New Hospital FAQs
Cascade Medical Center – New Hospital FAQs
Why does Cascade need a new hospital?
We’re out of room. Given our current patient base and volumes – we have half the space we need to provide the medical care according to current care standards.
The existing facility is nearly 50 years old and lacks certain expected hospital features, such as in-wall medical gasses, ADA bathrooms, and a safe room. The building has electrical, plumbing, and mechanical systems that cannot be readily repaired or replaced. In some cases, parts can no longer be found to fix certain issues. This creates a less-than-comfortable environment for patients and staff and makes adding new or updated medical equipment and technology much more difficult and expensive. Several areas do not have adequate ventilation, heating and cooling, making climate control a frustration for patients and staff alike.
Why not do a renovation and small expansion at the current hospital now?
Renovation and expansion in a hospital setting is expensive and disruptive to patient care. A hospital must be able to maintain 24x7 operations to serve its community, honor its license granted by CMS and the State of Idaho, and meet its mission. Closing during construction is not an option. Any money spent prolonging the life of the current hospital hampers our ability to prepare a new campus that will serve our community for future generations.
Why can’t the current hospital be renovated?
Much of the current facility was constructed in such a way that replacing critical infrastructure simply cannot be done, short of demolition. Known asbestos content makes demolition more difficult. The cost and disruption of renovating the existing buildings make a new facility, in a new location, a much better option for our community.
Adding a new building on the same site is not feasible due to our limited space (2.6 acres split down the middle by a public road). With required set-backs, there is simply not enough space to expand or build a hospital large enough to meet the community’s needs beyond 10 years. Even parking is a problem, with only 40 spaces which are further reduced when snow piles up.
What are the biggest problems with the current facility?
CMC simply does not have enough space to meet the needs and demand for medical services at current health care standards. CMC operates in a space that is approximately HALF of what is needed to meet patient needs – and that doesn’t even consider future growth which our community is already experiencing. Climate control in each season is a big frustration. Even concrete is beginning to break down. Basic accessibility requirements are not met, including public stair and ramp slope and ADA bathroom requirements. There are other issues with plumbing and electrical systems that are simply not sustainable. The use of multiple outbuildings is inefficient.
Why do we have to move the location of the hospital?
In 2020, CMC hired Wipfli to assess the ability of our existing hospital to meet the community’s needs. (Wipfli is an independent company with expertise in strategic planning and financial auditing of rural hospitals.) Over several months they conducted detailed audits and interviews to reach an opinion in a 76 page report. In summary, Wipfli concluded that “The existing site is extremely constrained and expansion zones are limited by topography and the public street; any growth will displace parking which is already tight on campus. The existing site cannot accommodate needed expansion to serve the hospital over the next 10+ years.”
The existing hospital seems just fine, why change it?
Our incredible hospital and clinic staff has done a great job providing high quality medical care in this building for several decades. They continue to do so today but it is becoming more and more difficult as health care changes and our community grows. In its facility assessment, Wipfli stated that there are “major facility and operational issues.” Departmental space issues and challenges were documented in every single department. Even with renovation, we are simply bursting at the seams.
How much space is needed to build a new hospital?
The existing hospital sits on 1.6 acres, with an adjacent helipad and empty lot of 0.6 acres separated by a public street (Lefever Drive). Wipfli recommends at least 10-15 acres for new Critical Access Hospitals to allow for growth and expansion. Currently at 12,000 square feet, the new hospital needs to be roughly double that size to meet TODAY’s needs, with the ability to expand further to meet the future needs of our community and support the growing retirement and tourism activity.
Where will the new hospital be located?
We are still finalizing that decision. The new location will be in or near the City of Cascade so that we can continue to serve our current community while positioning ourselves to care for an ever growing population who desire to receive health care close to home.
Why do we have to do this now?
The process for planning, funding, and building a new hospital takes years. By starting now, we can open the new hospital in 2025. The current facility will be over 50 years old by then and its mechanical systems will be at their limit. Waiting will require further renovation and replacement of equipment and systems which will nickel and dime the health district and its tax payers while only postponing the inevitable replacement of the medical center. We are already seeing accelerating growth in the area and new residential developments are coming on line from Clear Creek to Donnelly and from Cascade to Tamarack. Improved access to the area once the canyon’s road construction is complete will create even more interest in our area by the time the new hospital opens in 4 years.
Why not sell out to one of the large health systems and have them pay for expansion?
In 2020, Cascade Medical Center polled its community and received over 400 responses. Two-thirds of those surveyed asked that we remain independent. While we enjoy excellent relationships with other health providers, including St. Luke’s, Saint Al’s, and the University of Utah, independence has its advantages. As an autonomous provider owned by the taxpayers, we can be laser-focused on the needs of the people who live in our area. We get to make decisions and invest in resources that make the most sense for people living in the west central mountains. Our local control allows us to move quickly and make decisions locally.
