St. Agnes joining Hospital boom

$160 million plan to include expansion, repairs over 6 years


Joining a construction boom among hospitals nationally and locally, St. Agnes Hospital announced yesterday a $160 million expansion and renovation to be completed in three phases over six years on its Southwest Baltimore campus.

The project will include a new tower to house nearly two-thirds of the beds in the current hospital, which is more than 40 years old. St. Agnes expects to complete detailed plans for the tower over the next year, with construction to be completed by 2011. Plans call for it to include 192 beds, replacing all the regular medical-surgical beds in the current hospital.

Remaining in the main building after the construction will be 116 beds, including the critical care and intensive care units, which were rebuilt about a decade ago. Maternity rooms will be updated as part of the first phase, a $14 million project begun this week. The rest of the main building will be adapted for other uses.

The announcement comes at a time when construction equipment seems almost as common at hospitals as MRI machines.

"It's the most significant expansion and replacement of hospitals since [the period after] World War II," said Richard Wade, senior vice president of the American Hospital Association.

Hospitals nationally spent $14 billion on construction in 2003, up from $9 billion in 1999, according to the U.S. Census Bureau, and Wade said the trend is expected to continue through the rest of the decade.

The Maryland Health Care Commission, which regulates hospital construction projects, estimates that it will have reviewed $2.7 billion in capital projects in the three years ending in 2005, compared with $734 million approved from 2000 to 2002.

Nationally, hospitals built rapidly in the post-World War II period, as federal construction aid became available and as suburbs grew, Wade said. Now, that generation of hospitals is being replaced or extensively renovated.

In Maryland, the need and ability of hospitals to do construction projects has been driven by an increase in occupancy in recent years and an adjustment in state-regulated hospital rates to allow hospitals to generate funds for capital projects, said Pamela Barclay, deputy director of health resources at the Health Care Commission.

At St. Agnes, the number of admissions increased from 19,942 to 22,302 from fiscal year 2000 to fiscal 2005, and the number of emergency room visits from 73,280 to 82,400.

Kenneth Bancroft, chief executive officer at St. Agnes, said he initiated a planning process in 2002 with the hospital board.

"Our facilities were about 40 years old, and we had outgrown them," Bancroft said.

"Many of the hospitals in Maryland were built at about the same time, and the average age is about 40," said Nancy Fiedler, executive vice president of the Maryland Hospital Association.

In the Baltimore region, the Health Care Commission approved this month capital projects for $210 million at Anne Arundel Medical Center in Annapolis and $124 million at Baltimore Washington Medical Center in Glen Burnie. Last year, Johns Hopkins began an $800 million-plus project - the largest construction project ever at a Maryland hospital - which will replace half its facilities.

Projects under review include a preliminary application for $400 million from University of Maryland Medical Center, expected to undergo revisions, and projects for $72 million at Howard County General Hospital in Columbia and $28 million at Carroll Hospital Center in Westminster.

Outside the Baltimore region, the commission approved this year a $235 million replacement hospital for Washington County Hospital in Hagerstown and is reviewing a $323 million proposal for a new facility to replace both hospitals in Cumberland.

Many of these projects share key elements with the St. Agnes plan. Single rooms are replacing semiprivate ones, with an eye to meeting consumer preferences and better controlling infections. Rooms are getting larger, as hospitals use more equipment and involve families more in care.

Outpatient facilities are being expanded. Outpatient care has gone from slightly more than 10 percent of hospital revenues in 1980 to about 30 percent in 2002, according to American Hospital Association figures. Many renovations also are being used as opportunities to group added-on outpatient services with similar impatient care; St. Agnes will be bringing together different types of cardiology in one location.

And emergency rooms are being enlarged. "We used to try to get people not to come to the emergency room if it wasn't an emergency," said Wade. "We lost the battle."

The first phase of the St. Agnes plan, begun this week, will include replacement or expansion of its emergency department, cancer center, cardiology unit and operating suites in addition to its maternity unit. A second phase, to begin in the summer, will add a 500-car garage for $7.2 million. Both phases should be completed in about 18 months. The third-phase inpatient tower will be behind the current main hospital building, which faces Caton Avenue.

Founded in 1861 on Lanvale Street in Baltimore, St. Agnes moved to its current campus in the 1870s and has been there since.

William C. Greskovich, vice president for operations, said St. Agnes would be kicking off a campaign to raise $20 million to $25 million for the project. The rest will be financed with the help of Ascension Health, the 60-hospital system that is St. Agnes' parent.

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