Introduction
For 75 years, Prosser Memorial Health, a rural, 25-bed critical access hospital, has served Prosser and its surrounding communities. After years of enthused community-led fundraising, PMH's rich history began in 1945 when construction crews broke ground on the 19-bed facility. Two years later, on December 26, 1947, Prosser Memorial Hospital opened, dedicated to the memory and service of World War II veterans.
Prosser Memorial Health is owned and operated by Prosser Public Hospital District, a municipal corporation of the State of Washington. The hospital district is governed by a seven-member board of commissioners.
This modest, small-town hospital blossomed into a community-focused center for exceptional medical care serving thousands of patients every year. Our care, and provider base scope, includes family medicine, advanced surgical care, laboratory, state-of-the-art diagnostic imaging, obstetrics and emergency care.
Today, the hospital's facilities are dated and not fully compliant with the Americans with Disabilities Act. Building a new facility is a more cost-effective approach than renovating the hospital. In addition, we continue to grow and are adding new service lines and providers to meet the healthcare needs in our community. We have simply run out of space.
Prosser Memorial Health has over 54 employed providers, numerous service lines, three primary care clinics, orthopedic, cardiovascular, general surgery, urology, ENT/allergy, Women’s Health Center, dermatology, gastroenterology and a rehab/therapy clinic. Our primary service area includes the Lower Yakima Valley from Sunnyside, south to Benton City and West Richland. Our secondary service area extends further west into Yakima and as far south as Pasco and Kennewick.
In 2017 PMH purchased 33 acres of land north of I-82 for a new hospital. We plan to sell the existing grounds and facility or raze it and return it to a residentially zoned area.
Prosser Memorial Health will improve the health of our community.
We will become one of the top 100 Critical Access Hospitals in the country through the achievement of the following pillars of excellence.
#1 patient loyalty: PMH will provide outstanding customer service, aspiring to treat those we serve the way they want to be treated.
#2 medical staff development: PMH will respond to the medical staff concerns and needs in a timely manner, pursue initiatives in collaboration with our medical staff and ensure the availability of the appropriate providers for those we serve.
#3 employee development: PMH will encourage and provide for the ongoing development of our employees. We will provide an atmosphere that values our employees and promotes:
- Open communication
- Competitive wages and benefits
- Selection and retention of effective, caring personnel
- Utilization and development of talent throughout the organization
- Ongoing education
- Employee recognition
#4 quality: PMH will develop and maintain a system of continuous improvement which is incorporated into the daily work of every employee and medical staff member.
#5 services: PMH will develop and maintain appropriate facilities, technology and services to meet the needs of those we serve that includes building a replacement facility.
#6 financial stewardship: PMH will continue to strengthen its financial stewardship position to enhance the ability to develop new services, obtain needed technology, modernize facilities, recruit physicians and ultimately ensure long-term viability.
Prosser Memorial Health by the numbers
- 486 employed
Compensation multiplies throughout the area spent on groceries, dining, retail goods, services, vehicles and more!
Category growth
Hospital Admissions and outpatient services have consistently increased since 2015. Adjusted patient days that include inpatient and outpatient services combined have more than doubled since 2013.
| Admissions | Clinic OP visits | Adjusted patient days |
|---|---|---|
| 2013: 1,029 | 2013: 42,739 | 2013: 8,742 |
| 2015: 1,332 | 2015: 51,581 | 2015: 15,479 |
| 2021: 1,980 | 2021: 71,356 | 2021: 20,438 |
Category growth
Births have increased by nearly 24% since 2013. In 2021 we delivered a record 583 babies.
- 2013: 275
- 2015: 583
- Budget 2022: 600
We have grown our active medical staff 66% since 2017, hiring 29 new providers and adding specialty providers in cardiology, urology, ENT/allergy, dermatology, gastroenterology and joint replacement. We plan to add an additional 16 providers between 2022–2024.
We performed 1,196 surgeries in 2020. In 2020 that number declined slightly due to the COVID-19 shutdown of surgery cases. We performed 2,148 surgeries in 2021.
- 2021: 2,148 (budget 1,646)
- Budget 2022: 2,249
From 2019 to 2021, our digital imaging volume grew 15% to procedures performed. We performed 35,907 procedures in 2021.
- 2020: 27,358
- 2021: 35,907
- Budget 2022: 34,216 (reduction based on reduced COVID-19 volume)
We performed 171,918 laboratory procedures in 2021, up 21% from 2020. We are forecasting to perform 149,410 procedures in 2022 (reduction based on COVID-19 volume).
* All statistics are 2020 budget or annualized.
