Plans are still being researched to put long term care at the new hospital site in St. Ignace, some staff changes have been made but no layoffs are expected, and fundraising efforts are continuing and will likely be expanded outside the local community as the hospital prepares for its move to the new facility next year.

Patients at Mackinac Straits Hospital will continue to see a variety of changes over the coming months as the hospital readies for its move to the new facility being built on North State Street, administrators say.

The goal, Hospital CEO Rod Nelson said, is to get all of the programs, services, and staff in place before the move date, which is expected in the spring of 2010. Changes include the addition of a hospitalist program, improvements to the pediatric and oncology programs, expansion of radiology, cardiac, and dialysis services, and other adjustments meant to provide a wider spectrum of care to patients in the region.

Funding for the new hospital building has been secured through a combination of direct loans at a 4.25% rate of interest through the U.S. Department of Agriculture (USDA), which accounts for $10.4 million of the cost, USDA-guaranteed bank loans through ArborOne Financial, which makes up $26.8 million of the cost, and community donations and pledges, of which about $300,000 has already gone into paying construction costs.

The Mackinac Straits Health System Foundation, which organizes fundraising for the hospital , needs to raise $3 million to satisfy a local effort required by lenders, and has collected pledges and donations amounting to about $800,000. Some of these funds have gone to help pay for hospital construction, and Mr. Nelson said anything additional that is raised could help pay for improvement to programs like long-term care and for other equipment and services at the hospital.

"We still have a few projects that are going to be underway, we hope," he said. These proposed projects include a maintenance garage for EMS vehicles, an assisted living facility, and the long-term care unit, all of which hospital administration hopes to build on the new hospital property.

To reach the goal of $3 million in the next 18 to 24 months, Mr. Nelson said the foundation would likely need to look for funds outside of the local community. If the $3 million is not reached in that time frame, Mr. Nelson said, it will not affect construction at the new hospital. Any local donations received beyond the current $800,000 will be put into a fund and the foundation will decide how it is spent, according to hospital needs, he said. Earmarked donations will go to the programs they are designated for.

One event Mr. Nelson said could create recognition for the project and possibly help fundraising efforts is the foundation's plan to pay drivers' tolls on the Mackinac Bridge, still being planned by the hospital.

The weekend set aside for the toll-paying program was originally scheduled for the last weekend in August, but has been postponed to give the hospital foundation more time to find co-sponsors, plan the event, and to reduce the high cost that offering to pay tolls during the busy tourism month of August would entail. Several dates are now being looked at, including the bridge's 52nd anniversary of November 1. (See related story.)

Future of Long-Term Care

Still in Question

The future of the long-term care facility in St. Ignace is still up in the air, although several options are being explored by hospital leadership to potentially build a new facility behind the new hospital.

One of these options, Mr. Nelson said, is to work with USDA to receive additional loans for the hospital to finance and build the facility. Another option that has been pursued is working with investor firms to raise the capital necessary to cover construction costs.

Probably the most seriously considered option would be to work with a construction company and developer, Sundance Construction from Norway, Michigan, to build a new long-term care facility for the hospital. Sundance would then lease the building back to the hospital, assuming that, eventually, Mackinac Straits Hospital will buy the building back from the company.

This plan needs first to be approved by USDA and ArborOne, the bonding agents for the hospital complex, because the bond agreements cover all development being done on the new hospital property. Mr. Nelson said Sundance is on board with the idea, but before any agreements can be made, they must receive approval from the bonding agencies.

"We are just trying to secure access to the property and to make sure we meet the financial requirements in the bond covenants," he said.

The hospital has just completed a feasibility study to see if the hospital could carry the financial burden of funding a new long-term care building. This study is currently being reviewed by the hospital's auditors, and will then be presented to USDA and ArborOne.

"We believe the feasibility study supports our contentions that we should go ahead with long-term care this fall," Mr. Nelson said.

If the project is approved, he said a new building could be built on the new hospital campus as soon as July 2010, which would be shortly after the hospital is completed, if the current completion target date of March 2010 is met.

"The project is shovel-ready to go," Mr. Nelson said.

The hospital board of directors has expressed a strong commitment to USDA and ArborOne to build a new facility to house long-term care one way or another, Mr. Nelson said.

"Our seniors deserve it, absolutely," he said. "It's nice, from my position, that the board feels so strongly about that."

The addition of an assisted living facility behind the new hospital has also been discussed by the hospital board, although it is unclear if funding will allow its construction to go forward alongside a new long-term care building.

"It would be nice to get both, but I don't know if we will get both," Mr. Nelson said. "Our focus right now is long-term care."

The future of the current hospital building on Burdette Street, and the long-term care building if a new facility is built, is also uncertain. Bonds are scheduled to be paid off on the property in 2014, and Mr. Nelson said the hospital plans to pay off its existing bonds.

Mackinac County owns the land the current hospital sits on, and Mackinac Straits owns the building.

Until 2014, some doctors and other staff may stay at the old hospital building, Mr. Nelson said, but any other use of the space has not yet been decided.

New Services Will Not Come

Out of Patients' Pockets

Services being added at the new hospital include an 18-foot by 13- foot pool for aqua therapy, 15 private acute care rooms, each with its own bathroom, additional chemotherapy and dialysis stations, an inpatient pharmacy, a cafeteria overlooking Lake Huron, and additions to the radiology department, including upgraded services for CAT scans, digital mammography, and, for the first time at the hospital, magnetic resonance imaging (MRI) services.

"It will be a state-of-the-art radiology department," Mr. Nelson said. "Just about every department will have updated capabilities."

Some laundry facilities may be added, he said, although the hospital does not expect to do all laundry on site because of the expense.

"We are still evaluating the laundry issue," Mr. Nelson said. Currently, prison work crews at Straits Correctional Facility Laundry in Kinross wash linens for the hospital, a change from in-house laundry service made in 2007. That change eliminated three positions and saved the hospital about $50,000 each year.

Patients will not directly bear any costs of these new services or from the building of the new hospital through increased prices on services, Mr. Nelson said. Cost windows for health services are largely determined by requirements from insurance companies and government healthcare agencies, he said.

The price of hospital service will remain the same as the hospital moves to the new facility, although periodic increases over time, approved by governmental and private insurance, are always expected.

No Staffing Changes

Anticipated in Move

Staff are not expected to be added or eliminated in coordination with the move to the new hospital, Mr. Nelson said, although some staff positions have been added and some have been changed in preparation for the big move. There have been no layoffs.

"We're getting everything in place," he said. "We've been rightsizing the organization toward the new place. I think we're pretty much where we need to be."

Additional staff would be needed, however, if the hospital adds new facilities like the assisted living program being explored, which would likely be housed in a building on the new hospital campus.

A goal of this reorganization was to maintain every job currently held at the hospital, Mr. Nelson said.

"I just hate the thought of layoffs," he said, "and we have tried to avoid that."

He said hospital employees have put up with cramped conditions and shared spaces for a long time, and the new hospital will give everyone the space they need.

"We're finally giving our community and our employees a facility that we believe is a reflection of the care we're giving now," Mr. Nelson said.