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Four reasons why I’m Voting NO for the Lake Chelan Community Hospital Levy (Op-Ed)

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Those opposed to the Lake Chelan Community Hospital Levy have signs like this prominently displayed around the community. (Photo by GoLakeChelan.com)

Four Reasons Why I’m Voting NO for the Lake Chelan Community Hospital Levy

(Opinion – Editorial) By Ann Congdon, “Retain Our Hospital”

I am voting No for the Lake Chelan Community Hospital Levy because I believe that we can meet our community’s health care needs for the future in a responsible, affordable way. More specifically, here are four reasons I’m voting NO:

First, the new hospital proposal is NOT AFFORDABLE. Our hospital is already carrying over $7 million of existing debt (Washington State Audit Report) Over the past 5 years, Lake Chelan Community Hospital’s (LCCH) expenses have risen faster than revenues. The community is already supporting our hospital and EMS with an annual tax of over $1.4 million. The proposed hospital will require an additional $22.5 million of non-voted debt, in addition to the $20 million proposed hospital bond. All non-voted plus voted debt at current interest rates will total approximately $154 million over 35 years!

Second, there are better alternatives to explore. Our current hospital is structurally sound and can be renovated. Structurally sound hospitals are not abandoned; they are improved. Examples include Wenatchee, Leavenworth, Omak, Pasco and several hospitals in Seattle area. The total cost of expanding our current hospital will be substantially less than building a new facility. Our hospital consultant’s report indicates that our slightly enlarged, remodeled hospital can adequately meet our health care needs for the next 30 years. (LCCH website, “Facilities Master Plan”)

Resident Ann Congdon shares four reasons why she’s voting NO on the Lake Chelan Community Hospital Levy. (Photo by Jillian Foster)

Third, there is no proven need for a new hospital building. National trends show a decline in inpatient use of rural and critical access hospitals (CAH’s) Our hospital has experienced a 54% decline in daily acute care census (occupied beds per day), declining from 4.8 to 2.8 over the past 5 years. (Washington State Dept of Health)

Finally, rural and critical access hospitals are in trouble. In Washington state alone, 13 of 39 rural critical access hospitals are facing financial difficulties. In each of these cases, medical programs are being cut and widespread layoffs are occurring to the detriment of the health care in their communities. Our hospital requires large federal subsidies to meet cash flow projections. There is great uncertainty about future federal reimbursements due to the administration’s proposal to reduce federal subsidies. (Medicare, Medicaid)

I’m voting NO because I believe that we can meet our community’s health care needs together with sensible, well-vetted plans that are lean, flexible and transparent to all. Please join me in voting NO on Chelan Hospital Bond!

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35 Comments on Four reasons why I’m Voting NO for the Lake Chelan Community Hospital Levy (Op-Ed)

  1. Here are clear and concise reasons to vote down this grandiose nearly doubling of the size of our present hospital and all those who want to save our present hospital should take note and VOTE NO on the massive new debt. This is no time to take this tremendous risk with healthcare in the valley. We, the taxpayers of the Chelan Valley, could easily find ourselves with another Toyota Town Center debacle that will require the small population to bail out LCCH if we want to continue having a hospital. The employees of the hospital and real estate land speculators are giving these optimistic forecasts, that sound exactly like the hype that was put out in Quincy, Kennewick, and Grand Coulee hospitals before they went broke. With even the liberal Governor warning small hospitals to not go into debt it is time for all of us to insist that the Hospital Board sell off that land out at the dump and put their funding into taking care of the present hospital. It has plenty of life left in it, if properly maintained and upgraded. VOTE NO Save our present classic hospital

  2. 1. The hospital is affordable. The hospital is meeting its financial obligations and making a profit. And under no math whatsoever can a $44.5 million dollar hospital add up to $154 million dollars over the lifetime of the loan. Go to http://www.mortgagecalculator.org and plug in the numbers.
    2. The other alternatives HAVE been explored and they are more expensive. $56 million to remodel and still have the geographical constraints to expand vs. $44.5 million to build new on a piece of property that can be expanded on and be flexible for generations to come. Leavenworth did not abandon the old hospital, it is not, however being used for patient care.
    3. The need has been proven. We do not have private rooms, there are woefully inadequate OB rooms, the same can be said about the OR space and ER space. It is about patient care. The current building cannot adequately supply what medicine in 2017 demands.
    4. We are not one of the 12 or 13 critical access hospitals that are in trouble. We are one of the 26 or 27 that are doing well. Those communities that are doing poorly have no similarities to Chelan. This is just statistics out of context, and statistics out of context are just numbers. Medicaid has come under fire with the ACA talk, but Medicare has not. The Critical Access Hospital program is under Medicare. There is no uncertainty about Medicare.

    Most of all, this is about patients and healthcare. A new facility will be able to help with patient dignity, privacy and comfort. That is what this is really about. Investing in our community’s health and future.

  3. Five reasons that Ann Congdon should be voting YES for a NEW HOSPITAL.

    First of all, none of those opposed to the hospital project have zero to none expertise in the design, construction, financing, or managing a healthcare facility. Those opposed have little to no experience as providers of healthcare in a hospital setting. Whatever Ann’s expertise may be, it is not in healthcare. Her ignorance of healthcare is not equivalent to those in the community who do have this expertise.

    Second, the hospital proposal IS AFFORDABLE. Although the opponents have looked at the hospital’s financials they have misinterpreted them, despite many attempts to explain them and evidence to show that in fact the project is affordable. I’m waiting for the next signs going up that exclaim OMG! A Bazillion Gazillion Dollars. OMG! The hospital has worked with reputable accounting and hospital design companies and have done due diligence to craft a proposal that is both affordable and that will safeguard the future of healthcare in the valley. Will it cost money? Of course. Is it manageable – yes, it is – but it will take both the hospital and community pooling resources to make this happen. I see it as an investment in the future of my community, much like I saw buying a home as an investment in my own future.

