University of Iowa Health Care optimistic about new North Liberty hospital, despite state rejection

IOWA CITY - One week after a state council narrowly denied a University of Iowa Health Care application to build a new $230 million hospital in North Liberty, UI Vice President for Medical Affairs Brooks Jackson said the hiccup wasn't surprising and he expects the project eventually will materialize.

'The outcome, while disappointing, is not unexpected,” Jackson told the Board of Regents on Wednesday. 'Those of you who may be familiar with the Iowa certificate-of-need process know that it is not uncommon for a project of this significance to require more than one hearing before receiving approval.”

Despite fervent opposition from regional community hospitals and health care providers to the proposed 300,000-square-foot UIHC expansion planned for 60 acres at the southwest corner of Highway 965 and Forevergreen Road, Jackson described the planned facility 'as a vital extension of our academic medical center in a community setting that is centered on the patient.”

But UIHC patients, unlike those at community hospitals, 'are complex, with multiple comorbidities commonly,” Jackson said.

'And this allows us to provide that service, not only on this campus but out there - as the need continues to grow year over year,” he said. 'This will help us decompress our main campus and open capacity for clinical services for those complex patients that need to remain on campus.”

Speaking confidently about the future of the proposed four-story hospital, Jackson told the regents it will add up to 36 UIHC inpatient rooms, up to 16 operating rooms, an emergency department, and advanced ancillary services like imaging, pharmacy, and laboratories.

'It will be connected to a building that will house ambulatory clinics for comprehensive coordinated care, as well as dedicated space for teaching and research,” he said. 'It will deliver care best suited to be provided away from the main campus in an ambulatory setting with support from inpatient and emergency care facilities for patients who have complex care needs.”

Before the State Health Facilities Council last week denied a certificate of need for the UIHC project, its five members heard nearly seven hours of testimony from supporters of the project and opponents - like Mercy Iowa City, Mercy Cedar Rapids, and UnityPoint Health officials.

'This project, in my view, is completely unnecessary,” Mercy Iowa City emergency department medical director Peter Peraud said in the hearing. 'It's bad for our physician group, bad for the community hospitals that we serve, and bad for the patients in our local community.

'This duplication of services could close the only community hospital in Iowa City.”

Critics said community hospitals have plenty of open beds to ease demand at UIHC and projected the demise of community health should UIHC be allowed to veer out of its 'lane.” UIHC officials said they're not interested in engaging in community health and serve an entirely different - and sicker - set of patients, many of whom those smaller hospitals transfer to UIHC.

Those transfers, in part, have UIHC crammed and overcrowded but without space to expand near its main campus next to Kinnick Stadium, which is why it's eyeing the land it owns in North Liberty, university officials said.

'We see the coming tidal wave of an aging population with increasing comorbidities that will require the kind of complex care for which we are the only provider in Iowa,” Jackson told regents. 'We know that a second academic health care campus will address these growing health needs while simultaneously continuing to advance our research and education missions.”

UIHC administrators are waiting on a formal report and justification from the state council - which a representative told The Gazette could take weeks - to determine next steps and to 'better understand and address questions and concerns they may have as we move forward in this process.

But, Jackson said, 'We will continue to give 100 percent effort to make the case for this project for the people of Iowa, just as we gave 100 percent effort to ensure we can meet the needs of our community to protect our state's hospital from collapse against the weight of a terrifying COVID surge.”

'Because that's what academic medical centers do, and that's what Iowa's future demands.”

COVID recovery

In addressing UI Health Care's updated COVID-19 response and impact on its finances and operations, Jackson reported a 'sunnier picture” than November - when UIHC had activated its COVID 'surge” plan - or last May, when the campus projected it could take a $100 million hit.

Instead, UIHC on Wednesday reported $1.1 billion in revenue to date this budget year, which ends June 30, above the $1 billion budget and last year's $988.5 million through the same period. With increased expenses for things like agency nurses, overtime, pharmaceutical, and supply costs, UIHC's operating income sits just under the $52.9 million budget at $51.9 million.

And, as far as COVID care goes, Jackson said, 'The pandemic picture has improved significantly.”

'We were able to deactivate our UIHC surge plan at the start of the new year,” he said. 'And COVID-19 positivity rates in Johnson County and across the state have continued to trend downward.”

UIHC on Wednesday reported 14 COVID inpatients - far fewer than the peak over 100.

'And we are seeing many fewer patients in ICU beds now,” Jackson said.

More than 12,500 UIHC employees have received one dose of vaccine; more than 9,200 have received two; and by the end of Wednesday UIHC 'will have vaccinated over 6,500 patients, and over 1,200 teachers in Johnson County.”

'UI Health Care has demonstrated its capacity to administer swiftly and efficiently any doses we receive,” he said. 'But, as is the case elsewhere, (supply) is currently limited, which is a factor we do not control.”

Jackson reported UIHC on Wednesday alone vaccinated more than 2,000 patients in Coralville, 'which is quite a feat.”

'So there continues to be glimmers of light, as we keep an optimistic eye toward the future.”

Even with those improvements, UI Hospitals and Clinics CEO Suresh Gunasekaran told regents his campus still has the highest COVID ICU census in the state and the largest number of patients on ventilators.

'And none of them are from Johnson County,” Gunasekaran said, pointing back to the different patient population UIHC serves and his argument for the need to expand.

'This is again a story of what the health care system needs us to do and what we need to have capacity and expertise to do, which is ultimately to serve the whole state,” he said. 'I think we continue to look forward to explaining a core part of our mission, which is to make sure that in the broader health care system of Iowa that we continue to have the capacity to serve the need.”

If UIHC has the resources it needs to serve the sickest patients - including those with COVID who require longer hospital stays - 'The majority of other hospitals in Eastern Iowa and Central Iowa can continue to move on with the business of other health care.”

'The model is working,” he said. 'We just need to continue to advocate for more capacity to be able to do it.”

Comments: (319) 339-3158; vanessa.miller@thegazette.com