Community was crucial in Avera's plans for new Gregory hospital

Mar. 9—GREGORY — Plans are moving ahead for a new hospital to be built in Gregory.

Avera Health announced a $35.7 million project to construct a new 88,000 square-foot facility that will house a 17-bed hospital and 30-bed long-term care center and clinic east of Gregory on U.S. Highway 18.

To fund the hospital, Avera raised more than $3.5 million — exceeding a $3 million goal and a $2 million projection — and Avera will provide $9 million from its capital budget, while the rest will be financed over time. The city also contributed a $600,000 grant for the project.

Avera tentatively plans to break ground on the hospital on April 23, with the long-term care center projected to be completed in the summer of 2022 and the hospital in the fall of 2023.

Avera Gregory CEO Tony Timanus attempted to create a diverse fundraising board that included ranchers, retired physicians and local business owners for a 14-person steering committee that conducted more than 60 meetings with potential donors over eight months.

"When Avera looks at a project like this, they're looking at it as a 40- to 50-year commitment to the community," Timanus said. "When we build a building, that's how much life we're hoping to get out of it. We have four doctors, four nurse practitioners and a physician's assistant, so we have a pretty robust medical staff for a small community. But our coverage area is Tripp County, Gregory County and part of Boyd County, Nebraska — we pull from a population of 10,000 people. We see a lot of patients."

An aging boiler system and heating unit — the long-term care facility was built in 1964 and the hospital in 1972 — along with an increased ability to provide outpatient care drove Avera Gregory to seek a new building rather than seeking an estimated $10 million in repairs.

When the heating system began to fail in 2014, contractors estimated a critical failure within the next five years. Expanding the current facility would have been difficult with farms occupying surrounding areas. Timanus also acknowledged rising construction costs, but also referenced favorable finance rates, "making this an optimal time to build."

The new hospital will sit on 20 acres of land that Avera plans to lease from the Gregory Area Health Care System and Foundation, with a buy-back plan over roughly 30 years. Avera submitted an offer of $210,000 to the city of Gregory, which is still to be approved, according to the Gregory Times-Advocate.

The Gregory Area Health Care System and Foundation is a non-profit organization funded in part by proceeds when the current Gregory hospital was sold to Avera. In recent years, has picked a student and aided in their student loans after working one year for Avera Gregory. Over four years, the foundation can pay up to $40,000 in student loans, designed to keep local kids in Gregory.

Strengthening ties to the community made the idea of having a stake in the hospital a viable option for the foundation to contribute.

"It shows Avera that, with our community being involved, we want them here," said Laura Petersen, secretary and treasurer of the Gregory Area Health Care System and Foundation. "We want our hospital to be new and thriving. It means we want our community to keep going, moving forward and sustaining, not disappearing like some other small towns."

Learning from COVID-19

In 2018, Avera embarked on its fundraising campaign for the new hospital and the project received board approval the following year. Avera typically attempts to break ground on a new project within six to eight months after a fundraising campaign, but plans were tabled when the COVID-19 pandemic hit.

Prior to the pandemic, the project was estimated to cost $33 million, but new designs were created to accommodate concerns brought on by COVID-19. With one-fourth of its population of 4,185 being over the age of 65, Gregory County has totaled 544 COVID-19 cases, 81 hospitalizations and 29 deaths, with 10 confirmed deaths coming residents at Avera Rosebud Country Care.

New additions to the blueprints include negative pressure rooms — or isolation rooms for patients with infectious illnesses — along with increased security measures and improvements for emergency services.

"In older structures, there really isn't the best air flow," Timanus said. "We measure air exchanges in all our departments. In the new design, every single room we have will have negative air flow. ... If there's something in the hallway, it doesn't go into a room where that sick person is. We have one of those rooms now, but we decided we needed as many rooms as possible with negative air flow."

The new facility will accommodate 10 local providers and specialists, a 24-hour emergency room, diagnostic imaging center, larger surgical suite, dialysis center and a helipad.

Currently, Avera Gregory sees 1,300 outpatient and 600 inpatient visits annually and is licensed for 25 beds, while the nursing home is licensed for 40 beds. But despite the new facility seeing a reduction in size, changes in medical insurance coverage and how people seek care called for reduced space with more services available.

"(Twenty years ago), if you came to the hospital, you'd probably be admitted, you'd have a bed and we'd take care of all your needs," Timanus said. "We're finding that insurance companies don't like that plan because it costs them more and patients don't like that either. They'd much rather have outpatient procedures done and they'd much rather have home help come visit them. They'd like to do everything they can to stay out of that nursing home."

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