Released: 4/3/2020 12:43:47 PM
Buffalo Business First: What Does It Take to Turn a Building Into a Hospital?
Buffalo Business First
A new directive from the Centers for Medicare & Medicaid Services should help Erie County as it considers converting the Buffalo Niagara Convention Center into a COVID-19 care site. But there are lots of other considerations, too.
A series of new rules and waivers announced this week by the Centers for Medicare & Medicaid Services should hasten efforts to convert part of the Buffalo Niagara Convention Center, college dorms and closed health-care facilities into hospitals to treat coronavirus patients.
The move by CMS provides expanded flexibility for hospitals and health systems to respond to the COVID-19 pandemic, using a “hospitals without walls” approach to more effectively absorb and manage potential surges of patients using telehealth as well as ambulatory-surgery centers, inpatient-rehabilitation hospitals, hotels and college dormitories.
The temporary rules will allow hospitals to transfer patients needing less intensive care while using inpatient beds for COVID-19 patients.
Erie County officials last week toured the convention center with the Army Corps of Engineers to determine site suitability. County Executive Mark Poloncarz last Wednesday said it's one of several sites being considered.
Andrew Kornacki, public affairs officer for Army Corps of Engineers' Buffalo district, said the mission assignment from FEMA and New York state officials requires the assessment of how to bring people in and out of the site, mechanical systems such as water, electric and fire suppression as well as possible layouts for beds and equipment.
The process is similar to what took place to create the emergency center that opened in Manhattan at the Javits Center last week, he said.
“That’s what the Corps of Engineers was working at: A simple solution that can be applied across many different states,” Kornacki said. “It’s taking and building a simple solution to build out bed space quickly. Having a simple design that can be replicated is the best way to execute quickly and provide as much support to the region as possible.”
Maria Whyte, deputy county executive, said during Thursday's daily update that the county’s incident-command center is exploring other sites beyond the convention center for people who might need sub-acute care or need to be isolated but aren’t able to do so in their own homes.
A similar process is just starting now to transform a former nursing home in Orchard Park into a post-acute specialty site for patients leaving the hospital. Catholic Health is working with McGuire Group to reopen the 200-bed Absolut Care of Orchard Park site, which closed down last fall when the company filed for bankruptcy.
Catholic Health has signed a deal to lease the site and reopen it as the St. Joseph COVID-19 Recovery Center, with McGuire Group providing staffing and management. The site will open with 80 beds and likely expand from there, said Mark Sullivan, CEO at Catholic Health.
“We’re addressing the acute-care surge and where do patients go when they can be discharged,” he said.
Catholic Health last week converted its Sisters of Charity Hospital St. Joseph Campus into a COVID-19 acute-care site, with 41 patients now receiving care. That figure will jump to 90 in the coming days as other patients who tested positive Thursday are transferred over.
The sub-acute site could be open ideally in about three weeks, depending on what the two companies find when they reopen the building, Sullivan said.
“We don’t have access yet to the building, but we’re going to use the same approach as we did at St. Joe’s: a rapid deployment of resources,” he said. “We want to be a little ahead of the apex if we can.”
Both the Absolut site and the convention center still must be cleared as safe settings for whatever level of care is required for both patients and caregivers, said Joe Cassata, CannonDesign’s Buffalo office leader and president of its Facilities Optimization Solutions, a wholly owned subsidiary.
“We still must follow life-safety codes,” he said. “Regardless of how they open a facility, they still have to be safe.”
The company provides physical-asset-management consulting for clients in all markets, including health care and education. FOS is offering its building-recommissioning services pro bono to health systems and governments planning for surge capacity as well as reopening closed buildings.
For closed buildings, the process starts with assessing the building envelope, especially if the building has been closed for any period of time. That includes making sure it's structurally stable, that there were no hazardous materials left behind and that it meets air-quality-control standards, Cassata said.
“Are the ducts cleaned and are the pipes not leaking? Do they have the proper hot water for sterilization and are the hot-water tanks in good shape? Do they have an emergency generator if the power goes out?” he said.
So far, it seems these alternate sites will be used for patients who are not critically ill or those transferred out to make room for sicker patients inside actual hospitals.
Cassata said the company is in conversations with state officials on how it can help.
“CannonDesign has the expertise in health care with our planners, designers and clinical experts," he said. "We have the tools in place where we can be a real benefit to help reduce the spread of virus in our communities and statewide.”