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The new three-story wing would cost $40 million and include more
than 50 beds in an expanded emergency room, intensive-care unit,
telemetry unit and penthouse obstetrics area. The target
completion date is 2008, but the timing would depend on approval
by the state and other factors.
The idea is to position the 105-bed
nonprofit community hospital to meet the needs of
Placerville-area residents as the region continues to grow and
older people require more healthcare services.
The plan also seeks to recoup business
lost to a rival surgery center in town and to woo back patients
who now go down the hill to Sacramento for care the local
hospital does not provide.
The system issued $50 million in bonds
late last year to help pay for the plan and has $45 million in
cash to help with financing. With a BBB-plus rating from Fitch,
the small community health system has a better bond rating than
California.
Marshall Medical, a community health
system with more than 150 affiliated doctors and more than 900
full-time employees, reported net income of $4 million on
revenue of $268 million in its fiscal year ended Oct. 31. It
operates outpatient centers in Cameron Park, Placerville and
Georgetown, and will open a clinic in El Dorado Hills in
February.
"This is a huge investment in the
community for a hospital our size -- and a little scary, given
how unsettled the healthcare industry is," said hospital
administrator James Whipple. "But the community needs it."
So does the hospital, if it expects to
remain competitive.
Rivals are building too
Kaiser Permanente has preliminary
plans for a 50-acre campus in nearby Folsom that could add more
than a million square feet of medical space over the next 25
years. Its development plan includes a 430-bed hospital to be
built in three phases, an outpatient surgery center and four new
medical office buildings, depending on membership growth in the
region.
Catholic Healthcare West, parent
company of local Mercy hospitals, is spending $15.8 million to
expand the emergency department at its Folsom hospital, which is
also down the hill from Placerville. Construction is to start
next year and finish in 2006.
In a clear sign that patients want --
and will drive to -- new facilities, the number of births at
Marshall Hospital dropped precipitously after Mercy Folsom
opened an expanded birthing center in 2001.
It's a medical arms race, and Marshall
may have an edge.
The small health system has money and
the ability to move fast, so Marshall might be the first in the
area to have high-tech equipment in place such as all-digital
mammography. And Marshall's $100 million development is a
five-year plan that could put the hospital on solid footing
while its bigger rivals crank through a more cumbersome internal
approval process and a longer building schedule.
"People think of us as a Band-Aid
station, but a lot of times, we have better equipment than the
big guys," Whipple said.
"They've got a couple of things going
for them," agreed Robert David, regional vice president for the
Hospital Council, a trade group. "They are locally managed and
controlled. They are doing this in a time of cheap money, so it
makes sense to stretch a bit. The demographics up there are
terrific. They have Bay Area retirees and dot-com folks with
change in their pockets. It's a great place to live and growing
like a weed."
The Marshall plan includes a bunch of
projects, some recently completed, some in the works and others
still on the drawing board.
Get surgery back
One of the first elements, an $11
million surgery center, opened in Cameron Park this month. It
offers general surgery, pain management, orthopedics, urology,
plastic surgery -- and hope that patients who've chosen to go to
a competing center in Placerville will come back to Marshall.
Several doctors linked to the hospital
opened a rival surgery center on Missouri Flat Road in November
2002. It offers orthopedic, gastro-intestinal, eye and ear, nose
and throat surgery.
"It took 40 percent of our business
away," Whipple said. Marshall wants it back, but there are other
reasons for the new center in Cameron Park too: It should reduce
emergency room wait times and make space for expansion of
inpatient surgery at the hospital.
The two-story, 25,000-square-foot
building has a surgery center on the bottom floor and offices on
top. A pedestrian bridge connects the center to diagnostic and
lab services now available at Marshall Medical's Cameron Park
campus.
Winging it
Marshall's development plan also adds
an 85,739-square-foot wing to the hospital, with a four-story
parking garage next door.
The addition would span a ravine
behind the hospital. Twice the size of the stand-alone
obstetrics center initially proposed in June 2002, it would have
three above-ground floors and a basement and cost about $40
million. The $8 million garage would have up to 280 parking
spaces.
A new cafeteria and kitchen would go
in the basement of the wing, a new emergency room on the first
floor would be three times the size of the current one, and a
new imaging department would go in next door.
"We've been up to 26 patients at one
time, with only 15 or 16 rooms and gurneys in the hall," Whipple
said. "We are busier, seeing more patients than ever before, and
they are a lot sicker."
The second floor of the new wing would
include a 12-bed intensive-care unit, up to 10 beds in a new
"step-down" unit for less seriously ill patients, and about 35
beds in a new telemetry unit.
The top floor would be an
all-private-room obstetrics penthouse, five times the size of
the current OB unit at the hospital. Marshall now has four
labor-and-delivery beds and eight postpartum beds.
Talk of beefing up obstetrics goes
back years. The number of births at Marshall dropped almost 30
percent from 1990 to 2002 as Mercy and other health systems
opened new birthing centers. Meanwhile, Mercy Folsom's birthing
business grew by more than 60 percent. The plan now is to
improve services so Placerville families will flock to the local
hospital instead.
Other projects in the plan include:
·
Radiology upgrades, costing $8 million, such as a positron
emission tomography (PET) scan machine.
·
A
second-floor hospital remodel (up to $5 million), including a
new pharmacy, laboratory and conference center.
·
Various building projects, such as a gastroenterology center --
already opened-- and coordinated cancer services, for about $4
million.
·
A
$2.5 million cardiac catherization lab, which opened in early
December.
Marshall Medical is also working with
county health officials and Barton Hospital at South Lake Tahoe
to coordinate health services in the area and improve the public
health overall.
"We don't want to just cut and sew up
people -- but do some prevention," Whipple said.
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