Changes are being made to the first phase of a planned expansion at Salem Memorial District Hospital to address pressing needs, the hospital board was told at its rescheduled September meeting last week.
Administrator Kasey Lucas said replacement of the hospital’s generator, a new water heater, water softener and plumbing improvements that include replacing the sewer main, have been added to the plans as priority items.
The project, now in the engineering phase, originally included moving several departments to accommodate a centralized imaging area where the new MRI machine would be housed.
Plans now are to put the MRI in a new brick and mortar addition to the rear of SMDH near the patio entrance. That space will be constructed to allow for future expansion to possibly include the CT unit and create a new imaging area.
Cardiopulmonary services will be relocated to vacant space previously occupied by the medical records department.
A new outpatient registration area will be created to separate ER and outpatient registrations. The new area will allow for two outpatient registration clerks, a waiting area and small office for patient billing questions to be discussed.
The chapel and acute care waiting area will be relocated. Also still in the plans are a new hallway and exits to meet life safety codes.
The savings created by eliminating some of the department moves will allow the MRI addition and other improvements without increasing the estimated $1.8 million project cost, Lucas said. The contract still calls for a May 31 completion date.
He said plans were modified after it was discovered that moving the materials management department to a new location would require additional exterior construction. That added expense and the cost of all the other planned department moves, plus the generator and other needs, tipped the scales toward moving the MRI instead, he told the board.
After the meeting, Lucas told The Salem News that putting all the imaging in one location is a long-term goal.
“We like that central imaging area and that’s what we want to get to,” he said. “That was the big thing about Phase 1, to get the MRI in the best scenario, its home forever where you wouldn’t have to move it.”
By building on instead of moving more departments to create space internally for the MRI, about $600,000 was saved, he said. That money can go toward the MRI exterior addition, keeping costs the same.
It also allows the inclusion of the generator and infrastructure improvements in what is now a 50-year-old building, he said.
“That’s the original generator, and we’ve got plumbing (issues). We need to do something about that,” he said.
To finance the project, officials are in contact with Gilmore Bell, a public finance law firm, about issuing revenue bonds. The board approved a resolution at the meeting to issue up to $2.5 million in bonds to be repaid with hospital revenues. The amount is larger than the estimated $1.8 million cost, but will allow for any contingencies that arise, Lucas said.
Estimates prepared by the Esterly Schneider Associates architectural and planning firm place the cost of the MRI addition at $430,000, hospital renovation costs at $500,000, infrastructure improvements at $517,000 and projects already under contract—acute care window replacement and central bath renovation—at $383,100 for a total of $1,830,100.
Lucas also told the board that Alexander Construction began the central bath project Sept. 16. Alexander is making good progress and keeping the construction mess contained, he said.
In her monthly summary of operations, Monica Stogsdill, chief financial officer, reported another good month in August with 116 inpatient admissions, up from 97 a year ago, and 434 inpatient census days, compared to 273 in August last year. The acute care occupancy rate was at 56 percent in August, up 21 percentage points from last August.
Outpatient registrations were at 1,912, compared to 1,648 a year ago, with 393 home health visits, up from 298 in August last year. Emergency room visits totaled 826, unchanged from a year ago, but 92 of those patients were admitted and only 44 transferred to other facilities, compared to 68 transferred and 64 admitted a year ago, her report stated.
Total patient revenue totaled $5.49 million in August, with a gain after expenses of $162,254. Payrolls for the month totaled $972,910.
Lucas also announced a new billboard has been installed across from Walmart promoting the hospital’s new Level IV STEMI Center designation and its Level IV stroke designation achieved in 2016. Another new billboard promotes SMDH Family Medicine.
Board president Dennis Fiebelman questioned whether many people in the area knew what STEMI means. STEMI stands for ST Elevation Myocardial Infarction, a serious type of heart attack involving a blocked major artery.
Chief nursing officer Debbie Hines said Jason Mayberry, ER director, is going to all the county schools to educate fifth graders on medical topics, with one day devoted to STEMI, what it means and how to recognize it, and another day devoted to strokes. SMDH has also done some advertising and made presentations at Southwest Baptist University on the topic, she said.
In other business, the board:
• Approved the purchase of IT new storage replacement, a Unity 300 unit with a 700 GB flash drive and 4 terabyte disk, from Dell for $15,932.
• Approved the purchase of a bathtub lift replacement, an Apollo Advantage bathing system, for long term care for $19,324 from Apollo Corp.
• Approved entering into a 36-month contract with Home Health EHR Software for billing software for an initial cost of $18,000 and monthly payments of $2,119. There is also a $10,500 implementation fee and $7,500 for iPads used for tracking home health visits.