The complex relationship between Natrona County and the nonprofit Wyoming Medical Center Inc., will come under discussion about a lease at the commissioners' biweekly meeting at 5:30 p.m. today at the County Annex at 120 W. First St.

The nonprofit WMC and the for-profit Albuquerque, N.M.-based Ernest Health, Inc., have built the Elkhorn Valley Rehabilitation Hospital at 5715 E. Second St. to provide intensive therapies for patients recovering from stroke, head and spinal cord injuries and other illnesses.

The 48,000-square-foot, 40-bed hospital is scheduled to open by spring 2008. It will offer a wide range of intensive services including physical, occupational and speech therapies.

Real estate developers Bill Luker and his late wife Betty donated six acres for the hospital.

The hospital and Ernest Health have shared costs for the $16 million building, paying $4 million in cash and financing the rest. The Wyoming Medical Center will pay $1 million as its cash share and as a pledge for the loan.

That's where the matter can be complex, especially about a lease needing approval by the county commissioners.

Natrona County owns the hospital assets - worth about $200 million - leased by the nonprofit Wyoming Medical Center Inc. The rent, in effect, paid by the WMC consists of caring for indigent patients and prisoners at the county jail. The lease is overseen by a five-member board of trustees - appointed by the county commission with the consent of the WMC's own board of directors - of a legal entity named the Memorial Hospital of Natrona County.

The WMC occasionally comes into possession of real estate, and state law requires it to deed the property to the county.

The WMC will transfer the six acres to the county by the end of the current fiscal year, Commission Chairman Jon Campbell said Monday.

Meanwhile, the joint venture rehabilitation hospital will begin caring for patients and making money for both Ernest Health and the WMC.

The lease before the county commissioners today addresses some of the financial intricacies since the county owns the land and has an interest in this asset managed in part by the Wyoming Medical Center, Campbell said. "It is an unusual (arrangement)."

WMC Board Chairman Steve Chadderdon said a concern exists about to where and how the income from the rehabilitation hospital will flow.

"The discussion is where revenue from that lease will go," Chadderdon said.

Reach Tom Morton at (307) 266-0592, or at Tom.Morton@trib.com.