Good afternoon, everybody. I got Steven Hartz and Charles hall here with the H and H Impact. This is episode six, and we are here recording a live podcast at the NRHA Policy Institute conference in Washington, D.

C. the second week of February. How are you, Charles? It’s great to be here, Steve.

Excited to be a part of this. I’m going to call it a bit of a movement, you know, where the rural hospitals have come together over the years and really we’re stronger together. And it’s policy working with delegations to Capitol Hill with each state.

And we’re around many leaders and policymakers right now, really trying to advocate for the needs of rural health. Absolutely. And you know, for those who aren’t familiar with the nrha, that’s the National Rural Health Association.

You know, they’re a nonprofit membership organization with more than 21,000 members nationwide. So it’s much more than critical access hospitals. It’s much more just rural.

It’s. It’s the entire country from coast to coast. And their goal is really to help fight issues that affect rural health.

We saw today, I guess this morning around 8 o’, clock, they started having busloads of people from states heading out to go see their congressmen and senators over at the Rayburn Building. And I think their goal is to talk about their needs for individual states to help solve some of their problems. Because every state’s slightly different.

Not everybody has the same challenges. There certainly are similar challenges across many states. But I think that’s a big thing to look at when we think of the NRHA and this policy institute is how do we affect it on the front lines when we’re back at home working in rural hospitals? But also how do we affect the legal side of it when we’re here in Washington, D.

C. and we can talk to our congressmen, our senators, who can lobby on our behalf for rural health care? Yeah, you know, I think from a more global point of view, National Rural Hospital association really is an advocate arm to assure that the rural environment’s healthcare is sustained. And here specifically, you know, advocating for a movement, appropriations bills, specific money that can go to the state and definitely the local areas for a thousand reasons.

One, to provide rural healthcare is difficult. The resources are sparse, the remote areas, it’s hard to recruit. Volumes aren’t quite there.

The complexity of specialty services many times are a commute to higher levels of care hours away. And this organization really promotes funding and talents and policies and processes to be really empowered at the most local level so healthcare can be sustained in the most rural environments. You know, one of the graphics they shared with us when we checked in yesterday, they gave us some phenomenal documentation and paperwork about rural health care.

And, you know, when you look at the graphics, a couple of things really stood out to me. Nearly 70% of rural counties are health, professional health professional shortage areas, meaning they’re, they’re lacking the resources for people to provide great quality care. And even beyond that, the one that really, really kind of stuck out to me is lack of obstetricians.

About 57% of the nation doesn’t have an ability to see an obstetrician. And that’s a huge number. Yeah.

So let’s talk a little bit about the struggles of rural health over the years. Declining volumes. We’re seeing population centers growing and the rural markets actually declining.

And so when you talk about a hospital, a clinic, you’re seeing those volumes go down. Those volumes with the unstable pair mix doesn’t allow an organization to sustain itself, of course, population health and our aging population assuring chronic conditions are met and chronic conditions are met many times through specialty or a proactive approach to preventing chronic conditions itself. And so the rural market is getting and has been destabilized for a period of time.

I would tell you that the National Rural Hospital Association’s primary purpose is to strengthen the care itself so it can be sustainable over time. Well, I would absolutely agree with you. And you know, people look at the rural health and rural communities in general and don’t realize that it’s such a large percentage of the United States graphically or geographically.

But when you look at the percentage of people, it’s a relatively small amount. But, you know, the ability to be able to go to your doctor needs to be the same whether you’re in New York City or whether you’re in, you know, Hope Hobbs, New Mexico, for example. You know, you need to be able to have that primary care.

And you know, having. You and I have been out in a lot of rural locations of Montana, Colorado, Kansas, Oklahoma. And what’s interesting and almost shocking if you’ve never seen it, is you go in and see a primary care manager, you need a higher level of care, and it could be a four, four and a half hour drive to the next level of care.

I think of our hospitals that we worked with out in Poplar, Montana, where you would have to drive four and a half to five hours to get to Billings if the weather’s good, if the roads are clear, if you’re stable enough to go there, and that’s a very big challenge for a lot of rural communities. And yeah, that’s a. You bring up a really good point.

You know, Poplar, Montana, a great group of folks over there, great providers. And the way that Steve and I over time have thought about it is, you know, how far from a Walmart and they’re. There are many hours from a Walmart.

