At Telluride Med Center, too close for comfort

Staff at the Telluride Regional Medical Center work closely with each other, they’re also very close to their patients. But according to Medical Center staff and their CEO, that’s not exactly ideal.

Since 2007, patient visits have grown 166 percent, according to the medical center’s Financial Director, Julie Wesseling. To meet that patient demand, primary care and emergency department staff has grown 43 percent.

For nearly forty years, the Telluride Regional Medical Center has leased a remodeled 1960’s building, on the corner of Pacific Ave., and Townsend St., from Newmont Mining (once Idarado Mining Co.)

The facility is approximately 10,000-square-feet, half the size it should be. An independent, report commissioned by the Telluride Hospital District, estimated that looking only at today’s population, patient needs, staffing numbers and current building and safety codes, the facility should be 20,000-square-feet—and that’s without adding additional services or room for future growth.

“For years, by way of design tweaks, renovations, staff increases, we’ve worked to keep our patients from feeling the ‘capacity crunch’ at our facility, but inch by inch, our staff is creeping towards a tipping point where it’s no longer comfortable for us to maintain the illusion,” said Dr. Sharon Grundy, Primary Care Medical Director at the medical center.

According to Dr. Grundy, over the last year specifically, her staff is feeling the stress of living in the crosshairs growing patients needs and a facility stretched to its limits.

“To best provide compassionate, efficient care, we work hard to make sure our patients are not sitting in halls, or in the lobby for extended periods, but the truth is our lab has outgrown its space, we have a manager working from a closet, blood is drawn in hallways, patients have to negotiate our hallways in medical gowns to get to the imaging department,” said Dr. Grundy.

With the recent addition of another primary care provider, the medical center now maintains four providers, five days a week. This puts provider capacity near 100 percent, according to Dr. Grundy. “It would be difficult to add more provider hours to any given week, there’s simply no room for another provider without adding another exam room.”   “We also have had to put a freeze on bringing in new ‘visiting specialists’ who would like to host clinics at our facility to serve the local population.”

In the almost 40 years the medical center has existed in the current space, there have been nearly a dozen renovations to keep up with complex healthcare technologies and patient growth.

In 2015 the Hospital District moved the medical center’s administrative offices to a location on the east side of town and turned the conference room into an exam room for visiting specialists. “Other essential staff have moved their work stations below the clinic, into what was an area where on-call doctors would spend the night,” said Dr. Grundy.

This summer the Hospital District is applying for permits and zoning approvals to add a temporary annex outside the facility for their growing mental health services and community education forums, to bring the CEO’s office back on-site and to add a handicap ramp for the Primary Care entrance.

Kate Wadley is the executive director for the Telluride Medical Center Foundation, the arm of the medical center dedicated to raising funds for medical equipment, capital projects, and ultimately, a new facility.

“We know our staff have been feeling the squeeze for some time,” said Wadley. “But our patients are telling us, and our exit surveys confirm it, that the community still receives exceptional care here,” she said.

“But that doesn’t mean these issues can go unresolved. These aren’t champagne problems,” said Wadley. “We’re desperate to find a new location for a new facility,” said said.

“And we’re ready for the community to join us in understanding the urgency.”

Since 2006—and as early as 1991, according to a Telluride Times Journal press clip the medical center’s CEO recently unearthed—the Telluride Hospital District has been pursuing a site suitable for a medical facility to serve the community.

In 2014, it looked like the search might finally be over when, after years of negotiations, vetting, evaluations, elections and occasional controversy, the Telluride Hospital District announced the future site for a new medical center would be in Mountain Village. In 2015, on schedule, the Town of Mountain Village went so far as to convey the land, at no cost, to the Hospital District for a facility to be built just behind The Market at Mountain Village and Mountain Village Town Hall.

The site would have offered pedestrian access via a gondola terminal, bus service, as well as convenient access for Ski Patrol and a helipad.

The only hurdle to clear was a Wetlands Permit and Mitigation Application approval from the U.S. Army Corps of Engineers.

In October of 2016, after an application process spanning more than 18 months, the Telluride Hospital District, upon consultation with the Town of Mountain Village, withdrew its wetlands permit application. “It became clear opposition to the application was slowing the process to a standstill and that the ultimate approval of our application was never coming,” said John Gardner, CEO of the Telluride Regional Medical Center.

By withdrawing the application the Hospital District transferred the parcel back to the Town of Mountain Village.

Since then the Hospital District’s board of directors have continued their work to find a new home.

“We’re looking at every opportunity; looking under every stone,” said Gardner.

The most plausible lot, according to Gardner, seems to be a property owned by the Lawson Hill Homeowner’s Association, who may take as long as a year before they know if they would be willing to make the land available to negotiate with the Hospital District. Their next scheduled HOA meeting is scheduled for March of 2018.

“We understand that every single open acre in the area has its own unique pros, cons and other demands for it, but what we’re hoping for is the collective consciousness of this community to turn its attention to this urgent and necessary need.”

“We continue to be open to any and all ideas,” said Gardner. So much so, Hospital District representatives are revisiting options with Newmont Mining; working with architects to troubleshoot the current facilities limitations; and consulting with experts on what possibilities exist to split primary and emergency services between two locations.

Additionally, the Medical Center’s board representatives continue to meet with all representatives of all three local governments.

“The need for an expanded medical facility, is no longer just our organization’s challenge, it’s our collective moral responsibility to find a solution,” he said.