Seventeen years into his career as an administrator with Samaritan Health, Marty Cahill has gotten to know the nonprofit health provider pretty well.
But this year, as he has taken over as CEO of the five-hospital chain, which serves an area stretching from Lincoln City to Lebanon and Corvallis, a lot has changed.
Cahill, who is in his “mid-50s”, came to Samaritan after, he said, getting interested in the world of health services while working in sales for Pfizer.
“You walk around, talking to clinicians about pharmaceuticals, the benefits of your medication over the benefits of your competitors’ medication – I realized after a number of years that that was not going to be my career,” Cahill said.
“I was interested, intrigued by hospitals. I was intrigued by the hospital administration component of it.”
Cahill had grown up in Massachusetts and found Oregon, he said, after meeting some people from Eugene while working a summer job at the beach when he was in college.
“I came out for the summer and never left,” he said. “I transferred my credits from New England to the University of Oregon and never left.
“Mt. Hood, Mt. Bachelor, Sunriver, the Oregon coast – everything’s like within four hours of, you know, Eugene and Portland. If you look at the summers with no humidity, no bugs, it’s way different than New England.”
Having graduated from the U of O in 1992 with a bachelor’s in sociology, Cahill worked for Pfizer for 5½ years, then moved to Samaritan as director of physician relations for a year and a half.
“I met with all of our clinicians, kind of like an ombudsman,” he said. “I talked to all the community docs, you know, any issues or concerns they had. I tried to address them, from Samaritans’ perspective, tried to make sure they had all the information.”
Meanwhile, he was working on an MBA in organizational behavior from Marylhurst University, which he completed in 2008.
While doing his graduate work, Cahill lined up an interview with then-Samaritan President and CEO Larry Mullins, who was midway through his 25-year career with the organization.
“I just talked to him about hospital operations, hospital administration, and we talked for seven or eight months, and he hired me and the rest is history.”
In 2008 Cahill was named CEO of Samaritan North Lincoln Hospital, where he stayed until 2015, when he took over as CEO of Samaritan Lebanon Community Hospital.
He was at SLCH until November of 2023, when he became senior vice president and chief operating officer of Samaritan under Doug Boysen, who had succeeded Mullins.
The day after Christmas 2024, Boysen announced he was planning to step down from the role in 2025 and Cahill was named to replace him, which took place May 19.
He took the helm literally as turbulence began rippling through Samaritan’s ranks and surrounding communities, including east Linn County, sparked by talk of impending closures of some services in some Samaritan hospitals, including Lebanon.
Cahill issued a statement a few days after the talk began circulating, confirming that Samaritan administrators had indeed identified some possible cuts to general surgery, orthopedics, women’s and children’s services and urology.
Samaritan nurses and others held a rally on May 27 outside Samaritan’s corporate headquarters in Corvallis, and a change.org petition entitled “Keep Lebanon’s Birth Center Open,” launched May 13, listed nearly 3,000 signatures by July 1.
‘Significant Challenge’
Cahill said Oregon’s hospitals are facing “a significant challenge right now” due to increased costs resulting from tariffs and other factors, and accompanying difficulties in collecting reimbursements from the government and insurance companies.
Plus, there is a growing shortage of physicians and nurses, especially those interested in working in rural settings.
“Probably two-thirds of the hospitals in the state are either performing in the red – not making money – or barely breaking even,” Cahill estimated.
According to Oregon Health Authority data, Oregon’s 60 acute care hospitals, as a whole, saw an improvement in profitable operating margin (profit made after accounting for direct costs of earning that revenue) over the one-year period ending in the third quarter of last year, increasing from -$9.7 million to $11.2 million. Samaritan’s recent numbers, as posted by OHA, are mixed.
In addition to Lebanon and Lincoln City, Samaritan operates Good Samaritan Regional Medical Center in Corvallis, Samaritan Albany General Hospital and Samaritan Pacific Community Hospital in Newport, all of them acute care hospitals. Its network also includes more than 100 clinics.
Of Samaritan’s five hospitals, according to Oregon Health Authority data, Lebanon is the most profitable of the five hospitals, earning a profitable operating margin of $24,414,294 in 2024, continuing a trend of profitability that extends back to 2014.
North Lincoln and Newport were also in the black last year, to a lesser extent, but Albany and Corvallis finished 2024 with losses that total roughly $32.3 million, just short of the roughly $39.6 profitability of the other three.
Cahill said expenses have risen “significantly” since the COVID pandemic “and reimbursements are not matching that.”
“They’re flat.”
And, he added, “insurers are taking longer to reimburse us as well. So not only are we not getting reimbursed what we did five years ago, it’s taking longer to collect on that as well.
“It’s just hard right now. It’s challenging for Samaritan and it’s challenging for the state; quite actually, nationally, it’s an issue as well.”
Cahill said that although some Samaritan hospitals are in the black, the five are interdependent.”
“All five hospitals do a great job. They provide great care. They do great things.”
He acknowledged that Lebanon is a “successful” operation with a “positive bottom line,” but there’s more to the situation.
