The Guy & Guffey Show – Episode 1

Why a new hospital now?

I know, I know – the video is a little long. But bear with us – we’re new to this. Hopefully it answers some of your questions about the new hospital.

And feel free to post questions or topics you’d like to see addressed in future videos and future posts! Hope you have as much fun watching it as we had making it. Happy viewing!

The GuyTh

Support the Hospital – William Cagle, MD Psychiatrist

Support hospital

I had the good fortune to move back to the Chelan area a few years ago and to reestablish my connection with the Behavioral Health Department and the Sanctuary. I guess that makes me a bit biased in my appreciation of the hospital bond initiative that will be back on the ballot this year. I can tell you, however, that I am not personally in need of a new hospital in order to see patients in my office. In the service I worked out of a Quonset hut in the Philippines, and that met my needs just fine. Actually, now that I reflect on it, my Quonset hut was twice the size of my current office.

Once I get out of my own office the situation changes. Our Sanctuary patients who come with their medical problems wind up having to share rooms for the better part of a month. If one snores, the other is awake. If one is talkative and social the other prefers quiet and relaxation. CPAP machines and oxygen machines make noise for the roommate. One person is messy, the other fastidious. They share bathrooms, whether someone has a bleeding problem, chronic hepatitis, or MRSA infections. During lectures and meetings the entire group of patients crowds together in small meeting rooms.

If I have to see someone on the medical floor, I will have to draw a thin curtain across the room in order to pretend that I have privacy to interview someone. We will likely not find another space to talk.

My colleagues who practice medicine and perform surgery have an even greater set of problems. They are the ones who deliver babies in such crowded conditions that furniture has to be moved if they need to get to a certain piece of equipment during the delivery. The equipment for anesthesiologists, surgeons and radiologists has changed dramatically in the past few decades, but the facility that houses this equipment has not, and space is squeezed. If you compare what your car engine looks like today to how it was in the 50s, this is how medical equipment has changed since the hospital was built.

Beyond these considerations is my sense of duty and community, to the people here now and those who will be here in the future. I hope my children will inherit my home some day. If they move here, I want them to be in a community that looks ahead and invests in its future. I don’t want to stick them with this problem we have today, it will only get more expensive and necessary over time.

I encourage people to vote for funding a new hospital.

William Cagle, MD Psychiatrist, Chelan

Rumor: National Trends Show Decline in Rural Hospital Use, Steadily Decrease in Market Share, Decrease in Number of Inpatient Days

Opposition Rumor 8:

National trends show a decline in the use of rural hospitals. Our hospital is showing this same trend with a steadily decreasing market share, a decrease in the number of inpatient days and the inability to meet its operating budget for the past 5 years.

Fact 8:

LCCH’s inpatient visits have actually been very steady over the last 6 years. The average daily census has been 17. This appears on reports as a loss of market share because our region is growing.

With the additional flexibility offered by private patient rooms in the new hospital, the flat inpatient numbers would likely rise. Health care consumers are attracted to new and pleasing environments.

The important point is that inpatient stays account for only 30% of LCCH revenue. The outpatient revenue (70% of total) has been steadily increasing, jumping by over $1,000,000 in 2016 alone.


Rumor 7: National Trends Show a Decline in the Use of Rural Hospitals.

Opposition Rumor 7:

National trends show a decline in the use of rural hospitals. Our hospital is showing this same trend with a steadily decreasing market share, a decrease in the number of inpatient days and the inability to meet its operating budget for the past 5 years.

Fact 7:

Many rural hospitals do in fact face an uphill battle. But the future for Lake Chelan Community Hospital is very bright.
Due to our growing community, our strong administration and staff and our expanding outpatient profit centers, we have much to be proud of and much to look forward to. However, we need a new facility to take the next step towards a bright health care future.
Additionally, not all rural hospitals enjoy Critical Access Hospital status. As a CAH, LCCH is guaranteed 101% of expense reimbursement on over 60% of its business. This creates a very stable operating position.

