The Future of Healthcare: Major Upgrades Ongoing at Watauga Medical Center
Originally published in High Country Magazine, Aug/Sept 2021. Used with permission.
Healthcare in the High Country has come a long way since 1925, when Dr. Henry B. Perry moved into Boone’s first hospital facility in the Lovill House Annex. Blanford B. Dougherty established the infirmary – where Dan’l Boone Inn is currently located – to support Watauga Academy, now Appalachian State University, and the surrounding town.
After operating on the university campus for 29 years, a new Watauga County Hospital, now Watauga Medical Center, was built at its current location on Deerfield Road. Its first patients entered the building on March 23, 1967.
The original building was constructed through money allocated by the Hill-Burton Act of 1946. This piece of federal legislation, signed into law by President Harry S. Truman, allocated money to states for the purpose of constructing hospitals and healthcare facilities.
Since that time, Watauga Medical Center (WMC) has served the healthcare needs of countless patients, including a major expansion in 1980 and continual additions of new and updated services.
The quality of care continued to improve after the 1980 expansion, but infrastructure problems such as power failures and repeated HVAC system repairs have plagued recent years. These issues prompted stakeholders to begin planning for infrastructure upgrades.
Rising to meet the community’s needs
Appalachian Regional Healthcare System (ARHS) has begun a $126 million construction project, making structural and technological enhancements to ensure the delivery of premier healthcare into the future.
“When we started talking about this project initially, it involved building a new bed tower and moving outpatient services back to campus in a new medical office building,” said Rob Hudspeth, Sr. Vice President for System Advancement at Appalachian Regional Healthcare System and the President of the Appalachian Regional Healthcare Foundation. “The board of trustees started considering how to make that happen – if we could afford it and how it would impact services until we were able to build it all. Meanwhile, our new CEO Chuck Mantooth was transitioning into the role Richard Sparks had filled for more than 30 years.”
To aid in the initial plans for hospital expansion, a team of Master of Architecture students from Clemson University’s Architecture + Health Concentration visited Boone to perform a needs assessment and survey the land. They performed the initial assessment and made recommendations for the bed tower and medical office building. Soon however, power plant issues began to arise, changing the initial building plans for the hospital.
“We had a prolonged air conditioning failure during the hottest week of 2019 because of old and outdated HVAC equipment. While we were thankful for the support we received to try to keep our facility as cool as possible, our board of trustees realized we needed to consider major upgrades. They approved an engineering survey to review all our systems. Charlotte Engineering’s report stated we had multiple issues that needed to be addressed. The cost was estimated at $22 million to repair the 60-year-old building,” Hudspeth said. “Our central energy plant was antiquated. If you don’t have power, it’s hard to do surgery; it’s hard to keep patients comfortable and provide quality healthcare for them.”
The decision to replace the central energy plant at WMC added approximately $28 million to the project cost which is being funded from a $126 million bond issuance.
“We felt like it was the right thing to do for the community. We were designated by the Centers for Medicare and Medicaid as a five-star hospital, but we know we can’t keep delivering five-star care in a 60-year-old building,” Hudspeth said.
“The expansion project started with the new central energy plant,” Hudspeth said, “because we couldn’t just tear down the power plant and build another one in its place. It has to be a staged, staggered approach. The new central energy plant will give us all of the modern technology and power we need.”
The new 100,000-square-foot energy plant will include two fire tube dual fuel steam boilers, three condensing boilers, five hot water heating pumps, three 750-ton water-cooled centrifugal chillers, a three-cell cooling tower, two 30,000-gallon above-ground fuel tanks, two 2,500 kilovolt-ampere (kVa) utility transformers and a 1,000-kilowatt (kW) generator.
“For years, ARHS has successfully worked around limitations in space and declining buildings that have kept us from achieving our full potential. It’s time we invest in people, systems, and facilities. This will expand our opportunities and position us for the future,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System.
A new and improved patient care tower
A new 48-bed tower will provide larger patient rooms capable of accommodating high-tech mobile medical equipment, state-of-the-art surgical suites, an updated Emergency Department, new waiting areas, and more. A new two-story entryway will greet patients as they enter the building, with natural light and serene mountain images.[/caption]
Watauga Medical Center is currently licensed with 117 beds, which is enough for inpatient demand, so the bed tower will not add additional beds. This new facility will allow the hospital to create new modern spaces and renovate and repurpose space in the current facility.
Patient privacy is a primary concern of the new building. Separate patient and visitor elevators are planned for the bed tower to provide more privacy for patients traveling to and from their rooms for diagnostic tests, surgery or physical therapy. Built-in medication carts will be integrated into the six new surgery suites so all necessary supplies are at the staff’s fingertips.
The bed tower will also be home to women’s health services as well as imaging and laboratory services – both of which are currently located outside of the hospital. Patients will be greeted by new registration and waiting room areas.
