HUMBOLDT — Allen County Hospital has the lion’s share of the health care market in the county, but perhaps not as much in the southern tier of the county, including Humboldt.
Several residents told members of the Hospital Facilities Commission here Thursday evening they opted for Neosho Memorial Regional Medical Center in Chanute when hospital care was required. Reasons were several.
“There’s nothing you could do to change me and my family,” said Janice McCullough, noting she was pleased with care she received through the Humboldt branch of Ashley Clinic, an adjunct of the Chanute hospital. “Our relationship with our doctor won’t change,” regardless what occurs with ACH, she said.
Others made similar observations, but noted if Allen County Hospital or Iola doctors had regular hours in Humboldt, there might be a shift.
Mayor Bob Sharp said Humboldt doctors many years ago moved their referrals from Iola to Chanute, for reasons lost to time. That Humboldt residents tend to shop in Chanute also favors the Chanute hospital.
Commission members asked whether better facilities and more comprehensive specialty services at ACH might make a difference.
Several said that would be helpful.
Ernie Davidson, who once directed the Southeast Kansas Multi-County Health Department office in Iola, said that despite good experiences at ACH, he went elsewhere for specialized treatment. “I received very good care there and everything looked good,” except some minor cosmetic features.
He asked whether Hospital Corporation of America, which operates ACH, would plow profits into either remodeling or building new on another site.
“Otherwise, it will fall to the taxpayers, and we’re paying enough taxes already,” Davidson said.
Joyce Heismeyer, ACH chief executive officer, said she couldn’t speak on behalf of HCA, but pointed out that the current management agreement was an owner model with HCA operating the hospital with the intention of making a profit.
“There are other management models that would have revenue stay with the hospital,” she said. HCA would have to agree to those models, however.
THE HUMBOLDT session was the second of three public forums in a week’s time for the Hospital Facilities Commission. The first was in Iola and another will be at 7 p.m. Monday in Moran at the Senior/Community Center, 407 N. Cedar.
After a disappointing turnout of less than a dozen in Iola, commission members were visibly — and vocally — pleased that 29 came to Thursday’s session in the Humboldt Library community room.
HFC member David Toland noted the commission’s charge was to make a recommendation to county commissioners about whether ACH should be remodeled and expanded or a new hospital built.
Factors to be considered are whether there is patient support for an upgrade and whether changes are affordable through hospital-generated revenue and, if necessary, an infusion of tax money.
Ultimately, the commission’s role is advisory.
“We’ll make our best recommendation and then the county commissioners will decide what to do,” Toland said.
“We’re the lay people of the process,” said HFC member Terry Sparks. “Health Facilities Group (the consulting firm hired by the county) has the expertise,” to determine physical needs of the hospital and whether its market share, now or projected, can support any proposal.
ONE WOMAN declared a new hospital shouldn’t be considered until “all of the hospital’s 25 beds are full most of the time.”
That occurs three or four times a month, Heismeyer observed; the daily average is 12 or 13.
It was pointed out critical access designation and hospital occupancy often are misunderstood.
Critical access hospitals are limited to 25 beds and have financial advantage in that federal Medicare reimbursement is near 100 percent of cost, above that sent to conventional hospitals. Also, being designated critical access means Medicare funds are available for construction, Dick Works, county commissioner from Humboldt, pointed out.
Mary Ann Arnott, a commission member, noted also that delivery of health care has changed.
“The average stay now is about two days and people need other services,” she said, noting that outpatient care was a much larger part of a hospital’s role in community health care.
Simply put, “The direction is different than before when you had longer stays in the hospital. Remember when you were in the hospital for a week or more when you had a baby?”
That stay is now about 36-72 hours.
Richard Lundstrom, an architect with Health Facilities Group, said the key word in construction of modern hospitals is flexibility.
“We design hospitals with swing or flex beds to meet a variety of specific needs,” he said. “That way we don’t overbuild.”
He noted HFG works extensively with small hospitals in Kansas.
“We have experts is each area,” he said. “We will accurately determine the cost of remodeling and building new and we’ll offer financing options. We understand ways to grow your market share. Right now we’re gathering information and will look at options for the county commissioners to consider. We’re looking at ways to transform what you have into a modern hospital.”
SEVERAL asked what about costs and financing.
“We don’t know,” is the answer to either question, Works said. That’s why the consulting firm was hired and facilities commission members brought on board, he said, “to help us find the answers and then reach a decision.”
Preferred financing would be revenue bonds, Works said, which would be retired with revenue generated by the hospital.
HCA has provided the consultants with financial records which will give them a good grasp of whether a project could be financed strictly with hospital revenue. HFG also will project what additional revenue could be expected from ACH if it had a larger market share through more diverse treatment and specialty opportunities.
The second tier of financing would be public money. Two apparent sources are sales and property taxes.
Facilities commission members toured six hospitals other than ACH, three built new and three remodeled and expanded. Revenue bonds mainly carried the cost of improvements at each. Remodeling and operation of the Fredonia hospital is supported by a quarter-cent city sales tax. The new hospital at Neodesha had the advantage of more than $2 million on reserve ahead of construction, much from public donations.
LUNDSTROM said Health Facilities Group should complete its surveys and assessments of ACH and its operations by mid-July.
“We’re still in the fact-finding position now,” Arnott said. “It’s not going as fast as we’d like. We’ve gathered a lot of information,” and given residents, medical staff and others associated with the hospital opportunities for a thorough airing of concerns.
Toland noted Thursday evening’s session in Humboldt wasn’t a one-time visit.
“We’ll be back for another meeting when we have more information” — including specific financial data — “to give you another chance to speak,” he said.