And so when we think about I need advanced care, the challenge in environments like that is that relationship with the higher level of care. If that’s not solid, of course the population is wanting a one stop shop and so they go to in this case billings for their specialty. Oh by the way, by their primary care and maybe even some of their ancillary and advanced care needs, which means that care is not local.

And it’s more important than ever that our rural communities partner up with in the right way, higher levels of care. That local care is primary care specialties. If they have offering to keep that care local with the established care to make sure it’s sustainable over time.

Well, you know, I was just looking at the Census Bureau’s data from 2020 and it says one in five Americans live in that rural environment. You know, rural would be considered probably about 75% of the US and it’s 1 in 5 that live in those rural communities. I think the other challenges you face is getting people there to perform those services.

As we talked about in kind of a few seconds or a few minutes ago, about 70% of the counties are struggling to find people, whether it’s nurses, radiology technicians, people to work in the lab or physicians. And that’s a big challenge because even though there are programs out there that’ll help individuals get paid for training and education, it’s still recruiting them to those locations. Is it right for them? Is it right for their family? And everybody wants somebody to come to their community
and be a part of their community.

But unfortunately that doesn’t always work that way in the rural environment. You hit a great couple good points there. We talk about the population is diminishing in many of the rural counties.

The Census Bureau is a great place for education and knowledge on what part of the United States is struggling. We see since 2010 to 2020, over 140 rural hospitals have closed. Many of those hospitals have been operating in the negative margin and rely on grant and third party funding for sustainability.

Our goal as Americans as health care itself is to assure that care is as close to home as possible for every American, for every individual seeking the care that they need to support themselves. And their families. And so the need is greater than ever.

Today we organize ourselves in a meaningful way to assure that the right resources, the right talents, the right leadership and knowledge and skill set is presented to these communities to assure that moms and dads and children alike all need that healthcare coverage. Well, you know, you talk about the healthcare coverage and again I’m looking at numbers from different organizations, whether NRHA provided or the U.S.

census, you know, and insurance disparities is huge. You know, about 24% of rural residents rely on Medicaid. These are individuals that are working but you know, the compensation that they get for working doesn’t cover necessarily insurance or the employers aren’t required to pay pay for insurance like in bigger cities.

And so you have a large percentage on Medicaid. And so the payer mixes that the hospitals are dealing with are challenging. Right, because you have higher Medicare, higher Medicaid, you have to make sure those are covered and funded by the federal government and the states to be able to pay for that.

And so when you start talking about those financial challenges in rural healthcare, that’s exactly it. You know, it’s a paramix issue. It’s lower volumes.

I think the other thing haven’t really talked about yet, but I think it’s certainly a factor is larger systems are going in and kind of taking over some of the critical access hospitals to, to manage them, which is great. But you know, a lot of that higher level care is getting pushed to those bigger systems. So again it’s still requiring people to travel for higher levels of care.

And so it’s taking away from that ability to keep care local. And you know, we’ve been seeing some interesting things come out as we talk about innovation and the Rural Health Transformation Fund and some of those things. But I was impressed with one of our strategic partners last week talking to us about their new product that they’re going to be putting out on the market, which is a really robust telehealth system.

And I think that is something that, you know, could really benefit rural communities. I’d love to hear your thoughts. Yeah, so I think in the first part of the conversation we attempt to kind of paint the picture of the challenge in the rural environment.

We talked a little bit about challenges with the population, diminishing funds and support and talent. And so we have to be innovative, those next steps of being innovative, again keeping the care local, but in this case in a technological kind of way to fill those gaps. And telemedicine say prior to Covid, because we’re mentioning that was one way of thinking and today it becomes actually the norm.

Telemedicine we can provide from primary care to any form of specialty. We’re seeing dermatology, we’re seeing ultrasound, internal medicine, cardiology. All those tools are there.

And to really care for your population, we must bring the services in this type of way to these facilities to assure that it’s accessible for the population to get in easy access kind of way. So I would encourage everyone that’s out there that’s listening, they give telemedicine a chance, whether it’s in the root of your own home or it’s going to the facility and seeing your primary care provider and getting these consults locally if your facilities have that capability. Yeah, I think, you know,
the telemed I think offers a lot of opportunity.

I think it’s an innovative way to do it. You know, now that you’re seeing stronger Internet connections in the rural environment. That was an initiative that was done many years ago to try to get consistent Internet out to these rural environments.

And so that helps to make the telemed a better thing. I think the other thing is because CMS and the payers are starting to pay on telehealth more consistently and it’s being put into legislation. I think that’s a big thing.

