Portneuf Medical Center, a county-owned hospital in Pocatello, Idaho, had been formed several years ago through a combination of the two hospitals in the county. The combined entity had embarked on an ambitious program to expand one of its campuses to accommodate the merged hospital. Severe financial pressures placed the completion of the project in jeopardy. PMC’s owner, Bannock County, asked us to evaluate PMC’s potential to complete the new campus on its own, and to represent the County in finding a buyer or partner if appropriate. We guided the County through a robust public discussion and, finally, through 77% referendum vote in favor of our plan to establish a joint venture with a well-financed national operating partner who invested $201 million in the health system for a 77% interest, but split Board control 50/50 with the local partner.

Before we even arrived, a heated public battle had been raging among the County Commissioners, leaders of the hospital, medical staff, and the public at large. After we arrived, our in-depth assessment of the hospital’s current financial situation and an intensive series of listening sessions with individuals and groups of citizens turned the tide of local opinion and a formerly skeptical medical staff to support the Commissioners’ plan to apply our “Community Objectives Process” in full collaboration with the various community stakeholders to source an appropriate partner. After an intensely competitive proposal process, the successful suitor executed a unique non-profit/for-profit joint venture between the local Hospital Foundation and their capital partner. The formerly antagonistic debating teams coalesced around the recommended model, with the citizens voting in a binding referendum more than 3 to 1 in favor of the transaction.

Trustee Magazine found the successful process so compelling that the publication devoted its March 2010 cover story to an article describing our facilitation of the formerly divisive debate and the benefits of the resulting transaction to all stakeholders and the community-at-large.