STORY AND PHOTO BY KAREN BOSSICK

St. Luke’s Wood River has replaced its administrator with a chief operating officer/chief nursing officer.

Carmen Jacobsen, who had been chief nursing officer, has replaced Cody Langbehn as the head of the hospital and its 435 employees.

Eight administrator roles in the St. Luke’s system were eliminated. Six were replaced with the new COO/CNO positions as part of a system-wide restructuring as part of St. Luke’s Strategy 2020 to cut health care costs while improving service.

“This is not about the individual,” said Mike Fenello, vice president of population for St. Luke’s. “Everyone in this organization has the utmost respect for Cody. He has the opportunity to look at other positions within the organization and we hope he will stay with the organization. But we need someone with a nursing background, someone who can bring a clinical perspective to our leadership.”

Additional positions are being cut, some positions are being consolidated and new roles are being created as the hospital moves away from the traditional pay-for-service model.

It’s about getting the right people with the right skill sets in position to take St. Luke’s to the next step, said Fenello, whose own position as administrator of St. Luke’s Magic Valley was cut.

St. Luke’s, the state’s largest private employer with 14,000 employees, embarked on its new model in 2017. Clients pay one lump sum and it’s up to the hospital to provide the full continuum of care.

For that the hospital needs leaders who have experience at nursing or clinical levels in addition to financial capabilities, said Fenello.

 Under the traditional model, administrators operated independently, setting strategy and making operating decisions for their individual hospitals. Jacobsen and her cohorts will collectively create plans, then make sure their hospitals implement those plans.

“My clinical experience helps me understand where we need to go and how best to support the patients,” said Jacobsen.

By broadening Carmen’s position, St. Luke’s has eliminated the middleman, said Fenello.

St. Luke’s built the infrastructure for its Strategy 2020 in 2017. Then the hospital system ran a pilot program that proved very successful, reducing patients’ use of the emergency room and costs dramatically.

One woman with diabetes made as many as two visits a week to the hospital, Fenello recounted. It turned out that she did not buy the insulin that would have kept her body regulated because she didn’t have the money to fill the prescription, nor did she have a refrigerator to store it.

“While I’m sure we treated her with care, we were not connecting,” Fenello said. “Under the new plan, we’re switching our focus to spend money to keep patients from coming to our hospital.”

The hospital is providing patient monitors for patients like that, Fenello said. They’re sending them home with an iPad and a blood pressure cuff and they’re connecting them to nurses who monitor their blood sugar daily, even hourly, detecting immediately when something needs to be changed.

Fenello couldn’t say how many positions are being eliminated since affected employees are just now learning of the restructuring. He could not say what new roles will be created, either, with the exception of the new director of continuum care.

New positions will be offered to existing employees before they’re advertised outside.

“We won’t know the impact until the end of January because new positions just opened,” said Joy Prudek, coordinator of public relations. “We do know, however, the impact will be minimal.”

Fenello added that this is not a traditional reorganization due to a financial crisis. Instead, it’s due to the hospital’s new approach.

“We’re telling people: We don’t need you in your old role but we could use you in this new role,” he said.

But St. Luke’s Chief Operating Officer Chris Roth told The Idaho Statesman that he expected the reorganization to cut up to a hundred jobs, saving the system millions of dollars a year.

Fenello said Jacobsen will bode well for the community.

“Community members want to know the person in leadership is someone who lives here and understands them,” he said.

Jacobsen grew up in a small town in North Dakota but went to the University of Portland for a nursing degree and a master’s degree in public health. She worked in surgery and as a bedside nurse at Providence Portland Medical Center in Portland before moving to the Sun Valley two years ago.

She lives here with her husband Nate Jacobsen, a former engineer for Nike who now freelances for various outdoor manufacturers. The couple has a 3-year-old son and 9-month-old daughter.

“We had a son and he wanted to make a change,” she said. “My husband and I both grew up in small communities--active communities. And this community has so much to offer for raising children, which was a big draw for us. “

Jacobsen said she’s excited about her role in St. Luke’s shift to value-based care.

“Lowering the cost of health care while improving care is why I got into nursing,” she said. “It’s not easy work to do—it’s complex and exciting. But it’s the right thing to do.”