Final forum on struggling Boulder City Hospital canceled

By Cassie Tomlin

Friday, Oct. 10, 2008 | 4:37 p.m.

Boulder City Hospital has canceled its final forum on a proposed property tax district, Chief Executive Officer Thomas Maher said after a town hall meeting Thursday evening.

The final forum in the series was scheduled for Oct. 23.

At the second informational meeting, which drew about 30 people in City Hall, Maher dedicated most of the hour and a half to deflecting accusations, explaining financial reporting and trying to convince the audience that the mission of the independent facility needs to be the responsibility of residents.

He had an agenda at the follow-up to a July 30 town hall about the nonprofit hospital's November ballot initiative: addressing what he called wrongful facts and denying the hospital has withheld information or fixed its numbers.

The hospital has lost $500,000 annually in its operating budget since 2000, he said, and it forecasts a negative cash flow by 2012 without intervention.

The hospital serves a no-growth market in an aging facility. That combined with the need to pay competitive salaries leaves the hospital running out of money to continue.

The tax revenue, an estimated $750,000 annually at 15 cents per every $100 assessed property value, would be restricted for capital expenditures. That comes to about $155 a year for a home valued at $300,000.

Nearly three months ago, Maher said he wouldn't give up on convincing voters they needed the hospital as much as the hospital needs the tax.

"By delivering the message over and over again," he said, "people will come to understand that having a hospital in a community like this is a luxury."

But after Thursday, Maher said he would abandon that approach. All the forum did was provide a venue for the opposition to be videotaped for BCTV, he said.

"I don't think it was very productive," he said. "We had the same cast of characters sitting at the podium pontificating the same way they did last time."

However, he said, one person who provided "civil give and take" was one of the hospital's most high profile and vocal opponents, former Hospital Board of Trustees member Ron Milne, who had previously called Maher disingenuous.

Milne stood by his claim about Maher, saying that Maher's prior assertion the hospital would close by 2012 without the tax or other financial intervention was a bad scare tactic.

Milne questioned the hospital's claim it loses $500,000 annually on operations, because that figure doesn't factor the grants and bequests it receives.

Maher said, because most of that money is restricted, the hospital can't claim it as operating revenue. A 2006 $600,000 Department of Energy grant, now long spent, was meant for emergency room improvements, not payroll and maintenance, he said.

"I'm not going to plan the hospital's future on winning the lottery," Maher said.

Milne suggested more patients could bring in the money the hospital needs and urged Maher to advertise in Henderson to draw that population.

The emergency room sees a patient about every 93 minutes and could see more, Milne said. "Another person a day in the ER would solve all your problems," he said.

Kathy Pantuso, who works in the hospital's operating and emergency rooms, said some days the ER is empty, but on some days 10 patients line the walls waiting.

The hospital shouldn't start advertising until it can comfortably accommodate the potential result — more frequent influxes.

Already, she said, indigent patients travel on buses from Las Vegas to Boulder City Hospital after hearing about the excellent care.

She suggested overwhelming the current staff might diminish that excellence.

"If the money goes for expansion, it's a win-win," she said. "If the quality care goes down, it's the credibility of who we are."

Marilyn Koenig, a former hospital consultant in California, said the hospital could raise its rates to make more money.

"I know everybody's got goodwill in this," she said. "But I know there are ways you can raise rates. They don't have to just stay. The fact that the rates are so much lower than the competition, I just don't think that's to the hospital's advantage at all."

Charles Harrison, the hospital's chief financial officer, said the hospital raises costs daily.

He said X-rays, laboratory work, ER visits and CAT scans go up 4 percent to 5 percent in patient price annually.

"We raise them as much as we can," he said.

But, Harrison said, the hospital needs to keep rates slightly under the rest of the Las Vegas Valley's, because 15 percent of Boulder City patients have Medicare only, and no secondary insurance, which means they pay 20 percent of their charges out of pocket.

"We need to be sensitive to that," he said.

Resident Mark Koenig said he objected to that philosophy.

If 24 percent of hospital users don't live in Boulder City, as Maher has said, and if another 20 percent who use the hospital are renters who aren't paying property taxes, then just over 50 percent of the population is subsidizing the hospital for the whole, he said.

"It's a disparate impact, with one class being forced to pay the bill," he said. "I want taxation with representation. This isn't a fair deal."

Koenig said he'd rather see the hospital bought by a larger hospital system than pay out of his pocket for the same care.

Maher said he hadn't heard of any larger system seeking to buy Boulder City Hospital.

On Sept. 30, Maher told the Boulder City News he thought the tax question would fail, and he was working with consultants to determine the highest and lowest fiscally performing services to determine which ones could be cut.

After Thursday, he said he felt "too close to the action to be objective" in forecasting how the measure would fare.

Maher said he urges anyone interested to call or e-mail for "constructive, informative dialogue."

Cassie Tomlin can be reached at 948-2073 or cassie.tomlin@hbcpub.com.