MetroHealth's Critical Care Expansion Will be Ready to Handle Emergencies at 2016 RNC

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By Steven Litt, The Plain Dealer 

CLEVELAND, Ohio – The MetroHealth System plans to finish the 85-bed, $82 million expansion of the Critical Care Pavilion at its Main Campus in time to handle any emergencies – even big ones – that might occur during the Republican National Convention in 2016.

The facility would be ready for an event of the magnitude of the 2013 Boston Marathon bombing, for example, Dr. Akram Boutros, president and CEO of the county's health system, said in an interview prior to Friday's Second Annual Stakeholders Community Meeting, held at the Cleveland Convention Center.

"We're [going to be] prepared for a Boston-type event," he said, speaking to reporters and editors of The Plain Dealer and the Northeast Ohio Media Group.

Boutros defined a potential emergency to include "literally anything."

As the county's public hospital, "we're the responsible party for the president or any senators coming through," he said.

Also a factor in the time pressure on MetroHealth to complete the facility quickly is the need to handle demands that could include safeguarding intensive care patients during harsh weather.

During the so-called polar vortex in January 2014, the Main Campus nearly had to evacuate twice as the facility's aging buildings came close to failing under the outbreak of extreme cold.

In such an emergency, the expanded Critical Care Pavilion would be available to care for especially vulnerable patients. That's why Boutros referred to the pavilion in the interview as a "lifeboat" for MetroHealth.

The two new floors in the project will include 75,000 square feet of new construction atop the pavilion's existing Level 1 Adult Trauma Center, the highest level facility of its kind in Greater Cleveland, according to the health system.

A new Neurosciences Intensive Care Unit will be housed in the expansion.

University Hospitals announced Friday it would open the region's second Level 1 trauma center in the fall at its main campus in University Circle to serve what that institution calls an "acute community need" on the East Side of the city and Cuyahoga County.

The MetroHealth project is the first step in what it calls a $1.2 billion"transformation" of its 52-acre campus on West 25th Street overlooking the I-71 curve southwest of downtown.

Boutros announced the formal launch of the planning process last year, but has offered few details since then that go beyond the Critical Care Pavilion, the first element in the project.

In the interview, he said the project could take between eight and 12 years, and could cost up to $1.2 billion, an amount equivalent to a complete interior overhaul of the existing 30 buildings on campus, which range in age from 11 to 103 years.

Even without renovations or new construction, the campus faces an estimated $100 million in repairs over the next decade, according to Boutros.

But Boutros said he wants to modernize the campus and make it more technologically efficient. The evolving plans call for reducing the total square footage of construction on the campus by one-third, from nearly 3 million to 2 million square feet.

He said the health system wouldn't release detailed plans for the project until it has secured funding.

He estimated that MetroHealth could itself contribute $400 million and raise another $100 million from private sources. He said the health system could have private developers build $200 million worth of facilities, which the hospital would occupy on a lease-purchase plan.

He said the remaining $400 million to $500 million gap could be filled by county, state or federal sources.

When asked whether he thought the transformation plan would require a county tax increase, Boutros said: "Honest to goodness, I'm not sure."

Speaking of recently elected County Executive Armond Budish, Boutros said: "We have a new county executive whom we are working with. They're taking their time to understand all the pieces of this."

Boutros said he considered the Critical Care Pavilion expansion to be part of the $400 million the health system would invest in the transformation plan, and that MetroHealth decided to pay for the project itself because of the urgent need for it.

"We've decided to move ahead with it because of time constraints, so we've decided to do it ourselves," he said.

The health system will pay for the project with $15 million from its strategic reserve, $25.5 million in Build America Bonds, and $41.5 million from its investments and cash from operations. 

The project would produce efficiencies for the campus, Boutros said.

"By building the Critical Care Pavilion first, we will have emergency rooms, trauma bays, operating rooms and all ICUs [intensive care units] in one vertical location with helicopters coming right by; that creates efficiencies," he said.

Boutros said elements of the transformation next in line could first include a new central utility plant.

He also suggested that the project could evolve in a pay-as-you-go fashion.

"We have to figure out what we can afford along the way and we'll do whatever we can during that period," he said in the interview.

At the convention center on Friday, he added: "What we build will depend upon what we, as a community, can afford."