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Advocate for the Little Guy

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As the new chair for the AHA’s Section for Small or Rural Hospitals, Kathleen Hoeft aims to give rural hospitals a national voice.

Kathleen Hoeft is no stranger to advocating for a community’s health needs at the state and federal level. Hoeft is administrator and CEO of 22-bed Ashley (ND) Medical Center, where she has been since 1998, and has served on the American Hospital Association’s Small and Rural Hospitals Governing Council since 2003, during which she was a member of the AHA’s Small/Rural IT Educational Advisory Group.

Now Hoeft has been tapped to lead the AHA’s Section for Small or Rural Hospitals in 2008. The 22-member governing council represents small or rural hospitals in the AHA’s policy process and member service initiatives. Hoeft also is a member of the American College of Healthcare Executives, the North Dakota Long Term Care Association, the North Dakota Healthcare Association, and the American Healthcare Association.

HealthLeaders recently caught up with Hoeft to discuss her priorities in her new position at AHA, the challenges facing smaller hospitals today, and how rural hospitals can find their voice on a national level.

HealthLeaders: What are your goals for the AHA’s Section for Small or Rural Hospitals?

Hoeft: The governing council serves as an advisory committee to the AHA; we are a sounding board for policy priorities and strategic planning. The emphasis is on representation, advocacy, and federal health policy and how it affects hospitals and our ability to care for our community’s health needs. So our goal is to communicate the perspective of the rural hospital constituency so that it is included in the overall AHA strategy.   

HL: What do you think is the biggest issue facing small and rural hospitals?

Hoeft: The biggest challenge this year is the same challenge we face every year--to do more with less by providing more services for patients with less reimbursement. We will continue to advocate on behalf of our hospitals for equitable reimbursement, a reasonable regulatory framework, and recognition of the important role rural hospitals play in delivering quality care to some of America’s most vulnerable residents.

HL: How do you think your experience in small and rural hospitals will help you in your new role with AHA? 

Hoeft: My experience has been invaluable. For a number of years, I worked as an RN in a small rural hospital, where I worked in all the departments--from OB to ER to any other place where help was needed. As a nursing home administrator of a 201-bed facility, I dealt with financial, union, and reimbursement issues. Next, I did consulting in administration and nursing in California. Now, as CEO of a critical-access hospital, I have worked with state and federal agencies in developing support for rural facilities. My experience and that of my colleagues on the governing council is directly related to the issues and policies discussed by the AHA and will be an important part of the association’s policy and strategy.

HL: How important is it for small hospitals to have a voice on the national level?

Hoeft: It is vitally important. Out of the 5,747 U.S. registered hospitals, there are 2,001 rural community hospitals, and 1,292 of the rural community hospitals are critical-access hospitals. Rural hospitals serve a large percentage of Medicare patients in some very rural areas. Without many of the CAHs throughout America, many elderly patients and at-risk patients would receive only limited--or nonexistent--care.

HL: So how do you plan to further the voice of small and rural facilities? 

Hoeft: We will work to see that the interests of small and rural hospitals are represented. The council meets three times each year to provide input into the policy priorities of the AHA board and to offer our perspective on emerging issues for the board to consider. We have an opportunity to meet with our members of Congress to communicate the needs of rural hospitals and help them better understand the special role we have in advancing the delivery of care and improving the health of rural Americans. We can raise awareness of the unique needs of small or rural hospitals and how federal policy must address these needs so that rural Americans have access to the best quality of care our nation has to offer.
—Ben Cole