    Third, five alternatives were explored with community focus groups last fall – the proposal on the ballot was the one that received overwhelming support of the groups that studied the various scenarios. Although opponents would suggest the building is sound, and it is true it is not in any danger of collapsing, it’s location and construction material make trying to remodel and renovate the most expensive option explored by the commission and the focus groups. Hospitals relocate more often than you would think. I worked in Pullman, the hospital there was completely landlocked on the campus and could not expand. It was relocated to a flat spacious piece of land to accommodate the immediate needs of a modern hospital but also to allow for future growth. That is the same scenario Chelan finds itself. Landlocked on a steep hill no cost effective means to expand. Confluence completely demolished a portion of their building to construct the tower. This was only possible because they had options to relocate patients during the disruption of construction. They also incurred considerable losses of revenue in the process. LCCH cannot shut down to remodel infrastructure as the opponents would like to assume. They wouldn’t understand this because they don’t know very much about hospitals or patient care activities. The naysayers have shown exactly zero evidence that trying to expand the current building on the current location is “substantially” less.

    LCCH’s current building cannot be just “expanded”. Any attempt to add square footage to the current footprint will trigger a number of required expensive and decidedly patient unfriendly circumstances. With added square footage, additional parking must also be added – by law. The community made it clear in 2006 that a parking garage was a waste of taxpayer funds. The costs of excavation plus renovate the building while still attempting to care for patients would be a nightmare. Nothing says healing quite like the sound of a diamond blade gnawing through concrete. Ann claimed that she had a team of experts coming to visit the hospital to do an assessment and that the naysayers would have numbers soon, so very soon. Well, two guys were found wandering the halls of the hospital. They did not have an appointment. They did not check in with reception. They were not dressed in a professional manner. When an employee asked if they needed help they stated they were in the building to assess it. They self-described as an architect and a builder. The people who could best help them were not available, so they were invited to make an appointment and return. They have not returned. My guess is that they took one look at the location and the concrete/steel construction and determined it was a fool’s errand. Point is, the naysayers have offered no credible design, no numbers, and no realistic planning to how a remodel will actually be achieved while still staying open to care for the community. The naysayers ‘Can Do’ attitude is more like the community “Can Do” with diminished expectations of healthcare in the valley. I’m not sure I want to trust the future of healthcare in my community to an anonymous group of naysayers with a farmer, a former school teacher and a guy who drove a boat as the public face while the rest stay in the shadows. Transparency? Not so much.

    Fourth, there is a true need for a modern building that can accommodate the advances in medical practice and the associated technology needed to support these activities. There is just not enough space available and gaining additional workspace is not a practical reality given the limitations of the building, location and regulatory requirements.

    Finally, although it may be true one-third of Critical Access Hospitals in the state are experiencing some financial difficulties, two-thirds of such hospitals are not. LCCH is one of the sound ones. Lake Chelan Community Hospital has a solid financial track record and has served the community for almost 70 years. Comparing LCCH to the situations the naysayers continually cite is just nonsense. LCCH and the Chelan Valley have very little in common with the circumstances of Quincy, Grand Coulee or the non-Critical Access Hospital in Kennewick. As recently stated – trying to compare LCCH to these scenarios is like comparing apples to bowling balls.

    I’m voting YES because I do have confidence that our community deserves quality healthcare with the capability of growing with the community in the future. The current plan has been vetted by objective experts in the field, the commissioners and members of our own community. LCCH committed to being transparent from inviting the community to tour the facility, sit down with those who can explain the financials, and explain why rebuilding is actually the most sensible and least risky option for preserving healthcare in our valley.

  4. LCCH receives more than 1.5 Million Dollars per year in tax subsidy from the taxpayers of Chelan, Manson, and Stehekin, and that is why they are saying solvent, in debt certainly, but still paying their bills. This shiny new hospital will put the hospital district into extreme danger of going broke, and all the grandiose rhetoric from the employees of the hospital and real estate land speculators will not change that FACT. Those of us who want to keep a viable hospital in Chelan just have to look up on the hill overlooking the city to see one, it just needs proper maintenance and care and it will outlast all of us. It was built to last, unlike a wooden structured mini mall type building out at the dump. There is terrific uncertainty in medicare, where the proponents come up with that fuzzy math denies every report on the internet, the nation is 19 Trillion dollars in debt. This is not time to endanger our present hospital with massive new debt, it is time to retrench and live within out means and save our present classic hospital on the hill and forget about sending out sick and injured to a hospital out at the dump. VOTE NO Let’s protect what we have

    • Holy Hyperbole Bill !!! I know I wake up every day and ask myself “how can I put our hospital district in extreme danger of going broke”. It’s right at the top of my “To Do” list. Your understanding of all things hospital is as fuzzy as your math. True Fact: The pyramids will outlast us all – but that doesn’t mean they’d serve as a functional hospital no matter how much maintenance or remodeling is done to them. I’m voting YES, with confidence, that the planning and due diligence done by the expert financial consultants, hospital architects, 4 out of 5 commissioners and administration, will ensure a successful outcome for LCCH and the community. Stay Calm and VOTE YES!!!!

  5. A rural hospital with a small patient base is never going to attract the high quality doctors that a big city hospital with more patients will attract, there just are not the amount of people to support the high cost of those type of doctors. It does not matter how shiny the hospital there just are not enough sick and injured people in the community, that is just reality. Instead we need a hospital that satisfies the needs of the community for emergency care and short term hospitalization. Elective and exotic procedures need to be handled in hospitals in the larger population centers that can afford the latest equipment and training that are required. LCCH is already doing “stabilize and ship” for those procedures that they are not equipped to handle and that is OK. We have a hospital that is well equipped for the needs of the community and a helicopter service in Brewster and a well financed EMT system to transport those that need further treatment, it does not require a brand new hospital. Let’s not take our present hospital into deep Massive debt when the present hospital is adequate and just needs proper maintenance and upgrade. VOTE NO, We have a great hospital lets not bulldoze it

    • Bill- none of the rural providers in Chelan or across the nation take offense that you wrote because we do not work in a big city we are not “high quality”.