Our community need
Prosser Memorial Health has grown at a rate of 10% each year for the last four years. We have expanded service lines, purchased new equipment, and added clinics and providers to our team in response to community needs. Today, it is clear we must continue to grow and respond to the increased demand for high-quality, low-cost healthcare in the communities we serve.
Our patient count from both east and west of Prosser continues to grow. Patients have changed their healthcare provider because they trust PMH, and they know they will receive excellent care with dignity, respect and optimism.
Our current facility is from a post-World War II era with many renovations and expansions to stay current. Unfortunately, we have run out of room to expand the hospital at its current location. The facility is not ADA-compliant and struggles to meet state and federal regulations for hospitals.
The hallways are narrow, operating rooms are too small to contain all the new equipment needed and there are limited private rooms for inpatient care. There is a lack of parking and treacherous winter conditions make navigating the hill upon which the hospital sits challenging. This building and site have exceeded their useful life for several reasons:
- The building currently has semi-private patient rooms, with insufficient space for conversion to private patient rooms without decreasing bed capacity. A decrease in bed capacity would not meet the communities current and future needs for bed capacity. Private patient rooms are required by current code and demanded by patients and payors alike.
- Numerous hospital departments are without necessary space to provide needed, modern medical services, i.e., insufficient space to add MRI services inside the hospital.
- The current configuration is insufficient, expensive from an operating perspective and does not provide the desired level of quality of care for patients.
- Due to the existing site’s grade differences, there are numerous elevation changes, both inside and outside the building, which present accessibility issues, unnecessary and unacceptable liability exposure, and quality of care issues.
- Due to the number of additions over the past 70-plus years, there are numerous egress issues for the building that create undesirable problems with patient flow issues creating inefficiencies and patient care problems.
There are limited resolutions to the infrastructure problems of the existing facilities that will lead to continual costly repairs into the future without a long-term solution. These infrastructure issues will cost the District a significant amount of money due to the disruption of patient care issues that will exacerbate future operations.
- Buried sanitation sewer lines are over 70 years old in portions of the building and are beginning to fail. Solutions to this problem are few, with none of them providing acceptable resolutions.
- All major mechanical, electrical and plumbing infrastructure, i.e. air handling untied, boilers, chillers, etc., have all exceeded their useful lifespan.
- Air handling unites are over 28 years old and replacement will require closures of portions of the Hospital. Again, few options are available to resolve this problem satisfactorily.
- There is moisture entering the exterior wall cavity at various locations, which has damaged the building’s exterior enclosure, forcing temporary remedial actions, including replacing portions of the exterior enclosure with painted plywood.
- The roof has exceeded its useful life span and replacement will be another significant capital expense with no improvement to patient care services or revenue streams.
- This site is bounded by streets on two sides, and a steep hill and residences on the other sides.
- Lack of parking for our current patients.
- Consistent overcrowding of every hospital department, confined workspace and repurposed rooms that do not meet our current operational demands.
- There is a consistent lack of storage in every hospital department, leading to hallways being used for storage (a violation of several building codes that create operational and liability problems.)
- There is a lack of conference and meeting space in the hospital. Our medical staff meetings need to be held off-site to accommodate all of our providers.
- The Dietary Department is ill-suited toward transitioning to menu-based food service due to a lack of preparation and cooking space, a lack of storage space, and a lack of refrigeration space. Menu-based food service is the direction most hospitals are moving to and is directly tied to patient satisfaction.
- The dining area is lacking sufficient space and after-hours amenities for staff and visitors.
- There isn’t a functional loading dock and receiving area. There is limited storage for the Materials Management Department to store necessary supplies correctly and efficiently.
- The surgical department layout is less than ideal, including inefficiencies in patient and material slow and an undersized operating room. This limits the type and volume of surgeries that can be done.
- There isn’t adequate space to expand the operating room or to create another operating room.
- The current hospital does not have ICU rooms.
- There are security concerns because of the existing departmental layouts within the existing building, especially as it pertains to infant security and our ability to lock the facility down in an active shooter situation.
- The existing building’s utility costs are more than $292,000 annually, accounting for over 50% of the annual operating budget of the maintenance department. These numbers equate to approximately $5.04/SF of hospital space—well above the average amount for a new facility.
Based on all the information above, the existing building is not suitable for continued use as an acute care hospital. For these reasons, coupled with the growth Prosser Memorial Health has experienced over the last several years, we began researching options to ensure the successful future of the organization.
The way forward
This is How We Care is not merely a Prosser Memorial Health slogan; it is our way of life. We are committed to delivering high-quality healthcare. To serve our community now and well into the future.
