PINEDALE – Construction on the new critical access hospital and Sublette Center in Pinedale is slated to begin in May, said Karl Lueschow of Lueschow Project Management, at the March 29 Sublette County Hospital District (SCHD) Board of Trustees’ meeting.

Lueschow, the SCHD’s owner’s representative, provided an update on the timetable with Jeremy Hobbs, vice president of Layton Construction, the SCHD’s general contractor and construction manager.

Construction, originally planned to begin in April, was pushed out a month as the SCHD finalized its financing for the $75.1-million project, Lueschow remarked. While an April starting date was preferable, commencing building in May was more realistic and “aligned” better with ongoing winter weather and a heavy blanket of snow covering the ground in Sublette County, Lueschow added.

SCHD board chairwoman Tonia Hoffman expressed confidence in kicking off construction later in May due to the unpredictability of the weather in April.

A few small, line-item bids remained to be ironed out in the final construction budget, roughly $135,000 out of the $75.1-million overall project cost, Hobbs told trustees. These included subcontracts for components like generators and doors.

Otherwise, the construction budget is “in good shape,” Hobbs said. He estimated Layton would wrap up the few outstanding bids by the first week in April.

Lueschow stressed on March 29 that the construction budget matched the SCHD’s confirmed funding sources to within 99.83 percent of the overall project cost.

Primary sources of funding for the project include a $32-million loan from the U.S. Department of Agriculture approved in June 2022. The Board of Sublette County Commissioners unanimously pledged $20 million to construct a new Sublette Center in February 2020.

The SCHD contributed an additional $2.2 million in equity and $1.5 million from its cash reserves.

In December 2022, the Wyoming State Loan and Investment Board awarded the SCHD a $10-million grant in federal American Recovery Plan Act dollars for health-care infrastructure.

The Joe Ricketts family donated $1 million to the health-care project on Feb. 13.

On Feb. 21, county commissioners voted, 3-2, to approve $5.4 million in county dollars to close the remaining budget shortfall.

As soon as Layton closes the last remaining bids, the SCHD can finalize its construction manager at risk contract with Layton, Lueschow said. The gross maximum price will likely be locked in at around the same time that Layton’s contract is finalized in coming weeks, Hoffman told the Examiner.

Once the gross maximum price is set, Layton Construction is responsible for any cost increases from subcontractors under the “construction manager at risk” contract, explained Hoffman. As a result, Layton will carefully review each bid to make sure the numbers are tight, she said.

Leuschow praised Layton for preventing construction costs from “escalating” over the six months between the receipt of bids for each aspect of the project in August and the SCHD’s successful efforts to bridge an approximately $9.2-million budget shortfall by the end of February.

“Layton has done an outstanding job holding escalation to almost nothing over the last six months,” said Lueschow. “That is a monumental feat in itself.”

The final construction budget contained “no surprises” as the SCHD made its final drive toward startup construction in May, Lueschow said.

The construction budget accounted for a later starting date than anticipated, Lueschow said. The document also contained funds to cover costs accrued by “winter conditions” in 2023 and 2024, Lueschow replied to concerns raised by trustee Jamison Ziegler.

Trustees thanked Lueschow and Hobbs and their teams for the work they put in since August. Lueschow returned the gratitude, commending Davis Partnership Architects, Dave Doorn, SCHD administrator, and Mike Hunsaker, chief operating officer for the SCHD and its management partner, Star Valley Health, for “fantastic leadership day in and day out.”

“This has worked out well so far,” Lueschow added. “We just have to keep the momentum going and get this project out of the ground.”

Hobbs echoed Lueschow’s statements.

“We pray for warmer weather in Pinedale, Wyoming, to get some snow melted and the ground thawed to get this thing rolling,” he said.

In other SCHD news

The SCHD added two new tests to the battery already available at the clinics, said Sharon Rutsch, clinical services director and laboratory director. The C-reactive protein test can help detect inflammation while the second test measures lactate levels to diagnose acute liver failure and help detect sepsis, Rutsch added.

The two tests will “enhance the decision-making process” for providers caring for patients in the emergency room, said Dr. David Burnett, SCHD medical director.

Doorn reported that the SCHD had received almost $13 million in grants from July 2022 to March.

Doorn also announced the promotion of Dr. Buck Wallace, emergency medicine, to chief of staff over the providers, an administrative role.

Trustees passed a unanimous motion committing $100,000 to Arrow Ambulance in Iowa to remount new chassis on three ambulances in the SCHD’s fleet.

SCHD staff continue to “dive deep” into the process of drafting new policies for the district as it transitions to a hospital, along with bylaws for committees and handbooks, reported Lindsey Bond, assistant administrator.

The finance committee intends to present a preliminary draft budget for the upcoming fiscal year at the SCHD board meeting in April, said trustee Dave Bell.

Negotiations are ongoing to sign a contract with Dr. Feinstein to practice with the SCHD, Bond said. Dr. Feinstein is a board-certified emergency room physician, added Burnett. The district is also in talks with a nurse practitioner specializing in women’s care who would be based at the Marbleton Clinic, Bond stated.

Following an executive session, trustees unanimously passed a motion approving the renewal of contracts with providers John Said, PA-C, and Cori Anderson PA-C.