Struggling Boulder City Hospital to seek tax district status — and funding

By Tony Cook (contact), Mike Trask (contact)

Tuesday, March 4, 2008 | 2 a.m.

The chief executive of the private Boulder City Hospital has grown weary of hearing demands for more — and better — services from his little hospital, the only one in town.

Well, he says, if residents want more doctors, more fancy equipment and faster emergency room care, they are going to have to chip in.

And he thinks he knows how to make it happen: by passing the hat and requiring that everyone reach into his wallet.

That’s the idea he’ll pitch today to Clark County commissioners: that Boulder City residents be taxed by the county to subsidize the private hospital. Under the proposal, which likely would go to city voters for approval, the owner of a home worth $200,000 would face a $300 annual tax, based on the proposed assessment of 15 cents per $100 of assessed value.

It would be the first such hospital tax district in Clark County. Using tax dollars to subsidize a private company is not unprecedented in Nevada. Eight formerly private hospitals now have tax districts in the state, most in rural sections of Northern Nevada.

Boulder City Hospital officials say they have little choice but to tax homeowners if they want the facility improved.

“We’re required to provide certain services and be in a state of readiness for other emergencies,” hospital Chief Executive Tom Maher said. “Frankly, we operate at a loss each year. That’s why we hold fundraisers.”

Maher said the 67-bed hospital with a $19 million annual budget has lost about $500,000 each year since 2000.

The proposed tax assessment would raise about $1 million annually for the hospital.

The 15-year-old hospital relies on donations and fundraising, such as an annual art show, to stay afloat.

There are no pediatricians or pulmunologists, nor a full-time cardiologist, on staff because there isn’t enough business in town to cover their costs.

“It’s economics,” Maher said.

But if the hospital had the funds to provide specialty services it could recruit specialists, and serve patients who now seek those services in Henderson or Las Vegas.

Among the hospital’s hardware needs: a magnetic resonance imaging machine, which comes with a million-dollar price tag.

The hospital, Maher said, needs to increase the size of its emergency rooms from 170 square feet to about 260 square feet to care for more patients and meet privacy regulations. Maher said the need for emergency rooms will only increase when the new Hoover Dam Bridge opens in 2010, bringing thousands of additional vehicles through the small town and prospects of more traffic accidents.

Robin Keith, president of the 14-member Nevada Rural Hospital Partners, a network that works to keep hospitals in small communities and to which Boulder City Hospital belongs, said the same issues have forced private hospitals to go public in Northern Nevada. State law allows the creation of tax districts if the area being served cannot otherwise support a private hospital.

The burden on rural and small-town hospitals, she said, is to provide certain levels of care “even if you only deliver half the number of babies or have half the number of ER patients.”

The matter will be discussed at the request of County Commissioner Bruce Woodbury. He said he would not support the tax unless Boulder City residents support it in an election.

Woodbury said the hospital’s current board of directors would likely continue to oversee its operations under an agreement with the county, which would receive an annual report on how the money had been used.