By Cathy Locke -
clocke@sacbee.com Site work for a $62 million expansion of
Placerville's Marshall Medical
Center, one of a relatively small number of independent community hospitals remaining in the state, is expected to get under way next spring.Administrator James Whipple said the hospital awaits state approval for construction of a four-story, 88,000- square-foot wing that will house a new emergency room, women's center and birthing rooms, intensive care unit and additional acute-care facilities, as well as a new cafeteria.
The expansion, he said, is necessary to handle the 34 percent increase in the 105-bed hospital's patient census that has occurred over the past seven years. The number of people treated in the emergency room during that time rose 37 percent and continues to rise, he said, while the number of meals served in the cafeteria is up about 77 percent.
He attributed the increase in business to El Dorado County's growing population, as well as a reversal in the flow of patients to medical facilities in Sacramento County.
"More people are coming from Sacramento and El Dorado Hills to use Marshall," Whipple said during a recent presentation before the Placerville City Council.
Some people, he said, likely are drawn by the high marks Marshall has received from HealthGrades, an independent health care ratings company. The firm announced in February that Marshall Medical Center was among the top 5 percent of hospitals in the nation for overall clinical excellence, based on a study of mortality and complication rates. Marshall was the only hospital in the Sacramento area to achieve the distinction in 2007.
But increasing business has stressed emergency room facilities, where eight to 16 patients typically occupy gurneys outside the 13 designated treatment cubicles, Whipple said.The intensive-care unit also is full most days, he said, with patients often housed in overflow areas, and birthing mothers share small two-bed rooms designed in 1959.
The cafeteria serves 680 employees and visitors daily, he said, though it can seat only 46 at a time.
Steve Calfee, Placerville's community development director, said that unlike most development projects, hospital construction plans are approved by the state, not the city.
But he said the hospital will need city approval for related activities, including parking lot design and signage, relocation of utilities, and vacating streets and right of ways.
Like most projects in the foothills community, the hospital, on Marshall Way east of Cedar Ravine Road, has had to deal with topographical challenges over the years.
"A hospital on a hill is not ideal," Whipple said.
It would be easier to build on flat land, but Marshall Hospital was founded with community support in the late 1950s and continues to enjoy strong local backing, he said.
The Marshall Foundation for Community Health seeks to raise $3 million for the new wing. But Whipple said the majority of project funds will come from internal financing and revenue from a bond issue.
He said eight nearby houses and a garage will be demolished to make way for the new wing and adjoining parking lots.
The new structure is planned on the southeast side of the current building. It will feature a "daylight" basement, below ground on one side and at ground level on the other. It will house a cafeteria and mechanical equipment room.
The first floor will include a new lobby and 32-bed emergency room. A 17-bed birthing center and 12-bed intensive care unit are planned for the second floor, while the third, or top floor, will house 34 to 37 beds for acute-care patients, Whipple said.
New parking lots also will provide more convenient access for patients and visitors, who have had to park across the street from the hospital. This is an important improvement for a medical facility that derives 60 percent of its business from Medicare patients, Whipple noted.
He said plans call for installing solar panels in the new lots and eventually adding them to existing parking lots. Electricity generated by the solar arrays is expected to supply about half of the hospital's energy needs.
Because of rising construction costs, facilities inside the new wing will be completed in phases. The emergency room and lobby, and the birthing center, are expected to open in late 2010 or early 2011.
The intensive-care and acute-care facilities will be completed as additional funds become available, the hospital administrator said.
"This is what we started with three years ago and thought we could complete," Whipple said in an interview, explaining that all facilities in the new wing initially were to open at the same time. "We had to cut back our expectations."
The new wing will be built on top of an existing portion of Marshall Way. The street forms a loop, connecting at each end to Cedar Ravine Road.
Whipple said a new circulation pattern is proposed that would direct hospital traffic east along Rowland Street to Washington Street while eliminating the Rowland Street access to Cedar Ravine.
Mayor Mark Acuna said the hospital expansion may provide the city with its last shot at developing a master circulation plan for that section of the city.
This is a chance to create a plan for vehicle and pedestrian traffic, he said.
Whipple said city officials and others have suggested that Turner and Washington streets might be used to take some traffic off heavily traveled Cedar Ravine Road.
Marshall Medical, which employees about 1,500 people in Placerville, Cameron Park and El Dorado Hills, has sought to reduce parking and traffic problems around the hospital by staggering shifts and moving some services to other sites in the city. But 500 to 600 people work at the hospital itself, Whipple said.
Calfee said city staff members are working with hospital representatives to address vehicle, pedestrian and transit options.
Marshall will provide copies of environmental studies for the expansion project to the city for use in future planning, Calfee said.
About the writer:
* Call The Bee's Cathy Locke, (916) 608-7451.
Hospital ready to grow
Marshall sees spring start to project, with state OK.
By Cathy Locke - clocke@sacbee.com
Published 12:00 am PST Thursday, December 13, 2007
Story appeared in El DORADO FOLSOM RANCHO CORDO section, Page G7
