Medical Quarterly

Metro Magazine
February 2010

Regional Healthcare Building Boom Defies Recession

By Rick Smith


A lingering global recession and concerns about the costs of healthcare reform have done little to slow a continuing expansion of medical facilities across much of the Triangle and eastward to Greenville, Wilmington and Hoke County. Also underway is the new state mental health hospital in Butner, NC, to replace Dorothea Dix Hospital in Raleigh.
Projects worth close to $2 billion have produced new hospitals, hospital additions, emergency care units and specialty facilities across the region. And other projects are still in the pipeline.
On Jan. 20, Rex Healthcare filed plans with the state to add two operating rooms at a 9000-square-foot outpatient center in Holly Springs. The state approved the project just two years ago and is looking at Rex’s request to open a surgical physician practice at the same location.
But not every project has won state approval, despite the wealth of building underway. Just last year Novant Health, which operates Franklin Regional Medical Center in Louisburg, NC, failed to achieve the go-ahead to build a $100 million hospital in Holly Springs.
Meanwhile, approval by the state of competing hospitals in Hoke County has triggered appeals from both healthcare providers that secured permission to build that cite concerns about overlapping facilities. Cape Fear Valley and FirstHealth of the Carolinas filed their objections in December. The various projects from the Triangle to the coast must receive state approval based on a Certificate of Need process that focuses on controlling costs and determining need.

Demand Is There
Despite all the building in recent years, David Strong, president of Rex Health­care, said there is patient demand for more.
“We hope the state recognizes the need to support this application for operating rooms (OR), as Rex generated the need for the three ORs in the state master facility plan,” he said. “The addition of these operating rooms to our campus in Holly Springs will provide a comprehensive center in this high-growth area of Wake County.”
The third operating room he mentioned would be an addition to Rex’s main campus in Raleigh. Rex also has facilities in Apex, Cary, Garner, Knightdale, Wake­field and downtown Raleigh.
Town leaders want the additions, said Holly Springs Town Manager Carl Dean.
“We fully and exclusively commit our support to Rex’s (certificate of need) application to the state,” Dean said in a statement. “Our town is growing, and we look forward to Rex Healthcare’s ability to provide much-needed medical services to our community through the addition of these two new operating rooms.”
The Holly Springs project is just one of several that have included expansion in Wake County by Rex — which is owned by UNC Hospitals — as well as projects by Duke Health and WakeMed.
The latest project outside Wake County is a $227 million, 68-bed hospital UNC Hospitals wants to build in Hills­borough by 2013. That project received initial North Carolina approval from the Department of Health and Human Services last September. However, a recently filed protest by the Alamance Regional Medical Center, which fears increased competition for an outpatient facility it opened in nearby Mebane, has led to a delay in a final decision by the state.
The UNC plan for Hillsborough is just the latest in a blizzard of expansion by the major healthcare providers.
UNC Hospitals and Rex Hospital, Duke Health and its Duke Raleigh Hos­pital, as well as WakeMed, have sprouted outpatient, specialty and emergency care facilities all over Wake County, especially in the fast-growing areas near Wake Forest.
Not to be outdone, Johnston County Health is building a major new tower in Smithfield and wants to grow even more. In Greenville, East Carolina University’s burgeoning healthcare system recently opened a new state-funded heart hospital.
Also building is New Hanover Region­al Medical Center, which is in the midst of expansion and upgrades that will stretch into 2010.
Here’s an overview of the healthcare building boom:

UNC Hospitals
Construction continues of a center for imaging and spinal treatment. The facility will cost $22 million. For the moment, however, plans for another patient tower at the main facility on the UNC campus are on hold.
In 2009, UNC opened a $208 million hospital focused on cancer treatment. The facility includes programs from the UNC Lineberger Comprehensive Cancer Center, as well as UNC Health Care System programs.
A biomedical research imaging building is also going up, budgeted at $242 million and including a 343,000-square-foot building for lab research. Completion is expected in 2013.
UNC Hospitals also is adding a $118 million, 216,000-square-foot dental sciences building that will open in 2012.
In Wake County, Rex and UNC Health Care, along with Raleigh Ortho­paedic Clinic, recently received approval for a $6.5 million ambulatory surgical center that will include four operating rooms.
In Siler City, meanwhile, UNC Health Care is expanding the hospital and related facilities it acquired in 2008. A $6 million addition is underway that includes a new $26 million, 66,000-square-foot building.

