Hospital Construction Begins This Week

DAYTON—June has been a busy month for the Columbia County Health System administrators and commissioners, and it will come to a close with a groundbreaking ceremony for the hospital construction project on Thursday at 9 a.m.

Construction for the hospital enhancement and renovation project was a major topic of conversation at two hospital board meetings, held June 16 and 23.

CEO Shane McGuire said that construction was to begin Monday. He said that initial construction would not be about “bulldozers and dynamite,” but that work will begin on fencing, and installing temporary security measures.

At the June 16 meeting, McGuire said he met with the construction contractor Leonie & Keeble, Inc. earlier in June to discuss getting the projected cost for the project as close to within budget, at the outset, as was possible.

“The project came in around $127,000 over budget,” McGuire told the commissioners.

McGuire said they were able to save $117,000 from that figure by eliminating costs for such items as terminal cleans, which could be done by the hospital environmental services team.

McGuire also told the commissioners that if none of the 8% contingency from the $3.6 million project is used at the project halfway mark it could be released back into the project, and he hopes that the $36,000 over-run will be absorbed by the contingency.

Commissioner Wes Leid asked about project risks and McGuire said that he was told by the contractors that the ground work in Phase I for demolition at the physical therapy site, and for the physical therapy pool, carries the most risk, due to its proximity to the Touchet River. The need for possible asbestos abatement and digging next to the foundation of the building could also be problematic, he said.

“Firm numbers” for the project were presented in McGuire’s report at the hospital board meeting on June 23.

McGuire said the project contingency is $169,914, which is 5% of the Maximum Allowable Construction Cost (MACC). The project breakdown is:

MACC $3,299,295.00

Support Services: $ 229,550.00

General Conditions: $ 264,970.00

Contingency $ 98,979.00

GC/GM Fee: $ 183,758.00

Total contract: $4,076,552.00

McGuire said the hospital district is responsible for project elements including taxes, permitting, nurse call, telemetry, the Stroudwater report, and other elements, and are added to the above numbers for a total project budget of $5,511,324.85

Comments from the Department of Health construction review services were received the week of June 6, and McGuire said CCHS responded back the week of June 13.

Comments from Labor and Industries have been received and McGuire said they are working on a question L&I had about the generator.

McGuire said because the first part of the project carries minimal risk, it was decided to sign an Acknowledgment of Owner’s Risk, so that the project could begin.

“We have the Columbia County permit, and we are working through responses to the city,” McGuire said in his report.

A preconstruction meeting is scheduled for June 30, following the groundbreaking ceremony, and meetings will be held every month, thereafter, he said. Meanwhile, the general contractor is issuing sub-contract agreements to subcontractors, McGuire added.

The expected completion date for the project is October 2016, according to the contractor.

Cash Flow and Financial Statements

In his June 23 report to the commissioners McGuire said statistics are holding steady with hospital acute and swing bed census remaining at a full patient day higher.

Computerized Tomography and Magnetic Resonance Imaging were particularly strong in May, with seventeen MRI’s performed, said McGuire. “It only takes eight to break even, and they have good reimbursement”, he said.

McGuire said cash flow has been tight in June, and cash is being aggressively managed. He also said he talked to a representative at Banner Bank regarding short term loan strategies and was told there are options for municipal organizations, and he said he will be looking into that.

Outreach and business enhancement initiative

McGuire told the commissioners a draft agreement with Walla Walla General Hospital for cardiology and sonography services is in the works, and work is continuing on business models for a wound care program, supported by a hyperbaric chamber.

An audit firm specializing in Medicare Part A billing is currently reviewing the historical data to apply a Medicare Part A service model, he added.

Also, research continues on turning some Booker Rest Home beds into assisted living spaces, and McGuire said that a square-footage study has been done for the rooms.

McGuire told the commissioners that his team recently attended Kadlec Medical Center’s vendor fair to market the hospital swing bed program. As a result, two patients from KMC were received at Dayton General Hospital last week, he said.

Security

McGuire told the commissioners that hospitals are a huge target for firewall and network breaches, for phishing e-mail, encryptions, and problems with ransomware. He said that every year a security firm audits security in the hospital and in the clinics, and this was conducted recently.

The auditor was only stopped by due diligence at the Waitsburg Clinic, McGuire said. After a second visit, the auditor told McGuire,” I could have done anything.”

As a result, an in-service training session regarding security measures was conducted last week for department managers. Staff will also be trained in security measures, he said.

Construction workers, staff, vendors and visitors will be issued badges in the coming months, McGuire added. It is especially important to lock doors, and to secure the emergency room and acute care services during the remodel, he said.

Hospital commission chairman lobbies for 340B Prescription Plan

Chairman Bob Hutchens told the commissioners that he spoke to Congresswoman Cathy McMorris-Rogers about the need to retain Prescription Plan 340B, which is a federal plan to subsidize rural health care and that keeps drug prices lower for patients.

CEO McGuire added that “Big Pharma” is lobbying “hard” against it. “It is critical because it adds three quarters of a million dollars to our bottom line, this year,” he said.

Controller Tom Meyers agreed saying that the partnership with local pharmacy Elk Drug allows pharmaceuticals to be purchased for “pennies”.

Search for new CFO

The hospital district commissioners have begun taking steps to hire a new Chief Financial Officer to replace CFO Lee Holter, who resigned earlier in the month.

CEO McGuire said they will search for the right candidate for the position – someone who is well-versed in the financial goals for rural critical access hospitals.