      I agree with you that we need a hospital that satisfies the needs of the community for ER and hospitalization. It is just not in the building that we have. It is about patient privacy, infection control and dignity. I understand that those things are not important to you.

      Doing nothing is going to put the hospital in financial jeopardy. The code upgrades will eventually come due and they will have to be fixed ($12-$14 million) and they will not address patient privacy, infection control and dignity.

      You and Mike Sherer were Navy guys, the ship I was on when I served was the USS Nassau, commissioned in 1979 and decommissioned in 2011. Why? because it had served it’s useful life and could not be upgraded reasonably to accommodate the modern military. The same is true with the current building. It served Chelan well, but it is time to decommission it.

  6. 1. She can’t do math. Or she thinks the bond will be in excess of 10% interest. Sort of unheard of in the economy.
    2. Yeah, they have a remodel and addition plan for the current facility. it would cost $12 million than buying a new facility. After having to build a parking facility and second road to the facility that are not necessary to have at the new proposed hospital site.
    3. Inpatients space is only one issue. The amount of surgical and out patient procedures have more than doubled in the past 10 years. There is just not enough space in the current facility.
    4. Those failing rural hospitals have one of two things wrong with them, a shrinking population, or no financial support from the community. LCCH has neither of these problems.
    I vote Yes.

    • Luke, in the 1980’s when the fed was trying to get inflation under control, just as the fed is now raising rates, interest rates went to 18.5%. Just a couple of years ago here in the valley houses on the lake stayed on the market for years and the prices plummeted, and with it tax revenues. One hiccup from Boeing or Microsoft and the Chelan economy goes into recession, and a hospital with an average of 2.8 beds occupied will become a real burden. There is a fact that might change some minds about needing to nearly double the size of the present hospital, 250 employees up at LCCH for 2.8 beds, that is 89 people per bed, WOW. Try to run a business, even one subsidized at 1.5 million per year with that kind of overhead and you will quickly go very broke. Time to remember a little history here in the valley, boom and bust in tourist towns are a fact of life, and depending on some pollyanna vision promulgated by the real estate land speculators is foolish. VOTE NO we are lucky to have a building that can be maintained we don’t need to nearly double the size

      • Except Bill there are some teensy tiny hiccups with your stats. If you want to play the statistics game let’s make sure that we are comparing apples to apples.

        Confluence has 3527 employees and 198 beds: ~18 employees per bed
        LCCH has 250 employees and 25 beds: ~10 employees per bed.

        It appears that LCCH is a mean lean fighting machine compared to that bloated behemoth down in Wenatchee.

        In any given day LCCH provides services to about 200 inpatient and outpatients in the hospital and the clinic. Consider also that care is being delivered to patients at Columbia Valley Health Center as well, approximately 40-50 per day. That is 2.5% of our hospital district needing medical care on a typical day in Chelan. (Hospital district encompasses a population of about 10,000).

        The daily inpatient census at LCCH is not 2.8 it is ~ 17 inpatients per day. I should know – I’m working with all of them each day I am on duty. This inpatient number does not include all the other outpatient folks who come to the hospital for emergency care, outpatient surgery and diagnostic procedures, lab work, x-ray procedures, physical therapy, specialty clinics, behavioral health and other care needs. Some people come up just for the food in the cafeteria – it’s that good.

        You sure have a pessimistic view of Chelan’s prospects – why do you even stick around if all you see is doom and gloom on the horizon? Right now interest rates are at historic lows and rates don’t go up once a loan is secured. So what is the point of scaremongering about the 80s. How is that relevant to now? Remember 60,000,000 million years ago a meteor hit the Earth and all the dinosaurs died? That could happen again – guess we just give up.

      • Failing to learn from the past is a bad thing, almost as bad as failing to plan for the future.

        FYI, bond rates don’t change after they have been sold so it’s not like they will get more expensive as time goes on. If there is such a danger of the economy collapsing in the Chelan valley to the point where citizens can no longer pay property taxes and their medical bills, we have worse problems than a financially strapped hospital.
        The bed occupancy rate is way higher than the number you are suggesting, that is just for one category of patients.. Also, The primary revenues of the hospital is not inpatient care. It is much more important that they have space for out patient care, that is where the money is generated.
        Apparently we are all teetering on the brink of disaster. I didn’t know. I guess I should have a doom and gloom outlook of the future and be afraid of paying new taxes or anything else new for that matter. Because you never know, any second now it could all be over. But in the most likely scenario, the world doesn’t all fall apart, people will wonder why we didn’t do the responsible thing and build a new facility rather than waste money on an old and out dated one in a terrible location.

  7. Bill – your statements represent a completely uneducated opinion and baseless speculation. What credentials do you possess that make you an authority on what is needed for healthcare providers to effectively and efficiently do their work? Or what patients require and expect when receiving care? We already have high quality doctors living and practicing medicine in our small town. What they need are the proper tools to attract them and keep them. Where’s your “Can Do” attitude Bill? All I hear from you and the naysayers is that the Chelan Valley “Can Do” with diminished expectations of quality healthcare right here at home. Why is that Bill? Is that increase of ~$23/mo in your taxes so personally onerous to that you are unwilling to support this project that supports one of the main economic drivers in the community? Remember a rising tide lifts all boats . Vote YES!

  8. First, I’m appalled that a public and elected official can have such an uninformed view of the issues affecting our community. I really hope everyone remembers this when Ann comes up for re-election. She hasn’t really studied the issues, or apparently been able to comprehend them because her entire op-ed is full of lies or pieces of data taken out of context to lead to an erroneous conclusion. Not a good skill for someone who is a leader with the PUD.

