. There are some guidance in there. There are some requirements to it. There are some ways that we track the information that really does make it appear that our caregivers may be losing time which is really not the case. So, we have work to do to communicate that benefit better. We've also asked the state, we're working with our local associations, both the New Mexico Hospital Association and some nursing organizations, to see if we can get some flexibility or some exemptions to allow us to be a little bit more flexible on how we implement that program.

Right now, it's a great program. We are really happy to be able to offer it to our caregivers, but there are some complications to it that we would like to address over time. We are working on it and we do hear loud and clear that our caregivers would like something that's a little bit more straightforward and understandable. We definitely have work to do on that.

The state of San Juan Regional Medical Center coming out of COVID, we're coming into FY '24, even though we had a challenging last quarter, very financially stable. Our balance sheet is strong. We have over 240 days cash on hand, and that's a metric that a lot of our bond ratings are based on, our financial institutions who loan us money look at, and that's really a statement on how well we are able to pay our bills.

So, we're in very good shape along those lines. We are in a position where we can expand and execute on our strategies as we need to. We also have those reserves at hand if we need to weather some additional storms that are coming in there. But right now, we are focused on investing in our caregivers. We're investing in our facility and executing on those strategies.

And speaking of strategies, I did emphasize to our caregivers that we are in the middle of a three-year strategic plan and had a brief refresh last year to make sure that we were on track. So, we are executing on those, focused on operational excellence, as well as some growth initiatives. I think over the next year, nine months to 12 months, we're really going to be looking at another strategic refresh to really take into account some of the analysis we've done on physician supply within our area, recruitment challenges for providers specifically, and some service line opportunities that we think we have in front of us. We're optimistic about our ability to expand and grow and be able to execute on those strategies.

The other question involved our involvement in community partnerships. And we have a lot going on that. Not only from a not-for-profit partnership, working with the other not-for-profits in our area to deliver our mission, but also from a business standpoint, we have a number of initiatives that are underway. We have a joint venture ambulatory surgery center called Four Corners Ambulatory Surgery Center that we are invested in and doing great things with. We also recently have joint ventured for kidney care with Dr. Pandya and have great expectations for growth in that area coming up. So, that, Scott, really addressed the core questions that we got from our associates from that survey.

Host: Yeah. Just a few things on your mind, right?

Jason Rounds: Just a few things.

Host: Let's talk about some of the opportunities that are on the horizon for SJRMC.

Jason Rounds: Coming into our first quarter, we knew it was going to be challenging just with everything that's going on in our market. But the good news after we're just about to publish our fourth quarter financial results. So with some adjustments, with some improvement in patient volume in September, as well as some of our cost mitigation strategies really starting to bear fruit, we're expecting to be able to break even on this first quarter, which is not a bad place to be considering where we started the beginning of our fiscal year. It is behind budget, but we are optimistic that over the course of the upcoming quarters that we'll be able to address those shortfalls and catch up.

But we are facing some challenges in the market. I don't think it's going to surprise many folks. But coming out of COVID, we really saw a dramatic and quick change in our patient volumes and the needs that those patients have and why they're accessing us. We have challenges in workforce. I think we have certainly over a 30% vacancy rate right now. Within San Juan County alone, there is a deficit of 390 nursing positions that are needed in this community. So lots of challenges that are not unique to Farmington, New Mexico. These are challenges that are nationwide that we're all struggling to address.

We've had a shifting payer mix. There's been some changes in our businesses and folks that had good commercial payers have been moving out of our market. So, we are seeing a decline in the commercial base with an increase in some of the federal programs like Medicaid in our unfunded patient payer mix.

And of course, everyone has been feeling this at the gas pump, at the grocery store, in rent, in utilities and everything else is increasing costs. And so, we are certainly not immune to that in healthcare. We have the added challenge that if we were target, for example, and our labor costs go up and our supply costs go up, the next day our prices go up and pass that directly on to the consumer. In healthcare, there is that gap. So, we are feeling those prices go up on a weekly and monthly basis, but our ability to increase the revenue is not the same. There is payer renegotiations. And since a large portion of our payormix is government sponsored, it is working through that process. And so, that usually is a pretty substantial lag as revenue does not really keep up as quickly with our rising cost. So, that's been a significant challenge.

