Cost. Prices are now higher than before conversion, but in recent years have become more competitive. HMA also has a more businesslike attitude towards collections, which concerns some community members. Quality. Quality appears to have improved following conversion. Despite tightened staffing, both quality and patient satisfaction seem improved due to new HMA information and monitoring systems. Byerly=s latest Joint Commission on Accreditation of Healthcare Organizations (JCAHO) score was 98 (compared to 85 three years ago). Public Health. The sale has produced an increase in city public health activities. The new Foundation and city funded a major needs assessment to set priorities for Foundation giving and other local health initiatives.

Economic Impact

Use of Conversion Proceeds. The Byerly Foundation plans to spend the funds available from the purchase of the hospital for broader purposes other than just health. To determine its funding priorities, the Foundation helped the city fund a strategic planning process. The Foundation delayed grant-making until new hospital construction had begun, making initial awards in the Spring of 1998. The new Foundation board has selected education as its first priority. Other priorities include economic development and quality of life. The Trustees anticipate allocating at least 65 to 80 percent of their resources in the education area. Most spending will be targeted in the greater Hartsville area.

Staffing. There have been some minor post-conversion reductions in staff via attrition but these might have occurred anyway. There were not massive staffs or administration layoffs following the sale, helping maintain morale. Nursing staff was tightened through attrition, but this likely would have happened without the sale. Morale is somewhat lower than before the sale, but is related to anxiety about market changes, not the sale; morale should improve when the new facility opens. Capital Investment. Capital investment has increased following conversion. Post-conversion capital expenditures include $40-50 million for the new hospital/medical office complex, purchase of a local family practice (to recruit more physicians) and expanded services. HMA is expected to maintain its presence in the community over the long haul. Taxes. The hospital annually pays about $1.9 million in taxes, of which $400,000 is for the county and $75,000 to the state.

Net Assessment

This conversion appears to have resulted in a positive impact on community health due to expansion of services and a probable increase in quality. There has been no change in access to care for the disadvantaged. There has been a positive economic impact on the community due to new capital investments, new foundation spending and new taxes.