FMC Biennial Mill Levy Renewal

By David Espeland,

CEO, Fallon Medical Complex

Fallon County voters will be sent mail-≠in ballots next week for an election to be held on May 2, 2017. The sole purpose of this election is to determine whether the Fallon Medical Complex (FMC) Health Facility Levy should be continued for another two years.  This levy is not a new tax.  It is simply a continuation of the ten mills that have been continually renewed by voters for the past 14 years.

This levy was started in 2003 to provide assistance with keeping FMC’s buildings in good operating condition.  The levy’s funds have been, and will continue to be, strictly dedicated to this purpose.  None of the money is used to pay wages or benefits, purchase supplies, pay utility bills, buy medical equipment or cover overhead expenses.

Fallon Medical Complex is operated as a non-profit charitable organization through a management agreement with Fallon County, which retains ownership of all assets.  FMC is expected to operate substantially on its own.  However, providing healthcare to a small rural county does not return any profits after paying for its day-to-day operations.

Larger facilities with more robust margins can “fund” improvements by tucking away excess profits each year.  When an asset reaches the end of its useful life, the facility has the money to make the necessary upgrades.  Small facilities such as FMC do not enjoy such a luxury.  We have not been, and perhaps never will be, able to sock away money for future facility improvements.

The mill levy funds fill that void, so that we can make the necessary upgrades and improvements to the county’s healthcare assets.  Prior to 2003, FMC had a difficult time keeping the facility in good repair.  We found ourselves putting off much needed repairs and upgrades because we couldn’t afford to take out a loan.

But since we have been receiving mill levy funds, we have been making great strides at improving Fallon Medical Complex.  Virtually every department has been a beneficiary of the mill levy funds, either through facility-wide infrastructure upgrades or department-specific improvements.  For instance, since the last renewal of the mill levy in 2015, multiple years worth of funds were combined to pay for a significant remodel of the basement space under our long term care wing.

This project involved the removal and replacement of the damaged and heaving concrete floors which were installed 50 years ago.  This allowed us to repurpose our abandoned old purchasing department, which had been moved to a more central location in the facility during a previous project.  Our laundry, housekeeping, and maintenance departments had to be temporarily relocated until new space was built for them.  The project also allowed us to create various storage rooms from the vacated space.

An equally important part of the project was to keep water out of the basement in the future.  This work was two-fold: first, we had to replace leaking sewer pipes under the building and tie them into a new location on an existing trunk line.  We then had to install a foundation drain around the perimeter of the building and empty it into a new sump pit.  Outside, we had to build a new basement stairwell as an emergency exit and cut in trench drains just below ground level that are designed to carry gutter and surface water away from the building and into the street.  This required the replacement of paved surfaces, including sidewalks and parking areas, as well as retaining walls.

In addition, during the past 12 months, we have also been working on a number of smaller projects throughout the facility, such as:

1) Resurfacing the asphalt parking lots surrounding the building complex;

2) Upgrading the controllers that manage all of our Heating, Ventilation and Air Conditioning (HVAC) systems to the latest operating system;

3) Replacing both a non-functioning air handler heat exchanger in the LTC wing of the facility, as well as dual air conditioning compressors in the hospital wing;

4) Replacing 25-year old flooring in the clinic wing, by upgrading from carpet to hospital-grade sheet vinyl;

5) Replacing the rubber flooring in the Emergency Room, which is frequently subjected to harsh cleaning chemicals for sanitation purposes, heavy, rolling gurneys, and concentrated foot traffic with hard outdoor footwear;

6) Renovating ten LTC rooms to create a more homelike and modern appearance, which includes replacing the existing 50-year old cabinets, installing drop ceilings, replacing vinyl flooring with rubber tile, and providing electrical upgrades to meet new government codes;

7) Paying architectural and engineering fees for these projects.

Should another two years be approved by the voters, we anticipate the need to make additional improvements throughout the facility, including the following projects:

1) Installing an enclosed ambulance bay adjacent to the hospital that allows patients to be transferred under cover from the ambulance to the ER;

2) Installing a facility-wide security system, including cameras, video recorders and door access controls;

3) Replacing our 13-year old Private Branch Exchange (PBX) phone system which runs on an obsolete operating system;

4) Landscaping a number of locations around the complex which were affected by construction over the past few years;

5) Paying architectural and engineering fees for these projects.

All in all, most small rural non-profit healthcare facilities cannot operate without some form of subsidy.  Most will squeak by year-to-year operationally, but they are forced to defer much-needed maintenance and improvements indefinitely.  Without incremental care being given to a facility, it will eventually fall into disrepair and it will need a greater infusion of money to keep it functional or to replace it altogether.  Mill levy money provides the needed funds for this incremental care.

It is my hope that Fallon County voters will see the tremendous value of the mill levy to the ongoing operating condition of our community’s healthcare facility.  FMC employees simply want to be good stewards of the assets entrusted to them by the county and to provide a favorable environment that fosters the best possible care to our patients and residents.  It is my hope that our voters will see that the Health Facility Levy funds are an essential means towards the success of that mission and that they will vote in favor of the levy for another two years.