Hospital District presides over full agenda
Photos by Morgan Traughber, Layton Construction The tractor in the photo above carries out high-energy impact compaction in the construction zone for the hospital and long-term care facility. The rollers behind the tractor weigh 16 tons and can apply 32,000 pounds of pressure to ensure a high percentage of compaction throughout the entire site. The machine pictured above is used for compaction testing. It sends a probe into the ground to test the density of the soil. The probe is lowered as far into the ground as it will go before there is too much pressure being applied and the computer tells it to stop.
PINEDALE – Construction crews are progressing on the project to build a new critical-access hospital and long-term care facility in Pinedale, providing plenty of tasks for the Sublette County Hospital District (SCHD) Board of Trustees, administration and staff over the course of a busy month.
The SCHD tackled a wide range of issues at a board meeting that lasted beyond two hours on Wednesday, Aug. 23. Topics ranged from a construction update, housing and recruitment, providers stepping into new positions, storm damage at the Sublette Center, Rocky Mountain Power rate hikes and more.
Laying the foundations
Workers continue to move earth as the ground is prepared to construct a health-care campus where the town’s ballfields once stood.
“There is a lot of activity on the hill,” said Karl Lueschow of Lueschow Property Management, the SCHD’s owner’s representative. “It’s starting to look like something other than the old ballfields.”
Teletractors, Inc., wrapped up the compaction process and carried out tests to ensure that the groundwork meets regulations, Lueschow told trustees. Compaction is where the soil is compressed to a certain density in order to eliminate pockets of air.
Crews finished laying the water lines, allowing them to dig out a storm-water retention management system, Lueschow noted. Activity is expected to begin on the sewer lines this week, he added.
Overall, construction is proceeding on schedule and foundation work is slated to commence on Sept. 1, Lueschow said.
Lueschow praised Teletractors for an “outstanding” job on all the excavation completed to date and he highlighted the company’s “top notch” safety record at the site.
Dave Doorn, SCHD administrator, expressed a desire to start tearing out the parking lot next to the Pinedale Clinic this fall rather than delaying it until the spring.
Housing and wages
The shortage of affordable housing options in Sublette County poses a significant obstacle to attracting top-notch talent to work for the district, said Dr. David Burnett, SCHD medical director.
Dr. Burnett proposed converting the old Marbleton-Big Piney clinic building that was completed in the 1980s into housing for providers and staff.
Upon recent inspection, the old clinic was in “sound condition structurally,” Dr. Burnett told trustees. The space covered approximately 5,000 square feet and could house four residences, he continued.
Using the old clinic would save the SCHD a “great deal” of money on housing, serve as a “fantastic recruitment tool” and boost the economy in Marbleton and Big Piney.
“This is a great building that is not being used,” Dr. Burnett said.
If the SCHD decides to pursue renovating the old clinic into housing, the next step is to hire an engineer or architect to develop a floor plan and provide a project cost estimate, Dr. Burnett noted.
The finance committee reviewed salaries for SCHD providers and staff, concluding that the district’s current wages came up short when compared to rates across the region, said trustee Dave Bell. Future wage increases were necessary to recruit “quality and exceptional talent,” Bell added.
“This was a wake-up call for us on wages,” Bell remarked.
The finance committee tasked senior staff with developing plans to “get wages competitive” and to present their ideas to the SCHD board for an extensive discussion among trustees and staff at the September meeting, Bell said.
The SCHD received approximately $700,000 in federal employee retention credits, funds that could “give room to help us fund additional wage costs,” Bell told trustees.
Damage to the Sublette Center
A powerful storm barreled through Pinedale on Tuesday, Aug. 22, wreaking havoc across the community, including at the Sublette Center.
The wind and rain caused “significant flooding” in the Heritage Room at the Sublette Center, said administrator Dawn Walker, requiring the replacement of carpeting and ceiling tiles.
The employee break room also sustained damage to its ceiling, though Walker confirmed to the Roundup that the tiles were all replaced by Friday, Aug. 25.
Immediately after the storm, staff checked in on each resident to confirm that everyone was okay, Walker said, and fortunately the residential rooms escaped damage.
“We are really grateful for the actions the staff took to come in and check on residents and clean up afterwards,” Walker told the Roundup.
Familiar faces in new places
SCHD Assistant Administrator Lindsey Bond introduced the new interim co-directors of EMS – EMTs Jen Adam and Steven Sanders. Longtime EMS director Bill Kluck transferred to the SCHD nursing department.
In response to concerns raised by SCHD board chairwoman Tonia Hoffman about coverage, Adam stated that EMS had formed a hiring committee and was conducting interviews. The situation was improving and “moving in the right direction,” Adam added.
