Friday, December 31, 2010

Middle Park Medical Center by Kremmling Memorial: Middle Park Medical Center: Top 10 Questions Answered

Middle Park Medical Center by Kremmling Memorial: Middle Park Medical Center: Top 10 Questions Answered

Middle Park Medical Center: Questions Answered

The construction of the new medical center, scheduled to open early 2012 in Granby, has generated a lot of questions from the public.

Is the Grand County Rural Health Network building the new medical center?
A: Kremmling Memorial Hospital/Middle Park Medical Center took over the lead on the Middle Park Medical Center project in late 2007/early 2008. Kremmling Memorial Hospital District conducted the feasibility study and attained the financing. The project is based on principles and community feedback developed by the Network over the years, but the hospital is leading the project solely.

Why is it being built in Granby?
A: Granby is the demographic hub of the east side of Grand County. The land was also donated by Grand Ranch Holdings, LLC.



Why was the name, "Middle Park Medical Center" chosen?
A: We felt the name signified a more regional approach to healthcare. it also speaks our past where the hospital used to be called Middle Park Hospital. It helps tie in the entire region whether your coming from Fraser, Granby, Winter Park, Hot Sulphur Springs, Parshall or Kremmling. Part of the branding strategy is to say that we are not just Kremmling anymore, it is Middle Park.

We know that there are somewhere between 12,000-14,000 full-time, year-round residents in Grand County, so we know the market exists. The problem is the net out-migration of healthcare from those who have felt they couldn't get all of their healthcare needs met here in the county and as a result go down to the front range for services. With the development of Middle Park Medical Center in Granby, we believe people will be more apt to stay put and receive their healthcare services in the county.

We also know that roughly 80%-90% of all healthcare related services are utilized outside of the county. Between all of the primary care providers within the county, a good estimate is around $20M worth of healthcare services purchased within the county. So, if $20M is provided within the county and that amounts to only 10%-20% of the total healthcare dollars demanded, then that number extrapolates to a big number, possibly upwards of $200,000,000. Part of our forecasting model is based on those projections and our ability to retain a portion of that lost business.

how is the capital construction financed?

A: The Middle Park Medical Center project in Granby was financed with revenue bonds, backed by lease payments to the Middle Park Facilities Corporation. The District liability is limited to the lease.


Will the Kremmling Memorial Hospital District seek to expand its taxing district to include the rest of Grand County?

A: There are no plans to expand the tax district. This possibility was investigated in 2008. The board determined that it was not going to take it to the November, 2008 ballot for a variety of reason, including the general economy. There has been no talk of extending the boundaries since 2008. We feel that the money we will be receiving from operations is going to be sufficient to not only fund the debt on the new facility and grow and sustain on the east side of Grand County, but to also sustain and grow on the west side of the county.

Will the hospital in Kremmling close?

A: No, it will not close. We see that there is a sufficient size populations on the west side of the county to support the hospital. The services that we offer and the frequency of those services is going to change to meet the demand of the people on the west side. The configuration of the rooms, how the ER is set up, how surgery services are organized and how laboratory and radiology work with ED will be logical to how a facility should be operated in a rural setting. Our overall goal, hopefully in 3-5 years, is to secure additional financing to and build a facility on the west side of the county that people can be proud of. In the meantime, we are undergoing a beautification process which will include a face-lift to the nurses station, improvements to the patient financial services area and newer fixtures in the clinics and patient rooms.

Do you have questions about the Middle Park Medical Center? email me: eric@kmhd.cc

Wednesday, December 1, 2010

Flights at Kremmling Memorial Hospital

Kremmling Memorial Hospital District, soon to be doing business as, Middle Park Medical Center, Kremmling gets a variety of flights to major terciary hospitals in Denver. This is a collection of photos taken by Charlotte, KMHD employee.

full collection of photos can be seen here:

Saturday, November 13, 2010

Ground Breaking Ceremony Pictures
























































Thanks to all who attended our ground breaking ceremony! We're happy to share these pictures taken by Helen Sedlar of KMHD.





























Ground Breaking Ceremony a Success: Middle Park Medical Center Project offically launched!

Opening Speech Gave Appreciation, Reasoning and Goals
by Kent Whitmer, President of the Kremmling Memorial Hospital Board of Directors

[From his speech given at the groundbreaking ceremony on November 12, 2010]: Good after noon ladies and gentlmen and welcome to the groundbreaking ceremony for Middle Park Medical Center by Kremmling Memorial Hospital District.

