Reiterating that Foresight Health System is considering all options – including donating the hospital to the county and operating it for them – company officials responded Monday to a statement by Brandon Simmons, chairman of the Patrick County Board of Supervisors.
Last week, Simmons said the company would not reopen the hospital in Stuart as planned.
“After reading the statement, I was enraged,” Foresight’s Chief Operating Officer (COO) and General Counsel Joseph Hylak-Reinholtz wrote in a Monday release. “Rarely in my career have I ever been blindsided so callously by a local government official.”
The company, Hylak-Reinholtz said, “wants the public to know that, never, not even once, did Mr. Simmons try, either personally, through electronic mail, or through an intermediary, to reach me or anyone else who works for Foresight to ask for a status report on the project before releasing this surprise attack against the company. His attempts to demonize Foresight Health are unprofessional and frankly, just plain wrong.”
Late Monday, Simmons said his statement “was based on the information given to me months ago that they were going to rethink the project. I, as well as others in Patrick County, have been watching the work being done at the hospital – the temporary fences and the signs.
“Based on the information given to the county at the beginning of the process,” and limited progress at the hospital, Simmons said it was clear the “hospital was not opening as planned.”
Since obtaining ownership of the property formerly known as Pioneer Hospital, Hylak-Reinholtz said, “we have developed and considered several plans to achieve the goal of reopening the hospital. However, as 2023 turns into 2024, we have yet to develop a plan that makes sense both clinically and financially. That is, we have yet to develop a plan that we believe can provide an adequate scope of services while also being profitable. That is precisely why we did not open the hospital in 2023.”
The statement from Hylak-Reinholtz “completely contradicts conversations recently had between Dr. Sameer Suhail, Foresight Health’s CEO, and Patrick County administration,” according to a release from the county.
“As reported by The Enterprise on January 24, 2024, Foresight Health currently owes $33,101.12 in real estate taxes to Patrick County and $526.12 in past-due utilities and $7,980.54 in unpaid property taxes to the Town of Stuart. … Even though Hylak-Reinholtz claims that ‘several plans’ have been developed, none of them have been presented” to the county, a release stated.
However, “we are considering all options now that we are in the first quarter of 2024. Nothing is off the table. We will continue to work with local officials to make something happen,” he said.
Hylak-Reinholtz confirmed the company has been in ongoing discussions “about a possible transfer of ownership of the hospital property to the county” with Del. Wren Williams, R – Stuart, and several county officials, including County Administrator Beth Simms and Pat Cooper, director of the county’s Economic Development Authority (EDA).
“These discussions were supposed to remain confidential,” Hylak-Reinholtz said, but Simmons “broke that trust, and Foresight now feels compelled to tell its side of the story. If the residents of Patrick County want the truth, I am happy to give it to them. I hope they can handle it.”
During the discussions with Williams and local officials, Hylak-Reinholtz said “neither I nor any other Foresight executive suggested that we would completely abandon the community. If the county accepted the donation of the hospital, we offered to manage it for them.”
In the latter half of 2023, “before considering the idea of donating the hospital to the county, I personally suggested to Del. Williams that if the county or a state agency provided financial assistance with the rising cost of renovations, that Foresight Health could get this project open much sooner,” Hylak-Reinholtz, said. “Perhaps this information was never conveyed to Mr. Simmons.”
Williams said he conveyed the company’s proposals to EDA officials, but he did not discuss the proposal with Simmons or the Board of Supervisors.
Williams, Hylak-Reinholtz said, “ultimately rejected the idea of a management agreement with Foresight because he believes, and perhaps it is true, that the community likely doesn’t want us around anymore.”
Williams said he did not feel the proposed arrangement was in the county’s best interests.
“The company has never taken any option off the table, nor will it,” Hylak-Reinholtz said. “But the residents of Patrick County need to be reminded that Foresight Health is a for-profit business, and that a for-profit business, or any business for that matter, needs to turn a profit. It makes no sense to start a business that has a significant likelihood of failing.”
“If Foresight had requested assistance to facilitate their reopening of the hospital in Patrick County, as suggested by Mr. Hylak-Reinholtz’s statement, we would have promptly responded. However, no such requests were ever made,” Patrick County Administrator Beth Simms said in the release.
