Hospital board moves toward forming a district

Tuesday evening, the Hot Springs County Memorial Hospital (HSCMH) Board approved resolutions regarding a Specific Purpose Sales and Use Excise Tax and formation of the Hot Springs County Memorial Hospital District.

The Specific Purpose Sales and Use Excise Tax is a one percent tax that would be a source of funding for renovation, construction, expansion, remodeling, furnishing and equipping of HSCMH. Cost for such is estimated at $16.4 million, which includes the $15.8 million cost and $675 interest. The board will shop for the lowest interest rate, and if it has the support of the community they will apply for grants and other funding sources to bring the cost down.

The district resolution would require a three-mill levy. With the average Thermopolis home cost of $150,000, CEO Robin Roling explained, it would result in an additional $3.75 per month, or about $42 per year for the homeowner. As valuations in the county go up and down, so does the amount of money generated from the district. Roling further explained the establishment of the district allows Thermopolis as a community to fund the hospital. It also provides for the election of a board of directors, rather than their appointment, and gives even more control to the people.

Funds from the district would be utilized to pay for equipment purchases, and ongoing operations such as physician and staff recruitment.

Board Chair Bill Williams said if both the tax and the district formation are approved by the community, it will allow for more leverage when negotiating an interest rate.

The resolutions will go before the Hot Springs County Commissioners and will be on the ballot in the November election.

Prior to approval of the resolutions, Roling presented information regarding affiliation with other facilities. Roling explained the hospital has to determine what is the best strategy to achieve its goals and vision and remain an asset to the community, while also assessing risks. While affiliation is not a goal, Roling said, it most certainly could be a strategy.

Among the hospitals looked at for partnerships was the clinic in Billings, Mont. HSCMH has done some partnering with Billings, in terms of electronic medical records. However, differences in culture — such as Billings nurses being specific to one area where Thermopolis nurses are well versed in several areas — and other issues made this a challenge.

In affiliation discussions over the past couple years, Roling said among the entities considered were Wyoming Medical Center, St. Vincent’s, SageWest and Billings. Roling said each of the medical facilities considered for partnership is great to work with. However, some chose not to partner with HSCMH, or provided no firm promise of capital toward the renovation and new construction of the hospital. Another possible partner — which Roling noted is has been good to work with — was Banner Health, which could provide capital, but might take a look at how the Thermopolis hospital operates and consider a smaller scope of care locally while other services are moved to the facility in Worland.

HSCMH currently has a contract with HealthTec. Roling said the company helps provide services to allow small hospitals to remain viable.

Joe Casciato raised the point that the hospital ought to explore other partnerships further. He also voiced concern as to how much the three-mill district levy would provide, as valuations change from year to year.

Dee Hillberry emphasized there be deeper assessment, in a collaborative manner to involve those in support of the hospital district, those opposed to it, the hospital board and the county commissioners. Then, with all the information laid out, it should be determined whether to have a district or continue operations as they are now. He raised a point that the hospital has operated several years without a district.

In other action, the board approved the Compliance and Health Information Management policies, as well as the filing of Form 990. As the hospital is both a governmental entity and a 501c3, Form 990 is required. The form itself includes data from the hospital’s audited financials.

A renegotiated contract with Toshiba was approved. Though the current contract, which provides for maintenance on CT scanners, was set to expire in 2018, new regulations require hospitals measurement of radiation doses.

Director of Diagnostic Imaging Daryl Mathern was credited with re-negotiating the contract, which will now expire in 2021, to provide for equipment and software updates for the CT scanners. The new contract was negotiated at $75,000 but could’ve been up to $200,000 had the board chose to wait.

The board also approved a bonus of $5,000 to A. Pleasant Construction. The company provided for renovations necessary to bring in the new magnetic resonance imaging (MRI) into the hospital. There was $286,000 budgeted for the renovation, with a $50,000 if needed. It was reported at the meeting that A. Roling noted the $5,000 bonus was included in the contract with A. Pleasant as an incentive. Pleasant was able to stay well within the total budget, requiring less than $9,000 from the contingency.

A real estate lease option will go before the county commissioners. Roling explained a couple apartments from the hospital are under consideration for use as staff housing.

Additional dollars were approved for Mortimore Ambulance Service. The hospital contracts with Mortimore to provide transport care from the county to the hospital.

An additional $20 per run was approved, which could result in $8,000 to $10,000 per year depending on the runs done.

The next Board of Trustees meeting is scheduled for 6:30 p.m. April 26.