Fort Atkinson Economic Achievements: Fort HealthCare $38M Remodeling Near Completion; Open House Planned for Dec. 9

Exclusive Interview with James Nelson, Fort HealthCare

Fort Atkinson’s economic development has significantly advanced over recent months – and in particular this summer – as measured by several new private, public, and non-profit capital expansion projects. Much of this development has progressed quietly and unnoticed by the public. But now, appropriately, it must be keenly noted and celebrated.

While more regionally-centered projects such as Jefferson County’s new Food and Beverage Innovation Campus have raised the county’s profile, Fort Atkinson’s recent capital investment accomplishments in the city are to be no less distinguished, as they too, extend economic and quality of life benefits extending well beyond the city’s bounds.

Fort Atkinson Independent Reporter (FAIR) takes stock of our positive gains with an in-depth series featuring five recent and important local capital investment accomplishments:

• $38 million Fort HealthCare facilities transformation

• Klement Industrial Park speculative development launch

• Fort Atkinson public works campus completion

• Opportunities Incorporated warehousing completion

• Ridge View Estates housing development groundbreaking

  
  

Fort HealthCare – A Major Transformation

FAIR begins this series with a comprehensive look at Fort HealthCare’s renovation.

In a relaxed September Friday afternoon interview in Fort HealthCare’s new dining room, the Healer’s Cafe, James Nelson described Fort HealthCare’s remodeling project as a “major transformation,” referencing the six-year renovation project at the main hospital campus on Sherman Avenue. The project represents a major stride in community health services, symbolic of positive local economic development. Three years in planning and 18 months of major on-site work, the renovation is now within two months of completion.

Details will soon be announced for a public open house of the renovation tentatively set for December 9.

James Nelson is Fort HealthCare’s Chief Financial Officer and Senior Vice President for Strategic Development, responsible for all finance and administrative functions. He is a Certified Public Accountant and holds a Master of Business Administration degree from Marquette University. Nelson began his healthcare administration career in 1987 starting in Beloit, then at Watertown, ultimately joining Fort HealthCare in 1998.

Nelson’s expertise has also extended nationally. He served a four-year appointment to a federal-level advisory panel for the Centers for Medicare and Medicaid under the Department of Health and Human Services. The panel was tasked with innovating new business systems for emerging health services and procedures.

James Nelson, Senior Vice President & CFO, Fort HealthCare

Distinguishing Fort HealthCare

Fort HealthCare is the only hospital in Jefferson County. Fully accredited, Fort HealthCare’s services extend to residents throughout the county and adjacent regions. The hospital offers comprehensive inpatient services, ambulatory surgery and specialty clinics, a birthing center, cardiac care and rehabilitation, emergency services including the Urgent Care Program for after-hours treatment of minor illnesses and injuries, occupational medicine, in addition to other medical services.

Fort Medical Group is a multi-specialty “group practice” subsidiary, operating satellite clinics for primary and specialty care in Fort Atkinson, Cambridge, Jefferson, Johnson Creek, Lake Mills, and Whitewater. Physicians from UW Health, Dean Medical Center and other organizations maintain continual collaboration with Fort HealthCare and Fort Medical Group to address health needs of patients.

During FAIR’s conversation with Nelson and the ensuing tour of remodeled clinics, offices, and patient amenities, Nelson emphasized Fort HealthCare’s mission and vision: “To improve the health and well-being of the community with a vision to be the healthiest community in Wisconsin.” For all practical purposes an obligation to the communities which it serves, this mandate represents the principal rationale for the renovations soon to be completed.

Fort HealthCare’s “Remodeling” Project

The Fort HealthCare campus consists of about 300,000 square feet. “About every 20 years, health care seems to go through a transformation,” according to Nelson, “and it’s about that time, quite out of necessity for the health needs of the community, that we again upgrade our facilities.”

“Comparing the original 1949 building which had 110 beds, we’ve since quadrupled the size of the original hospital. But the physical requirements of our building – the original section of this hospital – will never again accommodate comprehensive patient care as was the case those many years ago. Now presently, for specific clinical patient requirements and surgical procedures, new technologies in medical equipment and building infrastructure are absolutely essential – that’s the fundamental purpose for this transformation.”

Measuring Hospital Effectiveness – A “Community of Medicine”

There have been successive transformations over the years, each weighed against Fort HealthCare’s mission and vision toward community well-being.