The idea for this project has been germinating and building for a very long time. About 10 years ago, an organization known as the Grand County Rural Health Network was formed. The Network is a non-profit composed of concerned citizens and groups that truly care about Grand County's present and long-term health care needs. Kremmling Memorial Hospital District was a charter member and remains a member of the Grand County Rural Health Network.

At the time, studies were conducted by the Network to determine the present and long-term health care needs of Grand County ciitzens. Out of those studies, a number of things were determined:

1. First, it was determined that the county, in general, was and still is, severly deficient in available health care services.

2. As a result of this health care services deficiency, it was found that 90% of the people in Grand County go outside the county for their healthcare needs, which often means traveling more than 100 miles each way to meet those needs; not a good situation from a couple of perspectives: First, people need the availability of quality health care where they live, and second, Grand County needs those dollars spent on health care here in the county.

3. The recommendations from those studies said that a significant facility was most needed in a central location in the county, namely the Granby area.

The conclusions from these studies weren't earth shattering. The big question was who and how to accomplish the task. Many players and ideas were considered. It boiled down to finding the resources and someone to take the risk, and it needed to make economic sense to whoever was that risk-taker.

At the same time as the Network was sorting through this conundrum, IKMHD was struggling to determine a strategy for its own long-term survival and viability. KMHD realized it was not going to survive long term, even with tax dollars subsdidizing it, if it focused only on providing health care within its district.

With this in mind, about five years ago, KMHD purchased Timberline Family Practice, Dr. Rojec's family practice here in Granby. With that purchase it became appareent that it made a lot of sense for KMHD for its own well being, and for the well being of the community in gerneral, to take the lead and fill the health care void illuniated by the studies conducted by the Network.

KMHD began thinking hard about how to accomplish this goal. Over the last five years, that thought process has taken so many twists and turns that, frankly, it's been hard to keep up.

KMHD looked at a number of different possible sites in the Granby area, and different ways to finance the project. With each potential site or financing proposal, there seemed to be insurmountable hurdles and roadblocks and it seemed this project was never going to happen. Then the perfect storm happened.

Granby Ranch was gracious enough to donate the land; KMHD found a way to finance the project; the town of Granby was more than accommodating; and the economy is such that building costs are within our budget. Lightening struck and so did KMHD.

So, we're here today to celebrate the beginning of a total win-win for KMHD and the citizens of Grand County. And I'm here today to personally thank and acknowledge all of the people that cared enough about this project and have devoted endless time and energy toward making it happen. Thank you.

~Kent Whitmer, President of the Kremmling Memorial Hospital Board of Directors

Saturday, August 21, 2010

Special District Transparency Information for KMHD


Kremmling Memorial Hospital District believes that honest communications is the best way to develop trust. In addition to providing regular newspaper advertising, multiple websites, all social media outlets, public speaking events and the like, KMHD is compliant with reporting to the Special District Assocation. Please copy and paste the http address below to view.

Special District Transparency Information

Senate Bill 09-87 Compliance

Special District Association of Colorado Website


http://www.sdaco.org/transparency/view_userprofile.php?id=402

Free Initial Screening Mammogram


To the right: The advertisement for sponsorship in the Winter Park Susan Coen Cancer Walk. Kremmling Memorial Hospital has been proud to sponsor this important event for over 5 years.

Kremmling Memorial Hospital
Radiology Department

FREE initial screening Mammogram Month of your 40th Birthday

Early Detection Is Key


KMHD’s Mammography Department is accredited with American College of Radiology and FDA Mammography accreditation program

We also offer 20% discount for uninsured patients for all services. Payment required at time of services


970 – 724 3181 TO SCHEDULE YOUR MAMMOGRAPHY

Pharmacy Bag Advertising Promotes Important Message




Mark Paulsen, Board Certified Family Practice Physician, Chief of Staff at Kremmling Memorial Hospital and primary physician at Timberline Family Practice in Granby delivers an important message to patient picking up their prescriptions at City Market Pharmacy, Granby, Colorado:

"Make sure you tell your doctor about everything you are taking. This includes prescriptions and over-the-counter medicines and supplements, such as vitamins and herbs."

