[Music] Lakeland Currents, your public affairs program for north central Minnesota.

Closed captioning is made possible by Bemidji Regional Airport, serving the region with daily flights to Minneapolis-St Paul International Airport.

More information available at bemidjiairport.org Hello again everybody.

I'm Ray Gildow, co-host of Lakeland Currents.

Today I have a very special guest, a person who is pretty new to her job and is doing a fantastic job.

Lisa Bjerga is the CEO and President of Lakewood Health System in Staples and where else, where do you have your clinics?

Yes we have clinics in Pillager, Motley, Eagle Bend, Browerville and then a dermatology clinic in Sartell as well.

Wow and how long have you been on this job now, Lisa?

I've been on this job for 2 years but I've been at Lakewood for 16.

And you did what before that?

So my background is in finance.

I was, I'm a CPA by training and so I was in public accounting, from the St Cloud area, moved up to Lakewood was hiring someone in their finance department right after they expanded to the new facility that we're in now.

They had a lot of growth that year and so I started as an accountant in 2008 and then that evolved into Finance Director which then evolved into Revenue Cycle Director and then I was Chief Financial Officer for seven years and during those seven years the last year and a half, two years we did a pretty extensive search and succession planning process under Tim Rice who was our CEO for 42 years so had the opportunity to, you know, shadow and train right with him and then at the end of 2022 moved into this role officially, so.

You're pretty unique in that a lot of people in finance aren't natural leaders, you know, but you are a natural leader, I've heard that from so many of your doctors that are so pleased with how you just stepped in and took over for Tim who did a phenomenal job for 40 some years but you didn't miss a beat and I think that's a real tribute to your leadership, and tell me what are some of your skill things that you focus on as a leader at the hospital?

So when I came into the role the three areas I wanted to really kind of have as my main themes were relationships, focus, and alignment and so I took time right at the beginning to really focus on that relationship piece and so I went and shadowed within every department across our system.

So I got up at 2 in the morning and went in with laundry and folded laundry and saw what their routine was and, you know, to better understand each of the positions and their roles.

That's impressive.

So then you can best support it.

You know I don't like to micro manage but when somebody comes to you and says it's super busy in our department I kind of have a recollection of maybe what that busy looks like, you know.

Shadowed an ER doctor for a shift to see how that all looks and you know watch the nurses of course and the techs and everything going on with that.

Rode in the ambulance, followed maintenance around just to get a flavor of we know what everybody's roles are in healthcare.

We have everything from, you know everybody thinks healthcare is doctors and nurses, but in healthcare we have IT, we have human resources, we have dietary, we have maintenance, and so just to get a better understanding of all those kind of specialties and what that looks like on a day to day and that was fun, I learned a lot.

I bet you did, I bet you did.

How is funding, pretty stable for rural hospitals now, are you in a pretty stable period?

You know obviously politics can change things here and there but we are a rural healthcare system, so we have a critical access in rural health clinics, which is basically a designation under Medicare, that is I would say relatively stable.

Our commercial contracts, those are the ones that we have some negotiation power, but overall our reimbursement is not increasing, we're still in, you know, declining reimbursement with inflationary environment and so those two things aren't very favorable put together.

And when you look at your site do you have five, four sites off campus.

And then plus we have the assisted livings, and then we have the long-term care facility.

So how many staff do you have when you put all those together?

We are almost hitting a thousand.

Wow.

We have 900 and some and then also when you add in the physicians with that we're almost at a thousand.

Wow.

So this past year we grew a lot.

We kind of hovered right around that 800 mark but with the oncology service line expanding that's added a lot of staff as well as orthopedic growth and then when we acquired Longbella Drug that really increased our FTE's as well or our employee numbers.

So you have Dr Wade Swenson who is the oncologist who came, he's also my doctor, very, very excellent doctor by the way, what is it he's doing at the hospital that's new?

So he's our oncologist, he brought a whole team with him when he came to Lakewood and bringing in the oncology program but not only is he focused on oncology he is very, very passionate about rural oncology.

