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Hospital in Southeast would be half the size of United Medical Center

United Medical Center in Southeast Washington was built in the 1960s. It is set to be replaced with a new hospital. (Michael Robinson Chavez/The Washington Post)

D.C. Mayor Muriel E. Bowser’s plan to replace United Medical Center, Southeast Washington’s troubled public hospital, calls for a new facility less than half its size, according to proposals to be released Tuesday.

The new medical center would be built by the city on the sprawling campus of St. Elizabeths Hospital — a 19th-century psychiatric facility that today is home to a small public hospital for the mentally ill and a large swath of land slated for redevelopment — and would have 106 beds, at a cost of $248 million, according to the reports.

UMC, which sits on the border between the District and Prince George’s County, has 234 beds, according to D.C. Department of Health records.

The reports, prepared by consultants, offer the most detailed picture to date of District officials’ plans for decommissioning UMC and replacing it with a more modern and economically viable facility. Money has been set aside in the mayor’s budget for construction costs, although the D.C. Council could influence the plans as they move forward.

City Administrator Rashad M. Young said in an interview that plans for a new public hospital are framed around the goal of minimizing the city’s involvement. Although the District will probably own the buildings and equipment used at the new facility, it will hand off most other functions to a private health-care company, Young said.

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“The sort of principle here that we’re focused on is D.C. being out of the hospital business,” Young said. “That’s the approach here.”

He said city officials hope to announce a private-sector partner in the next few months, but he declined to name any companies under consideration.

The new hospital would take several years to design and construct, and would probably open in 2023, according to the reports.

Public health has become a more urgent priority for Bowser (D) over the past year.

D.C. lawmakers have grown increasingly concerned about the city’s high rates of infant and maternal mortality. UMC — run from the spring of 2016 until February by a consulting firm owned by political donors to Bowser — has required millions in taxpayer subsidies.

The hospital has also confronted fallout from high-profile lapses in care for obstetric and nursing-home patients who died under questionable circumstances. In August, regulators closed the hospital’s nursery and delivery rooms, citing dangerous medical errors in the care of pregnant women and newborns.

Amid those problems, the D.C. Council opted against renewing the contract of the firm that had been running the hospital, and a new operator was brought in earlier this year.

D.C. Council member and former mayor Vincent C. Gray (D-Ward 7) has accused the mayor of dragging her feet on building a new hospital in Southeast, saying at a recent budget hearing that there should be a faster timeline to phase out UMC.

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City officials hope a new hospital will be able to shed the negative reputation of the current public hospital, which according to a recent report by Huron Consulting Group is not the top choice of adult residents in Wards 7 and 8, despite the convenience of its location. (MedStar Washington Hospital Center is the most popular option in those categories, the report states.)

They also hope the new facility can find a more economically viable formula for caring for a heavily Medicaid-reliant mix of patients.

Money is driving the hospital’s reduction in size. UMC, built in the 1960s, was designed at a time when hospitals offered fewer outpatient services and has more beds than its current business can justify, city officials say.

Young said the city had initially asked for its consulting firm, Healthcare Building Solutions, to prepare plans for a 144-bed hospital.

Those plans were downscaled after confidential discussions with potential partners in the enterprise, he said. “Less beds is what is viable and can be sustainable,” he said.

Young said the new hospital would have an emergency room, but most other details about the services it will provide will have to be ironed out once a private operator is chosen.

A key question will be whether the new hospital offers obstetric and prenatal care. Southeast suffers from infant mortality rates that are dramatically higher than those in whiter, more affluent parts of the nation’s capital.

“We want to have that conversation with our partners, but at this point I see no reason why we would not have obstetrics as part of that facility,” Young said.