The local health-care construction boom is echoing as far away as Kellogg, Idaho, where Shoshone Medical Center hopes to begin construction next year of a new, $18 million hospital.


The facility would replace an aging, 25-bed hospital at 3 Jacobs Gulch, says Gary Moore, administrator of the hospital. It would be built on Shoshones 20-acre site there, with construction beginning in the spring of 2003 and lasting about 15 months, he says. The new hospital also would have 25 beds, but would be technologically superior to the current facility, Moore says.


Were looking at putting a good deal of money into diagnostic capabilities, he says. Its designed to be all digital, with electronic medical records.


The focus of the hospitals services would be outpatient diagnostic procedures, outpatient surgeries, and emergency-room care, Moore says. Patients who need more complicated procedures are transferred to Kootenai Medical Center, in Coeur dAlene, or other hospitals, he says.


The current 45,000-square-foot facility, which opened in 1958, was designed as a full-service hospital, but thats no longer its main purpose, he says.


It was very well-built, but it wasnt designed for any outpatient (services). They didnt even know what the outpatient was back then, Moore says.


The design work for the new hospital, which would be a 39,000-square-foot, one-floor structure, already has been completed by Johnson Johnson Crabtree Architects PC, of Nashville, Tenn., he says. The construction project manager will be American Health Facilities Development LLC, of Brentwood, Tenn. American Health is an affiliate of Quorum Health Resources LLC, also of Brentwood, which has managed Shoshone Medical Center under contract since 1999, Moore says.


Shoshone expects to pay for the project through tax-exempt bonds offered through the Idaho Health Facilities Authority, Moore says. As an adjunct to that, the hospital currently is going through a lengthy process to try to obtain mortgage insurance for the project from the U.S. Department of Housing and Urban Development, Moore says. If the hospital is successful in that process, HUDs support would enable the bonds issued through the financing authority to receive a triple-A credit rating, which would lower the cost of financing the project, he says.


HUD representatives will visit Shoshone Medical Center in early June to hear a presentation on the project, Moore says. If they approve, funding would occur late this year so that construction could begin as soon as the weather allows next year, he says.


In the scheme of things weve rounded second base, Moore says.


Even without HUDs support, however, Moore says he believes the hospital will be built.


Thats because more than a year ago, Shoshone Medical Center was designated as a critical-access hospital under a federal program that has helped bolster the hospitals bottom line, he says. Because of the program, its conceivable that Shoshone could finance the project even without HUDs help, he says.


Under the critical-access program, small rural hospitals that meet several criteria are reimbursed fully for their costs in providing care to Medicare recipients. Previously, those hospitals, like their bigger counterparts, received from the U.S. government only a partial reimbursement when providing treatment to the elderly and disabled under the federal Medicare program.


Because small rural hospitals offer limited services and tend to treat a higher percentage of Medicare patients, without critical-access designation keeping up with technology and physical plant (improvements) at the same time is quite an ordeal, Moore says.


At Shoshone Medical Center, for example, Medicare pays the bills for about 60 percent of the patients treated each year, he says. Last year, which was the hospitals first as a critical-access facility, Shoshone had excess revenues over expenses of about $246,000, he says. The year before that, its excess revenue was just under $25,000. Shoshone is community owned through a public hospital district.


Being a critical-access hospital allows us to regain our financial footing, Moore says. I think the critical-access program has given new life to small, rural hospitals.


He adds that Shoshones financial standing is improving continually, so, We feel that if (HUD) said no, this time next year wed be in a better financial position than we even are now and have our debt paid down and give it another run.


Nevertheless, consultants whove helped Shoshone through the HUD process are positive that weve got a good chance at receiving the agencys backing, Moore says.


I feel very confident that were going to get this facility built, and I feel pretty good that were going to get this thing built in 2003, he says.


Moore says its a great time for Kellogg to be getting a state-of-the-art medical facility.


When you combine our opportunity with whats coming, we hope, with the ski resort, tourism, the new industrial park, its just coming together at a good time.