Kirby Hospital taking steps to serve Monticello long into future

Facility is taking steps to serve community long into the future

MONTICELLO – Not long ago, folks in Galena would bypass their own little hospital and travel to Dubuque, Iowa, for their medical care.

And with no surgery and no MRI in town, many of them had to.

"Now we're seeing that reversed," said Galena's Midwest Medical Center CEO Jeff Hill. "They're staying here for their care, for a lot of good reasons."

The No. 1 reason: Last December, the hospital moved out of its old building and into a modern new one on the outskirts of this historic town – a step Hill said already has helped recruit more doctors to the area and boost outpatient business.

Can a new hospital do the same good things for Monticello? Steve Tenhouse, CEO of Monticello's John and Mary E. Kirby Hospital, is confident it can.

"We're building for generations to come," he said.

In June, Kirby Hospital joined a handful of critical-access hospitals in the state that have launched building replacement projects, two of which already opened in Galena and Kewanee.

Federally designated critical access hospitals are 25-beds-or-fewer facilities that serve a largely aging and rural population.

Many of these small hospitals were in danger of closing until Uncle Sam stepped up in 1999 and began giving them a slightly higher-than-cost reimbursement for the care of their patients on Medicare and helping them (again, through Medicare) with their building costs.

Kirby Hospital is planning a $30 million new campus with a building twice the size of the current hospital.

Nobody expects the average inpatient volume – six a day – to increase with this new building, Tenhouse said. But with doctors now able to do so much more for patients on an outpatient basis, the inpatient census no longer tells the real story of how busy a hospital is.

"When people think of hospitals, they think of patients lying on beds," Tenhouse said. "But 80 percent of our volume is outpatient."

And conditions for those patients are less than ideal in a 35-year-old building that's out of room to expand.

Tenhouse said space at the hospital – which is landlocked on all four sides – has been stretched as far as it can to add a sleep lab and facilities for cataract surgery, chemotherapy, outpatient speech and occupational therapy and a larger physical therapy area – all in the last four years.

In recent years, Kirby Hospital also invested in its own CT scan equipment and would dearly love to have its own MRI – another large and essential diagnostic tool – but there is simply no space for it, Tenhouse said.

Patients must either wait on visits from a mobile MRI – which arrives on a semi-trailer truck that must back into the parking lot, squeezing around parked cars to reach a concrete pad – or they have to drive out of town for an MRI.

What else isn't there room for at Kirby?

Tenhouse said the hospital needs more employee and patient parking, a larger surgical suite that he hopes will help recruit a staff surgeon, more room for therapy services and more space for visiting specialists.

Other issues behind this rebuilding project:

– Today's inpatients want private rooms, and hospitals dealing with infection control and new privacy laws want badly to provide them.

Kirby Hospital is licensed for 16 beds, but all but two of its rooms are semi-private, "so we wind up not being able to use all our beds to provide patients the private rooms they want," Tenhouse said.

– Privacy is also an issue in the patient check-in area, where the hospital has to keep a TV going to help keep one patient from overhearing another's personal information.

– The old building is also difficult to heat and cool. And its electrical system was never designed for today's power-sucking medical equipment.

And even if there was room to add everything Kirby Hospital needs with an addition, Tenhouse said, there's still another major consideration: The hospital stands amid the stately old homes of Monticello, and adding more traffic and congestion to the neighborhood wouldn't be very neighborly.

"Our board wanted to preserve State Street, which is a beautiful area," he said.

A rebuilding boom

Several other critical-access hospitals in Illinois are also looking at rebuilding. And if you've ever wound up replacing a car after shelling out for lots of repairs on your old one, you can probably understand why, said Pat Schou, executive director of the Illinois Critical Access Hospital Network.

Constant repairs strain hospital budgets, they don't provide the extra space the hospitals need, and eventually executives weighing yet another addition and repair job learn from consultants that around $5 million or so more than they're considering spending will buy a whole new building, she said.

And here's how new buildings can add more health care services in a community: Doctors like new hospitals, so doctor recruitment gets a shot in the arm, Schou said.

Patients like new hospitals, too, she said, so ideally, economic development in the region also gets a boost.

It's too soon to know the economic impact of the new hospitals in Galena and Kewanee, but she pointed to a 2006 study of 24 critical-access hospitals in other states that have undergone replacement projects.

The study found the hospitals improved their patient volume, efficiency, clinical performance, profitability, work force recruitment/retention and doctor satisfaction.

What economic development professionals can tell you is employers like nice hospitals nearby.

William Price, executive director of the Kewanee Community Development Corp., said a nice hospital isn't the first thing a new company looking at your community wants to see, but it's definitely high on the list of secondary considerations.

Employers want a healthy work force, Price said, and "a new facility means a lot to an employer because it's pretty indicative of the care that's being provided."

Even when it was still under construction, Kewanee's new hospital had an impact on the economic development prospects he took by the building site, Price said.

Schou said hospitals pay for these replacement projects with a combination of fundraising and debt financing, but the federal government also lends a hand.

Tenhouse said Medicare reimburses critical-access hospitals for a share of their depreciation and interest costs for new construction, and the amount is tied to how many Medicare patients the hospital serves.

Currently, 60 percent of the patients served at Kirby Hospital are on Medicare, so Medicare is expected to pick up 60 percent of the depreciation and interest costs on the new building, Tenhouse said.

It's money that will help retire the debt that is planned to cover 75 percent of the building cost, he said, with the remaining quarter of the $30 million to be funded with cash reserves and fundraising.

Waiting in Monticello

Board chairman Steve Ayers said this new hospital wasn't a sudden decision.

The board has been studying the idea and working out the details since 2005, and wouldn't be moving ahead if the community didn't support it.

"We have done a lot of homework on this," he said.

But it's going to be at least a few more years before a new hospital can open.

The board is on the verge of choosing a piece of land, and once it's acquired, Kirby Hospital must undergo a review process before the Illinois Health Facilities Planning Board to prove the new building is needed.

If all goes according to plan, Tenhouse said, the new hospital could open by mid-2011.

For Ayers, the new building is the next logical step in providing the best health care for Piatt County. And he thinks the community is lucky to have this hospital.

"I like to say it's a jewel in Monticello's crown," he said.

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