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RALPH HALL
Vice President/Facilities Services
Pitt County Memorial Hospital

February 7, 2000

Interviewer: Beth Nelson (Carol Baker, Administrative Assistant, participating)

Beth Nelson: Mr. Hall, what I would like to do is go through your background and some of the history of PCMH.

Mr. Hall: I will start with July of 1973. At that point in time they had designed the new hospital. I would like to give you a little bit of background that has been told to me.

Beth Nelson: Can you first give me a little of your personal background.

Mr. Hall: I was a construction manager at the hospital in Kinston. At that particular time Jack Richardson came over to see me and asked me if I would be interested in coming to Pitt County Memorial Hospital. As I completed the work at the hospital in Kinston, I came to Greenville. Kinston was the first hospital where I had worked. I had come back from the Philippines before I went to Kinston. My wife was from eastern North Carolina and we wanted to stay around eastern North Carolina. I was basically a construction engineer and had experience in industrial engineering and time management. so I started looking at a job in Kinston. I also had a lot of mechanical experience with systems and boilers and chillers and things like that.

Beth Nelson: Where did you grow up, was it South Carolina?

Ralph Hall: I am originally from West Virginia. My father moved to North Carolina in 1950 and I started high school then. He came to Edenton to open up the military base that had been closed for years. That's is how I came to North Carolina. I did go to school at the University of South Carolina for a period of time. After that I married and my wife and I moved around the country for about nine years. I was hired by the County, the hospital, and the architects jointly.

Beth Nelson: I would think that would be fairly unusual.

Ralph Hall: That was indeed highly unusual to work. Yes, I've been the only facility manager this hospital has ever had. That's one of the reasons the hospital looks so uniform. I've supervised 25 construction projects here. That's also the reason there's only one story. Two reasons. One, the land was cheap and two, so you could allow for expansion.

Beth Nelson: Carol, let's hear about your background.

Carol Baker: Well, I started in 1979. I had been an inventory control manager at a sportswear company. I decided one day to turn in my application to the hospital and I received a call that I had an interview with Ralph Hall. I interviewed and before I got back to Farmville they called me and told me the job was mine if I wanted it. I had certification from North Carolina State University in industrial engineering time management and Mr. Hall seemed to think that might have helped me. Actually, I think I am the only one who ever went in that office and wasn't intimidated by the DMS 400 computer system that they had at that time and it was fascinating to me and I just went in there and started asking all these questions and I think that Mr. Hall was impressed with that.

Mr. Hall: We were looking for a secretary and a dispatcher to dispatch work orders and we needed somebody who would understand the technology. Not only did Carol have an industrial engineering background, her husband was also an electrical man so she had some common knowledge of the language they speak. This was a great opportunity for us to bring her in.

Carol Baker: Actually when I came to work at the hospital we were sitting almost in the middle of a cornfield. There was hardly anything out here. I was the only lady in the department. At that time Mr. Hall had Plant Operations, BioMedical Department, Environmental Services, which was Housekeeping at that time, Security, Telephone switchboard, and the front desk. At that time there was me, Mr. Hall and A. C. Whichard. We had less than fifty employees at the time in the whole department and at that time we did everything including construction, special projects and all the day to day activities.

Beth Nelson: What could you see here career-wise that would recruit you to stay?

Ralph Hall: I will tell you that people were taking bets on how long I would stay here after the construction of the project because I was a really well-qualified construction manager used to doing big projects and nobody could see me staying here. I was interested because the hospital continued to grow and it was really an opportunity to stay in one location and see the hospital develop. We had about twenty-five projects that we had to do and so that made the job more interesting.

Beth Nelson: Could you have foreseen that at the time that you had signed on that there would be all this dynamic growth?

Ralph Hall: Mr. Richardson had talked to me at the time about staying on and operating the place but I didn't know whether I would or not. I could not anticipate the growth that we have had here. About the time we got the hospital finished we had other projects with the medical school and we actually added on to the building construction to accommodate the med school. We expanded the Emergency Department, we enlarged the Radiology Department, and we enlarged the Cafeteria and dining area. We added the front section for the med school. We also added on to the Psychiatric Unit.

Beth Nelson: So there were additions in the process before you even finished the main building?

Ralph Hall: You are exactly right. We got a grant from the State for the Rehabilitation Center and we also got the State AHEC grant and we got the Family Practice Center.

