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  1. TopTop #1
    jmarler's Avatar
    jmarler
     

    Hospital Sale - Measure A

    March 5 is the deadline for voting on Measure A in the special election is bringing us closer to resolving the political turbulence swirling around the fate of our West County hospital.

    A YES vote on Measure A is the only way to preserve an acute care hospital west of Hwy 101 while reducing future tax liabilities.

    A NO vote could result in the loss of hospital services in West County forever while increasing the tax burden by millions of dollars with no benefit whatsoever to the community.

    More information is attached.


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    Last edited by Barry; 02-15-2019 at 02:54 PM.
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  2. TopTop #2
    Barry's Avatar
    Barry
    Founder & Moderator

    Hospital Sale

    n
    Board nails down terms of hospital lease/sale

    By E.I. Hillin, Staff Writer, [email protected] Feb 9, 2019 Updated Feb 11, 2019

    District values hospital at $5.2 million

    In a 4-1 vote the Palm Drive Health Care District board of directors finalized the terms of sale for the Sebastopol hospital building and property at 501 Petaluma Ave. The approved terms include a $275,000 annual lease agreement with an option to purchase within the first two years for $5.2 million.

    The details of the lease/sale agreement between the district and American Advanced Management Group were approved by the health care district board on Feb. 4.

    The terms of agreement come just as voting by mail begins for Measure A in the March 5 special election. Voter approval is required in order for the sale of the hospital building and the property it resides on because the district is a publicly owned entity, funded primarily through property taxes.

    Board President Dennis Colthurst and Director Richard Power led negotiations with AAMG on behalf of the district. Power was initially skeptical about the fair market value and co-authored the rebuttal to the argument in favor of Measure A in the Sonoma County Voter Election Guide.

    Power said the fair market value of the hospital’s property and building does not fit into a “classic” situation, like the purchase of a house or business.

    “There’s a lot of deferred maintenance,” he said. “I believe we’ve entered into a transaction that in the context we are working in, does reflect the fair market value.”

    After more than two months of negotiation, Power, Colthurst, Director Gail Thomas and Director Eira Klich-Heartt voted in favor of the hospital sale terms. The one “no” vote came from Director Jim Horn.

    Horn said he was not convinced the appraisal’s determination of fair market value for the building and the property was correct. Under law, the hospital must be sold at fair market value because AAMG is a for-profit company.

    In October of 2018, Health Care Appraisers, Inc. valued the land at $6.5 million and the building at $3.7 million conducted an appraisal.

    In December 2018 Wright Construction conducted a deferred maintenance study. Due to the necessary building maintenance needed, no value was assigned to the building and a $1.3 million demolition cost was added to determine the fair market value.

    Lease and sale terms

    Continues here


    There's also a good article by Jonathan Greenberg in the Sonoma Independent here


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  4. TopTop #3
    rossmen
     

    Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt

    Your description of the consequences of voting are not accurate. Probably has a lot to do with your deep involvement in efforts to keep a hospital in seebasstoepull. Selling the property to a private for profit company only guarantees that the public loses control. Yes, while we haven't managed it well in the past, and you have done more than your share, that doesn't mean giving up public ownership is automatically a good thing. Perhaps the old hospital property is the place to build affordable housing rather than downtown parking lots? I know you have donated millions to local health care, I appreciate that.

    Quote jmarler wrote: View Post
    ...A YES vote on Measure A is the only way to preserve an acute care hospital west of Hwy 101 while reducing future tax liabilities.

    A NO vote could result in the loss of hospital services in West County forever while increasing the tax burden by millions of dollars with no benefit whatsoever to the community.
    Last edited by Barry; 02-13-2019 at 02:41 PM.
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  5. TopTop #4
    Shepherd's Avatar
    Shepherd
    Supporting Member

    Re: Hospital Sale

    Urgent Care Now Open in Sebastopol. Join us for a Grand Opening Reception Today! Wednesday, February 13th 4PM - 7PM in the conference room at Sonoma Specialty Hospital, 501 Petaluma Avenue in Sebastopol.

    In keeping with this time of expressing and providing care for those near and dear to us, young and old, our family, friends and neighbors Sonoma Specialty Hospital is very proud to announce the grand opening of Progressive Urgent Care now open 7 days a week, 9AM to 9PM.

    Sonoma Specialty Hospital and Progressive invite you to join us in celebrating our Urgent Care facility which is now open, offering the same compassionate, personal, no-wait patient service the County’s only acute care hospital west of HWY 101 has long been known for.

    Urgent Care will handle about 90% of past Emergency Room visits and accepts most insurance. A visit to this Urgent Care facility is much less expensive than a visit to an Emergency Room.

