EL: Currently we have six corporations here. We have the Pocono Health System which is a holding company that oversees the operations of all the other subsidiary corporations; the Pocono Medical Center which includes the Dale and Frances Hughes Cancer Center, the Clementine Abeloff Community Care Center and of course, our hospital; Pocono Health Foundation which is the fund raising arm system; Pocono Health Care Partners which is a joint venture between us and radiologists who develop joint venture imaging services around the county; Family Care Center which is a physician practice management corporation; and Pocono Ambulatory Services, an ambulatory surgery center which we’re part owner of. We’re licensed in total for 192 beds and we also have a 12-bed rehabilitation hospital that’s separately licensed.

We have just completed the most aggressive capital campaign ever for an expansion of the emergency room and the Dale and Frances Hughes Cancer Center. The most ever raised in the county prior to this was about $2.5 million. We raised almost $10 million. We just completed a strategic plan about seven months ago and we are in the process of finalizing a master facility plan that is going to guide the organization over the next three to ten years. We’re looking at developing various new service lines to support the community’s needs here. Right now we are presenting to our board phase one of that plan, which includes additional medical surgical beds, all brand new operating rooms, special procedures rooms, same-day surgery, potentially some additional ICU and CCU beds. Also fairly extensive renovations for the radiology department, as well as about $7 million in new radiology equipment: $5 million of which is to be allocated here at the Pocono Medical Center and about $2 million in new equipment going up to the Mt. Pocono area where we have a joint venture for a 54,000-square-foot medical office building. We’re putting in an imaging center up there as well that’s scheduled to be completed probably around the first of February.

EL: Most of it is geared toward expansion of existing services: surgical lines, additional primary care centers, additional imaging centers, special surgical capabilities internally, upgrades to the ICU and CCU areas, pre-admission testing. We just revamped the emergency room admissions process and our patient satisfaction score hit the 99 percentile for registration. That put us in the top one percent of all emergency rooms around the country for our admissions process. We want to do that also for our inpatient and outpatient services. So a lot of what we’re gearing up is not only bricks and mortar, but policies, procedures and information systems to provide that level of service to our patients. I’m not at liberty to discuss potential new services at this point because we haven’t finalized those plans yet. But there will be additional services that we have not had in the past. The growth itself is not so much adding more geography to our service area as it is meeting more of the communities’ needs within the geography that we have.

EL: Our population has been growing and we made a deliberate effort to go to the Mt. Pocono region to help with the medical needs in that region, providing a much more comprehensive local service to a community that was fairly underserved. Our joint venture facility there will include imaging services, potentially a retail pharmacy, rehabilitation services, renal dialysis, space for a number of newly-recruited physicians to the community, as well as additional rooms for specialists and others that would relocate to that area. We’re looking to do similar things in other parts of the county as well.

EL: We floated a $47.5 million bond issue back in April. About $20 million of that money will be used for this expansion; the other monies were used for refinancing of existing debts. We have other fundraising initiatives, savings and investments, as well as continued operations over the next several years.

EL: We estimate our population right now to be 148,000 or so in Monroe County, a fast-growing region of the state. We’re projecting, because of the population growth, basically an increase in all of our service lines. We’ve had about an 18 percent increase in our revenue this year based upon additional admissions, services that we’re providing and additional physicians we’ve recruited to the community. Dependent upon our volumes, we plan to expand into phase two of the building project in about five years. With the physicians that we’re recruiting, the new services we’re providing, we’re expecting to see an increase in admissions. The first phase of the building project is to address that need by building about 30 additional medical surgical beds and we’re looking to build some additional shell space as well so that, if we need another 30 beds, we can just go ahead and do that pretty inexpensively.

EL: We are focusing on a number of primary care physicians as well as various specialties, including pediatric physicians, family practice, internal medicine, vascular surgery, general surgery, OB. Those have all been recruited already for this year or will be starting in the next several months.

EL: Our goal this year was to recruit ten new physicians and we actually recruited 22. Some are in solo practice, some are in group practices, some are in multi-specialty group practices and some are employed. So, we’ve been fairly effective at recruiting physicians to the community, but we still have extreme difficulty with orthopedics and ob/gyn. It’s not easy.

EL: Yes we are. Orthopedics and OB, primarily. These are private practice physicians who are newly recruited to the community, possibly from outside of the state. We’re not subsidizing physicians that are already here.

EL: Yes we do. We also have a very positive story to tell: the ability for us to raise over $10 million dollars from the community, the fact that we’re expanding and developing satellite clinics in the outlining areas, the fact that we have a fairly aggressive building program that’s going to add additional capabilities, the fact that we’re financially fairly strong right now. Also improvements that people have seen in our quality: we’re in the top ten percent in the country for stroke care, according to HealthGrades Hospital Report Card. We’re in the top 10 percent of all emergency rooms in the country in terms of patient satisfaction. In our medical staff survey we’ve seen a 400 percent improvement in working relationship between the physicians and administration; that’s 30 percent above the national norm. The fact that we’re a sole community provider is also pretty helpful because physicians don’t have to travel to multiple locations and the level of competition for them starting a new practice is not as big.

EL: We’re doing okay with Medicare reimbursement, but we could always use additional revenue from Medicare as well Medicaid. We’re a sole community provider and we’ve had two wage index reclassifications that were recently approved that did help us probably to the tune of a million and a half, to two million dollars a year for increased reimbursement.

EL: Blue Cross represents about 13 to 14 percent of our business. They’re dominant in their market, but we’re dominant in this market, so it kind of evens out when we negotiate. We have a pretty good relationship with Blue Cross. We’ve been able to negotiate reasonable contracts.

EL: I think every market is unique. I think it’s much more difficult up in the Scranton market, say, than it is in our market because of the four or five hospitals that are up there competing, drawing on resources. I think running health care organizations today is tough in any market, particularly with the cutbacks in reimbursement, the increase in medical malpractice insurance. I don’t think there are any easy markets out there.