But that leads to another aspect that we’re starting to see a little bit more in rural environments. And I think it’s been around for a while. I couldn’t tell you when it’s really started.

But you think about mobile integrated health, community paramedicine are another opportunities I see is potential to help with the population health. How do you keep patients local? How do you help with care communities? And you know, those programs help to leverage services that they often have through emergency medical services or paramedics that you can go out into the community and do wellness checks, you can do wound care, you can do blood draws, things like that. Where populations that are
struggling to get to the hospital because of transportation issues or mobility, now you can actually take care to them.

And Congress recently just passed in the last couple weeks that the home health has been extended out to 2030. I think those are a lot of great things that will help hopefully the rural environment. Yeah, you know, let’s just talk about.

I’m just going to do a really rapid fire side of it and my brain is just going 90 miles an hour when I think about all the barriers out there to rural health. But then really what are those solutions out there, the innovative ways to really address those gaps as we move forward? Yeah, absolutely. Talent is a cornerstone.

Not every leader is equipped with the knowledge and skill set to really lead their organization. In fact, if you take a look at the statistics on that, a large amount of leaders are raised in their community and make their way from frontlines all the way into the C suite and down the road even onto the board itself. And so they have a strong level of experience, but may not have the total knowledge and skill set from a diverse background.

And so many leaders, unfortunately, don’t have that knowledge and skill when really they only know one way of health care in their community itself. And so I think, most importantly, as we think about getting the right talent or equipping the talent that’s local with the knowledge and skill set to run their facility is really the cornerstone of being successful in the rural environment. I 100% agree.

You know, I think it’s, you know, we look at what we do as H and H on the, you know, operational architecture side of healthcare when we go into these organizations. And I think a big part of that is, you know, you teach an organization and we help them implement different processes or procedures, and then it’s getting them to the sustainability piece of it. And I think that’s a challenge for large systems, small systems.

But in rural healthcare, it’s even a bigger challenge in many ways because, you know, the ability to get out and train and educate. It’s not like if you’re in Dallas, Texas, and you have all these health systems right there and all this education right there that you can go to immediately when you’re out in the middle of, you know, Diamond, Oklahoma, or liberal, Kansas, very small communities. And it’s very hard for that one person that runs that particular job or department to be able to leave
for two to six weeks to go get additional training and education.

And oftentimes they have to bring in, you know, coaches, consultants, whatever it may be to help that. I think that’s a very big part of it. And it’s just a very, very big challenge.

And I don’t think it’s hard for people to understand. You know, you look in a large organization or a large community, let’s say, and you go on LinkedIn or you go on indeed, or, you know, some other job platform, and you put in for a nurse, you will see 100 nurses looking for a job in Washington, D.C.

or in Seattle, Washington. But if you do that same thing in a rural environment, you’re not seeing that same type of capacity to be able to fill those positions. And so it’s that competitiveness on pay, which is also a challenge.

But I want to dispel another myth about rural healthcare. And we go into organizations all the time, and you talk to this team and the staff and you say, what do you think your numbers are right? What do you think your margin is? What do you think your profitability is? And we’ll hear everything from 20% to 30%. And I don’t think most people understand that hospitals in general, whether you’re large or small, the average is somewhere between 1 and 5% of a margin.

But most critical access hospitals are actually underwater. They’re not making a profit. And with that money that they’re making, they’re including grant funding, they’re including foundation work, and that has to cover not only salaries, but capital.

Improvements to equipment, to improvements to buildings, the education pieces, so many different aspects. And when you’re not making all that money, it’s got to come from somewhere. And so you end up fighting a lot of fires.

And, you know, the prioritization has to be there. And it’s. When everything’s a priority, how do you make that one thing a priority? Yeah, you speak about knowing your business, and many organizations don’t know their business.

And the root of that is being raised correctly. And what I mean by that, a good orientation, professional development on a regular period of time, being the expert in that area that you’re leading, that department that you’re leading. And many times you’re the next person up and you get promoted and you have to discover the position without coaching and mentoring.

It goes back to, in my opinion, one of the number one challenges in healthcare, let alone rural healthcare, is equipping our leaders with the right knowledge and the skill set. And many times they don’t reach out and they don’t expose themselves to, to what’s possible and what’s needed to leave their organization. So they end up unfortunately, in many ways doing more harm than good.

