Three Rivers Hospital board addresses strategy options as vote approaches

BREWSTER – The Three Rivers Hospital Board of Directors is keeping several balls in the air while it juggles options in the face of an upcoming bond vote in November and strategies for how the outcome will affect services.

The ballot measure is asking voters to approve a $72 million, 30-year bond for a new facility to replace the existing 75-year-one.

At its regular monthly meeting on Sept. 27, the board discussed where the emphasis should be on future services and whether to make any specialist hiring decisions now or after the bond results are in.

Chief Executive Scott Graham gave his support to primary care.

“I think one of the things we want to do regardless is continue to grow our primary care,” Graham said. “We know that is the direction this is going; ultimately Medicare, Medicaid, the big insurance companies want to keep patients out of the hospital and are emphasizing being able to prevent in-patient stays by doing more robust primary care.”

Graham said the shift for TRH has been incremental in that direction from five or six years ago when the focus was more on specialty care but as they look toward the future the hospital needs to look for opportunities in primary care.

Graham explained that while the long-term goal for TRH is to provide more primary care, the short term is more problematic with the bond vote pending.

“Timing is everything and we may not have everything in the sequence that we would like,” Graham said. “We may end up with providers at our doorstep who are ready to engage even though we are not ready financially or space-wise.”

If the bond measure passes, the hospital will be challenged with maintaining operations and treating patients while a two-phase renovation and building process is taking place in the same 50,000 square feet that the facility now occupies.

One Methow Valley citizen suggested relocating the hospital to Pateros to be closer to access from the upper valley. Pruett said he discussed the near impossibility of putting Three Rivers in a more central location to the state’s largest hospital district.

“A concern we will always have for people in the upper Methow is that ‘golden hour,’, that window,” said Pruett referring to the trauma term often used for the first critical 60 minutes to get definitive treatment for an injured or sick person.

Graham summed up a major decision about resource allocation options ahead.

“In terms of primary care and specialty care it may be time to think about where we want to make some investments, or do we wait until we know about the new building?” asked Graham.

Board vice chair Cherri Thomas recommended waiting until the bond results are in.

Board chairman Mike Pruett concurred.

Pruett said more efficient transportation options to TRH are also being pursued.

“It’s still slow but we are talking with TranGo (Okanogan County transit) because if we can get a bus to come to Brewster from Twisp on one route it would be huge.”

Board secretary Leslie McNamara favors taking on available specialists now because regardless of the election outcome the hospital must survive and continue to grow.

“If we have someone on the line who would bring us more business, extend our primary care now, bring in more money to help keep us surviving, I'm open to looking at it now and not waiting until after the vote.”

Graham reminded the board that the interview and hiring process approved now for another specialist would probably not be completed until well after the vote.

This is just one of several decisions the board grapples with every month as it addresses the cost-benefit ratio a rural hospital must navigate to best serve its patients.

Mike Maltais: 360-333-8483, michael@ward.media