MORAN — A pair of nagging questions keeps Allen County Commissioner Dick Works awake at night.
1. Can Allen County afford to remodel or build a new hospital without a tax increase?
2. What sort of costs would be associated with breaking the county’s contract with Hospital Corporation of America, which operates the hospital today?
Works spoke Monday evening at the third and final public forum hosted by the county’s Hospital Facilities Commission to hear the public’s views on Allen County Hospital.
The Facilities Commission will make a recommendation to county commissioners later this summer about whether ACH should be remodeled and expanded or have a new hospital built.
The county also is awaiting a separate market assessment by Hospital Facilities Group of Wichita, which is looking at potential ways to grow the ACH market as well as the financial picture facing the county should a large-scale improvement take place.
Ideally, any new construction or remodeling would be paid for through revenue bonds and funded with hospital revenues. However, if costs to build exceed those, a sales or property tax hike may be necessary.
The HFG report is due in mid-July.
It’s important to note that “nothing is decided,” Facilities Commission member David Toland said. “Don’t get frustrated if we don’t answer your questions right off. We don’t know. We haven’t seen all of the data either.”
Still, it’s not hyperbole to note that the hospital issue “is one of the most important decisions to be made in Allen County for a long, long time,” Toland said.
THE FACILITIES Commission fielded a number of questions and comments from a crowd of more than 30.
Larry Manes of Moran said three elements are essential to the future of the hospital: geriatric services for Allen County’s aging population; an upgraded obstetrics facility; and capable trauma care. He also noted that ACH must adapt to current medical trends providing outpatient services while still providing a solid foundation of basic care and hosting traveling specialists.
One gentleman relayed a story about his wife’s hospital stay at ACH about three years ago, when the nursing staff was unable — or unwilling — to ensure his wife’s comfort. He recalled having to change hoses on an oxygen tube because nobody on staff would do so.
Bill McAdam of Moran had a different story. He said his wife underwent surgery at ACH about three weeks ago. She was wheeled into surgery at 9 a.m. and was back home by that afternoon. He also recalled undergoing cataract surgery there.
“I was told that the facilities for cataract surgery at Allen County are far superior to what you’ll find elsewhere,” McAdam said. “I think the hospital does a wonderful job.”
Several in the audience spoke about local residents traveling outside Allen County for their medical care, to newly rebuilt or remodeled hospitals in Fort Scott, Chanute and Parsons.
Getting those folks back to Allen County may take a generation, Works replied.
JIM LEWIS, Iola, said most medical facilities are capable of paying for capital improvements if their management is good. “The is money there,” he said.
If the hospital is poorly managed, it likely will be closed within the next five years, Beverly Lewis predicted.
Allen County Hospital is managed by Hospital Corporation of America, a private business. Several area hospitals that have been upgraded in recent years are operated as non-profits, meaning that all of the revenue generated goes back into those facilities.
Works noted that HCA has said it was not interested in building a new facility, so any plans must be spearheaded by the county.
“That’s the only way to move forward,” he said. “I don’t see any way to (build new) with the current system.”
Breaking its contract with HCA could be costly, Works said, because of HCA’s ongoing expenditures to upgrade the hospital. The county would be required to reimburse HCA for those costs.
The county still could contract with HCA to manage a new facility, Works added.
Bill LaPorte of Moran noted the subject of acquiring property has been broached, which led him to believe plans already are in place to build anew. LaPorte acknowledged that the 58-year-old hospital needs improving, but wondered if a new hospital is needed for a facility that averages only 13 patients a day.
Those talks were simply discussing scenarios in a public meeting, Facilities Commission chairman Mary Ann Arnott answered.
“You realize if we are going to talk about something, it has to be discussed,” Arnott said.
JOYCE HEISMEYER, chief executive officer for ACH, spoke about the hospital’s designation as a Critical Care Access facility.
Such a designation entitles ACH to more federal reimbursements for Medicare patients, which make up more than 60 percent of the current patient load.
In order to retain the Critical Care Access designation, ACH is limited to 25 beds, Heismeyer said.
Critical Care Access is important when discussing the hospital’s future, Facilities Commission member Terry Sparks noted.
“The Critical Access designation is big,” Sparks said. “When we are getting funding and able to factor in the cost of doing business, that changed the whole playing field.”
Sparks noted that at one time, HCA had been looking to end its lease. Those plans were called off after the Critical Access designation was put in place.
“The whole profit picture changed,” Sparks said.
“They’re making money,” Jim Lewis responded.
The designation means that ACH will still be able to operate without depending on drawing additional patients from neighboring hospitals, Sparks said.
“We’re not wanting to build or rebuild hoping that people will come,” Sparks said.
“We need an up-to-date, modern hospital in Allen County” for Allen Countians, she noted.