Along with the expansion to the new patient care tower, the existing space will be upgraded and utilized. For example, a brand-new Intensive Care Unit recently opened inside the current hospital building.
A new era of surgical excellence
Along with the new building comes a whole new era of new technology advancement at Watauga Medical Center. A major feature of the new patient care tower is a spacious, efficient and modern surgical suite.
“The current 300-square-foot surgical rooms limit our capabilities for advanced procedures like robotics-assisted surgery and orthopedic joint replacements, “said Kevin Henson, Senior Director of Surgery and Anesthesia Services for ARHS. “Many of the rooms are just not big enough for the equipment needed.”
In designing the new surgical space, a cross-functional planning team considered facilities such as WakeMed, UNC Health, Duke Health and others, and aimed to meet or surpass the technology available in larger metropolitan areas of the state. Watauga Medical Center, already a high-achiever in quality metrics, will be considered one of the premier hospitals in North Carolina.
According to Henson, the expansion will double the space of every new operating room. “With the expansion and design of these rooms, we can extend our robotics program. Every room will be able to handle the various needs of all surgical specialties, rather than relegating certain procedures to only certain operating rooms.” The new surgery department design will also have the pre-op and post-op rooms close to the operating rooms to improve efficiency.
“On a typical surgery day, surgeons can log more than 18,000 steps and spend precious time they could use for patient care. They walk from one area of the hospital to speak with the family before surgery, then travel a couple long hallways to scrub in, and back down another hallway to go into the surgery department,” Hudspeth said. “We will relocate departments that work closely together to allow for more efficiency and a seamless transition between services.”
Watauga Medical Center has recently seen people traveling longer distances to receive care at the hospital. A significant portion of outpatient and inpatient surgery patients live outside Watauga County. “It’s a testimony to the vision that is being realized,” said Henson, “and it’s going to be an incredible facility for this small community.”
ARHS leaders hope the expansion will help them continue to recruit talented physicians, nurses, and staff. In addition to patients seeking out Watauga Medical Center for their procedures, they anticipate that doctors and healthcare professionals will increasingly view ARHS as an employer of choice and a place they want to be for a long time. Currently, many of Watauga Medical Center’s healthcare professionals live in Wilkes County, Ashe County, Caldwell County, and even across the state line into Tennessee. Many top physicians are also relocating to the High Country from other states, drawn by the facility improvements, the beautiful local area, and more.
A new and improved Heart and Vascular Center
One of the earliest efforts of this expansion was a new Heart and Vascular Center. Formerly known as The Cardiology Center, the 8,000-square-foot facility opened in a new heart care wing at the medical center on August 17, 2020.
The Heart & Vascular Center provides more efficient and convenient access for patients, by integrating outpatient heart care with diagnostic services in the same convenient location. The center includes twelve exam rooms, three device rooms, and two heart failure treatment rooms. The new name represents the enhanced service offerings and multi-disciplined team of board-certified cardiologists, advanced practice providers, cardiac nurses, office staff, and device technicians that all partner with patients to manage symptoms, monitor medications, and create customized treatment plans.
“Bringing services – diagnostic testing, catheterization lab, etc. – under one roof reduced the wait time for patients and enhanced the level of interaction between medical professionals to collaborate and delivered customized care,” said Kim Bianca, President of Watauga Medical Center.
After analyzing the number of people WMC was sending ‘off the mountain’ for cardiac catheterizations – approximately 300 each year – ARHS invested millions hiring additional cardiologists and enhancing the cardiac program.
“During a cardiac emergency, time is muscle,” Bianca said. “Any delay in restoring blood flow increases the chance for significant damage to the heart muscle.”
The WMC catheterization lab is open 24 hours a day, 7 days a week, 365 days a year. High Country residents no longer have to leave the mountains for interventional and diagnostic services from the nation’s top medical professionals.
The future of Family Medicine, Wellness and Orthopedics Programs in the High Country
Over the last several years it has become evident that access to primary care, including family medicine, is a challenge in the High Country.
The MAHEC Boone Rural Family Medicine Residency Program, located at Watauga Medical Center and AppFamily Medicine is a partnership between ARHS and Mountain Area Health Education Center (MAHEC) and will also serve as a clinical training site for medical students from the University of North Carolina School of Medicine. The program was created to train full-scope family doctors to serve in rural and underserved communities. Resident training will take three years, and ARHS and MAHEC are hopeful that many residents will choose to continue their careers in the High Country.
The Watauga Medical Center expansion ensures that resident doctors will be able to train in the most up-to-date, advanced environment while providing care to our rural population. A $1 million investment will be made into the future of the residency as a part of the capital fundraising campaign that supports the overall project.
