By Tom Crabtree, MD, FACS, Chair, Telluride Hospital District Board

 

Over the past year, a tremendous amount of work has gone into determining what the future of healthcare should look like in Telluride. As Chair of the Telluride Hospital District Board, I want to share where that work stands today, some of the challenges and opportunities we are considering, and, importantly, how our community can be part of the conversation as we move toward a comprehensive plan.
For many years, the assumption was that the Telluride Medical Center would eventually need to leave its current location on West Pacific Avenue. We had been told that the property would no longer be available to us after our lease expired, which meant planning appropriately focused on relocating the Medical Center to the Society Turn property.

That changed earlier this year when the owners of our current property, Newmont Mining Company, indicated that a long-term lease may be possible. As I shared at the time, that development created new options that we believed were worth seriously evaluating.

Rather than continue down a path simply because it was the path we had been on, the Board decided to take the time necessary to understand whether a different model could better serve our patients and community.
This work has also benefited from the involvement of community members with extensive experience in the healthcare industry, whose expertise and commitment to Telluride have helped inform the planning process.
What we are trying to solve

Our current facility has significant limitations. Much of the space does not meet modern healthcare facility standards, and the building was not designed to accommodate today’s technology, diagnostic equipment or models of care. Simply staying where we are without making significant changes is not a long-term solution.
At the same time, building a new facility does not by itself solve the larger challenges facing rural healthcare.
The economics of operating an independent rural medical center are increasingly difficult. Costs continue to rise. Reimbursement remains constrained. Recruiting and retaining healthcare professionals is challenging. Small independent providers also do not have the scale, infrastructure or resources available to larger healthcare systems.

The Medical Center is in a stronger financial position today following operational improvements and increased community tax support. Our responsibility now is to build on that progress and develop a model that can remain sustainable over the long term without asking taxpayers for additional support.
That means this process has become about much more than determining where to put a building.
We have been looking at the services our community needs, where those services should be delivered, how we improve access to specialty care, how technology and telehealth can expand what is available locally, what type of facility is required, and whether a relationship with a larger healthcare system could strengthen the Medical Center while preserving appropriate local control.

Where the plan is headed
The direction that has emerged from this work is a two-site model: maintaining and improving primary care in Telluride while developing a new freestanding emergency department at Society Turn.

Under this concept, the current Telluride location would continue to serve as an important center for primary care and other appropriate services like behavioral health and concierge medicine. The Society Turn site would provide a modern facility designed specifically around emergency and diagnostic care, including 24/7 emergency services, imaging and laboratory capabilities, a helipad and the infrastructure needed to support mobile diagnostic services. The two-site approach allows us to preserve convenient access to primary care in town while creating a modern emergency facility designed for the needs of our community.

We have not yet determined the final size or cost of the Society Turn facility. Before we can meaningfully engage architects and developers on a design, we need to confirm the programming: what services will be provided there, what spaces those services require, and how the facility needs to function. Those decisions will ultimately drive the square footage, design and cost.

The land at Society Turn is being donated through a generous contribution from Genesee Partners. If you have driven by the property recently, you may have noticed work underway. That work is being completed by the landowner and includes site grading and utilities associated with the approved PUD. It is not construction of the new Medical Center.

One question we are beginning to explore is whether some type of healthcare presence in Mountain Village could make sense. At this point, the idea is purely exploratory. Before we start designing a solution, we need to better understand the need we are trying to address. No decisions have been made about programming, services or location.

We have also been exploring a potential partnership with a larger healthcare system. A partnership could provide resources that are difficult for a small independent medical center to develop on its own, including better technology, billing and revenue-cycle infrastructure, payer contracting, recruiting support, specialty access, telehealth and improved coordination when patients need to be transferred elsewhere for care.
At our public October Board meeting, the Board voted to move forward with a Letter of Intent (LOI) with CommonSpirit. This is an important next step in evaluating a partnership.

The coming months will involve a robust due diligence process to evaluate both the desirability and feasibility of a potential partnership. This includes understanding the financial and operational implications, the resources and support CommonSpirit could provide, and important considerations around local governance, clinical decision-making, patient choice and maintaining the character and responsiveness of healthcare in Telluride. This process will help us determine how a partnership will strengthen the Medical Center and serve the long-term interests of our patients, staff and community. Input from Medical Center staff will be an important part of this process, along with opportunities for community input. Any decision to move forward would be made by the Board through its public process.

What has been decided, and what has not
I think it is important to distinguish between the direction of the project and a final plan. We have made substantial progress, but there are still important pieces to complete.

We are continuing to refine the facility program, understand renovation and construction costs, work through the details of a potential healthcare partnership, and develop the financial model that will support the Medical Center over the long term.

We also need to make sure the pieces work together. A facility plan cannot be developed independently of the operating model. An operating model cannot be separated from the services we want to provide. And none of those decisions can be made without understanding what they will cost and how they will be supported.
Earlier planning anticipated that the project would advance over several years, with design and construction planning continuing through 2027 and construction and activation following thereafter.

We plan to take the time to answer questions now than rush into a decision that our community will live with for decades.

We want to hear from the community
Community participation is incredibly important. The Telluride Hospital District Board is a public board, and our regular meetings are open to the public. The Board generally meets on the fourth Thursday of each month at 8:30am MT, with both in-person and Zoom participation available. The November 2026 meeting is scheduled for November 19, and the December meeting is scheduled for December 10. Meeting notices, agendas and participation information are available through the District’s Board Meetings page . Each regular Board meeting includes an opportunity for public comment.

I encourage people who have questions, concerns or ideas about the future of the Medical Center to participate. In addition to public meetings and opportunities for public comment, members of the Hospital District Board are available to answer questions and hear directly from community members.

There has understandably been a lot of interest in how and when decisions about the project are being made. While a great deal of research, analysis and discussion goes into preparing the Board to make informed decisions, decisions about the project are made by the Telluride Hospital District Board at public Board meetings. As the project advances, those decisions will continue to take place through that public process.

We want to understand what matters most to our community as we consider the final model: which services are most important to have available locally, how people think about access to care, what concerns they have about a two-site model, what they want us to consider in evaluating a healthcare partner, and what they believe we should be thinking about as we plan for the next generation of healthcare in Telluride.

Public input does not mean every person will agree on every decision. Healthcare is complicated, and there are real financial, operational and regulatory constraints within which we have to work. But hearing from the people we serve is an important part of making informed decisions.

The work ahead
Our goal throughout this process has been straightforward: identify the best path forward to meet the healthcare needs of our community for generations to come.

Getting there requires us to look carefully at the facility itself, the services needed, where and how those services are delivered, and the partnerships and operational model necessary to support them over the long term.

We have learned a great deal over the past year, and the picture is becoming considerably clearer. There is still work ahead, and there will be more information to share as the remaining pieces come together.

When I wrote to our Medical Center staff earlier this year after learning that our existing location might remain available, I said that one task was paramount: whatever we decide must serve our community, our staff and our patients. That remains the standard by which the Board is approaching this work.

This is an exciting time for healthcare in Telluride. Together, let’s figure out how best to care for each other over the coming years.

Tom Crabtree, MD, FACS Chair, Telluride Hospital District Board