He feels that your zipcode should not dictate your outcomes.

And oncology is a specialty where people in rural areas travel the furthest distance for their care and usually you're talking about very frequent trips and you know long duration and so overnight stays and so he's very passionate about how can we create a model, maybe a hub and spoke or what is that look like when we have some outreach where we can really build this care management piece of oncology alongside with our oncologists to hopefully care for the greater part of Minnesota, not just urban Minnesota.

I have some doc friends who are not part of your system who follow him just because he's such an innovator for rural issues, not only rural Minnesota but I think he's been a kind of a leader in rural issues across the country so that's really saying something.

So you're building a new oncology center, when is that expected to be functional?

In about 11 months, so September of next year.

Wow, you've had a great fall for working with no rain.

We have, we had some rain at the beginning but I think they've had some good weather to catch up and we should be enclosing it shortly so the winter weather won't impact that but yeah with that we're going to be able to double our infusion bays.

So a couple years ago we actually increased the space of our infusion area and that was right before we onboarded Dr Wade Swenson and the first time he saw it he said this is too small, we're going to outgrow it, and we did, and so we're doubling the infusion space but we're keeping our current space to do for non-chemo patients.

And so our chemo patients will be within the cancer center.

Also adding radiation oncology so we'll have radiation, a linear accelerator will be within that space, people can see it looks like we're building a vault out there right now because they have to have some pretty thick concrete, yes think we had 32 trucks the one day.

Just with concrete.

So when you look at the growth that's going to come, cuz I know there's already patients coming from the metro area to this city to the oncology center that's amazing is that word of mouth is that how that's getting out?

Yeah I believe so.

I mean we have a really good patient base with our primary care docs that have built that local patient base and then they're spreading the news to maybe their friends from the metro or their you know family that lives an hour north or an hour south and so bringing them to Lakewood for that level of care.

Most recently we've brought on Dr Emily McGovern, was Emily Westergard she recently got married, so she's the second oncologist that we've added to the team in addition to three PA's that we have and so ready to really absorb that additional volume that we're going to see.

And do you how many beds do you technically have?

We have 25 inpatient beds.

Okay.

That doesn't count you know if somebody's in observation or if somebody's in outpatient status and so 25 actual inpatients.

So when somebody has a surgery say a knee surgery and it's more of an outpatient status they can be in a bed but that's not part of that 25.

How difficult is it right now to get doctors in rural areas?

So at Lakewood we've been very, very blessed on that front.

I would say if you were to ask most facilities it's a very much a challenge but we have the rural physicians program, physicians associates program, the RPAP is what we call it, it's through the University of Minnesota and basically students in their third year of med school come out and they spend their third year at Lakewood, so that serves as somewhat of a pipeline for us.

They, you know, they get acquainted with us, we get acquainted with them, they also speak to their network.

We've had Dr Benson was actually our first RPAP student that became one of our providers and so we've had that program for several years.

Right now we have two that are within the facility in addition to that because we've been so successful on the RPAP front.

Shoot my phone's ringing sorry.

So because we've been so successful on the RPAP front we actually got contacted by the University of Minnesota this past year and they would like to do a rural residency program at Lakewood.

Is that from the main campus of the U?

Yes and so they will do or the residents will do their first year residency at North and then years two and three will be at Lakewood.

Wow.

So in the first year that we're up and running, which will be 2028, we will have two residents and then in 2029 we'll have those same two will be in their last year and then we'll have two second years.

How challenging is it, not that you expect everybody to live in Staples, but how challenging is housing when you bring in new people.

Very, that's probably one of our biggest areas and again when you look at healthcare you have every kind of set of wage.

You know you've got entry-level positions all the way through your providers and so different levels of housing are also needed and so it's hard to have this inventory that's going to be just perfect for whatever we're bringing in.

We do incentivize our providers to live within the school district because we really want to make sure we're supporting our core service area Staples-Motley.