And once again, coming out of COVID, we restructured, we retooled and our cost structure looks a little bit different. So, we know that we're going to need to do some fine tuning as we believe that we are entering into a time that we're going to look more like pre-COVID demand, pre-COVID needs of our patients.

Host: Yeah, I know we're all feeling it at the pump, at the grocery stores, but as you say, a different financial model behind those things versus running a hospital healthcare system, all of that. And I know that talent and technology is something that the organization is really vested in, right? So you say that there's a shortage of caregivers, shortage of nurses, but that doesn't stop you from looking and investing. So, what investments are you making in both of those areas?

Jason Rounds: Absolutely. So as a community-based hospital that's not-for-profit, we invest in our caregivers, our infrastructure, and everything that we need to execute on our mission. So, really talking about what is our financial strategy around that, it's grounded in our mission and in investing in our caregivers. And for example, cost savings and service line growth this year are allowing us to do some pretty good things for our caregivers. So, we were able to absorb the benefit cost increase again this year. And I believe this is the fifth year in a row that we have not had to pass on an increase in premium. We've been able to budget appropriately and absorb those costs and not pass it on to our associates. We've continued our educational benefit, and we really look at a lot of our retention strategies about how we are basing how we pay our caregivers. We want to invest in them and their growth professionally in that. So, we have some really fantastic tuition reimbursement opportunities and other educational benefits that we really do encourage our caregivers to take advantage of.

We were also able to provide a 2% across-the-board wage increase. And as we're finishing our budget and we really realized how much the benefit cost was going to go up, there was a lot of conversation and some adjustments to make sure that we were able to absorb that cost so that the people could at least feel this 2% wage increase and not just get it in one hand and then give it back in the other one and these can increase premiums. So, our planning really allowed us to be able to do that for our caregivers this year.

And likewise, we also are able to continue to invest in our service lines and patient care. So over the last year and really since I've been here, we've brought on our da Vinci robots. Our surgeons are really enjoying using that. It's been a great addition to our OR technology. We've added negative pressure rooms in our hospital. We've been able to expand our ICU licenses to be able to address a growing need for our sicker patients. We've been investing in radiation oncology. And most recently, we have hired our full time radiation oncologist, Dr. Fuller, who will be with us in November. We've had the ribbon cutting and grand opening for our Metabolic and Bariatric Institute, and we're looking forward to seeing our first patient surgically in November, is the tentative date right now. We've expanded our NICU capabilities through telemedicine. As I mentioned earlier, we've also been able to launch a joint venture with Dr. Pandya, our independent nephrologist, for kidney care joint venture that we really think is going to do great things across our community. A lot available on how we're really kind of approaching our talent technology this year.

Host: You mentioned some of the community partnerships earlier, and I know you have this deep commitment as a community hospital. So, let's talk about how that ties into the Community Health Needs Assessment and what that is exactly. What is a Community Health Needs Assessment?

Jason Rounds: Sure. Part of being a not-for-profit these days is every three years you need to do a community needs assessment. So, we've worked with a group over a number of years that comes into our community and they interview stakeholders. They interview other not-for-profits. They look at data across a multitude of sources to do really a thorough needs assessment for what our community needs. So, it's not just what San Juan Regional Medical Center needed to do, but it really looks at it from the perspective of the community and our neighbors and people who live here, what their needs are within that community.

I learned a lot in this process this year. It will not surprise anyone that's listening to this, that our community has a vast array of needs across multiple areas. But doing this process is not only a requirement, even before it was a requirement, it's consistent with our mission. So having that objective third party come in there and really ask these questions and help guide us allows us to Invest where we need to support our community but also helps us align strategically going forward, and it really does provide a foundation as we have those types of conversations.

So our priorities for this year, which I don't think is going to surprise many folks, is we've narrowed it to three are very broad and relevant categories. Number one was access to care. And so, that covers a lot of ground and really supports our initiatives in recruiting providers and trying to address our workforce issues here in Farmington, as well as how we can work better with some of our community partners.

