Rehoboth McKinley Christian Hospital overcomes debt to revitalize care

By Nicholas House
Navajo Times

GALLUP, N.M. – In just over a year, Rehoboth McKinley Christian Health Care Services has nearly erased $34 million in debt and is now preparing to reinvest in its aging infrastructure, workforce, and patient services, according to CEO Wayne Gillis.

The transformation at RMCHCS, located in McKinley County, one of the most predominantly Navajo counties in the country, marks a turning point for a hospital that has long struggled with financial instability, provider shortages, and a reputation in need of rebuilding. Now, with its debt almost fully paid off, RMCHCS is turning its attention to improving access to care, expanding telehealth services, and strengthening its commitment to serving Navajo patients and employees.

A $34 million turnaround in 14 months

Gillis emphasized that poor leadership decisions in previous years had left RMCHCS with a crippling debt load, creating uncertainty for staff and patients alike. However, in just 14 months, the hospital has cut its debt from $34 million down to $3 million.

“The exciting thing for us is we’re down to $3 million right this minute,” Gillis said. “That’s a $31 million decrease in 13 months, and we’re fixing to wipe out the last $3 million in the next four to five weeks. So, we will have no debt at all, which is going to be huge for us.”

For a health care facility serving a high number of Navajo patients, financial stability means more than just balancing the books. Gillis explained that without the burden of debt, RMCHCS will be able to operate in a financially sustainable way, ensuring critical services remain available.

“This February, the month we are just in the process of closing the books on, will be our first month that we are not in the red,” Gillis said. “We will be in the black, and as that continues, we’ve got a lot of initiatives in place to reinvest in the organization.”

Investing in outdated equipment, facility upgrades

One of the hospital’s most pressing issues has been outdated medical equipment, some of which are over two decades old. With financial solvency within reach, RMCHCS plans to reinvest in equipment, facilities, and staff.

“We need to update that stuff,” Gillis said. “We also need to reinvest in our teams and the facility, and now we’re going to be in a position where we actually can do that, which is super exciting.”

These upgrades are particularly significant for Navajo patients who rely on RMCHCS for local medical care. Many Diné residents travel long distances to receive health care and having modern equipment available at RMCHCS could reduce the need for referrals outside the community.

Improving reputation, access to quality care

Beyond finances, RMCHCS is focused on rebuilding its reputation. Gillis acknowledged the hospital has suffered from negative public perception, but he believes RMCHCS can become a respected regional provider.

“There’s no reason why Rehoboth can’t, rather than having the negative connotation from a reputation or access standpoint, be a shining light in New Mexico,” he said. “We could be a referral center; a place people are excited and want and desire to come to.”

Achieving that goal requires improving the hospital’s performance through key performance indicators, a system that Gillis has implemented from previous leadership experiences.

“When you think about organizations and how they measure themselves, they typically have key performance indicators,” Gillis explained. “We need to establish a baseline so that we actually know where we’re at in space and time on a particular topic, then compare that to best-in-class standards around the country.”

He emphasized that RMCHCS is developing mitigation strategies and action plans to continuously improve performance. “That has been exciting for our team,” he said. “It’s new for the organization. That is not something they have done in the past, but we are in a great position now to move forward.”

Expanding health care access through telemedicine

One of the biggest challenges facing RMCHCS, and rural hospitals nationwide, is the shortage of medical specialists.

“Most critical access hospitals—we can’t be all things to all people,” Gillis said. “And part of that limitation, honestly, is providers. There are huge, massive gaps.”

He pointed out that radiology, for example, faces a severe national shortage. “There are about 15,000 open radiologist positions across the United States, and we only put out less than 1,500 new providers a year in that specialty,” he said.

To overcome these limitations, RMCHCS is embracing telemedicine, which will allow patients to consult with specialists remotely rather than traveling to Albuquerque and beyond.

“How do we work smarter at this? Technology is an advantage for us,” Gillis said. “We’re going to have to figure out how to embrace that and leverage it.”

With recent advancements in video and diagnostic technology, virtual physicians can now conduct detailed patient assessments from a distance. “They can hear your heart sounds over Zoom,” Gillis said. “The technology is really advanced significantly, and we’re going to leverage that in a much bigger way.”

Introducing swing bed rehabilitation

Another major development at RMCHCS is the introduction of a swing bed program, which will allow the hospital to provide inpatient rehabilitation care.

“This is a problem in our area. We don’t have enough skilled nursing facilities for people who need rehab or long-term IV antibiotics,” Gillis said. “People are having to leave the area, which is a big strain on families.”

For Navajo families, keeping their loved ones close to home during medical recovery is crucial. Many Diné patients prefer to receive care in familiar surroundings where they can maintain cultural and familial connections.

“This is going to allow us to provide that service, which we couldn’t do before,” Gillis said.

Developing high-quality surgical programs

RMCHCS is also working to improve patient outcomes through structured programs for surgeries, starting with orthopedics.

“When multiple patients go through the same procedure, but their entire recovery process isn’t managed properly, it impacts outcomes,” Gillis said.

The hospital plans to implement pre-surgery educational programs for patients and families, as well as ongoing support after discharge.

“When you’re mentally prepared and understand what you have to go through, statistically, people do significantly better,” he said. “We’re starting with orthopedics, but we will roll this out to urology and certain general surgery procedures as well.”

