University of Rochester Medical Center to Apply to State for Major Patient Care Expansion
Project To Ease Overcrowding, Enhance Children’s Care and Enable Regional Growth
October 01, 2007
"Increasing demands for beds due to our concentration of high intensity services such as complex surgical care, transplant and trauma, as well as an aging population, routinely cause us to exceed our current bed capacity."
In response to a need for more patient care space, the University of Rochester Medical Center (URMC) will submit an application this week to the New York State Department of Health for the largest clinical expansion in Strong Memorial Hospital’s history.
The Medical Center is requesting permission to boost its licensed bed capacity by 123 beds, from 739 to 862 beds, adding a six-story tower adjacent to Strong Memorial Hospital. The 330,000-square-foot addition would house 56 beds for Golisano Children’s Hospital, an additional 56 adult beds for Strong Memorial, two floors for imaging sciences (radiology) including a dedicated area for pediatric patients, plus an expanded pharmacy and other support space. Once the tower is complete, the 48,000 square-foot space currently occupied by the Golisano Children’s Hospital would be converted to beds for up to 67 adults.
The proposed expansion, dubbed the PRISM project for Pediatric Replacement and Imaging Sciences Modernization, forms one of the cornerstones of the Medical Center’s proposed 5-year strategic plan. Because of the severity of Strong Memorial’s space needs, URMC leaders will begin the application process for the PRISM while working with the University trustees for final approval of the project and the full strategic plan. Preliminary estimates are that the two-phase project will tally approximately $250 million.
“Increasing demands for beds due to our concentration of high intensity services such as complex surgical care, transplant and trauma, as well as an aging population, routinely cause us to exceed our current bed capacity. For the last several years we have struggled to make room by renovating small numbers of beds. It has not allowed us to provide ready access to the kind of high-quality, private, and respectful care that our patients expect and deserve,” said URMC CEO Bradford C. Berk, M.D., Ph.D. “Nearly everyone knows someone who has been admitted here who’s had to endure long stays in our Emergency Department waiting for an inpatient bed. That’s simply not acceptable for our community or region.”
“The need for this facility is compelling. Additional capacity allows us to provide more appropriate health care, and take advantage of Rochester’s opportunity to build its new economy on the pillars of higher education, health care and biotechnology,” said University President Joel Seligman. Preliminary estimates by the Center for Governmental Research show that the proposed expansion would create roughly 530 construction jobs per year. Staffing estimates for the new tower include another 300 permanent jobs for nurses, social workers, imaging staff, and other support workers.
URMC will begin planning of the proposed facility as it is being approved by the New York State Department of Health and the University Trustees. If approval is received, construction will begin around July of 2009, with completion of the new building in 2012 and renovation of the space in Strong Memorial Hospital in 2014.
Demand Outstrips Space
Over the last ten years, Strong Memorial Hospital has witnessed a steady increase in discharges, along with a rise in the number of patients coming from outside of Monroe County. Today, nearly one-third of its patients travel to Rochester from outside of the area as smaller, outlying hospitals have come to rely on Strong, particularly for patients needing complex, intensive care. Strong Memorial Hospital is the region’s sole provider of a variety of advanced services such as solid organ transplant, severe trauma and burn care, cardiac subspecialty care, and more. In addition, it cares for more indigent patients than any other hospital in the region.
Pediatrics, in particular, has seen real growth, largely in children with complicated health issues who once sought care outside the region. For example, cardiac surgery has grown exponentially, from 103 surgeries in 2000 to more than 300 expected in 2007 – an increase of 190 percent. The PRISM creates a contiguous, family-centered space for these very ill children within the hospital, including dedicated imaging space for children only one floor below the new inpatient unit.
“This project changes the face of children’s health care in our region,” said Nina Schor, M.D., Ph.D., chair of Pediatrics and pediatrician-in-chief at the Golisano Children’s Hospital. “It brings our facilities to the level of the nation’s top children’s hospitals enabling us to attract and retain top pediatric sub-specialists who are in short supply. That creates hope for all the families in our region.”
While demand has escalated, space limitations have prevented the hospital from expanding imaging facilities and equipment, creating delays and inefficiencies. Since Strong’s original radiology department was built in 1970, the number of imaging procedures has risen from 60,000 to over 350,000 per year. Small incremental renovations and program shifts to Highland Hospital have provided brief periods of relief, yet the problem persists, compounded by the need to accommodate sophisticated new machines.
“This expansion is simply not optional, it is vital to the health of our region’s residents and our economy,” said URMC board chair Tom Richards. “We have an obligation to provide the best possible care and to do so we need appropriate facilities. Without it, we lose the chance for vital economic growth in this region.”
“This project is an important element of an orchestrated University strategy not only to propel this institution to new heights, but also to meet our responsibility to play an active role in reshaping Rochester’s economic future,” said G. Robert Witmer, Jr., chair of the University of Rochester Board of Trustees. “We have exciting days ahead and this project is a major step forward for the University of Rochester and our community.”
This expansion addresses what’s needed long-term to manage the growing demand for care at Strong and to decompress space that must be renovated to meet current care standards. For instance, URMC is proposing that:
- all new rooms created in the new PRISM tower would be private rooms, reflecting new standards for managing contagion and privacy;
- in particular, the pediatric rooms would be considerably larger than present rooms, enabling families to stay comfortably with their children;
- each floor is designed with higher ceiling-to-floor heights to accommodate high-tech equipment needs;
- two dedicated imaging floors would create areas for imaging and treatment of children that are separate from adults;
- the pediatric floor would connect directly to the Pediatric Intensive Care Unit which opened in January of 2005;
- simultaneously, Strong is exploring plans to enlarge and relocate the neonatal intensive care unit (NICU) which is a cornerstone of the perinatal center serving the Finger Lakes region. This relocation and expansion is being designed to optimize post-natal care for newborns and their mothers and would be separately funded from the PRISM;
- the PRISM’s foundation will be constructed to support the possible addition of three more stories, creating the flexibility to renovate other aging patient care areas.
The closings of acute care beds at St. Mary’s Hospital and The Genesee Hospital have left Rochester’s five remaining acute care hospitals with only 1,805 total beds – or 2.44 beds per one thousand residents. This is considerably fewer beds per population than other communities in New York, which range from 2.8 beds per thousand to 3.4 beds per thousand residents. Most days, Strong Memorial Hospital now averages 103% of occupancy, meaning that all of its inpatient beds are full and 40 to 60 admitted patients are waiting in its Emergency Department for beds on patient care units.
Given the severity of Rochester’s bed shortage, its hospitals have limited ability to plan for a large-scale calamity. This lack of “surge” capacity would force hospitals like Strong to care for patients in non-patient-care space, sacrificing safety and privacy.
An analysis completed by market assessment consultants Kurt Salmon Associates documents that, with the aging of the population in Monroe and the surrounding 15 counties served by Strong, the need for hospital beds in the region is projected to increase by 171 beds within 10 years, making the need for more inpatient capacity even more acute.
A community-wide effort to examine the issue of bed need, chaired by Monroe County Health Director Andrew Doniger, is currently underway through the Finger Lakes Health Systems Agency. The University of Rochester Medical Center is an active participant in that process.
University leaders say that the expansion would be financed by a combination of philanthropy, borrowing, and reinvestment of hospital equity.
For more information, please visit www.urmc.rochester.edu/prism.