We’ve come a long way since Sumter Regional Hospital was destroyed by a tornado just over a year ago. We have, I believe, largely stabilized the local physician community that all of us depend on for medical care, and I appreciate the patience and community spirit of the fine physicians who are toughing it out with us. We all owe them a debt of gratitude, and our business.

We have launched a fundraising effort that has so far brought in more than $3 million and Sumter County voters last year approved a Special Purpose Local Option Sales Tax (SPLOST) that should generate another $3 million for the rebuilding effort. Further, we are working with our congressional representatives on emergency appropriations to help with our rebuilding effort. And thanks in part to Siemens Medical Solutions, we’ve been able to spread our story all over the world and ensure that we’ll have brand new state-of-the-art MRI when we open our new hospital.

Best of all, we’ve just opened our new interim hospital, which we’re calling Sumter Regional East, and the community reaction has been very positive.

But we still face major challenges and uncertainties in our recovery effort, and I want to use this column to bring the community up to speed.

I’m sure it won’t come as a surprise that our biggest challenge relates to our financial situation. The immediate challenge we face is that before we can sign a contract with a general contractor to begin construction of the new hospital, we’ve got to know that we’ll have enough money to pay for the construction and repay any debt we incur in the process. Right now we simply don’t know that.

After the insurance settlement, the anticipated FEMA and GEMA funding, the SPLOST funds and the philanthropic fundraising, it appears that we will face a $25-30 million capital shortfall on the interim and the new permanent hospital combined — and that could be low. That is largely due to the fact that we had to use property insurance proceeds to pay off over $17 million in outstanding debt on the buildings that were destroyed by the tornado. We are continuing to explore various options to cover the shortfall, but there are limitations and problems associated with each of them. Generally, our options include seeking public funding from the local governments; securing appropriations from the state and federal governments; borrowing the money; securing philanthropic grants, or seeking an outside partner to invest the necessary capital into the construction. Our ultimate solution may be some combination of several of those options.

Let’s look at each option individually.

• Local government funding. Of course, local voters have already overwhelmingly approved a SPLOST that is expected to generate approximately $3 million for the rebuilding effort, and we greatly appreciate that support. Closing the larger gap could possibly be accomplished through the issuance of County-backed bonds which would require the County to either guarantee the financing with a commitment to levy taxes in the event of payment default or to levy a property tax increase to directly service the debt. We have been updating our City and County leaders about our situation and will be formally approaching them to discuss these capital funding options in the coming weeks.

• State and federal funding. We are working with our congressional representatives and with state officials on possible appropriations from both levels of government, and there is some reason to be hopeful — especially at the federal level. Congressman Sanford Bishop, who is a senior member of the House Appropriations Committee, and his staff are working very hard on our behalf, as are Senators Saxby Chambliss and Johnny Isakson. They have all been very responsive to our problem. Congressman Bishop is seeking $13 million in federal funds to help our cause in the next federal budget and our senators will be helping as well. The difficulty in this situation is the timing of the federal appropriations process. We won’t know until this summer, at best, whether we have a realistic chance of securing any federal funds, let alone the amount being requested, and it would be October at the earliest before those funds could be released.

• Debt. Under normal circumstances, we would go to the bank or the bond market for the funds we need for a major building project. To do that, we must be able to demonstrate that we can repay the debt — and right now we can’t do that. Since our interim hospital has just opened, we have no current operating experience upon which to base revenue and expense projections, and without those projections we have no way of predicting how much debt service the hospital can assume. Best case, it will be July or August before we have sufficient trend data to make rational borrowing decisions. Further complicating this picture, of course, is the current state of the economy and the debt market in particular.

• Philanthropic grants. Again, we have already raised more than $3 million through charitable donations from several major foundations and personal donations from the community and elsewhere. While we continue our fundraising efforts, it’s difficult to imagine that capital fundraising alone will enable us to raise the amount of money we need in anything resembling a timely manner.

• Strategic partner. This last broad option would require finding a partner interested in investing in Sumter Regional Hospital. Most likely this would be another not-for-profit hospital or health system in Southwest Georgia, and we have already had very preliminary, exploratory discussions with several such entities. We have found some interest, but this approach, too, will take time and will no doubt involve other challenges.

Some people have suggested simply delaying construction on the new hospital until we can bring our financial strategy into sharper focus, but such a delay would come at potentially a very high cost. FEMA regulations require that the state and federal funds available for rebuilding the hospital be spent within 48 months from the disaster declaration date (March 3, 2007). Since it will take nearly two years to build the new hospital, we obviously don’t have much time to spare.

So, as you can see, we have many issues to be resolved during the next few months. But in the meantime, we are blessed to have a wonderful new interim facility to serve us until we are in a position to move forward on the construction of what will be the newest, most modern hospital in the Middle Flint region.

Since the tornado hit 13 months ago, one of our guiding principles has been to do our best to keep the community informed about the recovery process, including the good news and the bad. In many respects we have made great progress. The opening of Sumter Regional East was a huge milestone. As challenging and uncertain as the road ahead remains, I remain confident that we have the strength, faith and resolve to finish the job. We appreciate the community’s support and welcome your feedback.