"Update" Program with Vernon County Cares Volunteer Greg Hoffman and NRMC Board of Directors Aimee Meyer

0:00Good afternoon and welcome to today's update program on 97.5 FM double K country. I'm Thomas Singles. Thank you for joining us this afternoon. Today we're going to talk a little bit more about the hospital district on the ballot for the April general municipal elections. Give you guys some more factual information that you can use when going to cast your vote. And to talk about that, today we have a couple of guests with us. First up we have Greg Hoffman, a volunteer on the Vernon county cares committee as well as Amy Meyer, NRMC board of directors. Thank you guys for both joining us today. Thank you for having us. Yeah, thank you. Well, let's kind of talk about a little bit of the basic overview. Kind of tell us a little bit what is the ballot question about? Well, the ballot question is about forming a hospital district similar to the consolidated public water supply district and the ambulance district. So the hospital would be owned by that entity, not by the county government, not by the city government, by its own separate entity.

1:00And that's really what the ballot question is about, whether or not we should form the hospital district to take ownership of the hospital and control it locally. And somebody ask, well, why is that being considered? So kind of tell us why is that being considered? Sure, currently the hospital is a is part of the city and running an organization with two boards having two groups of leadership trying to make decisions really doesn't do a service to either entity. And so the city has expressed interest in getting out of the hospital business and our board is looking for ways to make that happen. It really does give us the freedom to be nimble and take action as an organization that will protect our hospital and keep it in the community long into the future. And I'm sure there's a additional cost that goes with it. So what are some of those costs? How much can residents expect that to be? Well, part of the ballot question is allowing for and up to $1 per $100 in assessed

2:10valuation. And that's the maximum it could be. I know there's been some misconception about, well, a dollar would be the initial amount. And then next year, the hospital district would come back and ask for a dollar 50 or $2 per assessed per $100 assessed valuation. And we had to put in the board had to put in the language that the maximum it could be was $1. That doesn't mean it's going to be $1. Because once the hospital district is formed, they will then make the decision about what property tax will be. So it's not set, but it's going to be $1. It could be up to that, but not more. And just to add to that, so one of the major changes of this process would be that the board that would operate the separate entity hospital district would be an elected board,

3:12much like the Vernon County ambulance district, the public water supply. We would follow the same lines as the ambulance district. And that's where our elected new board members would come from. And so to Greg's point, we don't know what the levy will be, but the maximum by state statute is up to $1. So that's why the language in the ballot reads without voter approval. And that's caused a lot of confusion and angst perfectly understandable. But what that means is that that board has the freedom based on what the needs of the hospital are at the time. That's ever changing. I know that very intimately. It's ever changing. And so they have the freedom up to no more than $1 each year. We don't know that that's what that what they would choose. If I were sitting on the board today and I needed to make a decision about how much the hospital needed, it would not likely be a full $1 based on some of the financial turnaround that we're having, but it does give them the

4:12freedom to do that to keep the hospital running. And we talked a little bit about taxes outside of that. What would the hospital district kind of do for residents? Would it change anything as far as care is concerned or their ability to get health care access? No, it would not. The hospital would continue to function just as it is. And Amy mentioned the turnaround, you know, over the last couple of years, we've seen a dramatic turnaround in the frequency local people are using the hospital instead of going somewhere else because the quality of care has improved substantially over the last couple of years. We hear a lot of comments about the mistakes of the past. And you know, we can't fix those. And we're not blaming anybody for what's taking place. Part of the challenge is reimbursement rates for Medicare and Medicaid have been cut several times over the last several

5:18years. And 70% of the users of our hospital are on Medicare or Medicaid. And so it's been a financial challenge because the reimbursement rates are a whole lot lower than they used to be. And they're going to be cut again beginning in December of this year. So that's a challenge that all rural hospitals are having to face right now. And we're trying to get ahead of it and be proactive rather than reactive and keep the hospital open and functioning here in Nevada and Vernon County. Well, you mentioned there 70% of the hospital revenue being Medicare and Medicaid. What are some of those other revenue streams that go along with it? Sure. So we, like you said, 70% that we have private insurance. And then we also have a program called the 340B pharmacy rebate program. It's exactly as described. But as you can imagine, the pharmacy companies don't

