Council, County Board Hear FCH Update

Published on Monday, 12 July 2010 20:38
Written by thenebraskasigna


Signal Editor

Fillmore County Hospital (FCH) CEO Paul Utemark appeared at the June 21 Geneva City Council meeting to give the council an update on what steps led up to the hospital's governing board deciding to pursue a replacement hospital solution to the current and ongoing needs at FCH. Utemark asked the Fillmore County Board meeting the next day to place the replacement hospital proposition to a vote of the people in a Special Election on August 10.

Utemark began his power-point presentation on June 21 stating that he was asked by Geneva City Administrator Kyle Svec to come talk to the city council. He told the group that the FCH has been a critical-access hospital (CAH) for 20 years. He said this is a very special designation, since being a CAH allows for a higher medicare-reimbursement rate for FCH.

He also said that FCH is continuing to experience significant growth in its outpatient services.

"A lot of today's medicine is preventative," said Utemark, who began as CEO at FCH on July 1 of 2008.

He noted the FCH was built in 1961 with the south wing being added in 1970. A significant renovation project took place five years ago at the hospital. The long-term area at the hospital was closed in 2002. In 2003, several doctors bought out the clinic at the hospital. FCH currently leases the medical clinic to several doctors.

"The dynamics of the hospital have really changed," Utemark said. "We currently have about 23 specialists coming to Geneva each month. They like coming to Geneva and feel this is a good part of their practice."

Utemark noted that FCH performs between 1,900 and 2,300 treatments each month.

He went on to tell the city council that concerns are beginning to arise in the functionality of the hospital, which is now nearly 50 years old. HVAC and other problems are popping up in earnest. He said he and the FCH Governing Board feel now is a good time to look at the longterm goals of the hospital.

"Our facility has never been designed and renovated to house outpatient services, and this is a very large concern," Utemark said.

He also noted that the bathrooms in the individual hospital rooms are not ADA compliant and the ER facilities at FCH make it nearly impossible to serve two patients at the same time.

"We thought it was time to start with a clean slate and identify the best solutions," Utemark said.

Options looked at by the governing board included: doing nothing; limited remodeling; significant renovation; building a replacement facility; or opting for pursuing a private company to build a new hospital in the community.

After conferring with experts in the medical field, the governing board opted to pursue the replacement hospital option.

"To make a long story short, the board decided to pick a company and then pick a chassis of what type replacement hospital that we would like," Utemark said. "That's where we're at."

He said that a replacement hospital could cost as much as $18 million fully equipped. About 70 percent of this cost would come from a USDA Rural Development Guaranteed Loan (through the American Recovery and Reinvestment Act) with the additional 30 percent coming from Revenue Bonds. He told the city council that the blended cost for the debt would be about 3 percent over 20 years.

Utemark went on to say that because FCH is a county-owned hospital, the replacement hospital proposition has to go to a vote of the people.

"Ultimately, it will be a vote of the people that decides this," he said.

There are also limited concerns about meeting USDA loan application deadlines.

Utemark said that current plans call for the medical clinic to operate at its current location. He also said that the governing board is interested in purchasing a three-block square area near the U.S. Highway 81 Bypass, on which to build the new facility. A part of the City Well Field area would also be a part of the new location.

"We have always had the ability to install other wells there," Geneva Mayor Rod Norrie said. "And, it has always been the idea of part of it being made available for some type of economic development."

When asked about renovation ideas, Utemark noted that renovation is much more costly than building new.

"We have found out that there are a lot of hurdles when looking at renovating in a limited area," Utemark said.

A member of the audience asked the two-year administrator what happens if the voters elect to not approve the replacement hospital proposal.

"We'll have to go back to the governing board and the county board and explore other options," Utemark said.

Polls for the August 10 Special Election will be open from 8 a.m. until 8 p.m.

"What things boil down to right now is what the people say on August 10," Utemark said.

On June 22, Utemark attended the Fillmore County Board of Supervisors meeting. After his presentation, the supervisors voted unanimously to have Fillmore County Clerk Amy Nelson prepare the necessary paperwork to have the replacement hospital proposal on a Special Election ballot on August 10.

Utemark again went over the process that led the FCH Governing Board to take the replacement hospital proposition to a vote.

"Basically, 70 percent of our business is being performed in areas that weren't built to do them in," Utemark said. "You have a very solid hospital here. With this, there will be many more possibilities.

"There comes a time that you need to look at the long term and decide which way to go."

Utemark said that revenue projections made by outside companies indicate that hospital revenue should be significant to cover the bond payments for the replacement hospital. The language on the August 10 ballot indicates that county taxpayers will be liable for bond payments if FCH is unable to make the payments.

"It's low risk, but it's not no risk," Utemark said.

He also said he feels confident that USDA officials would not make a loan where they thought the loan would have a good chance of failing. He also noted that the USDA has an excellent history of working with people to adjust terms of loans if they are needed in the future.

Utemark said he and the FCH Governing Board feel that having the residents of the county vote on the proposition is a positive.

"The consensus is this is something that needs to go to the vote of the public," Utemark said. "I'd be remiss if I didn't give due diligence in looking into this option. We're trying to be on the ball here and present something that can be done. We're not reaching out further than we can here."

Utemark told the county board that he will be attending several community-group meetings to get the word out on the proposition. He also said seven town-hall meetings have been scheduled.

Town hall meetings that remain to take place include: Thursday, July 15, at the Fairmont Senior Center; Monday, July 26, at the Grafton Community Center; Tuesday, July 27, at the Geneva State Bank-Shickley branch; and on Thursday, July 29, at the Milligan Legion Hall.

Members of the FCH Governing Board are Dick Nelson, Annette Marget, Lucille Capek, Deb Hoarty and Howard Johnson.

The current FCH contains 38,000 square feet. Current plans for the replacement hospital indicate the new facility would contain 47,000 square feet.