Health Corridor: Hospital's long-range plan comes into focus

The windows of the Kootenai Health administration conference room along U.S. 95 opened up an afternoon view to the east, where the hum of traffic buzzed with intermittent roars of heavy trucks and speeding cars.

“This is something that will benefit the community, benefit the patients and benefit the economy,” CEO Jon Ness said. “When you have that perfect fit that can help a community asset grow…You rarely come across that kind of luck.”

He wasn’t talking about the traffic; not directly, anyway. Ness was referring to the Coeur d’Alene City Council’s just-approved Health Corridor urban renewal district.

“Luck” actually played only a small part in the bigger play. Eight years of a strategic eye toward the future led to a chain of fact-finding missions, public seminars, design workshops, open hearings, outside consultations and a rigorous community campaign to extract every last morsel of resident direction and opinion.

“This is a long-range vision,” Ness said in a sit-down interview along with fellow executives from the community hospital, the de facto anchor of the new district. “This is something that will help guide us and the community as we look to responsibly expand the reach of our service to the community.”

That guidance will be necessary sooner than later, Ness emphasized, citing Kootenai Health’s 110-percent growth increase since 2011 while speculating the hospital will not require another eight years to double in size once again.

“From a strategic view for a regional hospital,” he said, “you could not ask for a better location than where we are right now. Along the intersection of Interstate 90 and Highway 95? You couldn’t dream of a better location for a community hospital. So the overall location is ideal...But for not only us, but for the support services and businesses around Kootenai Health to grow, we had to address some serious issues that are out of Kootenai Health’s control.”

While a business’s ability to grow can often be stifled by an economic downturn or a fluctuating marketplace, Kootenai Health — one of just 32 remaining independent community hospital networks in the U.S. — is hampered by boundaries far more physically restraining than a financial shift in the medical landscape. Ness cited consultant decisions that pinpointed infrastructure, land access and traffic as three barriers that require resolution if any institution could survive, let alone thrive.

“Instead of giving up the location that we love in the town that we love, we started asking: ‘Is there a different way to think about this?’” Ness said.

That different way, consultants and planners agreed, was to partner up.

“We needed to strategically partner with the City of Coeur d’Alene, the Idaho Transportation Department, ignite cda [the city’s urban renewal agency], the metropolitan planning organizations and other property owners to figure out a way to continue to grow.”

What’s an asset on one hand is a drawback on the other.

“It’s the perfect location,” Ness explained, “but we’re facing barriers by [U.S.] 95, by the interstate, by [property owners] to the south and west, so there’s not land and the ability to grow there.”

While Kootenai Health’s location might be a dream, Ness said the new Health Corridor’s big early success was to establish a framework that will head off a logistical nightmare: Starting with a bull charging east-to-west through the medical community’s china shop. A bull named Ironwood Drive.

“That road was designed for less than half the daily traffic we have,” Ness said. “It’s very hard to turn left. It’s not U.S. 95, but...I think the [vehicle] counts are close to what you get on 95 [during certain times of the day]. That road — from a traffic engineering standpoint — was never designed to handle that kind of growth.”

Traffic, Ness added, was a symptom of the growth nightmare to come, not the root cause itself.

“When we look at population projections and we look at the future in terms of who’s moving here, we can paint a scenario where Kootenai Health is going to double in size again,” he said. “When we paint that scenario, a conclusion from a pure facilities standpoint is, ‘We don’t have the capability on this site — this site that we love — to do that.’”

Growth around Kootenai Health is a central issue not lost outside the hospital walls. Across the street, Dr. Todd Hoopman of Ironwood Drive’s North Idaho Lung, Asthma and Critical Care said he’s been following the Health Corridor discussion from its infancy.

“At first, it was more of a curiosity, not a concern,” he said. “But then it was eventually followed by optimism: Optimism that [the Health Corridor is] more about the theme and the concept of understanding sustainable growth. Where does Coeur d’Alene and Kootenai Health and the medical community as a whole want to take this community center over the next 20 years? Or 30 years? Or 50 years? That’s what this tries to address.”

Hoopman came to the 25-year-old practice in 2011 and recognized the practice was growing at a steady, then strong, then skyrocketing rate.

“I thought we were busy in 2011,” he said. “Just our clinical case volume in the ICU alone blew up. We used to need only one ICU doc; now, we need two. When I got here, we were a team of five; since then, we’re at six, we’ve hired two new physicians to be here in 2020, and we added a mid-level nurse practitioner. We’ve almost doubled our provider staff, and that’s the thing: Every time we add a provider, their panel is already full with patients.”

That growth, Hoopman said, becomes a problem only when it’s not managed. Conversely, he believes, managed growth can become an asset to patients and businesses alike.

“I would imagine the other way we’re going to see a benefit is the growth of other provider entities right here [within the corridor’s boundaries],” he said. “More opportunity will bring more direct providers to the area center right here, and they’ll be incentivized to stay close by.

“In the past, for example, we’ve seen [durable medical equipment, also known as DME providers] have to set up shop up the road or in Post Falls or on side streets a mile away. Ideally, with the Health Corridor, a patient can see the doctor right here, get diagnosed, get handed a prescription for an oxygen tank or a walker and go a block to the DME provider, get what they need, and they go about their day. Now, in some cases, there are patients who have to drive all over to get what they need, and that’s not sound strategic planning.”

Hoopman’s vision of a consolidated future, however, doesn’t happen without a critical change.

“That kind of patient access starts with drawing those patients here, and we can’t do that if they’re discouraged from driving,” he said. “Getting patients to go to the doctor isn’t the easiest task under the most ideal circumstances. But we have patients that are afraid to come here because they’re afraid of the traffic. Many are afraid to drive and negotiate these roads. I think getting that done is a big first step.”

Easier traffic patterns will include accommodating cars easier, which means the need for additional parking stalls. It’s a need that literally stared Ness and Kootenai Health executive vice president Jeremy Evans in the face from their conference room view.

“Don’t get Jeremy started on Shopko,” Ness said with a smile as traffic outside zoomed between Kootenai Health’s parking lot and the now-shuttered, once-thriving Coeur d’Alene store, its vast and vanquished parking lot sitting empty. “He’ll never let me forget.”

“It would’ve been perfect parking for us,” Evans said, shaking his head with a smile in return.

A deal between Kootenai Health and the Shopko property owners never materialized. Ness said striking the right agreements — whether with businesses or property owners — is a responsibility that requires painstaking patience, even as real estate prices throughout the county continue to climb, especially out on the prairie, where there’s room to grow.

“We have not [purchased any land],” Ness said. “We have to complete our master facility plan first. Being community-owned, we don’t have the luxury of being speculative. We have to know — know — that we’re going to use it, whatever we buy.”

“I think by the first or second quarter of next year we’ll have some form of [the master facility plan],” Evans added. “But remember, regardless of what’s in that plan, this is where emergency care gets directed. This is our surgical center. I’m not saying we’ll never expand to other areas, but the growth that needs to happen needs to happen here.”