Ben Taub to get $70M for ORs
But six rooms will go unused because of a lack of funding
A $70 million expansion project will increase the number of operating rooms at Harris Health System’s Ben Taub Hospital from 11 to 18, but funding challenges will leave six of the rooms unused, hospital officials said at a board meeting on Thursday.
The hospital system is facing an $8.6 million operating loss for the fiscal year ending Feb. 28, 2017, and officials estimate it would need an additional $135 million per year to fully equip, staff and use the remaining six rooms.
“We are building it out entirely,” Harris Health CEO George Masi said, “but what we won’t be able to do is operationalize it.”
Construction of the new operating rooms — the first in almost 30 years — is scheduled to begin this summer and will take two to three years to complete. At that time, Harris Health expects to use six of the new rooms and six of the existing ones. One of the new operating rooms will be used only for trauma cases.
“The new ORs are bigger, better and fully up to code,” said Michael Norby, executive vice president and chief financial officer of the health system.
“Part of the challenge that we have today because of the limited ORs and the limited size of the ORs is we consistently have to bump scheduled cases for trauma cases,” Norby said. “Adding ‘right-sized’ ORs, and one more, substantially adds flexibility and should reduce the amount of cancellations that we have to do.”
The new operating rooms were needed to maintain the hospital’s Level 1 trauma center status, which will not be affected by the decision to shutter six of the rooms. But the shortfall will limit the hospital’s ability to expand its surgical and trauma care.
“It just feels like we keep putting Band-Aids on a leaky boat,” Dr. Kimberly Monday, a board member and practicing neurologist, said at the meeting. “We’re going to have to let the public and the Commissioners Court know that we need more money.”
Ben Taub and Memorial Hermann Hospital operate
the only two adult Level 1 trauma centers in Houston, representing a major undersupply of capacity for the most complex emergency cases. When those trauma centers are filled to capacity, trauma patients must be transferred as far away as Galveston or San Antonio.
Norby said even if the hospital system could find the additional $135 million to operate the remaining six rooms, the system also would have to build additional primary and specialty care capacity to generate the demand for more surgical procedures.
“Patient volume doesn’t come out of thin air,” he said. “For operating room cases, it has to work its way through the system.”
The hospital also would need to find additional inpatient hospital beds for the patients after surgery. Ben Taub already is operating at full capacity.
A fraction from taxes
The expansion will be financed with $70 million in 20-year bonds, issued by Harris County and supported by real estate property taxes. Property taxes in the county are expected to add a fraction of 1 cent to the 17 cents per $100 in valuation to cover the nearly $5 million per year in interest and principal repayment.
Harris County Commissioners Court approved spending $70 million for the upgrades in November, and the Harris Health board formally approved the expansion plan at the Thursday meeting.
The Commissioners Court now will have to approve the bond issue at its July meeting and assign the necessary property tax rate increase in September.
Ben Taub was built in 1990 with 11 operating rooms and one special procedure room. Since that time, however, there have been no upgrades to the operating rooms. Several years ago, hospital administrators had taken three operating rooms out of service because they no longer met standards for air exchange or square footage. But that left the hospital with insufficient capacity to operate a Level 1 trauma center.
Funds reallocated
Harris Health initially had budgeted $67 million to renovate the rooms, but budgetary pressures forced officials to reallocate those funds.
The American College of Surgeons, which accredits trauma centers, conducted a routine visit of Ben Taub in late 2014 and cited the lack of operating room capacity. The group required the hospital to come up with a plan of correction to retain its status.
The inspectors returned Nov. 3 and, after reviewing the hospital’s plans for the expansion, renewed the trauma center’s certification earlier this year.
County property taxes allow Harris Health to provide free or almost free care to low-income, uninsured residents of Harris County. But fiscal shortfalls have forced the health care system to cut back on eligibility this year. Most of those who lost coverage were eligible for subsidized health insurance through the Obamacare exchanges.