“We are enormously excited to welcome these family medicine residents,” said Molly Benedum, M.D., Director of the MAHEC Boone Rural Family Medicine Residency Program. “Their interest in our program indicates their strong commitment to spending their careers meeting the primary healthcare needs of communities across the state. We look forward to what they will accomplish in the years to come.”
Recognizing the relationship between physical fitness training and healthcare for joints and bones, ARHS is allocating $1.5 million to relocate their acclaimed orthopedics programs to the Paul H. Broyhill Wellness Center. Orthopedic physicians will now be able to collaborate more closely with physical therapy and wellness staff to provide access to specialized pre-surgical training and post-surgical physical therapy.
David Jackson, President and CEO of the Boone Area Chamber of Commerce, greatly benefitted from a customized pre-surgery conditioning program before orthopedic surgeon Dr. Steven Anderson performed his hip replacement procedure. This “prehab” gave him the best possible chance of overcoming his lifelong struggle with a rare condition and chronic hip pain that threatened to destroy his active lifestyle and consume his family life.
With the growing number of active seniors in the High Country, people who use the Wellness Center for fitness may increasingly find themselves in the midst of a major health event where they experience illness or need surgery. They may need help to get back to their previous level of activity.
Fitness services, cardiac and pulmonary rehabilitation, physical and occupational therapy through The Rehabilitation Center, and other clinical wellness programs are currently housed in the 54,000-square-foot building. With the addition of AppOrtho orthopedics and sports medicine, ARHS can consolidate services and help patients successfully navigate the cycle of wellness and rehabilitation.
“We wanted to take the integrated care concept and create a unique space – something special for the community,” said ARHS President and CEO Chuck Mantooth. “With our specialized staff, trained to work with different health populations, we can help people live up to their potential at any age and condition.”
Support from Appalachian Regional Healthcare Foundation
Appalachian Regional Healthcare System is a 501c3 non-profit organization that reinvests earnings to improve healthcare services for the High Country. It is important to note that construction of the central energy plant and bed tower will not raise taxes for residents or require the use of town or county funding.
In addition to the $126 million bond issuance for construction, the ARHS foundation has been tasked with raising $12 million through a capital campaign for ancillary costs such as people, programs, and technology to enhance the project further.
“Our foundation hired a consulting firm from Winston-Salem to perform a feasibility study and help develop our fundraising plan. We surveyed people in the community about a variety of themes around healthcare delivery,” Hudspeth said. “We are currently in the silent phase of the $12 million capital campaign and have raised about $6 million.”
Created in 2007, Appalachian Regional Healthcare Foundation engages with the community to identify individuals, businesses and organizations who want to partner with ARHS in providing for the healthcare needs of the community.
Appalachian Regional Healthcare System has been able to continue to provide excellent healthcare in part because of the generosity of full-time and seasonal residents in the High Country.
“The support the foundation has been able to garner from seasonal residents is vital to our success, and we couldn’t provide this funding without them,” Hudspeth said.
To kick off the capital campaign, the foundation received two major gifts from generous benefactors to recognize the excellent care they have received in the past.
The first gift came from Blowing Rock residents Bonnie and Jamie Schaefer, together with their family, Marla Schaefer and Steve Weishoff, who generously gave $3 million for the future Schaefer Family Patient Care Tower at Watauga Medical Center.
“They say people make a place and it’s a good thing, because the core hospital, built in 1967, is dated, in disrepair and in need of improvement,” said Bonnie Schaefer.
“Watauga Medical Center offers life-saving medical care to those living in the High Country,” said Jamie Schaefer. “The patients and healthcare professionals need and deserve a new, state-of-the-art hospital.”
On June 17, 2021, Blowing Rock resident Ken Lewis surprised his wife, Donna, with a $1.5 million contribution to ARHS in her honor to name the new Donna C. Lewis Heart and Vascular Center.
Both Donna and Ken have needed cardiac interventions in the past. “Donna had some heart issues and she needed repair work about 15 or 16 years ago. I’ve had a heart stent myself,” Lewis said, “When this (capital campaign) came up, I thought about how lucky and blessed we were to have the ability to access this kind of facility.”
Lewis noted that as seasonal residents, they typically have all the facilities and technologies nearby their primary homes to address emergency situations. “But that is not necessarily the case when you are in the mountains,” he said, “It’s all about time in those situations. We have what we think are the best hospitals in the world [in our primary home cities], but they might as well be in China. At certain times of our lives, it is all about this hospital [in Boone]. It may be enlightened self-interest, but it’s also about all of the things we can do for the people of this region and this community. This is a great thing to do because it will help save people’s lives and Donna and I feel privileged to be a part of it.”
The Appalachian Regional Healthcare Foundation hopes to have continued success to fully fund the capital campaign. For more information, and opportunities to contribute, visit apprhs.org/higherelevation.