    Second, does everyone know that the majority of the people on the “no” side have a significant amount of local property? Like, >$2,000,000 worth? I wonder if that’s the real reason they want to shut down a new hospital, they just don’t want the tax hit to their estates?

    A few facts:
    1. There is a desperate need for more space at the hospital. Every dept is maxed out on space and can’t respond to any more demand. The clinic sees 2-5 new patients establishing care daily. There is a growing population, the majority of which is >65 yrs old, and they are the biggest users of healthcare services.
    2. Alternative plans have been created by experts and then vetted by the community. The community chose the new build as the best use of resources. The commissioners are following through on that community input.
    3. The new build IS affordable. And furthermore, the taxpayers are being asked for $0.38 per $1,000 of assessed value of property. That’s it. That’s all. We’re talking about 4% of your annual tax bill. It’ll be slightly more than you pay for the library. So, let’s keep things in perspective. All this back and forth over 4% of your tax bill?!?
    4. The financials at our hospital have been stable, even improved since Kevin Abel came on board as CEO in 2010, but we won’t be able to keep them that way in the current (but very old, outdated) facility. As demand goes up and there is no capacity to increase service to meet that demand, wait times will get longer and longer. Providers will likely leave the area, creating even longer wait times and likely cut backs in services. And every year that building gets older and more out of date. It can’t be renovated cheaply. It’s a cement box.

    Our community has different healthcare needs than it had in 1972. Medicine has changed. Technology has changed. The population has changed. Expectations have changed. We need a hospital that can accommodate those changes. The current facility just can’t do that. Be informed. http://www.chelanhospitaltruths.com or http://www.newhospitalnow.com Ask them questions. Know the truth. Then vote YES with the facts on your side. Vote yes with confidence.

    • Same old argument that has three times been defeated at the ballot box and is heading for defeat again. When will the commissioners realize that the voters do not want to put this valley into massive debt to nearly double the size of the hospital while their patient bed count is declining and 12 out of 39 CAH hospitals in the state are on life support. Correct on the population and needs have changed, but not in the way described, transportation is improved between Chelan and Wenatchee, and Confluence health is now the preferred provider for any elective care. What we need and have is a good emergency hospital, capable of delivering babies, and stabilizing and shipping anything extensive on to bigger better funded, staffed, and equipped hospitals throughout the state. Building this white elephant has the potential to break the bank here in Chelan and is a foolish and unnecessary use of tax money. Lets take care of what we have and forget nearly doubling the size of our hospital out at the dumpsite. VOTE NO take care of what we have, let’s not risk it all on a bad investment

    • Chelanhealth’s whomever they are, attack on Ann Condon is a classic attack on the messenger not the message in an anonymous post. While Ms. Condon is an elected official of the PUD, she is also a landowner and long term resident of Lake Chelan, and she put her name on the op-ed, and did not hide behind some anonymous posting. Her service with PUD has been well documented and she has been easily reelected to that post. All of her statements in the OpEd were subtitled from whence
      they were drawn from and have been vetted thoroughly by local experts in the fields mentioned. Three times previously the LCCH board has tried to push this onerous debt on the landowners, renters, and citizens of Chelan and have been turned down, and when they lose again we should expect a mass resignation of this board and fresh blood with new ideas to take over. We need the taxpayer/citizens to read the OpEd closely and see that the Facts are clear. LCCH needs to rein in their proliferate spending, get control of their out of control management costs and maintain their present structure. Forgetting nearly doubling the size of the hospital and getting back down to doing the job that the taxpayers subsidize them for, which is emergency care. VOTE NO, this time they MAY get the message

  9. ALL of us with any memory remember the 2008 real estate crash here in the valley when homes dropped 40% from their high value and subsequent taxes were reduced, the lake front was full of houses for sale and remained that way for a couple of years. Many of us remember when mortgage interest rates exceeded 10%, and a quick look at the Federal Reserve shows interest rates rising for the first time in a number of years and house sale subsequently slowing down. So lets stop with the “pollyanna” picture, Chelan is famous for downturns that are tied closely to the economy of Seattle. Ann can certainly do math and the math tells us that expanding a hospital that is down to and average of 2.8 beds per day occupied and declining, will not possibly need expansion to nearly twice the size. Lets not let the employees at the hospital, the real estate land speculators, and the janitorial staff dictate the health care future of the valley. It is time to be conservative with our hospital, be glad that we have a hospital and take care of what we have with proper maintenance and upgrades. VOTE NO on this folly, now is not the time to take on this massive debt

    • The average census of the hospital is not 2.8. In fact there were 18 admitted patients today, which doesn’t include those admitted for day surgery, seen in the Emergency Room, those who received x-rays, had lab work or physical therapy done as outpatients. Opponents of the hospital are providing their readers a very inaccurate picture of what a day in the life of LCCH really looks like. The average daily census of patients in beds, overnight, is between 15-17. The building has been maintained and is up to life and safety standards or the doors would have been shut a long time ago. What Bill tries to conflate are remodels of the infrastructure embedded in concrete walls VS the day to day maintenance and upkeep of the building. Remodeling the building’s infrastrusture embedded within that concrete and steel structure and the cost and disruption that would result is what is at issue. Cost and disruption that would not result in the additional space needed for patient care activities and comfort.

      Who better to advise the community on the needs of 21st century healthcare in our valley than those who are the experts in this field. It is quite disheartening to see Bill continually denigrate the LCCH staff with his negative comments and derogatory insinuations. What credentials does he bring to the table to authoritatively proclaim what he believes our community needs for health care? Is he not dictating to all of us what he, and his mostly anonymous committee, think is sufficient healthcare in the community?