    Progressive Urgent Care is enhanced by its access to traditional services offered by Sonoma Specialty’s acute care facility including:

    • Radiology
    • Laboratory
    • 3-D Mammography
    • ICU
    • Out-patient services
    • Operating Room (out-patient surgeries resuming soon)
    • Hospital admission when referred by a doctor
    • Continued participation in the County Emergency Management Services program.
    Many competitive-paying jobs for medical professionals
    Sonoma Specialty plans to open the first ever Long Term Acute Care in Sonoma County (one of only 5 in Northern California) once the certification is complete later this Spring.
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  7. TopTop #5
    MFlute's Avatar
    MFlute
     

    Re: Hospital Sale

    The December 2018 deferred maintenance study assigned no value to the building and $1.3 million in demolition cost. Why, then, would the appraisal two months earlier give a $3.7 million value of the building?
    Quote Barry wrote: View Post
    Board nails down terms of hospital lease/sale
    By E.I. Hillin, Staff Writer, [email protected] Feb 9, 2019 Updated Feb 11, 2019

    District values hospital at $5.2 million

    ...
    In October of 2018, Health Care Appraisers, Inc. valued the land at $6.5 million and the building at $3.7 million conducted an appraisal....
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  9. TopTop #6
    luke32
     

    Re: Hospital Sale

    I believe that is at least part of the reason behind Jim Horn's NO vote on the lease and sale to AAMG - and a reason to vote NO on Measure A.

    Quote MFlute wrote: View Post
    The December 2018 deferred maintenance study assigned no value to the building and $1.3 million in demolition cost. Why, then, would the appraisal two months earlier give a $3.7 million value of the building?
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  10. TopTop #7

    Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt

    Quote rossmen wrote: View Post
    ... Perhaps the old hospital property is the place to build affordable housing rather than downtown parking lots? I know you have donated millions to local health care, I appreciate that.
    It seems crazy to tear down the hospital and rip out the parking lots to build apartments. What a waste that would be.
    Last edited by Barry; 02-15-2019 at 11:32 AM.
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  12. TopTop #8
    Barry's Avatar
    Barry
    Founder & Moderator

    Re: Hospital Sale - Measure A

    from:



    What you should know about Measure A

    Who owns the hospital?

    The Palm Drive Health Care District (or in other words, the people) owns the hospital building and the property it sits on. The district is primarily funded through an annual $155 per parcel tax. American Advanced Management Group (AAMG) took over hospital management in September after Sonoma West Medical Center could no longer fulfill their contractual obligations. AAMG renamed the hospital Sonoma Specialty Hospital, which is now operating as a long-term acute care facility with an urgent care center.

    Why do they need a special election?

    By law, voter approval is required in order for the district to sell the hospital building and the property.

    If Measure A passes, what are the terms of the lease/sale agreement?

    The approved terms between the district and AAMG include a $275,000 annual lease agreement with an option to purchase within the first two years for $5.2 million. The purchase price includes a $4 million cash down payment and a $1.2 million promissory note to be carried through a 10-year period.

    If AAMG operates the hospital as a long-term or short-term acute care hospital with an urgent care facility for 10 years, the $1.2 million will be forgiven. A Deed of Trust secures the promissory note.

    What happens if Measure A doesn’t pass?

    AAMG is under a 10-year contract with the district to manage Sonoma Specialty Hospital, formerly Sonoma West Medical Center. When the management agreement was made, it included an exclusive option for AAMG to purchase the hospital. If Measure A does not pass, AAMG will still be under contract to manage the hospital.

    What about the district’s debt?

    If AAMG purchases the hospital, a $4 million cash payment is required right away. That money will be used to pay off the district’s general obligation bond, which will be triggered by the sale and be due in full. The other two bonds the district is paying off will need to be refinanced as taxable instead of nontaxable.

    The sale of the hospital would in no way impact the district’s bankruptcy plan. The district’s most recent financial statement reflects a $1.3 million reserve for bankruptcy pay out.

    Will the district be dissolved if the hospital is sold?

    The district can be dissolved after the hospital is sold, but only by voter approval.

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  14. TopTop #9
    lola's Avatar
    lola
     

    Re: Open House at our community hospital in Sebastopol (formerly SWMC, now Sonoma Specialt

    Quote Goat Rock Ukulele wrote: View Post
    It seems crazy to tear down the hospital and rip out the parking lots to build apartments. What a waste that would be.

