TMH, Told clinic continue talks

Nothing final regarding a lease or acquisition

The Memorial Hospital and Craig Medical Center continued negotiations Thursday regarding the hospital's possible lease of the clinic at 580 Pershing St.

Samantha Johnston, TMH service excellence officer, said there is a verbal agreement for the hospital to lease the main floor of the Medical Center for three years.

The hospital does not plan to purchase the clinic's patient records or the practice itself, Johnston said.

No contracts have been signed, however, and terms of any possible deal could be different after attorneys are done negotiating, Johnston said.

Talks between TMH and the Medical Center began in 2008 after the clinic's owner, longtime Craig resident Dr. Thomas Told, agreed to become Dean of Clinical Medicine at Rocky Vista Medical School in Parker, a town southeast of Denver.

At least one of Told's former patients is concerned about the clinic's future.

Barbara Jean Sonntag, 71, was one of Told's patients for about 30 years.

She worries the clinic's estimated 2,500 patients will suffer if its doors do not reopen soon.

"I think (the negotiation) has been taking a lot longer than planned, which is unfortunate," Sonntag said. "Where are all those patients going to go? It's been over a month, and many of those patients have monthly visits they have to make because of blood pressure or anything else."

Sonntag said she worries about the hospital's decision to not buy the Medical Center's patient records.

By law, Told must provide a copy of every patient's medical record if asked, and although Sonntag received hers without having to pay, she fears others may not know to ask or may not be able to get theirs before the clinic closes.

"Can you imagine someone who's been there (at the clinic) for 21 years trying to remember all the little visits they had?" Sonntag said.

"It's unfair. I really wish this could have been handled smoother."

Johnston said patients should not be afraid they won't be able to get their medical records. The law requires the Medical Center provide any former patients with their records even after it closes for a certain period of time. She added clinic employees should be able to tell patients how to go through the process of getting their records and taking them to a new doctor.

TMH is dedicated to providing an additional family doctor to the community, whether TMH reaches a signed agreement with the Medical Center or not, Johnston said.

The hospital recently hired Dr. Andy Hughes to serve the community as a family doctor, and he can start as soon as he has office space, she said.

If that space is not the Medical Center, then TMH will find room for him at the hospital.

"TMH is committed to opening our clinic doors to the community immediately, if not sooner," Johnston said. "Whether we reach a lease agreement for the (Medical Center) or not, we will make space to provide the care we know the community seeks."

Hughes will accept patients with all types of health insurance, including Medicare and Medicaid patients, Johnston said.

Mollie Told, Thomas' wife and acting administrator at the Medical Clinic, said she is unsure the two parties will reach a final agreement.

She and her husband want Hughes to work at the clinic space, but she said the hospital has backed out of verbal agreements before.

Mollie Told said she could not comment further.

Collin Smith can be reached at 875-1794 or cesmith@craigdailypress.com

Comments

bullriderwife 5 years, 2 months ago

I'm fairly new to the area and the Clinic was the ONLY place that would see me without requiring me to come in on a Saturday, and pay an urgent care price, cash only. Now that it's up in the air, I have better luck driving to the front range to see a doctor...or my favorite option...you can always go to the emergency room....right.....

I pray that something works out here, some of us residents do not have any other options.

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CindyLou 5 years, 2 months ago

So the hospital has told us over and over again they were buying Dr. Told's clinic. Now they are backing out of the deal? I have been a patient at Craig Medical for over 20 years and I think it is a shame to see the hospital shaft him this way. The hospital made it very clear to the public that they were taking over Dr. Told's practice. Now they are saying they they are just going to put it in the hospital and leave Dr. Told's patients blowing in the wind and in the same breath say that they are dedicated to healthcare in Craig? Can we ever get the truth out of these people? What rock did they crawl out from under to take over our hospital? Why are we letting them get away with treating our town and our doctor and his patients this way? I just think it is a shame and a sham.

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whispering_rain 5 years, 2 months ago

You are so right CindyLou, I agree with you 100%. I have been with Dr. Told since he bought the clinic from Dr. Witham. My son has been sick since Dr. Told left. I don't trust any other dr. in town so I had to go out of town for treatment. I guess I need to call and get my families records not sure what dr. to move them to . It more then likely will be a Steamboat dr.