Cardiac Risk Assesment Kiosk Now at Kremlmling Mercantile Pharmacy

 
Pictured with donated kiosk is Amy Bubar, MPH Project Coordinator CPC Community Health
Posted by Picasa

An explanation from the CDC website regading the use of this kiosk:

The Colorado Prevention Center recently donated a Cardiac Risk Assessment kiosk to the Middle Park Medical Foundation. As a service to the public, the Foundation decided to house the kiosk at the Kremmling Mercantile, near the pharmacy. The intention is for people to be able to enter in information regarding their health and have a print out of recommended plans for better cardiac health. The Middle Park Medical Foundation is grateful to the CPC for their donation.

In Public settings: Health-e-Solutions is an interactive cardiovascular disease risk assessment delivered via a touchscreen computer kiosk. In less than 3 minutes, individuals obtain a customized heart disease risk score and recommendations to reduce their risk. Through a statewide grant, kiosks have been placed at health fairs, physician offices and public settings.

In 2006 and 2007, CPC collaborated with 9Health Fair and Colorado’s Area Health Education Centers (AHEC) to bring kiosks to 65 health fairs around the state. Nearly 9000 individuals completed the cardiovascular risk assessment at the fairs. In a pilot program, individuals found to be at high risk for heart disease received follow-up phone calls from our CPC nurse to motivate entry into treatment and to enhance their understanding of heart disease risk.

Middle Park Facilities Corporation Health Facilities Revenue Bonds

The following is more information on the structure of the Middle Park Medical Facilities Corporatoin and the Health Facilities Revenue Bond structure. It is taken from an email from counsel. The intention here is to provide greater understanding of how this project will be financed. This is perhaps the most thorough and clearest explanations of the structure:

"The Site Lease between the District and Middle Park Facilities Corporation, the 63-20 issuer (the "Corporation") creates the leasehold interest of the Corporation in the Poject site. Fee ownership of the site will remain in the District, subject to the Site Lease and the Lease.

The Lease is also entered into between the District and the Corporation. It proves for the District to lease back the site and the improvements, (i.e., the clinic to be constructed on the site) from the Corporation, subject to annual appropriation of rental payments by the District's Board of Directors. when all of the scheduled rental payments under the Lease have been made, the Site Lease and the Corporation's interest in the Project terminate and the District own the Project free and clear of the financing documents.

The Agreement to Construct appoints the District to construct the Project for the Corporation, with money provided by the Corporation from the Bond transaction. It has the effect of putting the District in charge of construction and the submission of construction fund requisitions to the Trustee. The Corporation would not be expected to have any ongoing role in construction.

the Indenture is entered into between the Corporation and the Trustee. It provides the issuance of the Bonds by the Corporation. In the Indenture, the Corporation assigns and mortgages its interest in the Site Lease and the Lease to the Trustee as security for the Bonds. The effect of this assignment is that the District will make rental payments directly to the Trustee, rather than to the Corporation. the Indenture does not mortgage the District's underlying fee ownership in the site ... "

Monday, August 9, 2010

What is KMHD doing to drive business to it's current services? (Because ALL Questions Deserve Answers)

KMHD welcomes questions from the community. As a matter of fact, the Board of Directors encourages not only the questions, but is happy to provide answers as best as possible.

Some have asked if the hospital will remain in Kremmling after the development of the proposed Middle Park Medical Center in Granby (target: 2012) and how administration and the board believe it is possible. (See previously published blog post: "Hospital Will Remain In Kremmling"

Others have asked about our financial reporting and we have provided links to DOLA's records as well as info to link them to SDA's records (Special District Association.

Many questions from the public have been addressed on YouTube-published interviews: see "Middle Park Medical Center" on YouTube.

One of the more recent questions asked about what we are doing currently to sustain the current operations at Kremmling Memorial Hospital in Kremmling. Thank you for the question--below is the email answer:

From: "Eric Murray"
To: PERSON WHO ASKED QUESTION VIA EMAIL
Sent: Tuesday, August 3, 2010 11:36:04 AM
Subject: Thank you for your question. I am happy to summarize our marketing strategy ...



Good Morning NAME OF PERSON ASKING QUESTION,

Thank you for your questions! It's true, Ide Bailey (audit firm) did recommend strong marketing strategy to both retain and gain business at the hospital currently.



"Tell people about your services and then ask them to 'utilize us'!"