So I think the cornerstone of rural health is really equipping our leaders out there with that knowledge and skill set. Without that, they don’t know their business and they don’t know the models of care. And I think if we can say that’s the number one element, from there, everything trickles.

Good decision making happens when a leader is properly equipped with knowledge and a good skill. I mean, that’s, I think those are great points. You know, we’ve been in, you know, several dozen critical access hospitals over the last several years.

You know, if you had to pick Say like the top three things you typically see in an organization that are some of their biggest challenges. What do you think those would be? I, I know we’re going to have a. Well, we probably have a good podcast on these next couple things that I’ll pop in there and you hear that I’m really talking about equipping the leader right there, right there with the knot.

The. Sorry. With the right knowledge and to coach them to develop that skill set.

I would say everything trickles from that leadership knowledge and skill set. Number two, this will be a fun one. It’s probably hand in hand with housing and daycare.

If you can’t get the right talent there, or you can get the right talent there but you don’t have housing or daycare. That’s one of the bigger barriers from recruitment side that falls directly into your world. How easy or how hard it is is dependent on community resources.

Well, that’s a great one because when you, when you recruit people, whether you’re using an executive recruitment firm or you’re doing it on your own in an organization, I think that question is often missed. They’re so worried about bringing in the individual talent. Sometimes you gotta think beyond that and say, hey, I’d love to hear more about your family.

What are your family’s needs? If you have kids that are world class athletes in soccer, but there’s no soccer for five hours, is that really gonna be a great place for your family to go and be at? And, and the daycare is a huge one. We’ve seen some organizations, I, I think of Greeley, Kansas or Greeley County Hospital in Tribune, Kansas, did a great job developing a program for daycare and then they opened a second one with the support of the school district. And I thought that was awesome to see
that.

We’ve seen organizations I think of like Jackson Hole, Wyoming for housing where they works to build a apartment complex so they could provide affordable housing for their employees. Because the cost of housing in Jackson Hole is just skyrocketed beyond possibilities. You know, I’m going to throw in a little different kind of a more holistic challenge that I see in a lot of hospitals.

And I think a lot of it comes to accountability. If I go into a lot of rural communities and really any hospital, I see accountability is always a challenge because when you’re having to follow policies and procedures, are they accurate, are they up to date, do they exist? We’ve seen sometimes where they don’t necessarily exist, but then holding people to accountable standards and sometimes it’s challenged because hey, that’s the only person in our community or the only person we’re going to do
that. We’re afraid of losing them.

That’s a challenge. We see that. Well, yes, it’s a big deal, but it’s not our biggest deal right now.

And so we willing to let it slide. And I will tell you the faster organizations can get to standards of accountability so it’s consistent across the board. Teams appreciate that.

Teams want to see that because those who are holding themselves accountable get really frustrated when leadership or organizations don’t hold others to that same level and same standard. I we’re broadcasting the middle of February right here shortly after the super bowl and so our Seattle Seahawks champions. But I want to correlate the the Seahawks for a minute.

For those who know the Seahawks, they have a 12th player and that’s the fans. Right. And the player in the rural community is actually the community.

And when we think about accountability and, and holding folks to a higher standard, the community plays in that partially because every member of that hospital is part of the community in the rural sense and everybody’s related to everyone. So those dynamics of personal relationships are very integral in how they make decisions because it’s like a house of cards. And so some leaders who normally wouldn’t be a CEO are of CEO because they have that clout and they may not have that skill set, but
they have that relationships in a necessary way.

And without that knowledge of skill set of expectations, accountability, unfortunately you can do more harm to an organization than good. And the likability factor is there, but the performance factor is not. Well, yeah, I’m thinking back to some of our organizations and we’ve seen that in many different ways.

We’ve seen organizations that have had leaders for 20 plus years that had violated regulations and compliance. Yeah, huge variations. But the community was hesitant to react because of how the community would respond to that person.

But that’s the challenge in healthcare. And what I would tell any board member, I would tell any senior leader and we actually had a conversation with a few last night at dinner that we were talking about is in any organization there cannot be what we would call sacred cows. People that cannot be touched or cannot be addressed because you’re fearful of what would happen to the organization.

Because I will tell you, of the hundred plus organizations that have failed, there are probably half of them that had failed because there were sacred cows or people that couldn’t be touched in that organization. And that ultimately led to the downfall. And that’s the thing that that’s the part of leadership that’s challenging.

You know, there’s a. There’s a great many leaders who sit there and talk about being a leader is hard. Right.

