PORT ANGELES — Olympic Medical Center is taking on debt to fund an $8.3 million expansion of its emergency department to meet patient needs for the next 20 years.
The project, expected to be completed in summer 2013, will be covered by a $10 million limited tax general obligation bond that will be paid back over 10½ years at a fixed rate of 2.9 percent.
OMC commissioners approved the bond Wednesday.
They will consider approving $733,855 in design costs for the emergency room expansion at their next meeting at 6 p.m. July 6 at the hospital at 939 Caroline St., Port Angeles.
Chief Nursing Officer Lorraine Wall said the expansion is needed because of growing demand in a small space.
OMC frequently uses hallway beds, and patients are reporting longer wait times.
OMC gets an average of 27,000 emergency room visits per year. That number is projected to rise to 40,000 by 2031.
“The industry standard is about 1,500 to 2,000 visits per bed [annually],” Wall said.
“We have 11 beds currently, so that takes us up over 2,500 visits per bed,” she added.
“We’re already outside the standard.”
Chief Executive Officer Eric Lewis said the emergency room is at the “core of what the hospital does.”
“This will give us the space and the facilities and the equipment for the coming decades,” Lewis said.
“I think it’s probably vital for us to continue to meet our patients’ needs.”
In July 2009, OMC formed a task force to research the expansion and make site visits to emergency rooms at eight Western Washington hospitals.
Olympia-based architect Scherer Associates was chosen from a list of four finalists.
The expanded emergency room will include two large triage rooms, a designated area for emergency medical technicians, two secure rooms for psychiatric and detox patients, a decontamination room and a chapel.
“We still have some work to do,” Wall said.
“This is not a final design.”
According to the current time line, the design will be completed in January, and a construction contract will be awarded in March.
Construction is slated to begin next spring.
“This has been long-planned, and obviously, the board has seen this over the last few years,” Lewis said.
“This is a major part of our strategic plan.”
OMC Commissioner John Beitzel described the debt as “painful.”
“But we can’t avoid doing it,” Beitzel said.
“We have to do it. We can’t keep struggling along where we are, getting worse and worse, delivering poorer and poorer service.”
Commissioner Jim Cammack said the expansion is needed to reduce wait times and overflow in the lobby.
“I find it really kind of sad that you look around all the communities, and everybody’s expanding their ER,” Commissioner Jim Leskinovitch said.
“And it’s not because of a population base increase; it’s because a lack of insurance.”
Lewis said OMC has a “relatively low debt level now” at $11 million with a $140 million balance sheet.
“We have less than 10 percent leverage right now,” Lewis said.
“The average hospital has about 40 [percent] to 50 percent leverage. So even with this extra $10 million, we’ll still be relatively low,” he added.
“The biggest wild card,” Lewis said, is uncertainty about Medicare and Medicaid payments in the next decade.
“If we knew we were going to get modest inflation increases every year, this is easy. But if they cut us by 10 [percent], 20 percent, then it becomes real difficult,” he said.
“We’re trying to be as prudent as possible, but not expanding the ED [emergency department] would also have very negative consequences for our patients and our community.”
Staff in the expanded emergency room will use the same Epic electronic medical records that are planned in the rest of the hospital.
Lewis said the Epic system will improve work flow by allowing emergency room staff to access a patient’s primary care records on the same system.
“That information will flow to CCU [critical care unit], which does not happen as well today,” Lewis said.
Installation of Epic digital medical records is a major reason why OMC, Jefferson Healthcare and Forks Community Hospital are considering a tertiary affiliation with Swedish-based Seattle Medical Center.
Final decisions are expected in late summer or the fall.
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Reporter Rob Ollikainen can be reached at 360-417-3537 or at rob.ollikainen@peninsuladailynews.com