The Washington Healthcare Corporation has resubmitted its ambitious plan for a $70 million expansion of the Washington Hospital Center, the largest hospital building project in the District's history.
The plan is a slightly scaled-down version of a $74.6 million plan that the staff of the District's health planning agency rejected in September as being too expensive and unnecessary because of the city's growing number of unused hospital beds and the hospital center's dwindling occupancy.
The new plan is about $5 million cheaper and trims a proposed bed tower by one floor, meaning that 60 fewer beds would be replaced.
Since the initial rejection, Carl Wilson, the director of the District's health-planning agency, has been promoted and a new director, Carlissa Hussein, hired. The hospital center held a reception two weeks ago for Hussein, who worked at the hospital two decades ago as a registered nurse, according to Stephanie McNeill, director of public affairs for the hospital. "It was a 'come and meet the people' reception," McNeill said. "It's commonly done for people we work with."
The Washington Healthcare Corporation, the parent company of the hospital, also has hired former city administrator Elijah B. Rogers, a close associate of Mayor Marion Barry, as a consultant. Clarence Brewton Jr., director of planning for the corporation, said Rogers is a "consultant on retainer" to the corporation. McNeill said Rogers has worked on "community relations and assisted with financial arrangements" for the corporation.
The project would be financed chiefly by $62 million in tax-exempt industrial revenue bonds that the hospital is seeking from the city. The hospital's application for the bonds was submitted last summer. The remaining $8 million would be provided by the Washington Healthcare Corporation.
"The fundamental need for the project hasn't changed," said Dunlop Ecker, executive vice president of the Washington Hospital Center. "The emergency room and operating rooms are terribly cramped and overcrowded."
The Washington Hospital Center, like other District hospitals, has lost patients as suburban hospitals -- many with cheaper room rates -- have grown in the last two decades. Ecker said the expansion and renovation is "not a magic answer" to the hospital's declining caseload, but "it will help tilt the decline."
Hospital unions, citizens groups, the local Blue Cross-Blue Shield plan and other hospitals opposed the center's initial proposal.
One sticking point was the increased number of private rooms, which cost patients more.
Under the new plan, two-thirds of the rooms would be private. Currently, one-third of the rooms are private.
Ecker said more private rooms will save the hospital money, as some 7,200 room transfers are made each year because of roommate incompatability due to patient condition, sex, age and smoking habits. "The amount of time, effort and manpower is enormous," he said.
Another problem involved hospital employes. The Service Employes International Union, which represents more than 1,200 workers at the hospital under a recently renegotiated contract, complained earlier that the expansion was not needed because the hospital recently reduced about 180 positions, laid off 91 workers and closed 117 surgical beds because of dwindling occupancy.
The 922-bed hospital has a 69 percent occupancy rate if all beds are considered and a 76 percent occupancy rate if its 80 out-of-service beds are excluded, according to hospital spokeswoman McNeill. This is well below the 80 percent level that the planning agency set as a benchmark for facilities wanting to expand. Hospitals throughout the city, which are nearing an excess of 800 beds, have an average occupancy rate of 73 percent, according to the Metropolitan Council of Governments.
Part of the hospital's resubmission is a promise to take 50 of its unused beds out of service, which would improve its occupancy rate. The beds would be "banked" for possible future use and would not be deducted permanently from the hospital's allotment.
The hospital's plan to spend $2.3 million to consolidate the hospital's cardiac services remains unchanged, but the unit's earlier title as a "heart institute" has been dropped. "There were a lot of misconceptions," said Brewton. "People thought we were trying to be like the Texas Heart Institute. We don't have a name for it now ."
The corporation estimated that the original plan would raise patients' bills by $34 a day by its completion in 1989. The increase would be about $28 a day under the revised plan, according to McNeill.
These changes are seen as too slight to make a difference to many who originally opposed the plan.
"I stand on my original statement," said Michael M. Barch, administrator of George Washington University Medical Center, who said last fall that the 26-year-old hospital was too young to be overhauled. "I don't see that the plan's modified at all."
John L. Green, an executive vice president of the Washington Healthcare Corporation, said the revised project has been "well received" by the District's planning agency. "After the first application was submitted," Green said, "we received some 270 questions to answer. This time, there are 20 questions to answer."
Margaret Graves, an administrator with the District's health planning agency, said a new staff report on the revised project should be ready by mid-January. "We can't characterize it until we receive all the information we've requested," she said. The project will be reviewed at an agency committee meeting on Jan. 24, and if approved, will receive a final vote in February from the State Health Coordinating Council.
Under District law, all health facilities spending more than $600,000 for a new service must win approval from the city's health planning agency.