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Thursday, Mar 28, 2024

Hospital Needs Building Funds

Residents within the Antelope Valley Healthcare District will vote on a $350 million bond measure next month that will determine the fate of the region’s hospital. A proposed replacement hospital, to be built on district-owned land southwest of the existing Antelope Valley Hospital, is expected to cost between $600 and $650 million in total. The measure will need to pass with two-thirds of votes cast on March 3. The district plans to pay the remaining $300 million of the construction budget with revenue bonds, according to Ed Mirzabegian, chief executive of Antelope Valley Hospital. The need for a new hospital is driven by the state’s seismic safety standards, Mirzabegian told the Business Journal. Physical space is constrained, too. AV Hospital’s emergency room, for instance, was built to accommodate 40,000 patients per year; the hospital currently sees between 130,000 and 140,000 pass through its emergency room annually. “The emergency room would be designed to have a fast track, different zones based on acuity. There would be large, state-of-the-art trauma rooms, and then we are putting emergency imaging, surgery, cath lab, (gastrointestinal services), outpatient, everything on the same floor, next to each other,” said Mirzabegian. “That’s a huge way to really efficiently move the patient.” Supporters of the bond measure, according to the campaign’s website, include Dr. Mateo Olivarez, chairman for the district’s board of directors, and mayors Rex Parris and Steven Hofbauer of Lancaster and Palmdale, respectively. The 30-year bond would be repaid by property taxes of approximately $40 per $100,000 of a property’s value. Taxpayers within the district can expect a $10 per month increase for a median-priced home if the bond measure is approved, according to the separate campaigning arm in favor of building the new hospital named Yes on Measure AV. Fewer beds Plans for the hospital are still in its early stages, but the district has brought on RBB Architects to develop renderings. The proposed building has a capacity of 250 beds, a stark difference from the current 423 licensed beds which includes 85 to 90 beds in the Women and Children’s Pavilion, a newer facility built 15 years ago. “Health care is going toward outpatient,” Mirzabegian explained. “We are really concentrating on the functionality. You need less beds, to tell you the truth, for the future. The patient is staying less time, and that is based on insurance and governmental agencies looking at this very closely.” Currently, not all of the hospital’s beds are in use; some of the rooms are very old and built to house three to four patients. Now many of these rooms are used for offices or storage, Mirzabegian said. “It’s not adequate with three to four patients with one bathroom and one television; it’s just not conducive to today’s standard, so we don’t use those rooms. Most of the rooms are for two beds. We put one patient there in order to have a private room,” he added. Ironically, because of inefficiency, space is at a premium in the large hospital. In fact, the district board has approved $9 million to add a prefabricated building with 40 beds to the existing emergency room. “That is in the state planning commission right now. Hopefully in the next couple months that will be released and we will start that,” said Mirzabegian in a Jan. 27 townhall meeting. “We are hoping that by summer the building is ready. That is something we have to have now.” Square footage for the new hospital stands at roughly 350,000, with 1,500 to 2,000 square feet per bed, Mirzabegian said. Each bed will cost about $1.9 million. Management upheaval Similar to a school district, a hospital district is a political area on the map that collects taxes and provides the public a service. Management decisions for the hospital district are determined by a board of directors, with the hospital owned by the district. Mirzabegian returned to the position of chief executive after pursuing other executive roles with Avanti Hospitals Healthcare System, Healthcare Partners/IPA and Prime Healthcare Services. Prior to Mirzabegian, Michael Wall served for two years in the position before being put on administrative leave in October 2018; third-party health care management company Alecto Healthcare Services was ousted in 2016 before Wall was bought on, an attempt by the district to straighten out its finances. Antelope Valley Hospital was built in the 1950s and could be retrofitted, which Mirzabegian estimates would cost $400 million. That’s the only other option to building the new hospital. “(State regulators) gave us a timeline, they told us that we have until summer of 2020 to say what we want to do. Then, we have until January 2021 to have all architectural design and everything completed,” Mirzabegian told the Business Journal. “By 2022, you have all contracts for builders and developers and all that, it’s done and submit those plans to us. After their approval we have to start construction in 2022 and have it finished by 2025.” If the district misses any of these deadlines, the state could fine it $5,000 a day, Mirzabegian added. If AV Hospital closes, roughly 500,000 people would need to travel to other facilities. In addition to having the third busiest emergency room in the state, the hospital also houses the closest neonatal intensive care unit and in-patient mental health care facility for 50 miles in any direction – the next closest is Henry Mayo Newhall Hospital in the Santa Clarita Valley. Medical Main project In the event that the district builds the new hospital, other regional projects such as Medical Main Street could flourish. The development, a joint effort by the city of Lancaster and the hospital district, aims to transform 107 acres of vacant land in downtown Lancaster into a working health care cluster. “Medical Main is not going to happen if there is not a hospital there,” said Mirzabegian. “If you have a new hospital there going up, then the land will be attractive to people who want to invest in a nursing home, skilled nursing, surgery center, dialysis unit, even a hotel.” AV Hospital’s chief executive expects Medical Main Street to expand during the next 20 years at least, with parcels being bought up and added to project efforts. As for the existing hospital, the district may choose to demolish the structure and build a parking structure, Mirzabegian said, but it’s still too early to tell. “It could be a lot of things,” he added. “That hasn’t been decided yet but there are three or four plans for it. It’s not usable anymore.”

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