    How about converting the existing structure into small affordable living units?
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  15. TopTop #10
    natural home
     

    Re: Hospital Sale - Measure A

    I have been trying to follow this thread..but I do think that the need of walkable downtown mixed age affordable housing is something so important to the growth of Sebastopol that I don't know if I could put a $ sign on it. The hospital is very valuable. I t does not need to be demo'd just re-purposed. ..Why not sell flats like in Europe? The resident puts all kitchen.appliances,flooring in and when they leave they take it all! Folks use some imagination and start thinking just a little outside the box.. Has anyone put a pencil to cash flow to having the units rented or purchased? I say keep it and create..If you sell you will be sorry because it gives nothing back to the community., Our community needs housing! Less cars and more walkability
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  16. TopTop #11
    1104GT's Avatar
    1104GT
     

    Re: Hospital Sale - Measure A

    I've been reading all the information trying to understand the two options we have. I'm hoping someone can offer an answer to a few questions:

    1. If the measure passes, what assurance do we have that AAMG will actually operate the hospital for the long term? What will keep them from exercising their option to buy within the first two years, then close the hospital and either sell or develop the property for a profit? I see a financial incentive to operate for ten years, but nothing about limiting the sale before or after that.

    2. If I understand the Sonoma West Times article quoted below, the District currently has a 10 year agreement with AAMG to operate the hospital. I found it on the District website. That seems like our best chance for having an operating hospital for the next ten years. Other than debt accruing, what is the downside of letting that agreement continue?

    3. If the District's debt grows, does that just mean that the parcel tax ($155/year) goes on for a longer period of time? If that's the case, I'm not sure I care. I figured that was a permanent thing when I voted for it years ago.

    Quote Barry wrote: View Post
    from:
    What happens if Measure A doesn’t pass?

    AAMG is under a 10-year contract with the district to manage Sonoma Specialty Hospital, formerly Sonoma West Medical Center. When the management agreement was made, it included an exclusive option for AAMG to purchase the hospital. If Measure A does not pass, AAMG will still be under contract to manage the hospital.
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  18. TopTop #12
    Norbu's Avatar
    Norbu
     

    Re: Hospital Sale - Measure A

    What’s unclear to me is:
    if the sale goes through and the voters vote to dissolve the district does the parcel tax end?

    and

    There was a high appraisal which included giving the building value and a low appraisal calling for demolition of the building. The low appraisal value was used for the sale price. However, the building is not being demolished. It’s being used by the purchaser. So why use the lower appraisal value as the price?

    and also

    why the language on the ballot that says the property can be bought at appraised value when it appears to me that the value has been already determined and the writer of the proposition seems to just be avoiding saying what it actually is, and that it is based on the lower of two appraisals. I am either in the dark about the full picture or the wording of the ballot measure seems misleading to me.

    i humbly invite a response from someone more informed than myself.
    Last edited by Barry; 02-22-2019 at 02:47 PM.
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  20. TopTop #13
    luke32
     

    Re: Hospital Sale - Measure A

    I believe the questions are part and parcel of the reason Jim Horn, a member of the PDHCD board, voted no on the lease and sale. Your "no" vote would agree with him..
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  22. TopTop #14
    photolite's Avatar
    photolite
     

    Re: Hospital Sale - Measure A

    After reading through this whole thread, unless I missed something or misunderstood something, I still don't know, should the sale go through, if the parcel tax goes away or not. Can anyone answer this with a yes or no?
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  23. TopTop #15
    luke32
     

    Re: Hospital Sale - Measure A

    Quote photolite wrote: View Post
    ...should the sale go through, if the parcel tax goes away or not. Can anyone answer this with a yes or no?
    No
    Last edited by Barry; 02-25-2019 at 01:46 PM.
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  25. TopTop #16
    1104GT's Avatar
    1104GT
     

    Re: Hospital Sale - Measure A

    Quote luke32 wrote: View Post
    No
    To elaborate on that, the Hospital District went into debt that is backed by the parcel tax, so the parcel tax will continue until the debt is paid off. I've always assumed that we'll be paying the parcel tax forever.
    Last edited by Barry; 02-25-2019 at 01:47 PM.
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  27. TopTop #17
    farmerdan's Avatar
    farmerdan
     

    Re: Hospital Sale - Measure A

    Barry,

    In response to your request, I'm not sure what questions you are trying to clarify but here are some answers to a few of the posts on this thread:

    1) Converting the hospital to most other uses is not practical because of the special nature of the construction and mechanical systems and the high cost of renovation. Wright construction estimated the cost of conversion to an office at $10M, much more than the value of the building or cost of tearing it down (Estimated at $1.5M by the appraiser.)