      The big problem with a lot of the information being put forward by the naysayers is that it is inaccurate, misleading because they’ve left out important bits and pieces of the whole story or they are just plain guessing because they don’t understand or are unable to interpret correctly what they reading in the various audits, reports, spreadsheets in the context of healthcare. Or worse, they are just plain making stuff up to demonize the commissioners, administration, staff and other professionals who have been involved in proposal. This is unfair to LCCH and unfair to the community. This is why I urge you all to get clarification of your concerns from people who have the expertise in healthcare in our community. Vote YES.

  10. The myth that a shiny new 25 bed hospital at the dump is going to attract new doctors is exactly that a myth. Doctors average $225,000 in college loans when they leave medical school and specialists more, do you really think that they can afford to come to a small rural hospital with an average of 2.28 beds filled per day. Shiny and new as a new hospital will be, a doctor will have to really hustle just to make their monthly payments, and Chelan does not have the population base to generate that kind of income. This is just one of the myths that LCCH has been promulgating in order to borrow 20 million dollars from the community, there are plenty more accounting gimmicks that don’t show the 7 million dollars of debt they have currently, the meager profit that they made last year, and the 6 managers that totally wipe out the 1.5 million dollar tax subsidy we already give them. Add to this the 250 employees handling 25 bed hospital 10 to 1, vs Confluence with 600 employees handling a 198 bed hospital 3 to 1. And it is easy to see that LCCH is marginally profitable at best with the subsidy, and definitely in the red without it. This is no business that has any business nearly doubling the size of their hospital, and anyone who has ever run a business can see this right away. VOTE NO, lets keep our hospital in the black, and not assume this massive debt.

    • Bill- I really wish you would research statistics before you post them. Confluence has over 270 physicians and over 150 mid-level providers (over 420 providers) so do you really think that anyone is going to believe your 600 employees at Confluence? The port of Chelan County report of June of 2015 shows Confluence employs 3527 people. A shocking 17.2 employees per patient. 10 to 1 doesn’t seem so bad does it! Or they fired 2900 employees in 2 years? I think we would have heard that one.

      And please, do not even try to get anyone to believe you have any idea what physicians look at when looking for a place to practice. You really don’t have any idea.

    • Bill – the more you post, the more you highlight your ignorance about all things healthcare and medicine related.
      1. physicians who choose to train in specialty care don’t leave medical school with more debt; they all graduate with the same amount of debt. When they choose specialty training, they spend more time in residency and fellowship, meaning they delay the time to making a larger income, so potentially rack up more interest before starting repayment – but some pay interest off along the way, negating that phenomenon.
      2. The physicians who work at the hospital also work in the clinic. On average, they see patients all day in clinic, also take care of patients admitted to the hospital, deliver babies, and some perform surgery. They all pull double duty. Many of them come to this area specifically so that they can do all those things. Also, Chelan is a HPSA (healthcare provider shortage area) meaning some providers can qualify for student loan repayment from the state or the federal government for working here. Whether Chelan then has enough attractiveness of the health care work environment and community to keep them here is another issue. Primary care doctors are in very high demand and can be choosy about where they practice. The providers in Chelan are plenty busy everyday. Call the clinic and see how long the wait is to be seen as a new patient.
      3. Other financial gimmicks? You’re off base here too. The 7 million of current debt gets rolled into the new loan payment, lowering the total debt payment annually. So, the hospital can DEFINITELY afford paying a smaller loan payment than they pay now – and getting a new hospital bargain in the bargain. Final net income for 2016 isn’t in yet, but will adjusted positively to the tune of a few hundred thousand dollars when the dust settles. But thanks for spreading rumors about which you have no knowledge.
      4. When you say the tax subsidy is roughly $1.5 million now, you’re adding in the amount paid for EMS services – so not all of that goes to the hospital. About half. In fact the hospital still subsidizes the EMS service further than that because it’s not a money maker but it’s an essential service for the community. I certainly want an ambulance to respond to my medical emergency, don’t you?
      5. Your employee to bed ratios are ridiculous as has been pointed out above. No need to repeat that here.
      6. There IS increasing demand for service. The hospital’s business is 70% outpatient, and that’s growing, but there is NO MORE ROOM. We need the increased space for many, many reasons and you’ve never once in all you’re rambling, repetitive posts been able to disprove that.
      7. Healthcare isn’t like any other business. It’s intensely regulated, expensive, and has very small margins. That’s why it takes people with special training and knowledge to provide it and manage it. When you’ve garnered some of that special training and/or knowledge—-let’s talk. Until then, you shouldn’t pretend your opinions are anything more than that – opinions, not based in fact or reality.

      In 2014 this bond failed by 85 votes. That’s all. We’re not going to let that happen this time. This community is in favor of a new hospital. They know we can no longer afford to wait and they want a new hospital now. And they deserve one.

  11. Those folks who don’t vote in off year elections need to Vote NO. If you really don’t care one way or the other about the hospital, would never use it, for whatever reason then you need to actually send in your ballot this time. The reason is clear, we have a fully functioning emergency hospital and Not voting is actually a vote for this new expensive white elephant at the dump. The employees of the hospital and the real estate folks and their families are a solid block, this hospital benefits them beyond anyone else in the community, but all it does for those who don’t care is raise their taxes, cost of living, and rent. A simple postage stamp on that ballot will save you money for the next 30 years. So if you “are just not interested in the issue”, vote NO. I know that there are people in the valley who have never set foot in LCCH, and never will, but that shiny new hospital at the dump is going to be expensive, has anyone ever seen a project like that that did not have massive cost overruns. Heaven forbid that they go broke like 12 out of 39 other CAH hospitals, but you can bet who those “pollyanna’s” will come to to bail them out when they do. So pull that ballot out of the junk mail and VOTE NO, Maintain what we have, we don’t need to build a new mini mall structure at the dump

