04/16/18 — Public meeting for $48M hospital expansion not well attended

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Public meeting for $48M hospital expansion not well attended

By Steve Herring
Published in News on April 16, 2018 5:50 AM

It took less than 15 minutes Friday morning for Wayne UNC Health Care officials to state their case for spending nearly $14 million more than initially approved to expand and renovate surgical and endoscopy space.

The project, originally budgeted for slightly more than $34 million, is now expected to cost just under $48 million -- 24 percent over budget.

Hospital President and CEO Janie Jaberg and Dr. Anthony Bruno, chief medical officer and vice president of medical affairs, were the only two to speak at a certificate of need public hearing.

Held in the Wayne County Public Library's Gertrude Weil Auditorium, the hearing was officiated by the state Department of Health and Human Services.

It was attended by five people -- all representing the hospital. No written comments were submitted.

State law prohibits health care providers from "acquiring, replacing, or adding to their facilities and equipment, except in specified circumstances, without the prior approval of the Department of Health and Human Services."

Prior approval is also required before certain medical services can begin.

The intent of a certificate of need is to restrict "unnecessary increases in health care costs and limits unnecessary health services and facilities based on geographic, demographic and economic considerations."

Jaberg provided a brief history of the hospital calling the project an example of the hospital's commitment to providing quality health care to the community.

The existing facility has been well maintained, but has aged significantly, she said.

It has been forced to accommodate multiple services of size and scope that were not contemplated during the original design of the facility, she said.

The original certificate of need was filed in June 2015, for just more than $34 million and was approved by the state.

"During the subsequent planning we determined the costs in the CON were underestimated," she said. "Specifically the architect estimated construction cost at $235 per square foot when the actual cost now is expected to be approximately $308 per square foot.

"These costs have increased due in part to additional electrical and infrastructure requirements not anticipated with the original CON."

Also, soil borings identified unforeseen needs for enhancements to the structural system including a deeper foundation, additional concrete for lateral support and a crawlspace, Jaberg said.

Estimated equipment costs also changed for several different reasons, she said.

It was decided it would be prudent to equip all 13 operating rooms, instead of just the two in the original plan, with technology to integrate the surgical environment with select surgical/medical equipment so that all rooms can be used interchangeably, Jaberg said.

Rather than hold up construction that is nearly 50 percent complete the hospital is seeking approval to spend the additional capital to complete the project as intended, she said.

Not doing so is not in the best interest of the patients, Jaberg said.

Bruno said some of the existing operating rooms are too small to accommodate modern technology.

Of the existing 12 operating rooms, six were constructed in 1970, two in 1991 and four in 1992, he said.

"Future surgical trends related to an aging population, a shift from in-patient to out-patient surgical procedures and the rise of chronic conditions all support the need to replace the operating rooms and renovate and expand the entire surgical suite as the demand for surgical services is expected to increase," Bruno said.

The hospital's initial certificate of need allowed for it to spend 15 percent above the original projected cost.

Since the cost exceeds that amount the hospital had to apply for a new certificate of need.

The state has up to 150 days to rule on the request.

Wayne UNC Health Care has taken out variable rate bonds through the North Carolina Medical Care Commission to pay for the project, which is scheduled for completion in late summer of 2019.