Although some sticky issues still need to be resolved, the Montezuma County Hospital District board expressed optimism that a new nursing home would be built soon on the Southwest Memorial campus.

As part of its lease agreement with the district, Vista Grande’s management company, Continuum, LLC, plans to construct a 75-bed facility on the northwest corner of the 30-acre campus.

During a meeting this week with hospital managers, attorneys and board members, Continuum president Steve Briscoe indicated that the project is moving ahead, reported MCHD attorney Kelly McCabe.

"After some initial fencing, it was a real positive meeting and my sense is that they were very enthused about moving forward with construction plans," McCabe said at the Wednesday district board meeting.

Several pieces of the plan still need to fall into place before construction can begin. Because Continuum will be building on taxpayer-owned land, a ground lease with the district was drawn up for a period of 50 years. That lease has been sent off by Continuum to the Housing and Urban Development office for approval. HUD is the lending backer for Continuum, which will pay for and manage the new home for profit.

The lease details quality-care requirements set by the district that mirror state and national performance standards for nursing homes. As an additional safeguard, the district’s standards established in the lease are purposely intended to be separate from similar nursing home care-levels monitored by the Department of Health and Human Services and other health accreditation organizations.

The idea, McCabe said, was that if, for whatever reason, those state inspections or health standards fall by the wayside, Continuum would still be required to meet certain quality-care norms under the lease.

"We wanted those guarantees that those standards would ultimately be applied," McCabe said.

But Briscoe and his attorney were concerned about how lenders would react to a care-requirement stipulation in a ground lease, which acts as a basis for loan funding.

Location of the building also is of some concern to Continuum. It preferred to construct the new home on the southeast corner of the campus, where public visibility would be greater. But hospital officials want the building on the northwest corner (behind SWMH) because it would be easier to access electrical and sewer taps and mesh better with long-term facility plans.

Continuum officials are concerned that the northwest corner is too low in elevation and is hidden behind the hospital, but told the board that they would "revisit the issue," according to McCabe.

The amount Continuum would pay in "rent" for use of the district land and the parameters of a proposed joint venture between Continuum and Southwest Health Systems for operating the home also still need to be finalized.

Unless an extension is granted, according to the current lease, groundbreaking needs to begin within 90 days after SHS designated a construction site, which would be by June 1.

In other action, the MCHD board:

• Publicly announced plans to purchase nine acres of vacant land along the north boundary of the campus from Dr. Robert Heyl. Preliminary price before appraisal is $160,000. The land was recently annexed into the city of Cortez, and will be incorporated into the hospital’s long-term facility plan if the deal goes through.

The board said that the purchase was needed to insure more control over how that land is developed and to accommodate future expansion needs at Southwest. The property has convenient access to Mildred Road.

A public hearing on the purchase will be held May 1, at 7 p.m. in the hospital cafeteria. A vote by the board will follow on whether to purchase the land from district-collected tax dollars, now totaling $1.3 million.

• Heard from Mike Guillette on the status on a proposed low-cost health clinic in Mancos. Valley Wide Health Clinics, based in Alamosa, hopes to set up shop in Mancos at a vacant doctors office, but requires federal grant funding to do so. Initially, Guillette said, the funding was denied, but a recent letter sent to Valley Wide from the Health Resources and Services Administration affirmed that the clinic was approved for funding but would not receive payment until the end of August. The clinic could be open by the fall, joining two others recently started by Valley Wide in Durango. Guillette said the group advocating the clinic may approach the board at a later date to request funding assistance to cover start-up costs.

• Heard from hospital CEO Bob Peterson regarding physician recruitment. Peterson said a general surgeon will be visiting this weekend to tour the facilities and meet with doctors. Southwest is in dire need of an additional surgeon to handle patient loads now being lost to nearby hospitals. The shortage also has put Southwest at a Level IV trauma designation, instead of the preferred Level III, because on-call surgery shifts cannot be covered 24/7.

Board member Randy Smith stressed the importance of staffing over wish-list facility improvements presented last month totaling some $15 million.