Now unfinished, this room contains the infrastructure to become the ambulatory surgical center at the new hospital. If partnership agreements are reached, and the state and lenders approve the service, residents could begin having outpatient surgeries performed closer to home. The hospital board and administrators say they should know before August the fate of the unfinished space. Long term care could be moved behind Mackinac Straits Health System by the end of this year, and outpatient surgery could be offered in St. Ignace by next spring, if financing and permits fall into place this summer.

Plans now are to focus on the construction of a $5 million long term care facility. The feasibility of that will be determined within the next eight weeks and, if the project is approved, it could be completed in December.

The hospital's long term care facility is now housed at the old hospital site on Burdette Street.

Surgery, long term care, assisted living, and ambulance housing are all in the hospital's long-range plan, and the 16.5-acre lot where the new hospital was built is designed to accommodate all of these services, said CEO Rod Nelson.

“Our ultimate goal,” he noted, “is to provide 80% of the health care needs of our community” at that site.

The board has worked on long term care for more than a year, he said.

“The bond holders are OK, the [United States Department of Agriculture] does have the funds, so there isn't any reason why we can't go ahead,” said Mr. Nelson.

“Personally,” he added, “I would be very disappointed if long term care is not completed by December.”

The project includes about $4.5 million to build the facility with another $0.5 million for interest, closing costs, and related charges.

A fundraising effort probably will be needed to furnish the structure, although Mr. Nelson remains confident the hospital will be able to raise the necessary funds. Referring to the new hospital, he said visitors donated $8,000 during the open house Friday, April 9.

“I think that is an indication now that the facility is open, fundraising may be a little bit easier because there's a tangible asset to look at,” he said. Fundraising will be an ongoing project.

Planned for Long Term Care are 48 private rooms with toilets. Bathing usually requires assistance and three specially equipped bathing areas would be constructed.

An 85-foot hallway would be constructed from the second floor of the hospital joining Long Term Care to the building. A hallway at the new hospital was designed to be connected to the proposed corridor.

Ambulatory Surgical Center

Once Long Term Care moves forward, focus will shift to the proposed ambulatory surgical center and adding a professional office building. Eventually, four buildings are planned to be constructed behind the hospital, including an assisted living facility and ambulance garage.

By next spring, colonoscopies, laparoscopic procedures, and orthopedic, cataract, and ears, nose, and throat surgeries are just a few of the additional services that would be offered at the North State Street site in the proposed ambulatory surgical center, if plans continue to move forward. A few obstacles must be overcome first, however, said Mr. Nelson, who is cautiously optimistic about the opening date.

A certificate of need must be approved by the state and partnerships with other hospitals and physicians must be developed to make the service a reality. Mr. Nelson expects to hear from the state by July.

Approval also is required from the U.S. Department of Agriculture (USDA), said Mr. Nelson, which financed the new hospital building. The new center would require the use of an unfinished room on the second floor of the new hospital. Use of that room impacts the USDA agreements, he said, and requires its approval. If the USDA approves use of the space for the outpatient surgery area, then the new center would likely be established as a limited liability corporation, said Mr. Nelson.

“So, there's still some maneuvering that has to be done,” he said.

The similar certificate of need for the surgical facility has been filed with the state and he is not expecting any roadblocks from Lansing that would stall or deny the request.

“The key is the partnership with physicians,” said Mr. Nelson. “That's the key to make it work.”

A certificate of need must convince the state that there are enough potential patients to support the service.

The proposed surgical area, he said, was designed with the necessary infrastructure in place to accommodate the outpatient surgical center. A special surgical floor has been constructed along with proper air systems and piping for surgical gases. On architectural drawings, the space is marked “future” room.

The room just needs to be finished, he said.

The hospital has been talking with physicians who specialize in fields that fit the needs of residents and the capabilities of the hospital. Physicians in a 60-mile radius, said Mr. Nelson, have expressed an interest in working here . The hospital already works with 15 specialists who travel to St. Ignace to see patients.

Plans also include working with other regional hospitals, he said.

Back when the original certificate of need was filed for the new hospital, two in-patient surgical suites were planned in the building. That certificate was approved, however, as the planning process for the new hospital evolved, said Mr. Nelson, it was decided the surgery aspect could wait.

The hospital does not have surgeons and to bring in the staff to support a surgical program would be very expensive, he said. Surgical nurses, technicians, anesthesiologists, and a sterilizing department would be needed to support the program. At the same time, he said, planners decided to explore the possibility of establishing the ambulatory surgery center in a partnership with other hospitals and physicians.

“Then, we felt the service would be utilized,” he said. “For years and years, specialists have been coming to Mackinac County seeing patients, taking those patients back to their respective facilities, and that's where the care is given. We thought this would be an opportunity for the residents that we serve to actually stay in the community and have outpatient surgeries performed in this center.”

The hospital wants to change the original certificate of need from the two surgical suites to two outpatient surgical suites, and allow partnerships to be formed.

“It would be in a partnership and we haven't determined who those other health care facilities or who those physicians are, but it would be a comprehensive program,” said Mr. Nelson. “We have all of the ancillary support services here with radiology, laboratory, in-patient nursing, and emergency department to support that program.”

If plans for the ambulatory surgical center do not happen, he said, the space can be used for other services.

Financing for the center would come from a variety of sources. The hospital could seek private investors and costs could be included in the partnership agreement, with the hospital providing the space and physicians and providers supporting the completion of the space and purchasing equipment. They also would support the development of an office building that would house offices for the physicians, including the pediatrics department, which now remains at the Burdette Street site, and administrative offices that also now remain in the old hospital building.

“It would be done under the premise that this is a true partnership,” he said. “I think it's really important that the physicians have a lot of input to make this successful. That's the key.”

Mobile MRI by Fall

Also by fall, the hospital hopes to have a mobile magnetic resonance imaging (MRI) unit make periodic visits to the hospital.

“We have enough procedures for two days a week,” said Mr. Nelson. “We're hoping it's in by the fall.”

The hospital is waiting on the approval of the certificate of need.

“Usually you can tell if there is going to be some problems, and there have been no objections,” he said of its anticipated approval.

“I don't want people to think this is it,” said Mr. Nelson referring to the new hospital. “This is only the beginning.”