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Like many rural hospitals, Faith Community Hospital in Jacksboro, Texas was on the edge of insolvency in 2014. And it had recently flunked a Medicare inspection due to mold and asbestos. To survive, Faith would need a new facility.
But the community had already rejected a bond issue to pay for one. And, due to an interstate highway running through town, Faith didn't qualify for Critical Access Hospitalreimbursement rates.
To make the new hospital financially feasible, Faith's new CEO Frank Beaman needed to find revenue streams other than local taxes or federal subsidies. And, he knew, the hospital would need to reach out and reconnect to its community to drive those streams.
A bank loan funded construction for the new $28 million facility. As it was designed, new services were added to draw in local people and help keep them healthy: a nourishing restaurant and a state-of-the-art wellness and fitness center. And these non-medical services would generate revenue for the hospital to help pay back the building loan.
Far from a stereotypical hospital cafeteria, the Faith Café was placed at the front of the building — and soon became one of the town's most popular dining and meeting spots. “The food is fantastic," says Clint Myrick, president of the local bank. “For the hospital to provide the option of a healthy meal, it's an anomaly in Jacksboro, where we've got a lot of barbecue, pizza, and fast food. We forget how important good nutrition is."
The hospital's fee-based Swan Family Wellness Center also attracts community members with offerings like Zumba and cycling classes, a walking track, indoor heated pool, and wellness education.
The Faith Café is so popular it regularly caters events around town, producing “a very nice revenue stream," says Beaman. And the Wellness Center's post-holiday Shape Up in Faith Weight Loss Challenge helped residents drop a total of 1,281 pounds in just 12 weeks during its first year.
Along with a new facility, says Beaman, Faith Community Hospital “has built a culture around population health and service to our community." While rural hospitals continue to close across the country, in Jacksboro, Texas, the hospital's doors are wide open as residents come in for medical care, a workout, or a good meal.
Erin Graham is a writer based in western Massachusetts.
The new Faith Community Hospital. (handout)
Faith Community Hospital is about to open a new $28 million facility in Jacksboro, Texas, a stark turnaround for a facility that nearly closed over poor management and unsafe conditions.
The 60-year old hospital had mold and asbestos, and had flunked Medicare inspection, said CEO Frank Beaman.
"We received conditional deficiencies based on our facility," Beaman said. "It meant we were losing our participation in Medicare."
Faith Community Hospital also did not have the advantage of getting a critical access hospital designation that would have been a huge benefit for receiving cost-based reimbursement, according to Beaman.
Highway 380 runs through the center of Jacksboro town, which meant critical-access designation was out of reach. Faith Community Hospital is a rural provider in a town with an 84 percent industrial tax base. This proved beneficial in eventually getting tax funds to build the new hospital.
[Also:Wellness centers become money-making population health engines]
However, Beaman saw voters reject by a 3-1 margin an original $17 million bond issue for a new hospital. He came aboard about the time voters rejected the bond request five years ago.
Residents understood the hospital's problems, but said, "'We believe you, we don't trust you,'" Beaman said. "People didn't like the image of the hospital."
So the board told him to change the image, Beaman said.
Rooms were painted and employees not committed to change were let go, he said.
A big upgrade came by chance during a board meeting two weeks into his new job. Beaman and board members were handed a lunch of dried meat, mashed potatoes and green beans in a Styrofoam container, he said.
Beaman asked if patients also ate the same meal, in the same Styrofoam container. They did.
[Also:Are rural hospitals on the road to ruin?]
Despite the cost savings from using cheap Sytrofoam, the hospital made sure real plates replaced plastic, and the chefs were told to get creative. A new executive chef was brought onboard. The patients noticed it and so did those who visited them.
"We built a garden. All of our vegetables come out of our own garden. People inside had a great attitude, 'How do we make it better?' Next thing you know, in November and December, we had at least one event every day. We do Christmas parties and special events. We cater chamber events. My dietary department has become a revenue center," he said.
While the hospital may only have six to eight inpatients, "last month it did over 1,400 meals," Beaman said. Two-thirds of diners are employees, he said.
The new hospital, opening in mid-September, will have a large kitchen, retail café and the Cindy Dixon Memorial Garden named in honor of the late special events coordinator.
It is more than twice as large – 30,000 square feet to 75,000 square feet – but has 17 beds compared to the current 41.
The clinic is increasing from 3,000 square feet to 15,000 square feet and will have 24 exam rooms, up from seven.
Faith Community Hospital will expand outpatient care to include physical therapy, rehab physician practices, a cardiac rehab, post-acute care services and outpatient centers.
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This time around, before going to the voters for approval, the hospital did a needs assessment for a new building and held several public hearings.
The $28 million bank loan is being paid back over 15 years through an increase in the hospital district tax rate. The rate of 11.5 cents per $1,000 of assessed valuation was raised to 31.5 cents. It was a large increase, but only a little over the 30 cent rate that existed in 1990, according to Beaman.
Senior citizens were given an increase in their homestead exemption so their tax rate would not get a large increase.