Mission Health President and CEO Ron Paulus has touted one of the system’s current construction projects, the Mission Hospital for Advanced Medicine, as the single biggest investment in the history of Western North Carolina.
Mission is spending $400 million to build the new hospital.
The project is part of a larger initiative planned by the health care system — Mission Future Ready, a plan that, according to the Mission Future Ready website, will help ensure the system will be prepared to meet the health care needs of the future.
An estimated 2,300 new jobs will be created at the height of construction, and $160 million will be pumped into the Buncombe County economy by the end of the project, according to an independent economic analysis by Asheville-based Syneva Economics, according to a press release last week from the Economic Development Coalition for Asheville-Buncombe County.
Mission is also in the middle of renovations at several of its other facilities, including a 6,800-square-foot replacement of the emergency department at Highland-Cashiers Hospital, a new $45 million facility at the McDowell Hospital campus and an expansion of the emergency department at Transylvania Regional Hospital, according to the Mission Future Ready website.
“These investments in Western North Carolina are absolutely necessary to ensure that the families we serve have access to the best-quality care, close to home, for decades to come,” says Rowena Buffett Timms, senior vice president of community and government relations at Mission Health.
Plowing ahead with construction
The centerpiece of this initiative, the Mission Hospital for Advanced Medicine, will replace the facility on the St. Joseph campus, which Timms says is deteriorating and would be costly to renovate.
“That facility, parts of which were constructed in the 1950s, will soon be unable to provide safe care for patients,” she says.
Mission Health has not decided how it will use the St. Joseph campus following the completion of the facility.
Officials are also working to ensure the new facility will be able to accommodate more advanced equipment.
“Today’s health care technology has vastly different structural requirements than were in place when these existing facilities were constructed,” Timms says.
For example, Timms notes the new operating room equipment, which the current facility would have difficulty accommodating, typically requires more ceiling room than older pieces of equipment.
Once complete, the new facility will reach 12 stories tall and cover 600,000 square feet of space, according to the Mission Future Ready website. It will also link the St. Joseph and Mission campuses and will include and will include 220 beds.
This change, however, will not add to the total number of available beds.
“It is simply a bed-for-bed replacement of the St. Joseph’s campus,” Timms says.
Timms says one of the reasons the system decided to keep the total tally of beds the same is that inpatient admissions have been decreasing nationwide for years.
Timms says this trend has also been happening statewide as well as in Western North Carolina and can be attributed to a change in how Medicare defines who is an inpatient, as well as changes in technology.
“As these advancements continue, even more care will be delivered in the outpatient setting, and we will see an ongoing decline in admissions and the total number of inpatient beds,” she says.
Inpatient admissions decreased 4.6 percent between 2008 and 2016 in Western North Carolina counties and decreased 1.3 percent in the remainder of the state over the same time period.
The numbers for inpatient admissions at Mission Health, however, have increased over the same time period by 10.2 percent, a trend Timms attributes to more hospitals joining the Mission Health system and “consumers’ increasing preference for Mission Health hospitals.”
At the same time, that local trend is also balanced by “an ongoing reduction in length of stay that creates ‘more capacity’ in the same number of beds,” Timms says.
Though Mission is not adding inpatient beds, “We are changing the types of beds (ICU and step-down) so that we are prepared for higher acuity/intensive care patients,” Timms says.
“The most significant ‘shortage’ that we experience is for high-intensity beds — intensive care unit beds and step-down beds (serving patients who don’t require an ICU bed, but who are too ill for a standard hospital room),” Timms explains. “We have significantly increased the number of ICU beds, and every single other room in the new tower will have the capacity to serve step-down patients.”
The new facility will include 97 beds in an expanded emergency department, up from the current 58 emergency department beds.
Officials expect the new Mission Hospital for Advanced Medicine will be complete in 2019.
Crews are also building a new facility at the McDowell Hospital campus in Marion that, once complete, will feature expanded emergency room services, more inpatient rooms and updated equipment, according to information available on the project website.
Crews broke ground at the facility on Oct. 27, 2015, and officials expect construction will last through December. The new 69,703-square-foot hospital will replace the existing facility, which will be demolished once construction is complete.
The new hospital will boast 25 inpatient rooms and obstetric facilities, including five delivery rooms and a cesarean section suite.
A new, 38,615-square-foot medical office building is also being constructed in connection with the project.
As of August, crews were working on glass fittings in the nursing viewing stations and interior storefronts, according to the project website. Crews have also been finishing work on air ducts, installing electrical wiring and placing sprinkler heads in the ceiling.
McDowell Hospital will hold a grand opening for the new facility in February.
Meanwhile, Transylvania Regional Hospital in Brevard is undergoing changes to its emergency department, with 10,700 square feet of new construction and 1,555 square feet of renovations. The $7.8 million project will result in, among other things, 12 larger exam rooms, which will ensure enough space is available for equipment and caregivers.