You have to make difficult decisions and they’re not going to be liked by everybody. You’re not going to be liked by everybody. I mean, you’ve been a CEO, Charles, and you and I have talked about it before.

You know, when you’re the CEO, you live in a glass house on top of a mountain and everybody wants to throw stones. And sometimes those are the difficult challenges of being a leader is having to make those decisions on when somebody is considered a sacred cow. But they need to go.

And it’s not an easy decision to make. But I will tell you, most organizations, when they make it and they go through the churn and the turmoil after that person leaves, end up being in a better place. And those who are following through and doing what needs to be done and trying to hold their teams accountable appreciate it and will work hard to make sure that the organization is successful.

Yeah, we’ll narrow down on the board and the CEO just for a moment. That’s true for any of the executive or director positions itself. You know, in the rural environment, it’s a difficult way to learn and to lead.

It’s to being able to lead your community members, your family members, your friends. The people have seen you grow up and go. And that’s a challenge in leadership itself.

And it’s hard. And so now we identify much of the challenges out there because you’re moving a community inside of an organization of neighbors, caring for neighbors. So what’s the advice? The advice really is making good decisions regardless of the players.

What is best interest of the healthcare system in the community itself. And that is easy said than done. And so we may be fearful to lose someone because they’re a value member of the community, but that’s the landmine.

We have to make the best decision for the organization and the health of the community and find a way to not damage the healthcare system to assure that healthcare can be sustainable through tomorrow. So if many of those listeners out there are struggling a little bit with I might have the right leader, but they may not have the right skill set or knowledge. Invest in that leader.

Sometimes you have the wrong leader, but the most popular individual, that’s the fortitude and the skill to make the tough decision to either invest in that person or to transform the organization by bringing in a leader that may bring the organization to the next level. Well, you know, I think you bring up a great point there. You know, I would tell you another challenge with being a leader is sometimes having the, the courage to say, I don’t know, you know, and when you talk about that, I don’t
know, I’m not familiar with it.

And, and I will tell you, some of the best leaders I’ve seen out there, at least in my realm of, you know, in the military as flag officers, when they defer to expertise and say, hey, I don’t know, you’re the expert at this position, you’re the expert at this field, you take charge and tell me how we should do this better. And the expectation, I think leaders feel they have to know it all, they have to be everything to everybody all the time. But that humbleness that you can have as a leader and
say, I don’t know, I don’t know the best way to approach this.

We need to bring outside expertise or hey, you just came from this program. I know you understand this better than I do. What’s the best way forward? I think that’s a huge aspect in leadership because it really goes back to your point earlier.

Know your business. You know, and we go into organizations and even people that we would consider to be very strong leaders if we ask them certain questions about knowing their business, like what’s your retention rate? Or how long does it take you time to place candidates? Or, you know, do you know your, your copay collection rate? And you know, we’ll hear like, I don’t know that I’ll have to get that out there. And I think there’s some things that you just in your position, you want to have that
top of the mind.

You want to know that’s a number that you’re always focusing on. Like, you know, people always defer to like accounts receivable or cash on hand. And those are great numbers to have.

But is that what’s important to your line or your business? You know, I would tell you probably as a radiology director, you know, you probably don’t really care about cash on hand, but what’s your no show rate? Right. What’s the longevity of your staff? Do you have the people that have the modality training so they can go back and forth, all those different aspects might be better metrics for your particular department than say, what is my days cash on hand? What are your dust? Yeah, so actually,
it’s a fun story we can share. We’ll keep a name out of it, but I know it’ll pop your head in there.

You know, we Came across a healthcare system, multi hospital system that we or engaged with shoulder to shoulder for years and a leader vice president who’s been in the position for some time. But we started investing in him, if you remember correctly, and then introduced him to a CEO course. And I think if I remember the words he used was, oh my goodness, there’s so much to learn.

How do you keep that all in your head? And so those fundamental statements is healthcare is complex and that it is numbers driven. And you have to know your business, whether it’s a turnover rate, a no show rate, a fill rate rate, shows on the financial side, to know your business allows you to improve your business. And if not, you’re just there to accept patients at the level that is current and never improving.

Well, I know exactly who you’re talking about. It comes to mind. But I think it is especially if a lot of people, and I don’t think this is necessarily just rural, we see this in larger systems too.

