At a time when the health care industry is cutting back on inpatient beds, BJC HealthCare is looking to add beds with its proposed replacement hospital in west 狐狸视频 County.
BJC says it wants to build a 100-bed replacement for Barnes-Jewish West County Hospital 鈥 23 beds more than it currently operates there. That鈥檚 despite the fact that the Creve Coeur hospital currently has the lowest occupancy rate in 狐狸视频 County and is located just a few miles from three other major hospitals.
The Creve Coeur City Council is currently weighing whether to approve BJC鈥檚 concept plans for the 54-acre site that include adding medical office buildings. A decision by the council could come as early as Dec. 12. At this juncture, city officials are narrowly focused on the placement of the future buildings and not specific details, which would need approval at a later date should the overall concept plans gain approval.
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BJC has said the current hospital is old, out-of-date and needs modern upgrades, such as single-patient rooms. The hospital, which was built in 1969, was acquired by BJC in 1989.
Officials with the health care system won鈥檛 disclose their plans for the extra beds, but in an emailed statement sent Thursday said: 鈥淏arnes-Jewish West County Hospital is a surgical specialty hospital resulting in high activity, but shorter patient stays. Across BJC, we consistently invest in the renewal of our hospital facilities to meet the expectations of our patients and families for private rooms and to keep pace with the requirements of advancing technology.鈥
Health care experts say a plan to add beds appears to run counter to industry trends. Inpatient utilization rates have been steadily falling for years as technology has improved, shifting more patients outside of the hospital to outpatient facilities.
Data show that the average patient stay is shorter too. Even the way hospitals are paid is moving toward rewarding providers for keeping patients healthy and out of the hospital.
Another concern is that excess and duplication can drive higher prices for consumers, experts say. It鈥檚 why some states like Rhode Island have worked to identify and eliminate excess beds in hospitals.
Researchers at Columbia University Mailman School of Public Health identified that excess obstetrics beds in New York City cost $26.4 million a year.
鈥淥nce built, unused beds don鈥檛 cost that much unless they鈥檙e staffed, said Martin Gaynor, a health economist at Carnegie Mellon University. 鈥淭hey can be costly if they鈥檙e staffed and then don鈥檛 get used,鈥 he added.
Based on the number of beds in use, the current Barnes-Jewish West County Hospital had an occupancy rate of 27 percent in 2014, according to data provided by the 狐狸视频 Area Business Health Coalition. (The hospital actually has a state license to operate 113 beds at that location, but only uses 77.)
Barnes-Jewish West County鈥檚 occupancy rate is well below the national average of 61 percent, and the 狐狸视频 area average of 54 percent, the coalition says.
Des Peres Hospital had the second-lowest occupancy rate, 37 percent, in 2014. DePaul Health Center (now known as SSM Health DePaul Hospital) had the highest occupancy rate in the county with 69 percent.
Within a 5-mile radius of Barnes-Jewish West County are three other hospitals, all with higher occupancy rates, according to Business Health Coalition figures:
鈥 Mercy-狐狸视频, 58 percent.
鈥 Missouri Baptist Medical Center, 56 percent.
鈥 St. Luke鈥檚, 48 percent.
All three of those hospitals have more beds than Barnes-Jewish West County. Mercy has 856, St. Luke鈥檚, 361 beds, and Missouri Baptist Medical Center has 461.
Donn Sorensen, a regional president for Mercy, said Mercy does not oppose additional beds at Barnes-Jewish West.
Whether it鈥檚 appropriate to add beds with an already low occupancy rate is a very difficult question to answer, said Nan Liu, assistant professor at Columbia University who conducted the study on New York City鈥檚 obstetrics beds.
But for those responsible for voting on the decision, he said, they should consider asking BJC a few questions.
鈥淔irst of all, do you really have a need to increase the size of the hospital? Are you anticipating more patients to come or do you have other strategic directions that you want to go after?
鈥淚f you don鈥檛 have concrete reasons to expect growing demand, then I would question why would you need to increase the hospital capacity.鈥
Eugene Litvak, president of the Institute for Healthcare Optimization and an adjunct professor at Harvard, said the capital costs to build a hospital range from about $1.5 million to $3 million per bed. That鈥檚 not including the cost to operate or staff each bed, he said.
One way or another that cost trickles down to consumers, he said.
While BJC may need a new, improved facility, he said, 鈥渏ustifying additional beds, I would strongly argue with that.鈥
He said officials should explain what the beds will be used for and how many nurses will staff each bed.
While hospital representatives have said the building is old and needs updating, they haven鈥檛 said why they need more beds. And they haven鈥檛 said what services the new beds will be used for. In a hospital, bed usage can range from pediatric to intensive care.
鈥淚magine that you鈥檙e coming to the bank and you want to borrow money. They will ask you two basic questions: How much and what is this for specifically, and you tell them, 鈥業 don鈥檛 know.鈥
鈥淭he point that I鈥檓 making is the hospital is asking for more beds, and they have to be specific; I need three additional ICU beds, I need 10 medical/surgical beds. They should be able to justify why they need 5 telemetry beds and why not four,鈥 he said.
But Creve Coeur Mayor Barry Glantz said hospital officials have told him that they have mentioned expanding a whole suite of services. He said they have already added an entirely new building for hospice care on the property.
He鈥檚 not as concerned over occupancy rates.
鈥淔rom my perspective and my role, I鈥檓 thrilled to see them reinvesting in the community in their existing campus, which can only benefit the community,鈥 he said.
Glantz said the hospital will join Donald Danforth Plant Science Center among the largest investments in Creve Coeur in recent history.