affiliation
Be Informed. Get Involved. Participate
Embedded Files
SEPTEMBER 14TH RFP UPDATE
SEPTEMBER 14TH RFP UPDATE
AUGUST 30th RFP UPDATE
AUGUST 30th RFP UPDATE
REGIONAL was the only organization to respond to the Hosptial's Request for Proposal.
Regional Health is based in the Yakima Valley and is the parent company of the Sunnyside Community Hospita. The organization is also in the process of finalizing the purchase of Yakima Regional Medical and Cardiac Center as well as the Toppenish Community Hospital.
Only four of the five Commissioners scored Regional's proposal (slide title is incorrect, should read 4 of 5).
Commissoiner Pollard chose not to score the proposal.
On balance, Commissioners scored Regional's proposal a little higher than did staff.
The detailed score sheet is available to the public upon request.
Regioanal Health Proposal (redacted version)
Regioanal Health Proposal (redacted version)
[The Consultants and Hospital Staff] will be working on analyzing the proposal and will begin a discussion with the Regional Health to clear up any questions they have. They will then form a report for the board of commissioners, highlighting the information from the proposal and from their discussions with the respondent.
At the next hospital board meeting, set for Sept. 14, the board will discuss whether or not to proceed with Regional Health’s proposal and continue work on the affiliation agreement.
SVH Response August 2017-FINAL - Redacted.pdfSeptember 14th: Consultant report to Commissioners & decide on next steps
September 14th: Consultant report to Commissioners & decide on next steps
August 2nd RFP Update
August 2nd RFP Update
Summary: About sixteen organizations were invited to participate in the RFP Affiliation process. It appears that three or four proposals will be submitted:
- CHI/Franciscan Health jointly with Virginia Mason
- MultiCare Health Systems
- Regional Health
- Overlake Medical Center (“intent to carefully evaluate the opportunity”)
August 11th is the deadline for proposals to be submitted. Commissioners will select finalists during their October 12th Board meeting after two months of deliberations. An additional Public Hearing will be scheduled once a final candidate is selected and a Letter of Intent executed.
The consultants will update Commissioners during the August 10th Board meeting .
08 - SVH Affiliation Update (FINAL 80217).pdfBackground: Almost all rural hospitals in the country are feeling a financial strain. For example, there were 66 rural hospital closures between 2010 and 2016. unc.live/2q4ua7M. Meanwhile, Snoqualmie Valley Hospital, with its newly built facility and regionally acclaimed Swing Bed Program, is among the most respected and successful Critical Access Hospitals in the State of Washington. It is fortunate to have a stable financial situation with many good options, but long term financial viability remains a concern.
For this and other reasons, the Hospital is working to affiliate or merge with a larger hospital or healthcare provider, and hired Huebner Advisory and Sarah Cave Consulting to work on the process.
One of the more interesting options for affiliation is the Verdant Health Model. Under this model, tax and lease payments would underwrite grants awarded each year to Valley health services and civic organizations while an affiliate healthcare organization would be in charge of running the hospital.
5-30-17 Public Hearing
5-30-17 Public Hearing
Here is a 3 minute excerpt of Commissioners asking for added Public Comments.
First of five planning meetings
First of five planning meetings
SVH Work Study Session 42617 (FINAL 42617).pdfSteve Huebner and Sarah Cave, the consultants engaged for the purpose of seeking an affiliate partner, were present to work with the commissioners and executive staff to begin the process. The main objectives were to review and affirm the process and the phases of the work, agree on guiding principles for affiliation, and to reaffirm and clarify the goals of affiliation. Meeting minutes.
Second of five planning meetings
Second of five planning meetings
SVH Work Study Session 32217 (FINAL).pdfDuring the April planning session, the consultants laid out in detail two models for affiliation: (1) Murger/assets sale, and (2) Lease of the Hospital, etc. Within these models, the goal of the RFP is to ask respondents how they plan to satisfy the affiliation priorities The consultants also shared a list of potential RFP respondents . Meeting minutes.
Third of five planning meetings
Third of five planning meetings
Market Assessment for SVH Board (50817).pdfMarket Assessment Presentation
Market Assessment Presentation
SVH Affiliation Process Timeline (50517).pdf
Fourth of five planning meetings
Fourth of five planning meetings
SVH Work Study Session 52417 (52217).pdfSVH Work Study Session Agenda 52417 (FINAL).pdfSVH RFP Criteria (DRAFT 52217).pdfSVH RFP Outline (As of 52117).pdfAffiliate RFP OUTLINE
SVH RFP Outline (DRAFT 50717).pdfAffiliation priorities
Affiliation priorities
- 1. Affiliate now from a position of strength,
- 2. Debt reduction ,
- 3. Branding,
- 4. Viability (move to consistent profitability),
- 5. Further clinical integration/Grow scope of services,
- 6. Expand local community health education offerings,
- 7. Mitigate organizational risk,
- 8. Leverage affiliate brand and resources to accomplish more community outreach,
- 9. Spread risk in value-based contracting, and
- 10. Capital access for expansion of services.
