116 3rd St SE
Cedar Rapids, Iowa 52401
IOWA CITY — Even as crews are developing a new University of Iowa Hospitals and Clinics in North Liberty, UI Health Care is making plans for another tower and a new College of Medicine building and clinic on its main campus in Iowa City.
Planning for those three projects — likely to cost in the hundreds of millions — is in its early stages. But they are envisioned to come online within the next decade or so, UI Hospitals and Clinics Chief Executive Officer Suresh Gunasekaran told reporters.
“We think this is a tremendously exciting planning effort, we think that this significantly improves our ability to serve Iowans by the end of the decade,” he said. “We think that when we get all of this done 10 years from now, or so, we would increase the capacity of UIHC’s ability to see Iowans by probably 30 to 40 percent.”
First among UIHC’s expansion projects is a new hospital tower on its main campus — which regularly is near capacity and forced to turn away transfers, despite its 860 beds serviced by 16,500 employees, students and volunteers. Second in line is a teaching and research building for the UI Carver College of Medicine.
“As the faculty size is growing so much, and the number of learners is growing so much, we need more teaching and research space at the campus over the next decade,” Gunasekaran said.
Third is an ambulatory care building — or another clinic — for patients on the main campus. Specifics of what that clinic might hold haven’t been ironed out, but Gunasekaran said campus clinics typically focus on interdisciplinary needs.
“So transplant, cancer, neurosurgery, cardiac surgery, some of these more complex programs, their clinics will always be on main campus,” he said.
UIHC has expanded its clinics operation across the state in recent years, from Fort Dodge, south to Des Moines, east to Davenport and up to Dubuque and Waterloo. But all three of its new buildings announced this week will be added to the main Iowa City campus.
That, Gunasekaran said, is because this development is driven by a need for renovation and modernization. Some of the clinics to be modernized were built in the 50s, 60s and 70s. “So there is a certain component of this entire master plan, which is just replacing and modernizing,” he said. “It's not really growth.”
That concept holds true for the new planned main campus tower, which is meant in part to relieve hospital facilities that are at or nearly 50 years old and out of space. Due to rising health care demands, Gunasekaran said, the hospital system can’t afford to shutter portions while they’re under renovation.
“We knew it would be a big problem within the state of Iowa if we started shutting down services so that we can build things,” he said. “So what we've come up with is preliminary planning that would allow us to be able to continue to expand capacity and renovate while not reducing capacity.”
The new tower will enable UIHC to expand and modernize operating rooms, surgical suites and inpatient rooms. The new tower could enable UIHC to offer more beds and more single rooms, Gunasekaran said.
“But our anticipation today would be, hopefully, that this is only a modest increase in the number of beds that we have, and that the majority of these are replacement beds,” he said.
Because UIHC is under its licensed bed capacity, Gunasekaran said, it doesn’t need state approval to increase its bed total. In fact, the hospital system doesn’t anticipate needing state certificates for any of the planned construction because “when you modernize an existing facility, you do not tend to need a certificate of need.”
“You also don't need a certificate of need for a clinic building,” he said. “You definitely don't need a certificate of need for academic and research buildings. So the only question on the table would be whether we need a certificate of need to make our current hospital modernized, and I don't think we will.”
UIHC did need a certificate of need from the State Health Facilities Council to build a portion of its $395 million North Liberty project — a request the council initially denied after widespread pushback from community hospitals and health care providers accusing UIHC of veering out of its lane.
Representatives of Mercy Iowa City, MercyOne, Mercy Medical Center in Cedar Rapids, and UnityPoint Health-Cedar Rapids all strongly opposed the project, telling state decision-makers the project could trigger the demise of community health care.
But UIHC in Aug. won approval for its North Liberty development upon reapplying with a revised application characterizing the development as an expansion.
The North Liberty facility will include another UIHC emergency room, which typically is slammed on the main campus — with some care-seeking patients leaving without ever being seen.
And, even with that new ER in the wings, Gunasekaran said the lack of emergency capacity on the Iowa City campus isn’t a problem that can go unaddressed for a decade. Thus, UIHC expects to expand its main emergency room in a year or two.
“Because we just know our patients need it,” Gunasekaran said. “Our emergency room is so overcrowded. We also have already started a renovation of an additional observation unit on lower level that will open next year. That would allow patients who are waiting for a bed to not have to wait in the emergency room.”
In the end — after the new tower and main campus renovations are complete — Gunasekaran said UIHC will have a little more space for everything it does.
“It'll increase beds, it'll increase ORs, it'll increase psych, it'll increase med surge, it'll increase OB — everything a little bit because every part of UIHC has a backlog of needed patients,” he said. “So every type of capacity will increase.”
Only its pediatrics capacity doesn’t need a boost, as UIHC debuted a new 14-story Stead Family Children’s Hospital in 2017 at a cost that grew to $392.7 million.
Although plans are in their infancy, Gunasekaran said the new main campus tower could be as imposing as the new Children’s Hospital, which overlooks Kinnick Stadium as the tallest in town.
“The Children's Hospital is the tallest that we are allowed to build for flight patterns and other things, so we know it can be as tall as the Children's Hospital,” he said. “And if we build an inpatient tower the way that I think we will, it will likely be as tall as the Children's Hospital.”
Covering the cost
Costs for all the work aren’t yet known. But Gunasekaran said the money won’t come from taxpayer dollars through state appropriations by the Iowa Legislature.
“The primary fund source for all of this will be our business operations,” he said. “We will finance through cash. We will finance through debt on the open market. And we anticipate that, given the success that we've had over the last several years financially, if we continue to have this kind of success over the next decade, we think that we will be able to finance this as we have financed other projects — just through our health care operations.”
In a meeting next week, the university is seeking Board of Regents approval for this big-picture planning. But officials said they will come back for permission on specific projects, planning and budget needs.
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