MATT GENTRY The Roanoke Times

Tour group members look at a CT scanner last week at the Carilion Giles Community Hospital. The hospital contains $10 million worth of new digital equipment. New beds and toilets can hold patients up to 500 pounds.

The emergency department has tripled to accommodate the some 13,000 people who pass through its doors each year. There is also a room for psychiatric patients.

Certified registered nurse anesthesiologists Judy Ikirt (left) and Dallas Swire show off one of two new operating rooms last week at the new Carilion Giles Community Hospital.

People walk into an outdoor patio and dining area with a view of Pearis Mountain during a tour of the Carilion Giles Community Hospital last week. It took about six years to design and construct the 86,388-square-foot facility.

PEARISBURG -- Diabetes, obesity, mental illness and an aging population were just a few of the health needs considered in designing a new Carilion Clinic hospital in Giles County.

Carilion Giles Community Hospital will open May 22, replacing the rundown Carilion Giles Memorial Hospital. The name change was made to reflect the community's ownership of the new facility.

Meeting the physical health needs of the rural population wasn't the only goal in constructing the hospital. The economic health of the community has also been closely tied to the success of the hospital.

"To have quality health care is a huge component for quality of life and we are very interested in providing a high quality of life for our citizens," said Giles County Administrator Chris McKlarney. "And it is difficult to sustain economic growth without a hospital."

It isn't the first time a local community has put economic hope behind a Carilion operation. Roanoke has put strong faith in Carilion's collaboration with Virginia Tech in opening a medical school and biomedical research institute to help bolster the local economy.

Although Giles County and the town of Pearisburg aren't counting on medical research and students, both are hoping for new businesses and a residential community to surround the new 25-bed hospital.

"It's a project that the town is extremely pleased with. And we think there will be other good things that will come about as a result of the hospital being there, that other developments are going to want to be near it," Pearisburg Town Manager Ken Vittum said.

The town was so eager about the economic development possibilities surrounding the new hospital that it fast-tracked the approval process for it.

"We would sometimes not take all the time for reviews allowed by code, but simply try and move it ahead and meet some of the time frames Carilion had for their schedule," Vittum said. "Everything got reviewed. We just shortened the time considerably."

Even so, it took about six years to design and construct the 86,388-square-foot facility, Giles hospital Administrator James Tyler said.

New features

By all accounts a new hospital was needed. It would have cost an estimated $50 million to renovate the existing hospital. Plus, much of the equipment was outdated, making it hard to keep pace with the emerging trends in medical care.

The new facility was built for $34 million, including purchasing about $10 million in state-of-the-art digital equipment.

Nearly everything is new.

There is the $64,000 floor in the operating rooms. Drop a scalpel, slicing the floor, and it self-seals.

The emergency department has tripled in size to better accommodate the approximately 13,000 people who come through its emergency room doors each year. New features include two large trauma rooms, a room designed for psychiatric patients and a decontamination room.

A new 64-slice digital CT scanner is a vast improvement over the current dual-slice scanner.

The new digital mammography equipment was such a need for the aging female population that Tyler challenged all the local women's clubs to help pay for the $250,000 piece of machinery. The women raised $4,000.

"One in eight women are diagnosed with breast cancer in a lifetime," said Tyler, whose wife died of breast cancer in 2007. "To be able to do annual screenings and any follow-up in a population that is considerably more elderly here is extremely important. These images [from the new machine] are so much clearer that you don't have to drive to another place like Roanoke for follow-up studies."

Even the beds and toilets are designed to meet the local needs. Each is designed to hold up to 500 pounds. Seven beds, costing $32,000 each, are specially equipped for bariatric patients.

"We see a lot of obesity and a lot of diabetes, mostly type 2," Tyler said in pointing out the new features during a tour of the building. "So in planning our hospital, some of the things we tried to do were to specifically account for that population."

The new hospital also has a corridor designated as an outpatient clinic to allow specialists, such as a gynecologist or cardiologist, to come once a week to see patients. Typically, patients have to travel to see a specialist.

Tyler said the new hospital has made it easier to attract doctors interested in working with the hospital for the clinic. He is talking with an oral surgeon about coming and is interested in bringing in a neurologist.

Besides being a magnet for specialists, the new facility could also make recruiting full-time doctors easier, Tyler said.

"It's a shame to say, but if you are looking at the public perception of a hospital, from a quality perspective a newer facility is perceived as having higher quality," Tyler said. "And physicians want to be part of a quality organization."

The hospital frequently has to use a temporary staffing firm to maintain a large enough physician staff.

"Providing care in a rural population is challenging and you're seeing evidence of that across the country," said Nancy Agee, Carilion's chief operating officer. "In Giles you don't have a population that can support a full complement of specialists, a team of care. It is a challenge to us, but it is part of our mission."

Most patients are sent on as outpatients. The hospital had 1,330 admissions in 2008.

Critical access

Giles is one of two critical access hospitals operated by Carilion. The other is Stonewall Jackson Hospital in Lexington.

There are seven hospitals in Virginia federally designated as critical access. A critical access hospital is certified to receive cost-based reimbursement from Medicare to help improve its financial performance. The ultimate goal is to keep hospitals open in areas where they would otherwise likely fail. As of March 30, there were 1,309 critical access hospitals in the country.

Even with the special Medicare reimbursement, the Giles hospital typically operates at a loss or just breaks even. It survives because the financial success of other Carilion entities help to support it, Agee said.

For the fiscal year ended Sept. 30, 2008, the most recent year for which Carilion has audited data, the hospital reported an operating loss of $854,000. That's on operating revenues of $22.9 million

The new hospital could not have been built if it weren't part of the larger Carilion system, Tyler said. Carilion used bonds to pay for the hospital.

A master plan

The new hospital is located on a hill behind Walmart. It occupies part of 150 acres that was owned by the Giles County Industrial Development Authority. Carilion swapped the old hospital and land for 26 acres to accommodate the new hospital.

The county also spent $2.5 million on grading and bringing utilities to the 150 acres, McKlarney said.

"The hospital is meant to be an anchor for other development," Tyler said. "It's part of a master plan. ... I see a retirement community, a hotel, maybe a Cracker Barrel and office space for physicians."

A McDonald's will soon be constructed on some of the nearby property, McKlarney said. But no other development plans have been approved by the town yet, Pearisburg's Vittum said.

Some picture the design plans including an upscale retirement community.

Currently, however, adding medical office space appears to be the next step, with some conversations already taking place to bring that development under way, McKlarney said.

The economic effects tied to the hospital don't just rest with future plans. Vittum said that often families, including his, want to live in a community with a strong local hospital presence.

In a county of about 17,000 people, the hospital is the third-largest employer, Tyler said. He estimated that the approximately 200 people on the hospital's payroll equates to an economic impact of $50 million.

"It is a huge economic engine, so you can imagine if it was to close," Tyler said. "It would devastate the community."