Survey and slides

The Healthcare Sustainability Project Subcommittee (HSPS) met at 5:30 p.m. Wednesday during an open meeting which had been rescheduled from the previous Wednesday due to the snow storm that hit on that day.

HSPS member Will Faust opened the meeting by thanking everyone for attending and announcing a new HSPS website.

The website at www.plattevalleyehealthcare.org is to feature past meeting minutes, a link to the Platte Valley Healthcare Assessment Survey and slides from the subcommittee's recent trip to visit Critical Access Hospitals (CAHs) in similarly sized communities in Montana.

Healthcare Survey

Faust, along with all the subcommittee members, encouraged everyone in the community to visit the website and take the short survey so that a clearer picture of community wants and needs could be taken into consideration in planning a possible CAH.

Faust added that for those who were not inclined to take the survey online, paper copies of the survey would be available around the area. The paper versions, which come in pre-stamped and addressed envelopes, will also be available at local churches, schools, merchants (including the Saratoga Sun), libraries, along with the Platte Valley Community Center, Chamber of Commerce and the Encampment, Riverside and Saratoga Town Halls.

It was stressed that the greater the input collected, the better the entire community would be served in the long run.

BKD Update

Faust reported that BKD, the healthcare accounting firm the Corbett Medical Foundation has retained to assess the feasibility of a CAH in Saratoga, has preliminarily completed the first of several phases in the determination.

Faust did say that the first phase report on schedule but was not quite ready for public disclosure yet as these preliminary results were still being looked at by HSPS and that changes were still being made. Faust did add that results were looking positive at this time.

CAH Field Trip

Faust then turned the floor over to fellow HSPS member George Haigh who gave a slide presentation to attendees on the trip several subcommittee members took to CAHs in Montana.

It was pointed out that Karl Rude, president of Health Management Services (HMS), selected the locations to visit based on similarity to Saratoga as far as land area, population, healthcare needs, recreational tourism and distances of at least 30 miles from larger hospitals.

The group which was comprised of Corbett Medical Foundation representative Laura Bucholz, HSPS members Faust and Haigh, Saratoga Care Center Administrator Mark Pesognelli, HMS president Rude and architects Mike and Cheryl Burke.

The slide show said the three facilities toured are "operationally and financially stable thanks to broad community support, dedicated physicians, excellent internal management, USDA reimbursement programs, cost based reimbursement funding, medical grants, private donations and charitable fundraising."

The three Montana facilities toured were the Beartooth Billings Clinic in Red Lodge, the Stillwater Billings Clinic in Columbus and the Ruby Valley Hospital in Sheridan.

The Saratoga Sun has given a distilled version of the hospitals visited here. For a more detailed look at each facility, the slide show is to be available on the HSPS website.

Valley Baseline

For comparison to the CAHs visited, the Platte Valley has a population of 3,164, has a clinic that is 5,200 square feet (including the ambulance barn) and has a distance to the nearest hospital of 45 miles.

Red Lodge

The first discussed was the CAH in Red Lodge which has a population of 3,580 and a distance to the nearest major hospital of 63 miles.

Services offered at the Redlodge CAH include: ER Care, Inpatient Acute Care, Transitional Swing Bed Care, Post-Acute Care, Endoscopy, Diagnostic Radiology, CT & Ultrasound, Mammography, Hospice and Home Care, Lab (Walk-In) Services, PT, OT, Speech, Cardiac Rehab, Outpatient Nutrition, Public Health Services.

The 46,000 square foot building completed in 2010 boasts 10 beds, two observation rooms and three ER suites.

The main positives noted with this facility were large, comfortable room sizes and a recently expanded and profitable physical therapy area. Features the group felt were unnecessary for Saratoga were vaulted ceilings and fireplaces. Overall the group found the facility to be about twice the size Saratoga would ever need.

The Red Lodge CAH has 144 employees including five physicians (three full time), two Physicians Assistants (PAs), one family nurse practitioner (FNP) and numerous associated staff members.

