Carson-Tahoe Hospital will have a new home. The hospital's Board of Trustees wasted no time Saturday, voting unanimously to approve a plan for a new regional medical facility on a new site.
The old hospital's location, surrounded by homes and away from major thoroughfares, is difficult for ambulances and other emergency vehicles to access and officials contend that lack of accessibility is costing the hospital part of its market share.
The purchase of land necessary to expand past the super block and the cost of retrofitting to accommodate new technologies were just a few of the factors influencing officials' decision to move.
"The hospital is landlocked and business will suffer, not only in the immediate future, but in the long term," said Trustee Paul Saucedo. "It's just not appropriate to stayEThe medical staff wants a regional medical center. They're saying, 'let's get down the road and get this done.'
"Some of the older medical staff , those who are entrenched, aren't as excited as the younger ones. But who's going to be running this organization in 10 years? I urge the board to take a hard look at the numbers," Saucedo said."
Chief executive officer Steve Smith conceded that some physicians strongly oppose the move, but the price tag to stay is just too high and expansion is critical to the hospital's success. In past weeks, all beds have been occupied and more are needed, he added.
Smith said it would be impossible to remain at the present location and still attain the organization's goal of becoming a regional facility. The old hospital could be remodeled, but the concept of a regional medical center would have to be dropped and the price tag would be too high.
The property from Division Street to Highway 395 would have to be acquired at a cost of about $29 million, according to Smith. Officials would also have to consider acquiring the Andersen field property in addition to expanding into the historic district, which poses more problems.
"I would like your action so we can bring back the best proposal as soon as possible for this body to review," he said.
Trustee Jo Saulisberry argued against the move, saying that Washoe Medical Center is landlocked, but over the years the organization bought up most of the surrounding real estate. No one knows how much of the market share could be captured should the hospital move and many physicians and locals are comfortable with the hospital's current location.
"We need to look carefully at what we've got, " Saulisberry said. "A lot of community effort has gone into this building. People feel like they own the place and we need their support."
Officials said the money for the project could come from a number of sources, including capital partners and bonded indebtedness. Ideally, a number of factors, including the identification of a site, its cost and the cost of a new facility would come together at about the same time.
Kaufman Hall consultant Jody Hill-Mischel estimated the hospital could shoulder between $30 million and $50 million in bonded indebtedness and still maintain its "A" bond rating, allegedly related to an organization's financial stability.
She said the figure is a rough estimate at this point and many factors could come into play. Interest rates, amortization rates, the quality of the plans submitted and how they will affect the new medical center's future profitability all affect the amount of bonded indebtedness the hospital can assume.
Carson City will most likely serve as the issuer of these bonds, a common practice according to Hill-Mischel.
"Typically, cities located near the hospital act as a conduit to facilitate bonding," she said. "It helps the community and there is no liability for the city."
Before the hospital can issue bonds it must acquire its tax exempt status from the Internal Revenue Service. Application for that status was submitted last week and it will take three to six months before the process is complete, moving plans for completion of conveyance of the hospital from the city past its September target date, into October.