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Globe 5 years, 2 months ago

I think it boils down to the hospital once again lying to the public again. For months we have been told one thing while they were doing something else. That place is an information black hole. They are so secretive in everything they do. Stan asked for all kinds of information and they told him NO all the time that they don't have to give out information. They kept telling Stan to come in and talk and not to do it in public. They kept saying Stan was incorrect and now we find out he is correct, but its too late. Isn't this a county hospital? Why aren't they more open with the public. For months you hear nothing and then at the last minute they spring this on the public. They made it very clear three months ago they were buying Dr. Tolds clinic. The CEO was even qouted in the paper and now they are changing their minds? Sounds like someone needs to get a lawyer involved is what it sounds like.

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countrylocal 5 years, 2 months ago

I would like to take a to comment on the Told clinic issue. Firstly since when has there been only one side to a story? Why are we so quick to assume the blame for things going crazy are the hospitals fault only? We don't hear their side most likely because they are being professional about their dealings, trying to work out all the details and negotiations privately with everyones lawyers before going public with the details. This way no one gets embarressed, however as we have seen someone is quick to talk and talk bad. Yes I to would hate to see the clinic close, but if both parties can't come to an agreement so be it, let bygones be bygones and everyone step away peacefully, not this mud slinging that been going on. As for getting a new doc well I believe the clinic has had 30+ years to do that and as everyone in town knows doctors are just not quick to move to Craig. We have been very lucky to get some good ones coming in recently. Has everyone forgot about the two very capable surgeons we have now and an OB doc, who, guess what, work for the hospital! We need to quit blaming each other and start working together as a community and support our hospital and medical clinics if we want to be able to have good health care providers in our own town. Oh and lastly I don't believe I have ever seen any thing where the hospital put in writing they were going to buy the clinic and can't they like the rest of America change their minds should they find out things weren't as rosy as they were portray when they originally showed interest in the clinic? Anyway best of luck to Dr. Told on his future adventures, we will all miss you.

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lonelyone 5 years, 2 months ago

Well right now two surgons and an OB doc don't do me much good. I want a family dr that I can go to for everything, not just those change of life issues. You are right tho, countrylocal, Craig doesn't seem to have alot to offer Drs just getting out of school. We've had some very good ones in that clinic that seem to move on after a year or two. I hope things start looking better soon as I need to see someone!

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Cole White 5 years, 2 months ago

countrylocal,

I know how you feel about people being quick to judge the hospital on every little issue. It seems like many of these posts are pointed directly at the hospital on a lot of both major and minor issues. It is sad that every time something goes wrong with the hospital everyone is so quick to assume that it is the hospital's fault. I think even more sad is the fact that most of those assumptions are usually right on the mark.

Almost everytime ovre the last couple years that someone says the hospital is up to some kind of shinanigans it turns out that those accusations are right on the mark. Lack of correct information from the hospital results in many misscommunications in our community. It seems the hospital is always trying to hide information or doesn't feel the public is smart enough to understand the "complex" working of a hospital. My grand father was both a board member and an administrator at our hospital in the early 70s when things were way more complex than they are now if you compare apples to apples (thing were really changing at that time) and he would go have coffee every morning with community members and tell them exactly what he was doing. The people currently running our hospital keep secrets and run it like they are part of the CIA.

Just from their recent history, if the paper is reporting that the hospital is up to more shinanigans, you can bet they are and are trying to stiff Dr. Told. This is a clear cut case where the left hand is doing one thing while the right hand is doing something else. Sadly the hospital will $h1t on another community member and try to walk away and tell you they smell like a rose.

If they were straight forward with the community in all of their dealings, they wouldn't have this problem all the time.

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countrylocal 5 years, 2 months ago

Highway 1340 and Lonelyone, I would have to agree with you that the hospital does not always seem straightforward in keeping the community informed on their up and comings, but in their defense I can't imagine it is easy to recruit family doctors to work for the hospital or other clinics in town without upsetting other clinics. It has to be a fine balancing act to keep everyone playing together nicely and for the benefit of us, the patients. I also image they have to keep some things under wrap because they don't even know for sure what the final decision will be, as the CMC fiasco has shown. Also I wouldn't even begin to say I know what the laws are governing these types of events, and I'm sure there are laws, there seems to be about everything else. I have hope the new board member and hospital administration are on the up and up, I would like to believe they truely have an interest in the community not just their pocket books. Also it's true a OB and surgeon are not much good for a well child exam or your basic run of the mill illness, however they are a good start in the right direction for getting good docs to come to Craig. We have unfortunately had a few of the other side and I for one am glad that tide is turning. As for CMC, I'm sorry to see in the paper today things didn't work out for a lease agreement, too bad BOTH sides couldn't work out their differences, sure would have been nice. I guess "this to shall pass" and in the end it will all work out somehow. All I can say is let's hold in there and see if this new doc, (Hughes is it?) turns out to be an asset to the community.