Duke University Health System

The Durham-based healthcare network plans to continue its aggressive expansion. At the top of the list: a $250 million cancer hospital that opens in 2012. The hospital will encompass 267,000 square feet and include 140 examination rooms and 75 treatment stations.
In 2008, Duke won approval for a massive $596 million expansion project that includes nearly 550,000 additional square feet, new intensive care units and so-called “step down care” units for patients who have left intensive care. The complex is set to open in 2013.
Duke also has discussed building a $50 million, 80,000-square-foot building for medical school instruction.
The Duke system includes Duke Uni­versity Hospital, Durham Regional Hos­pital and Duke Raleigh Hospital.

WakeMed Health & Hospitals
WakeMed is in the midst of expanding its new WakeMed North Healthplex with 41 beds for a women’s hospital. A year ago, WakeMed prevailed in a permit battle over Rex and Novant for the required state permit. The beds were authorized based on growth projections.
At its main campus in Raleigh, Wake­Med is building a $35 million, 60-patient tower for a new children’s hospital that will include a neonatal intensive care unit that will cost more than $8 million. In Cary, meanwhile, the WakeMed facility recently completed a two-story addition with 42 beds.

Johnston Health
Johnston Health is building a $62 million, five-story patient tower at its main Smithfield facility with 101 beds. Johnston Health is also expanding into Clayton with Johnston Medical Center-Clayton, which opened in October 2009 and includes an emergency room, an imaging department and a facility for outpatient surgery. Johnston Health plans to transfer beds from Smithfield to Clayton at some point, turning the Clayton facility into a full-fledged hospital.
The Clayton facility will cost $60 million once its transition to a full-service hospital is complete. $28 million is budgeted for the 27 acute-care beds to be moved from Smithfield.

Cape Fear Valley Health System
The Fayetteville-based healthcare network is seeking to build a 41-bed hospital on US Highway 401 near the Cumber­land-Hoke County line. It also would include a 16-bed emergency department. The facility will be called Cape Fear Valley West. Cape Fear also wants to add an outpatient center in Hoke County.
Both Cape Fear and FirstHealth recently received state permission to build facilities in Hoke County within 10 miles of each other. The hospitals have filed appeals with the state over the decision, saying the facilities would duplicate operations.

New Hanover Regional Medical Center
This large hospital in Wilmington is wrapping up a renovation project ap­proved in 2005 — the largest in the history of the hospital.
Last June, a new surgical pavilion that includes 26 operating rooms and covers more than 186,000 square feet opened. In September 2008, the Betty H. Cameron Women’s and Children’s Hospital was added. Covering 195,000 square feet, it includes a pediatric intensive care unit and a neonatal intensive care unit.
Still underway is a renovation of the main patient facility that will not be completed until late 2010. Almost all of the rooms in the nine-floor structure will be private. The first two floors were opened for patients last June.
At nearby UNC-Wilmington, construction is nearing completion on a $15.7 million nursing school building that covers 80,000 square feet.

