Q: Why is the hospital building an expansion?
A: There are several reasons. When the hospital relocated from First Street to Rush Drive in 2008, the vision of the hospital’s board and administration was that a new, modern facility would attract new doctors and services to Chaffee County. The acreage surrounding the new hospital would allow for future growth and creation of a medical campus to centrally locate health care services in our region.
That vision has become a reality in only a few short years. Since 2008, HRRMC has added over 200 more employees to its payroll, and in the past three years alone, we have added 13 new services. All of this growth means we have outgrown our current space. The expansion will provide additional space for our providers and staff and allow for better access to services for people in our community.
Many of our providers are now located off-campus, and the expansion would relocate those practices into a medical office building that would be part of the hospital. It is convenient for patients and increases staff efficiency to have all of our outpatient services in the hospital building. Physicians can communicate more easily between departments and have better access to all services.
Q: Where will the expansion be located on the hospital campus?
A: The expansion is actually in two locations. HRRMC’s laboratory has experienced substantial growth in recent years and would be adding a one-story addition on the west side of the hospital.
The medical office building will be built in the grassy space south of the café between the staff and visitor parking lots. This space was designated for a future expansion when the hospital was built in 2008. A portion of the parking lots to the east and west of the building site would also be used for the expansion. There would be separate entrances to the new medical office building for easier patient access.
Q: How big will the expansion be?
A: The three-story medical office building is 46,601 square feet. The building at its tallest point is 53 feet, 9 inches, which is below the 54-foot maximum allowed for commercial buildings in Salida. The lab addition would add another 2,200 square feet.
An additional 160 parking spaces will be added to the west side of the hospital primarily for staff. This would make parking for visitors and patients much more accessible near the front of the hospital and the new medical office building.
The Colorado Department of Transportation has required HRRMC to relocate County Road 154 to make exiting off of Highway 291 safer. Therefore, instead of crossing over the small bridge that is currently on the road, a newly relocated County Road 154 will be developed to accommodate increased traffic. This will provide a separate entrance for future services located west of the hospital, allow staff and service vehicles to access the campus from the west, and keep the hospital’s main driveway from becoming overly congested.
Q: What practices/services would be in the expansion and why?
A: Most practices currently located at the HRRMC Medical Clinics on Highway 50 would be relocated into the expansion. These include orthopedics, gynecology, neurology, pain management, urology, psychiatry, rehabilitation and Wellness U. The rehab/wellness space alone will be double the size of the current space at Highway 50. Plans include a walking track, a therapy pool, and a kitchen for hands-on therapy sessions for occupational therapy patients and cooking demonstrations for Wellness U.
Practices in the hospital’s Specialty Clinic would also move into the expansion. These include cardiology, general surgery, vascular surgery, plastic surgery, gastroenterology, internal medicine, nephrology and pulmonology.
Since these practices would be moving out of the Specialty Clinic, additional space would open up for oncology and infusion. Infusion would increase from five to eight stations, and a blood-draw room would be conveniently located by medical oncology.
Q: Why wasn’t this done when the hospital was built initially?
A: This was identified as a wing in the original plans for the hospital. The hospital board and administration hoped that the new hospital building would spur a growth in services but felt it was not financially prudent to assume this would happen quickly. The rapid level of growth in services and volumes of patients was not anticipated at the time.
Q: Why isn’t this being built on the west side of the hospital? What are the future plans for that space?
A: The medical office building will house outpatient services only. The west side of the hospital will be used for inpatient service expansions in the future. There are no immediate plans to expand inpatient services at this time.
Q: Why was additional land purchased behind the hospital?
A: For future expansion and growth opportunities. We have been approached by Rocky Mountain Eye Center and Solvista Health about potentially building clinics on the land. There is also potential for a long-term care facility down the road, but nothing is in our immediate plans.
Q: Does the hospital own all of the buildings on the campus? Why are there so many single-story buildings?
A: Many of the practices on the hospital campus are privately owned. First Street Family Health, Central Colorado ENT, Central Colorado Dermatology, the VA clinic, and Wentz Foot & Ankle Specialists are all privately owned facilities. Single-story buildings made the most economic sense for the business owners.
We are not able to “build up” on our existing hospital because of structural restrictions and because it’s much more expensive to build on an existing structure.
Q: Why not build a parking garage instead of so many parking lots?
A: Multi-level parking garages are very expensive to build. For now, parking lots work better for our campus, and we are not large enough that a parking garage would make sense.
Q: Would the expansion block the view of residents to the south of the hospital?
A: It should not obstruct views for the homeowners. The building will not exceed the 54-foot maximum allowed height for commercial buildings.
Q: Would there be any other impact from the building on nearby residents?
A: Sound and visual screens would be implemented to surround all equipment. These will help to reduce the noise and prevent equipment from being visible.
Q: Has the hospital board approved the expansion?
A: Yes. They approved it at a special board meeting on June 16.
Q: What is the projected timeline for the expansion project?
A: The anticipated timeline is 16 months.
The HRRMC medical campus provides a central location in our region for health services. The biggest reason that we want to expand our campus is so we can provide better service and offer more health care options to residents. Our community can access specialty services locally instead of traveling to the Front Range.
Q: What is the financial impact on HRRMC of building the expansion?
A: HRRMC has experienced significant growth since the hospital was constructed. Recent remodels on the main campus and at the HRRMC Medical Clinics on Highway 50 have been completed in an effort to squeeze more services into existing facilities but there just is no more available space. Our physician clinic and infusion services can no longer grow, despite additional need in the community. The laboratory cannot function in its original space due to significant growth in volume and equipment needs. Rehab and cardiac services can no longer expand to support the needs of our physicians and patients. Finally, operational challenges continue to increase as a result of inadequate space, facilities and parking.
With the additional revenue projections, as well as potential operational savings, we will recover the cost over the next 20 to 25 years. The building’s useful life will be approximately 40 years so we will realize a favorable return on our investment.
The new addition would result in an estimated $2.3 million in additional cash flows. Cash flows will result from expanding rehabilitation, wellness services, infusion, internal medicine and other physician specialty service lines. The new addition will also produce cost savings by eliminating the space the hospital is currently leasing for its Patient Financial Services and Education departments—both will be relocated to the Medical Clinics on Highway 50.
To fund the project, HRRMC will use existing cash reserves and has arranged to borrow an additional $10 million after the project is completed. We recently refunded our original 2006 net revenue bonds that were issued for $30.20 million at a 5.25% interest rate. The new loan, including the additional $10 million earmarked for the expansion, was issued at 2.96% for $33.36 million. HRRMC’s preliminary financial projections demonstrate that we will maintain overall financial benchmarks and performance indicators at favorable levels.