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STANHATHHORN 5 years, 2 months ago

I believe it is reasonable to assume that TMH's acquisition of the Told clinic did not happen because it was out of reach financially, either as an asset purchase or lease. The apparent financial condition of TMH is in need of health care, and it doesn't appear that the board understands or is willing to make changes. I recently reviewed a TMH cash flow projection captioned "TMH 2009 Cash Budget (Board Updated 1-28-09)". That document noted a beginning 2009 cash balance of $1,750,741 with a footnote "Beginning cash at Jan 1, 2009 based on 10/31/08 cash balance and expected HUD settlement in December." Why would the board, on 1/28/09, accept using the 10/31/08 balance and the value of a settlement that apparently didn't happen? The actual 12/31/08 ending available cash balance was about $91,000, which should become the 2009 beginning cash balance. That same document shows cash at the end of December, 2009 dwindling to about $36,000, in spite of a budgeted operating profit of $800,000. There hasn't been an operating profit in years, 2008 recorded about a ($750,000) loss. The financial obstacles seem insurmountable. In order for TMH to even end the year with the untenable cash balance of $36,000, they will have to exceed last year's operating performance by $1,550,000 and also make up about $1,660,000 to offset the apparent bogus beginning balance in their projection. There is something apparently wrong when the Board will accept cash and profit projections so far from reality. If that's the best Quorum can do, the Board should consider the value of their advice compared to their high dollar contract. It may already be too late. If you look at this objectively, it's hard to imagine survival! On 12/01/08, TMH executed what is tantamount to a payday loan, $350,000 for six days at about 19% interest. Remember, the new facility loan payments of $150,000 per month begin in March, changing to $380,000 monthly in summer 2010. It's not pretty.

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Cole White 5 years, 2 months ago

so who is going to follow up on this? Stan you are saying that you have a bunch of concerns that thte hospital isn't beign straight forward with the public. Why doesn't our news paper pay a CPA (not local) to look at the financials and provide a report on what they see. You've state the hospital has huge losses each year, but the hospital's annual report last year said they made a ton of money. Are these financial reports tantumount to our own local ENRON? Are they using legal accounting rules to mask or hide the real condition of the hospital? Do you think Dr. Told will likely sue the hospital? When I was selling a house last year the buyer made me an offer and then backed out for no reason and I got just over 5 grand from it because I had another offer that I passed up because of their offer and when they pulled out I filed a law suit in small claims. Stan if everything is as you say, I think you should take up a collection and take out a full page add to better show the financials of the hospital.

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countrylocal 5 years, 2 months ago

Okay my last comment on this subject and I'm only doing that because I just couldn't resist. So if the Craig clinic sues the hospital for breach of contract, does the hospital get to sue the Tolds for slander? Now if both decide to sue each other we may just be able to get rid of both with the same stone and the only ones to benefit will be the lawyers, not the community. Seems like an interesting solution with the only lawyers as the winners. I have to ask, you got your 5 grand, what did it do to the person you sued, I only hope they are still afloat, granted that is not much but some people are just barely staying afloat. So they may have learned a valuable lesson but at what expense and if they claimed bankrupcy after that, (hopefully not) we tax payers got to eat that expense and pay you in the long run, so fork over some of that 5grand, I could use some.

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jeff corriveau 5 years, 2 months ago

Hasn't anyone considered that maybe Told's might also be the problem? Even though I respect Tom and what he has done here, Molly has run the clinic with an iron hand, and many times been pretty ugly about it. It's all about money for her and I know of many occasions that could substantiate that. The hospital, in trying to do the "right thing" and keep that clinic and patients local, may have in fact screwed up. Let's try to keep an open mind about this.

