Title
Receive a report on Natividad Medical Center’s key capital projects
Report
RECOMMENDATION:
It is recommended the Capital Improvement Committee receive a report on Natividad Medical Center’s key capital projects.
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. NMC is responsible for management, operation, and maintenance of building facilities and roads within the NMC campus.
Radiology Modernization:
The Diagnostic Imaging Department, located on the first floor of building 500, 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 CT scanners ($1,279,497/ $1,044,751), a MRI ($1,991,841), Nuclear Medicine ($455,978), Angiography Equipment ($1,338,757) and a Hemodynamic System ($137,426) which have been approved during prior budget cycles with the exception to the second CT scan scheduled to be submitted in FY2020 budget. The project was approved by the Board on September 30, 2014 in the amount of $14,300,000 which did not include the equipment cost. On November 14, 2017, the Board approved to advertise the project and go out to bid. The bids were read aloud at the Clerk of the Board’s office on February 22, 2018. On July 10, 2018 the Board awarded the project to Otto Construction in the amount of $12,947,000 and approved to increase the construction project cost to $18,373,081. The total project cost, which includes design, construction and equipment equals $24,621,331. 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. This project is currently approved by Office of Statewide Health Planning and Development (OSHPD). Construction started on September 4, 2018 and is currently 35% complete with Phase 1 of the project. The remaining balance for Radiology Modernization project is $15,443,402 as of January 2019. Exhibit B is the Radiology Modernization project schedule.
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 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. On May 22, 2018 the Board approved an increase of $1,651,000 for a total project cost of $3,001,000. It is the intent of NMC to phase the removal of the current system and to provide and install a new nurse call system. NMC will use a phased approach to install the system in which each phase will be fully operational prior continuing to the next phase. 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. Designers submitted the construction documents to OSHPD on November 30, 2018, which were returned with comments on January 10, 2019. The architect is responding to the OSHPD review comments. The remaining balance for the Nurse Call project is $2,698,822 as of January 2019.
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 in 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 fiscal years 2017-18 and 2018-19. 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 project was submitted for plan review to OSHPD on October 26, 2018. The remaining balance for the Pharmacy project is $1,145,512 as of January 2019.
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 $417,969 as of January 2019.
NMG Clinic Bldg 200:
The Natividad Medical Group (NMG) project will expand primary care clinic services for the community. Presently, NMC has primary care clinics with a capacity of four exam rooms located in building 400. The expansion will provide seven additional exam rooms bringing to a total of eleven exam rooms. The expansion project also includes one procedure room which the clinic would perform minor surgical procedures under local anesthetic. In addition to primary care services, the clinics anticipates offering after hours urgent care services. The seven additional rooms will provide access to approximately 150 visits per day. The additional capacity for primary clinics is much needed to better serve the community and the region needs for primary care physicians. The NMG Clinic Bldg 200 project was approved by the Board of Supervisors on February 1, 2018 with a total project cost of $2,225,000. Construction started on September 10, 2018 and is estimated to be completed by the end of March 2019. The remaining balance for the NMG Clinic Bldg 200 project is $1,428,785 as of January 2019.
OTHER AGENCY INVOLVEMENT:
This report will be scheduled to be presented to the Capital Improvement Committee and Budget Committee.
FINANCING:
Capital projects are funded from NMC’s operations. Where capital projects exceed $100,000, funds are transferred from NMC Enterprise Fund 451to NMC Capital Strategic Fund 404 to ensure funding is available for approved projects. Funds are transferred from the Capital Strategic Fund to the 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, Exhibit B - Radiology Modernization Schedule