I appreciate your questions as to what is being done marketing wise. I believe the board of directors is very pro-active in promotion of our current services as part of the overall strategy of the sustainment and growth of KMHD, here in Kremmling. I've got a mult-faceted answer for your question regarding what we are doing, what we've done and what we intend to do to drive revenue to hospital and clinic services. Although it is not a complete answer, (that would take hours and perhaps and sit-down conversation which I'd be happy to arrange if you like), I hope it gives you confidence in our marketing/publicity strategy and methods. It's important to note that we are always up for suggestions and continually strive for improvement.

First, each October I present a marketing report, reviewing the previous years successes, and a marketing plan and budget for approval by the board of directors. Depending on resources available and the projected ROI (Return On Investment) on any one campaign, the directors work with me to adjust accordingly. Sometimes these efforts are adjusting during the course of a year, as situations and budgets dictate, but most often we accomplish the marketing objectives with valuable return.

I've attached an example of the 2009 press strategy report, which proved quite successful--all factors considered. Keeping in mind that $0, zero dollars were spent on this particular proven method. Although I have published over #300 newspaper columns, (at zero cost), the downsizing of the paper and the discontinuation of my previous, long-running, weekly newspaper column, has driven us to another effective method, a more direct method --our eNewsletter (see more explanation below). [If you would like to be on this eNewsletter mailing list, please send your request to: eric@kmhd.cc ]

Besides outreach to area and Denver hospitals, to capture referrals from case managers, [an inter-agency communications approach that informs case managers of our services and allows them to better plan the entire plan of care for a patient who might have received treatment in a Denver facilty] (plan also attached) we also sponsors several local events including blood drives, the Winter Park Cancer Walk, Alzheimer's, five wishes, bike rodeos, helmet safety programs, Emergency services outreach education, inviting the public to the April Meet the Candidates, and much more.
We hold a regular Mammography promotion along with the WP Cancer Walk Sponsorship: FREE INITIAL SCREENING MAMMOGRAM FOR ANY WOMAN ON THE SAME MONTH AS HER 40th birthday. Additionally we offer regular Quick Lab specials which we offer at even lower prices than what are offered at the 9HealthFair. In addition to sponsoring the 9HealthFair itself, KMHD offers FREE 9HEALTHFAIR RESULTS CLINIC, which allows individuals to come in to the hospital for free and sit with a trained staff member to go over results obtained from any one of the three county-wide healthfairs. We've also had several mini-health fairs. We have held clinic open houses, ED open houses, Flight for Life Open Houses. Oops, I nearly forgot to mention the FREE SPORTS PHYSICALS we offer at both schools! (Yes, we believe that these outreach efforts to ingratiate us with the community and promote the use of our family practice clinics and hospital services).

Our eNewsletter is yet another low-cost, regular advertising, promotion and information source. The first was in January to present. The email list grows on a daily basis as people sign up to be recipients. (Still getting this word out).

As you may have noticed, we are delving deep in to our social media, as this is proving to be a more valuable method every year (not to mention is it very low-cost and provides greater depth and detail) i.e.; YouTube, Blogger, FaceBook--not only to inform about Middle Park Medical Center, but to also explain about the service line currently offered in Kremmling. This highly effective media--also nearly free (but time intensive). Please click below to watch extensive video footage and read blogs on specific subjects. We also welcome viewer/reader comments and questions. We believe healthy dialog is important.

Facebook: MiddleParkMedicalCenter (must be a member)
Blogger: http://middleparkmedicalcenter.blogspot.com
YouTube: type in MPMedicalCenter (here you will see video footage of mostly MPMC Project questions including: "6320 Board Appointed", "GaryCenturaStrategicPlan", Explanation of MOUpartnership" "Cole white explains MPMC" "ColeWhite Addresses Risk" "Meet Cindy Callihan" "Meet KMHD's New Physical Therapy Manager" and more.
Then of course there are our two websites, (new and improved site is in development)
www.kremmlinghospital.org
www.middleparkmedicalcenter.com

www.skyhidailynews.com has an archive of around #300 newspaper columns promoting of hospital services, clinic services, doctor biographies and interviews, healthfair and other event announcements and write-ups, etc., as well as providing informative health tips from our practitioners/clinicians. Plus we are online members so we are able to reply to comments left under each press release or each newspaper column. We get some great feedback from this local newspaper site!

Another part of what I do in my Public Relations role, is to have daily conversations with people who contact me via my readily advertised phone number. Whether town council members, county government, EMS, Denver hospitals, regional hospitals, tax payer groups such as the Friends of the Lower Blue, visitors, contractors, or physicians or other medical professionals seeking to know more for possible employment--I speak to several people every day.

