Keith leaves St. Edward at top of game.

For the first time in 27 years, officials at St. Edward Mercy Medical Network in Fort Smith look for a president and chief executive officer.

Sister Judith Marie Keith retired from the position July 1 at the Fort Smith-based health care network she led since 1970.

I've enjoyed a very, very happy and successful career here," Keith says, "but I knew I was not going to do this for the rest of my life."

The 62-year-old nun is credited with gaining community support for a hospital that was literally on life support when she took over and guiding it into one of the top five hospitals in Arkansas in terms of revenue. In turning the hospital around, Keith developed an innovative network of rural hospitals in the Fort Smith region that gained national acclaim.

Keith came to Fort Smith in 1968 after completing her administrative residency in Salt Lake City. Two years later she was charged with taking the dying hospital and turning it around or putting it out of its misery.

"St. Edward was at a point where we either had to close or we had to move and do something dramatic," she says. "We needed to move or die.

"St. Edward was in trouble. We had to move from a parochial society and include the civic community. The real success story here has been the involvement and support of a broad base of the community. They stood with me when hard decisions were made."

In 1975 a new facility, St. Edward Mercy Medical Center, was dedicated with the help of the community's involvement and support, she says.

From the new campus, Keith organized a network of rural-care facilities that started with a 22-bed hospital at Paris (Logan County) in 1979.

"We did an interesting concept," she says. "We took a 22-bed unit and placed it in Paris and didn't build a kitchen; there was no administrative office. We did all that in Fort Smith."

Keith says all the used linens were brought back to the main campus and cleaned ones shipped back to Paris to keep overhead costs of the satellite facility as low as possible.

The New York Times wrote about the concept in 1977, calling it a major innovation in rural medicine.

In 1982, St. Edward began operating a hospital at Waldron (Scott County). Also in that county, St. Edward Mercy Medical Network runs the Pinewood Nursing Home.

Harbor View Mercy Hospital, a psychiatric division of St. Edward, opened in 1983, and seven years later St. Edward took over the hospital in Ozark (Franklin County).

Growing in the '90s

The 1990s has been a decade of growth for St. Edward, Keith says. Hembree Regional Cancer Center opened in 1995, and last year St. Edward opened the Mercy Center for Life, a comprehensive birthing center.

Mercy Fitness Center opened in May. The 36,000-SF facility includes a 75-foot lap pool, spas, weight training equipment, aerobic areas, an indoor basketball court and two outdoor tennis courts. The $4 million fitness center can accommodate 2,800 members, she says.

Keith says the new fitness center is an effort by St. Edward to move area residents from thinking about health after becoming ill to considering efforts to prevent illness. The shift to prevention is an advent of managed care, she says, which is one of the biggest changes in the industry.

"In the early '70s," Keith says, "everybody was extremely busy. The demand exceeded the supply, which created a shortage of beds; there was a shortage of nurses, doctors, etc. There was no focus on the patient at the time of arrival that they needed to plan for that patient to start leaving."

Now hospitals are overbedded, by and large. They have the human resources. The focus is on holding the line on costs.

Gross revenue in the early 1970s at St. Edward was about $4.5 million a year, compared with about $200 million today - another change in the business, Keith says.

"The complexity of the business has grown tremendously. Managed care puts pressure on doctors and hospitals," Keith says.

She says that although she's had an exciting career and has been successful, she wanted to leave while at the top of her game.

"Recognizing the strong position of St. Edward and a desire to experience a different ministry, it became clear that 1997 should be the year [to retire]," she says.

"I will take a few months to wind down, thereafter, pursuing a host of new ministry options, including more involvement with the civic and church community. It's time for me to do some of those things that I've wanted to do for years."

She says she intends to remain in Fort Smith - "where my friends are" - and where, she believes, she still has plenty to do.