The struggling economy has amplified care at the Wyoming Medical Center in the first two months of its fiscal year, its chief financial officer said Thursday.

Uncompensated care, written off by the hospital as charity care and bad debt, in July and August amounted to $10 million, Nancy Brandt said.

At this rate, the hospital will write off $60 million in the 2009-10 fiscal year, compared to $40 million for the entire 2008-09 fiscal year, Brandt said.

"This truly is a reflection of the economy, not the Wyoming Medical Center," she said at the monthly meeting of the five-member board of trustees of the Memorial Hospital of Natrona County. The board oversees the lease of the nonprofit Wyoming Medical Center Inc., which offers care for the indigent and county prisoners in exchange for using Natrona County's hospital assets.

The Wyoming Medical Center revised its application for patients seeking charity care, but it has not changed any policies about charity care itself, Brandt said.

The increased demand for charity care has come from people who have lost their jobs or health insurance, she said. "It really is a miracle that the Wyoming Medical Center is able to provide that level of care."

The hospital is still in the black, but Brandt declined to comment further, saying the details of its finances should be discussed in executive session.

In another report, the Wyoming Medical Center will receive by the end of the week a guaranteed maximum price of the proposed improvements to the emergency room, CEO Vickie Diamond said.

The improvements will cost slightly more than $5 million, and will require six phases of construction to minimize disruptions in the emergency room, Diamond said.

The improvements are necessary because of overcrowding that has led to hospital staff and physicians caring for patients in the hallways and lobby, she said.

The Wyoming Medical Center's Sage Medical Group has recruited two new primary care physicians, and a current Sage physician will become a hospitalist, Diamond said. A hospitalist serves as a case manager for patients.

The hospital also has been trying to recruit a second nephrologist (kidney doctor), and an endocrinologist (a doctor of glands such as the thyroid), she said.

Reach Tom Morton at (307) 266-0592, or at tom.morton@trib.com. Read his blog at tribtown.trib.com/TomMorton/blog