Still another part of the board-directives for public relations and awareness of services is our local, inter-agency efforts of communications. As the certified Public Information Officer, with training from the Office of Emergency Management, KMHD is represented in emergency "tests" or mock drills of mass-casualty situations. These trainings and drills get us to communicate with agencies such as fire, police, EMS, coroner's office and more. This is believed to be an important part of our awareness campaign and outreach.

I am also President of The Western Colorado HealthCare Communicators. This is a regional organization made up of Marketing, Public Relations and Public Information Officers in hospitals such as Aspen, Valley View, Yampa Valley Medical Center, Craig and Grand Junction. Regular meetings with this group keeps KMHD up on the latest and most effective methods of advertising, promotion and public relations. It also is a networking resource to share ideas that work, from billing suggestions to survey programs. As a matter of fact, this group has expressed to me for years that they cannot believe how much press we get for being such a small hospital.

Another thing we do on a regular basis, is to address both the Summit and Grand County Commissioners between 2-3 times per year, in person. We update the commissioners in person, usually regarding our Service Plan, Elections, plans for expansion or development, current financial etc.

Another part of the marketing and public relations plan at KMHD is to be as transparent as possible. We are compliant with the Special Districts Association as well as DOLA. But we realize that we can be more transparent and are continually emphasizing improvement in this area.

In development: We are looking in to having a new billing service which would allow for a newsletter to be printed on back of each invoice. This may update hundreds of more people each month about our services or about any number of different topics regarding the hospital. We are also consider a sign on the property where we intend to build the replacement hospital in Kremmling one day. Lastly, we are developing a new, enhanced website to supplement our two current websites that each provide a certain degree of information for the public.

We are also offering the next several board meetings, open to the public, at the Kremmling Chamber of Commerce. For one, we think it is more comfortable; lighting, seating, temperature and for two, it accommodates more audience members.

, thank you again for your question. Although this email and attachments do not completely address all we are doing, I hope it serves to give you a broad perspective.

The Kremmling Memorial Hospital Board of Directors would like everyone to know, that each and every one of them believes that the hospital must remain in Kremmling, now and forever. They believe they are incorporating strategies that will ensure the sustainment and growth of healthcare services county-wide including those offered in Kremmling.

Thank you, again for your questions. We know that KMHD is your hospital and that questions and comments provide us with valuable feedback that we utilize and appreciate!

Sincerely,
Eric Murray
970-409-9017

Sunday, July 25, 2010

Memorandum of Understanding between KMHD and Centura Health



A Memorandum of Understanding was signed on July 22, 2010 at the Kremmling Memorial Hospital Board of Director's meeting. Gary Campbell, CEO of Centura Health and Bill Widener, CEO of Kremmling Memorial Hospital signed the MOU.

President of the Board of Directors, Kent Whitmer explained: "An MOU is a recitation of what each party's understanding are as we go forward and try to ultimately reach and affiliation, a partnership or some sort of arrangment where we are working together [on delivering healthcare in Granby, in particular regarding the proposed Middle Park Medical Center Project by Kremmling Memorial Hospital District] ... "

"Kremmling Memorial Hospital is staying"

Although a recent poll from Sky Hi Daily News shows that the vast majority of responders believe the proposed Middle Park Medical Center Project by Kremmling Memorial Hospital is needed and a good idea,
( http://apps.skyhidailynews.com/utils/polling/poll_results.php?poll_ident=1978a )certain minority (and appreciated) perception exists that the hospital in Kremmling might one day disappear because of the measured decision to also provide services on the east side of Grand County with the proposed Middle Park Medical Center.

There are several reason why the hospital in Kremmling must remain in Kremmling and even more reasons why the propossed Middle Park Medical Center will actually provide the resources necessary to not only provide services to the Kremmling neighbors to the east side of the county, but to also provide the means to continue and grow the hospital services on the west side of Grand County. The full intention of everyone involved in the planning process is to have both the hospital in Kremmling AND the Middle Park Medical Center in Granby.

First of all, it is important to note that the hospital is needed in Kremmling. Sure, there are not a lot of people on the west side, (approximately 80% of the entire county population resides on the eastern portion), but the residents and guests of the Kremmling area still need Emergency care and always will. (We also figure that a significant population within the Kremmling area can be re-captured, as we develop and enhance services).

