The Green Mountain Care Board exercised its authority over hospital construction projects for the first time last week, unanimously approving two applications worth almost $30 million.
The board OK’d Fletcher Allen Health Care’s request for a new mother-baby unit and medical research center worth $15.8 million, and it gave the go-ahead to Gifford Medical Center in Randolph for a new nursing home and associated hospital renovations valued at roughly $12 million.
The Legislature gave the board the power to approve or deny what are known as Certificates of Need for hospital capital improvements, and it received that authority in 2013. Previously, that power belonged to the Department of Financial Regulation.
Fletcher Allen’s maternity unit is currently located in two aging structures — one constructed in 1941 and another in 1960.
Al Gobeille, who chairs the Green Mountain Care Board, said Fletcher Allen showed an evident need to upgrade the facility.
“What’s the impact on the ratepayer? The $15 million price tag will not adversely affect rates; it can be done with cash on hand and in donations,” he said. “I agreed that the current mother-baby unit being far away from the point at which babies are delivered is not the best way to care for people, especially mothers and babies.”
The new 28-bed, 14,724-square-foot unit will replace a 33-bed, 12,281-square-foot unit. The older unit is comprised of nine individual rooms that lack toilets and 12 double rooms with no accommodations for families. By contrast, the new unit will feature 25 individual rooms and three “boarder” rooms for discharged mothers with babies still in the hospital.
The first phase of the project will move the clinical research center out of the hospital’s Baird 7 building and into a space previously occupied by an oncology unit. The hospital will then expand the building by about 3,000 square feet, and move the maternity unit there. The project is slated for completion in 2015 and has not yet gone out to bid.
Dave Keelty, Fletcher Allen’s director of facilities planning and development, says the single rooms will allow the hospital to provide “more care in the room, rather than moving babies and mothers around.”
“We have some situations where … mothers are using communal showers,” Keelty said. “We think it’s a big improvement in the patient care environment.”
The new unit is part of a larger set of capital improvements worth an estimated $120 million.
Like Fletcher Allen, Gifford is building a new facility that is part of a grander plan.
Joe Woodin, president of Gifford, says the hosptial’s 30-bed nursing home has had a waiting list since it opened. “For 20 years we’ve had a waiting list,” Woodin said. “We have never not had a waiting list, and we’ve had this challenge of how to address nursing home needs in the community.”
Gifford’s nursing home provides all 30 of the nursing home beds in Orange County, and Orange County has the fewest overall number of beds of any county in the state. According to Gifford’s analysis of state and federal data, the Orange County also has the fewest nursing home beds per 1,000 Vermonters over the age of 65 at six. Addison County, which is only one notch up, has 19 beds per 1,000 Vermonters older than 65.
The new nursing home will also have a capacity of 30 beds. Woodin says that it’s only phase one of a larger campus, which will include assisted and independent living facilities next to the hospital. His team expects the entire campus to be complete in 15 years.
The Green Mountain Care Board projects that Gifford will run a more than $600,000 loss on the current nursing home in 2013 and a similar loss in 2014. In the new location, the board expects the hospital to run an annual operating deficit for the nursing home of about $1 million over the subsequent three years.
“Nursing homes are very expensive to manage,” Woodin said.
Gobeille says it’s common for nursing homes that are part of hospitals to run at a loss. In the case of Gifford, the hospital will absorb that cost, or shift it to other parts of the budget.
Correction: The story originally stated that Gifford has the fewest number of nursing home beds per capita. The correct data point is the fewest number of nursing home beds per 1,000 Vermonters older than 65.