Before we get too far along. There is another thing I would like to touch on. Back in 1967--it takes about ten years to do a hospital--there was a move on to remodel the old hospital. At that time it was decided it would be much better interest to build a new hospital. They were depending on a Hill Burton grant to build a new hospital. Just about the time they got ready to build the new hospital, the Hill Burton Grant fell through. So, they loaned them $2 million. The $2 million was a grant that we didn't have to pay back, but, we had what we identified at that time was a $11 million project so they passed general obligation bonds of $9 million and then a $2 million revenue bond and then the County would put in money too.

Beth Nelson: Going back to the Hill Burton situation, I guess you designed the hospital and counted on that $2 million to be in place. At what point did you find out otherwise?

Ralph Hall: I had come from the Kinston Hospital and the Hill Burton people had paid for about three-quarters of that. So we were anticipating that they would give us at least about three-quarters of the money. But it ended beforen we completed the design. So, that left the hospital with the fact they needed that money. The hospital had a $9 million obligation and a $2 million loan which added up to $11 million and that's what we thought we had when we did the hospital. From that when we got the hospital ready to bid and everything the price was coming in at probably around $14 million so we were another couple of million dollars short and we started to raise money. We got revenue sharing, gifts and grants to help out. We put all of that money together to get the total amount of the contract. Then, Margaret Roberts, who was the County Finance Officer, took the money that we had around $11 million and invested that money and she got very, very good returns on that money and earned about $1.5 million for construction which allowed us to actually put back in some of the things that we had taken out. The total construction cost ended up to be $15.9 million.

Beth Nelson: Was the $15 million the cost of the original construction project or the added-on construction project?

Ralph Hall: The final cost of the project was $15,209,949. I have all the receipts and original notes. I have all these scrapbooks and notebooks and you are welcome to come out here and use these at any time. This is probably the most valuable history and I have kept them here. Wayne Williams is welcome to come out here and take a look at everything. I have all of my original hand written notes on everything.

I will tell you that the County and the Hospital Board worked really well together. When we got ready to award the contract we didn't have quite enough money and we were asking the County for the money and Bob Martin really wasn't in favor of doing this but when the time came and we got down in the basement of the old hospital for a meeting, he made the motion for the County to come up with the extra $500,000. And Bob stood over here in the hallway a couple of years ago and said you know I really was not in favor of doing this place but I am real proud of it. I have saved about everything that was written about all of this taking place. The campaign chairman was Joe Pou. He was the one who actually spearheaded all of this business and it is my understanding that the City of Greenville did not vote for the hospital bonds and that the tobacco farmers, and Joe was a man who worked for Wachovia, and he represented the big tobacco guys. By that you can just see who the people were who were involved in getting the committees to build this hospital. In October of 1976 the new hospital was 90% complete. I have just reams of information you can look over. I have budgets, photographs and other things also.

Beth Nelson: What did we have to do to get State approval?

Ralph Hall: We had a 1122 Review. This was sort of like a Certificate of Need. I did have a good lawyer. I had Bill Speight and he was the best lawyer I have ever worked with because he really would tell me how to do what I wanted to do. Bill would always ask what I wanted to do and then he would tell me how I could do it. He was a really great man. He did all of this work which included all the bond issues and all the construction issues over about a five-year period of time and charged us about $36,000.

Beth Nelson: What about when the bond issue was up for consideration. I have heard Jack Richardson say that people would shout him down at meetings.

Ralph Hall: There was a lot of opposition to the revenue bonds and hospital bonds because they had to increase the tax rate. It is my understanding that Joe Pou got them to put 5 cents a dollar on tobacco allotments to build this hospital. It was an increase of 5 cents in the tax rate. This was just on tobacco allotments. They were the ones who kind of swung all of this and that was just told to me as I was not here at that time. Jack Richardson told me about this.

Beth Nelson: You were not here during the fight for the bond issue?

Ralph Hall: No, I was in Kinston. I was not involved. I came here after the bond issue had passed.

Beth Nelson: What do you think has made it a success? Why do you think it has the success it has?

