Quist returns

Nearly four months since first appearing before the Saratoga Town Council, Bob Quist, interim Chief Executive Officer (CEO) for Memorial Hospital of Carbon County (MHCC), returned for the Aug. 6 meeting of Saratoga’s governing body. The attendance of Quist at the meeting came 10 days after a press release from MHCC announcing the Board of Trustees’ intent to establish a clinic in the Platte Valley (see “MHCC announces clinic” on page 3 of the July 31 Saratoga Sun).

Along with Quist, current and former members of the MHCC Board of Trustees were in attendance as were Health Management Services (HMS) President Karl Rude and Saratoga Care Center Administrator Mark Pesognelli. In his initial address to the council, Quist explained the intent the Board of Trustees had in announcing an MHCC clinic.

“Conspiracy theorists would say that we were only trying to disrupt the current debate on the future of healthcare in the Valley and that couldn’t be further from the truth. Let me explain what our reasons are for the timing of the announcement,” said Quist.

Quist went on to inform the council and the public that MHCC was debt-free and had been able to remain in the black for the past few years, that the Board of Trustees had paid cash for the $3.5 million clinic recently opened in Rawlins and that the board had decided to wait until the project was completed before making their announcement on July 26.

The interim CEO added that, until recently, the Board of Trustees had opted to stay out of healthcare in the Valley because they felt things were running well and “it wasn’t the hospital’s intent to come in and supplant those active physicians.” Quist also raised the issue of the clinic going on nearly a year without a physician, stating that one of the reasons was the cost.

“I’m sure most of you are aware, one of the most highly sought after specialties or groups of physicians now are family practice. Every rural community in the country wants family practice physicians,” said Quist. “In order to recruit and retain, you’re going to spend anywhere from $300,000, including benefits, to $320,000. That’s the range that you have to do. To have a physician here on staff, in the clinic, they have to be able to support that.”

This echoes statements made by Rude in the past (see “Finances, survey discussed at healthcare sustainability meeting” on page 12 of the April 24 Saratoga Sun) in which the HMS president has stated that the cost of a doctor could not be offset by the clinic alone. During the April healthcare sustainability meeting, Rude quoted a number of $330,000 for a physician.

“We can bring the physician in. We can afford the physician and, essentially, we came to the conclusion, as a board, that we can offer more to the residents of the Platte Valley than any outside for-profit company can,” said Quist.

The interim CEO for MHCC also commented on the critical access hospital being pursued by the Platte Valley Healthcare Project (PVHP), referencing the ongoing issues currently being encountered in Sublette County by the Sublette County Rural Health District. Last April, the health district had been told by the United States Department of Agriculture to reduce their $28 million package for their critical access hospital.

Quist ended his speech by telling the council and the public “We think that we have an opportunity to do something that would be great for this Valley. We want to be a part of it. We are local. We are Carbon County.”

Councilmember Jon Nelson asked Quist a series of questions pertaining to the current lease between the Town of Saratoga and HMS. These questions included if MHCC could provide maintained clinic hours of 40 hour a week, 24/7 on-call services and two full-time mid level practitioners with oversight from a doctor of medicine. Quist stated that MHCC could provide 40 hours per week for clinic hours and pointed out that the clinic currently did not have 24/7 on-call or oversight from a doctor of medicine.

Nelson, in regards to the 24/7 on-call services, informed Quist he was aware of the lack of services, but stated his concern in terminating the lease with HMS for non-compliance only to present MHCC with an entirely different lease. 

“I’m trying to understand whether or not the language that’s in here is attainable by anybody or not,” said Nelson.

Quist also stated, with the requirement of two-full time mid level practitioners and oversight from a doctor of medicine, MHCC would provide a physician and one advanced nurse practitioner.

Once questions were opened to the public, the Saratoga Sun asked what had changed for Quist and the Board of Trustees between the May 21 meeting and the Aug. 6 meeting for MHCC to promise a full-time physician. During the May 21 meeting (see “Presentation consternation” on page 3 of the May 29 Saratoga Sun), Quist had informed the council that any physician that the hospital found would split their time between the Saratoga clinic and the Rawlins clinic.

Quist informed the Sun, and the rest of the room, that he had been contacted “out of the blue” by a physician who was interested in moving to Saratoga, but did not want to work in the current environment.

Following Quist’s statements, Rude was allowed a chance to address the council. Rude began by commenting on the progress the clinic was making before taking aim at Quist’s statements on the feasibility of a critical access hospital in the Valley. The HMS president stated that the MHCC Board of Trustees did not know what the numbers would say and claimed MHCC was “busy rejecting this community when the starting gun went off.” 

“We intend to serve you, long term, with a critical access hospital,” said Rude.

The next meeting of the Saratoga Town Council will be at 6 p.m. on Aug. 20 at Saratoga Town Hall.