    • Bill- This post is about as close to being honest about your reasons against a new hospital. “If you really don’t care one way or the other about the hospital, would never use it, for whatever reason then you need to actually send in your ballot this time.” What that really means is, you will never use the hospital, so you really don’t care about the conditions the patients that actually do use the hospital (your neighbors) have to endure. You don’t care about their privacy, infection control or dignity. You want all that the valley has to offer, but aren’t willing to help pay for the infrastructure that makes it what it is. I don’t agree with your reasoning, but at least you are being honest.
      Where you lose us again is spouting the same numbers, hospitals and cities that do not compare at all to Chelan. It once again proves that you and the naysayer mouthpieces that did all of the various presentations around the valley either have no understanding of medical economics and financing or are deliberately trying to put out false numbers to support baseless claims.
      If people want the true facts, go to http://www.newhospitalnow.com or if you want to go to a site that refutes all the baseless claims of the naysayers go to http://www.chelanhospitaltruths.com. Vote YES for better healthcare for the valley!

  12. A blast from the past from Dr. Tagge:

    The letter that Dr Tagge wrote to the Wenatchee World pertaining to the Hospital Bond disturbed me. So I did some research and found this letter that he had written in support of the bond in 2014 and he also wrote one in 2012. .The only thing I can see different is that he does not work at the hospital any more. thought some might be interested in what he said back then.these can be found on the Lake Chelan Mirror website under letters to the editor.

    Letters to the Editor
    Published by admin on Wed, 06/25/2014 – 5:31am

    Support Hospital Replacement

    The Lake Chelan Community Hospital Board recently decided to ask the community for a replacement hospital on the November ballot and I am writing to ask for everyone’s support. Our local hospital is a community treasure that I have been employed by for more than 12 years. It either employs or has treated a significant number of our friends and families and I don’t think one can overestimate its benefit to all of us.

    Healthcare delivery has gone through, and will go through, immense change, and our dated facility needs help. The issues are not secret to those that have walked the halls or inhabited its bed space, rapidly advancing technology, need for private rooms, need for more beds to avoid diverting patients, recruiting new employees/providers, and costs of major repairs/renovations. Larger operating rooms is one issue that is near and dear to my heart. There are more reasons but I will stop there at the risk of losing the reader. Its remarkable to me how well the facility and the district employees have worked around these issues.

    I believe supporting the replacement hospital will benefit the community for decades to come.

    Gordon Tagge, MD

    LETTER TO THE EDITOR — Supports hospital levy
    Published by admin on Thu, 06/28/2012 – 4:10am

    Dear Editor:

    I am writing to tell your readers why I believe our community needs a new hospital. In the interest of full disclosure I am a ten year employee of the Lake Chelan Community Hospital. Our hospital is a great community resource and I am proud to be associated with local professionals caring for our friends and neighbors. Many have asked me and others why we need a new hospital to complete our mission of local healthcare delivered close to home.

    As a taxpayer, I want to see our tax dollars put to the best use. As I work at the hospital I see and hear of a myriad of costly remodels, upgrades, and maintenance issues inherent to a 40 year old building housing a rapidly changing industry. I can’t help but wonder, however, if at some point we are throwing good money after bad and, like a used car, there comes a time when you realize your dollars are best spent on a new one. Mind you, it doesn’t have to be a Cadillac, but it should be new, As I look at the hospital project, the land is already owned, many other funding sources are being sought out and used, and the request to the taxpayer is approximately $8.34 a month on a 200,000 dollar house.

    Secondly, we are outgrowing our facility. With advancing technologies, new and expanding departments like physical and occupational therapy, information systems, radiology, and the need for larger operating rooms and private patient rooms, we simply need more space. This hopefully will help reduce the significant increase in diversions, or sending patients to other hospitals because we don’t have rooms, and allow us to handle the significant increase in patient days we have seen recently and are likely to see in the future as the demand for healthcare services increases.

    The 12 acres already owned by our hospital district are large enough to allow for possible expansion in the future and an on-site helipad thus minimizing transport times for critically ill patients.

    We are in a competitive marketplace when we are recruiting for specialized employees, nurses, and physicians. When people, medical or not, look to move to a new place they want to see and know about the schools and hospitals. Just in our immediate area, Grand Coulee and Leavenworth have built new hospitals.

    People are receiving great care currently from the dedicated staff at LCCH. To sustain first class local healthcare and to remain competitive in an ever-changing industry we need a new hospital.

    I really don’t think one can overestimate the benefits that accrue to a community when they have a hospital that is state of the art, thriving, and well supported by the voters.

    Gordon Tagge, M.D.

    Chelan

  13. Times have greatly changed since 2012 and so have opinions. The number of small hospitals closing because they overextended has skyrocketed, and Dr. Tagge has seen it first hand in his instrumental rescue of Brewster Hospital. Now is not the time to overextend, 12 out of 39 CAH hospitals were not failing 5 years ago as they are now, the Governor of the State was not warning small rural hospitals of the risk of failure as he is now. Obamacare was not in danger of collapse, as it is now. We did not have 19 trillion dollars of national debt, as we have now. Times change and with them opinions, and Dr. Tagge is not the only one that sees the demise of Kennewick, Grand Coulee, and Quincy, as handwriting on the wall. The financial facts are clear, now is a time to retrench and maintain what we have, not build this grandiose nearly double the size hospital out at the dump. Local experts with nothing to gain tell us that upgrade and maintenance of the present hospital is the right plan, and the only ones pushing this white elephant are employees, janitorial staff, and real estate land speculators. So for all those who don’t care one way or the other, break out those ballots, cause not voting will mean a 30 year tax on your hard earned dollars, and when this Toyota Town Hospital goes broke those same people will come back to the taxpayers to bail them out. VOTE NO, don’t let the land speculators bulldoze our beautiful hospital overlooking the lake, and send our sick and injured to the dump

    • Trios and Grand Coulee both tried to do their entire projects on their own and borrowed beyond their debt capacity. LCCH is not doing that. Quincy and Chelan are two towns that besides being in Washington, have nothing in common.