In order to provide emergency care, a hospital must have radiology services, laboratory services and a clinic. From there it's just a simple step up to provide patient beds. (Further more, it is believed that improved billing systems, electronic medical records, the continuation of retaining extraordinary medical providers and other medical professionals, will actually prove to recapture locals who had stopped patronizing KMHD years ago for one reason or another. Yes, we are working hard to give those people legitimate reason to come back and utilize their hospital. In fact, we have testimonials galore of people who believe they or their family have received very high levels of care, with unusually compassionate and caring providers and high-technology).

Additionally, the hospital simply CAN NOT move and discontinue current services in Kremmling and maintain it's business model. That drastic and unimaginable move would require CMS (Centers for Medicare and Medicaid) approval--a vital part of KMHD's revenue matrix. (see: http://www.cms.gov/) Doing so would also alter another revenue stream, so vital to the financial operations of the hospital--Critical Access designation. (see: http://www.coruralhealth.org/programs/cah/coloradocahs.htm )
So, by vitue of maintaining two revenue channels, the mere thought of building the propossed Middle Park Medical Center Project in Granby and discontinuing services in Kremmling automatically becomes counter-intuitive.

KMHD CEO reminds all citizens and guests of Grand County, that "the hospital is not leaving Kremmling now, while we are developing the proposed Middle Park Medical Center in Granby, nor after." Every effort and intention of the administration and the community elected board of directions is directed towards a county-wide, community oriented view of managing and providing sustainable and viable healthcare systems.

The hospital board believes we are approaching this project very thoroughly. (Keep in mind this has been in the works for well over 12 years!) No stone has gone unturned. Diligence has been applied in every single aspect, from feasibility studies to community feedback forums and more. It is this well-thought-out approach, with a community wide perspective that seeks to retain healthcare services locally and keep them managed and controlled locally, that fuels the drive and energy of so many professionals and volunteers, government officials and citizens engaging in thoughtful discussion and forward-moving actions to provide healthcare.

"Why Neenan?"

KMHD is working with The Neenan Company, selected as the design/build team by Request For Proposal, (RFP) through the Grand County Rural Health Network, (which included Kremmling Memorial Hospital representation and board approval). As required, the RFP was published in late 2005. Dozens of firms competed. After much investigation, Neenan was chosen. Out of 27 Critical Access Hospitals, [KMHD is a Critical Access Hospital], Neenan has been involved with several including: Lamar, Trinidad, Burlington, Brush, Holyoke, Del Norte and Ledville—about 20% of Colorado’s Critical Access Hospitals. (For a definition of Critical Access Hospitals and a map of Colorado Critical Access Hospitals, visit: http://www.coruralhealth.org/programs/cah/coloradocahs.htm ) Further confidence in Neenan came from their experience in the county with the school projects they had been involved with.

MARKET ANALYSIS

June 2010

The last market study/financial feasibility report was done in 2007, based on census data from 2000. The economy had also changed significantly since the 2007 report, requiring an update. 2010 census projections were estimated and considered in the report.

Stroudwater Associates, (www.stroudwaterassociates.com), was chosen by the hospital board of directors as the independent research firm to re-assess the project and provide the new results. This report has been completed and is now in the process of being audited by an independent accounting firm.

Murray says the results of the report are favorable to a smaller facility than planned in 2007 and that it is economically viable to go forward with the project.

PROJECT UPDATE: JUNE 9, 2010

Kremmling, Colorado – Kremmling Memorial Hospital District is continuing to make progress on the proposed Middle Park Medical Center project, with the goal of providing a variety of needed healthcare services in East Grand County sometime in 2012.

Recent developments of the project include the process of acquiring capital financing, auditing recently completed third-party market-analysis, to determine viable service lines, (those services that have enough market demand to warrant investment and expect reasonable return), and analyzing financial feasibility studies; ultimately for the approval of the financing company, which will be the true launching point for this significant community-oriented and initiated, long–term healthcare endeavor.

On July 22nd, a MOU (Memorandom of Understanding) was signed by the President of Centura Health and the KMHD CEO. The agreement, although not legally binding, is thought to be a significant development and a positive sign of colaboration between Centura and KMHD.

“We are hopeful to join forces with Centura in order to bring the highest quality of care possible and the most requested and financially reasonable services to Grand County,” noted Jeff Miller, VP of the KMHD Board of Directors.

