South Nassau Communities Hospital has changed its plans for the development of the Long Beach Medical Center property, saying that it recently determined that construction of a new medical facility with an emergency room would be too costly.
Hospital officials told the Herald on Tuesday that the costs associated with the initial plans for a medical arts pavilion on East Bay Drive — first proposed in 2015, and slated to be housed in what remains of the medical center’s main and west wings — would far exceed the $40 million in Federal Emergency Management Agency funds that South Nassau earmarked for the project.
Still, officials said that the freestanding emergency department built in 2015 would continue to operate 24 hours a day, and accept ambulances through the 911 system.
Hospital officials also said that South Nassau remains committed to moving forward with the construction of a 15,000-square-foot, elevated one-story medical pavilion, albeit in a different location on the property. And though it would no longer house the emergency room, hospital officials said that it would still provide the services proposed in the original plan, including OB/GYN, medical oncology and other specialties.
“The original proposal was to move the emergency department into the medical pavilion,” Joe Calderone, SNCH’s senior vice president of corporate communications and development, explained. “When the design process really got down to where the rubber meets the road, and as they sharpened their pencils . . . the design requirements changed to conform to the 500-year flood plain, and that added massive amounts of costs to the overall construction.”
The initial plan
In 2014, SNCH acquired the medical center, which was shuttered after Hurricane Sandy, for $11.8 million following a bankruptcy proceeding. The sale was finalized after South Nassau reached an agreement with FEMA to accept $154 million in disaster relief funds originally earmarked for LBMC after Sandy to redevelop health care services in Long Beach and to expand South Nassau’s Oceanside campus.
The deal sparked criticism from a number of residents, who called for the funds to be invested in Long Beach.
South Nassau opened a 6,500-square-foot emergency department in 2015 in a parking lot on East Bay Drive, adjacent to the former Komanoff Center for Geriatric & Rehabilitative Medicine, which was meant to serve as a temporary facility until the medical pavilion was built.
The medical arts pavilion was proposed in 2015, and was slated to be housed in what remains of the medical center’s main and west wings following a major reconstruction of the buildings.
The plans called for a $40 million, 25,000-square-foot facility on the former LBMC campus, with an expanded 24-hour emergency department that would receive 911 calls and about 15 exam rooms as well as primary care and radiology services, space for a variety of medical subspecialists, and women’s and children’s health services. It was expected to open in June 2019, pending a series of approvals by the state Health Department, FEMA and local governments. Last year, South Nassau filed building and environmental assessment applications with the Town of Hempstead and the City of Long Beach to move forward with the plans.
Officials said that South Nassau’s recent affiliation agreement with Mt. Sinai played no role in the change.
But because the structure would have had to be elevated to meet FEMA height requirements — to 23 feet above sea level, above the 500-year flood plain — and meet the requirements of state public health law governing hospital operations, officials said that the estimated cost of the Long Beach pavilion increased to roughly $74 million. Additionally, officials said that a hospital-licensed facility would be too costly to build and operate, and receive lower Medicare reimbursements.
“New federal regulations created lower reimbursement rates for ambulatory centers that are not located directly at a hospital,” Calderone said. “That also changed the economics of it.”
Keeping buildings separate
By building the medical pavilion separate from the emergency department, officials said, South Nassau would not be bound by public health law requirements, and can elevate it only above the 100-year flood plain.
County Legislator Denise Ford, who was among the elected officials who pushed for expanded medical services at the facility, expressed disappointment that the project would no longer include an “expanded” emergency department. “At this point, I welcome anything they can start putting here for us, so we can get our doctors back and medical services, and create some jobs,” Ford said, adding that she would continue to push for more services. “I’m disappointed with a smaller emergency department, and I understand the constraints as to why they can’t do it, but . . . I had envisioned we would have a big medical pavilion with a larger, state-of-the-art emergency room and all these other services. I think people will be disappointed.”
Members of the Beach to Bay Civic Association have long maintained that a medical pavilion was inadequate to meet the needs of a “geographically isolated” community, and could not accept ambulances with patients suffering from certain “time-critical” medical conditions. South Nassau officials have said that rebuilding a full-service hospital was not financially viable.
Asked why South Nassau could not move forward with the initial plan using additional FEMA funds, Calderone said, “To use all of the money on the barrier island doesn’t make sense, from a programmatic standpoint and standpoint of getting ready for the next storm. As we all know, the barrier island was evacuated. You want to put resources off the barrier island and serve the entire region. If you need an advanced kind of service, you’re coming [to Oceanside]. If you’re a trauma patient, you’re coming here. If you live in Long Beach, you want Oceanside to be as advanced and as strong a hospital as it possibly can.”
New plans for a ‘medical campus’
Hospital officials said they are committed to providing the medical services announced as part of the original plan, and maintain that the emergency department has been a success (see box). To date, they said, South Nassau has invested $38 million in the property using state, federal and hospital funds, and has earmarked an additional $40 million in FEMA funds for the new pavilion. “We think that this current plan will provide the most services in the best possible way for the residents of Long Beach,” Calderone said.
Mark Bogen, South Nassau’s senior vice president and chief financial officer, said that it would make additional investments to bolster the emergency department’s backup power system. “No one should think they’re getting some sort of raw deal,” Bogen said. “There will be nothing lacking in that facility in terms of services . . . by the fact that it’s not going to be consolidated into a single site. That facility was built to be permanent. Ambulances will still have the ability to go there. Services will still be performed.”
Officials said they have yet to present the revised plans to the city, the Town of Hempstead, FEMA or the state Health Department, but they intend to file formal plans next month.
It is now unclear when construction of the medical pavilion would be completed, officials added, but they dismissed rumors that the former LBMC property would be sold to build condominiums. They said that the hospital envisions eventually bringing in a private developer to renovate the buildings into an assisted-living facility.
Still, officials said that the buildings could remain vacant for five to 10 years. South Nassau, they explained, would have to complete its FEMA-funded project before it could develop the Long Beach property.
“The concept here [in Long Beach] is really a medical campus,” Calderone said. “It just seems to make sense.”