GPHA Clouds

Building Maintenance under a Lease Contract

We recently got an excellent question from a community member where we operate a leased hospital.  The question was, “Why isn’t GPHA responsible for the cost of keeping the building up if they are leasing the hospital?”  First, I hope my wording and understanding of the question is right.  I believe the question relates to the relatively static condition of a building that has been well maintained for many years, but is having problems related to age and use similar to what my 1996 Lincoln Town Car is experiencing at 150K miles.  Incidentally, my other Town Car was a 1994 with over 230K miles on it and my son just bought it.

Now for the answer…  The buildings that hospitals are operated in are just that, buildings.  Yes they have to meet special criteria, codes and certifications to be eligible to have a hospital operated in them; but in the end, unless an organization is licensed as a hospital in that building it is only a building.

Great Plains Health Alliance (GPHA) leases the responsibility, accountability, and authority to operate hospitals inside of these buildings in 8 Kansas communities as of 12/18/2014.   These leased operations function under 501(c)(3) not for profit status.  In each case the 501(c)(3) organizations exist with a sole purpose of operating the hospital.  The GPHA board is the board of control for each of these hospitals.  They have authority delegated through the lease to operate the hospital.  They have accountability to the local community that is exercised at each monthly local board meeting through the attendance of the GPHA Vice President for Regional Operations in attendance.

Leases for automobiles, homes, and businesses often require regular maintenance – tires, oil, belts, and hoses in the case of the car;  cutting the grass, keeping power on, calling the owner if there is a plumbing or electrical problem in the case of the house;  cleaning, grounds maintenance, day-to-day systems maintenance in the place of buildings.  In every case the terms of the lease dictate the level of maintenance.  You might be interested to know that all GPHA Leased Facilities have a maintenance budget that is intended to keep the buildings in good shape.  Still, there are issues that are present or that come up with age and use.  Roofs, boilers, and fire alarm systems are just a few of many issues that regularly throw this budget out of whack.

Actually, the hospitals (you will notice that I use hospital and GPHA synonymously at times when we are talking about leased hospitals) works pretty hard to keep the building in good condition, but there are items that fall outside of the scope and responsibility of the hospital.  In the recent case of Phillips County, a focus group was looking at options for meeting the hospital’s needs. I, and all other GPHA staff members, made a point not to participate or attend any of these meetings.  The reason was to be sure there would be no confusion that GPHA was pushing for any one of the potential solutions.  The solution needs to be the community’s solution.  We will operate the hospital in a way that will be best for patients, community, and staff in as sustainable fashion as possible given the realities of our environment. In short, we operate the hospital to the best of our abilities, guided by the wants and needs of the community as well as the expertise of GPHA and hospital staff.

Les Lacy



Les Lacy is a Regional Vice President for Operations at GPHA. If you have questions for Les, send him an email at


Posted by Aaron Miller on January 22, 2015 in GPHA Hospitals, Healthcare Improvement.


2 thoughts on “Building Maintenance under a Lease Contract”

  1. Dave Engel says:

    Very well stated Les…

  2. Kelly Vanderplas says:

    Thanks for this explanation, Les.

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