By Tara Bannow

The Bulletin

St. Charles Health System announced Tuesday it plans to spend $16 million renovating its Madras hospital, including the construction of a 26,000-square-foot addition that will include a new main entrance, combined operating room and emergency department and imaging department and laboratory.

The 25-bed hospital, built in 1967, is showing signs of age in more ways than one. Its emergency department has seven beds, each separated by curtains, and only one operating room.

Its crammed laboratory has sat in a modular unit near the hospital’s emergency room for the past decade. Its heating, cooling and electrical systems are the same ones installed nearly five decades ago.

Piecemeal additions over the years have made for multiple entrances, making it tough to find the main one.

St. Charles Madras and Pioneer Memorial Hospital CEO Jeanie Gentry said the Centers for Medicare & Medicaid Services and the state set standards on hospital buildings that the Madras hospital met when it opened, but no longer does.

Although the hospital is legally in the clear as it is grandfathered out of the newer regulations, it is no longer OK to be exempted from them, she said.

“Back in 1967 when that hospital was opened, we didn’t have all of the technology that we have now,” Gentry said. “The operating room back then was big enough to accommodate all of the people and equipment, but now it’s really tight in there.”

St. Charles leaders mulled the idea of building an entirely new facility, as they’re doing with Pioneer Memorial Hospital in Prineville, but the Madras hospital is 15 years younger and has had more renovations and additions than the Prineville facility. In the end, building the addition to the Madras hospital and renovating its infrastructure was the least expensive option, Gentry said.

“It has quite a bit of useful life left in it, so we didn’t want to completely tear that down and build this completely new hospital,” she said. “We wanted to do as much with as little money as possible.”

This year, St. Charles took on $75 million in debt to finance a number of projects, including building a Prineville hospital. Within that, $10 million was set aside for the Madras hospital, Gentry said. The remaining $6 million for the project will come from the health system’s reserves, she said.

St. Charles took control of the Madras facility, previously Mountain View Hospital, on Jan. 1, 2013. St. Charles’ high bond rating and ready access to reserves has allowed it to secure a far lower interest rate on its debt than its former ownership would have been able to, Gentry said.

St. Charles Madras — which serves 21,000 people in Madras and the surrounding areas, including the Warm Springs Indian Reservation, Fossil, Antelope and parts of Wasco County — is designated by the Centers for Medicare & Medicaid Services as a critical access hospital, which places it under a different reimbursement structure than other hospitals. Critical access hospitals can’t have more than 25 beds, the average length of stay can be no more than 96 hours for acute inpatient care, and they must offer 24/7 emergency care and must be at least a 35-mile drive from other hospitals.

The project in Madras will include renovations to the hospital’s main entrance, including a larger food service area. The bulk of the spending on the project will be dedicated to the addition, which will include an emergency room and an operating room that will share space. Rather than curtains separating emergency patients, they’ll have walls between them.

The current design is to have six rooms that are usually pre- or postoperative but can also be used as emergency rooms, another six dedicated solely to emergency patients and four rooms that can double as emergency or operating rooms, Gentry said.

“That fits really nicely and that’s why the operating room and the emergency department will be next to each other and will share some space,” she said. “It’s kind of an innovative approach to designing an emergency room.”

Construction on the project will begin in May 2015 and stretch until mid-2016.

St. Charles leaders have discussed improvements to the Madras facility since 2008, Gentry said. St. Charles President and CEO Jim Diegel wrote in a statement that the need for facility improvements has been recognized for years.

“This renovation to St. Charles Madras is truly going to enhance the quality and safety of patient care and serve the community for years to come,” he said.

— Reporter: 541-383-0304,