Firm unveils hospital floor plans
GOLD BEACH, OREGON - Oct. 10, 2014By Jane Stebbins, Curry Pilot staff writer
A design team outlined to Gold Beach residents Wednesday night the floor plans of the new hospital they are in charge of building in that city.
The new building, almost double the size of the existing facility, will feature four stories at the west end of the property, an array of new technology the current hospital lacks, a dedicated helipad and space for 100 vehicles.
The existing hospital is more than a half-century old, offers little privacy to patients, is outdated and out of code.
"Its time of usefulness has come and gone," said Steve Wolters, senior vice president of the Wisconsin-based Erdman Health Care Real Estate Solutions. "Codes have changed tremendously. Every space in the hospital you have today does not meet code."
He added that the goal in constructing a new hospital has a "Triple Aim" of providing patient access, quality healthcare and safety for a lower cost, in hopes of "portraying confidence and stability".
The district asked voters to approve a $10 million general obligation bond to build a new one; those funds are hoped to be matched [correction: augmented] with a USDA loan.
According to Sam Goldstein, community programs director with the Oregon office of the USDA, the cost to replace the hospital now hovers around $29 million. The sale of Curry Health Network's Shore Pines, an assisted living facility in Gold Beach, could help the hospital's bottom line to obtain better loan terms. The board has been deliberating its sale in recent weeks.
The new, four-story hospital will be 60,200 square feet, feature 18 hospital beds, two operating rooms, five emergency rooms - three being exam rooms, one for triage and a two-bay trauma room - an array of imaging equipment, a clinic with 10 exam rooms and a cancer treatment floor.
It does not, however, feature the much-needed dialysis facility, Bair admitted.
"I think I've given up the right to speak to that because it is an unfinished (discussion)," he said. "It is not in this building (plan). There might be other opportunities in the future, but not this time."
He said he realizes the anguish dialysis patients experience every week, as they drive five hours round trip - to Coos Bay, Medford or Eureka - for a four-hour treatment, often three times a week.
Bair said the district would need a service whose cost would offset the expenses of a dialysis center, which are often paid for by Medicare and not fully funded.
"A year and a half ago, I thought that would move ahead," Bair said. "Then Medicare reimbursements were cut by 10 percent and that changed the dynamic of the conversation."
The district is not giving up, he said, adding that DaVita, a Medford dialysis provider, might be interested in a co-venture in which the district provides the capital dollars for a center and they would lease and operate it.
The hospital is institutional in appearance, with a wide, wooden-looking band around the third floor and heavy canopies over the entrances. Architectural details are few, to cut down on costs.
"This is not a Cadillac hospital folks," said Gold Beach City Administrator Jodi Fritts. "We're getting a Chevy, and we're glad to have it."
Cascadia's fault
Site plan discussion was segued by Al Davis, an engineer who expressed his concern about earthquakes and tsunamis, which had been briefly discussed in a meeting last May.
Reports available last fall that utilize better technology now depict a higher tsunami inundation line than the old analyses. Those have yet to be adopted by the state, and Erdman is using current state and city codes to design the complex.
"That (new) data is not codified (in state building codes), nor is anyone ignoring it," Wolters said. "The board took it into consideration. How much money do you put into a building? How much do you go beyond what you need? What's the risk?"
"Our environmental review process is complete, and a finding of 'no significant impact' has been issued (by the USDA)," Goldstein said. "They have to make some decisions as to what kind of preventive measures they're going to take. We can't say 'no' if they're following the rules. We have to use the information that's published and available at the time."
Hospital plans put vital mechanical equipment in elevated locations and patients on the upper floors - "Patients are incapable of self-preservation, so we put them as high as we can," Wolters said. Rooms where people don't spend much time - and assuredly not at night, he said - include the cafeteria, administration and kitchen, and will be in the lowest level of the building.
Putting patients in the top floors and getting ventilation and electricity systems at higher elevations increase the chances of survival during an earthquake and tsunami.
"All these issues have been talked about for a long time," Wolters said. "No one was dismissing the potential of a tsunami. No one is taking this lightly. At the end of the day, a lot of decisions have to be made.
"You can spend a lot of time and money to build for a (certain) velocity of water coming at you," he added. "But (how much) money do you spend for something that may or may not happen? It's a trade-off."
Gold Beach Administrator Jodi Fritts agreed.
"Risk assessment? Yeah, we thought about it," she said. "There's a lot of data out there - a lot of data the city, hospital and these gentlemen have (processed)."
On shaky ground
The district board is also under deadline: The state fire marshal and the Department of Health have told the district there are "issues with that building" they will no longer allow to be grandfathered and ignored.
Geological reports did not bode as well as hoped, either, and changes have been made to plans for the foundation because of them.
Erdman opted to build on the west end of the property where the soil is better - although even there, they've dug to 105 feet and found only sand.
"In the beginning, we expected to get a little different material," said Erdman architect Todd Wambach. "It was a surprise to everyone. It's not great stuff; let's put it that way."
In an earthquake, sand is the most vulnerable of soils. The many facets in a grain of sand create "contact stresses" that hold the grains together. If there is enough force in an earthquake, they break. That liquefaction of the soil structure causes the ground to lose all its strength, potentially bringing a building down.
In light of those geotechnical reports, Erdman officials have changed the design of the hospital's foundation.
When presented with the new earthquake and tsunami information this spring, the board decided to thank the state for providing it, and said "they'd consider it" in their deliberations.
Next steps
Erdman officials will continue to work on engineering construction documents, permits and lining up subcontractors for an anticipated ground-breaking next spring. The building is slated to be completed by the end of 2015, with the first patients arriving in the spring of 2016.
Bair said he anticipates hearing from the USDA about the "conditional loan note guarantee" - essentially the loan the district needs to pay for the balance of the cost - in mid-December.
"We feel it's first in the queue because we've been engaged with them for quite some time," Wolters said.
Bair said that, while "there is nothing to make us believe we're not going to get that funding ... there are other funding mechanisms that can get this done."
"This is a big investment for the community," Goldstein said. "A facility in a rural area, especially with an elderly community, is very important."