Out of space: hospital discusses expansion


Staff Writer

The Upper San Juan Health Service District (USJHSD) Board discussed the district’s need for expansion during their regular monthly meeting Tuesday night.

Out of space

Mark Floyd, vice chairman of the board and part of the campus planning committee, presented development plans for an expanded hospital and clinic.

The first part of putting together a plan for expansion was updating the district’s demographic data through a market study by Turning Point Healthcare Advisors. The updated data was then used to assess current community needs, to make projections for future needs and to incorporate those projections into a strategic plan.

The biggest concern for the district right now is that, frankly, they are out of space.

Floyd stated during the meeting that the planning committee’s work has been, “about solving problems. And the first and foremost problem was the lack of space and the lack of usable space in the clinic itself — and that’s an immediate and pressing issue which we need to solve.”

Floyd informed that the community’s growth warrants bringing in more specialists to work with patients; those specialists are going to need space to work, Floyd told the board.

In addition to needing specialist space, Floyd said the hospital will need to expand its surgical, lab and imaging capacities in the next 10 years in order to continue providing quality health care to the community.


To help broaden the understanding of the need for district expansion, Claire Bradshaw, director of marketing and development for the district, presented a series of figures and percents based upon the newly update demographic data.

Bradshaw was seeking board input during her presentation, as she and her team will soon be reaching out to the community for support on the project.

Some of the figures Bradshaw presented include the following:

• There were 15,438 clinic visits in 2013, up 309 percent since the clinic’s opening in 2010.

• Inpatient admissions last year were 245, a 136-percent increase since 2009.

• Radiology has experienced a 91-percent growth since 2009, with 4,434 procedures performed last year.

Bradshaw was also able to provide the board with statistics about Archuleta County, ranking it 32nd out of 59 counties for overall health in Colorado. The leading causes of death, in order, for Archuleta County are cancer, heart disease, accidents and suicide.

Bradshaw was also able to report on the economic health of the community, ranking Archuleta County 41st out of 59 economically for the state, with 27 percent of children living in poverty, compared to the 18-percent state average.

Bradshaw labeled the USJHSD as a “trusted source to address these challenges for our community.”

While Bradshaw and the board recognized that the hospital district is not equipped to solve economic disparities in the community, they did recognize that the district plays a key role in overall community health and is a significant economic contributor.

In the six years it has been open, “Pagosa Springs Medical Center has become more than a healthcare provider,” Bradshaw presented.

PSMC was the second largest employer in the county in 2013, expanding from 50 to 175 employees from 2007-2013. PSMC estimates that by 2015, it will have over 200 employees and an $11.1 million projected payroll.

Bradshaw’s report states, “We have become a force for civic good and a significant economic engine.”

Less than 10 percent of the district’s support came from taxes in 2013, down from 30 percent in 2008, Bradshaw reported, and “every healthcare dollar spent locally recycles through the community one and a half times.”

Bradshaw and CEO Brad Cochennet expressed their confidence in the hospital district and its capabilities, but stated that in order to continue to serve the community in a responsible and quality way, expansion needs to happen soon.

Bradshaw reported that the demographic projections reveal that by the year 2025, there will be a community need for “Eleven primary care physicians, General cardiology, ENT (ear, nose, and throat), Urology, A second operating room, Urgent care/fast track emergency care, Additional blood draw stations Expanded imaging and diagnostics.”

Bradshaw and her team will present their findings to the community in a series of small forums beginning May 12, with the largest forum for the general public scheduled to be held May 21. The general public forum, open to anyone interested in attending, will be held Wednesday, May 21, from 6-7:30 p.m. at the community center.

The new plan

With the evident need for expansion, the board previously approved Boulder Associates and GE Johnson to develop a building design and cost estimate for an expansion plan.

Nick Rehnberg, an architect with Boulder Associates, attended the board meeting Tuesday and gave a multimedia presentation, including a virtual exterior tour, on the proposed expansion project.

According to Rehnberg, the plan is currently budgeted at roughly $16 million, which includes the costs for “building construction, ... site improvements, utilities, fees that might be paid to the city or the state, design costs for engineering, architecture IT costs to equip the building.”

Rehnberg said the figure also includes furnishing the hospital and even budgets for art to decorate the walls.

The new building plan would expand the clinic, provide specialist space, expand areas for surgery and diagnostic imaging, create one entry for the hospital and clinic to increase accessibility and create a more efficient environment for providers and several other changes.

“We feel comfortable that things are covered,” Rehnberg told the board, adding that the goal will now be to push costs down as much as possible.

Rehnberg and Cochennet did point out, however, that one significant element not included in the $16 million budget is the need for a $1.5 million MRI.

Cochennet added that there may also be other pieces of necessary technology, or other key items unknown at this time, not included in the estimated budget.

Cochennet and his team are currently working to find $20 million dollars worth of funding for the project, with the additional $5 million in funding requests going towards necessary technology purchases and / or other unforeseen expenses.

The team has already been actively seeking funds for the expansion and recently returned from a funding campaign trip in Texas where they met with several potential donors.

“We were well received, welcomed and accepted,”Cochennet said of the trip.

Cochennet reported that the highlight of the Texas trip was that everyone they spoke with seemed interested in becoming part of the district’s project.

Several times Cochennet mentioned that potential and current donors have told him that they feel the district has “proven itself” as a quality health care establishment and they are eager to support the district’s efforts.

“We’re seen as an unusual hospital story,” he told the board, “a ‘Cinderella Story’ it was described, and that’s exciting for them to join.”

Overall, Cochennet’s report was optimistic about finding and securing funds, but he recognized that there is still a lot of work ahead.

While the figures and plans presented Tuesday night were purely informational, plans are expected to be finalized in the coming months after the board, community, staff and donors have had a chance to ask questions and give their input.