The John C. Fremont Healthcare District has yet to break ground for its new hospital, by far its most ambitious endeavor to date, but the district is already dreaming of what may come next.
Should the existing hospital be converted to skilled nursing? What about pediatrics? Perhaps oncology? Or an outpatient surgery center?
On Jan. 29 the board of directors held a special meeting to discuss “strategic master planning” and to hear from its architect, Cunningham Associates, about what may be possible for the existing buildings after construction of the new hospital is expected to be completed sometime in 2030.
The public was invited to attend the meeting in a Facebook post the day before. Given the short notice, only a handful of people from the community attended in person and the room was still near capacity.
People were encouraged to think boldly, but in the end the meeting perhaps did more to underscore current challenges than to paint a bright path forward.
Leading the discussion was Wayne Hunter, design director for Cunningham Associates, who has been designing healthcare facilities for 45 years.
Quoting Yogi Berra, he said, “If you don’t know where you are going you might end up somewhere else.”
“Why do people leave the community?” Hunter asked the assembled group.
“What are you hearing, what are services we are not providing today that we could be?”
District CEO Stacey Kuzak offered that outpatient physical therapy is currently the single biggest referral to other healthcare facilities. Oncology is also a frequent referral, she said.
Kari Kisela told the group that as a parent she would like to see pediatrics, rather than dealing with a referral to Madera or Merced.
Board Director Teresa Johnson mentioned the need for an outpatient dispensing pharmacy, especially since Rite Aid closed.
Johnson also noted how the district “made the tough decision” to shut down its home health care and hospice program last year, but has not surrendered its license.
Board Director Jesse Bullis said a major challenge for the community is keeping people from having to enter a skilled nursing facility.
Because of transportation needs, he has also heard of people skipping physical therapy and dialysis.
Those in a behavioral health crisis also have no place to go other than the John C. Fremont emergency room, Bullis said.
Board Director Rose Fluharty focused on Mariposa County’s aging demographics.
“There’s a population that would like to move back but they don’t know if they can get care here,” she said.
There seems to be broad agreement that whatever direction is chosen it would need to generate new revenue.
There is also the question of what kind of retrofitting would be required of buildings more than 70 years old that would be in compliance with state and federal regulators.
Fluharty said she wasn’t prepared to talk about potential demolition of any of the buildings.
“Today is not that day,” she said. “I don’t know if we’ve had the eduction to understand the benefit.”
Hunter, of Cunningham Architects, suggested the district should be researching other Critical Access Hospitals (CAH) with a similar service area.
“You need a benchmark, what’s working well and what’s not,” he said.
Hunter said he wouldn’t anticipate a large demolition or capital campaign.
“The end result won’t be you need to raise $55 million,” he said.
Hunter said it could be done “in chunks that we can manage,” and suggested a 10 to 15 year strategic plan.
Quoting a line from a recent television show, Hunter said, “A hospital is not like a frozen dinner. We don’t throw it in a microwave and 10 minutes later we have dinner.”
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