We're also going to be focused or continue our focus with diabetes care and management and treatment. So, we have lots of initiatives that are already underway, but we have some also bright ideas on how we might be able to do things better over these upcoming years.

In a relatively new restatement of a priority along the lines of cancer care and treatment, looking at the numbers and the incidence and some of the challenges that our community has in making sure that they have access to good quality oncology care here is we think there's an opportunity to do something really great for our community in partnership with the other providers that are in this community. Those are our three kind of key focuses that came out of the community needs assessment that we went through our approval process and the board has adopted. We're excited to get busy on that.

Host: Yeah. It always brings a smile to my face when I do this type of podcast. When I hear from CEOs that they're both listening to their employees, the caregivers, right? And also the community, right? Everyone has a seat at the table. And then, your job obviously is listen to everybody and manage all of that and juggle everything, if you will. And one of the things that I'm sure is on your plate is patient satisfaction. All of us are patients, right? You, the doctors, nurses, me, everybody. It's really important in healthcare, obviously. So, how do you measure patient satisfaction and how are you working to improve at San Juan?

Jason Rounds: Patient experience is important for a variety of reasons, not the least of which it's why we're here delivering care to our community directly. But within our statistical structure and how we get paid and how we are measured, which is a patient experience survey and measure, it really drives things like our CMS rating and how Medicare will pay us. So, it's a key foundational way that we track how we're doing on patient experience. There's a lot of detail, there's a lot of great information about it.

Part of our approach in addressing the needs of our patients and their experience is a program that we've rolled out. It's called What Matters to You. This was a new program that I was not experienced with until I came to San Juan Regional. And it was a great experience. I really did enjoy going through that learning. Our team in patient care and with the help of an army of other folks rolled out this training to all of our associates, I think over 1300 on a very short period of time. And it's been integrated into our new caregiver orientation. So, anytime that anybody new is coming onto our system, they go through this. It turns the golden rule on its ear as opposed to do unto others as you would have done to you, it's basically do unto others as they would like to have done.

Host: Right.

Jason Rounds: And to do that, you really have to understand what their needs are. So, it is really the concept of asking the right question at the point of care as, "What matters to you? How can we assist you best? How can we serve you best in your care needs?" And listening to that, their needs, their family needs, and those types of circumstances. I certainly will never look at the word sympathy the same way again after going through that training. And I think the caregivers who may be listening to this podcast probably can appreciate that. But it really is shifting away from a sympathetic approach to empathy, really getting into the shoes of the people that we're caring for.

Host: Yeah. That makes sense. And just wondering, you know, I know you have a lot on your plate, of course, but I'm wondering if you ever look at the Google Reviews. When we talk about patient satisfaction, is that something you ever look at?

Jason Rounds: Now, Scott, thanks for bringing that up. I talked about HCAPS earlier, which is a great statistical tool and it helps us make lots of good decisions. It tends to be a lot of data and late in the game, so you're trying to track it back to where was this, what opinions were about or what was going on at the time.

Google Reviews is really a wonderful site that gives us more timely feedback and direct comments from the patients who've just gone through this experience. And It really has allowed us to make adjustments faster and more focused and meaningful to improve that experience.

As an example, over the last year, San Juan Regional Medical Center, our overall rating started at 2.6 stars out of five, which isn't great. And we only had a 46 percent positive rating on the site. So over the course of the year, we have been able to increase that to 4.4 stars and an 85% positive rating. And comparably, our San Juan Regional Health Partners, they started at a 2.9 star rating and a 40% positive rate and has raised that to 4.7 stars and a 97% positive rating.

So, how do we use this data? I mean, It really is not dissimilar to what you may experience if you're shopping on Amazon and you're looking at a product, you can scroll down and get real time comments about that program the level of service and the like. So we've had some really good comments. So as an example, one of our patients was talking about her hospital stay. And so, she said, "My experience while I was at the hospital was great. The nurses were so good to me. Care was gentle, thorough and made my time the best it could be." And then, she was able to go through that and really acknowledge some of the caregivers by name that made that experience so valuable. And so, that gives us, as healthcare providers, a lot of great information, people to recognize ways to emulate that type of experience for other patients. So, we get a lot of really good information from that. So, it's not just one or the other. We're trying to use a range of these types of surveys to really try to better meet the experience needs and the customer needs of our patients.

