The Carson City Board of Supervisors and mayoral candidate Tom Keeton have expressed concern over Carson-Tahoe Hospital's search for an affiliate.
The hospital is considering affiliation with another health-care entity to strengthen its position in the competitive medical care market.
"Affiliation looks like it's the thing to do," Mayor Ray Masayko said at Thursday's meeting. He agreed that it's a good move because the hospital is financially stable and because of the volatility of the health-care market. "One year it's a rose garden, the next a bed of thorns."
Carson-Tahoe Hospital chief executive Steve Smith agreed, saying the hospital is in good financial shape right now, but the market's volatility means he could be asking taxpayers for operational funds in the future. He emphasized the need for growth to stay competitive in this market.
"We presently have $26 million outstanding in bonds, but we will have to triple that number to stay competitive," he said.
Smith was referring to a projected $63 million price tag for capital improvements to the hospital.
And while he may be able to acquire that sum through affiliation, local control of the hospital maybe lost, according to Keeton.
"If we lose control of our hospital to a larger organization, and you're looking for $63 million, we're going to lose control of our hospital and how it functions," he said. "I don't care what you call it: affiliation or anything else. I don't care what their mission statement is. We (Carson City) can end up with a situation (we) dislike and can't get out of without penalty.
"We have a really good hospital that works," Keeton said. "If they really need $63 million over, say, the next five years, I suggest we work hard at trying to find that somewhere and not get encumbered.
"Ten years from now, we might have to raise taxes to recover losses, but it could be worse to have someone else calling the shots. They might say the same thing on a larger scale," Keeton said.
Smith assured the supervisors that hospital officials would consider affiliation only with a clause allowing them to get out of the contract at any time.
"You may not have a penalty, but it may be financially pretty steep to get out of a situation like that," Masayko warned.
Supervisor Robin Williamson said the hospital has received strong support in the community and that should be kept in mind when considering affiliation.
There are "hospitals in the Bay Area that have affiliated and are now striking for better pay and patient care," she said. "I don't want all of this to be determined by money."
"I know we have loyalty from the community," Smith said. "But when we really need the taxes, we won't be able to give this hospital away."
As an example, Smith cited Nye County General in Tonopah. The hospital's financial woes there were not due to lack of growth, but to services taken out of the community.
Lack of technological services there meant health insurance providers cut patients out of the service area and left the hospital with a smaller customer base.
Supervisor Kay Bennett said it is important that the affiliate has some commitment to serve all members of the community.
Though she doesn't see it happening, the worst scenario would entail selling the hospital to a private, for-profit health-care entity that would serve only those who could afford to pay.
"Access to health care will become more critical as the population ages," Bennett said.
"I'm not sure the public understands the risks," Smith said, noting there are 7,000 members of the community in a hospital health plan using Carson-Tahoe's hospital. "The right affiliation could mean more of these contracts and relative financial stability for the hospital."
