Hospital plan reignites debate

Aurora calls proposed renovation of Oconomowoc facility 'ironic'

Milwaukee Journal Sentinel, May 28, 2006

By AMY RINARD
arinard@journalsentinel.com

Oconomowoc - ProHealth Care Inc.'s announcement this month of a $37 million renovation and expansion of Oconomowoc Memorial Hospital has done nothing to cool the debate over health care needs in western Waukesha County.

Officials with Aurora Health Care, who won a court decision Thursday in a lawsuit against the City of Oconomowoc, but have been thwarted for five years in their efforts to build a new hospital in this fast-growing area, called the ProHealth news "ironic" considering that ProHealth has spent years trying to convince people that its Oconomowoc hospital is capable of accommodating the medical needs of area residents.

ProHealth defends its plan as a prudent, moderate upgrade of health care facilities in the face of Aurora's more extensive plans and charges that Aurora has greatly understated the full cost of its expansion plans.

After intense lobbying by both sides, the County Board in April 2005 rejected a land use change needed for Aurora to build an 88-bed hospital in Summit about three miles south of Oconomowoc Memorial.
ProHealth, which also owns Waukesha Memorial Hospital, strongly opposed the plan and led the opposition to it.

ProHealth's announcement that it would add patient beds and significantly expand the emergency room at Oconomowoc Memorial proves the point made by Aurora that more medical facilities are needed to serve residents of western Waukesha County, said Sue Ela, senior vice president for Aurora and president of its Kettle Moraine region.

"We certainly do not question ProHealth's decision to enhance services for its patients," she said. "We intend to do the same for the benefit of Aurora's patients in western Waukesha County, and we believe it is only right and fair that we have this same opportunity."

Summit Town Chairman Len Susa was more blunt.

"How hypocritical," he said. "It's hypocrisy for ProHealth to be preaching for years against Aurora and then they do exactly what they didn't want Aurora to do."

Aurora officials continue to say they are committed to building a hospital in western Waukesha County and, in light of ProHealth's announcement, Susa said the County Board should immediately reconsider its previous vote rejecting Aurora's requested land use change.

"It flies in the face of any rational person," he said. "It's obvious ProHealth was just trying to keep out competition."

In addition, Aurora officials said Thursday they will proceed with construction in western Waukesha County following the court ruling, but Oconomowoc officials have said that decision could be appealed.

Also, officials said the city, which Circuit Judge James Kieffer found had violated its own procedures in rezoning land so a hospital could not be built there, might vote on the rezoning again to cure the legal defect that resulted in the judge voiding the vote.

John Robertstad, CEO of Oconomowoc Memorial, argues that the renovation and expansion of his firm's hospital is simply the normal evolution of a medical facility as it continues to make improvements and upgrades to meet patient expectations and accommodate community growth.

"The quality has always been here," he said.

"But now, to help support staff and patients, we'll have a facility that's an appropriate size and designed for family care."

He said the plan to add up to 11 patient beds, taking Oconomowoc Memorial from 79 beds to as many as 90, is more than adequate to meet community needs until 2015.

Aurora's plan, he said, is too big, too expensive and would result in duplicative services, medical support staff shortages and cost increases for all area health care users.

"You don't need 88 more beds and you don't need all the additional support facilities for those beds," Robertstad said.

ProHealth officials point to a recent filing by Aurora in its lawsuit against Oconomowoc, which rezoned land in the city in 2001 so that a new hospital could not be built there, that shows the total cost of building the proposed new hospital was $132 million, including the cost of land and equipment, not the $85 million Aurora officials had said.

Today, according to Aurora's financial expert, the cost to build the same hospital design later proposed for Summit, would be $166 million, including land acquisition and equipment costs.

Aurora officials said that when they announced the project more than two years ago, their best estimate of construction costs was $85 million.

"More detailed planning subsequent to the announcement brought the figure closer to $89 million. These estimates did not include the cost of acquiring the land or purchasing medical equipment and other equipment for the hospital," the company says in a statement. "The long delay in starting the project has added many millions of dollars in construction and equipment costs."

By comparison, Robertstad said, ProHealth's investment of $37 million in renovating 80,000 square feet and adding 44,000 square feet of space at is reasonable even in addition to the costs of smaller recent remodeling projects inside the hospital.

Under the construction plan, which will require city approvals, the emergency room would be remodeled and greatly expanded in size with a more visible ER entrance built at the front of the hospital at the northeast end.

The current emergency room, located at the back of the hospital with only a couple of signs in the parking lot directing people to its entrance, is difficult to find, too small and was not built with the kind of patient privacy amenities that most people now expect in a medical facility, Robertstad said.

The hospital plan also calls for a new section of patient rooms to be built at the front of the hospital in a sweeping, glass-fronted addition next to the main entrance.

This new construction also would house an expanded cafeteria now located down a corridor that is difficult for the public to find.

A renovated main lobby area, designed to be more homey, would be two stories high, with a larger waiting room and a new, more private admitting and patient registration area.

A separate elevator will be built for use by patients being discharged so they do not have to be wheeled through the main lobby area.

In a nod to the new demand for patient privacy, a separate bank of elevators will be devoted to patients going from one area of the hospital to another for tests and treatments. Patients and visitors have to use the same elevators now.

The existing medical office building now connected to the hospital would be partly renovated, with a community room and conference center space built on the first floor and hospital administrative offices moving to the third floor.

The second floor would continue to house the offices of obstetricians and gynecologists, who would have access from that floor to the hospital's OB/GYN unit nearby.

Existing hospital patient rooms, now located toward the back of the hospital complex, would be remodeled and enlarged from 180 square feet to about 400 square feet.

Construction would begin next spring. It will take about 34 months to complete all phases of the new hospital project.

The project would be funded through a bond issue, corporate revenue and donations from the community.