Since 2017, we have worked closely with the United States Department of Agriculture (USDA) on the extensive application process to secure a loan. The USDA approved our pre-application in 2019, which included a site visit to our current hospital. They agreed—PMH requires a new facility to care for patients.
With the USDA loan, PMH will not bring a levy or bond to voters to fund this project. The architect and construction consultants project we would open the doors to the new hospital in 2024.
The USDA loan requires community support as a component of the loan. To demonstrate substantial community support, we anticipate raising $3 million dollars from the community with a capital campaign. As of November 2022, we are halfway to that goal with $1.5 million in donations.
Cost and revenue projections
Total project cost: $112 million
PMH contributions
Purchase of land in 2017: $1,724,500
Capital lease: $5,000,000
Cash (20% of project cost): $25,500,000
Contribution total: $32,224,500
Estimated USDA loan proceeds: $80,500,000
- Original loan at 2.25%: $57, 500,000
- Second USDA loan at 2.12%: $13,000,000
- Third USDA loan at 3.50%: $10,000,000
- Grant: $1,000,000
*Weighted average for the USDA Loans: 2.39%
About the foundation
The Prosser Memorial Health Foundation pursues, receives and administers donations and gifts for PMH. The Foundation supports and enhances healthcare for the Lower Yakima Valley and the surrounding region. The Foundation assists with new equipment purchases, funding for scholarships, building projects and other organizational advancements.
The Foundation has several designated funds. The Wayne Hogue Capital Fund will “host” gifts for the new hospital.
The Wayne Hogue Capital Fund: Financial support for staff training, hospital equipment and facility improvements, including building the new hospital.
Wayne, a generous philanthropist and businessman, led by example. As a past Chairman of our Board of Commissioners, he used his many resources and talents to improve the high-quality healthcare we enjoy today.
Wayne believed in fundraising, "You just have to ask." The hospital and Wayne's objectives are well-aligned for the best options and treatment with advanced technology and resources delivered in an inviting environment.
Community support from businesses, individuals and foundations for the new hospital will be administered through this fund.
Design and layout for a new hospital
Outcomes
Prosser Memorial Health will be a Center of Excellence, providing high-quality, low-cost healthcare services to the communities we serve. This includes:
- State-of-the-art surgical suites and technology to respond to the needs in our community
- New Birthing suites will allow for water-birth opportunities, enabling more flexibility to accommodate mothers' preferences in delivery
- All inpatient rooms will be a private room with amenities to accommodate family and support people for our patients comfortably
- 16% of rooms will be equipped for ICU, providing a higher level of care for our patients and keeping them close to home
- Expand the Cardiology Clinic to include cardiac rehab and pulmonology, allowing patients recovering from a heart attack or pulmonary issues to stay in Prosser for their rehabilitation
- A savings of 10% to 15% annually in utility costs with a new facility
- Expanded Emergency Department
- Medical office building for specialists
Conclusion and recommendations
Based on the information included in this document, we believe that we have adequately conveyed the need for a new facility for PMH. Our current facility has aging infrastructure that cannot be easily remedied without extreme disruption of services. This, along with multiple code deficiencies, affects patient satisfaction and care. The current facility does not have the capacity to support the organizations mission and growth, either through renovation or an addition to the existing campus.
A replacement facility is the only feasibly option to meet the current and future goals of the organization. This will allow PMH to adapt and grow in the future with the least amount of disruption to patient care. This is also the most favorable option in terms of financial feasibility.
The proposed new facility will be used for hospital and medical office space and will house all current modalities as well as planned future modalities. The campus can expand in multiple way in order to support the Public Hospital District in adaptable way so that it can support the mission and growth of PMH for 100 years to come.
Thank you!
We appreciate you reviewing this summary of our plan. Your thoughts and counsel about this exciting endeavor are essential.
- Stephen Kenny, Chairman
- Keith Sattler, Vice Chairman
- Glenn Bestebreur, Secretary/Treasurer
- Sharon Dietrich
- Susan Reams
- Brandon Bowden
- Neilan McPartland
- Julie Sollers, President
- Rich Legerski, Vice President
- Stephen Kenny, Secretary
- Evan Tidball, Treasurer
- Elisa Riley
- Frank Schroeder
- Glenn Bestebreur
- Keith Sattler
- Lisa Veloz
- Neal Ripplinger
- Stephen Kenny
- Susan Reams
- Carolyn Knee
- Shelby Moore
- Craig Marks, CEO
- David Rollins, CFO
- Merry Fuller, CNO / COO
- Bryon Dirkes, CHRO
- Phillip Braem, CIO
- Kristi Mellema, CQO
- Shannon Hitchcock, CCO
- Dr. Brian Sollers, CMO
- Annie Parker, CCOO