The Samaritan group is interdependent, he said, recounting how the system came together over time: “It was five independent hospitals that were trying to survive.”
The Backstory
Samaritan was founded in 1948 when the Episcopal Church in Western Oregon reorganized Corvallis General Hospital as a not-for-profit facility.
In 1997 the current nonprofit came into being when Corvallis merged with Lebanon Community Hospital, which was founded in 1952 by a community effort led by local Mennonites and was managed for decades by Mennonite Health Services.
Albany was added in 1999, followed by North Lincoln (2001) and Newport (2002).
“They came together mainly out of the fact that being alone was not going to be a strategy, moving forward, for them,” Cahill said.
He said that because the hospitals are now interdependent, even though in a particular year one might be doing well, “we’ve got to look at the whole, at all five hospitals, because they’re independent.”
“The expense of being an independent hospital was too much 25 years ago,” he said. “Five hospitals that were within the region recognized that they could not survive on their own. So they came together.”
Today, Samaritan emphasizes integrated care, providing patients with coordinated, comprehensive care that addresses all aspects of their health, including medical, behavioral, and social needs, through a holistic collaborative team approach that reduces fragmentation and duplication of care.
It also has the second-largest residency program in the state, with 112 young doctors working in its hospitals and clinics, along with some 650 clinicians.
“We’ve come together in a way that we provide great care in an integrated way,” Cahill said.
Forced Economy
He said that things are changing, with the financial difficulties Samaritan is facing and the organization is being forced to look for ways to do more with less.
“What we have to look at now, I think, is the fact that reimbursements are flat, hospitals are really struggling to be sustainable.”
Samaritan serves the approximately 290,000 residents in Linn, Benton and Lincoln counties.
“How can we take care of 290,000 people with the infrastructure we have in a meaningful, sustainable way?” Cahill asked.
Retiring Practitioners
Then Samaritan is seeing another problem that’s complicating all of this, Cahill added: retirements.
“There are more clinicians retiring today than are being created in the residency program,” he said. “We’re seeing a decline in clinicians. There’s not enough nurses being generated in the nursing programs to replace the nurses that are retiring.”
It’s a complicated problem, he said, noting that one cause is that residency programs are generally capped at the number of residents they accepted 25 or 30 years ago. Now, as Baby Boomers retire, “we’re not creating more doctors and the same is true in the nursing program.
“We’re having more people retire than we can get educated and through the process.”
That, he said, is a “bottleneck” that won’t be solved even if hospitals can improve their reimbursement rates.
“There are no easy solutions,” Cahill said.
With the lack of available practitioners, particularly those who want to practice in a rural setting,
Samaritan branches are “all of a sudden competing against ourselves” in trying to deliver the same services at all five hospitals.
“We need more clinicians and we need them at all five sites.”
“There are not enough anesthesiologists right now, and there’s other constraints.”
Consolidation Solution?
Faced with a shortage of clinicians and financial shortfalls, Cahill said, the best way to address the issue would be to consolidate certain services. The most likely prospects are women’s and children’s services, obstetrics, general surgery, orthopedics and urology, the latter being a “growth strategy” for Samaritan.
He noted that for the past 25 years, each of the five hospitals has done “five of everything.”
“We believe consolidating services is the best way to ensure the delivery of those services in our system right now, because we think we can’t hire the staff to man those services across all five hospitals in a meaningful way. It’s becoming cost-prohibitive to do that because there’s just not enough doctors to hire.”
He said the goal would be to “consolidate services in a safe way to create higher volumes at a site in a more sustainable way, and staff maybe three units instead of five units.”
For example, Cahill said, deliveries of babies may take place in Albany instead of Lebanon, though mothers would still visit their OBGYN practitioners at local clinics prior to actually giving birth. Inpatient surgery might take place somewhere other than Lebanon.
“They’d go see their doctor every day that can see them, Monday through Friday, in the clinic, Cahill said. “If they had outpatient surgery that they needed, they would still get that outpatient surgery in Lebanon.”
Public Weigh-In on ‘Proposal’
Cahill said a coterie of “clinicians and some administrators and folks” have weighed the issues and are producing a proposal that will be introduced to the public in the near future.
“We’ve got to talk to internal stakeholders, external stakeholders, people that have interest in this, and get feedback from everybody,” he said, cautioning, “The proposal is not a plan. There’s no decision made yet on that proposal.”
He said “listening tours” will be conducted, in which local residents would be provided the “data” behind problems and “we have to do a lot of listening.”
“This topic is a very emotional topic. And so the first thing that I want to do, that the team wants to do, is listen to everybody, hear the concerns, and then start to address those concerns in a meaningful way with data. We’ve got to validate the data and make sure we have all the right information, and then we’ve got to start to talk to people about that as well.”
Samaritan is willing to provide speakers for local community groups and service clubs interested in discussing the situation. To connect, email [email protected]. Those interested in voicing their opinion on prospective closures can do so by email at actionnetwork.org/letters/save-our-birth-centers.
“We’re looking for all the input that we can get,” Cahill said.