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SamanthaJohnston 5 years, 2 months ago

Forum Readers: Stan is correct. Simply put, the hospital's operating revenue alone is not enough to sustain hospital operations. Non-profit hospitals and in particular, governmental entities all have to rely on non-operating revenue to support the services that we provide that a for-profit hospital would choose not to provide. Such services might include: ambulance service, taking all patients regardless of ability to pay and ancillary services that are non-revenue generating. As a county entity, we provide these services to our community as a matter of social responsibility. In addition, TMH subsidizes public health by providing rent assistance to the Visiting Nurse Association and providing hundreds of thousands of dollars in charity care each year. Physician recruitment continues to be an enormous front-end financial burden on the hospital. TMH budgets and spends approximately $200,000 annually in physician recruitment to meet the needs of the community. TMH also provides signing bonuses to physicians who will be employed by private for-profit practices. TMH agreed to these sign-on bonuses as part of our commitment to providing more physicians for the community. The median operating margin for the 135 QHR hospitals is less than one percent. Operating profit for small non-profits is virtually non-existent. The whole purpose of asking for a mill levy increase was to supplement cash revenue inflows to make a portion of the debt service on the new hospital. Without it, there would be no new hospital. Stan is correct we must have "non-operating income" to sustain and grow.

(continued)

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SamanthaJohnston 5 years, 2 months ago

(continued) .... TMH spent nearly $4 million developing the land where the hospital/CNCC is being built. These bills were paid for from TMH's existing cash reserves and operating revenue. TMH received approximately $2 million in DOLA grants specifically for the site development. Unfortunately, DOLA reimbursements are non-operating revenue and therefore do not count toward the operating gain or loss. Bottom line: we use operating revenue to pay the bills, but the reimbursements don't count toward the same line item. In addition, like growth in any business, TMH financial projections in 2010 and beyond include growth based on demographics provided by the state that were reviewed and approved by the Department of Housing and Urban Development. Other factors in our ability to make loan payments include: increased Medicare reimbursement based on building assets (new hospital) and successful physician recruitment. In response to Stan's assumption that the Told deal was financially out of reach, he is correct. Purchase or acquisition was impossible given our financials. We have never openly discussed lease figures, so Stan's assumption that we could not afford a lease is purely speculation. No doubt, leasing the Told clinic would have put a large added financial strain on TMH. The only reason to pursue a lease was the anticipation of future space needs and the lack of available clinic space. Such a lease would have been betting on the come if we add physicians, we would realize revenue to make us whole on the deal. (continued) ...

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SamanthaJohnston 5 years, 2 months ago

(continued) In response to Stan's assertion that TMH took a $350,000 pay-day loan at 19%, TMH had a two-month, $2million line of credit in place in the event that we experienced continued delays in the HUD loan closing process. This was necessary to ensure that the work on the hill could continue uninterrupted. In the days before the loan closed, we utilized $350,000 of the $2 million to bridge the gap. It was at an interest rate of 4% and was paid back immediately with loan closing proceeds. Stan expressed his concern about Quorum (QHR). To be clear, TMH does not have a management contract with QHR, but a consulting agreement. QHR is the largest hospital management/consulting company in America. QHR was recently acquired by Community Health Systems (CHS), which is the largest hospital chain in the country. The point is that the resources we have access to through our affiliation with CHS and QHR are some of the finest in the healthcare industry. As part of our consulting agreement, all of our financials are thoroughly reviewed on a monthly basis by QHR, audited annually by firms who specialize in healthcare financials and TMH has passed every test from private investment firms that view them as solid enough to invest $42 million in our hospital project as well as review and approval by the government backing the loan. We believe that the cost is worth the benefit we receive for the services. In the interest of transparency and making these complicated financials more clear for those who have an interest, TMH will advertise a public meeting by the end of February where community members will hear a financial overview presentation and have the opportunity to ask questions. We will advertise this heavily to ensure that those with an interest attend. (continued)

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SamanthaJohnston 5 years, 2 months ago

(continued) As always, I encourage anyone interested to attend our monthly board meetings at 7 p.m. the last Wednesday of the month. Monthly financials are reviewed at each meeting as are a variety of other topics such as quality, service and growth. Hospital financials are complicated. Stan has a strong understanding of our financials and what he says is a correct piece of the pie, but it's only a piece. I encourage those of you interested to attend our special meeting and to attend monthly board meetings. Ask the questions we will answer them. I am more than willing to accommodate as many public meetings as it takes to educate those who are interested and to answer the questions that the community asks. I would prefer to schedule public meetings rather than hash these issues out via the forum a lot is lost in translation. I will post the February public meeting time and place on the forum as soon as I have time to put it together this week for sure. Call or email with questions. Samantha Johnston

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Onkyo 5 years, 2 months ago

highway1340, silentman, and countrylocal,

Thanks for trying to express some sanity.

Stan obviously has an agenda, but I applaud that he posts under his name, and is very obvious in what his personal agenda is. (I don't have that courage - too many cult members read this). His view appears to be that everybody is a liar, and thank God he is here to protect us idiots.