    2) The confusion with the appraisal(s) is due to the fact that the initial appraisal did not have the cost of deferred maintenance and was based on a revenue stream generated by 90% occupancy. Once the appraiser received estimates of necessary uprades, they re-appraised the property at $5.2M. (This was the same appraiser, not a different company.) AAMG's bank also did an appraisal that was $4M. The proposed sale price is $5.2M, the higher of the two.

    3) The problem with thinking that the hospital can continue operations under the district is that someone needs to invest heavily in the property to bring it up to more current standards. The district does not have the money to do this and AAMG will have a hard time raising this capital if they can't use the property as collateral. For this reason, I would not expect AAMG to stay around if a sale does not happen.

    4) While AAMG has a 10 year agreement with the district, it does not preclude them from leaving if they are not able to purchase the property and there is no reason to think that they won't since financing the improvements will likely not be possible. It also does not preclude the hospital from closing because necessary upgrades are not made,

    5) There is no guarantee that AAMG will continue to operate a hospital over the long run other than they will have to pay the full appraised price for the property if they quit within 10 years. (They will pay $5.2M instead of the $4M they are initially to pay.)

    6) While this may not be a deal that everyone likes, it is the best deal the district has and no other players came to the table during a very lengthy RFP process by the district.

    7) Taxes will not go away until all bonds are repaid. They will be lowered by the payment of the original GO bonds once the property is sold and they could be lowered further if the district is disbanded after a sale by reducing the overhead of the district but will continue until bonds are repaid.

    The people who are advocating a No vote think that they know more than two appraisers, four of the five board members, and those of us who have been involved over the last 20 years. Most of them are no longer in the district as they have recently stated themsleves and don't care if there is a hospital in Sebastopol or not. The others, like Jim Horn beleive they can get more money out of a turnip but badly underestimate the mess that will be caused.

    Best Regards,
    Dan Smith
    Last edited by Barry; 02-25-2019 at 01:47 PM.
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  29. TopTop #18
    luke32
     

    Re: Hospital Sale - Measure A

    Several points should be made.

    One, those who would vote yes tend to want a "hospital" at all costs, any kind of hospital, whether it offers emergency room services or not. They conflate the reason the Palm Drive Health Care District and the parcel tax were established - to establish hospital emergency room services - and "hospital". See Joan Marler's original post on this topic, above, particularly where she laments " the loss of hospital services in West County". And from Dan's post "The people ... who are advocating a No vote don't care if there is a hospital in Sebastopol or not." Its emergency room care that people care about.

    Two, Jim Horn was correct how many years ago when he said the proposed Sonoma West Medical Center would not succeed financially. Dan Smith was wrong. So while the issue now is not financial feasibility, whose judgement do you go with this time on the appraisal? Jim Horn or Dan and the others? Where would the bond debt be now if we had funneled the parcel tax into bond payments instead of Sonoma West Medical Center these past X years?

    To me its sort of like going with Hilary again because maybe this time she will get it right.
    Last edited by Barry; 02-25-2019 at 01:48 PM.
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  31. TopTop #19
    farmerdan's Avatar
    farmerdan
     

    Re: Hospital Sale - Measure A

    Quote luke32 wrote: View Post
    ...To me its sort of like going with Hilary again because maybe this time she will get it right.
    Luke,

    If you think Hillary would have made a worse president than Donald Trump, I am not sure you have been paying attention.

    ...Two, Jim Horn was correct how many years ago when he said the proposed Sonoma West Medical Center would not succeed financially. Dan Smith was wrong. So while the issue now is not financial feasibility, whose judgement do you go with this time on the appraisal? Jim Horn or Dan and the others? Where would the bond debt be now if we had funneled the parcel tax into bond payments instead of Sonoma West Medical Center these past X years?
    It is true that I underestimated the challenge of reopening the hospital, however your assumption that the district supported the hospital over the last few years is mostly false, since SWMC bore almost all of the financial costs. You might ask why Jim is a minority of one in opposing the sale (that he voted to put on the ballot.)

    Please don't take my word for anything, but you might want to listen to Richard Power, who Jim recruited to run for the board and now supports this sale. So if Jim doesn't want to see the hospital sold, why did he vote to put the initiate on the ballot, just so we can waste a lot of money and time?

    Dan Smith
    Last edited by Barry; 02-25-2019 at 01:52 PM.
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  32. TopTop #20
    luke32
     

    Re: Hospital Sale - Measure A

    Dan -

    I voted for Hilary. I think she would have made a very good president. She ran a poor campaign and Its nominating her again that I think would be a very bad idea.

