Hospital CEO gives insight on master plan

On March 1, 2012, current Hot Springs County Memorial Hospital Chief Executive Officer Robin Roling began her career with the hospital. Upon her arrival, she explained, the hospital was wrapping up a master facility plan.

"We were fortunate in being able to make some changes in legislation that would allow us to put a district initiative on the ballot in November of 2013. The reason we wanted to start with a district initiative is, based upon findings from the master facility plan, as well as information gleaned and worked on for many years, the very first step to improving our financial base was to implement a hospital district," said Roling

Once the district was in place it would allow them to leverage it with the State Lands and Investment Board for capital projects, including a new building.

The 2013 ballot initiative failed, and the hospital continued to have challenges with physician and staff recruitment, infrastructure and the load-bearing capacity of the floor, among other things.

In August 2015, the hospital board made a motion to go before the county commissioners, to update the plan to include a smaller footprint in the same location. This was based around community feedback received during the 2013 district election.

The update was requested, along with funding to support it, with plans to come before the commissioners again for a ballot initiative in 2016 to support a district for ongoing operational support and a specific purpose tax to finance a new building project. The tax is solely for construction purposes, including materials related to the project.

The commissioners provided funding for the plan update, done through the Erdman group. Erdman looked at marketing data and identified there is a business case for maintaining a hospital in Thermopolis. Roling said they looked at square footage, incorporated changes they and hospital staff thought necessary, and looked at new vs. remodeled space.

A complete remodel was not cost-effective, because it would have a large impact on revenues and costs were high. A second option involved building south across Arapahoe St. At a community meeting, residents expressed concern about building across a thoroughfare street, as well as the fact that north of Arapahoe is owned by the state while the southern half is owned by East Thermopolis.

Erdman then looked at building on the current site, but lengthy hallways and issues of relocating various areas were a detriment. Erdman came back with a plan for a two-storey facility, but costs were higher than leaving it at one.

"I was pleased to see that," Roling said, "because I think, in terms of staff efficiency, it's much easier to have it on one floor."

Going over the final concepts, they looked at what is needed for new space, vs. remodel. The idea is to create 10 rooms for medical surgical patients and two OB rooms, new operating rooms, central sterilization, an endoscopy room, areas for wound care, IV therapy and chemotherapy, and a new emergency department with larger trauma bays. Next, the current emergency department would be demolished, with imaging and laboratory services built in its place, within a self-contained unit. A late phase might include taking down part of the existing part of the building to provide more direct access to the hospital.

Space would also be remodeled for pharmacy, cardio-pulmonary or respiratory

therapy care, and to accommodate outpatient clinics.

There are still issues with the remodel, such as infrastructure, but the plan gives priority to patient care services. From a financial perspective, direct cost is about $9 million and total construction budget is about $12.6 million. As for renovating the current hospital, there are a number of options, but doing everything brings the project in at about $15.8 million.

Roling could not say whether the expansion would provide more employment, other than during the actual construction, but it certainly would continue to support the roughly 105 employees the hospital already has.

The hospital, she said, has a "$6 million payroll, plus all the ancillary kinds of things we contract with folks in our community for. It's a pretty significant economic driver."

In much the same way people take steps to take care for themselves, Roling said the community has to look at maintaining its health, and "good infrastructure for a community includes great education, great healthcare and economic viability. That is the way you attract people into your community... I want us to be a great Thermopolis, and you have to have investment in yourself in order to maintain and get better."

It really boils down to a community decision, Roling said, and the community has to decide whether to maintain and retain current healthcare services or do something different.