In a state with above-average unemployment, the state's premier hospital system is booming.
WVU Medicine hired 2,228 staff last year, has openings for 699 more and expects further expansion in its high-level specialties.
That follows this week's opening of a new 10-story tower housing its Heart & Vascular Institute.
As the West Virginia economy slumped, this corner of the state's health care industry has been thriving, thanks in part to the Affordable Care Act.
The law, which Republicans in Washington have said they intend to repeal, added $12 million to the hospital's bottom line in 2015, according to WVU Medicine Chief Executive Albert Wright. About 70 to 75 percent of its patients are on government-funded Medicaid or Medicare.
West Virginia is among the nation's poorest states, with median household income of $41,000, unemployment at 6 percent, and 18 percent of its 1.8 million people under the poverty line, according to federal data. It also has one of the highest cancer rates. And a 2015 report said it had the nation's second-highest rate of adult obesity, a condition linked to multiple health problems.
West Virginia University Health System is now now the state's largest employer, with nearly 14,000 people on staff. It received 63,435 job applications last year, but its needs are particular. It's been offering $10,000 hiring bonuses for registered nurses and recruiting from the state's two nursing schools as well as looking out-of-state.
Demand for its hospitals services is at an all-time high. It's anchored by Ruby Memorial Hospital in Morgantown, which has been running at 98 percent capacity, with patients on waiting lists for its 531 beds.
The tower's five new patient floors filled up as soon as they were opened this week.
"There's almost an insatiable appetite for everything we do," Wright said. "We open a bed, the bed fills. We open a clinic, the clinic fills. And the physician's working at 75 percent productivity in no time."
Doctors and nurses in an intensive care nursery provide care for newborns including addictions treatment. Other specialties planned for expansions are women and children's health, cancer, neurology and critical care. The hospital gets many patients from the rural state's smaller hospitals, including the seven in its network, facilities that cannot spend the millions of dollars for the expensive technology used for certain advanced care, he said.
"We have been recruiting intentionally very sub-specialized physicians," he said. "You call WVU and they have somebody who does that."
Most patients come from West Virginia, with increases from all 55 counties as well as some from Maryland, Pennsylvania and Ohio, Wright said. "What I've found, and I've only been here two-and-a-half years, is if WVU does something and does it well, people from West Virginia would prefer to come here."
The hospital was recently ranked sixth among 102 academic medical centers across the U.S. for delivering high-quality care. Among other measures, its rate of hospital-acquired infections, a problem at many large teaching hospitals that often have sicker patients, is low.
The health care industry has high turnover, especially among new nurses, which explains some of last year's hires. However, WVU Medicine added 818 net new positions in Morgantown — roughly half licensed medical professionals — while expanding toward 645 private rooms through tower construction and renovating older space.
As the academic hospital affiliated with West Virginia's land grant university, its job is to take care of anyone who walks through the door, Wright said. If the law known as "Obamacare" were repealed and not replaced, the system "would take a hit," Wright said, providing more free care with no reimbursement. WVU Medicine, "a large financially viable organization," would survive but many smaller hospitals wouldn't be able to take the hit, he said.
But patients would still get the care they need because of the hospital's commitment to its mission.
"We do not say no to care," Wright said. "If we say no, there's nobody else to take care of them."