Aging hospital requires costly upkeep

By Nelson Sigelman - July 6, 2006

For chief executive officer Tim Walsh, there's nothing unusual about managing the Martha's Vineyard Hospital's leaking ceilings. The remedy is an arrangement of buckets in the hallways.

But not every problem can be dealt with so simply and inexpensively while waiting to break ground on a new hospital building. Some things demand immediate and expensive attention regardless of the short-term benefits or the future building schedule.

The hospital recently lost one of the two vacuum systems used in the operating rooms to provide suction in the course of an operation. The system is designed to be redundant so that there is always a backup. With one pump down the hospital was forced to bring in portable vacuums while waiting to replace one system at a cost of approximately $30,000.

"That one was particularly bothersome because it is not going to move to the new building," said Mr. Walsh. "That is just money out the window."

The operating room air conditioning systems are another drain. "The guys we have working on it are terrific and work hard on it," said Mr. Walsh. "But we are going through it piece by piece." One consolation is that because the building will be used for office space in the future any heating and ventilation repairs would be of some benefit.

Another big blow came two weeks ago when the air conditioning unit in the Windemere nursing home and rehabilitation facility died. Mr. Walsh said the hospital was lucky enough to locate a portable 100-ton condenser in New Jersey and have it installed last week.

That temporary fix is costing the hospital about $11,000 per month. The unit that failed is located on the roof and Mr. Walsh said there is some question about how best to remove it, by crane or helicopter.

He said "if we are lucky" the hospital may be able to get a brand new unit by mid-August. That will cost about $95,000, not including installation charges, which could push the overall costs up significantly.

"We are at risk because it is such an old plant and it needs so much," said Mr. Walsh. "Some of it we need to do anyway, and that's fine, but there are other things that will be totally replaced by the new facility and I am hoping that that stuff doesn't start to die on us because you have to replace it. You have to have vacuum here or you can't run an OR and if you don't have an OR you can't have an ER, so you get into this chain of events."

The hospital is currently engaged in a fundraising campaign to raise $42 million to build on the current Beach Road site in Eastville. That estimate was based on projected construction costs expected to hold until the end of the year. Mr. Walsh said that any delays beyond that could start to inflate the overall construction cost by as much as $200,000 to $250,000 per month.

Hospital officials have yet to formally appear before the Martha's Vineyard Commission (MVC) to begin the permitting process. In a May meeting billed as an informal start, Mr. Walsh and Tim Sweet, board vice president and building committee chairman agreed to pay for a risk assessment study by an outside consultant selected by the MVC to evaluate the current site's vulnerability to natural forces such as flooding in the event of a storm.

The MVC request stemmed from the continuing skepticism some commissioners have expressed over the insistence of hospital officials that the current location is the only viable financial alternative, given the estimated cost of more than $70 million to build on a new site.

In June the MVC received two bids by outside consultants to provide a risk assessment. Mr. Walsh said one consultant is willing to do the work for approximately $15,000 in one month and the other submitted a proposal that would cost $24,000 and take five months.

Ultimately, the risk assessment will not affect the change of location, according to Mr. Walsh, but would be used to help plan how to mitigate any unforeseen problems. That is not to say that the work has not already been done.

Mr. Walsh said the architectural firm that designed the new hospital looked at the potential problems associated with major storms such as a hurricane and flooding and designed the structure accordingly. But, putting a positive spin on the cost of a study that he did not ask for, Mr. Walsh said, "That is not to say that we won't learn something from somebody looking at it again and coming up with some ideas. We were asked by the commission and we agreed to do it."

Mr. Wash said the hospital is willing to have a risk assessment conducted by a consultant as long as it does not delay the permitting process. But timing is becoming critical, he said, and any delays would begin to inflate overall building costs.