Ralph Hall: One word-Physicians! When I came here in 1973 Pitt Memorial Hospital had a very good reputation for having very high quality physicians and they were already in the mode of being a referral hospital. They had guys like Longino, Vick & Carter, Clement, Deyton & Douglas. We had the Orthopedic Group. Ira Hardy had come into town and brought Neurosurgery to the hospital. Then Al Ferguson and Wayne Kendrick came which brought the kidney dialysis to the hospital and then Emmet Walsh came with Urology. They were already starting to form a nucleus for a referral center here in Greenville before the hospital was built. I think that has been the leading factor in the growth of this hospital. They were high quality physicians and gave high quality of care. Ira was the first Neurosurgeon in eastern North Carolina. We had a good Orthopedic group here also with John Wooten. When Ira came, census went up 20% the first year. In fact, Ira used to catch me in the hallway and remind me that we had a 400-bed hospital here and he had fifty patients at the hospital.

Beth Nelson: Lets go back and talk about you being told to pack your bags.

Ralph Hall: The money was so very tight and we were getting near the end of the project and we gambled. We were running out of money and were scraping the bottom of the barrel and then I normally left town whenever the money ran out and Mr. Gaskins told me I could start packing my bags.

Beth Nelson: We also talked about not wanting local people being displaced by people coming in from outside the County.

Ralph Hall: When we affiliated with the Medical School there was an agreement that the State would give money for the patient beds for patients coming in from outside of the County and so that is when they gave Pitt County a $5.6 million grant to build a new bed tower. When we got ready to build it, the Certificate of Need Section said we didn't need the beds in Pitt County and they would not give us a CON. We had to get Governor Hunt to help us and he helped us to get these beds.

Beth Nelson: You talked about the biggest obstacle was the lack of funding. Please talk about that.

Ralph Hall: The funding we had to get from various places and raise money from the public and donations and those type of things just to get enough money to award the contract and keep the project going. In the earlier years that was really a major problem but as we got started in operations we started gaining some money. We also started building up some reserves but at one point in time we had no reserves and we always had to depend on the insurance check coming in order to pay the bills. It was a very tight situation. I think when Mr. Richardson left here we had $12 million in the bank. We went from that point with no money to at least we had some operational cash. Revenue sharing came along in that period of time and the County gave just about all the revenue sharing money to the hospital.

Beth Nelson: Was that a controversial decision? Were there a lot of people who thought that was not right?

Ralph Hall: It wasn't too controversial but I think some people would have liked to have that money for other projects.

Beth Nelson: Things that were interesting or funny? Can you think of anything like that

Ralph Hall: There was a big ditch in back of the hospital all the way down to Highway 43. It was like 12 feet deep or something like that and it was such a problem for us and the County gave us tobacco allotment money to fill in that big ditch. We had to get money where we could. We never spent money we didn't have. It was around $30,000 and that was the money the County earned off the tobacco allotment.

Beth Nelson: Can you think of any tense moments?

Ralph Hall: Yes, I can tell you about one tense moment. We went up to Raleigh. There was Bill Speight, Charles Gaskins, Jack Richardson and myself. We went to Raleigh to sign the bonds for the $2 million. When we got there they had sent two guys from Atlanta to review that loan and we went up there to sign it and those two guys hadn't even read it. They were saying that they had to read this and we have to do that. I think it was Bill Speight who really chewed them out. They were two very young lawyers and they had never even opened the book to look at the application. We had gone up to sign it. They were representatives from HEW.

Beth Nelson: Tell me about when you got ready to move to the new hospital and the money was tight. The money you hoped to have for furnishings and equipment was tight so you had to paint and patch up what was in the old hospital to get ready to move it to the new. Apparently some money came through at the last minute.

Ralph Hall: What happened was that we didn't have enough money for all the equipment for the new hospital and what we were doing is that we were trying to get enough money to put all new beds and patient room furniture on the first floor. We lacked eighteen rooms of having enough money and I was talking to Mr. Richardson and to members of the Board and Robert Monk asked how much money we needed and I told him it was around $18,000. Mr. Monk said that he was going to take care of that and he sent us a check for $18,000 so that we could have all new furniture on the first floor. We then took the old beds out of the hospital, cleaned them up and painted them to use on the second and third floors. We also got a grant from The Duke Endowment for $750,000. A man by the name of Charles Hite was with The Duke Endowment and he was a real friend of this hospital and got to know several of us and he liked us a lot and came down here to visit.