Com­mu­nity ser­vice

Lo­cal fundrais­ing—in­clud­ing a gift to the tune of $1 mil­lion from Dolly Par­ton—as well as a large in­vest­ment from the par­ent health sys­tem help build a new hos­pi­tal in ru­ral Ten­nessee town

Modern Healthcare - - Special Report - Jes­sica Zig­mond

Af­ter his wife, Cherie, was di­ag­nosed with brain can­cer in 2003, Bryan Atch­ley, mayor of Se­vierville, Tenn., be­gan the rou­tine of driv­ing 45 min­utes, one way, five days each week, to 485-bed Uni­ver­sity of Ten­nessee Med­i­cal Cen­ter in Knoxville so Cherie could re­ceive ra­di­a­tion treat­ments.

The need for high-qual­ity on­col­ogy ser­vices in the ru­ral, east­ern Ten­nessee town and sur­round­ing area served as the cat­a­lyst for the con­struc­tion of Covenant Health Sys­tem’s Le­Conte Med­i­cal Cen­ter, a 79-bed, full-ser­vice re­place­ment hos­pi­tal for the sys­tem’s for­mer Fort San­ders Se­vier Med­i­cal Cen­ter that opened in Fe­bru­ary.

On the same 70-acre cam­pus as Le­Conte— across the street from the old hos­pi­tal—is the Thomp­son Can­cer Sur­vival Cen­ter. Atch­ley, also a mem­ber of the state’s Health Ser­vices and Devel­op­ment Agency, re­cused him­self from the cer­tifi­cate-of-need pro­ceed­ings when the time came to ap­prove a re­place­ment hos­pi­tal in the re­gion. As he ex­plains, there was no op­po­si­tion to build­ing Le­Conte, which is named af­ter one of the high­est peaks of the Great Smoky Moun­tains and is vis­i­ble from the hos­pi­tal.

“There’s the old feel­ing that to get good health­care, you had to go to Knoxville,” Atch­ley says. “We’re try­ing to erase that.”

The story be­hind the need for and de­velop- ment of Le­Conte Med­i­cal Cen­ter in Se­vierville re­flects some of the most trou­bling prob­lems— and po­ten­tial so­lu­tions—fac­ing many ru­ral com­mu­nity hos­pi­tals to­day: the need for im­proved fa­cil­i­ties with ad­vanced in­for­ma­tion technology sys­tems dur­ing a time when ac­cess to cap­i­tal is dif­fi­cult, and part­ner­ship looks like an at­trac­tive means of sur­vival.

“Out of the roughly 175 hos­pi­tals in the state, about 140 of them are al­ready tied into some kind of sys­tem-work­ing ar­range­ment,” ei­ther as sub­sidiaries or af­fil­i­a­tions with na­tional groups, says Bob Gift, who works in Chat­tanooga, Tenn., as di­rec­tor of the op­er­a­tions and im­prove­ment ser­vices line for IMA Con­sult­ing, a Chadds Ford, Pa.-based health­care fi­nance and man­age­ment firm.

Gift says that aside from crit­i­cal-ac­cess hos­pi­tals, the two dozen free-stand­ing fa­cil­i­ties in Ten­nessee tend to be smaller, ru­ral fa­cil­i­ties. “I think the thing that we will con­tinue to see is the trend to­ward con­sol­i­da­tion of hos­pi­tals in some type of work­ing ar­range­ment,” Gift says. “They have to find ways to se­cure rev­enue and then find ways to man­age their ex­penses on an on­go­ing ba­sis.”

De­vel­op­ing strate­gies

In out­lin­ing some “sur­vival strate­gies” for ru­ral hos­pi­tals, Gift says fa­cil­i­ties need to eval­u­ate their re­sources. “Is it a rel­a­tively new fa­cil­ity, or is the hos­pi­tal an ag­ing plant that re­quires a sig­nif­i­cant amount of cap­i­tal in­fu­sion?” he says. “The ma­jor con­sid­er­a­tion is the avail­abil­ity of med­i­cal-cap­i­tal equip­ment,” such as suf­fi­cient tech­nolo­gies, he adds. “If they need cap­i­tal in­fu­sion, maybe you’re look­ing for some sort of strate­gic part­ner to in­fuse that.”

Cap­i­tal is one of the six ma­jor ar­eas of con­cern for Amer­ica’s small com­mu­nity hos­pi­tals that was iden­ti­fied in the first part of a three­part se­ries ti­tled, Sur­viv­ing the Storm: Tu­mul­tuous Times for Amer­ica’s Small Com­mu­nity Hos­pi­tals, a re­port funded by Siemens Fi­nan­cial Ser­vices and re­leased this month. The

Covenant Health Sys­tem in­vested $115 mil­lion in the new Le­Conte Med­i­cal Cen­ter, lo­cated on

a 70-acre site in Se­vierville, Tenn.

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