While important components of developing such an important capital project are moving along favorably, hospital leaders are responsibly quick to clarify that anything can happen between now and financing approval and that any number of variables might affect the development and the time-line of the project.

“We have a team of exceptional professionals working on this project and a dedicated board of directors who want to see both the survival of the hospital in Kremmling and the development of services in East Grand. We are confident and very motivated to make this project work,” Bill Widener, CEO of KMHD, said. “We are seeing a growing number of supporters who are realizing that what we are pursuing is most likely the best possible option for the development and sustainment of community –managed and operated healthcare.”

Widener kindly asked that Grand County residents, second-home owners and guest, “Be patient with us and know we are working hard every day to sustain current operations and to bring more and better healthcare to all of Grand County.”

“We’re getting closer to bringing these community healthcare needs to fruition and the future looks bright,” and he adds, “but remember that there are no guarantees on anything; in life, in business, in healthcare, (especially in this day and age),” he confessed.

“We need the support and encouragement of both communities [East and West Grand] to make this happen – to make healthcare accessible for everybody; their guests and their neighbors, whether that neighbor be to the east or to the west of them.”

Progress has also been made with land planning and building design. Recent preliminary adjustments have brought the square footage to approximately 37,000. In the plans developing around in as early as the late 90’s, propelled by such admirable and valuable efforts of numerous Grand County Commissioners, various municipality planners, town counselors, the Grand County Rural Health Network founders and successors, chambers of commerce, business owners and so many more, it was closer to 42,000 square feet.

Regardless of the immediate proposed square feet, there is room for growth and development as community medical need dictates. After all, the desire for Kremmling Memorial Hospital is to not only provide for as many needs as reasonable and possible now, but to plan for the care of future generations, who will live, work and/or play here.

Sunday, July 18, 2010

A History & Explanation of Kremmling Memorial Tax Revenues


A history and explanation of Kremmling Memorial Hospital District tax revenues
By Cole White, Chief Financial Officer, KMHD
June 9, 2010


Kremmling Memorial Hospital District (KMHD) has been operating at its current location at 214 South Fourth Street for more than 60 years. During that time, KMHD has seen major changes in both its physical structure and in the scope of services provided at the hospital. Major additions to the hospital and clinic were added throughout the last half a century, the last of which occurred in 1974. Early changes to KMHD were financed in part through Hill-Burton funds, which were appropriated for hospital reconstruction after World War II, and in part through generous community donations.

To assist the hospital in financing the 1974 expansion and the level of care available to residents of Middle Park, a mill-levy was introduced in the early 70s and a taxing district was formed. These funds have helped the hospital pay for not only the addition which was completed in 1974, but also with funding day-to-day operations, equipment purchases, physician recruitment, and countless other organizational improvements.

Throughout the last 45 years, the healthcare landscape has changed dramatically. Costs associated with providing healthcare have grown at double-digit inflation levels, while reimbursement from federal and state programs, commercial insurance companies, and private payers have grown at a much slower pace.

For many small hospitals this has spelled out their demise. Hundreds of rural hospitals failed during the 80’s and 90’s as a result of these changes. Most of the rural hospitals that were able to survive did so with both the support of the State and Federal government through enhanced reimbursement methodology and the unwavering support and patronage of their community. One such survivor is KMHD.

Kremmling Memorial Hospital District qualified as a Critical Access hospital in 2003. Essentially, this means that because of the hospital’s remote location and the need for 24/7 emergency care, the Federal Government allows the hospital to receive cost-based reimbursement from Medicare. This reimbursement is intended to improve financial performance and thereby reduce hospital closures. Among many requirements, the hospital must be 15 miles from another hospital in mountainous terrain. Critical access hospital must maintain a maximum of 25 acute care inpatient beds. They must also provide 24-hour emergency services, with medical staff on-site or on-call and available in 30 minutes or less.

Throughout the years, Kremmling and Grand County has seen numerous changes. Many traditional industries have come and gone, family ranches have all but disappeared, and much of what supports the area is now heavily reliant on tourism and the service industry. What hasn’t changed though is the community’s continued commitment to KMHD and the support of high quality, affordable healthcare for the people of our region.

A major change that occurred at the State level that directly impacted healthcare in our region was the passing of the Tax Payers Bill of Rights (TABOR) in 1992. TABOR, while effective at limiting the growth of government and reducing taxes, inhibited many parts of government from effectively planning for future changes and addressing the needs of the people they serve.

