.

I want to try and figure out what is going at the hospital. So I have decided to post info I receive on the hospital for a while to keep this subject before me and in front of anyone else who may be interested. Certainly I hope readers realize I am doing this for the good of the community and not for some vindictive negative efforts. One of my stated goals is to have forgotten more about NHRMC's financial situation and operation
than McGradrey Pullen will ever know, and I can't become this aware without a concerted effort on my part.

9-01-04

Idea

This county needs to spend some money on neat amenities which will help the region become "Cool,""Neat,""Hip,""Hot" and attract Boeing type companies to locate here. To attract Boeing types to Wilmington, South Eastern NC must plan as well as Boeing does. Our area must have no over capacity streets and we must have a really, really neat community. It must be clean as can be. South Eastern North Carolina should grow to at least a million people in my lifetime.

Thirty five thousand home building permits were issued by Brunswick County in northern Brunswick County near Leland in 2003. I would not be surprised if 200,000 home building permits were issued in Northern Brunswick County in my lifetime. Five hundred thousand people could be living in Northern Brunswick County one day. Brunswick County should be able to buy and sell New Hanover County for a tax loss one day. New Hanover County must get over the ego shock and should encourage any expansion of the port take place in Brunswick County.

As I have said many, many, many times all expansion of the port should be at Sunny Point. The river channel has been dredged down within about two feet of rupturing the clean water aquifer below the river near Wilmington. Dredging near Bald Head has already ruptured the rock covering of the aquifer and shallow wells beneath Bald Head produce salt water. If we dig our channel deep enough to handle the new ships at Wilmington our aquifer will be ruptured.

An intelligent move would be to expand the port at Sunny Point. Sunny Point is much nearer the ocean and the channel is deeper and I think the channel is deep enough there to handle the largest ships which may want to call on Wilmington right now.

So much for the diversion away from the hospital. But the regional planning to make this place something other than a one deer dog town needs to include the movement of the port as far as expansion is concerned to Sunny Point.

Also the government owns a super, large, great tract of land in Carolina Beach that is part of Sunny Point buffer. Six months or so ago I read the government would sell Sunny Point land to other government entities. Sunny Point does not need that land at Carolina Beach to protect Sunny Point, it was purchased probably because Dow wanted to sell and its purchase helped sell the idea of a munitions' bulk warehouse across the river, and New Hanover County should buy it for a park. Also the County should buy Duck Haven and operate it as a municipal golf course. There may be some other neat properties we should buy. I like that piece of property on the Carolina Beach road where the circus came next to Coddington Elementary School. We need park land.

We really need to start on a new transportation system in Wilmington. First of all we need to find out what kind of transportation system we need to get our streets back in balance, ie. no overcapacity streets. This is going to be expensive and take hard work. We need to continuously monitor the traffic count on our streets and take out ads in the newspaper or devise some other system to find out where the traffic is coming, going, why, and when. This data needs to be placed in a data bank and contact made to vehicles which may be contributing to our congestion via e-mail. Once we figure out who is going where, when and why then we can devise systems to abate our traffic problems. Our Planning Department would have to be increased in size and some horsepower added. We are not going to attract Boeing type of corporations unless we use the planning methods they use and plan as well as Boeing types plan.

This year's political buzz word is incentives. Everything this county does to improve the quality of life and reduce taxes are incentives for Boeing types to move here. People talk about affordable housing. Affordable housing needs to be better defined Are we taking about homes people who are already working in the region can afford are we talking new construction to bring people here. I have been a RE broker since 1975 and I never cared if I wrote a contract for house under $100,000 or one over $300,000.00 as long as I wrote contracts. By the way I don't actively practice RE anymore. But anyway. If we are talking construction to bring up our tax base the higher the dollar amount with the least people the better off our finances will be. Before we implement this affordable housing incentive program we need to really define what our goals are.

I want every business in this town to be successful and make lots of money. I want Boeing types to move here. The hospital, home builders, tourism, movie industry, port, they all need to success and they will if we plan correctly and have no overcapacity streets. Simply put no one wants to live in a traffic jam and top flight companies are not going to move to a traffic jam. Movie companies are not going to film in a town and pay thousands per hour if they can't get from here to there in a short period of time.

This town should be a million people in my lifetime. We must plan as if this area has one million residents right now. Yea. We can rupture the clean water aquifer and jam more of the port in New Hanover County, not give a flip if Smithfield Foods pollutes the river, but your taxes are going through the roof and you are going to loose some good people, me being one of them. Who wants to live in a place where people can't see beyond their next paycheck?

We need bike Interstates big enough for golf carts and hiking paths. We need light rail. We need park and ride parking lots.

Greenfield lake needs to be clean as a whistle. My guess is Greenfield will be a barometer that reflects the state of good planning in this community. When Greenfield is cured the city will be correctly planned and have its head screwed on correctly. Wilmington needs to be an artsie community and we must see to it that our movie industry makes it. Not too big, not too small. Just right.