Commitment to serving Navajo patients, employees

RMCHCS has a strong Navajo workforce, with over half of its employees being Diné.

“We have 53% of our employees who are Native American,” Gillis said. “They are our largest population that we’re serving.”

He acknowledged that cultural competency is essential in providing quality care.

“It’s been a learning experience for me, to be honest with you,” Gillis said. “I have learned a ton, and it’s been exciting from that standpoint.”

Ensuring Navajo patients feel safe, respected, and comfortable in a medical setting is critical to improving health outcomes. “The less stress, the more comfort, the more trust. All those things impact your recovery,” he said. “We can be great clinically, but we also have to make sure the people we serve feel that they are in a place that is safe and secure and that will meet their spiritual as well as physical needs.”

He said RMCHCS is continuously learning how to improve cultural awareness in patient care. “Sometimes we knock it out of the park, and sometimes we miss that opportunity,” Gillis said. “What we are trying to do when that happens is be a learning organization. That way, we won’t make that same mistake again.”

Driving hospital’s mission

Rhonda Ray, the director of marketing/development and public affairs for the Western Health Foundation at RMCHCS, has been instrumental in driving the hospital’s mission to serve God by making a difference in the health and quality of life for all people in the community. With the new leadership under Wayne Gillis and the board, Ray has seen significant improvements in patient care and staff satisfaction.

Ray, who is Diné from Lupton, Arizona, and resides in Gallup has been with the organization for six years, emphasized the importance of the hospital’s mission, vision, and values. “Our mission is to serve God by making a profound and lasting difference in the health and quality of life for all people in the community,” Ray said. “Our vision is to deliver excellent health care with our values of safety, community compassion, integrity, and stewardship.”

Notably, she said the hospital has made strides in various areas, including the emergency department, which now boasts shorter wait times because of full staffing. The human resources department has focused on recruitment, and the community is more involved in the health and quality of life of the population. Ray highlighted the importance of communication and transparency in achieving these goals. “Communication is the key to success, not just verbal but listening skills,” Ray said.

RMCHCS has also been working closely with neighboring hospitals, such as IHS, to assist with emergencies. She said RMCHCS was able to help assist the IHS and bring their patients over here when they had a water leak. The collaboration between the two hospitals has strengthened relationships and improved the quality of health care delivered to patients.

With the implementation of new tools and data information systems, RMCHCS has seen improvements in infection control and patient satisfaction scores. Ray expressed optimism about the future, saying, “There’s a lot of good that’s happening now, and we’re all in this together.”

Ray also mentioned the hospital’s efforts in community involvement and equity. “The community is now more involved in the health and quality and equity of the population that we have here,” Ray said. She also highlighted the importance of aligning all stakeholders, including the board, and the regular updates provided to employees through town halls and newsletters.

The hospital has also launched a new website and developed various dashboards to track key performance indicators. “We have KPI that we work with and different tools and data information that we’ve gotten,” Ray explained. The hospital’s Cerner system is now fully operational, and the financial operations are running smoothly with the help of David McGrail, RMCHCS’s chief financial officer.

Ray emphasized the importance of accountability and transparency in the hospital’s operations. “Everybody is accountable for it right we have to be we’re all about all into this together,” she said. The hospital’s swing bed program, the only one in the area, has also been a significant achievement, providing much-needed support to the Navajo Nation and IHS.

Importance of transparency

Skyler Stevens, the vice chair of the board for RMCHCS, emphasized the importance of transparency in the hospital’s ongoing efforts to improve. She acknowledged the hospital’s past issues but highlighted the board’s commitment to addressing them and moving forward. She added that all the board members are new, as the longest-sitting member has been there for about two years.

“We know that the hospital has a black eye. We know that there have been many issues in the past, and the community is aware of those,” Stevens said. “We’re not trying to shy away from our past. We acknowledge it. We’re looking at those issues as a way to make ourselves better.”

Stevens praised Bill Patton, the interim CEO, and current CEO Wayne Gillis for their focus on transparency and their dedication to improving the hospital’s services. “Our small community needs this hospital, especially for those who don’t qualify for IHS,” she explained. “We’re hoping to expand specialty services, such as orthopedic and cardiology care, which would be a huge benefit for our community. So many people have to be flown out to Albuquerque for these services. We want them to be able to stay here where their families are.”

Stevens expressed concern over the potential impact of Medicaid cuts on the hospital’s funding. “Money keeps the doors open, and it’s Medicaid that helps supply a lot of that money. Our community relies on that,” Stevens said, underscoring the fear that cuts to Medicaid or Medicare could threaten the hospital’s ability to stay open.

Despite these concerns, Stevens reflected on the progress made over the past year and a half. “It’s been one of the most rewarding experiences of my life,” she said. “Turning RMCH around and seeing the positive trends in care and expansion has been incredible.
“But it’s also terrifying watching the political climate and potential issues that could cause the closure of the hospital,” she added.

Looking forward

With RMCHCS on track to be debt-free, Gillis believes the hospital has the potential to become a trusted health care provider not just for Gallup, but for the entire region.

“We need to always keep in the forefront that the patient’s best interest has to be our first priority,” he said. “That’s what we are here for.”

As RMCHCS moves into its next phase, Gillis sees it as an opportunity to redefine how health care is delivered in McKinley County and the Navajo Nation.

“We exist for patients and patient care,” he said. “And we need to make sure everything we do reflects that.”

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