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Story last
updated at 9:03 a.m. Friday, October 8, 2004
MUSC gets
backing for new hospital
BY
JONATHAN MAZE
Of
The Post and Courier Staff
After two
years of planning, much anticipation and a good measure of anxiety, MUSC's board
learned Thursday that the government will back $401 million in bonds to pay for
a new hospital downtown.
The U.S.
Department of Housing and Urban Development's approval was the final hurdle the
university needed to start construction on the hospital, which will begin Oct.
21.
Marion
Woodbury, special assistant to MUSC President Ray Greenberg, told the
university's Board of Trustees that the 518,000-square-foot hospital will be
open by January 2008.
That may
not be soon enough for some.
Several
board members expressed concern that the university will struggle to manage a
bed crunch in the three years before the 156-bed facility is complete. "You have
to have beds in the hospital," said Dr. Don Johnson, the board chairman. "That's
the heart of the whole engine here."
Dr. John
Heffner, the medical director for the Medical University Hospital Authority,
told the board that in September the hospital averaged 514 patients a day in the
575 beds it has in operation.
That's an
average occupancy of nearly 90 percent, meaning that on many days there weren't
enough beds for the patients who need one, particularly in certain areas such as
the intensive care unit or surgery recovery rooms.
Typically, state regulators say hospitals should expand once they average 80
percent occupancy.
Last
year, the lack of beds forced the university's emergency room to divert certain
patients to other hospitals on 24 occasions, Heffner said. Also, more than 200
patients last year were made to wait an extra day or longer in other hospitals
before they could be transferred to MUSC for specialized treatment.
Along
those lines, moments after Heffner announced the news Thursday to the board, Dr.
Bruce Elliott's pager went off. It was a university-wide alert notifying doctors
that the ICU was full and would not accept new patient transfers.
The new
hospital "couldn't come soon enough," said Elliott, a vascular surgeon who said
the bed shortage is worsening.
Heffner
said the university has taken several steps to ease the problem. These include
discharging patients sooner and more closely monitoring admission practices to
make certain patients truly need hospitalization.
The space
crunch has some worried that patients will start going elsewhere.
As a
specialist, Elliott relies on referrals from other hospitals. If those patients
have to wait days to get in, the doctor doing the referring may direct patients
elsewhere, he said. "I may never get called again," Elliott said. "It may take a
long time to develop a good relationship. It takes a nanosecond to destroy it."
Sarah
King, director of public relations at the hospital, said Thursday that the most
frequent complaint she hears is from patients angry they couldn't get a bed.
Board
chairman Johnson
suggested the university consider converting some rooms to double-occupancy, or
"semi-private" when beds fill up.
"It's
what every other hospital in the community does," Johnson said. "When there is a
need for beds, all of a sudden private rooms are now semi-private rooms."
The
university holds state licenses for more beds than it uses, but over time it
converted all its semi-private rooms for private use. Stuart Smith, executive
director of the Hospital Authority, said the rooms are too small now to hold two
patients along with today's bulkier medical equipment.
The bed
crunch prompted the university to launch plans for its new hospital two years
ago.
In
addition to new beds, the new facility, on Courtenay Drive at Doughty Street
downtown, will house cardiac and digestive disease services while freeing up
space at the existing hospital.
It is the
first of what officials hope is a several-phase project over the next two
decades to replace MUSC's entire hospital.
Construction will start with several months of work to prepare the site,
including the demolition of two wings on the Harper Student Center.
The bonds
will allow the university to spend $276 million on the hospital plus $125
million to refinance existing debt.
The
university needed HUD to back the bonds so it could secure a competitive
interest rate. MUSC's finances are tight, and its reserves still too low after
being drained in the late 1990s, for it to get the best rates without the
government's backing. Consequently, the hospital likely couldn't have afforded
to borrow the money to fund the project without the government support.
Officials
had hoped to get the HUD OK in the spring, but the agency took its time and
asked for changes in the project. The university agreed to do several things to
satisfy HUD: separately fund $58 million for an energy facility and other
infrastructure to serve the hospital; raise its prices by a higher-than-average
8 percent for each of the next few years; and raise $50 million in private
funds.
Despite
the repeated delays, Woodbury, who headed the project for MUSC, insisted
throughout that the agency would come through.
"They did
what they said they were going to do. We've had some stops ... but phase one
will get built," he said.
Jonathan
Maze covers the business of health care and nonprofits. Reach him at jmaze@postandcourier.com
or 937-5719.
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