6:22really like to pay that. And so what I know to be true as a hospital board member is that there are constant threats coming at us, including giant cuts to Medicare and Medicaid, never seen before. It's going to hit really soon. We really have no way of preparing for that. There is, well, of knowing how much it will be in order to prepare for that. We know that part of that is the rural health care transformation fund, while there are going to be monies available to help as they state stabilize rural hospitals. It is a fraction of what's being cut from the system. So we really don't have a vision yet for how that will support hospitals. And so as Greg mentioned, this is really about preparing for the future. We do, if I were to make recommendations to a newly elected board today, if our board were to recommend to them, there are some programs that we can do to grow and enhance this hospital, keep services local. We know that lots of patients are

7:24leaving Vernon County for cancer care and oncology services. They're going to Boliver. When you're sick, that is a task that's difficult to have to travel. We've been in conversations with the Boliver hospital system for quite some time and plan to start those services right here. We plan to enhance some of our other services, including clinical services throughout the county. And so there are things that we can do that the tax dollars would not be used for the operations of the hospital, rather to improve and grow services at the hospital to make sure we're meeting the needs of our patient base and also offsetting the lack of income from the 70% by reducing the cost per patient, by simply increasing the patients that we have. And we've had a very expensive consultant perform a study of our community. And we know that we have the capacity to grow significantly. You talked a little bit about trying to get more patients and help more people. Who is currently

8:29going to be affected by this hospital district? It's easy to say Nevada residents, but this is beyond just the city of Nevada. So, so in terms of financially, anybody paying a property or real estate tax, it's everybody that lives in Vernon County, residents of Vernon County, or people who own, of course, if you own property in Vernon County and you don't live here, you would still pay it for the property that you own here. Who would be impacted by the growth, everybody? Hospitals have an incredible economic impact on the local community. Studies show two to two and a half times of the annual revenues go right back into the community around them. Something I'm really proud of as the chair of the Workforce Committee is the size of our organization. I know that 3M is somewhere around 630 to 650 and everybody knows that's the largest employer in our community with PRN employees and our MC is is nearing 500 employees. That is a significant piece of the Vernon County economy. And with the vote being April 7th coming

9:36up very shortly here, what happens afterwards, right? Like what are the next steps? I'm sure voters are wondering if they do decide to vote yes or you know, if it passes in general, what are the next steps as far as getting this hospital district established and getting it into working effect? It's kind of that's not an easy question to answer because it's kind of an extended process. The first thing that would happen would be an election of the hospital district board and that will happen in June. 90 days. I heard Adrienne Lee County clerks say that election would take place in June and keep in mind the hospital district board will not be the hospital board. It's going to be because the hospital board is appointed by the city. The hospital district board is going to be elected by the citizens of Vernon County and there are six districts so there will be six board seats voted on in June. Then after that negotiations will start with the

10:45transfer with the city about the transfer of ownership of the hospital from the city to the hospital district and so it's going to take a little while before the hospital district board is actually running the hospital so the current hospital board will still be in place and there will be operating side by side so there will be training for the new board to make sure they understand how complicated running a hospital is. It's not something that just anybody can do and so one of the first things Jason McCormick did when he came here as a consultant was to train the board on how a hospital operates and that's been one of the most important factors in bringing us to this point. The hospital district board will be in place for a while before

11:47the transfer of ownership actually takes place. It won't be just immediate and I want to make that clear. Great everything you said is accurate I want to say that in the background also happening are those transfer of ownership negotiations the worst thing that could happen is having a disruption and cash flow so you have behind the scenes of course the legal and the executives are working on ensuring that all of the insurance is transferred and that sort of thing so there's just lots that need to happen the estimation right now is somewhere around 18 to 24 months and to Greg's point hospital operations are at very complex and ever changing. I've been before prior to being on the hospital board I served on the foundation board for the hospital and prior to that I was an employee for the hospital. I've been involved with it for many years and I've given effort to learning to the best of my ability the finances and everything that impact hospital operations and I still don't get it. It's very complex I like I said I've tried really