But you were a great nurse, you were a great staff nurse, you were a great rad tech and you get promoted up to charge nurse or get promoted up to director of radiology or director of laboratory. But you never had any formal education in leadership, no formal training on how to have a crucial conversation or how you’re going to handle recruitment. And those are skills that take time to develop.

Some of us have had what I would call baptism by fire. They learned it because they learned what not to do and that led to learning what to do. But I think on the other side of it is knowing resources that you can go to.

I think of nrha. NRHA is a great resource, right? The National Rural Hospital Associate or health association has programs, certification programs for new leaders. If you’re a rural CEO, rural CNO, rural CFO, you can come to one of these programs for 12 months and get certified.

And you know, the myth for anybody is just because you’re certified doesn’t mean you know everything. Leadership is a continuous journey. You’re constantly learning.

For everybody in healthcare, change is inevitable. We don’t like it, most people don’t like change, but it’s going to happen. And learning to be able to be flexible with it, knowing where to go to get your resources will certainly help you be better, be better leader, be a better director or C suite within your organization.

But you know, I come back to NRHA and what we’re here for today. I was really impressed as we came in yesterday to see the amount of rural state, rural hospital associations that are being represented here. That CEOs, their current fellows or those going through the credentialing program through NRHA and board members here that want to be better, to understand policies and how it will affect them in their states through organizations and conferences like this.

And again, this is another tool to help leaders within the rural environment to be better, to understand more. Because I’ll tell you, to your point, we talk about knowing your business. It’s knowledge.

You know, knowledge is key. It’s, it’s a phenomenal tool to help you get better at what you do. I am going to keep bragging on NRHA for a moment and maybe be an ambassador on the billboard to it all.

I know that much of our audience is healthcare focused. If it’s not, it’s a great place to learn about healthcare. And as both Steve and I learn more about nrha, its purpose, we are partners with them and there’s a journey to become a partner.

And their vetting process is really impressive. It really assures that anybody who supports health, in this case rural health folks like H and H Leadership Solutions and the works that we do to support the rural health are properly vetted to make sure that they are delivering correctly. So for the audience of decision makers out there, healthcare decision makers, I would encourage you to go to NRHA and take a look at the partnerships of there.

And these are subject matter experts, the best of the best support services for hospitals, clinics, providers, leaders and whatnot to know that they’re vetted and that they can help support you in your journey. And anywhere from solutions groups to IT to clinical to provider groups to accreditation, it’s all there to assist you in investing in your organization. Yeah, I think, you know, when we look at the NRHA program, it’s so robust.

There’s so many ways to be involved with it and to kind of dive into it. I think they’ve got a phenomenal strategic partnership program. You know, for many organizations it’s hard.

You know, there’s so many people out there who do, I don’t know, billing and coding or consulting. You know, NRHA took the time to go through and evaluate organizations to determine, hey, who’s going to be best for our community, you know, our industry. And I think they do a great job of addressing that with, with their partnership program.

But yeah, I think it’s always exciting to be here and part of a conference and to see the people that are attending, to be able to meet with them, talk about their challenges. We have some people here that we know very well. I think of the, the Michael Hassells from our hospital, Melissa Memorial.

We have members of Torch here with John Henderson and his group coming out of Texas and. And just so many. We can’t even.

Can’t even name them all, but it’s. It’s awesome to be able to be a part of that and get to see them. And.

And I’m looking forward to the rest of this conference over the next two days before we get back out on the road and go meet with more clients. Yeah. As we wrap up this section, this podcast, for those leaders that are out there that are not part of nrha, who don’t look to them as a level of resource, a place to understand and gain skills and peership and thought partnership, please take a look at their website.

I’ll be that ambassador, nrha.com and take a look at their resources, their thought leadership, their white papers, their playbooks, their toolkits, really, to embrace what they contribute to our industry as we move forward. We’re broadcasting just outside of the Washington Mall, per se, and I can’t tell you what an impressive experience this has been with our teams, with our partners with nrha. And we look forward to a fruitful tomorrow as we’ve partnered with them.

Absolutely, Charles. Well, I appreciate you, as always, also appreciate the fact that you came out here to the east coast to be a part of this conference. We’ll be back in, what, two, three weeks for another conference out here.

Yep, absolutely. But again, everybody, thank you very much for listening to our sixth podcasts, our sixth episode, really focus on the NRHA conference here live and on challenges in rural healthcare. So with that, we’re signing off.

Thank you very much. And everybody, have a great week. Have a good one, everybody.