The trials and tribulations of Noble Health and its failed attempt to get a hospital up and running in Audrain County has been well-documented.

Currently, the hospital is in the middle of being launched under new ownership, but the story of the failure that led to this moment is still very much alive and well in the courts. Already, two default judgments have gone against Noble Health and potentially many more to come, pushing its debts into the millions of dollars.

Amy O’Brien, CEO of the Audrain Hospital, took time to sit and reflect on the last year of the tale of Noble Health and where the facility stands now.
The early days

“When I met the owners of Noble Health, I was amazed that there were three men with such a passion for saving rural hospitals,” O’Brien said. “My husband (Joe) and I made the decision to move to Mexico so that I could accept the challenge of leading our hospital through a significant change.

“I had been a part of other hospitals when they converted electronic health records, and I had seen firsthand the financial impact that occurs even when you have seasoned leaders in revenue cycle, a robust information technology team, and a complete leadership team.”

Noble Health had set up shop soon after SSM pulled out in March 2021 and tried to pick up the pieces and soon found itself banging its head against a proverbial wall.

“Throughout the first year, Noble Health experienced turnover and transition in some of their executive positions in the corporate office,” O’Brien said. “The central business office was trying to manage the setup of the two hospital systems and the two clinic systems in the midst of these changes and cash flow was severely impacted.

“As a result, many vendors were not paid, and our self-funded health plan was not receiving the monthly funds they should have received to cover the claims of our employees.”

Noble Health applied for the US Health Resources and Services Administration’s American Rescue Funds and anticipated to receive enough that would have covered the outstanding debt while continuing to work on the revenue cycle.

“We were fortunate to receive these funds in November and December, but the amounts were about one third of what we expected,” O’Brien said. “The funds we did receive went to cover payroll, the mortgage and much needed drugs and supplies.”

Then in March, the vendors could not continue to hold on and wait for promised payments.

“Without our vendors, we could no longer provide safe care for our patients,” O’Brien said. “We requested a temporary suspension of our hospital license while we began to review options for the future.

“At the time we suspended hospital services,  we employed approximately 350 people. On April 1, we had to furlough 175 full and part-time employees and another 35-40 staff who worked regularly as needed, were no longer needed.”

What’s going on now?
Some of the employed physicians and staff in the clinics began to find other options for employment which allowed the care to remain local.

Doctors Michael Quinlan and Peggy Barjenbruch, along with Ashlee Dougherty, PA and Andrea Feger, NP, supported by clinic and hospital staff have continued to find ways to care for their patients, according to O’Brien.

“When the Walk-In clinic closed in May, Dr Scott Dudley developed a plan to move it to the Stribling Building to allow our community access to care and to employ nurses and staff from the Emergency Department, keeping them available for our future opening,” O’Brien said. “He supervises Melissa Holcomb, NP and several others part time to allow for access seven days per week.

“Dr Brian Ellefsen has continued seeing orthopedic referrals in our Stribling Clinic and has had to perform surgeries in other locations, with follow up visits back in Stribling.”

Other surgeons – doctors Joe Corrado and Mike Jones – are also traveling to perform surgeries and the hope is to provide services locally, O’Brien said.

In recent weeks, reports have come out that Noble Health failed to provide insurance for its employees despite them paying for it.

“We do not have firm answers for our employees on the health insurance claims not paid,” O’Brien said. “Platinum Health purchased the stock of Noble Health and accepted all assets and liabilities. They have been working with attorneys on the legal claims from the corporate office while the staff here have been developing a plan for reopening.

“There hasn’t been a week go by where we haven’t discussed the urgency of the issues. Last week, I did hear of some claims being paid. It has taken months, but it does appear that some employees are seeing results. Given the number of claims crossing two calendar years, I do think it will take time.”
As far as when the hospital could potentially reopen, O’Brien laid out a basic plan going forward.

“(They would) open the emergency room, 3-5 medical beds, radiology, lab and pharmacy to get the license reinstated,” O’Brien said. “Outpatient rehabilitation and physical therapy will quickly follow as well as the operating room and outpatient surgery.

“We know our community needs this hospital, and we are seeing our community finding ways to help externally by providing some resources to help with lawn and weed management. We have also had physicians, staff, family members and community members grabbing weed eaters and lawnmowers and donating time and effort.”

O’Brien admits that this will not be easy going forward, but she and those who hold the hospital’s interests will not back down to the adversity.

“We have a lot of challenges as well as opportunities facing us in the coming weeks,” O’Brien said. “I look forward to the day I can announce that we will reopen the hospital and celebrate the efforts of those who have persevered through difficult times.”