They argued over nouns and pronouns and phrases, but little discussion preceded a decision to turn Carson-Tahoe Hospital into Carson-Tahoe Health Systems.
Carson City's 52-year-old public hospital will become a private entity by Oct. 1, barring any problems with filing for nonprofit status from the Internal Revenue Service, said Hospital Administrator Ed Epperson.
Carson City supervisors Thursday approved the transfer of the public hospital after months of discussions.
In a deal refined Thursday, the hospital, worth $85 million, will pay for itself with 25 years of guaranteed care for the poor and after that indigent care into perpetuity as long as the hospital makes a modest profit.
"Isn't that an oxymoron for a nonprofit?" Mayor Ray Masayko noted.
Even though the agreement between the city and hospital was all but signed, Masayko continued to hammer away at points of the deal relating to the sticky issue of care for the poor.
Counties are required to foot the medical care bill for those who cannot pay, and can only tax so much to provide for that care. Masayko insisted the agreement reflect that if the city ever has to write a check for indigent care, it will be a check within the city's legal obligation to pay.
Despite the few glitches, Masayko said the agreement shows the hospital "indicated by the terms of the agreement an interest and an intent to provide indigent care."
"There are details to protect the taxpayers," he said.
"Carson-Tahoe Health Systems, you are on your way. We wish you luck. We certainly know you'll do everything you can to proceed," Masayko said.
Tom Metcalf, chairman of the hospital Board of Trustees, said the decision was similar to separating church and state, creating a separation of taxpayers who were liable for the hospital and patients.
"Now we're separated, yet we still have local control to take care of patients," he said.
Hospital officials have argued local control is key to maintaining quality health care.
"Competitors will force so many changes," said supervisor and hospital trustee Pete Livermore. "Now we have a level playing field. We can compete directly with our competitors. Tomorrow is a new day for Carson-Tahoe Health Systems."
Carson resident Tom Hughes was one of only three residents who commented on the transfer. He said he didn't feel a nonprofit hospital would benefit patients or hospital employees and asked why the transfer couldn't have been put to a vote of the people.
"The newspaper said the hospital might be made a nonprofit tonight, that it would be debated," Hughes said. "The deal was done before we ever came into this room. I'm very disappointed."
Epperson said Thursday was "the realization of a long process."
"Now the real work begins," he said.
The hospital board will remain public until bonding to eliminate its current debt is completed and the IRS approves its nonprofit status. Epperson said the new board of directors will focus on the specific goals of the new private hospital.
The hospital will be directed by a board of directors, which will be comprised of the seven current trustees. It will also have a citizen's committee of 60 members. If you are interested in serving on the committee, call 885-4755 for information.