It will cost $761 million to renovate the 46-year-old Guam Memorial Hospital. The price tag for a brand-new medical facility is $743 million.
For the U.S. Army Corps of Engineers, it’s no brainer.
“The optimal solution to enhance health care services on Guam is the construction of a new medical campus on a site to be determined,” USACE states in a draft report presented to GMH officials on Thursday.
The actual cost to repair the aging public hospital is much higher than the initial assessment made by the USACE after completing the facility inspection in November last year. Preliminary estimate was $200 million.
Built in 1978, GMH is Guam’s only government-run hospital, with a licensed bed capacity of 158 acute care beds, plus 40 long-term care beds at its Skilled Nursing Facility in Barrigada Heights.
“The existing facility is incapable of providing enough space to meet the long-term needs of the patient population,” the report said.
A team of 13 engineers inspected the medical facility, which was found to be in a state of dilapidation. Further degradation of the infrastructure will result in additional non-compliance with standards and will result in denial of Centers for Medicare and Medicaid Services accreditation.
GMH lost its accreditation from The Joint Commission on July 16 , 2018 due to its failure to meet CMS standards. Immediate repairs to support accreditation of the facility will cost $21 million, the report said.
A major renovation will require demolition and recapitalization of the Z wing and a parking garage over the existing parking lot, according to the report. The estimated construction cost is $761 million.
This renovation project involves retrofitting all infrastructure to meet current building code and hospital accreditation criteria. The job would require immediate correction to deficiencies in the architectural, electrical, fire protection, mechanical and structural systems, the report said.
USACE also noted that the repair of the current facility will entail logistical problems throughout the renovation period.
It will cause operational disruption resulting from utilities outages that will require “interim life safety measurements,” which will impact the delivery of immediate patient care services.
The Army engineers also noted that the size of the hospital premises in its current site will not accommodate an increase in expansion capacity.
“The current hospital campus lacks critical expansion space to support replacements to the central utility plant, enhancement to the existing hospital wings and will not support additional parking without the construction of parking structures,” the report said.
“While individual systems could be brought up to current code standard through repair, this may not fully address the existing space deficiencies, meet the future end state of services.”
The report also noted that the GMH campus is currently too crowded to accommodate construction material storage, swing space and contractor parking.
“There is a high risk of encountering differing site conditions which would further escalate the cost and complexity of repairs,” the report said.
USACE thus recommended the construction of a new multi-story facility, of equivalent size on a suitable site, that is compliant with the current building code and hospital accreditation criteria. The project is estimated to cost $743 million including $21 million to support reaccreditation.
However, the cost assessment did not include requirements for land transfer, upgrades to island infrastructure and feasibility study that addresses potential impacts on patient travel to a new facility, the report said.
The estimate also does not address potential clinical space deficiencies to meet the future end state of clinical services that must be resolved prior to design, the report said.
Gov. Lourdes Leon Guerrero is inclined to build a replacement medical facility, noting that “band aids don’t fix bullet holes,” which GMH is presented with year after year.
In her recent state of the island address, the governor said the administration will explore several public and private financing options for a co-located new GMH and public health facility.
“This will take planning, and the option we choose will be driven by our government’s financial health, the amount that needs to be raised, our partnerships with the private sector, and the comprehensiveness of the plan we propose,” she said.