    With regard to PDHCD support of SWMC, I don't know what portion of the total annual tax receipts (@$155/parcel) went to SWMC during its lifetime. My point was that whatever tax money went to SWMC could better have gone to pay down the bonds.

    Could you 'ballpark' the amount of PDHCD tax money that went to Sonoma West MC over the years - just so we know whether we're talking about small change or to paraphrase Senator Everett Dirksen, "...a million here, a million there, and pretty soon we're talking about real money".

    I am aware of your very generous support of SWMC and commend you for that.
    Quote farmerdan wrote: View Post
    ... however your assumption that the district supported the hospital over the last few years is mostly false, since SWMC bore almost all of the financial costs...
    Last edited by Barry; 02-25-2019 at 01:54 PM.
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  33. TopTop #21
    farmerdan's Avatar
    farmerdan
     

    Re: Hospital Sale - Measure A

    Quote luke32 wrote: View Post
    ...Could you 'ballpark' the amount of PDHCD tax money that went to Sonoma West MC over the years ...
    Luke,

    I believe the number would be about $1.5M that the district provided to SWMC but $600K of that was for equipment that SWMC transferred to the district. Jim may have a more accurate number.

    That does not take into account that SWMC spent about $8M upgrading the building and purchasing equipment and supplies that all now belong to the district. In total, SWMC spent over $15M in donations getting the hospital going. So, the district got a lot more than it paid for even if you just consider all of the improvements. Unfortunately, this does not make the hospital more valuable because there is still a lot of deferred maintenance but it did allow AAMG to take over an ongoing business that was relatively well equipped and supplied and they may be able to run a profitable business.

    I hope it is obvious that I would not do it again (and certainly do not have the capital), but it was a gallant effort that saved some lives and now, perhaps will transition to something beneficial for the community going forward. It had long been my belief that the hospital needed to be managed by a system and that restarting it might attract Memorial or the Adventists and in fact, the Adventists showed a good deal of interest at one point. (They manage 7 hospitals north of here but finally decided ours did not fit because they could not run the clinics in the area like they do in the north.)

    When you take on impossible tasks sometimes you lose and this was one of those times for me. But I do not regret trying and I certainly think the district was not harmed by it since there is a possibility now on the table that would otherwise not exist. I think it will be a shame if the hospital is torn down but it is really up to the voters, not me.

    We can argue till we are blue in the face about who is to blame for our predicament but the reality is that healthcare is now the property of corporations, insurance companies, and big pharma and that is the real reason. The age of the family doc and the community hospital is gone and won't return. Perhaps we tried too hard to keep an emergency room in our town with local doctors and for that, I certainly share blame. But the fountains of vitriol that continue to pour forth against board members and others do not reflect well on us as a community.

    I agree about Hillary. The reality is that she was too easy a target for the Russians and the Trumps.
    We live in ugly political times unfortunately and I fear for us all that the nastiest win and the most thoughtful lose.

    Dan Smith
    Last edited by Barry; 02-25-2019 at 02:00 PM.
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  34. TopTop #22

    Re: Hospital Sale - Measure A

    Quote 1104GT wrote: View Post
    I've been reading all the information trying to understand the two options we have. I'm hoping someone can offer an answer to a few questions:

    1. If the measure passes, what assurance do we have that AAMG will actually operate the hospital for the long term? What will keep them from exercising their option to buy within the first two years, then close the hospital and either sell or develop the property for a profit? I see a financial incentive to operate for ten years, but nothing about limiting the sale before or after that.

    2. If I understand the Sonoma West Times article quoted below, the District currently has a 10 year agreement with AAMG to operate the hospital. I found it on the District website. That seems like our best chance for having an operating hospital for the next ten years. Other than debt accruing, what is the downside of letting that agreement continue?
    It is my understanding that there no longer is, nor will there be a hospital open to the public at the Palm Drive location. The “hospital” that now exists is currently a short term acute care facility, in the process of applying for long term status. Short or long term, the facility will only serve folks rehabbing from severe acute illness or surgery. In function this is similar to, if not the same as the Apple Valley Post Acute Rehab off of Hwy 116 just on the edge of town. These facilities are meant to be an in between stop following a hospital stay before returning home. This is not a general hospital that will serve you if you think you're having a stroke or heart attack. That kind of hospital care is no longer available in Sebastopol. In my opinion, this is an important distinction when we are talking about AAMG operating “the hospital”. So whether it's a 10 year contract at $100,000/mo that we pay to AAMG or a lease option for them to buy the facility at below market value, either way there is no general hospital.

