RDH counts down to opening

RANGELY I In less than two months, the new Rangely District Hospital building will open its doors to state inspectors, equipment movers and staff in preparation for welcoming the public on Dec. 17.
Construction began a year ago this week on the 73,000 square-foot building, which will replace the current hospital building constructed in 1961. An initial completion date of April 2013 was moved to November of this year after the mildest winter the area has seen in years.
Rangely District Hospital Chief Executive Officer Nick Goshe said that collaboration among contractors Adolfson & Peterson, architects from Davis Partnerships, and Adams Management owners’ representative Pam Solano were also integral to the building’s progress.
“I think one of the keys to our success has been that a lot of people don’t bring on a contractor until they’ve had the architects design it,” Goshe said. “We’ve brought the contractor in from the beginning… When that doesn’t happen, the architects plan it, you bid it out to a contractor, and the contractor says, ‘Well, that looks good on paper, but we can’t make that work.’ But we’d already worked through those (issues) for a year-and-a-half of planning.”
More than a year of planning before ever breaking ground wasn’t how Goshe and the RDH Board initially envisioned the project. A $38.7 million bond initiative passed in May 2010 was followed by a 15-month delay when conflicts between Housing and Urban Development (HUD) requirements and Bureau of Land Management (BLM) regulations stymied the project’s start. Rather than go through HUD, the hospital sought out help to sell the bonds privately, a move that cut the life of the loan by more than 10 years and reduced the interest rate from between 6.5 and 7 percent to 5.25 percent. The change resulted in an estimated $40 million project savings, Goshe said.
An initial proposal to build a new hospital was rejected by voters in 2007. When the hospital brought the bond issue back to the ballot in 2010, concerns expressed included the amount taxpayers would be responsible for and whether there was really a need for a new building. Goshe said that while he still talks to people who wanted more information or input on the process, many didn’t realize that 23 Town Hall meetings were advertised and held in various locations and times for that purpose.
Goshe believes that people may be getting used to the reality of a new hospital.
“I don’t notice the public opposition at board meetings now,” he said. “We used to have standing room only, and now it’s rare to have visitors attend a meeting.”
Workers have finished major components of the building’s interior in recent weeks, including drywalling and painting, with landscaping scheduled for completion by the end of the month. The wing housing the dental offices, clinic, and administrative area are finished with the exception of trim work and some wiring, while other sections of the hospital will soon receive flooring, trim, and cabinets.
“I’ve been on it since the very beginning, and that’s been exciting, getting to see it develop from the planning stage until now,” Goshe said.
All but one department manager and dozens of staff members have watched the project go from being a bond issue in early 2009 to a nearly completed building. That includes doctors Karyl Ting, Mercedes Cameron and Chris Adams and physician assistant Diana Wright, all of whom are nearing or have reached the three-year mark as regular hospital staff.
At the hospital’s open house, scheduled for Dec. 7, patients may be awestruck by the building’s size, which Goshe said exceeds most department managers’ minimum requests for space.
“Ninety-five percent of the hospital is built just to state code (requirements),” Goshe said. “Most managers, when they came in, said, ‘OK, we need this much space,’ and then we found out that the code minimum was more than what they were asking for. Some of that’s because we’re used to working out of a closet and now we’re going to a full-size department. But I think it’s very adequate. It definitely looks big.”
Big might mean 140 parking spots, more than twice the number at the current site, flanking the building’s main and rear entrances. A new helipad located next to the nearly 3,000 square-foot ambulance garage links to an emergency unit complete with four exam rooms, a triage room, trauma room and psychiatric room.
Other features of the building are larger than life, like the 12 exam rooms and six physician offices that curve around the clinic nurses’ station, with reception and check-out areas separating sick patients from those in the dental office waiting room down the hall. A 1,350 square-foot meeting room will host patient education, community outreach, or training sessions, while the new pharmacy’s retail section will offer over-the-counter medications and get-well cards. Just a few steps from the clinic, the cafeteria seats 40 and is framed by a slate fireplace and a wall of windows leading out to a patio with more dining tables.
Many staff members are looking forward to stretching out in the new facility.
“Everybody feels like they’re on top of each other here,” said RDH staff accountant Maxine Stewart, who shares office space with two other employees. “The hospital really has met its useful life. Now we’re just biding time.”
Another feature of the building is a distinct separation of spaces. The physical therapy department, which currently separates its “rooms” with curtains, will have four private rooms, along with separate exercise and aquatics rooms. The long-term care wing houses ten private rooms with amenities just for its patients, including an outdoor sitting area, food prep space and activities room.
With the new building comes equipment and built-in technology considered cutting-edge in the healthcare industry, Goshe said. That includes patient lifts in the eight acute and ten long-term patient rooms, negative pressure rooms for infection control in the acute unit, and a 64-slice low-dose radiation CT scanner. Eighty percent of the equipment will be new, Goshe said, with old equipment and furniture traded in as equity or sold to organizations that then take them to third-world countries.
To maintain all of the space and new equipment, the hospital has hired an additional maintenance worker and plans to employ more housekeeping staff, Goshe said. He said that other expenses may be comparable to the old building.
“As far as utilities, it’s a bigger building, but because our old systems are so inefficient, and because everything in the new building is energy-efficient, we feel like our gas and electric might stay the same,” Goshe said.
Otherwise, unless new services are added in the future, the current RDH staff will be the staff patients see in the new building. Patients should, however, expect to see more specialists coming to Rangely on a monthly or bimonthly basis. Administration has targeted the special procedures unit, which will only be used approximately two days per month at the outset, for increased use by specialists who currently require Rangely patients to come to their Grand Junction offices.
“We’ve got specialists who say, ‘We’re not coming up here if we don’t have room,’” Goshe said. “We realize we’re not going to be able to support an orthopedic surgeon or any kind of specialist. But there are enough patients in Rangely that (specialists) could visit once a month, and if we have the space for them, we will have them… Like we said during our Town Hall meetings, our goal is to save patients as many trips out of town as we can.”
At its current size, the hospital will never deliver babies or perform surgeries requiring general anesthesia due to insurance restrictions, Goshe said. But some procedures, like vasectomies, colonoscopies and endoscopies will continue to be done, and others like cataract removals may be options in the future.
Chief Financial Officer Jim Dillon said that RDH’s financial stability comes from its status as a critical access facility, which means that Medicare pays for some of its overhead costs, and as a special district hospital, which provides an operations levy that has been in place for years. Once the hospital is complete, administrators and the board hope to further plans for a six-unit apartment complex for visiting or interim staff, along with a six-bed independent living senior facility that could include light housekeeping and meal services. The facility would complement the Eagle Crest Assisted Living area and the hospital’s long-term care unit, Goshe said.
Right now, though, the goal is to get through the “punch walk,” or final check before state inspectors arrive in November, then look ahead to the hospital’s grand opening on Dec. 7, move starting Dec. 14, and opening day on Dec. 17.
“We’ll probably be running two places at the same time during the transition,” Goshe said. “And it’ll be chaos for a few days. But everyone’s excited and we have lots of good help to do it.”