
UPPER PENINSULA – Like many small rural hospitals, Dickinson County Healthcare System (DCH) in Iron Mountain, Michigan regularly faces its fair share of operational and financial challenges. In October 2019, Chuck Nelson took on his role as the new Chief Executive Officer with an energized action plan called “Focus Forward”. Focus Forward embraces the constant restructuring and service streamlining that a rural hospital needs to do to survive, while also ensuring that community needs are met with the highest levels of care. With Focus Forward, Nelson is taking DCH to a higher level and proving that rural community hospitals can excel in the changing and increasingly competitive healthcare landscape.
Nelson explains, “It’s not only about the quality of care and the points of which the patient is engaged with a provider. It’s also about all the administrative functions that go along with it: how you interact with the financial services, how you interact as you leave the facility, how your post-acute care might be positioned with home health and so on – it’s about the continuum across the spectrum,” he continues, “As we look forward, we will never take any aspect of our care for the community or each other for granted. We are vitally important to the physical, mental, and economic health of our community. Dickinson is one of the largest employers in our area with over 600 healthcare professionals who are dedicated to taking care of the community every day. We also bring over $60 million in salaries and benefits that directly support the vitality of this entire region. This is a huge impact that few other healthcare providers even come close to bringing 24/7 care to the area like DCH does.”
Lois Ellis, Executive Director of Dickinson Area Economic Development Alliance, explains the economic impact that DCH has on the Iron Mountain Community saying, “DCH is a top employer in our area, creating a significant economic impact in our community. We are very supportive of the positive improvements that Chuck and the hospital leadership have pursued in order to create a more stable financial future for the hospital.”
As a community guided healthcare organization, Dickinson has a big challenge – how to serve the comprehensive needs of the community without the financial benefit of larger patient volume. The pressure is magnified with rising operation costs in diagnostic technology, electronic medical records, and physician staffing. The facility needs regular updates and most importantly, large capital upgrades to support the area’s only cancer center with radiation oncology. Dickinson embraces the constant budget pressure and community input to ensure that they are using their resources in the best way possible. Staff has been realigning and streamlining to help the organization stay on solid ground. To top it all off, larger healthcare systems are pushing into the region to draw community patients away, which creates ebbs and tides in patient volumes.

“Focus Forward gets us beyond each individual problem and focuses us towards the goal of being absolutely excellent in everything we do,” Nelson explains, “When we all perform at the highest levels, many of the constant challenges are easier to deal with in the long run because we are successfully caring for our community.” DCH continues to maintain their relationship with the community while providing quality healthcare, showing more financial strength in the last five months than in the last five years.
While DCH has faced challenges, they have also continued to provide excellent care to their patients. Nelson said, “Despite the challenges the organization has faced over the last couple of years, the physicians, the medical staff, the support staff, and the entire team involved in the care process, have not taken their eye off the ball. Most recently, Dickinson achieved an A rating by The Leapfrog Group, an independent hospital watchdog organization. To receive a rating like that with the challenges the organization has had is very significant. Quality is very important. It always has been at this organization, so the good news is, we start with that platform and build off of the experience and the services that we can improve upon.”
Being a community owned healthcare organization; DCH is integrally connected to its residents and is guided by community health needs and priorities. The hospital executive team has regularly scheduled meetings with county officials to discuss everything healthcare – from patient stories and testimonials to financial challenges and service updates.

The very public nature of how Dickinson is required to operate as a county hospital creates a special set of challenges and opportunities. DCH is providing healthcare services in a way that their community needs: personal, compassionate, and high quality. As other systems have made entry into the market, causing some patients and providers to leave, the Iron Mountain community has also been the biggest cheerleaders for Dickinson, even so much as to create a community campaign showing their support.
Nelson explains, “We have a competitor in the market that has drawn a few of our providers and staff to work for them. As they have local people working at their clinic, some may say that this makes them equally a key part of the local economy. I say that’s fine, but it is no comparison to the fact that Dickinson still has over 600 people bringing 24/7 care (from OB to ER services) and contributing over $60 million in salaries and wages into the community. We are not only vital for the healthcare we provide – we are vital for the economic foundation we bring to Dickinson County.”
About InvestUP
InvestUP is a private sector-led economic development organization keenly focused on driving economic growth across Michigan’s Upper Peninsula. Founded by the region’s leading private sector businesses and the region’s universities, its mission is to deliver business and job growth across the peninsula.
www.investup.com
About Dickinson County Healthcare System
Servicing Northern Wisconsin and the Central Upper Peninsula for more than 68 years, Dickinson County Healthcare System (DCH) is a 49-bed Community Hospital with a team of more than 80 active providers and each year treats over 150,000 patients. DCH employs more than 600 staff members, is one of the major employers in the Dickinson County area, and is a large contributor to the economic wellbeing of our community. DCH provides a range of services, including hospital and intensive care, emergency, full lab and diagnostics, surgical, OB, pediatrics, and is home to a Cancer Care Center that provides the only radiation oncology unit in a 100-mile radius.
www.dchs.org