Moore Regional Hospital
FirstHealth of the Carolinas is investing $90 million in a heart care center at Moore Regional Hospital in Pinehurst that covers 180,000 square feet. The building includes six operating facilities, six catheterization labs, 23 cardiology patient rooms and intensive care units.
FirstHealth, which is based in Pine­hurst, also operates hospitals in Mont­gomery County and Richmond County.
East Carolina University
As UNC Health Care built its cancer hospital, ECU completed its $220 million heart facility last year. The East Carolina Heart Institute at Pitt County Memorial Hospital covers 375,000 square feet and includes 120 beds, as well as six operating rooms in a six-story tower. It cost $160 million.
“This is the most advanced facility for cardiovascular care in this part of the country,” said Pitt County Memorial Hospital Vice President Brian Floyd on the one-year anniversary of the building. “But more importantly, we’re building an advanced team of caregivers who are expert at what they do and have a passion for people.”
The second part of the project is a $60 million Heart Institute.

Franklin Regional Medical Center
The state rejected a plan by Franklin Regional Medical Center to relocate facilities to Franklinton from Louisburg in partnership with Rex.
Last fall, Franklin Regional did land a new majority owner when Novant Health, which is based in Winston-Salem, assumed 99 percent ownership of the hospital from Health Management Associates.

Durham VA Medical Center
Upgrades and expansion worth $15 million are underway at the Durham facility. Additions include new clinical and research facilities.

MEDICAL NOTES
East Carolina Heart Institute Marks First Year

In its first year, the Heart Institute at Pitt County Memorial Hospital has treated more than 6000 inpatients with 70,000 procedures. The six-story, 375,000-square-foot Heart Institute is home to 120 inpatient cardiovascular beds, six operating rooms and 11 interventional laboratories.
The East Carolina Heart Institute at East Carolina University is a $60 million research, education and outpatient care facility. The four-story, 206,000-square-foot ECU building opened in September 2008. ECU and PCMH jointly dedicated the East Carolina Heart Institute in Dec­ember 2008.

New Heart Care Partnership

Nash Health Care Systems and the Boice-Willis Clinic in Rocky Mount, NC, have chosen University Health Systems of Eastern Carolina (UHS) in Greenville, NC, as the tertiary partner to explore improvements in the delivery of specialized heart care services for people in Nash and surrounding counties.
According to Larry Chewning, chief executive officer (CEO) of Nash Health Care, and Dave McRae, UHS CEO: “The focus here is to offer high-quality heart services in our four-county service area that Nash Health Care Systems has traditionally served.”
Dr. Nick Patrone, president of Boice-Willis Clinic, said the expanded cardiology program at Nash Health Care will provide a new level of cardiology service in Rocky Mount.
The heart center would be affiliated with the new East Carolina Heart Institute at Pitt County Memorial Hospital in Greenville. The Nash Heart Center could eventually serve as a satellite-training site for students and residents affiliated with The Brody School of Medicine at East Carolina University.

Japanese Heart Evaluator Demonstrated

NU-Tech 2010, a one-day conference focusing on investing in collaborative technologies (www.nutechshowcase.org), featured a demonstration by Japan-based FAIN-Biomedical Inc. of an endovascular evaluator designed for use in medical training and surgical practice.
Known as EVE, the FAIN device — the result of 20 years of joint research between engineers and physicians — the endovascular evaluator is a model of the human vascular system created from CT and MRI data. A high-precision model, it provides a realistic simulation environment that can be used for surgery rehearsal, medical student training, as well as medical devices and procedural evaluation.
NU-Tech 2010 featured more than 20 breakthrough technologies from the fields of life science, biotechnology and engineering. Held at the Starting at the Shera­ton Imperial, RTP, NU-Tech 2010 featured technology developments from Nagoya University, home to four Nobel Prize-winning professors in physics and chemistry (www.nagoya-u.ac.jp/en), North Carolina State University, The University of North Carolina at Chapel Hill and East Carolina University.
Featured speakers included:
• North Carolina Secretary of Commerce J. Keith Crisco
• Vice President of Eisai Inc., Dr. Ray W. Wood
• Director of Aisin AW and President of EQUOS Research, Masao Ando
• Nagoya University President Dr. Michi­nari Hamaguchi
• President and CEO of the North Carol­ina Biotechnology Center, E. Norris Tolson

Go to www.nutechshowcase.org for more information.