Patrick County elected officials and staff “have been inundated with questions about the status of the hospital project for months, and we stand behind the statement made and released last week, providing answers to our citizens and assurance that we are working diligently to increase healthcare access in Patrick County.,” the release stated
Hylak-Reinholtz said residents “want and deserve answers. We understand that they are restless and want to see progress, especially the removal of the ‘Opening in 2023’ sign.
“I and everyone else at Foresight Health shares your desire to see an operational hospital in Stuart, but as the company’s chief operating officer, I need to present my CEO with a plan that will not bankrupt the business,” he wrote.
As of Monday, and at Suhail’s direction, Hylak-Reinholtz said more than $4 million has been spent on the project.
“While that is a significant amount of money, Foresight Health needs to secure more funds to successfully open this site as a critical access hospital, with an emergency room, and a psych program, and to recruit and employ doctors and other necessary health care professionals,” he said, and noted that hospitals are expensive to operate. “Old hospital buildings like the one in Stuart, need a lot of attention, which can cost millions of dollars to do it right.”
Additionally, “it has been more difficult than anticipated to find qualified healthcare professionals who are willing to work in rural America,” Hylak-Reinholtz said. “Electronic medical record systems are quite costly. One of the more ‘affordable’ versions that could do everything we needed would have cost us about $250,000 to develop and then we’d have to pay an additional subscription fee that’s over $52,000 per month. That cost center alone, before factoring in salaries, would consume almost a quarter to a third of our monthly expenses based on the revenue model considered. We can seek grants, but those take a lot of time and are not guaranteed.”
Hylak-Reinholtz said another consideration is “the service line that Patrick County residents ask for most, emergency room care, and just how costly it is to provide this to the community. Report after report, consultant after consultant, tells us the same story— that, on average, emergency departments generate insufficient revenue from their billings to cover the costs. In a small, rural hospital with significant overhead costs, it becomes almost impossible to make it profitable.”
Most states, including Virginia, do not provide additional financial support to rural hospitals to help them keep the emergency room from being a loss leader, he said, and added that the company also asks the community to consider another relevant point.
“When Foresight Health first came to Patrick County, our intention was to reopen the hospital as a stand-alone psychiatric and drug treatment hospital,” Hylak-Reinholtz said. “Our vision for the property did not include an emergency department. If this was our only mission, I believe that a specialty hospital would have already been operational. But our initial mission changed as our CEO and others at Foresight started to hear from the community and the original plan was eventually abandoned to address additional concerns.”
Then, after meeting with local elected officials, first responders, and many others who live in or near the county, Hylak-Reinholtz said “our CEO, Sameer Suhail, instructed me to find a plan that would provide not only psychiatric services but also general hospital services and emergency care for the community.”
The change in the mission for the project was significant, and went much further than the original vision both in scope and in cost, he said. “It was a tough assignment for sure. Having heard the same comments and concerns as our CEO, I and everyone else who worked on the project at the time accepted the challenge.”
“Sometimes a company needs to speak frankly,” Suhail said. “This is one of those times. If Foresight Health had unlimited funds and an endless supply of blank checks, we would have opened the hospital many months ago. But our company’s pockets are not as deep as we’d like. We are not HCA Healthcare or UHS. Our funds are not unlimited. Consequently, our company must make tough decisions, like delaying the project, considering purchase offers, or coming up with an entirely different approach.”
In conclusion, Hylak-Reinholtz underscored that “Foresight Health will leave nothing on the table for consideration in 2024. We will review any purchase offer, joint venture proposal, change of scope, etc.”
Noting that the company “is a private business,” Williams said he worked to help keep the ball rolling between the company and the county’s EDA, but he does not have the authority to speak for either.
“Patrick County remains open to conversations with Foresight Health about future plans for their property located in Stuart, and/or remedying their outstanding financial obligations,” Simmons said.
Williams said he also is committed to moving forward.
Currently, “I think we just keep pushing forward. If Foresight goes forward, we’ll push forward with them. If not, we’ll keep looking at other options,” Willaims said. “We can’t just stop.”