We've been part of the solution to some extent when there's a shortage of housing we partnered with a local builder and then Central Building in Staples and we built four houses.

I mean it's only four but it's four more within the community.

Three of those have sold right now, the last one is on the market listed for sale.

So we bring in potential recruits, we can show them the options and maybe even it's a temporary option for them until they decide we want to live in the woods, we want to live on the lake, the river, wherever what part of town they want to live in.

Additionally last year we built The Plaza, so that's the multi, the commercial building just west of Ernie's in town, and that has 11 apartments up above.

Those were filled, we opened in January and they were filled in February.

Really and I know you've kept a few haven't you for visiting.

We've retained three of them for ourselves yeah.

And the hospital for a long time has had a great reputation of working in the community, talk a little bit about The Nest what you're doing there.

Yes so The Nest is basically it's a collaboration with Lakewood Health System and Staples-Motley School District.

We pooled our funds, so the school was going to do some renovation, some enhancements to their facilities, but in order to make that really impactful we pooled our funds together and what we've been able to do is the South gym that existed expand that and make it a true competition gym with bleachers, so that'll be the main gym for basketball, they're going to call it The Nest and then they'll call the old gym, if you will, the Legacy Gym and so they'll have two places to have actual competition with spectators.

And then is there a weight room involved with this, too?

Yeah so up above the The Nest gym is a walking track, it's just under a tenth of a mile so about 10 laps is a mile and as well as a fitness room and then there's a student weight room that can be used and in the fitness room there'll be, you know, some pieces of equipment bikes and ellipticals things like that as well as programming where there'll be classes that you can take.

So people can purchase memberships to The Nest.

We have the ribbon cutting on December 2nd.

I was just in there the other day, it's very exciting.

It's great to see because what that can do for the school district, the community, our patients, it's great to see.

Is The Nest connected to the Cardinal theme of the high school?

Yes one thing we've discovered is red and orange don't go together very well so we've tried to kind of sprinkle the Lakewood orange throughout a Cardinal gym.

Okay.

What are some other things that you're doing in the community for wellness?

So we're active on so many fronts, on the wellness front I mean.

Obviously, The Nest is our biggest initiative just because that's where people can get active and they have a safe place and a warm place in the winter.

You know we have a lot of efforts around food insecurity and so we do clinical screening for those that don't have access to food or have a fear of not being able to afford food and so we, actually the clinical screening drives once a month, we have food shares for them to pick up at Lakewood, during the summer we do it through our Farmers Market out in our parking lot.

I don't know if you've seen that.

I've been there many times.

Lots of vendors who come and so then those same individuals can get Market Bucks and get healthy access to food there as well as then once a month like I said in the winter they pick it up at the senior campus, that's available to our employees as well and so there's no stigma for who's picking it up.

It could be, you know, a provider's picking it up and then there's somebody who in the clinic screen that they couldn't afford or they're worried about affording their next meal.

Sure.

We also have Cardinal Packs which is a program that I think is just great, we do receive assistance from some of our local businesses to help us pack backpacks for the school and basically so the school has identified students that they feel don't have access to food on weekends and so we put some food that's available for them.

You know it's hard to get healthy options that are shelf stable but as healthy as we can get that can go, you know, toss it in their backpack and then they have something to eat over the weekend.

So you're doing a lot of things in the community, do you do things in the communities where you have your clinics?

We do yep, so, you know, obviously Staples is where we have the biggest clinic, it's where we have our home base, most of our patients come from there.

But Pillager as well we've helped their school enhance their weight room with our partnership with Twin Cities Orthopedics.

We provide their trainer program as well as at Staples we provide the athletic trainer there, as well.

Browerville we're active in you know other communities that we do have clinics as well.

I think Browerville we've pulled some of their athletes to be part of our billboards for Twin Cities Orthopedics but yeah and you know there's constant things here and there as far as can you help support this booster club or help support this initiative that we're just a lot of times we're behind the scenes but we're definitely present around all the communities.

