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Welcome!
Strategic Development and Facility Master Planning
Board Approved in October 2010
Hot Springs County Memorial Hospital
Research the Market
Evaluate Demographic Trends
Assess Hospital Performance
Identify Opportunities
What is our context?
Phase 1: Awareness
What works well and what does not?
Phase 1: Awareness
Site Analysis
Departmental Assessment
Clinical Flow and Adjacencies
Code Compliance
Phase 1: Awareness What do the stakeholders
want?
Patient Perceptions
Unmet Needs
Community Support
Phase 1: Awareness How much can we afford?
Capital Capacity and Resources
Current and Historic Financial Performance
Plan Within Our Means
Realistically Achievable
Financing Options
Phase 2: Actionable OutcomesWhat would it look like?
Explore Multiple Options:
• Renovation
• Expansion
• Replacement
The Deliverable
Assessment of our market and how we are doing in it
Understanding of our current facility situation, areas of exposure and for improvement
Awareness of our community’s unmet needs
Evaluation of what we can realistically afford
A financially and market appropriate facility response
Hot Springs Washakie West Park Wyoming Med Ctr
Powell Billings St. Vincent Other Hospi-tals
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
68.9%
1.9%
9.4%
15.9%
0.0%
3.9%
64.1%
2.2%
8.5%11.1%
0.5%4.3% 4.3%
5.0%
60.0%
3.5%
8.0%
15.6%
0.2%
5.5%4.4%
2.7%
55.4%
2.7%
8.5%
16.7%
0.3%
4.6% 5.1%6.6%
Market Share of Inpatient Discharges Hot Springs Co Memorial Hospital - Primary Service Area
FY 2010 FY 2011 FY 2012 FY 2013
Current Facility Issues
Current building in place since 1959 (Utilized Hill Burton funds) No private showers or bath Imaging equipment spread throughout facility Significant lack of efficiency Very ‘inpatient’centered “Upstairs/Downstairs” services Maintenance tunnel infrastructure Heating and cooling challenges HIPAA Recruitment and retention
• 55,000-60,000 square feet in size. • More focus on outpatient services• Two operating rooms• One endoscopy room• Emergency room with six treatment spaces• An expanded/consolidated imaging area• 14 medical/surgical patient rooms
• Two obstetrical rooms• Pharmacy• Laboratory• Specialty clinic• Cardiopulmonary space• Cardiac rehab space• Dietary area
New Facility
ALL ON ONE FLOOR
Cost Estimate Remodeling costs were equivalent to roughly
80% of full replacement.
The projected budget for this project as of July 2012 was $27,786,689
This figure does NOT include financing costs or required construction period interest
Assumes 17-month construction duration, and this was presented with an anticipated construction start date of Spring 2013
Financial Affordability
County bonding capacity as of 2013 valuation is $2. 35 million
County bonding with a district would result in bonding capacity of up to $5 million
A 3-mill levy based on 2013 valuation), would generate $684,000
A 1% optional sales tax (based on sales from 2013) will result in gross proceeds of $333,153.76
Financial Affordability
Financial Affordability Hospital District
Consistent funding mechanism• Provides improved strategic and long-term planning capabilities• Large equipment purchases• Bonds• Cash flow• Anticipated decrease in Medicare and Medicaid reimbursement• Continued use, and potential increase in charity care and
bad debt service
(FY 2013 HSCMH provided more than $1, 423,447 in bad debt and charity care-$513,762 FY14 as of Feb)
Financial Affordability
Spreads support across all county taxpayers
Currently 16 hospitals in Wyoming are considered Critical Access Hospitals (CAH)
11 of these hospitals are district-funded facilities, including West Park Hospital, Powell Valley Healthcare, North Big Horn Hospital and South Big Horn Hospital
Improved support from State Land and Investment Board because we are taking steps to tax ourselves
Improved bonding capacity
Provides for ongoing operational needs
Questions?Additional Information Needs?