SUNY Hospitals & A Healthier New York Capital Briefing March 1, 2013
Profile of SUNY Capital Programs Square Footage (in millions) 18.9 20.5 58.5 3.3 Educational Facilities Residence Halls Hospitals Community Colleges 2
SUNY Academic Medical Centers Combined Hospital vs. Academic Gross Square Feet (GSF) (Downstate, Upstate & Stony Brook) 5,852,159 3,329,804 Hospital Academic Excludes UB; Stony Brook Academic Includes West Campus Only 3
Hospital vs. Academic GSF Downstate Stony Brook Upstate 1,144,106 1,012,886 1,017,756 1,299,162 1,991,774 2,716,279 Hospital Academic Note: Stony Brook Academic Includes West Campus Only 4
SUNY Hospitals Gross Square Footage Number of Beds 1,017,756 1,299,162 607 882 1,012,886 589 5 Downstate Stony Brook Upstate
SUNY Hospitals Building Inventory Campus Type of Facility # of Buildings Gross Square Footage (GSF) Downstate Hospital * 10 1,299,162 Academic 8 1,144,106 Residence 2 140,586 Upstate Hospital 6 1,017,756 Academic 26 2,716,279 Residence 3 350,911 Stony Brook Hospital 8 1,012,886 * Includes 8 LICH buildings 456,562 GSF Academic West Campus 6 1,991,774 Academic 118 5,799,970 Residence 68 2,636,388 6
SUNY Hospitals Age of Facilities Based on GSF < 10 years 10-40 years > 40 years Downstate DMC ----- ----- 842,600 100% Downstate LICH ----- 354,047 78% 102,515 22% Upstate 231,425 23% 177,533 17% 608,798 60% Stony Brook 211,491 21% 795,732 78% 5,663 1% 7
SUNY Hospital Appropriations $500,000 $450,000 $400,000 $350,000 $300,000 $250,000 $200,000 $150,000 $350,000 $123,600 $126,700 2003-2008 $ in thousands $450,000 $150,000 $150,000 $100,000 $50,000 $0 $69,000 $99,700 $23,000 $23,000 $23,000 $150,000 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Downstate Upstate Stony Brook 8
$35,000 SUNY Hospital Disbursements by Fiscal Year through 1/31/13 $ in thousands $30,000 $25,000 $28,676 $28,148 $24,381 $25,448 $20,000 $15,000 $10,000 $5,000 $0 $20,201 $16,818 $12,493 $10,226 $8,668 $7,691 $6,074 $3,791 $3,118 $2,458 $40 $710 2008 2009 2010 2011 2012 2013 * Stony Brook Downstate Upstate * 2013 through 1/31/13 9
SUNY Hospitals Remaining Appropriations as of 1/31/13 $ in thousands $250,000 $200,000 $150,000 $146,653 $100,000 $50,000 $0 $145,009 $19,637 $90,105 $57,046 $2,793 Downstate Upstate Stony Brook 2003 2005 2008 10
SUNY Hospitals Major Capital Projects Currently Underway & Recently Completed Downstate Major Projects Currently Underway and Recently Completed: Program Improvements Pediatrics Intensive Care Unit - In Design Magnetic Resonance Imaging Equipment - In Design Interventional Imaging Modernization - Completed Transplant Unit - Completed Infrastructure, Energy Conservation and Renovation Projects Elevators - In Construction Hospital Kitchen - In Construction Energy Management Systems - Completed Infrastructure Improvement Projects Electric Upgrades - In Design Plumbing and Medical Gas Distribution to patient rooms - In Design Mechanical Equipment and Distribution - In Design Life Safety Improvement Projects Building wide Fire Alarm Systems - In Construction Smoke Dampers - In Construction Emergency Generators - In Construction GRAND TOTAL Underway and Completed $2.5 M $3.0 M $4.0 M $8.5 M $18.0 M $5.5 M $5.0 M $2.0 M $12.5 M $5.5 M $2.0 M $14.5 M $22.0 M $11.0 M $3.2 M $4.5 M $18.7 M $71.2 M 11
SUNY Hospitals Major Capital Projects Currently Underway & Recently Completed Upstate Major Projects Currently Underway and Recently Completed: Program Improvements North Wing Renovations - In Design Relocate Clinical Pathology - In Design Community General Renovations - In Construction Cancer Center/Clinical Labs - In Construction Inpatient Operating Room & Services Upgrade - Complete Tomotherapy Renovations - Complete Six floor vertical expansion to provide 135 adult bed, 70 pediatric beds, new Children's Hospital/Service Entrance - In Beneficial Occupancy Heart and Vascular Institute - In Beneficial Occupancy Emergency Room Upgrades - In Beneficial Occupancy Infrastructure, Energy Conservation and Renovation Projects Electrical Switchgear Improvements - In Design Upgrade Data Center - In Design Exterior Wall/Loading Dock Renovation - In Construction East Tower Repairs - In Construction Lobby Expansion & Renovation - Complete Various Renovations Infrastructure Improvement Projects Utility Relocations - In Design Water Supply Protection - Complete Life Safety Improvement Projects Roof Repairs - In Design Elevator Renovations - In Construction Fire Alarm Upgrades - Complete GRAND TOTAL Underway and Completed $6.0 M $7.0 M $5.0 M $88.0 M $3.0 M $1.0 M $140.0 M $15.0 M $7.0 M $272.0 M $1.0 M $1.0 M $2.0 M $2.0 M $5.0 M $3.0 M $14.0 M $1.0 M $1.0 M $2.0 M $2.0 M $1.0 M $1.0 M $4.0 M $292.0 M 12
SUNY Hospitals Major Capital Projects Currently Underway & Recently Completed Stony Brook Major Projects Currently Underway and Recently Completed: Program Improvements The New Beds and Support Tower- In Design (90 beds, Imaging, Children's Hospital) Comprehensive Psychiatric Emergency Program- In Construction Rehab for Heart Center- Completed Neuro Interventional Program- Completed Infrastructure, Energy Conservation and Renovation Projects Major Modernization Projects- In Construction (OR's, ED, Women's Programs, Lobby) Critical Maintenance- In Construction Infrastructure Improvement Projects Infrastructure- Utilities- In Construction GRAND TOTAL Underway and Completed $133.0 M $6.0 M $17.0 M $4.0 M $160.0 M $90.0 M $24.5 M $114.5 M $22.0 M $22.0 M $296.5 M 13
SUNY Hospitals Outstanding Debt as of 1/31/13 $ in thousands $251,818 $191,329 $187,542 Downstate (Includes LICH) Stony Brook Upstate Note: LICH Outstanding Debt = $100,222 14
SUNY Hospitals Annual Debt Service $ in thousands 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 TOTAL Downstate * $13,105 $11,702 $10,911 $10,324 $18,647 $23,864 $88,553 Upstate $19,330 $17,752 $15,240 $13,345 $14,697 $11,289 $91,653 Stony Brook $18,235 $17,869 $16,019 $14,895 $15,445 $15,174 $97,637 TOTAL $50,670 $47,323 $42,170 $38,564 $48,789 $50,327 $277,843 * Includes LICH debt payments of $48,487 15
SUNY Hospital 2013/14 Capital Budget Request $1.231B Planning & Approach Each hospital submitted a capital plan totaling $1.231B. Plans include projects to address critical maintenance needs, accreditation and revenue generating services. Capital improvements necessary in the face of ever increasing market demands and competition. Changing health care delivery systems makes planning challenging. Requires full project funding in order to properly plan and execute. Lack of predictable funding has made it difficult for hospitals to engage in strategic business development, accreditation needs and critical capital renewal. Funding Previous requests totaling $1.0B were submitted, however, the hospitals did not receive any funding in the last 4 years. The funding is financed through the Personal Income Tax (PIT) bond program. Hospitals pay associated debt service costs through an offset of operating revenues. Goals Maintain safe and up-to-date facilities. Keep hospitals competitive. Preserve accreditation to sustain federal reimbursement funding. Increase patient revenue and service to the communities. 16
SUNY Hospital Capital Request Downstate Capital Plan - FUTURE Downstate's capital plan is under review due to current circumstances. The following are capital projects to continue its mission of providing patient care and community services as well as maintaining good condition of existing facilities. LICH Projects Main Lobby Renovation Replace Chiller at Fuller Building OR Renovation Outpatient MRI Renovation Isolation Room Upgrades Observation Unit Upgrades Other LICH Projects (Critical Maintenances) Ambulatory Services Expansion at DMC (Under Review) Project is to expand the outpatient services at the hospital to meet evolving community needs and help improve hospital revenue. Phase 6 would add 44 beds. Other Program Improvement Projects at DMC Nursing Unit upgrades Operating Rooms Improvements Consolidation of Critical Care Patient room upgrades Converting 20 to 25 patient rooms to single occupancy Code Compliance Accreditation and Infrastructure Projects at DMC Install Sprinkler System Repair Upper Floors Parking Garage Remediate ARC Flash Asbestos Abatement Rehabilitate Ductwork Replace Smoke Dampers Emergency Generator Total Capital Required $25.0 M $5.0 M $3.0 M $5.0 M $2.5 M $3.0 M $49.0 M $92.5 M $284.0 M $50.0 M $11.0 M $25.0 M $14.5 M $15.0 M $115.5 M $8.0 M $4.0 M $5.5 M $3.0 M $1.0 M $4.5 M $5.0 M $31.0 M $523.0 M 17