Host: I know as you're saying, you want that timely feedback, you want that sort of transparent feedback that you get from a Google Review, which might be different than some other kind of survey. So, really great to learn that you're listening on all fronts. And just speaking about that, about those different constituencies that you're listening to, how are you engaging with the community outside the hospital, whether that's community involvement, sponsorships, whatever it might be?

Jason Rounds: As a community not-for-profit, our organizational structure is a little bit different and unique from where I came from. There's a corporation comprised of not-for-profits from San Juan County. And it is that corporation that appoints my board of directors to whom we are ultimately accountable to. So, we are organized structurally, really based in our DNA to support the community and have those types of partnerships in a meaningful way. But we also work directly with lots of our area not-for-profits. Most recently, for example, we were happy to help sponsor the San Juan Medical Foundation Walkathon supporting the Connelly House and Cancer Care in general for our community.

It was a great experience. They raised a lot of money for a great cause. We were able to support the Road Apple Rally, Boys and Girls Club. And a program that was new to me since I moved here called You Matter. And so, we were able to help 21 of our outstanding high school seniors that go through this program that helps them with good healthcare decision-making, good choices, how to honor your family and friends and all that. So, we're really thrilled to be involved at a granular grassroots level with a lot of these really great not-for-profit programs in our community.

Host: Yeah, I want to talk more about, Jason, I know you've been listening, we've been talking about that a common thread here today is just listening to the community and your caregivers and everybody at the table there. Let's talk about recognition and why that's so important and meaningful to employees and caregivers. What are some of the stories that you're celebrating?

Jason Rounds: Yeah. We have so many wonderful stories to tell here at San Juan Regional. But most recently, we were able to recognize the 500th air transport in our fixed wing aircraft of our second aircraft. And our caregivers who were staffing at that day had a terrifically busy day taking care of our patients. But it was such a wonderful testament to this service and something that we are so grateful that we are able to provide for this community.

Also, those of you who may not know, we have a wonderful daycare center here for our caregivers. So, I had an opportunity to go over there for the ribbon cutting of the new playground and saw it for the first time and I was just absolutely blown away. I had no idea of the facility or the services that we were providing in the support of child care for our associates there.

So wonderful opportunity, great recognition. Our lead caregiver over there wrote a grant and got that daycare playground supported and funded fully. So, a wonderful addition to our San Juan Regional Medical Center community. We also were recently at the New Mexico Hospital Association and they introduced a few new categories that were recognizing quality of care within the state. And we were honored to be able to nominate one of our partners in the community for recognition. And so, we nominated San Juan College recognizing a 50-year relationship that we've had with them across the spectrum, but specifically focused on the wonderful ventures that we have in nursing and how we support each other. And so, they were one of five partnerships that were recognized at the state level during our association meeting. And so, thanks to Dr. Brandon Watley and Dr. Boomer Appleman who made the trek up there to be recognized and receive that award.

Also for the first time, we were able to nominate one single caregiver from our San Juan Regional Medical Center family to be recognized as a distinguished caregiver at the state. And so, that was no small task to really narrow that down to one person. Because we have so many outstanding people doing outstanding work here. But as we reflected on the various nominations that we had locally, there was one caregiver that kind of rose to recognition and that was Rebecca French. And so, we were able to nominate her for distinguished service in healthcare for all of the work that she did during COVID to improve access and the care that our patients could receive, not only here, but back at their home. And so, she was one of eight that was recognized across the state for that honor. So, thrilled that she and her husband were able to attend the luncheon and receive that award and that recognition in person.

And also recently, Dr. Sugar Singleton was recognized by the University of New Mexico School of Medicine as a distinguished alumni for 2023. It's a terrific recognition, really recognizing all of the outstanding work that she does, not only as a clinician, but in her support of the community and healthcare in New Mexico and certainly specifically here in Farmington. So, we were happy to be able to help her. So many other examples, but I could be here all day.