Talk a little bit about your relationship with Twin City Orthopedics, how did they get started up in Staples?

Yeah so we were looking to expand the amount of coverage that we had for orthopedics and just because we didn't have five day a week covered and so we were looking to expand that.Twin Cities Orthopedics was looking to expand to the northern market, and so kind of by luck started a discussion around that and things moved forward.

How it works is initially we had four TCO docs that would rotate one week a month, they would come up and they would work out of our clinic.

They worked, you know, as a TCO doc but they would bill as Lakewood and part of the, you know, the Lakewood team.

We now have Dr Paul Diekmann who has become full-time at Lakewood so he's there every week living, just bought a home in Staples his wife and son have moved up here as well or will be moving up here I think they close in the next couple weeks.

Wow.

So he's here full-time and then we have three others that rotate and so then looking to secure another full-time down the road.

You know our goal is to find providers who want to work and live in the community and so that's our goal to secure another one of those as well.

What is it that's making the innovation so strong for the hospital system, is it your board, is it the community board, what's driving this, you're doing really some unique things.

I think, you know, we just keep our ear to what is needed, what service lines are not met in our community.

I think, you know, for patients to have to drive for those services if we can responsibly get that specialty or that service line at Lakewood and I mean responsibly by, you know, we don't want to bring in a neurologist that we only have one day of volume for, you know, making sure that we can bring that in and there's a true need for it and so just constantly looking for how can we grow, not necessarily grow to take over a larger footprint, but how can we deepen that to make sure we have all those service lines so people can stay close to home and then it also creates economic development for Staples, brings in, you know, more employees which is more patients, which is more business in Staples and so I think it's, you know Lakewood, their success story is really a little bit of everything, you can't just have one piece.

We have phenomenal doctors who provide that personalized care that really get to know their community, again they're part of that community.

You've got employees who are absolutely engaged and care about their patients like their family because quite often they can be family and then administration and a board that supports, you know, maybe some out of the box ideas and we'll try it and move forward with it.

I've been around a long time, when I started at the hospital there were two providers and, you know who they are, and how many do you have now?

We have over 30 MD's and about as many EPP's as well.

Wow so you got 60 professional level people there, that's amazing, really is amazing, and I talk to a number of those folks and they're so pleased with the organization.

For one thing you're not a big corporation, which is something that a lot of doctors are trying to get away from I think, but it's just a real success story, it's really exciting to hear, and when you look at down the road what are you looking at, are you doing doing things in telemedicine?

We are.

You know I think with Covid there was a blip of that, I think it's a good enhancement to a service line, but it definitely doesn't take the place of that provider.

Some specialties we will use that more just because again it's hard to get that specialist out to Lakewood, you know, we use it I think as a backup, it's not our primary route, just because I think for Lakewood being so personalized in our approach giving that whole comprehensive suite of care, if you will, it isn't the best approach but it absolutely is a good option.

And I noticed you have people circulating around in the hospital, you don't have the sometimes the reception is different every day and that's one of the things I hear that they like that they're not locked into just one thing all the time it's kind of unique.

Yep they can kind of job share or rotate into different positions for the day.

Yeah we have check out and check in.

I heard through the grapevine even on some Saturdays you bring in donuts or bakery goods.

We do sometimes.

Is that part of your healthy food?

Yes, I will make bran muffins, that's healthier.

The one thing, you know, people like food so if people gather around food bring that in and thank everyone.

And let's just talk a little bit about your robot, you have a robot, what does that robot do?

His name is Timmy, we had a little naming contest and it was right when Tim Rice was retiring and so he, actually we moved our lab, it used to be located on our main floor, and so our lab was busting at the seams with all of our growth and so we had to move it to a new location and with that it became a little further away from where draws would happen so the ER, up in the clinic, and so instead of having a runner, a person go back and forth, and this was 2020ish when staffing was really tight, we got a robot and he goes in the elevator and goes up to ER and picks up, they put the samples in and then he goes back and you know prevents us from having a person to run back and forth, he doesn't talk back much he's good but he does have issues once and while.