Why Affiliation Important
Why Affiliation Important
• Financial health and sustainability
• Brand recognition/elevation
• Debt reduction
• Time is now
• Better serve vibrant and growing community w/strong demographic
• Seeking a long-term, sustainable partnership
• Collaboration and coordination of services alone insufficient to meet SVH goals
• Seeking a partner that understands the value of all SVH assets/resources (hospital + clinics + land)
• Continued (and expanded) service to the community—e.g., peds, health and wellness, innovative new programs
• Debt-service obligation
• Open to a variety of roles in the future, but need to ensure community needs met
• Obligation to ensure tax dollars well spent
• Most not interested in continued role in day-to-day operational oversight
• Continued involvement in ensuring community outreach and educational offerings
Potential Affiliation Partners
Potential Affiliation Partners
Follow SVH Forum on Facebook: bit.ly/svhforum-fb
Follow SVH Forum on Facebook: bit.ly/svhforum-fb
Affiliation Options:
Affiliation Options:
SVH-Work-Study-Session-42617-(FINAL-42617)-017.jpgMerger/Asset Sale
Merger/Asset Sale
• Governance/Org Structure:
• Assets are either “merged” into, or purchased by, affiliate partner
• District gives up ownership of assets
• Governance becomes affiliate’s responsibility
• Role of District:
• District continues to maintain responsibility for LTGO debt and retains taxing authority
• Financial Structure:
• District uses proceeds of asset sale to retire revenue bonds and other liabilities
• Operations:
• Affiliate partner assumes all responsibility for operations
• Other:
• If face value of debt is greater than value of assets, District may not be able to retire all liabilities
• Current revenue bond debt covenants provide for lease provisions, but may not accommodate an asset sale
• 10-year call provision on debt may not allow for transfer of debt to affiliate partner
• District desires guarantee on LTGO bonds which may be better provided through a lease
• District desires for affiliate partner to assume responsibility for all debt service
Affiliate partner leases hospital
Affiliate partner leases hospital
• Affiliate partner assumes responsibility for operations
• Affiliate partner assumes governance authority
• District continues to own hospital, clinic, and other assets
• District has little, if any, role in overseeing operations
• District may retain “reserved powers”:
• Incurrence of additional indebtedness
• Sale or transfer of assets
• Expansion or closure of services
• District to receive periodic report from affiliation partner:
• Operating/financial results
• Annual operating budget
• Annual capital budget
• Proposed changes in services
Role of District:
• District continues to levy and collect taxes
• District may be required to maximize taxing authority to support debt service, uncompensated care, or operating losses
• Taxes will first be committed to covering LTGO Bond debt service
• Additional taxes may be retained by District
• Commissioners continue to represent the community’s interests in access and provision of quality care
• District may retain funding to meet other community health-related needs
Financial Structure:
• Long-term lease – 30+ years (possibly 20 years with 10 year extensions)
• Affiliate partner assumes all costs and expenses associated with leased assets, including maintenance and capital improvements
• District retains working capital assets and retains current liabilities (accounts receivable, inventory, accounts payable)
• District may retain some level of cash reserves
• Affiliate partner commits that sufficient funds will be available to cover District’s LTGO Bond commitment
• Affiliate partner commits that sufficient funds will be available to cover Revenue Bond debt service
• Affiliate partner covers the operating losses of the hospital/clinic operating entity
• District may participate in future earnings/cashflows of the operating entity, provided operating results are positive (may be cumulative)
• Affiliate partner assumes responsibility for future capital commitments
• Expansion service area
of primary care/clinics in
• Capital improvements
• Health IT
Operations:
• Retention of hospital management in key management roles
• Interests of hospital employees protected
• Consolidation/centralization of “back-office” services to reduce overhead
• Affiliation agreement obligates the affiliation partner to required services to the community
• Retention of current services
• Expansion of IP and OP services
• Services may change – 5 year, 10 year, 20 year commitments
• Joint effort on part of affiliation partner and District to define level of required services
• If CAH status changes, required services could change accordingly
• Affiliation agreement commits affiliate partner to physician recruitment plan
• Required commitment by affiliation partner to marketing/branding effort
• Affiliation agreement requires good faith effort to expand/optimize services on East Campus
Other: Community commitment:
• Protect the long-term interests of community that has committed to support the District
• Protect the interests of tax-payers responsible for servicing debt
• Provide necessary healthcare services
• Provide broader community outreach services
Termination provisions:
• Mutual consent
• Material breach of affiliation agreement
• Sustained operating losses
This is just the beginning.
Please bookmark this website and return often for frequent updates.
Join the conversation and "follow" us on Facebook:
Return to home
AUGUST 30th RFP UPDATE
AUGUST 30th RFP UPDATE
Report abuse