In a time described as the most significant era of hospital replacement since World War II, Bucks County is booming.
There is emergency department construction and renovation. New outpatient facilities are opening. There are expanded clinics, renovated laboratories, and even a new hospital building in the planning stages.
It is all part of a national building movement that is expected to rack up spending of $200 billion by 2014, according to the Robert Wood Johnson Foundation in Princeton.
"We're going to see it for the next 10 to 15 years," said Lee J. Steiger Jr., director of facilities design and construction for the Frankford Health Care System, which owns Frankford Hospitals-Bucks County Campus in Falls Township.
"Many of the hospitals are operating in buildings built in '60s and '70s. A lot of them are outdated and can't support what we are doing with technology today."
Among the county's six acute-care hospitals, Frankford Hospitals-Bucks County Campus is contemplating perhaps the most radical change: the construction of a hospital in Lower Makefield that is projected to cost more than $250 million.
Hospital officials are weighing what many have faced, making a decision between renovating and/or expanding versus building new in-patient facilities. Most of the hospitals in the county have elected to do the former, as have most in the throes of the national building boom, said Rick Wade, senior vice president of strategic communications for the American Hospital Association.
The facilities are investing millions garnered from reinvestment, capital campaign fund-raising, state and local grants and bond issues. The boom is fueled by demographic shifts, technological advances, competition, and an evolution of care that makes changes necessary.
National and state regulations are pushing hospitals to expand room size and provide private rooms to patients, said Ed Nawrocki, president of St. Luke's Quakertown Hospital, which has renovated nearly 30 patient rooms.
Population growth is another influence, but perhaps more important is the graying of a specific segment of the population: the baby boomers.
"The median age in Bucks County is increasing at twice the national average," said Patrick Knaus, vice president, strategy/marketing/business development at St. Mary Medical Center. At the root is a concentration of 55-plus communities and the state's position as having one of the highest percentages of elderly residents, Knaus said.
St. Mary, along with several other county hospitals, has invested in renovating or building a new emergency department. The facilities are adapting to their evolution as providers of primary care as well as emergency care.
"We've tried for generations to get people to stop using emergency departments for non-emergency care," Wade said. "We've failed."
At Doylestown Hospital, the current emergency department has 17 treatment areas, fewer than what the hospital needs, given its emergency-patient load of about 40,000 people a year, said James Brownlow, vice president of administration and chief operating officer at Doylestown Hospital. The new emergency-room department will have 40 treatment areas.
The evolution of care also has included a growing reliance on outpatient facilities. That is reflected locally not only in new and expanded centers operated by Grand View Hospital and Children's Hospital of Philadelphia, but also in the transformation of the former Warminster Hospital.
Abington Memorial Hospital purchased the hospital last October and has already spent more than $1 million in renovations for a new sleep center, and for the Institute for Bariatric and Metabolic Surgery. The hospital continues to provide lab testing, day surgery and other outpatient services, said Katie Farrell, the executive director of Abington Memorial Health Center-Warminster Campus.
Also expanding are services for the uninsured and under-insured. The St. Mary Medical Center Community Ministries recently renovated its facilities in the Bensalem Square Shopping Center.
And, a new free clinic has opened in Quakertown. Volunteer Doctors Care-Upper Bucks Clinic began offering services in March.
"We are seeing people who previously had insurance in their jobs and may still be working but now don't have a job that has insurance, or they can't afford insurance with the money they make," said Sally Fabian, executive director of the Bucks County Health Improvement Partnership.
Lower Bucks Hospital in Bristol Township treats many of the under-insured and uninsured in its community. The hospital recently completed a $10 million renovation of its emergency department to handle increasing numbers of patients who use the department as its primary doctor.
But serving the under-insured and uninsured is part of the reason the hospital finds itself in a difficult financial position, said Austin Cleveland, the hospital's CEO and president.
The hospital has an anticipated $1.6 million budget deficit and recently announced layoffs, but is planning to revamp services and underused hospital spaces.
The lack of reimbursement from insurance companies has a more deleterious effect on hospitals such as Lower Bucks, which are independent and must compete in a market with hospitals that have the finances and size of a chain behind them, Cleveland said.
"It's nice to have the slick-looking facility, but some of us have 54-year-old facilities that have been added on to over the years," Cleveland said. "What matters most is your reputation and what's on the inside. Bricks and mortar aren't everything."
Growth of Hospitals
Projects that have started or been completed:
A $63 million emergency department at Doylestown Hospital.
A $30 million renovation of the cardiac catheterization care unit, and a new medical office building that will house an expanded sleep center at St. Mary Medical Center in Middletown.
New orthopaedic center, medical surgical unit, and $15 million outpatient center that are part of a three-year facilities plan at Grand View Hospital in West Rockhill.
A nearly $4 million renovation of patient rooms, outpatient testing areas, and other infrastructure at St. Luke's Quakertown Hospital.
A $7 million expansion of the Children's Hospital of Philadelphia Specialty Care and Ambulatory Surgery Center in Chalfont.
A $10 million renovation of the emergency department at Lower Bucks Hospital in Bristol Township.
A $1.2 million renovation, creating a new sleep center and weight-loss center, at Abington Memorial Health Center-Warminster Campus.
Projects totaling $26.8 million at Frankford Hospitals-Bucks County Campus, including the expansion of the emergency department and intensive care unit, and the addition of a new heart center and interventional cardiac catheterization lab.
Contact staff writer Kristin E. Holmes at 610-313-8211 or firstname.lastname@example.org.