Our hospital is worth about $700,000,000.00 in my opinion and will generate cash flow next year of around $ 70 million. What the county needs to do is borrow about $100 million for bike roads, planning, Greenfield, parks, neat stuff and charge the hospital rent of say $ 10 million per year. Before anyone has a heart attack I do not advocate the rent charged NHRMC be so great that the hospital looses its A bond rating.

There are many good reasons the hospital should get enthusiastic about this good idea. The hospital and all the employees could take pride in helping make possible a really neat city without overcapacity streets and neat amenities I would think the intensity of curing people all the time would stimulate a need to think about something else. The hospital being in on a project which would really help Wilmington may be a good diversion and bragging rights. People will say, Can you believe Jack Barto gets that hospital to gin out $100 million per year and he built Wilmington into a World Class city with cool parks, clean water, bike roads, no overcapacity streets and Boeing types flocked here and O'Neal had to put in a new computer system to count the money the numbers are so large?

Plus it would be an investment for them as well as the city. The goal is no overcapacity streets which in turn would induce Boeing type companies to relocate here. Boeing is not coming here as Wilmington is now. What company would spend a lot of money to move to a traffic jam? Boeing is in Washington state now probably because they like clean water and good planning. Do you think Boeing is impressed with our polluted river from the discharge we get from Smithfield up river?

Also I would like our area to offer free kitty cat clinics on Saturday. For about a $1000.00 per week we could pay four vets in different parts of the county about
$ 250.00 each to give free kitty cat health care.

Possibly the hospital might not loose a dime paying the county rent. NHRMC plans to write off $50 million in bad debts in 2005.

If we had some neat parks and the community felt a pride of cleaning this place up some people instead going out Saturday night and stabbing someone who can't pay their doctor's bill might go for a bike ride instead, and stay healthy and won't use the emergency room and run up a bill they can't pay. I bet we could save 20 %, ten million million per year in less no pays.

The FTC picked on NHRMC for the Cape Fear Memorial purchase and our legal fees were an extra $3.5 million because of it last year when the FTC allows Microsoft control like 90 percent of the US computer systems market and NHRMC is the NINETH largest medical facility in NORTH CAROLINA and the hospital has miniscule market shares locally of medical practices. NHRMC may be the largest medical center in the area but it is struggling to stay competitive in individual medical practices, so NHRMC is not a competitive threat to medical practices.

Let's see. NHRMC in my opinion is worth $700,000,000.00 not including the value of the Foundation. The county has 170,000 residents. That means, if my math is correct, each man, woman, child's, every homeless, every everyone stake in NHRMC is worth $4000.00, EACH. Each one of our share of the annual cash flow will soon be $600.00 per year. Keep up the good work Jack. Build a free standing heart institute. Build another big hospital on Cameron property. Let's have a cool teaching college. Build a big hospital near Market and College. Go Jack Go. Yea. We love you. Keep up the good work. Ya'll are cool. I want my investment in the hospital to double every seven years. Isn't that what the big time Jimmy Buffet type investor's do. Let's see my share of the hospital may be worth $64,000.00 in 28 years. NHRMC is the best stock I ever owned. Heck. People would be smart to move to Wilmington just to get in on this. Cool as long as they don't forget who owns em. And they are providing $50,000,000.00 in FREE health care to boot PER YEAR. Everyone in this town should fall on their knees every time they go out that hospital. They were mighty kind to my Brandy, and they did not charge her one penny. Thank you.

8-25-04

New Hanover Regional May Borrow up to $150 million for new construction.

Information based on Cheryl Welch Star News Article

In my opinion it doesn't cost anything and people may have suggestions the hospital's management has not considered, and the hospital should welcome ideas and this is why I have added my two cents. The hospital's foundation received around $1.5 million in gifts in the year ending 2003 and that seems like a low figure. How active is the effort to receive funds if a donor gets his name on the building? What if the foundation money was earmarked for new construction? Would this increase donations? To my mind the less money borrowed the better.

The plan – talked about for the better part of a decade but officially in the making since March – calls for reshuffling, renovation and construction. The board hopes it will alleviate the hospital’s growing pains and improve the quality of services offered.

The plan includes:

MOVING the Coastal Rehabilitation Hospital to the Cape Fear Hospital campus and strengthening the orthopedic program there.

ORGANIZING all women and children’s services into the vacated Coastal Rehab space. This will house labor and delivery, the neonatal intensive care unit, pediatrics, obstetrics/gynecology clinics and all gynecological surgeries.

BUILDING a surgical pavilion between the new women and children’s hospital and the patient tower. This will allow the landlocked radiology program and cardiac services room to expand. A heart institute will be formed from the remaining heart surgical suites and services.

(Would a separate heart hospital near the hospital be a better plan possibly on at a nearby but separate location?)

