Alameda Hospital gets two-year break on seismic deadline

Alameda Hospital gets two-year break on seismic deadline

Michele Ellson

Alameda Hospital has earned a two-year extension on the January 1 deadline for seismic upgrades to two buildings it is required to retrofit, a report Chief Executive Officer Deborah E. Stebbins is set to give on Thursday night says. The hospital now has until 2015 to complete the work, though managers have told the state they’ll need an additional three years beyond that.

The cash-strapped hospital has asked the state for permission to put off retrofit work on the hospital’s original and Stephens Wing until 2020 under a bill that permits hospitals to apply for extensions to that date. The retrofit work could cost as much as $15 million, according to a recent estimate.

The hospital’s chief business development officer, Brian Jung, said state officials offered the extension because they need more time to consider the hospital’s request to be given until 2020 to finish the retrofit work.

“It’s sort of like an extension on our ability to get the extension,” Jung said.

The information is included in a report Stebbins is set to give the Alameda Health Care District Board on Thursday. A host of other non-structural seismic fixes, some of them long overdue, are being completed in an effort to win more time to make the costlier building retrofits; Jung said two of the three required projects are done, and a third should be finished this summer.

State officials told the hospital’s managers last May that they wouldn’t be eligible for a retrofit extension unless the non-structural fixes were made. That work included replacement of the hospital’s bulk oxygen tank and securing emergency lighting and other hospital equipment.

Hospital managers' prior attempts to win a longer extension on the seismic deadlines have been unsuccessful. Hospitals all over California have been struggling to complete the mandated retrofit work, which was originally due in 2008.

An annual report to the state, which was submitted in January, shows that the hospital hopes to initiate seismic safety work at both the original hospital and Stephens Wing in 2015 and to complete it three years later. The plans include retrofit work on the Stephens Wing, which houses 54 medical, surgical and skilled nursing beds, and moving the hospital’s kitchen to that building from the original hospital. Both buildings are at significant risk of collapse during a major earthquake.

Hospital managers hope to remove the original hospital building from service in 2030 and to move patient services in the Stephens Wing and the West Wing, which houses the hospital's surgical suite and which must be retrofitted or taken out of service by 2030, into more structurally sound facilities, the report shows; Jung said administrative and physician offices could be moved there.

Jung said the original hospital could be replaced with a more seismically sound structure, “but that decision is very much off into the future.”

Stebbins will also on Thursday present the results of a county review of the health care district’s service levels, finances and governance that was conducted as part of a regular review of the county’s special services districts. The Local Agency Formation Commission of Alameda County, which oversees the county’s special districts, signed off on the review and the 10-year-old health care district’s existing boundaries in January.

The review judged that the quality of health care services provided by the hospital is adequate based on patient death rates that were about the same as the state average and its capacity to provide them sufficient, though it said the hospital’s low occupancy rate – 51 percent versus a statewide average of 71 percent – could be an indicator that the area has too many hospital beds or that services aren’t adequate.

It also says the hospital’s facilities are aging compared to others across the country and in need of updates – the hospital’s facilities are an average of 41 years old, compared with 15.39 years for the lowest quartile of hospitals in the country; the review notes that two of the hospital’s seven buildings need seismic work.

Alameda Hospital’s emergency room was closed for 125 hours in 2011, compared with a state median of zero hours for that year, the review says.

Hospital managers said their existing financial levels were sufficient to deliver services but offered a list of potential challenges that included reduced Medicare and Medi-Cal reimbursements, the recession, the 2010 end of Kaiser Permanente’s contract to perform surgeries at the hospital and the new federal health care law, known as Obamacare, the review says.

It says the amount of money the hospital earns per patient day is less than the statewide average, and far less for inpatient services. In the 2010-2011 fiscal year, the hospital earned $1,281 per patient day for inpatient services, compared with $2,777 statewide, and $405 for outpatient services, compared to $475 statewide.

The hospital’s revenues for that year were $64 million and expenditures, $67 million, the review says; it says the hospital had a $2 million cash balance left at the close of the fiscal year.

The hospital’s books are showing a loss of $1.1 million so far this year, unaudited financials through the end of February show.