I've seen him a few times on the elevator.

He has blocked the elevator from time to time but no it's great.

We're really blessed, from Aitkin to Perham with some really good hospitals, do you folks work together?

We do, we actually have a CEO call every Monday.

I would say between our group of independent systems probably half of us are on each Monday sometimes it's just to say how you doing today sometimes there's an actual you know agenda or topic to discuss but we know that the key to independence is collaboration, you know, how can we work together.

It's maybe sharing a specialist, even support services.

When you look at a coding service line is there a specialty that maybe we don't have enough for one coder to do but two of us do, so some shared services or looking at how are you handling this there's definitely collaboration amongst the area.

And you have a board, how do you select members for the board and how big is your board?

So we have two boards, we are a, Lakewood Health System is a 501c3 nonprofit so we have an appointed board that four of the roles are filled with physicians that come from the physicians group and the rest are appointed kind of a typical board where you try to get someone in finance, maybe somebody in retail.

The history of Lakewood is that originally it was a district hospital and so there are 12 townships that came or sorry 10 townships, two cities, that came together and said healthcare is important, we want to make sure we have a hospital, so the United Hospital District was formed, they basically own the real estate and each township elects a member for that board.

Lakewood Health System then leases the real estate and operates Lakewood as a business.

That all happened, Lakewood Health System was developed, when we basically acquired the physicians group, the Lakewood Clinic in town.

I know expansion and innovation cost money, do you have some long range plans of things you'd like to see coming down the pike?

Yeah, you know, obviously the cancer center right now is our biggest capital that we have in front of us.

I think looking at, again you asked, you know, how many beds can we have.

That will always be 25 as a critical access facility that's the most we can have but how do we expand those outpatient beds because with oncology becomes more inpatients We see people are getting sicker, you know, in the hospital and so how can we expand our capacity to make sure we're meeting those day-to-day outpatient needs.

So I would say something around the outpatient front.

I couldn't do this interview without sharing that we deliver over 500 babies a year at Lakewood, which is, you know, in a town of 3,200 we're delivering 500 babies.

Is that the population now?

I think that's what the sign says.

Yeah it's over 3,000.

Yeah.

That's incredible.

And I've noticed in the papers they come from all over.

They do.

Absolutely, yeah.

And people always ask, you know, what started that or, how did Lakewood build that when you hear so many other facilities are closing their OB.

And again I don't think it's one single thing.

We were, you know, it really started to build when we built the new facility and we brought on Dr Uhlman but really our family medicine doctors deliver babies as well and so they're a piece of that number, the 500 number, they're a very key piece of that, so I think it's the whole program.

You've got nurses, again, who care for their patients just like their family and that's where I delivered both my boys.

I have friends in Nisswa who came down to have their babies delivered here, like the hospital so much they brought all their business down.

That's what happens.

Yeah, and if you walk in the parking lot it's just amazing to look at where the license plates are coming from, I mean they're coming from all over, it's just it is absolutely amazing.

Well we're about out of time.

You're doing a great job.

How do people find out what you do and do you have a website, obviously.

Could you just tell us a little bit about your website?

So lakewoodhealthsystem.com.

You know we kind of run basically our updates across the top but we have all of our service lines and our providers out there.

I would say if you're looking for more real time updates on what's happening at Lakewood probably on social media, Facebook it would be where we do the more real time updates and kind of what's happening at Lakewood.

Try to do some employee shoutouts or you know even from a recruitment perspective if somebody's looking to work at Lakewood not just be a patient at Lakewood how do we highlight and showcase really the fun things that happen at Lakewood?

We have an amazing culture and we want to make sure we capture that.

It is, it really is.

Well you do a great job.

Thank you.

We're out of time.

Thanks for jumping on with us again and good luck the rest of the year.

Well, thank you.

You've been watching Lakeland Currents.

I'm Ray Gildow.

So long, until next time.