Can Kingman support 2 hospitals?

KRMC officials, community leaders give opinions on whether facilities can co-exist

KINGMAN - Kingman will get its second hospital in the fall of 2009, if plans for Hualapai Mountain Medical Center proceed as scheduled.

Lake Havasu City now is served by Havasu Regional Medical Center.

However, the community once had two hospitals.

"The first hospital was Lake Havasu Community Hospital opening in 1973 on Mesquite Avenue," said Sheena Benson, public information officer for HRMC. "In 1974, Lake Havasu Medical Center opened on Civic Center Lane across the parking lot from the first hospital. Both were physician owned.

"They merged in 1981 when Lutheran Hospital and Home Society took over both and combined them into one entity known as Havasu Regional Hospital."

"The only official reason I've been given for the merger was consolidation of services.

"This was a community of about 18,000 people in 1981 and it was felt it would be best to consolidate."

Benson added it appears one hospital was more surgical in nature, while the other was OB/GYN-oriented.

Havasu Regional Hospital later was renamed Havasu Regional Medical Center.

The plan for HMMC calls for MedCath, a North Carolina-based firm, to own slightly less than 80 percent of the new hospital with a local doctor's group (Northwest Independent Physicians Association) owning the remaining 20-plus percent.

The hospital's Board of Directors will consist of eight members, four representing MedCath and four from NIPA, said Ed French, president and chief executive officer of MedCath.

Staffing

Brian Turney, chief executive officer, and Heather Crowl, executive director of human resources, responded to questions about issues KRMC now deals with and would face in the future once HMMC opens its doors.

On staffing, Crowl said there is a nationwide shortage of health care workers in all specialties.

"There are significant shortages in nursing and clinical employees such as respiratory therapy, radiology and cardiac catheterization laboratory nurses," Crowl said. "The nationwide vacancy rate for RNs and pharmacists is 8 percent. However, we had a net gain of 37 RNs last year, and our turnover rate of 11 percent is significantly lower than the national average of 17 percent."

On recruiting, Crowl said KRMC is very selective in hiring. Multiple avenues are pursued to attract qualified individuals such as career fairs, targeted marketing and online recruitment. The time to hire varies extensively with the specialty and current market but can take two to six months on average.

What do you foresee once the new hospital opens? Will personnel shortages increase in key areas?

"We anticipate that the new hospital will attempt to recruit from our staff," Turney said. "In fact, some of our staff has already been approached by physicians who are involved with the new hospital.

"KRMC values our employees and recognizes them as a key resource. We conduct an annual employee satisfaction survey to ensure that we continue to meet their needs and are in the top 25 percent nationally. We will continue to focus on providing a work environment that supports our employees."

Doctors as owners

Doctors could conceivably have staff privileges at both hospitals, he said. However, it would not lead to a good situation.

"It is obviously a very divisive issue," Turney said. "Hospital ownership by physicians is a definite conflict of interest.

"There is currently legislation addressing this issue before the Senate and House. The KHI Board will not make a decision about this until that decision is made."

Dr. Hesham Sahawneh is a general surgeon and member of the NIPA.

"I don't agree," he said. "Many hospitals in the nation are partially owned by doctors. It may be a conflict of interest to him, but physicians can co-exist with both hospitals."

An article appearing last Wednesday in the Wall Street Journal states Medicare officials want to crack down on joint hospital-doctor ventures in which doctors can refer patients to businesses in which they have a financial stake.

In that story, writer David Armstrong states, "Critics say self-referral fuels the ordering of unnecessary exams or procedures as the doctors stand to profit from the increased business. Supporters say that doctors' investment in new facilities improve medical services, especially outside metropolitan areas, where patients might not otherwise be able to access the latest technologies."

Physicians are professionals who first and foremost do what is right for the patient without regard to monetary gain, Sahawneh said.

Community leaders' take

So the question is, can Kingman support two hospitals?

"I'm not real familiar with the hospital's business, but I think we can," said Beverly Liles, president and chief executive officer of the Kingman Area Chamber of Commerce.

"The new hospital will start out small and it will be several years before it gets up and running, so hopefully our community will have grown by then and have the need for a second hospital.

"I don't know how many times per year KRMC is full, but I know there are times when they are and the emergency room is backed up as is the case all over the country."

On Aug. 17, Turney said recent expansion was built to accommodate growth for 10 years. In 2006, there was only one date in which all 170 beds were full.

Kingman Mayor Les Byram said he hadn't thought much about it.

"The hospital we have is in good financial condition," Byram said. "It will depend on financing of the new group and expensive type services they mean to provide.

"Before they can get it all done, two to three years will pass and that means Kingman would have a larger population and will continue growing, so we probably can support two hospitals.

"One positive with two hospitals is that it will help in recruiting doctors and key medical personnel. It also will give people a choice, which is a positive thing, and again, if we recruit doctors of different specialties that could be a plus for us."

Jonas Peterson, deputy director of economic development for Mohave County, also was asked the question.

"I'm not privy to population estimates and growth for supporting it," Peterson said. "But I think it's beneficial for the community to have choices. Similar sized communities have supported two hospitals, so I think it's possible."