Crews had finished tiling in bathrooms and showers and were nearly complete with doors and hardware installations, as well as wall protections, according to an update on the project website.
The project will have its grand opening in October.
Highlands-Cashiers Hospital had a ribbon-cutting and grand opening for renovations to its emergency department in May. Crews replaced the hospital’s emergency department with a 6,800-square-foot addition to the current building, according to information on the project website.
The ED includes several new patient spaces, such as a triage room, three exam rooms, an exam room set aside for behavioral health patients, an isolation/sexual assault exam room and a trauma room.Workers also made aesthetic changes to the facility’s main entrance that incorporate a mountain theme into the design.
Mission Health raised $5.6 million from 56 donors to help cover the costs of the $6.7 million construction project at Highlands-Cashiers Hospital.
Construction projects typically mean delays for motorists, but Mission Health and the city of Asheville have made an effort to ensure construction will be as nonobstructive as possible.
A new traffic signal was installed at the intersection of Livingston Street and Victoria Road on Jan. 1. The light will be updated with metal poles and mast arms as construction continues.
The entryway for the campus will now be at the Livingston Street and Victoria Road intersection. The old entrance, which used to be up the road at the intersection between Victoria Road and Lily Carmichael Drive, will now be a separate entrance for the expanded emergency department.
Because Asheville’s Complete Streets initiative requires bike paths to be on the road in both directions, there isn’t enough space at the intersection for a turn lane, according to the Mission Future Ready website. This prevents cars traveling south from using a turn lane to access the Mission Hospital campus.
To alleviate this problem, traffic heading north on Victoria Road will be stopped at the red light longer, giving traffic traveling south more time to make a left turn onto the campus.
Jeff Moore, a traffic engineer with the city of Asheville, anticipates construction on the Mission Hospital for Advanced Medicine will cause very little disruption to traffic flow. He adds that engineering conducted in conjunction with the construction project will ensure traffic will be improved along the roadway once the building is complete.
Mission Health’s initiative is moving forward at an embattled time for the health system.
At press time, Mission is embroiled in a dispute over contract terms with Blue Cross Blue Shield of North Carolina. The health system has also received blowback from members of the community for its decision to discontinue labor and delivery services at Angel Medical Center in Franklin and Blue Ridge Regional Hospital in Spruce Pine.
“I have never been more disappointed in a corporation as I have Mission Health,” says Franklin Mayor Bob Scott.
Angel Medical Center officially stopped labor and delivery services on July 14, and Scott said the fallout has caused a great deal of concern among his constituents. He believes the impact of this decision could have far-reaching consequences.
“It’s more than just a service,” Scott says. “There’s also an economic factor to this whole thing, because we want to keep our young couples here, and the lifeblood of a town are the young people coming along. If you don’t keep the young people, you’re eventually going to age everybody out.”
Members of the Angel Medical Center board of directors say they decided to discontinue the service out of a concern about finances.
“We were faced with a choice of making sure that the hospital can break even now and in the future so that we know there will be a hospital in Franklin,” the board said in a statement about the cuts released on May 8. According to the statement, labor and delivery services lose the hospital more than $1 million every year, a figure the board says would have continued to climb.
The statement says Mission has invested $11 million in Angel Medical Center over the past five years to keep the hospital solvent.
“Without the affiliation, [Angel Medical Center] likely would have closed our doors four years ago,” the statement says.
Timms also defends the decision: “Women living in communities across the region, including those living in areas where labor and delivery services are not available locally, continue to have access to deliver at Mission Hospital in Asheville or McDowell Hospital in Marion.”
Timms points specifically to the neonatal intensive care unit at Mission Hospital, which she says has staff available at all hours to handle emergencies. The unit is also highly mobile and capable of traveling to distant locations by helicopter, she notes.
Blue Ridge Regional Hospital will move labor and delivery services to McDowell Hospital on Sept. 30.
In a statement released on April 28, the Angel Medical Center board of directors said a significant number of children in Macon County are already born at either Mission Hospital or Harris Regional Hospital in Sylva. Mission Hospital is about an hour and 15 minute drive from Franklin, and Harris Regional Hospital is about 30 minutes from Franklin.
Between Oct. 1, 2015, and Sept. 30, 2016, 253 women from Macon County delivered babies at Angel Medical Center and 43 women from Macon County delivered at Mission Hospital.
In fiscal year 2016, Angel Medical Center had 374 total deliveries, and Mission Hospital had 4,040 deliveries.
As for the dispute with Blue Cross Blue Shield of North Carolina, Timms says the decision to make its infrastructure investment came well before Mission’s issues with the insurance company [see “War of Words: Mission Health and BCBSNC Continue to Battle Over Contract,” Sept. 6, Xpress].
“Our facilities will serve Western North Carolina residents for many decades,” she says. “It would be completely inappropriate to ignore the realities of our current facility needs due to a temporary — even if painful — dispute with Blue Cross.”