Columbus

Columbus has a population of 2028 and a distance to a major hospital of 37 miles. The major employer in Columbus is the Stillwater Palladium Mine with 1,600 employees.

The 10 bed, four ER room facility there was completed in 2012 at a cost of $18 million and offers radiology and physical therapy along with their emergency services.

The hospital has 75 full time employees (89 total) including one physicians, one Doctor of Osteopathic medicine and two PAs.

While comfortable rooms were noted, unused space and a costly aesthetic were negatives taken from this visit.

Sheridan

The Ruby Valley Hospital in Sheridan, Mont. was the closest the group came to a consensus as a potentially good fit for Saratoga.

Sheridan has a population of 2,703 with the closest large hospital being 34 miles away. Both Faust and Haigh agreed the town "just felt like Saratoga" and were impressed with the smart design and features of the facility there.

The Ruby Valley Hospital is a 29,000 square foot facility that was completed in August, 2018 at a cost of $12 million.

The facility has five beds, a radiology room, a CT scanner room, an x-ray room, lab, physical therapy, a swing bed and ER care to go with their two observation rooms and two visiting specialist rooms.

The CAH has 76 employees including two full time physicians, 4 nurse practitioners and one PA.

The facility also has a psychiatrist once a week, a pediatric specialist once a week, a chiropractic specialist two days a week and always has an RN, a CNA, a paramedic and EMT on call.

The biggest positive seen from this facility was the centralized location of the nurse station. From that station the ER, pharmacy and in-patient rooms are visible which allows the nurses to keep tabs on everything.

Haigh related that John Semington, Ruby Valley's CEO, was very helpful during the group's tour offering suggestions like: Build your facility near to senior care centers, assisted living and the pharmacy for greater efficiency and customer satisfaction; Take advice from the community board; only build what you can afford; and what makes all of it work is staff.

Recruiting Incentive

Many of the CAHs visited noted that they had a much easier time recruiting staff including physicians and EMTs due to the newer facilities. The Columbus facility noted that every job added at the hospital resulted in one and a third jobs added to the community. The Sheridan facility had only five EMTs before their facility's completion but now has three 24/7 medics and 14 EMTs.

Wrapping Up

As the presentation came to an end Pesognelli encapsulated the thought process saying, "Probably the biggest takeaway is that probably up until now this just kind of sounded like a great idea for everyone to think about. You can actually see that very similar communities to what we have went through the same process. It was doable. All of them (CAHs visited) used USDA funding."

Pushing an Agenda?

While questions were taken during the trip presentation there was an abbreviated period for questions afterwards. During that period, since attaching the senior care center to Saratoga's possible CAH had been discussed, one audience member asked if we would be funding a way for a private company to make money off of the nursing home and clarified that she did not want a private firm driving the overall agenda.

Faust explained that the building would be owned by the community but that a management company would have to run the operation. Faust went on to say that the Saratoga Care Center was operating at a loss despite subsidies currently being received and that it would be "hard to see it continuing the way it is operating now long term."

Faust felt that being able to add the Medicare reimbursements that CAHs are eligible for would help keep the care center viable.

County Commissioner Sue Jones added that any management company chosen could be changed and it was not a permanent choice.

Putting On Ayers

Citing a previous engagement. HSPS member Teense Willford bid the crowd farewell but made sure that newly acquired Family Nurse Practitioner Ruby Ayers stood and was recognized before he left.

Ayers started at the Platte Valley Clinic at the beginning of the month and the Saratoga Sun expects to present an interview with her shortly.

Shortly thereafter Haigh wrapped the meeting up for the evening and reminded the attendees that it was important for as many people as possible to fill out the healthcare survey either by going online to http://www.plattevalleyehealthcare.org or stopping by one of the participating local merchants or town entities to pick up a self-addressed and stamped papers copy of the survey.