    AAMG is a Modesto based company with a business model that appears to be one of managing, leasing and buying small failing rural hospitals and converting them to some form of specialty care facility. Don't know if that's good news or bad news, guess it depends on what you're wanting. It does however seem to lend credibility to the idea that they are in business to stay rather than just turn the property for a profit. That having been said there is a possible twist.

    The word in the medical community regarding these acute care facilities is that Medicare is seriously considering not covering the costs. Should these facilities get dropped from Medicare covered services it's likely these specialty hospitals will have a bleak future. If the acute care rehab center goes under, I wonder if we would also lose our new urgent care facility. But at least for now we have an urgent care facility, something I believe Jim Horn was suggesting we consider way back in the save our hospital campaign days...

    While I'm on the subject, I believe we've come full circle to Mr. Horn's assessments of the hospital's transitions. Starting with his measured opinion that SWMC's plan was not financially feasible and concluding with the suggestion that instead of trying desperately to preserve the hospital and ER, we might consider a transition to an urgent care and outpatient services facility. Less than 5 years later and I don't know how many millions of dollars spent, here we are, right where we could have started, serving the majority of our community with Urgent Care and Outpatient Services. Subtle difference, we're paying an outside management company $100,000/mo to run the operation. Now the same people who convinced us to save our hospital are urging us to sell our hospital because once again, the hospital is bankrupt. And who do we get to sell our only assets to? The lowest bidder of course, the for profit Modesto based corporation. I think this would be a good time to notice that Jim was right on the money, as the old phrase goes, and to say thank you Jim for your thoughtful and accurate insights and continued efforts to guide our community through our hospital's perils.

    And now as I understand it, Jim is once again the sole dissenting voice. His opinion is that the sale, as it has been negotiated, is a bad deal for us. His reasons are sound, but then again there are some valid arguments in favor of this deal, it's a tough call. Once you've hit damage control the choices are never optimum. But one salient point that I consider important for all of us to realize, which ever way the vote goes, is that there is no hospital, as we typically think of when we discuss “our hospital”, to save.

    The Measure A literature implies that a yes vote will preserve “the hospital” for years to come. I perceive that language as subtly misleading, which leaves me a bit skeptical of the yes vote proponents. Perhaps it's simply a matter of semantics but let's be clear, this is what we have: an Urgent Care Center which handles non-life threatening conditions, Outpatient Services providing labs, x-rays, etc and an Acute Care Facility which rehabs people after severe acute illness or surgery. There is not now, nor will there be in the future a hospital serving the general population regardless of how the vote goes.
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  36. TopTop #23
    Howard's Avatar
    Howard
     

    Re: Hospital Sale - Measure A

    My explanation of the appraisals is the same as Dan Smith's but with a little more in the weeds.

    The higher value by the same appraiser preceded the Wright Contracting estimates of $28M in deferred maintenance. Of this, $9M was estimated by Wright, and utilized by the appraisers for immediate requirements to make the building commercially viable. One can argue with these numbers and the necessity of each line item, but I heard no one from the board (or anyone else for that matter) arguing that. Wright is relatively well known with a good reputation in the commercial field and predates me (but not Norbert).

    The appraisers were asked to revise their value opinion given this new information. You can't utilize the higher value if there's new facts that tend to disprove the old. Appraisers aren't qualified to inspect roofs, heating equipment, etc. and generally assume they're OK unless otherwise known or observed.

    It's standard appraisal practice to determine whether the value of the building and land, as it's currently utilized or can be feasibly utilized for some other purpose, is worth more than the land, as if vacant.

    This is a hard concept for most people to grasp but we've seen it recently with the former lumber yard/tractor supply (now approved for a hotel) and the former auto dealership (now a CVS). Both improvements were demolished. The buyer was paying for the land (less demolition costs) and not for the buildings which were obsolete.

    So, the question becomes: What's the value of the land, as if vacant and less demolition costs, and what's the value of the building plus land as utilized for a hospital. All the approaches to value by the appraiser showed a value of less than $600K as improved and $5.2M for the land less demolition.
    The higher of the two is the "highest and best use", i.e. the market value.

    Jim Horn's only real opposition that I heard at the hearing I was at was his objection to the rent credit AAMG is getting for any deferred maintenance money they spend. I agree with Jim. The value and the rent are both based on land only and so unless they're spending more than $9M on the improvements, it ain't going to benefit us, the owner.

    On the other hand, the rent is only $275K per year for a maximum of six years, including extensions. This is a small price to pay given that the district is $20M+ in the hole, has had multiple bankruptcies, losing close to $1M per month and doesn't seem to be viable to any other entity given the lack of response to the District's RFP.

    I've voted for every hospital parcel tax and would have supported many more, but will be voting Yes on Measure A. I hope AAMG can make a go of it.

