Somervell County commissioners are one step closer to finalizing matters on the transfer of Glen Rose Medical Center from a foundation to a hospital authority.

Commissioners approved several agenda items in relation to the hospital authority, including two lease assignments and transition agreements, one for the  hospital and one for the nursing home, between the authority, Somervell County and Glen Rose Medical Foundation, Inc., amended and restated lease agreements for the hospital and the nursing home between the authority and the county, a ratification of all applications, filings and notices made or given to date to prepare for or facilitate the transition of the hospital and nursing home, and authorizing the county judge to execute agreement on behalf of the county.

Somervell County attorney Mike Dixon said the transition came after several catalysts for the foundation board, including the economy, the loss of a physician and the national healthcare crisis.

"Thankfully the foundation came to the county before it became (too bad)," Dixon said. "It was kind of a perfect storm."

Dixon, who was a key player in drafting the transition documents, said the proposal will ultimately place the control of the hospital in the hands of the public once again on two levels. The hospital authority will serve as one level and the county will serve as the other.

"In order to get (monetary) help from the county, the hospital authority is going to have to present a significant amount of documentation to justify it," Dixon said. "It will give you more control and a better understanding of what is going on."

Dixon also said as the hospital authority moves forward there are several things it should consider, especially its relationships with physicians.

"The hospital doesn't employ the physicians," he said. "They practice at the hospital but aren't under the management of the hospital. (The authority should) provide some management support services."

Dixon said among the support should be assistance from the authority if a physician is operating during a negative cash flow period. The money lent would be repaid during a positive cash flow period.

"The whole process fits together like a big puzzle," Dixon said. "The hospital can't work without the physicians and the physicians can't work without the hospital."

The county was also required to approve a holdback amount to cover expenses during the transitional period, which the county will retain if not spent. The amount was approved at $25,000.

"I am surprised at how well this hospital actually does in not a high populace area," Dixon said. "For you to have a hospital that offers this level of care, you won't find that anywhere else in the state."

Commissioners had few questions during the explanation from Dixon, but they had many thanks.

"Thanks to all the parties for a very hairy week last week and putting all the pieces together," Commissioner Mike Ford said.