Wythe County Community Hospital and Carilion Health System are looking at a plan to let Carilion operate the hospital as its own well into this century, in return for Carilion investing upwards of $50 million in the hospital and community.

The not-for-profit Wytheville hospital, whose mission is a triad of "healing, health care and health education," would be the ninth hospital in the Carilion family. Carilion, which is also not-for-profit, has managed or co-owned Wythe County Community Hospital in the past.

Jerome Horn, chief executive of Wythe County Community, said he expects "a Carilion name on the building" if both sides adopt their tentative agreement as written. Neither side is sure the deal will happen, however, because it isn't final. That could take three months, Horn said.

Horn announced the tentative deal last week.

"We were looking for some way to preserve a full-service, acute care hospital in our local community to match the growth that we're seeing in the Wythe and Bland County areas," Horn said Tuesday.

Horn said Wythe County Community Hospital is under the same pressures felt by small, independent, rural hospitals in many parts of the country. One source of relief is to affiliate with a larger hospital company with size and expertise. Affiliation enables a small hospital to buy in bulk, tap experts on health care regulations and pay for new equipment and facilities.

Under the plan, Carilion would supply $40 million to establish a community foundation for health, welfare and education initiatives in Wythe and Bland counties and spend an estimated $15 million within eight years to upgrade the hospital. Carilion would take a 30-year lease on the hospital from the board that owns it, with the possibility of extending the lease 30 more years. It would buy fixtures, furnishings and equipment; employ the workers, including Horn; and assume the financial risks and enjoy the financial benefits of operating the hospital. The hospital ran a surplus of $1.4 million during its last full fiscal year.

Carilion's spokesman, Eric Earnhart, said Carilion will take the money from "existing finances" and will not raise prices. "In fact, bringing a new hospital into the system helps spread out overhead expenses and keep cost inflation in check," Earnhart said.

Earnhart said the move fits with Carilion's mission "to improve the health of the communities that we serve."

For most of the past five years, Carilion owned 40 percent of Wythe County Community but sold its interest back to the hospital in January. Horn said the breakup was friendly.

"It was just the model didn't work. With them owning a minority interest, there was no incentive for them to make investments in Wythe County Community Hospital with capital dollars," Horn said. Interests in Wythe County were similarly hesitant. Plus, Wythe County Community had trouble meshing with Carilion's computers.

The loss of the partnership prompted the hospital to strike a tentative deal to affiliate with LifePoint Hospitals in Tennessee.

That deal is not going forward. When Carilion sold its interest, the health system won Wythe County Community's promise to let Carilion see any affiliation deal it intended to strike with another hospital company. If Carilion wanted the deal for itself, it had the right to claim it. Carilion exercised that right, bumping LifePoint from the scene.

Wythe County Community was established by the community in 1972. The hospital, which rises four floors, averages 40 patients daily. Doctors delivered 150 babies at Wythe County Community last year. In its four operating rooms, doctors replace joints, fix spines and perform all types of general surgery. The medical staff includes 47 doctors, and more than 400 people work for the hospital.The hospitals of Carilion Health SystemOwned:

• Carilion Franklin Memorial Hospital

Rocky Mount

• Carilion Giles Memorial Hospital

Pearisburg

• Carilion Roanoke Community Hospital

Roanoke

• Carilion Roanoke Memorial Hospital

Roanoke

• Carilion New River Valley Medical Center

Christiansburg

Managed:

• Smyth County Community Hospital

Marion

• Tazewell Community Hospital

Tazewell

Co-owned with Centra Health:

• Bedford Memorial Hospital

Bedford