Hospital board ties feasibility study vote

By Karl Terry: PNT Managing Editor

With the reorganization of the board at Roosevelt General Hospital an old argument reared its head Tuesday — the merits of offering obstetric services at the hospital.

In the end, a discussion of more than two hours came down to a tie vote over whether to spend $28,000 on a study of the feasibility of obstetrics at RGH.

New board member Peggy Davis and Lydia Ornelas voted for the study. Board chairman Terry Cone and Fred Anthony voted against. Board member Darwin Chenault was absent due to a large grass fire, so with the tie vote, the measure was tabled until the next meeting.

Portales attorney Eric Dixon was on the board’s agenda to discuss OB services at RGH. Dixon told board members he felt county residents haven’t received what was promised when they voted in favor of the bond issue that reopened Roosevelt General in 2001 after it had been closed down by Presbyterian Healthcare in 1998. He said voters were promised a full-service hospital with OB services and said hospital officials haven’t delivered on their promise.

Dixon presented a study sponsored by the Roosevelt County Commission done in 1998 prior a bond election to build the hospital that showed by 2003 Roosevelt County could see a possible utilization of OB facilities with 374 to 416 births per year. That study, done by hospital consultant James Roeder, showed the potential district could support at least two OB/GYN doctors.

“It seems to me there’s a lack of will to provide labor and delivery here,” Dixon said. “Labor and delivery is a money-maker not a money-loser, and for some inexplicable reason, we’ve been told we can’t have it.”

Dixon suggested the third-party study be done.

Seferino Montano, executive director of La Casa Family Health Centers, told the board his non-profit group recruited physicians for OB service and had them on staff at the time the hospital opened. He said he wanted to set the record straight, that it wasn’t La Casa’s fault that OB services were never started at RGH. He said he was told by hospital officials at the time that OB services were not financially feasible.

“I agree with Mr. Dixon that a study should be done,” Montano said. “We may well find it’s too expensive. OB was something that was promised and anticipated.”

Dr. Lonnie Alexander, who practices with Women’s Medical Center in Clovis but has served OB patients in Portales and Clovis for two decades, pointed out that rural hospitals all over the country are closing down obstetrics wards. He said the community would have to be ready to subsidize the hospital if it undertook OB.

RGH Administrator James D’Agostino told a packed house in the RGH cafeteria the bond election was strictly for brick and mortar and didn’t provide any operating subsidy. He said simply operating the hospital has been a challenge.

D’Agostino presented 2007 figures on possible revenues and expenses for obstetrical care that showed three scenarios based on number of deliveries.

In the worst case, with 124 deliveries, D’Agostino projected the loss to be $1.118 million. In the best case, with 195 deliveries, the loss would be $940,267. He said that even raising the price per delivery by $1,000 each still left the best case at a $745,267 loss.

“We’ve made a little money in the last year, but it’s been tough,” D’Agostino said. “We had a lot of naysayers … a lot of people predicted we wouldn’t make it. If you ask me, I would say we can’t take a million dollar loss and survive.”

Meeting Reactions
“I think the people of the town deserve that we have someone from the outside to look at it. I would like to see it settled for the people to know.”
— Peggy Davis
New RGH Board Member

“I think we’re live bait for lawsuits in a small hospital like this. When you take on OB, you take on a lot of extra risk.”
— Bert Wofford
Portales physician

“The beauty of a hospital district is your liability is limited. The hospital district has a competitive advantage of a $400,000 governmental cap on lawsuits.”
— Eric Dixon
Portales attorney

“If you’re going to do OB, you better do it right. You have to be able to start up a c-section within a half-hour. You need to look at it and make an informed intelligent decision involving your medical staff.
— Jim Wurtz
Vice president of regional
services for Covenant Group,
which manages RGH

“We’ve got to get beyond the point of who was promised what. We don’t care if it makes a profit or not as long as it doesn’t jeopardize the hospital.”
— Board Member Fred Anthony

“You can do your study, but unless you have your provider base, you’re not going to get that kind of coverage. It would be great to do it here, personally, I don’t think it’s feasible.”
— Dr. Lonnie Alexander
Clovis/Portales physician

“The first request was for ER help. We struggled for a couple of years and OB was not a priority … Every recruitment effort we’ve made has been under the auspices of the medical staff. It’s not something I did arbitrarily.”
— James D’Agostino
RGH Administrator