USDA Loan Approved!
Sublette County No Longer the Only County in WY without a Hospital
On June 24, 2022 the Sublette County Hospital District received approval for a $32.2 million USDA Rural Development Community Facilities loan to fund the construction of a new Critical Access Hospital (CAH), the first of its kind in Sublette County. Sublette County has long had the dubious distinction of being the only Wyoming county without a hospital, but in November 2020, voters chose to rectify that situation by overwhelmingly voting in a Hospital District. Healthcare is a fundamental need for Sublette County citizens and the approval of the USDA loan application is a key step in improving healthcare access across Sublette County.
Sublette County Commissioners Joel Bousman and Tom Noble note that “Sublette County approved the formation of a Hospital District with the understanding that the Sublette County Commission would provide up to $20 million to fund a new nursing home upon completion of a merger of the Sublette Center (the current Long Term Care center) with the Hospital District, which puts healthcare services in Sublette County under one umbrella. The goal of all of this is to improve healthcare services in our county and allow our senior citizens the option to remain in the county for care. With approval of the USDA loan, we can now move in that direction.” The current long-term care facility, the Sublette Center, is 50 years old and in desperate need of updating. The new facility will attach to the hospital with a number of improvements over the existing facility, including private rooms and a memory care unit.
This joint project is the capstone of a multi-year community effort led by community members eager to see healthcare improve in Sublette County. “The historical significance of this announcement is not lost on us,” said Tonia Hoffman, SCHD Board Chair. “We are thrilled to be a part of pulling the project together in spite of the many obstacles we faced and are grateful for the various members of the entire team of people who contributed in any way. We look forward to creating a lasting legacy of patient care in Sublette County.” SCHD Board members include Hoffman, Jamison Ziegler, Kenda Tanner, Wendy Boman and David Bell.
While Sublette County currently has two clinics (one with an attached emergency room), critical healthcare services – including blood transfusions, chemotherapy and, most of all, the ability for any patient to stay overnight – have never been available. The new CAH facility will consist of a 10-bed inpatient unit plus a pharmacy and laboratories. The building will be staffed with full-time doctors and mid-level providers, as well as a variety of professional staff in other health care positions. The 70,000-square-foot facility will also offer advanced imaging capabilities, including ultrasound, X-ray, CT and mammograms. The 50-bed long-term care facility will include a 10-bed memory care unit, one of only two in western Wyoming. “Having a Critical Access Hospital in Sublette County will greatly increase care. In the past we have been lacking in basic services.” Dave Doorn, SCHD Administrator, states. “Having a CAH will be a game changer for our community.”
A key piece to the project moving forward was the Sublette Center (the current LTC facility) agreeing to merge with the Sublette County Hospital District. As the Sublette Center currently operates as a nonprofit, the merger will improve pay and benefits for the Sublette Center staff. The merger will also allow both organizations to share services such as dietary, IT, infection control and housekeeping. “Forming one healthcare entity for Sublette County is better for the community” Sublette Center Board Chairs Patty Racich and Marilyn Jensen write. “Our board believes the success of elder care lies in strengthening relationships. We hope to work towards continued improvement of healthcare for all ages of Sublette County residents and provide exceptional care for long-term care residents.”
“Assuring quality healthcare for the residents was important to the support of the project” Sublette Center Administrator Dawn Walker adds. Each room in the new long-term care facility will have a bathroom and shower. Unlike the current facility where most of the rooms are doubles, requiring patients to have a roommate, most rooms in the new facility are private. Dawn Walker notes, “This will make such a difference for our residents.”
This project has been a long time in the making. Medical Director Dr. David Burnett, who has practiced medicine in Sublette County for 33 years, has a framed copy of the front-page article from the Big Piney Examiner dated October 15, 1925. The headline of the article reads “A Hospital Is Our Most Essential Need”. Dr. Burnett notes, “Thanks to years of hard work by first the Sublette County Rural Health Care District board, and then the newly formed Hospital District Board, and significant community support from all towns, mayors, county commissioners, our state representatives and our citizens, Sublette County will now have a hospital. One hundred years of progress and the hard work of many have led us to this. It is a most significant development that will have great impact on our county.”
After Sublette County’s November 2020 election to form a Hospital District, the newly elected board focused on an opportunity in the USDA’s Communities Facilities Program for rural areas. Established in the Balanced Budget Act of 1997, CAH is a designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services, essential to receiving compensation for eligible patient care. With the application’s approval in June 2022, and the obligation of funding, the SCHD is ready to begin construction.
Layton Construction has been selected as the Construction Manager. Layton is a national construction firm that has completed dozens of healthcare projects. Most recently, they built the beloved Pinedale Elementary School in 2010. With USDA loan approval, Layton stands ready to start the subcontractor bidding process and groundbreaking on this historic project. Completion is expected in 2024.
Part of the USDA loan process requires the submitting organization contract a management partner who has CAH experience. After an extensive process with multiple applicants, Star Valley Health was selected as the Sublette County Hospital District’s Management Partner. Mike Hunsaker, Star Valley Health COO, notes “Star Valley formed its first CAH in 2002 when we had only 65 employees. We currently employee about 450 people, operate in the black and only need to use tax revenue for capital construction processes. We hope to mentor Sublette County along the same path we have traveled and are excited to see their progress.”
Representative Albert Sommers knows that having a hospital is his county is critical to providing care but will also be an economic pillar of the community. Without the CAH designation and facility, healthcare services in Sublette County could not be maintained at their current levels. Sommers states, “A critical access hospital optimizes reimbursement rates, which makes financial sense.” Currently, though it is providing life-saving emergency care, the clinic can only bill as a doctor’s office, and therefore receives much-reduced rates. As a CAH, it will be able to receive fair reimbursement for the services provided. Additionally, healthcare services for Sublette County residents are leaving the county at an alarming rate due to lack of services. Improving services and critical care will stem the economic leakage that has plagued Sublette County for so long. “Quality healthcare and nursing home care is essential for the residents of this rural county,” says Sommers.
Healthcare providers reference the “golden hour” of care, which is defined as the time following a traumatic injury during which there is the highest likelihood that prompt medical and surgical treatment will prevent death. Public Relations Director Kari DeWitt notes, “This historic project checks so many boxes about what is important to a community: Quality of life, job creation, economic development, retention of trained workers and good-paying jobs that will retain young families. But most of all, it will provide lifesaving care to an area that has lacked these services for more than a century.” As Sublette County looks to the future, we couldn’t be happier about where healthcare is heading.