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Chattanooga's children's hospital could also see a face lift or full out replacement in the near future. Erlanger Health System CEO Kevin Spiegel has announced tentative plans to either completely renovate or build a new campus for T.C. Thompson Children's Hospital at Erlanger.
While no plans have been formally announced, the hospital has tapped renowned children's hospital architect and designer Bruce Komiske to serve in an advisory role during initial planning stages.
"If it were to happen, we're years away," Spiegel said in a July interview. "But we want to make people aware that this can happen in this community. ... We can build something where patients would rather come here than somewhere else."
Children's, founded in 1929, moved to its current downtown campus adjacent to Erlanger in 1975.
An $84 million, four-story inpatient tower is planned atop the Monroe Carell Jr. Children's Hospital at Vanderbilt, marking the latest expansion of the hospital.
The new tower is actually an element of a massive expansion plan that dates back several years but was put on hold during the Great Recession.
Construction should start on the tower in early 2015, university officials confirmed. The new tower will feature four floors with 40,000 square feet each, including one floor with 36 patient beds. The other three floors will consist of shell space for future use, Vanderbilt officials said in a letter to state officials.
Vanderbilt still needs the state's approval to modify its original plan and certificate-of-need request, which was initially approved in 2008. As part of the revised plan, the university asked for a four-year extension to the overall project timeline.
The state's Health Services and Development Agency is expected to consider the request at its meeting Jan. 22. Nearly six years ago, the board granted Vanderbilt's original request for a certificate of need for a $248 million, nearly 400,000-square-foot expansion project that would have nearly doubled beds at the children's hospital to more than 400.
At the time, hospital officials had said the expansion was needed to help ease a bed crunch and would be funded in part by a $20 million gift from the Carell family. However, they put those massive plans on hold and opted to expand in phases, starting with a $30 million, 33-bed expansion that officially opened in May 2012.
"It just makes more sense to expand the hospital in phases as needed," said John Howser, Vanderbilt's spokesman, adding that the approach allows for building to suit projected needs of the patient population, while also allowing the hospital to adapt to new technology over time.
Final details on plans for funding the construction are being developed, he said. The latest $84 million expansion will occur atop the southeast corner of the children's hospital. The hospital's helipad will be relocated to the roof of that new tower, Howser said.
Becoming a 'national leader'
Overall, the latest expansion would boost inpatient capacity of the children's hospital to nearly 1 million total square feet and grow the number of beds to more than 300.
The expansion also would give Vanderbilt one of the 20 largest pediatric hospitals in the country, according to a 2013 listing from Becker's Hospital Review. The largest children's hospital in the country, by comparison, is Texas Children's Hospital in Houston with 589 beds, according to Becker's.
"As we recognize the seismic economic forces impacting hospitals and health systems across the nation, we have chosen to make a strategic investment to increase Vanderbilt's support for the unique health care needs of children throughout the region," said Dr. Jeff Balser, vice chancellor for health affairs and dean of the Vanderbilt University School of Medicine. "The space and programs created in this expansion will allow (Vanderbilt) Children's to catapult forward as a national leader in health care, research and clinical training."
The first floor of the new tower will have intensive care beds to care for more premature babies and other critically ill children, said Dr. C. Wright Pinson, Vanderbilt's deputy vice chancellor for health affairs. The children's hospital neonatal intensive care unit today is operating at nearly 90 percent capacity, and current projections indicate a 33 percent increase in demand for those services in coming years, according to data from Howser.
He said it's possible that by the time the four new floors are completed, the children's hospital could already have a need identified for the three floors now planned as shell space. He wouldn't discuss any additional construction plans beyond the new $84 million phase.
Plan follows layoffs
The latest construction plans comes on the heels of Vanderbilt University Medical Center's "Evolve to Excel" program, which was designed to eliminate $250 million from VUMC's $3.3 billion operating budget by the end of the 2015 fiscal year. In addition to nonemployee budget cuts, the university laid off 400 employees and eliminated an additional 1,100 open positions. It also offered early retirement packages to more than 250 employees.
Earlier in 2013, VUMC terminated 300 more employees, although these cuts were unrelated to "Evolve to Excel," university officials said.
David Stewart, a principal and senior architect at Gresham Smith and Partners who works with hospital clients, said that after years of putting off building projects, hospital systems are starting to expand again. "When you've put it off for so long, the facilities are (either) deteriorating or new service lines are needed, so the hospitals like to either replace or expand their facilities to meet the growing need for health care services," Stewart added.
Getahn Ward covers growth and development for The Tennessean. Contact him at 615-726-5968 or firstname.lastname@example.org. Follow him on Twitter @Getahn.