As a business, Douglas County's only "critical access" hospital finds itself in sound financial shape and in a position of growth.
But, like all businesses, Carson Valley Medical Center can only grow if there's real demand for the services it provides.
"It's important the community supports the hospital," said CEO Bill Hale. "We can only grow and add services if the need is there. My goal is to add as many quality services as we can ... It's not just quality of care, but quality of life."
On Friday, the Genoa resident and former CEO of University Medical Center of Southern Nevada was in his Gardnerville administrative office with Director of Marketing Shannon Albert, Director of Clinical Services Christine O'Farrell, Manager of Surgical Services Lisa McKinney and Chief of Staff Dr. Stephen Perry.
Together, the group discussed the not-for-profit hospital's ever-widening array of services, designed to keep people in the Valley.
"We're not doing open-heart surgery or neural surgery," said Perry. "For those, you still have to go north, but we're now offering what most people need in ICU capabilities that we didn't have two years ago."
Partners with Barton and Renown Health, Carson Valley Medical Center now has the capability to perform surgeries 24/7, with surgeons from Carson Surgical Group and Job's Peak General Surgery on call.
"Our surgical services have more than tripled in two years," McKinney said.
With two operating rooms and six recovery beds, the hospital can perform general, orthopedic and emergency surgeries, including appendectomies, hip replacements and colonoscopies.
"It's really great we can accommodate our patients," McKinney said. "They come in and are excited to see they can get those kinds of procedures in their own community."
With 23 beds for acute-care and intensive-care patients, the hospital now provides in-patient dialysis treatment and neurology consults via telemedicine, as well as the ability to electronically receive electrocardiogram results from emergency vehicles, which allow emergency room staffers to respond to patients immediately upon arrival.
Hospital leaders are also proud of their 24-hour ER and CareFlight station, their imaging department with its 64-slice CT scanner, and their outpatient infusion center for chemotherapy patients, among others.
"Our board has been visionary," said Hale. "If we're going to represent the community, it's important we have the doctors and tools to make the right diagnoses."
But, as Hale will tell you, investment and continued improvements don't come free.
"The recession has hit health care hard," he said. "We've seen a significant increase in charity care."
Hale said that in 2008, the hospital wrote off about $400,000 in losses from people who couldn't pay their bills. Last year, that number ballooned to $3 million.
O'Farrell said people are coming into the hospital much sicker, having deferred treatment for financial reasons.
"And even when doctors tell them they should stay, people are leaving because they can't afford to stay," O'Farrell said.
Hale said hospitals across the country are in crisis mode.
"The average hospital has a negative 5 percent operating margin right now," Hale said. "Fortunately, we made profit last year - not a big one, but we did."
Hale said Carson Valley Medical Center is running at a positive 3 percent operating margin.
"Most hospitals have laid off people," he said. "Hospitals can't operate long with a negative budget."
Three percent may see like a slim profit margin, but Perry said for a not-for-profit hospital, a 3-5 percent operating margin, with about six months of working capital, is ideal.
While other hospitals have laid off workers, Carson Valley Medical Center has continued to grow its 300-strong staff.
"It's been really great to work in a hospital in that financial situation," said McKinney. "We have enough resources, and our nurses can give the best care possible."
Hale said another reason the hospital has succeeded is due to its half-dozen partnering offices around the Valley, including Job's Peak Family Medicine in Minden and Topaz Ranch Medical Clinic in Topaz Ranch Estates.
"We've set up a primary care system that makes things cheaper by keeping patients healthy and out of the hospital rooms," Hale said.
And, when in the hospital, patient-centered care rules.
"We're trying to put patients first," Perry explained. "If I were in the hospital, how would I want to be treated?"
Hale said Carson Valley Medical Center is the first private hospital in Nevada to adopt the "Planetree" philosophy, a national movement advocating patient-centered care.
"There were a number of patient complaints about the televisions in our rooms," Hale said. "We replaced them with plasma TVs, and now the patients are raving. It was an easy fix. If that's the biggest complaint we have, then all is good ... as quality of care goes up, patient outcomes go up as a result."
While hospitals continue to face challenges in the future, largely in the form of physician shortages and rising medical costs, Hale remains confident about Carson Valley Medical Center.
In fact, the hospital's nonprofit foundation, formed in 2008, will be hosting its first gala in May, followed by an arts and wine festival in August, and a golf tournament in October.
"Our biggest challenge is in telling the community what we do here," Hale said. "People get confused about what we do. We're Carson Valley Medical Center, and we are here for the community."
For more information about the hospital, visit www.cvmchospital.org.