EMTs recently expressed “positive feedback” on the direction the department was headed, Adam continued, and she stated that EMS employees were “happy to be at work.”
As a former teacher, Adam places a high priority on education and outlined plans for weekly and annual training for EMTs in collaboration with Sublette BOCES.
Sanders addressed efforts by EMS staff to compile a “detailed invoice” of the ambulance fleet to determine how best to use the additional $100,000 pledged by the SCHD board to update or replace aging vehicles. Plans are underway to seek out certified emergency vehicle technicians to service Sublette County’s fleet, Sanders added.
Dr. Burnett presented Ryan Grove, PA-C, as the SCHD’s interim emergency services director. Grove is a physician assistant with more than three years of experience at the Pinedale Clinic emergency room.
Despite the ongoing challenge of keeping the emergency room fully staffed, Grove told trustees he felt like there was finally light at the end of the tunnel with two new prospective PAs with emergency room backgrounds willing to relocate to Pinedale (see “Recruitment” below).
Grove expressed gratitude to existing SCHD staff for filling the gaps over past months.
“The nurses and providers really stepped up and put in long shifts in addition to their regular practice,” Grove said. “We hope the end is in sight.”
Morale in the ER was back on the uptick, Grove remarked to trustees, and the environment was once again more collaborative and energetic with the potential for two new providers.
Grove emphasized the necessity of “investing in the team” at the SCHD – from providers to nurses and X-ray technicians – to prevent burnout as the district transitions into a hospital.
“Building a team that we can put in this hospital is really important,” said Grove.
Following a lengthy executive session, the SCHD Board of Trustees approved contracts for Kelsey Wagner, PA-C, and Noah Chutz, PA-C.
Wagner practiced as a physician assistant in emergency rooms for more than five years, said Grove, including a stint working in Sublette County through Locums, Inc.
“(Wagner) has top-notch skills and is excited to start in November,” Grove stated to trustees.
Chutz served as a physician assistant in a “busy and underserved” emergency room in California, is bilingual in Spanish, fluent in American Sign Language and possesses experience in treating patients who are battling substance abuse, said Grove.
Dr. Rex Wortham, a board-certified family practitioner, is expected to start at the SCHD on Jan. 1, Dr. Burnett announced to trustees. The addition of Dr. Wortham will help close the primary-care gap in Sublette County, Dr. Burnett added.
The SCHD is still searching for one more primary-care provider before both clinics are considered fully staffed, said Dr. Burnett.
The district is interviewing a nurse practitioner, said Dr. Burnett, hoping to hire a female provider. Women’s health care remains a significant need in Sublette County, Dr. Burnett continued.
Trustees unanimously approved a motion to acquire a prefabricated office building donated by Jonah Energy. The costs for the SCHD to relocate the building from the gas field to Pinedale, reassemble the facility and lay foundations came to around $400,000, said Bell.
The motion included language committing the SCHD to advertise for bids to move the building, perform foundation work and reassemble it.
Trustee Jamison Ziegler called the building a “good investment” for the district.
The SCHD intends to use the facility to house its business offices and administration, said Doorn. Relocating administration into the donated building will free up space in the future critical access hospital for providers and patients, said Mike Hunsaker, chief operating officer for the SCHD and its management partner, Star Valley Health.
The building also contains a board room and “space for education,” Doorn remarked to trustees.
Hoffman thanked Jonah Energy on behalf of the trustees for its generous gift.
RMP rate hikes
Each trustee agreed to sign a letter drafted by Bell to the Wyoming Public Service Commission expressing “grave concern” regarding proposed rate hikes for electricity announced this summer by Rocky Mountain Power (RMP).
Lueschow and Paul Ulrich, a member of the Sublette County Health Foundation Board, looked into RMP’s planned rate hike, said Bell. If RMP’s increases come to fruition, the SCHD will spend an additional $78,248 per year on the electrical bill for both the critical-access hospital and clinics, Bell told trustees.
The additional costs would create a significant financial strain for the SCHD, the letter stated.
“As a hospital district, operating on razor-thin margins in rural Wyoming, this rate increase cripples our ability to offer competitive medical services to our residents in western Wyoming,” the letter continued.
Based on the SCHD’s study of RMP’s proposal, the price increases were the result of a “rapid switch from reliable fossil fuels” to “more sketchy and unreliable sources of power” like wind and solar, the letter claimed.
The SCHD raised the concern in its letter that the rate hikes will only be the “first of many” as utility companies’ hands are forced by “the national fever concerning climate change and alternative sources of energy.”
SCHD trustees requested RMP take a “more balanced alternative-energy schedule with less financial impact on its customers.”