Stan is talking about operational income, and 1340 is talking about total income. Yes, they turned a nice total profit, but of course every penny of that is spent on keeping services flowing. As usual, Stan only uses facts that support his agenda.

Stan is right, they appear to be in cash crunch, but haven't they been spending every penny they have saved over all these years (since the last evil administrator - who was also no doubt a liar) has been spent on making a new hospital a reality. Do you think the good folks that work so hard to help people really enjoy the battles they have to fight everyday? Only Stan enjoys battles, (as long as he can fight them from Arizona). Try showing up for a board meeting Stan, try being a part of the solution. You just throw rocks and run.

I think that because Stan mailed a bunch of letters, he now has the qualifications to correct all the problems in the US postal system. He fabricated steel, so don't tell him he doesn't know what is involved in building a hospital. He ran for public office and lost, so don't tell him everybody that voted against him isn't an idiot, and that everybody crazy enough to actually serve in office isn't a liar.

I'll not respond to any comments, but send 'em anyway!

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countrylocal 5 years, 2 months ago

THANK YOU SAMANTHA, you do a great job and provide a great opportunity for any of us to get in involved. Be a part of the solution not the problem! Thanks again.

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grannyrett 5 years, 2 months ago

Samantha--I've missed your comments. You do so well informing us. Please keep us up to date on how things are going. We appreciate it.

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James81625 5 years, 2 months ago

My father started taking me to Dr. Tolds office 27 years ago. The care and the staff at the clinic has always been the best, that is why I trusted them with my own family and kids health problems and I have never had any need to look elsewhere. The bottom line in all of this is that the hospital has neglected Dr. Tolds patients and his staff. He said, she said, does not matter. What matters is the Hospital should have picked up Dr. Tolds staff and his patients. The Hospital kept telling the people that things would be ok. Then the Hospital through it all out the window as if the patients and staff there didn't matter. Well they(we) do matter, and we are voters. That is why someone from the county should! look into the way the Hospital Board handled the hole thing and determine if any wrong doing was going on; Or should I say someone from the city, because our County Commissioners are way to close too the Hospital Board for this voter; And this voter will remember that closeness at our next election.

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STANHATHHORN 5 years, 1 month ago

Samantha, In your 2/9/09 post you stated, "TMH spent nearly $4 million developing the land where the hospital/CNCC is being built. These bills were paid for from TMH's existing cash reserves and operating revenue." You then go on to say that TMH received $2 million in DOLA grants toward that project. What you didn't say, was that CNCC, The Hospital Foundation and others contributed at least another $2 million toward the project. That doesn't leave much for TMH to contribute from operating revenue. All of those approximately $4 million in restricted donations and grants were funneled through TMH revenue stream so as to create an appearance of profitability.

In another paragraph, you stated, "Simply put, the hospital's operating revenue is not enough to sustain hospital operations." We know that nearly all the non-operating revenue claimed by TMH is in the form of restricted use assets as noted above. The exception is the 3-mil tax levy revenue. There is an inherent problem in your statement that, "operating revenue is not enough to sustain hospital operations." Soon, TMH will be facing payments of nearly $4.5 million per year. The only apparent source of income other than the $1.3+/- million yearly tax levy is "OPERATING REVENUE". In short, TMH's operating revenue (profit) will HAVE to increase to survive, but that hasn't been the case for several years.

In response to my assertion that TMH took a $350,000 pay-day loan at 19% interest, you are correct it was about 4% interest. You claim the $350,000 was in effect a bridge loan, and was "paid back immediately with loan (HUD) closing proceeds." The certified closing statement dated 12/17/08 shows $1,273,892.35 transmitted not to TMH, but to "The Memorial Hospital Facilities Corporation". The bridge loan was paid on 1/06/09. TMHFC is and will be the owner of record of the new hospital facilities until the mortgage is paid. My assertion that the $350,000 was a pay-day loan takes on a different context. I imagine without the loan TMH may have been strapped to fund pay-day for TMH employees in December. Remember, TMH closed December with only $29,000 in cash, while salaries and wages are about $600,000 per month.

Conspicuously absent in your response was anything to do with the TMH cash flow projection that shows TMH overdrawn twice and ending 2009 with only about $36,000, while huge payments begin in 2010.

Perhaps these will be topics of your upcoming meeting explaining the complexities of hospital finance. It's really not complex, "Profits are the root of all happiness".

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