Host: Yeah. Yeah. I was just thinking like with that many employees and caregivers and that many amazing folks there providing care we could probably be on all day, but just scratching the surface there and great to hear some of these great stories. And I know within any organization, sharing recognition can be tricky because there are just so many great stories to share. So, maybe you can take us behind the scenes a little bit. How do you do that? How do you share the recognition?

Jason Rounds: we've talked a lot about listening during this podcast and I've become a broken record about it, but that's really been my focus in the five months that I've been here is not having the answers necessarily, but listening to people and figuring out better ways to communicate across the board.

So this town hall, this session was an effort to address what we're hearing from our caregivers on how they want to be communicated with and what they want to be communicated about. But it's one of many avenues that we're taking. So not only the town hall, not only the podcast, but we also have a number of publications that are going out. We have a wonderful intranet site. That's available that on a quarterly basis, we do a pretty good update. In talking with our caregivers after the town hall meetings, I really did recognize that we have not been doing good job, really kind of sharing some of basic financial information.

It's not secret. We put that together, we share it at the board level, but we're going to be structuring something that we can share that we hope would be a meaningful level for our caregivers. So, stay tuned for that. But that'll be available on our quarterly updates. But also on our intranet site, we do weekly recognitions of caregivers and announcements and wonderful things that we're doing. We address the actions that we're taking according to the feedback that we're getting from our caregivers and any number of other avenues. We know that one size doesn't fit all, that you can't get all of the information that you need directly from your department leads or your supervisors. So, we're trying a shotgun approach to really make sure that we have lots of different avenues and lots of different ways that caregivers can get information.

Host: Yeah. It's really amazing. I just taken all this in today and it's been great to speak with you, get to know you. A 64,000-dollar question, Jason, what's the outlook for 2024?

Jason Rounds: Scott, we're absolutely optimistic about 2024. We have lots of foundational work to do, which we're focused on. Our operational focus is really taking center stage right now, but I am anticipating improved financial performance. We're focused on improving our quality and patient safety results. Those scores are not where we want to be, and we have a lot of initiatives underway to make sure that we're focused in the appropriate areas on that. We're going to make sure that we're focused on continuing improving our patient experience. A lot of the What Matters to you and the other training that we've gone through is really just the beginning of making sure that we wow our patients when they're here. We're not just healing them, but we're providing great customer experience. We're investing in facility improvements as well as some infrastructure improvements. We are expecting our caregivers to see and experience that firsthand in FY '24. I'm focused on caregiver engagement. That was a message that was loud and clear that I got from the board and coming in here and certainly message that I got loud and clear in some of the conversations that I had after the town hall meeting. So, I really did enjoy getting a chance to talk with our caregivers about that about the history of this place, how wonderful and committed they are to it, and some really good ideas on how we might be able to better retain, better acknowledge our caregivers going forward.

And ultimately growth, we are well positioned. The envy of some of our competitors in New Mexico, we are prepared to grow. So, it's not looking at, "Oh, gosh, which service line are we going to be looking at to change or reduce?" It's basically how are we going to be expanding into our community and really better address our community needs.

And, Scott, really in closing, it's been a really interesting time in healthcare, and not just in healthcare for all of us. So, I have really been surprised at looking at the statistical data on the number of people that are struggling in many ways, but specifically with depression. And we know that, especially in healthcare, we have been struggling with that.

So, I want everyone to remember that we really do have a wonderful employee assistant program here. It is completely confidential. The first eight sessions are completely free to you, and there's resources available even after that. And we've got great partners in Jasper and Associates. It is completely confidential. If you are struggling, if members of your family are struggling, please know that you do not have to struggle alone. And you can give our friends at Jasper and Associates a call directly, 505-326-0241. So, it's a great program. And if you need it, I encourage you to take advantage of it.

Host: I've just been nodding my head along with you today. Like all of this sounds awesome and there's just so much reason, Jason, for optimism in 2024. I think the best thing I could do for you and the caregivers and the community is let you get back to work. So, thank, you so much for your time today and you stay well.

Jason Rounds: Thank you, Scott. I appreciate 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.