Those successive transformations have been effective. Among Wisconsin’s 72 counties, Jefferson County has gone from 33rd ranking in health outcomes, and 34th ranking in health factors, to 8th in health outcomes and 13th in health factors. Accordingly, Fort Healthcare’s continuous gains in health service effectiveness in Jefferson County are statistically documented by evidence-based measures.

Nelson explained that it was once customary to gauge hospital status – and potential effectiveness in terms of patient services - by such factors as bed count. But now, according to Nelson, such measures are no longer proper. “About 88 percent of our work has nothing to do with a ‘hospital bed’ – it’s a very small part of what we do in the community of medicine. We currently have 49 beds, having previously de-licensed many of them because quite simply, those beds were not used.”

How “inpatient” care is defined has also influenced these changes. “People have the same illnesses and injuries,” stated Nelson. “What’s changed over the years is the ‘standard’ by which the hospital ‘stay’ is necessary. In many cases, the extended hospital stay is no longer needed in comparison to how we once understood it.

“A hip replacement is a great example. When I first started in healthcare, the hospital stay was 5-7 days in length. Now, with great strides in medical science and technology, you’re home for supper. Some of this change is attributed to medical technique, and some change reflects how medicine defines ‘recovery’ in bio-psycho-social terms. Another example is cataract surgery. In a previous time a patient might be in the hospital for as long as 10 days, but now it’s a 15 minute procedure and you’re home. You can imagine staying in a hospital for a week! Now in many cases, you’re home for supper.”

Another key factor in hospital efficiency is regulatory compliance. Regulations establish medical professional standards, clinic facility requirements, protection of patient data and confidentiality, disease control, and control the spread of disease. Regulations help to foster public trust in the healthcare system.

“Regulatory compliance enters healthcare management from multiple levels of government and industry - our world is heavily regulated,” stated Nelson. “We have 30 federal agencies that have regulations for us; 19 state agencies that write rules and regulations for us. In addition, there are numerous insurance companies that believe they can regulate us. We achieve and often exceed these requirements.”

“So the world has changed a lot, allowing us to be more efficient, safer, and allowing us to engage the community of medicine with better and greater health outcomes for the patient, their families, and the community. Transformations in medicine, how we design and plan our healthcare facilities, and how we accommodate patient accessibility to these advances, have significantly helped in driving down the cost of healthcare. That’s our ‘community of medicine’ – continually improving and transforming in response to patient and community health needs.”

Public Health & Community Progress – Factors That Matter Most

In addition to his 28-year executive role at Fort HealthCare, Nelson is uniquely positioned to participate and influence economic development in and around Fort Atkinson. He is actively engaged with the Fort Atkinson Economic Development Commission and is a board member for the Thrive Economic Development (ThriveED) organization of Jefferson County - a private-public entity that assists in strategic initiatives across Greater Jefferson County emphasizing workforce development, infrastructure, and quality of life.

Fort HealthCare’s soon to be completed transformation is also evidence of concurrent trends in broader issues of community growth and economic development and how these intersect with public health. “It’s really the analogy that a rising tide lifts all boats. That’s one of the beautiful things about it. As growth occurs in our community, quality of life and access to services - community healthcare for example - improve and expand for everyone,” according to Nelson.

And yet, other voices in the community have offered different opinions about investment and economic development between communities, namely Fort Atkinson and Jefferson, where the latter is now home to Palermo Villa, Kikkoman, and the Food and Beverage Innovation Campus.

One major difference between communities exists in electric utility infrastructure. The availability of larger-scale electric power indeed influenced site selection by the business firms mentioned. To this, Nelson offered an important consideration not often voiced. “In looking at recent business development in Jefferson - the way that growth has been going there - if we [here in Fort Atkinson] simply waited around for expanded utility capability rather than acting right now on the advantages we do have, it’s questionable if investment here would ever happen. We’re fortunate that the city of Jefferson had utilities in place from Tyson/LD Foods when they ceased operations in September 2021. That ‘installed capital’ was a major factor allowing new business investment to go forward.”

“Every community has its own comparative advantages,” explained Nelson. “We all have land, but we don’t all have larger-scale electric utilities to accommodate larger-scale industries. Jefferson is very fortunate in self-maintaining an electric utility for greater capacity. They’re in a position to influence more of what happens in their community in terms of the range of new capital that they can bring in.”

