The Butler Health System board of trustees had its annual public meeting Thursday night in its new hospital tower amphitheater, and no one came.

After years of annual meetings filled with Butler County residents and elected officials wanting to know what BHS was going to do about the expansion of Butler Memorial Hospital or the construction of a new facility, Thursday night’s meeting echoed in silence.

Health system personnel, administrators and trustees were perplexed, wished each other a “merry Christmas,” and left for home.

Ken DeFurio, BHS president and CEO, said he discussed the success of 2010 with the trustees as well as his concerns about health care reform legislation, which the hospital already is working to adapt to.

“2010 has been a great year (from) the completion and opening of the patient tower, which came in on time and under budget, to the amount of patients we have seen,” he said.

But as federal health care reform initiatives begin to go into effect, DeFurio said the hospital is being asked “to do more and get paid less” as Medicare reimbursements are cut instead of Social Security or defense spending. Assuming the entire reform package remains, it will be phased in starting in January through 2015.

“For a lot of hospitals it will be like the steel industry in the 1980s — adapt or close,” DeFurio said.

BHS and the hospital are in an interesting situation as these reform measures take effect.

“First, we’ve never been paid much because this isn’t a high competition area, so we already know how to do more with less,” DeFurio said.

“We have a platform of physicians that we work with closely. We went ahead and made this capital investment (patient tower) in difficult times and got it done, but I think hospitals who waited are going to have a tough time making the decision to make capital investments this large and an even tougher time finding the funding for them.

“Plus, as an independent hospital, we can move quickly to make decisions without too much angst, and a lot of larger systems aren’t as nimble as we are,” he added.

“We are a high value provider, that gives high quality health care at a reasonable cost.”

Anne Krebs, chief financial officer, presented the fiscal data to back up DeFurio’s comments.

The health system’s total expenses for 2010 are $220 million with $234 million in revenue. That will allow $14 million in excess revenue to be reinvested in programs and technology.

Over the past 10 years, Krebs pointed out, the health system has had growth in these areas:

n 40 percent in admissions with 16,463 in 2010.

n 26 percent in Emergency Department visits with 43,772 this year.

n 60 percent in surgeries with 19,370 this year, close to 10,000 of those done through outpatient visits.

n 59 percent in outpatient visits to 465,601 this year.

n Net patient revenue from $92.9 million in 2001 to $196.7 million this year

Regarding employment, the health system now tops 2,000 workers. Krebs added the health system has invested about $1.1 million in training and education of employees.

Krebs said the health system does not expect in 2011 to report the amount of surplus revenue it has over the past decade because it will begin to pay the debt service on the $150 million tower. However, about half of the construction expenses already were paid during building project, she said.

The health system also has seen a steady increase the amount of free or subsidized care it provides. That is up to $13.6 million in 2010 from $12.7 million in 2009.

DeFurio said, “We had a great year in 2010 and we hope to continue that trend in the years to come. We have the facilities and the staff to carry us into the future.”