    Howard

    Quote Norbu wrote: View Post
    ...There was a high appraisal which included giving the building value and a low appraisal calling for demolition of the building. The low appraisal value was used for the sale price. However, the building is not being demolished. It’s being used by the purchaser. So why use the lower appraisal value as the price?

    and also

    why the language on the ballot that says the property can be bought at appraised value when it appears to me that the value has been already determined and the writer of the proposition seems to just be avoiding saying what it actually is, and that it is based on the lower of two appraisals. I am either in the dark about the full picture or the wording of the ballot measure seems misleading to me.

    i humbly invite a response from someone more informed than myself.
    Last edited by Barry; 02-25-2019 at 09:25 PM.
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  37. Gratitude expressed by:

  38. TopTop #24
    farmerdan's Avatar
    farmerdan
     

    Re: Hospital Sale - Measure A

    Howard,

    Well said!

    One issue that I see is that closing the hospital was very expensive in 2014 and was one of the major reasons the district did not have a good way to exit bankruptcy. If the district has to close it again, this could easily add to the cost of selling the property and the delays with having to go back to voters to sell will also continue the costs for the district.

    Any developer who was going to buy the property would want to do so contingent on the city approving a project. We all know what a crapshoot this can be and it can take years.

    Dan
    Quote Howard wrote: View Post
    My explanation of the appraisals is the same as Dan Smith's but with a little more in the weeds....
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  39. Gratitude expressed by:

  40. TopTop #25
    jomo
     

    Re: Hospital Sale - Measure A

    I am one of those that support the sale of the hospital to AAMG. In addition to being convinced this is the best deal we will get for the property (as enumerated in the thread), it is the only option that will retain the hospital beds in Sonoma County. Sonoma County is aging and the demand for hospital beds continues to increase with the aging of the population.

    There are many times a year, mostly in the winter months, where our local hospitals are full and unable to accept new admissions. This results in a search for any hospital bed outside of Sonoma County and the person is transferred to the hospital with an available bed. If no bed is available the only alternative is to wait in the Emergency Department for a bed to become available, which can take many many hours and at times a day or more.

    If I am in a hospital it is important to me to have family and friends close, and to be in the same area as my primary care physician. In my experience, care is better when a family member or friend is present as a visitor as much as possible. This becomes difficult or impossible for many of us when the hospital is far away from Sonoma County.

    With AAMG offering hospital services in Sebastopol, the total number of hospital beds in Sonoma County is 37 more than if the hospital is no longer there. That to me is something that will someday be crucial for at least some of you reading this thread.
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  41. Gratitude expressed by 4 members:

  42. TopTop #26
    Kevind's Avatar
    Kevind
     

    personal experience with Urgent Care last Friday, February 22, 2019

    Last Friday, on our way to a restaurant in Petaluma, my wife slipped and fell as she crossed the street. Bracing herself against the fall, she hurt her wrist badly. In the restaurant, we asked for a bag of ice and drove home trying to decide what to do. She thought she might have broken a bone.

    It was about 6:30, and we decided to pull into what we still think of as Palm Drive Hospital, not knowing what kind of reception we'd get. We thought we might be turned away because it might be considered an "emergency" and Palm Drive no longer has an ER.

    My wife gave the receptionist her Medicare card and Anthem/Blue Cross supplement ID, filled out the usual clipboard form of medical history, and a nurse came out and explained that if we needed x-rays, we might get billed for a co-pay.

    Dr. Holmes took us back to an examination room, examined the wrist and arm, and said he'd see us again after he read the x-rays. A few minutes later, the three x-rays came back: there was no fracture.

    We left about an hour later with my wife's wrist in a flexible splint after Dr. Holmes offered a pain medication, explained what we could expect recovery to be, what self-treatment she should do, and what possible complications we should look out for.

    So that's what Urgent Care was for us last Friday night.

    We're voting for Measure A.
    Last edited by Kevind; 02-26-2019 at 06:27 PM. Reason: typo
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  43. Gratitude expressed by 7 members:

  44. TopTop #27
    farmerdan's Avatar
    farmerdan
     

    Re: personal experience with Urgent Care last Friday, February 22, 2019

    Kevin,

    My wife also went to the urgent care and got excellent treatment by Dr. Flowers.
    But what was more important is that Dr. Flowers saved a woman's life the day before.
    Most urgent care facilities are no where near as well equipped as Sonoma Specialty Hospital.
    She will be very glad to hear your story.

