Aspen Valley Hospital CFO Terry Collins retires
August 2, 2017
Terry Collins feels confident he is leaving Aspen Valley Hospital in strong financial shape.
Collins, the hospital's chief financial officer since December 2004, retired from his post Tuesday, turning over the fiscal reins to associate CFO Ginette Sebenaler.
"The board asked me to find someone who can take my place," Collins said Monday, "and fortunately we have Ginette in house. She's very bright and very talented."
Collins, 69, leaves the 25-bed critical access facility at a time when two of the first three phases of its redevelopment are complete. The third one, which includes a rooftop helipad and a separate entrance for ambulance patients, among other improvements, will be finished by the end of the year.
The first three phases carried a price tag of $150 million — $62 million came from hospital reserves, $50 million from general obligation bonds, and another $38 million through private donations — and happened under the financial management of Collins.
Starting the fourth phase of construction, estimated to cost another $11 million, remains contingent on raising additional funds, he said. That phase would include a chapel, additional medical office space and an expanded registration/admissions area.
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Collins' departure also comes when the dynamics of health care are constantly shifting.
While the hospital's outpatients once comprised 65 percent of all admissions, that number now is 80 percent, with the remaining 20 percent being overnight patients, he said.
"In general, the insurance companies, Medicare and Medicaid are encouraging health care providers to do things on an outpatient basis," he said, adding that medical advances have resulted in shorter procedures that reduce patients' time in the hospital.
As one in his position is wont to do, Collins has closely followed the political drama that has enveloped the Affordable Care Act, which continues to live to see another day.
"The Affordable Care Act, it has some weaknesses, but one thing it did do is to expand coverage particularly to Medicaid patients," he said. "And if they replace that, what's going to happen to all of these Medicaid people who are now covered? That's 26 million people who will not be covered if they repeal the act."
And when low-income patients lose their coverage, gone are their visits to doctors' offices, which are replaced with admissions to hospital emergency rooms, which are required to accept uninsured patients, he said.
Collins came to Aspen Valley Hospital when the nonprofit institution had just four days of cash on hand. Today the hospital's cash on hand stands at 190 days; it had been as high as 420 days before its facilities were remodeled and expanded, he said.
Compounding the situation was a dysfunctional billing system that frustrated and upset many patients because they would receive their hospital bills months after they had been treated. Some of those bills went to collections. One Aspen attorney even sued AVH in small claims court over its billing practices.
"The essential problem is that they were not getting the bills out timely," Collins said. "The first thing we did was hire a computer company to redo our billing, and it was done within a fairly short period of time."
Collins noted that the hospital's number of days in accounts receivable dropped from 170 when he arrived to the high 30s. The industry standard is approximately 50 days, he said.
"We cleaned all of that up," he said, noting the hospital's increased its Moody's revenue bond rating to Baa2 during his time.
Moody's Investor Service noted in a March statement, which reaffirmed the bond rating, that the rating "reflects the near completion of the first three (of four) phases of an extensive capital renovation and expansion project, continued strong performance, favorable payor mix including Medicare designation as a critical access hospital and demonstrated fundraising capabilities." Moody's also noted the hospital's fiscal challenges "include the hospital's small size and vulnerability to physician turnover, location in a ski resort area and associated seasonality and concentration in orthopedics."
Collins also served as the hospital's interim CEO for eight months until David Ressler was rehired and returned in early 2017. He wasn't interesting in pursuing the CEO position on a permanent basis, Collins said.
"It's a very different job, the CEO job," he said. "It's very people-oriented, where my job is heavy in the technical element, and I like that aspect."
Collins, who lives in Glenwood Springs, said he plans to move to Salt Lake City with his wife, Betty, in the coming months. He will continue to teach a graduate business course at the University of Utah. And he will continue to stay active, as if eight children and 20 grandchildren aren't already enough to keep him on his feet.
A former collegiate swimmer, Collins took up competing in sprint triathlons (quarter-mile swim, 20K road bike and 5K run) when he was 65. He said he found success in his age group and has enjoyed the diversity of physical training that triathlons demand. He also enjoys surfing in southern California.
In a prepared statement, hospital CEO David Ressler said, "Terry is a mentor, colleague and friend, and he will be greatly missed. Terry has contributed greatly to the success of AVH over the last 13 years, leading the hospital to the strong financial position it is in today. His excellent contributions are many, including leading a talented financial team who will carry us forward."