12:50hard to learn and understand but it does change all the time and so that continuity between the two boards is a really important timeline to happen we wouldn't want to start fresh and leave the hospital in a bad position. And we want to make clear that the hospital is not in danger of closing at the moment the cash flow is positive we've had this turnaround that's been taking place for some time now and we do have a few days of cash on hand which is something that we were lacking and got us into a little bit of trouble with the bond insurer and so but the bond insurer has so much faith in this hospital that they actually loaned the hospital 1.5 I think it's 1.5 million dollars that they didn't have to do and of course the last thing the bond insurer wants to do is have a default where they have to pay out the insurance but they believe that this hospital has life

13:54and this is all about care to our community you know we're not trying to frighten anybody and they're saying oh my gosh the hospital is about to close we need to do this because of that it's more how can we make this hospital better and make it a resource for our community because if heaven forbid we should lose the hospital there isn't a hospital between Kansas City and Joplin that delivers babies and we're the only hospital within that range that does that adding some additional services like oncology and we're just about to get stroke designation we are in June that's a really big deal yeah so people won't have to you know if if they have a stroke they won't have to be transported someplace else to be able to care for and if you are no someone or you've had a stroke you know how critical time is in getting that

14:57treated so the effects can be minimal one of the best things I think that I heard our CEO say the other night at one of our public meetings was this is a 100 year decision for this community we've been in existence for over 100 years this this is this gives us under the current economic climate this gives this board the newly elected board I say us because I'm so involved but it gives that newly elected board the freedom and ability to make decisions without being a sub entity of the city which is very limiting this is about a community coming together to retain healthcare services for everybody around and we really are a regional hub I think the utilization of NRMC they said that our areas over 24,000 and that's significant and so we are not a tiny hospital we are not the same as our neighboring Cedar County or our neighboring Barton County those are very small hospitals we serve a much larger and a much more diverse population and we have to

16:03have the services that we have in order to retain them we have to grow not shrink we talked a lot of information here and obviously we could continue talking about it I'm sure for a long time if there's listeners out there that have heard something that they're interested in getting more research in where can they find those resources right now the Vernon County cares has a Facebook page where every day they're posting information they call it the daily dose and it's just Q&A that have come through various areas of social media or into the hospital we have several speaking engagements coming up and I apologize I don't have that calendar with me right now but the Vernon County cares Facebook page is a direct source for where and when those events will take place it is it is just not a conversation that can happen in one or two questions one question leads to 10 more is what we generally find so if if you are really on the fence or if you really have concerns or you really want to understand the reasons behind this attending some of those public

17:04events or engaging through the social media platform are a really great way of doing it as well anybody can call the hospital through and ask for the administrative office and to the best of their ability we're going to provide administrators to answer clear questions of course if they know me they can reach out message me on Facebook voting taking place on April 7th of 2026 this year coming up important for voters to become educated especially for this municipal election yeah nobody likes to pay taxes I certainly don't like to pay taxes but you know you you get what you pay for and the sales tax is designated specifically for the boundary payment and that's going to go away no matter what in 2032 and but the hospital is in need of some repairs some deferred maintenance and so all I can say is we need the hospital it's going to affect the community in so many intangible ways

18:11if if we should happen to lose the hospital property values will go down businesses will choose to go to another community where there is a functioning hospital this is an economic development issue just as much as it is a health care issue and we just want people to be informed and educated and make good decisions based on your own personal situation be careful about rumors and misinformation that's out there that social media is a great way to communicate but it's not always good communication if I could make a closing statement is that yes if 70% of your population it pays you pennies on the dollar for your services that feels like not a great business model but that is an act of our federal government and they are saying loud and clear they are no longer subsidizing health care

19:11or hospitals not just Nevada Regional Medical Center it is hospitals across this nation are closing their doors and that is by design and what they are saying very loudly is if you want a hospital in your community your community in your state are going to have to participate in funding that process so this is not an Nevada specific issue this is a nationwide issue and we as a community have to decide if we're going to step up and make this happen well Greg and Amy thank you guys so much for all the information you provided for us today and appreciate you guys coming in thank you thank you that is Greg Hoffman a volunteer on the Vernon County Cares Committee as well as Amy Meyer on the NRMC Board of Directors again General Municipal Election scheduled for April 7th coming up here shortly make sure to educate yourself before you go out and vote but make sure to vote in general always good to perform your civic duty I'm Thomas Singles that will wrap up today's update program