Why not simply rely on the medical facilities in McCall?
Having local access to health care is an important quality of a vibrant community. Without Cascade Medical Center, many of our patients would need to drive another 15 to 30 miles to see a provider or receive physical therapy. For time sensitive emergencies, having a local hospital with 24x7 ER service is literally a life saver. Our patients enjoy receiving care close to home and continuing their care relationship with our providers to maintain wellness and improve their quality of life.
Will the new hospital offer additional services?
The primary goal is to assure continuity of existing services: primary care, family medicine, 24x7 emergency care, inpatient and rehabilitative services, mental health, and physical therapy. A larger footprint will allow us to consider new services, including specialties like cardiology, eye care, foot care, dermatology, urology, ENT, and digestive health. We will continue to look for ways to serve our local communities so they can receive as much health care locally as possible.
What is the current financial status of the hospital?
The hospital has achieved a positive bottom line each year for the past 5 years. This is the result of prudent financial management, public support of the medical center through property taxes, and partnership with the hospital’s Foundation and Auxiliary. This solid financial standing will help CMC secure bond or loan funding at attractive interest rates to support construction of the new hospital and clinic.
How many people are seen in the Clinic annually, and where do they come from?
Our volumes have been growing steadily. From 2018 through 2020, the family medicine clinic saw an average of 5,275 patients each year and this year we saw over 5,500 patients. Approximately 70% of our family medicine patients live in Cascade, 10% in Donnelly, 10% in McCall, and 10% from other communities. In addition, almost all of Cascade’s 4,000 plus physical therapy sessions this year were with patients who live locally.
How many residents are treated annually in the current hospital’s emergency room, and where do they come from?
The CMC ER treats 1,400 patients per year, of whom 56% live in Cascade, 25% in the Boise area, and 8% from other Valley County communities. The remaining 11% live elsewhere in Idaho or out of state.
How is the emergency department staffed?
The ER is staffed 24x7 by board-certified Physicians and Physician Assistants. A new hospital facility will provide the environment and appeal needed to retain providers and support staff as well as recruit additional health professionals as we grow.
How much will the new hospital cost?
The entire project is estimated at $33 million. To be on the safe side, we have included over $6 million in contingency and inflation factors in that amount, given the uncertainty of the economic and construction trades environment. The Board is forming a project management committee that will examine project details and dig deeper into the budget in order to validate these preliminary estimates.
How will we pay for it?
Hospitals routinely face the challenge of renovating, expanding, and replacing their infrastructure. As an independent Critical Access Hospital and Rural Health Clinic, Cascade has several good options. Federal agencies such as USDA have programs specifically to support hospital building projects. A combination of public and private loans and grants will be sought in addition to the operating funds surplus that the hospital has been able to accumulate over time. The hospital’s Foundation is readying a capital campaign to raise funds. Finally, a temporary property tax increase will be requested of voters to help service the debt necessary to build a new hospital.
How much will this add to my taxes?
This is still being determined. Over the next few months, we will narrow our funding options, which will then tell us how much help we need from property owners.
Will the projects generate new jobs?
In addition to short-term construction jobs, the new medical center is projected to increase the hospital’s workforce as we add new capacity and services.
What accommodations have been made for future pandemics or large-scale community disruptions?
The new hospital is being planned and designed with the capability to quickly convert beds to handle a higher number of inpatients, with rooms that provide negative pressure systems when the need exists. Emergency power systems will also be available in both the hospital and clinic, allowing for ongoing needs without interruption.
What would happen to the old hospital facility?
There are a range of possibilities for the future use of that property, but nothing has been decided. While it is out of date as a hospital, the building and grounds can be repurposed in many ways once the medical center moves into its new home.
Was a needs assessment conducted in considering a new hospital and clinic?
Thorough market and financial assessments were conducted, as well as a space analysis based on current use and future projections of patient volume. The proposed sites under consideration are being carefully studied by an experienced healthcare architectural firm based on factors such as access, topography, helipad location, zoning, building orientation, parking, site amenities, traffic, neighborhood, and environmental issues.
How long will construction take?
If voters approve the project in May, the new medical center could open in 2025.
Why should I support this if I don’t use the hospital?
The medical care provided for our growing communities should be considered in the same light as police, fire, schools, parks, public infrastructure and other essential services that are supported by tax dollars. Even if you don’t personally use such services, they are necessary and valuable. Maintaining a state of the art medical facility is key to improving public health, retaining local talent, and growing our economic base. Our medical facilities are available 24x7, to everyone.