In compliance with the TABOR regulations, KMHD has lowered their approved mill-levy over the years, (originally approved at 11%), effectively providing residents of the district with lower taxes. While the hospital is currently approved to collect approximately 7 mills, KMHD provides a credit back to the district of 2.5 mills, reducing the hospital’s levy to 4.5 mills, in order to cap our growth at the TABOR approved inflation rate. In comparison, the district supplied the hospital with $928,021 in 1991 and $852,180 in 2010.

Each year the taxing district contributes a portion of funding necessary to support healthcare services in Grand and Summit Counties. Throughout the years these funds have contributed a smaller and smaller portion of the resources necessary to support operations.

In 1991, tax revenue accounted for approximately 65% of the revenue necessary to keep the hospital operating. By 2009, the district supplied KMHD with less than 10% of the hospital’s total budget. Moreover, if the time value of money is factored, and expenses are adjusted for inflation, the tax revenue collected today means significantly less to the bottom line now than it did when the levy was approved in 1973. While TABOR has had a large impact in this area, this shift can also be attributed to the rising cost of healthcare, a factor not considered in TABOR legislation.

Changes taking place at both the State and Federal level have the potential to impact healthcare in both positive and negative ways. But after the dust settles in Denver and Washington D.C., it is ultimately left up to the people of our region to define what services and level of care are available here in our own back yard. Without the continued support of the District and the patronage of residents and guests of Middle Park, KMHD would struggle to acquire the resources necessary to provide a full range of services to the people of our region.

Simple zip code analysis of patient origin shows that the majority of hospital revenue is generated from services utilized by people from East Grand County; this includes those Timberline Family Practice patient patrons. (Timberline Family Practice located in Granby was purchased by KMHD in 2006). While approximately 10% of the hospital’s revenue is derived from the mill, nearly 60% of its revenue is derived from the utilization of services from people originating outside of the tax district, i.e.: east of Kremmling. That leaves approximately 30% of revenue derived from the utilization of services from people within the district. Simply put, if you minus the ever-decreasing revenue attained from taxes, and the patient base from East Grand, the hospital would not survive on the business from the population within its district alone.

A recently completed management feasibility market study indicates that the development of services in Granby to be provided by the proposed Middle Park Medical Center will be self-sustaining and contribute to the overall, bottom line of KMHD.
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Location for Middle Park Medical Center


The proposed Middle Park Medical Center will be located on the Southwest corner of the Granby Park development area, off of US Hwy 40, in the same area where the land was donated to the Town of Granby for the proposed Rec Center. It is between the Fraser River and the Ten Mile Creek. East side of the road. In other words, if you go to the old Grand Mountain Bank and Little Tree Hotel, go across the Hwy and it is in the flat meadow.

“1000 Granby Park Drive South”

Welcome to the Middle Park Medical Center Project by Kremmling Memorial Hospital District


Dear Friends:

Thank you for your interest in the new, state-of-the-art, Middle Park Medical Center. This blog has been created to keep you informed on our progress.

We are honored to have this tremendous opportunity to build a healthcare center central to the Fraser Valley, Grand Lake and Granby.

The demanded for healthcare services on the east side of Grand County is something citizens, second home owners and guests have been asking for years. We are happy to spearhead this development and answer the call to provide many health care services. We believe that Grand County needs and deserves this availability and quality of care.

With nearly 60 years experience in providing healthcare in Grand County we have a rich history of quality care and a specific understanding of what this county needs. In good times or bad, we have always maintained a strong commitment to Grand County. Our current board of directors, as well as directors of the past, has worked hard to get this lofty project this far with full-intentions of making it a reality.

When we open our doors and welcome patients in 2012, (knock on wood!) Middle Park Medical Center in Granby will provide many of the medical services enjoyed by people on the west side of the county at Kremmling Memorial Hospital.

We have seen an outpouring of support from federal, county and local government, local businesses, organizations and individuals. We especially thank Granby Ranch for their belief in local healthcare, proven by their generous donation of land. With other supporters joining our mission to provide improved access to care every day, we are sure to make Middle Park Medical Center part of your life in Grand County.

We would especially like to remind those who rely on the services currently provided at Kremmling Memorial Hospital in Kremmling: We not only intend on staying right here in Kremmling, but also continue to improve and develop services.

Lastly, we'd like to invite you to attend the open board of directors meetings. These are held the final Thursday of every month at 5:30 p.m.

Sincerely,

Bill Widener, CEO