Hospital CEO outlines 34,000‑sq‑ft replacement plan, warns of state funding risks

Bear Valley Community Health District CEO Evan Rener told the Big Bear Lake City Council on May 13 that the district is pursuing a roughly 34,000‑square‑foot replacement addition to its existing hospital, designed to be seismically compliant and to expand emergency, inpatient and specialty services.

Rener described the fourth iteration of preliminary schematics for land behind the hospital and said the plan includes a larger emergency department, private patient rooms, a two‑bed ICU and shell space to add services over time. He said the building would be designed to meet seismic standards identified in the presentation (SPC5/NPC5) and that site constraints — including power lines — have driven multiple design revisions.

The proposal follows an internal estimate that retrofitting the 50‑year‑old existing building to modern seismic standards would cost about $26 million, prompting the district to favor an addition rather than an expensive retrofit. Rener said the district is still several years from breaking ground and awaits cost estimates from project estimators; he cited volatility in steel, concrete and fuel prices as a near‑term concern.

Rener also warned of potential revenue pressures from changes to state and federal reimbursement. He said recent cuts tied to legislation referred to as "HR1" could reduce hospital funding nationwide and estimated that California hospitals face large aggregate impacts over the next decade. "We are not going to close," he said, adding that the district plans to pursue new programs and revenue streams — including interventional radiology, expanded orthopedics and a retail pharmacy — to offset potential shortfalls.

Rener said the district is pursuing multiple funding avenues, including USDA direct loans for construction and federal rural transformation grants, and that California’s implementation of the rural grant program will determine local opportunities. He also noted the district’s interest in a possible helport (FAA/CALR requirements apply) and that helipad siting has been a technical constraint because of nearby power lines.

Council members asked about obstetrics services, and Rener said delivering babies again at the hospital is not off the table but would require sustaining higher delivery volumes and clinical competencies; he cited the American College of Obstetrics and Gynecology guidance that a program typically needs about 20 deliveries per month to sustain safe staffing. He also answered questions about the district’s timeline, saying the project remains in design and that the earliest break‑ground is roughly five years out.

The district plans to return to the council with further updates on schematics, cost estimates and funding strategies. "We'll keep you apprised," Rener said. "We're going to continue to provide health care to this community and I intend to continue to lead the charge."