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Pardee embarks on major expansion

UNC Health Pardee is embarking on an ambitious plan to double the number of primary care physicians across two counties, expand its market and bolster specialty care, President and CEO Jay Kirby told Henderson County commissioners on Wednesday.

Expected to take shape over the next two to five years, the expansion would add new medical office buildings on Spartanburg Highway across from Brian Easler Toyota, in Mills River and in Transylvania County and add new operating rooms and specialists at the main campus on Sixth Avenue.
“This is the single biggest thing we’ve done in health care since we built Pardee Hospital,” said County Commissioner Michael Edney, who serves on Pardee’s board of directors.
The plan is the product of a strategic planning committee that worked for six months to examine the current health care market and project future gaps and needs. Made up of Pardee board members, county commissioners Edney and Rebecca McCall, County Attorney Russ Burrell, the president of UNC Health’s statewide hospital network and its chief financial officer, the committee drafted a strategy to meet the needs not just of Henderson County but adjoining counties and beyond.
“No. 1, we needed to be a regional provider,” Kirby said, describing a threshold finding of the committee. “By being a regional provider we can bring in advanced care specialists that stops our citizens from having to travel to Asheville, Greenville, Spartanburg, Charlotte.”
To provide that, Kirby said, Pardee needs quality medical space.
“Facilities will allow us to recruit the best and brightest to our community,” he said.
The role of the elected commissioners as a partner in the county-owned hospital is key: They must authorize the borrowing of around $80 million to build the brick-and-mortar space where the new physicians will practice. Kirby likened this new effort to the five-party agreement that resulted in the health sciences building and Pardee Cancer Center.
“I don't think anyone can say the partnership between Pardee Hospital, Henderson County, the city of Hendersonville, Wingate and Blue Ridge Community College was not money well spent,” he said. “It's amazing to see what happens when people check their egos at the door and do what’s in the best interest of the county. And that's what we've embarked on over the last six or seven months.”

New operating rooms

Pardee has already expanded beyond its Hendersonville campus, into Mills River, Fletcher and Brevard.
“As you know, we’ve been invited into Transylvania County and we continue to grow and flourish in that community,’ he told commissioners during their regular mid-month meeting. Although he said “our priority is Henderson County,” the strategic plan aims for a broader footprint.
Most patients start their journey to specialized care with a visit to their regular doctor.
“We want to put primary care across our county,” he said. “The more people that use our primary care, the more will end up using our specialists at Pardee Hospital.”
Plans call for 40,000-square-foot medical office buildings on Spartanburg Highway and in Mills River, where Pardee owns 21 acres and operates a day-surgery center. Besides primary care, the new clinics may also have pharmacies, physical therapy, infusion therapy and other services.
“In Transylvania County, we had to bring in 10 primary care providers with no medical office building and so we brought in two 10,000-square-foot modular office buildings to meet that community's needs," Kirby said. “It’s only so long I can keep 10 doctors in a mobile home, and so I've got to build facilities for those folks.
“As we bring in more primary care, more and more people are going to be seeking care using our ancillary services at Pardee. We need space for our specialists. We need more operating space. We're completely out of operating space.”
John Bryant, Pardee’s vice president for operations and support services, said the next step is to retain architects and invite bids for the work, probably by late fall.
“Once the programming and the exact square footage is finalized, you're probably estimating somewhere between 18 and 20 million dollars per facility,” he said. “We can estimate primary care pretty easily because that will take up about half of the facility for each one. But when you look at total costs — if you're gonna put pharmacy or infusion or PT or specialty care — you'll have some that will kind of wiggle one way or the other. The surgery center, of course, is going to be uniquely different because it's going to be outfitted to do procedures and the O.R.”

Stepping up to fill voids

Edney said Pardee’s expansion is being driven in part by the shortcomings of Mission Hospital, which has been the target of patient dissatisfaction and more recently warnings by Medicare and Medicaid for its quality of care.
“Pardee is the largest hospital in the western part of the state other than Mission, which I don’t know if you can count as a hospital anymore,” Edney said. “The demise of Mission has put a lot of pressure on us here locally to step up and fill voids. As a community hospital, we’re service-bound not only to take care of our own but also address the region’s issues, especially the specialty care aspects of it.”
Commissioner Bill Lapsley said the county’s quality financial rating makes enables it to borrow money at the low rates. As it has done in past, Henderson County would underwrite the loan and Pardee would cover the debt service.
“From a basic standpoint, what we're talking about here is the county using its funding power, its authority delegated by the legislature to borrow money, to use that borrowing power to benefit our county hospital,” he said. “We’re talking about borrowing multi-millions of dollars, much like we do when we build a new school or another facility that the county owns.”
Kirby said many of Pardee's primary care physicians have a full load of patients.
“I've got 53 doctors from a primary care standpoint that their (patient) panels are full and people are calling me saying I need help getting in to see a doctor,” he said. “This allows us to increase 10 providers in Spartanburg Highway, 10 providers in Mills River and 10 more providers in Transylvania and then more people get into see primary care. And then when that happens, those primary care providers are going to have referrals to specialists and so the medical office building at Pardee will house new specialists to see that volume of people that will be coming.”