      The Affordable Care Act or its replacement has a 4% or less impact on LCCH. Whatever happens, it will not significantly affect LCCH’s bottom line.

      Your local experts are not experts in building modern medical facilities and if your “experts” are the same ones who have done the presentations, they have proven the have no understanding of medicine and medical economics.

      Gordon Tagge now works in Brewster and his practice will be affected by a new hospital in Chelan. So I can understand his change of heart. But Bill, did you tell Dr. Tagge that you don’t think he is “high quality” because he chose not to work in a big city?

      Go to http://www.newhospitalnow.com or http://www.chelanhospitaltruths.com for all the information by experts in the field of medical construction and medical finance. This is affordable. It will give Chelan something it hasn’t had in the current facility, private rooms, better infection control and better patient dignity. Vote YES with confidence!!!

  14. Spin Spin Spin, Bill. Times are better now than they were in 2012 and 2014, considering the USA was still pulling out of a recession at the time. Now the valley is booming, houses are being built, values are rebounding, & Trump has promised to MAGA!! Interest rates are low! Tagge is a disgruntled ex-employee which might account for his “change of heart”. The only thing I see skyrocketing is your redundant hyperbole. You’ve almost become a parody of yourself. http://www.newhospitalnow.com. VOTE YES to preserve the future of healthcare in the valley!!!!

  15. I remember the hype that the real estate folks put out in 2008, and when the bottom fell out the silence, sound familiar??? Chelan is a tourist town and our economy is based on the extra income of the folks in Seattle which can come to a rapid end, as it has done many times before. The hospital board bought that land out at the dump at the top of the market as everyone knows and now seem determined to put a Taj Mahal grandiose shiny new hospital on the site. Time to take Governor Inslee’s advice and not go into deep unsustainable debt, nearly doubling the size of the present hospital with this 30 year debt. VOTE NO Debt is a bad thing, the hospital should save up their money til they have enough to build and improve their present structure. The community already gives LCCH 1.5 million dollars a year, enough is enough

  16. The $1.5 million that you reference, one-half of that is the separate bond that goes to support the ambulance service, which is not a money maker and still requires some subsidy from the hospital. That is a hint of why your favored model based primarily on emergency care is so flawed. The credibility of your assumptions suffers greatly from casually throwing out numbers without proper context. Your understanding of medical economics is equally flawed yet you persist in trying to pass your opinions off as fact, making declarations of faux authority on what the citizens of the community need or should expect in terms of healthcare. Irresponsible! Such hyperbolic rhetoric is not designed to engage in an honest conversation with the community on how best to preserve healthcare locally but to cloud the issue with fear and create mistrust toward the commissioners, the administration and staff of the hospital. Also irresponsible. Fun fact: the healthcare sector provides 21% of jobs in Chelan. That is a pretty sizable chunk of the local economy. LCCH has served the coummunity for over 70 years through both downturns and upturns in the economy.

    • While it may be a jobs bill! To the employees it is just a big expense to the rest of the community, after all where does the money come to pay those big salaries, “right out of the pockets of the citizens of the valley”. We are not providing 1.5 million dollars in tax money to subsidize employees, but rather to have a functioning emergency hospital, and the comment above regarding the hospitals not saving money for their own future replacement certainly strikes a bell. After all Confluence does not get a subsidy from the community, but rather pays its own way with service to the community. What happened to LCCH, why did they buy the clinic with their profit instead of putting it back into the hospital? These are great questions that the management and employees have failed to answer. As far as having a plan should their bond issue fail, (AGAIN) all they do is divide the community with another bond issue ever couple of years. Maybe the hospital board should come up with a new plan and upgrade their present facility instead of buying land, buying clinics, and overpaying their top heavy management VOTE NO, Save our Hospital from the Land Speculators and Bulldozers

      • Bill- they bought the clinic because it was having financial difficulties. Rural clinics that are not combined with hospitals rarely do well as Medicare is set up for better reimbursement for hospital owned clinics than just clinics alone. That has been mentioned many times. Without doctors, there is no hospital.
        As far as dividing the community, it is just the difference between a group that wants improved quality of healthcare for the community (a majority by the way) and a group that doesn’t.

  17. I would have to dispute that the clinic was not doing well, as the hospital has stated that it is a profitable operation now, and what has changed. Some of the math of those who are pushing this Toyota Town Hospital just go beyond belief, and that is one of the reasons that the voters have three time previously turned this grandiose plan down. With no plan but one, building this white elephant, all the Hospital Board has is to rerun the same old bond issue time and again, every two years throwing this formerly very unified community into turmoil. When it is defeated this time, what will be the result you ask, well those in opposition have learned to hang onto their street signs and handouts, cause the Hospital Board will be coming back again repeating their same unimaginative designs to try to justify their purchase of that land out at the dump. It requires 60% to put this community into deep 30 year debt for a good reason and that is the “majority” required. So read that ballot very closely, cause handing the Hospital Board $20,000,000 to do with as they please, will in debt this community for 30 years, and their history of buying Clinics, Land, while paying their management outrageous salaries may well be where that money will end up if they are unable to get the federal loans. VOTE NO Save our hospital from the empire builders, Maintain it don’t bulldoze it

    • The clinic is now doing better because the merger with LCCH has given it access to improved reimbursements through the advantages of the Critical Access Hospital program. I have stated before that the hospital board and community forums looked at 5 different scenarios, including the one option you seem to favor the most – which was the least preferred choice among all considered. The plan selected and now before the voters was vetted by consulting organizations, with both financial and structural expertise, the hospital commissioners and administration, and input from community forums conducted by an independent organization.