ADDING to New Hanover Regional’s emergency department, maintaining the current emergency department at the Cape Fear campus and building a freestanding emergency department in the northern end of the county.

(Sounds like a risky expensive project that is going to be a drain on the hospital's finances. What about an emergency clinic financed from another source of funds like the other county clinics are financed?Why not have a freestanding emergency department like Medac for less life threatening problems in the northern part of the county with serious problems sent to main hospital's emergency facilities. Possibly enlist Pender Hospital personnel with this project because Pender needs more business and there may be a way to tie an emergency department in northern New Hanover County with Pender Hospital that may help improve Pender's profits and save money on this new northern facility in the process. )

GENERAL medical and surgical patients will be consolidated in the patient tower at New Hanover Regional. All 10 floors will be renovated with upgraded heating and air conditioning.

MANY ROOMS, especially those in the women and children’s hospital, will be renovated into private rooms or suites. The number of private rooms will be increased from 40 percent to 65 percent to meet patient demand.

(Demand could swing back to double occupancy. Why can't double occupancy rooms just be used as single occupancy? Why not immediately change the mix to 65 percent single occupancy by taking double occupancy rooms and assigning them single occupancy status as a means of testing the market and other factors before spending a lot of money which might end up as not that hot of an idea?)

ZIMMER CANCER CENTER will expand as outpatient pediatric and OB/GYN clinics are moved to the women and children’s hospital.

ADDITIONAL parking decks for employees will be built to free up parking spaces for visitors.

Hospital chief executive officer Jack Barto said he believes the plan will be something the new management team can really dig into for the next five to 10 years.

“I think the residents of New Hanover County are going to benefit greatly .».».,” he said. “Now the hard part begins.”

Mr. Barto said the next step is to find and hire an architectural firm and prepare and send the plan to the state for approval. Plans call for the relocation, renovation and construction to take place between 2005 and 2008.

Officials said the hospital has the financial means to build a project of up to $150 million by taking out a loan.

8-18-04

Mr. Crow,
I will try to answer some of your questions.
The plan will be discussed by the Board before it is voted on. Those meetings will be advertised.

If you all have an e-mail list to notify people of open meetings I would appreciate being put on it.

Updated financial statements are provided at each Finance Committee meeting on the Thursday before the Board meeting.

If I could get the last updated financial statement it would be appreciated.

I am not able to answer your questions regarding variable rates. I do know these arrangements have been successful.

I certainly understand why you cannot answer my question on variable rates because in a way there is no answer. The variable rates only make sense if different interest rates are plugged in to the formulas to make the variable rates understandable. I would like someone to plug in some interest rates in to the formulas so I can understand the risk reward of the variable rates.

In the financial statement it says under Note 6. Bonds Payable (Continued) Because NHRMC anticipated that interest rates might decline, NHRMC decided to synthetically create variable-rate debt by entering into a derivative.

Alan Greenspan and the Federal Reserve have increased the Federal Funds’ rate one half percent to 1.5% on a road to higher interest rates which the Federal Reserve has said the FED would increase Federal Funds to 3.5%. Greenspan has also said foreign countries own a very large chunk of our about $5 trillion debt and the USA continually increasing its debt at the present rate is unsustainable and the consequences of China and other major holders of US debt selling US debt could send interest rates through the roof in a New York second. This means it may be impossible to get out of variable rate contracts with our shirts if the rates turn. However it could be the derivative is protection against rising rates. I would like to know more about NHRMC's variable rate contract and derivative so I don't jump to some negative conclusion which is not there.

It is pretty much common knowledge interest rates are rising. Rising interest rates seems to negate the NHRMC's reasons for going into a variable rate. I would like to now the current estimated fair market value of the swaps and also what are NHRMC’s contingency plans as interest rates rise. At what point does NHRMC punt and get rid of the variable interest rates and can we do so?

I do not know the specific "lawsuit" to which you are referring.

I guess I would like to know what we are getting for our legal fees pertaining to the FTC investigation and what is the status of the FTC investigation? Has the FTC filed a complaint against NHRMC? How much are the legal fees expected to be this year as a result of the FTC investigation? When and how is this FTC investigation going to end?

We will in fact provide more than $30 million in indigent care in FY 2004. Money raised by the Foundation does not offset these operational costs.

How is the money used the Foundation raises? Is there a financial statement for the Foundation and may I download or receive a copy of it?

As you may know, the medical center receives no tax subsidy to help offset this cost. Local taxpayers have never funded the operations of this medical center.

Good. Also local taxpayers own an investment which in my opinion should be worth a half billion dollars, not including the value of the Foundation, and I am not sure how much this $ 500,000,000.00 is earning the community. I personally like the community owning NHRMC and I consider part of the community's benefit, call it a dividend, is the fact NHRMC is able to write off $30 million in indigent medical services per year.