    Dan Smith
    Quote Kevind wrote: View Post
    Last Friday, on our way to a restaurant in Petaluma, my wife slipped and fell ...
    Last edited by Barry; 02-27-2019 at 11:11 AM.
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  45. Gratitude expressed by 4 members:

  46. TopTop #28
    Shepherd's Avatar
    Shepherd
    Supporting Member

    Re: personal experience with Urgent Care last Friday, February 22, 2019



    (selections from February Newsletter. See full newsletter here)

    LAFCO

    Susan attended and spoke out at the January LAFCO (Local Agency Formation Committee) meeting where proponents of detachment from the river joined forces with people in Bodega Bay to gather enough signatures to consider detachment. Unfortunately, it has been hard to share clarifying information to Bodega Bay residents who receive regular emails to which outsiders have no access. Incorrect information has been circulating and signatures gathered on that basis, such as “The hospital has remained closed.” So, it has been important for there to be voices of clarification and support for our hospital at the LAFCO meetings to set the record straight at that level. LAFCO's next meeting is scheduled for March 6 at 2:00. LAFCO meetings are held at 575 Administration Drive, Santa Rosa. It is very helpful to have supporters of the hospital and District present at meetings of the Local Agency Formation Committee, who makes decisions about our Health Care District.

    Urgent Care is Open!
    We are delighted that Urgent Care is open 7 days a week, from 9 am to 9 pm and receiving grateful patients. The soft opening was early in February, and the Grand Opening Celebration was held Wednesday before Valentine’s Day. Despite a steady downpour, about 75 or more people attended the opening and toured the facility. Even the first week, Urgent Care was saving lives. Earlier that opening day a patient was presented to Urgent Care in a grave condition with breathing difficulties. Our doctors and medical staff were able to immediately stabilize her and sent her to Santa Rosa in an ambulance. Without their intervening care the woman would probably not have survived the additional 30 minute trip. The Progressive Urgent Care doctors Pankaj Malhotra and Dr. Libby Flower have been kept busy each day.

    Our Urgent Care accepts most insurance plans plus Medicare. We are delighted that they can cover about 90% of the cases presented at our former ER and that West County now has a drop-in, no-wait option for those with non-life or limb-threatening medical needs. Unlike other Urgent Care facilities, Sebastopol’s has access to the acute care hospital facilities for radiology, lab work and other services for which most Urgent Care doctors have to send patients elsewhere. Several of our foundation community have used Urgent Care and give it glowing reviews.

    Election Update:
    On December 3rd the District Board voted 5-0 to sell the hospital and to pursue negotiations to determine the terms for the lease/sale. Ballots for Measure A were received around the 6th of February. On February 5th, with negotiations complete, the Board voted 4-1 to accept the terms (Directors Dennis Colthurst and attorney Richard Power represented the Board in these negotiations), with Mr. Horn voting No because of his “gut feeling” that we could get a better deal. The District had five Town Hall discussions scattered throughout West County and one League of Women Voter’s Debate to discuss issues and concerns. There are relevant articles at www.sonomaindependent.org that address questions about the hospital and our managing company AAMG, the issues and that answer many of the questions raised at the various meetings. (By the way, Kudos to Sebastopol’s own Jonathan Greenberg, editor of Sonoma Independent, for his recent Washington Post article which can be read in full at: www.sfgate.com - “Opinion: The 6 essential cons that define Trumps success”).

    A recent Press Democrat editorial addressed the daunting labyrinth one must negotiate for campaign compliance. We’ve experienced this maze for ourselves and are finally on track to finish the required reporting after filing a few days late. Fortunately, the IRS has clarified that a “non-profit” like ours can indeed sponsor and contribute to campaigns around specific issues. A Sonoma West Times article this week quotes criticized the postcard/flyer demonstrating the lively debate about the fate of our hospital throughout West County. Contrary to what opponents appear to be saying, the information on the card is accurate since no claims were made about contractual terms, just likely outcomes depending upon the vote. Please check out www.sonomaindependent.org and remember to mail in your Yes Vote by March 5.

    The terms of the negotiated deal are posted on the Palm Drive Health Care District web site (https://www.pdhcd.com/), if you are curious.<
    Last edited by Barry; 02-28-2019 at 01:11 PM.
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  47. TopTop #29
    podfish's Avatar
    podfish
    Supporting Member

    Re: personal experience with Urgent Care last Friday, February 22, 2019

    is walk-in urgent care going to be part of the plan going forward?
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  48. Gratitude expressed by:

  49. TopTop #30
    farmerdan's Avatar
    farmerdan
     

    Re: Hospital Sale - Measure A

    AAMG is running walk-in urgent care now 7 days a week from 9:00AM to 9:00PM open to the public.
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