      LCCH is scrutinized strictly by many regulatory bodies, including state auditors, so your fears that the hospital commissioners can do “whatever they please” with the voted bond monies is unfounded and to suggest otherwise continually is a falsehood. LCCH has a Moody bond rating of AA, if LCCH was unlikely to qualify for the USDA loan we would not be having this conversation. I understand from past comments you believe all debt is bad, however access to credit for well-vetted projects is the norm for large capital projects and not much progress would be made in any sector without it. Fun Fact: On July 1, 1958 the $6,000,000 Maple Street Bridge in Spokane WA opened to traffic, and for the next 32 years until July 13, 1990 you had to toss a dime into a basket to cross over. The bridge was built with credit from a bond and paid back yearly, dime by dime. My point being that they built the bridge first, and paid it back over 32 years.

      Three times the majority of voters has shown their support for replacing the hospital at the Apple Blossom location. Your continued assertions that the staff are overpaid is your opinion, and also not based in the reality of salary scales for comparable positions in comparable facilities. Correct information has been provided in numerous responses to your posts – yet you persist in making unfounded accusations. Your statements do serve to drive mistrust toward LCCH and the commissioners which will have long term consequences. And it may even get you the result you crave, but let’s not pretend you have any concern about access or the quality of healthcare for the citizens of this valley. That is duly noted and unfortunate.

  18. Statement from Ty Witt
    I have seen the profits and working revenue used very wisely and cautiously by the
    administration and commissioners. The building and equipment is constantly being repaired, maintained and upgraded. I can show you several examples if you would like to come up for a tour. To repeat, the building has been upgraded on an ongoing basis all along. If it hadn’t, we wouldn’t pass every industry inspection that comes through. We do pass, every time! The facility is just below current building codes and will require extensive infrastructure upgrades if a remodel of any size or scope is initiated.

    You may or may not know that margins in healthcare are tight. This hospital is blessed to be a “Critical Access Hospital” (CAH). Simply put, having a loan and interest as an expense actually helps the revenues increase because of higher reimbursement rates. It will be easier to make a bigger profit each year in the new building even if the volumes stay the same or even drop some. The expert financial analysis has shown the decision makers (commissioners) that “not doing anything” is a very risky choice when it comes to financial viability. The move to a new building increases the viability and sustainability; not jeopardize it.

    I also felt that a remodel project should be part of the options plan. It was seriously
    considered and analyzed. The building experts tell us that the remodel is 27% more
    expensive than the new build (that’s $12 million extra). That analysis impressed me. It
    addresses your future concern question. You are correct that things will continue to change. In 20-30 years, changes, upgrades and possibly expansion may be necessary again. That’s the beauty of the new site and design. The current project will only use 8 of the available 12 acres. We will have plenty of space to grow and expand if and when it is needed right on campus. Expansion is very difficult and expensive on the current site.

    As far as savings, you need to know that the commissioners and administration have saved $8 million dollars. But this money should not be spent. It needs to stay in the “rainy day fund”. LCCHC is a $28 million per year organization. There has to be reserves and savings to support the day to day operations. As a father, and husband you probably do the same thing with your family funds. Do you have a car payment or a mortgage? It’s the same thing here. Except, the hospital actually makes more money under the CAH model. So having the loan and paying the interest brings in more money and makes it easier to be profitable than the current financials can do. It would be the same with a remodel but the loan would be $12 million more and not allow the future expandability options. Really think about that.

    The hospital and clinic merged in order to save the viability of the clinic. Even with increasing volumes, the doctors in the clinic are not reimbursed at the same rate unless they are owned by a CAH. Now that the merger occurred, the clinic will be able to be profitable. Had the clinic failed, and the primary doctors departed, healthcare in the valley would have been destroyed. This decision by the commissioners saved healthcare in the valley. The acquisition pricing met the industry standard. Thousands of patients are seen in the clinic every year. The value of this clinic is really undeniable.

    There are thousands of men, women and children who need and use local medical care. We have a professionally analyzed and vetted plan that will sustain and ensure Healthcare in this valley for the next generations. Please help us reach this reality and vote YES for the $20 million bond.

  19. Same old plan different authors, now the professional managers have decided to use the doctors to try to convince people to take on this massive debt. Those 6 high priced managers have been pretty quiet since the public found out they take ALL of the 1.5 million dollar subsidy. Regardless of who is trying to dress this White Elephant up, it is still a terrible idea, with 12 out of 39 CAH hospitals in the state on Life Support. Local Medical Care is something we have now, why risk it with unsupportable debt. Time to pick those Ballots out of the recycle bin, not voting will mean that the fanatics who most benefit from a shiny new hospital, the employees, real estate land speculators, and janitorial staff will win, cause they are all voting in their self interest, and that is why those folks who would ordinarily not vote in an off year election should VOTE. Remember not voting is going to cost you an increase in taxes for the next 30 years, and hand $20,000,000 with no strings attached to the people who have run down our present hospital. VOTE NO, Save what we have, don’t risk it on a shiny new Toyota Town Hospital

  20. IT IS A BOND NOT A LEVY, it is a blank check for the hospital commissioners, don’t be fooled read your ballot carefully, the difference is essential, cause if they can’t get a federal loan they will still have $20,000,000 to use as they see fit. In past they bought land and the clinic when they should have been maintaining their hospital.
    A bond issue generally offers the advantage of raising cash immediately via sale. The revenue from a levy may only come in over time. But levied tax, unlike a bond, holds the great advantage of not needing to be repaid in the long run; repayment is understood to be the service or amenity that the county’s property owners will reap from their payment. Additionally, if the bond’s interest rate is not fixed, but rather tied to external interest rates or other financial factors, there may be a level of uncertainty to a bond issue that isn’t found in a levy. VOTE NO, lets maintain what we have and not risk it with massive debt

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