Rumor 6 – New hospital will increase the existing debt to $50 million (FALSE)

Opposition Rumor 6:

A new hospital will increase the existing non-voted debt by $22 million for a total non-voted debt of $30 million. This debt is in addition to the $20 million levy being voted on on April 25th for a total combined debt of $50 million.

New Hospital Fact 6:

Our hospital is no Town Toyota Center (TTC). Given its designation as a Critical Access Hospital, which secures strong and consistent reimbursements, the hospital faces a very strong financial future in a new building.
In addition, LCCH has had a long financial history as a known entity from which to base its ability to borrow money and afford to pay it back. That was not the case with TTC.

By law, voters cannot be forced to pay for more than what they agree to pay for in a public vote. Given our valley is a thriving and growing community, it’s important we have a modern, dependable health care facility to meet our needs.

#HearTheStories #GetTheFacts

Rumor 5: Hospital below budget in 2016. Net income of $13,000

Rumor 5:

In 2016, the hospital was $770,000 below budget with a net income of $13,000.

Fact 5:

This distorts the bigger picture.  LCCH is a profitable organization that regularly performs better than other Critical Access Hospitals (CAHs).

LCCH has averaged an annual profit of $483,000 over the last ten years. CAHs are designed to be low margin safety net hospitals for rural communities.  Medicare, through the CAH program, reimburses at 101% of costs, which lowers hospital margins but also supports things like new construction.

Because LCCH is reimbursed based on costs, the CAH-Medicare program will end up paying the vast majority of the loan payments on the new hospital.

#WeCantAffordToWait #HearTheStories #GetTheFacts

Sandy Calicot – They did everything perfectly

A year ago my husband was released from a two week stay at Harborview after suffering a stroke. His initial care was given at the LCCH emergency room. They did everything perfectly, prior to his transport by air to Seattle, alleviating the need for surgery. To continue that level of care a new hospital is needed to not only attract and retain qualified healthcare professionals but also to provide a facility which is up to current hospital standards.

Thank you, Sandy


Now is not the time to burden our citizens with this huge new debt.


Now is the time to support a new hospital for our community, because we can’t afford to wait any longer. The current hospital’s infrastructure is on its last legs, it’s bursting at the seams for space, has difficulty recruiting new staff, and the financial outlook looks much worse in the current building vs. a great outlook in a new one. The taxpayers are being asked to support half the expense of the new hospital, with the hospital shouldering its half by borrowing as much money as it can safely afford to do. The cost to the individual family after the bond is passed is roughly similar to the percent of property tax paid to support the library system. What is your family’s health worth to you?


60% of the hospital’s income comes from federal reimbursements. There is great uncertainty about future federal reimbursements due to the new administration and the repealing of the Affordable Care Act (ACA).


There is no uncertainty about the Critical Access Hospital program which is the cornerstone of our hospital’s finances and the cornerstone of small community hospitals nationwide. Additionally, our hospital wasn’t a big winner when the ACA was passed. LCCH reported only a 4% increase in Medicaid patients. So any changes to this program will have minimal effect on the hospital’s bottom line.


There is no financial safety net and no contingency plan if the hospital does not meet its financial projections.


The Critical Access Hospital (CAH) program is the hospital’s financial safety net. It guarantees coverage of 101% of expenses for the majority of the hospital’s patients. The hospital will never make excessive profits in this structure and this is by design, but it does create a stable revenue stream. The CAH program offers consistent health care to our community and 49 million other people nationwide.

Additionally, our hospital has a long-tradition of starting innovative programs to supplement the CAH program. In the 1990’s the Sanctuary Drug and Alcohol treatment center was established. And more recently, a host of out-patient departments including physical and occupational therapy have been created or expanded. The hospital’s outpatient revenues jumped by $1,000,000 in 2016 alone