Three Rivers Board approves new hospital resolution for November ballot

BREWSTER – The board of directors of Three Rivers Hospital (TRH) at its regular monthly meeting last Wednesday, July 26, approved a resolution that will appear on the November 7 Special Election Ballot to issue bonds for constructing a new hospital.

Specifically, the resolution that requires a minimum 60 percent or greater voter approval to pass, authorizes the hospital district to issue general obligation bonds “in the aggregate principal amount of no more than $72 million…for the purpose of paying or reimbursing costs of constructing, equipping, and furnishing a new hospital and related health care facilities,” per the official explanation.

“We have talked about this for over three years,” said Chief Financial Officer Jennifer Munson. “We have an aging building. We have some serious needs with this building that would ultimately cost us more to try to remodel or update what we have.”

The board also approved a second resolution to appear on the same November 7 Special Ballot for the renewal of the one-year $1,145,000 maintenance and operating levy for 2024, the same request that appears on the current August 7 Primary Election Ballot. If the August Levy wins approval the identical Levy for the November 7 ballot will not be needed. 

Feasibility study discussed

In other board business, Jody Carona of Health Facilities Planning Development (HFPD) in Seattle addressed the board via Zoom to discuss the feasibility study done for TRH. Among Carona’s key findings:

• The district’s near 16,000 residents includes 21 percent over 65 years of age and 40 percent who are Hispanic. The upper valley has a higher percentage of elderly (28 percent) while the lower valley population is younger and more diverse.

• The district’s inpatient numbers – including TRH - have significantly declined over the past five years regardless of which district hospital patients visited. Carona attributes this shrinking market and market share partly to TRH’s closure of its obstetrics (OB) unit but noted there are declines across most service lines with the exception being general medicine.

• The TRH market share is lower than most comparable hospitals HFPD identified, especially the nearby ones. For example, TRH market share in its home zip code is 16.7 percent – excluding OB, psych, rehabs and newborns – while the average is 23.1 percent for the other hospitals.

• Confluence Health has a nearly 50 percent market share of all district inpatient discharges and countywide its share is 33 percent.

• If TRH could return to its 2018-19 market share levels, Carona believes it has growth opportunities despite the decline in inpatient volume.

• TRH growth opportunities appear to be on the outpatient side, both to increase market share and establish new services. Further analysis of potential volume, revenues, and costs is needed.

• A closer partnership with the Brewster, Twisp, and possibly Bridgeport Family Health Centers (FHC) to support their clinic ancillaries could produce new volume.

“They are struggling with some of the same issues that you folks are,” said Carona of FHC, “it’s a great opportunity to see if there are places where you could provide a lot of the specialty support they don’t provide.”

In his Foundation report, president Dan Webster said he spoke recently with the Roots & Wings Foundation. Established in 2019 by Judy and Gordon Faulkner the organization provides grants to support basic needs, early learning, family safety, and health. Webster addressed the need for a hospital transportation van and R&W requested more information. Webster said he spoke with CFO Munson to secure that.

“I’m hoping to circle back around with Nicole Smith with Roots & Wings and provide her that information,” said Webster. “That would be a big thing and would certainly help.” 

Cyber security stressed

TRH Chief Information Officer, Chad Schmitt updated the board with the latest cyber security news. Schmitt said that last June the Federal Trade Commission (FTC) was granted expanded federal authority to conduct an announced cyber security control audit at any business. As it relates to the high-value status of hospital records as both a potential target for hackers and cyber audit candidate, Schmitt recommends a monthly line-item review of the TRH insurance policy to have that due diligence current and available.

“We’re going to be implementing a more robust cyber-awareness training program,” Schmitt said. “The new mantra we have is: “It’s not ‘if’ it’s ‘when.’”

Schmitt related a local attempt to breach security safeguards.

“Just last week a hospital right near us had a targeted attack with 80 emails,” said Schmitt noting the public records research the hacker had to first do to find those addresses.

“They’re at the front door trying to pick the lock,” said Schmitt by way of analogy. “They’re targeting us.”