Title
Receive a report on Natividad Medical Center’s key capital improvement projects for the period of May 1, 2017 through November 30, 2017.
Report
RECOMMENDATION:
Receive a report on Natividad Medical Center’s key capital improvement projects for the period of May 1, 2017 through November 30, 2017.
SUMMARY/DISCUSSION:
The Facilities and Construction Department staff at Natividad Medical Center (NMC) administers capital projects focused on strategically upgrading the hospital by reconfiguring and remodeling to better accommodate healthcare services for Monterey County residents and visitors. NMC is responsible for management, operation, and maintenance of building facilities and roads within the NMC campus.
Radiology Modernization:
NMC Diagnostic Imaging Department is located in Building 500, 1st Floor and requires a complete remodel and modernization. This includes the replacement of obsolescent medical equipment, such as Computer Tomography (CT) and Magnetic Resonance Imaging (MRI). In 2013, the department replaced aging X-Ray equipment with new digitally enhanced basic radiographic equipment. This was considered Phase 1, in a multi-phase approach to modernize the Imaging Department. Phase 2, includes adding two new CT scanners, a new MRI, and new Angiography Equipment. The cost for architectural services and construction is budgeted at $14,300,000 which does not include the equipment cost. The Security project has current expenditures of $66,500 in FY 2014-15 which was funded by the Radiology Modernization Project. The Security Relocation Project has its own capital budget in FY 2015-16 which will reduce the Radiology Modernization’s overall estimated project cost by $371,050 in FY 2015-16 and FY 2016-17, therefore, reducing the estimated total cost from $14,300,000 to $13,928,950. The project is forecasted to occur over a 24-36 month period with actual construction phased into several phases to maintain services during the remodel. On May 23, 2017, the board approved Amendment No. 2 with RBB Architects for the Radiology Modernization Project at NMC, extending the agreement an additional two (2) year period (July 1, 2017 through June 30, 2019) for a revised full agreement term of September 23, 2014 through June 30, 2019, and adding $1,307,000 for a revised total agreement amount not to exceed $2,524,350. This requested increase will leave $11,404,600 for construction and associated fees. Our original estimate for the construction is $10,236,545. On November 14, 2017, the Board approved to advertise the project and go out to bid. The bids will be read aloud at the Clerk of the Board’s office on February 22, 2018 at 2:00pm. This project is currently approved by Office of Statewide Health Planning and Development (OSHPD). The remaining balance for the Radiology Modernization project is $12,016,877 as of November 2017.
Nurse Call:
The original Fisher Berkley nurse call system that was put into service in 1998. The current nurse call system is a traditional system, which has a centralized annunciator panel with audible alarms and visual displays at the nurse’s stations. Additionally, the call system has a light that illuminates outside the patient rooms and patient bathrooms to alert staff to a fire or medical emergency. The bathrooms have a pull cord and the patient rooms have a hand push button cord with visual display. Pull cords are also found in patient showers and public bathrooms. All units have the same system but are independent of each other. All systems are original and have no interface with computer or other communication devices such as pagers and phones. The current Fisher Berkley Nurse Call system is at end of life and replacement parts have been discontinued.
The Nurse Call project was approved by the Board of Supervisors on June 2, 2015. It is the intent of NMC to phase the removal of the current wired system and to provide and install a new nurse call system. NMC will need to install a phased temporary wireless system which must be fully operational prior to the replacement of the old system. When the new Nurse call system is installed it will have the capability of using two way devices that are text capable to receive alerts from the nurse call system along with computer work stations in each unit. The schematic design phase of the project was completed and reviewed by the stakeholders. Currently the designers are proceeding with construction documents which is estimated to be submitted to OSHPD in April 2018. The remaining balance for the Nurse call project is $1,331,456 as of November 2017.
Pharmacy Remodel:
The Pharmacy Department is located on the first floor of building 580. The department develops intravenous (IV) medications that are introduced directly into the bloodstream, bypassing the anti-infective defenses of the stomach and skin. Contaminated compounding IV medications can result into patient harm due to infections. To prevent contamination, it is necessary that medications are developed by trained staff using proper procedures in facilities designed to prevent contamination. The current IV compounding facility in the Pharmacy Department will not meet new regulations set by the California State Board of Pharmacy for IV compounding. This project will update the facility to meet new laws and regulations by providing a new compounding room with a new non-hazardous anteroom and a hazardous medication storage room. The Pharmacy project was approved by the Board of Supervisors on March 1, 2016 in the amount of $1,200,000. The Pharmacy remodel project is expected span over two fiscal years (FY17-18 and FY18-19). NMC preliminarily contracted with The Stinnett Group to perform a feasibility study and work with the key stakeholders to propose a schematic design drawing to accommodate hazardous materials and IV compounding rooms. NMC then contracted with Kasavan Architects to proceed with the design development and construction document phase of the project. NMC signed off on the Pharmacy schematic set to let Kasavan proceed with development of the contract documents. The remaining balance for the Pharmacy project is $1,185,771 as of November 2017.
Parking lots and Roadwork:
Throughout the campus of NMC the roadways need improvement, from resurfacing and restriping of the parking lots, to providing additional parking spaces and resurfacing the main roadway. Bus stop locations need improvements due to the increased traffic. NMC needs to improve the sub grade and provide adequate foundation for the weight of the Monterey-Salinas Transit (MST) buses. The paint that designates pedestrian travel, stop signs, handicapped parking stalls, and curb paint has faded and will need to be repainted. The Parking lots and Roadwork project was approved by the Board of Supervisors on March 1, 2016, in the amount of $840,000. NMC has initiated a JOC project with Ausonio to provide this scope of work. Currently soils investigation was performed at the MST bus stops to identify the current condition of the sub grade. NMC is coordinating with MST to excavate the bus stop locations, compact the foundation, and resurface the roadway. The remaining balance for the Parking lots and Roadwork project is $568,178 as of November 2017.
PROJECTS COMPLETED
Central Plant Equipment Upgrade - Completed November, 2017
Central Plant - Cooling Tower Replacement - Completed November 2017
Central Plant - Water Softener Installation - Completed November 2017
Central Plant - Replace Boilers - Completed November 2017
Emergency Department Rapid Medical Evaluation Remodel Project - Completed November, 2017
MOB Buildout - Floor One - Completed November 2017
Building 400 - Mechanical Upgrade - Completed November 2017
Security Department Relocation - Completed November 2017
Temporary Parking Lot - Completed November 2017
OTHER AGENCY INVOLVEMENT:
This report will be scheduled to be presented to the Capital Improvement Committee and Budget Committee. The report was presented to the Capital Improvement Committee on February 12, 2018.
FINANCING:
Capital projects are funded from NMC’s operations. Where capital projects exceed $100,000, funds are transferred from NMC Enterprise Fund 451, NMC001-451-9600-8142 to NMC Capital Strategic Fund 404, NMC002-404-9600-8142 to ensure funding is available for approved projects. Funds are transferred from Capital Reserve to NMC Enterprise Fund as expenditures are paid to vendors.
Prepared by: Brian Griffin, Project Manager (831) 783-2605
Approved by: Dr. Gary Gray, Chief Executive Officer, (831) 783-2563
Attachments: Exhibit A - Capital Projects Matrix