New Vision for the Hospital

Architect Suggests Replacement at Current Site; Three Stories Would Be Built in Phases; Estimate Is $30 Million

Gazette Senior Writer

Picture this: A spanking new three-story building that houses a state-of-the-art diagnostic center and a modern emergency room, a "green" building that is efficient and easy on the environment, a therapeutic place that is at once a holistic healing center and a hub for health care on the Vineyard.

This is the new vision for the Martha's Vineyard Hospital.

It's a $30 million vision and still a good distance from reality, but trustees plan to demolish the leaky, ailing circa 1972 hospital building and replace it with a brand new structure.

The hospital has been working on a facility master plan for a number of months, and at a low-key public forum on Friday Marc Rowland, an architect with Thomas, Miller & Partners Inc., sketched an outline of what is now emerging from the work.

Held in the cafeteria of the Oak Bluffs School, the forum was sparsely attended on a stiflingly hot day, but hospital board chairman John Ferguson adapted quickly to the moment.

"I can tell you that the new hospital will without question have an air conditioning system," Mr. Ferguson said, drawing smiles.

The master plan calls for building a new hospital on the same property where the hospital has been located since 1922, in the Eastville section of Oak Bluffs. The hospital shares its campus with the Windemere Nursing Home and Rehabilitation Facility; Windemere is a business affiliate.

Mr. Rowland described plans to build a three-story 150,000-square-foot hospital for inpatient, outpatient, emergency, women's, laboratory and surgical services, along with ample space for doctor's offices, staff housing, administration and a child care center.

Mr. Rowland and hospital leaders said the concept is still "the view from 30,000 feet", but the plan is chugging along nevertheless.

The building project would take place in phases, and the old hospital - including the old cottage hospital - would eventually be demolished.

The entrance to the new hospital would face Eastville avenue. Mr. Rowland said the building would include a lower level built into a hill. Patient rooms will be located on the upper level, many with water views. All patient rooms will be private rooms - the plan calls for a total of 30 beds, including 19 private, three observation, three intensive care and three nursery beds. The plan also calls for building three operating rooms and expanding the examining rooms in the emergency department from 10 to 22. The extra rooms would see full use in the summer months and in the winter months could be converted for use by part-time medical specialists, Mr. Rowland said.

Other details in the plan include a roof garden on top of the first story of the building and a large space that can be leased to ancillary health care groups like hospice and the visiting nurses.

Mr. Ferguson and hospital chief executive officer Tim Walsh said the hospital is also hoping to become a Planetree Hospital, a holistic health care model that centers on the needs of patients and families and integrates complementary therapies such as massage, yoga and acupuncture into traditional medical care.

In his working life Mr. Ferguson is the CEO of the Hackensack University Medical Center, which is a Planetree Hospital.

Mr. Rowland said the plan calls for constructing a "green" building that is energy efficient.

Most of the medical services offered at the hospital will remain the same, with some expansion. Mr. Walsh said a plan is currently under way to add oncology services at the hospital; he said 30 Vineyard residents now travel to Falmouth for regular cancer treatments, and hospital leaders are working with a team of health care experts in Falmouth to train Island nurses for a startup program.

Under the most optimistic timetable, architectural plans will be ready by the end of October and a groundbreaking could take place as early as next fall. But hospital leaders face a long and arduous road between now and then - among other things there are regulatory hurdles to clear (approvals are needed from the Martha's Vineyard Commission and other local land use boards), and trustees must tackle the most ambitious capital campaign in the hospital's history.

The new building is expected to cost $30 million.

"It's a lot and this is when the CFO in me kicks in," admitted Mr. Walsh, who is the former chief financial officer at the hospital.

Mr. Walsh and Mr. Ferguson both said that talks have already begun with large donors, although no one is being asked for money yet.

It all comes during a time of quiet change at the Vineyard's leading health care institution.

The change begins at the board level.

Mr. Ferguson, who stepped in as chairman 18 months ago, has rebuilt the board, and the result is a mix of local and seasonal residents with strong backgrounds in business, finance and fund raising. Two board members who resigned during a conflict-laden period under a previous board chairman four years ago have returned.

Mr. Walsh, named CEO a year ago, has used his CFO background to tackle the pecuniary problems that have plagued the hospital for years. There are some visible results: Last year for the first time since the year after it emerged from bankruptcy, the hospital had a modest operating gain.

Audited financial statements for the fiscal year that ended March 31 show that the hospital ended the year with a $188,000 operating gain, compared with a $951,000 loss the year before. Total revenues were up as volume increased but expenses were also up, especially in the areas of staffing and supplies. Gifts and investment income totaling $1.3 million helped to enrich the overall bottom line, although this was down from $1.9 million the year before. Hospital endowment was badly hurt by the plummeting stock market - investment losses were listed at more than $1 million for the year.

These numbers are all for the hospital on a stand-alone basis.

But the hospital does not stand alone.

Audited statements also show that Windemere - the beloved but financially beleaguered nursing home - continues to drain hospital resources at a steady rate.

The nursing home closed the books on Dec. 31 with an operating loss of $600,000, an increase from a loss of $413,000 the year before. Cash has dropped to dangerously low levels, and Windemere is so far in arrears to the hospital for dietary services that the hospital does not expect to ever recover the money.

Two years ago under the management of a former board and former CEO the hospital mortgaged its entire property to retire a huge bond that had been used to build the nursing home. The nursing home had been in default on the bond for years.

Today the financial problems at Windemere persist.

Huge losses at Windemere transform an operating gain at the hospital into a loss of $410,000 when viewed on a consolidated basis. Mr. Walsh, who is working hard to reduce the losses at Windemere, was blunt in his assessment of the problems.

"It doesn't work, and we have to get this straightened out," he said yesterday.

The new budget at Windemere projects a $397,000 loss, and Mr. Walsh is taking steps to bring that down, all the while watching expenses like a hawk at the nursing home. His goal is to eventually bring the operating loss down to $100,000 and offset that amount with some annual fund raising. And if that doesn't work?

"It's important for us to all know that if we can't make Windemere work we have to to refigure what we're doing. Because at the hospital we are stable right now and that's great, but we have to keep it that way," Mr. Walsh said.

Meanwhile, the planning moves forward for a new hospital.

"We are going at a steady pace, but we're not ramming it," Mr. Ferguson said.

He concluded: "We have great quality of care at our hospital and some really good doctors and nurses. But they have to be given the right tools. So right now we are just talking to people. It's more of a welcome back and letting people know that our heads are screwed on. Because things were messed up for a long time and we need to get the confidence back."