By Gigi Wood
ANAMOSA – Jones Regional Medical Center has been one of the fastest growing nonprofit organizations in Eastern Iowa since it moved into its new building in 2009.
And now the UnityPoint Health-affiliate is planning an $11 million expansion.
The 22-bed hospital at the junction of highways 151 and 64, last month announced its expansion project, which will renovate and add additional space for the emergency department, surgery department, specialty clinics, rehabilitation areas, laboratory and pharmacy to the existing hospital.
For the second year in a row, UnityPoint Health-Jones Regional Medical Center was named in the top 40 of healthcare industry’s fastest growing companies by Modern Healthcare magazine. Since opening the new facility five years ago, emergency department visits are up nearly 30 percent, ambulatory surgery and endoscopy procedures have increased by 84 percent, physical, occupational and speech therapy visits saw an increase of nearly 60 percent, radiology visits grew by 33 percent and other departments are up by 10-35 percent.
Hiring and patient visits have been up at the hospital. In 2011, Jones Regional employed 162 people; now it has 185 workers. That’s a 14 percent increase. There were 8,000 emergency department visits in 2011 and 8,700 in 2013, an 8 percent increase. Overall outpatient visits have increased from 55,000 in 2011 to 62,000 in 2013, a 12 percent increase.
“It’s been quite remarkable growth as we add more staff to service the people we see here,” said Eric Briesemeister, Jones Regional’s CEO. “We do anticipate adding about 10-15 full-time employees once we fully utilize this spaces. So I anticipate in another three to five years we’ll be above 200 in total employees.”
There are a few basic reasons for the hospital’s growth, Mr. Briesemeister said. The main reason: the hospital’s emergency department (ED) was greatly improved.
“What we attribute (the growth) to is there was a lot of latent demand. I think people were going elsewhere. They were going to Cedar Rapids, they were going to Dubuque, they were going to Iowa City, because, honestly, 12-15 years ago, we didn’t have quite the reputation that we have now,” he said. “We didn’t necessarily employ or have consistent providers in the emergency room. And that’s really our front door. People may try us other ways, but they usually come in through the ED and like any rural hospital, that’s how you’re judged in a lot of ways.”
After seeing improvements to the emergency department, patients gave other departments a try, Mr. Briesemeister said.
“We don’t do (obstetrics), so if you’re not having a baby in a hospital, then your emergency room is typically your first experience,” he said. “Based off of that, the convenience and the high-quality providers and that family atmosphere we have now, people will think, maybe there are other services I can try. So I think the ED has really led our growth here in the last few years.”
He expects the emergency department growth to level off in coming years and growth in other departments, such as rehabilitation and surgery, to continue to improve.
Rebuilding the ‘front door’
To turn the emergency department around, Jones Regional focused on recruiting physicians who “fit” with the organization.
“We employ anywhere from three to four ED physicians,” he said. “The big thing is we found people who were the right fit; people who wanted to practice rurally, who wanted to be able to do ED medicine in a rural environment that really wanted to build something.”
Jones Regional partners with East Central Iowa Acute Care, which provides the rural hospital, as well as UnityPoint-St. Luke’s in Cedar Rapids, with backup physicians.
“Those docs rotate through and then provide backup for us if one of our doctors were to leave and we need to recruit,” Mr. Briesemeister said. “And they like coming out here, too. So it’s a win-win for both institutions.”
Three years ago, Jones Regional began partnering with the University of Iowa medical school, to provide rural medicine rotations for medical students.
“I think a lot of medical students don’t think about, unless they’re from a rural area, about practicing in a small town,” he said. “We expose them to the institution and let them know this is an option for their career. And we also started hosting; they can do a rotation through the Cedar Rapids Residency Program, through our ED or other areas of the hospital. And then we’re always looking at compensation. We’re constantly evaluating that to make sure we’re competitive with what the market may be offering.”
Jones Regional also contributed to the Iowa Rural Physician Loan Repayment Program, a new initiative that provides loan repayments for medical students who agree to practice as physicians in rural areas for five years following graduation and meet certain requirements.
The expansion project will renovate about 10,000 square feet of existing space and add about 20,000 square feet of additional space.
“We’re adding square footage onto our rehab therapy area and our cardio/pulmonary and that’s simply to allow for more space for them to treat their patients,” Mr. Briesemeister said. “Right now, they really are in need of more physical space. It really won’t add a lot more equipment; it’s just the physical space to see more folks in those areas. The fact that we don’t have additional space is really cramping our growth in those areas.”
The operating room area will also be expanded.
“The main thing we’re looking at there to really improve patient care and our abilities in that area, we need more prep and recovery space,” he said. “Right now, that limits us as to how many procedures we can actually do in a row and with the growth in our surgical areas, you start to see that become a bottleneck and we can’t get patients in when they want to get in.”
Jones Regional will construct a new building, too, that will house its specialty clinics and laboratory. The expansion project is expected to be complete in the third or fourth quarter of 2015.
“We’re building a new building that will house our specialty clinics, where specialists from Cedar Rapids or Dubuque or wherever they happen to be from would come and see patients out here locally,” Mr. Briesemeister said. “We can’t fit in all the physicians we need to treat patients, so we’re going to add a building on to do that and in that building we’re going to put our lab; that will be expanded slightly.”
To date, more than $300,000 in private donations and pledges have been secured in the effort to raise funds for the project, which budgeted $600,000 for in donations.
As far as the Patient Protection and Affordable Care Act go, Jones Regional is taking a wait-and-see approach, Mr. Briesemeister said.
“We’ve prepared slightly, but we have a more wait-and-see attitude to see what the real impact will be and honestly, no one really knows right now,” he said. “I think the greater impact will be on the clinic side, where instead of going down to the (University of Iowa Hospitals and Clinics in Iowa City), a lot of those folks will be seen up here.”
Volume is not expected to increase at the hospital, though, he said.
“On the hospital side if they’re going to come to the ED, they’re going to come to the emergency room anyway. So whether or not they’re insured, we’re going to treat them regardless of ability to pay, so we’re seeing those folks anyway,” Mr. Briesemeister said. “The big question mark is on the family practice side and the clinic, what are they going to see for numbers? It’s not like Cedar Rapids, where you can just go to the next clinic. Here there are only one or two choices.”
He expects a positive impact on patients, he said.
“We’ve done stuff to prepare, to get people signed up, to educate them on what their options are, but we don’t see a huge impact (at Jones Regional) at the moment,” Mr. Briesemeister said. “I think the impact on people’s health will be immeasurable. There are studies out there that show when people have access to insurance their health improves, not surprisingly. It’s a great thing for the patient.”
For more information, visit www.unitypoint.org/anamosa.