“In Fort Atkinson, we’re dependent on Wisconsin Electric to provide that infrastructure for us, explained Nelson. “You have to get into a 'queue' with Wisconsin Electric. There are long wait times for entities that need a greater size of infrastructure. We’re working with Wisconsin Electric through the efforts of Deb Reinbold, President of Thrive Economic Development. To her credit, we are working through ways to ramp up power infrastructure to gain a more level ground when competing for industry so that everybody has access to it. For our communities having land, and then realizing larger-scale power, everything is ready to go – those communities can then compete.”

Fort HealthCare – A Community-wide Economic Benefit

Returning to Fort HealthCare and its benefits to the community, Nelson stated that “from a hospital perspective, we’re delighted that patients have this level of care. We all benefit because for every dollar invested here, $1.25 of additional services are generated into the community. Whether its grocery stores or other retail establishments, restaurants and so on. The more that you organically grow the base, as is the case with Fort HealthCare expansion, new amenities are added for everyone - more residential development resulting in greater fiscal stability for the community as a whole, more retail sales – banks are going to benefit, the hospital and medical community, the schools and so on. At the end of the day, economic benefits expand for everyone within 15-20 miles.”

“As to the issue of housing, one of our biggest challenges is to grow that base,” Nelson stated. “Fortunately, new opportunities to Fort’s credit have emerged by virtue of the Banker Road project [Ridge View Estates]. It’s great to see that new development in place - housing expansion we haven’t seen in 25 years.”

“From a hospital perspective, we feel those benefits too as we attract nurses, physical therapists, doctors and many new professionals and staff,” according to Nelson. “We’ve had difficulties in recruiting and retention because employees don’t have any place to live. Employees can commute from Madison or Cottage Grove or from other nearby communities. But with our new housing initiatives, employees can raise their families here in this community – a great benefit for us.”

For all these reasons, according to Nelson, Fort HealthCare will always be a formidable stakeholder in economic development. “Why does the hospital care about economic development? Because we have to! As I earlier stated, a rising tide raises all boats – we all come up together!”

The Vital Role of Nonprofits in Our Community

Fort HealthCare is a nonprofit tax-exempt hospital and healthcare facility, operating with a public service and community-centered mission. While there are numerous “stakeholders,” there are no shareholders. Surplus revenues are reinvested into the hospital to provide services, acquire equipment, and support community programs. Tax-exempt status requires such institutions to provide broad community benefits, including financial assistance and care for those unable to pay.

Nelson expanded on the vital community-based role which Fort HealthCare represents. “There are times when the local non-profit sector which includes hospitals, may struggle with the load despite tax-exempt status. But here’s the point: Nonprofits fill gaps in public services for which the community’s property tax revenues cannot afford or provide. Nonprofits are often able to provide jobs and payroll, which in turn provides income for mortgages and housing, which contributes to family stability, and so on.”

“One of the things we recognized a long time ago, very simply put – and that we try to be very basic and very clear about is why we exist - it is for the well-being of the community. We display our Mission and Vision Maps and values throughout our organization. We are not just a hospital - this is not just simply a hospital with doctors. In partnership with the municipalities, other hospitals, our churches – we do not improve the health and well-being of the community by ourselves. So many influences and other stakeholders play vital roles. Your spouse and family, where you go to church, where you go to eat or where you shop, where you go to school, there’s so many influences out there that sustain community well-being.”

“Many of those nonprofit organizations that continually work their visions and missions realize that it’s only by helping each other that we raise a great community.”

“My whole career has been in the nonprofit sector,” Nelson said. “One of the very cool things is observing and participating in the very high level of collaboration among our community organizations. We recognize that by helping each other we go a lot further, faster. Resources are so constrained. You have to figure out how to be efficient in order to sustain community service and a great community. That’s why we help the Homeless Coalition of Fort Atkinson - to help support housing security. That’s why we’re excited about helping them get their start here in the community. That’s also why we help as sponsors of the food pantry. That’s why we’re active and engaged in supporting organizations such as the Fort Atkinson Club, the Hoard Historical Museum, the school districts and their activities, and the school nursing programs. All of this converges for the good of all citizens. It’s the intersection where our purposes find common strengths and opportunities. This is what we do in this community.”

Concluding Note - Fort Atkinson Independent Reporter Supporting Community Progress

One of the central features of Fort Atkinson Independent Reporter’s (FAIR) editorial policy is that local journalism should represent a robust co-partnership with its community and stakeholders equally devoted to shared community progress. FAIR’s effectiveness occurs when readers engage in a higher quality of public and civil discourse and greater sense of civic responsibility. This results in a more effective understanding of community challenges, opportunities, and progress, and a shared role in setting the local agenda.