SUNY Hospital Capital Request Downstate Capital Plan - FUTURE Downstate's capital plan is under review due to current circumstances. The following are capital projects to continue its mission of providing patient care and community services as well as maintaining good condition of existing facilities. LICH Projects Main Lobby Renovation Replace Chiller at Fuller Building OR Renovation Outpatient MRI Renovation Isolation Room Upgrades Observation Unit Upgrades Other LICH Projects (Critical Maintenances) Ambulatory Services Expansion at DMC (Under Review) Project is to expand the outpatient services at the hospital to meet evolving community needs and help improve hospital revenue. Phase 6 would add 44 beds. Other Program Improvement Projects at DMC Nursing Unit upgrades Operating Rooms Improvements Consolidation of Critical Care Patient room upgrades Converting 20 to 25 patient rooms to single occupancy Code Compliance Accreditation and Infrastructure Projects at DMC Install Sprinkler System Repair Upper Floors Parking Garage Remediate ARC Flash Asbestos Abatement Rehabilitate Ductwork Replace Smoke Dampers Emergency Generator Total Capital Required $25.0 M $5.0 M $3.0 M $5.0 M $2.5 M $3.0 M $49.0 M $92.5 M $284.0 M $50.0 M $11.0 M $25.0 M $14.5 M $15.0 M $115.5 M $8.0 M $4.0 M $5.5 M $3.0 M $1.0 M $4.5 M $5.0 M $31.0 M $523.0 M 18
SUNY Hospital Capital Request Upstate Capital Plan - FUTURE Bed/Service Reconfiguration - This initiative will provide a streamlined continuum of services between the main campus and the recently acquired Community General Hospital (CGH); all behavioral health beds will be consolidated at the downtown campus and all rehabilitation beds will be located at CGH. Specific projects include: University Hospital North/West Wing Renovations Emergency Dept/Behavioral Health/CPEP Community General Patient Service Reconfiguration Critical Maintenance/Infrastructure University Hospital - Power upgrades, life safety improvements, space renovations, MEP Upgrades Community General Hospital - Exterior façade renovations, power upgrades, life safety improvements, space renovations, MEP upgrades. Total Capital Required $70.0 M $75.0 M $30.0 M $175.0 M $70.0 M $25.0 M $95.0 M $270.0 M 19
SUNY Hospital Capital Request Stony Brook Capital Plan - FUTURE Stony Brook proposes the following new capital projects to continue its mission of delivering world class care as well as maintaining good condition of existing facilities: Program Improvements Renovation of Hospital for Single Patient Beds Renovation of Radiology Cath/ EP Lab Clinical Pathology, Open Lab Renovation OR Expansion in Hospital OR Expansion at ASC Renovations at Hospital (1) Cancer/ Imaging Center Renovations (1) Medical Office Building Renovation of Radiation Oncology SBUH Hospital Network (Southampton) New Parking Garage- 1600 cars Critical Maintenance/Infrastructure Elevator Upgrades Roof Repair at Level 6 Nurse Call Replacement HVAC Upgrades- 17 Fire Alarm Upgrades Surface Parking/ Roadways/ Site Work Data Center Expansion Total Capital Required $18.0 M $18.0 M $8.0 M $6.5 M $22.0 M $7.0 M $7.0 M $8.0 M $70.5 M $8.0 M $75.0 M $88.0 M $336.0 M $2.5 M $0.5 M $0.5 M $12.0 M $4.0 M $14.0 M $1.0 M $34.5 M $370.5 M Note: (1) Renovations of existing spaces within Hospital and Cancer Center are required to coordinate departmental and support space moves related to the construction of the MART and New Bed Tower Facility. 20
SUNY Hospitals Ten Year Capital Plan $1.231B Rehabilitation Program 35% New 30% $441.4 $467.1 Critical Maintenance 35% $322.0 By SUNY Categories Downstate Upstate Stony Brook 21