Much like every business, the Kingsburg District Hospital is preparing for the worst but hoping for the best when waiting for the state's budget. The hospital has been through many changes from closing its emergency room to borrowing money from the city to help pay its expenses. That money was a bridge loan to help the hospital pay its expenses in September and was paid back within 30 days, president and CEO Doug Skubitz said. Now, the hospital could be looking at borrowing money again.

"We do have a plan and it has to do with going back to the Department of Treasury, which has some emergency funds we will be requesting," he said. "We went to the city government for a bridge loan and we're hoping that is again an option as well as we move forward in preparation for what may come."

Another change the hospital went through is taking on an agreement with Adventist Health.

The six-month contract, which started in October, has brought about some changes to the hospital administration.

"Things have changed in bringing onboard some resources that weren't there before," Skubitz said. "We have a billing office consultant who has done a great job in getting the business office to the next level as far as quicker turnaround times."

Additional accounting people have helped get reports quicker, he said.

After the six months, Adventist Health will re-evaluate the hospital and the needs of the community to determine the next step.

Director of Marketing and Communications for Adventist Health Christine Pickering said the primary role Adventist plays in the agreement is to evaluate the needs of the hospital and the community.

They find the need, she said, and take it to the board of the hospital to see if they want Adventist Health to provide the service.

"There hasn't been much change in the number of employees so far, one to two employees added at the most," said Pickering. "Because the contract primarily is for management and accounting, we are using current staff for most of that work."

Even though this agreement is helping the hospital, Kingsburg Hospital board chairman Pilo Chavez said the hospital is still figuring a lot of things out.

"We're trying to figure things out if the state goes broke in February," he said. "We're trying to stay afloat. Every time we turn around there seems to be a crisis."

By the time the six-month agreement is up with Adventist Health, Chavez said things should be a little clearer.

"We're hoping to get a bunch of final statements completed to give a clear picture to where we stand," Chavez said. "We're hoping no later than April we'll have something finalized."

It's hard to say, though, for a hospital that has survived a lot. For now, it's a waiting game to see what it will have to deal with next.

"At this point it has just caused great concern and we have no idea what's going to be taking place," Skubitz said. "For us, it's back to square one like in July when we ended up borrowing a lot of money. We'll probably go through the same steps as we did in July."