Making MGH Earthquake Safe
By Norman Carrigg, MD
What with the media absent, a special open
December 6 meeting at Marin General Hospital (MGH) of the Marin Healthcare
district board was not reported. MGH, like all California hospitals, has to
comply with the seismic upgrade requirements of SB 1953.
A modest amount of retrofitting by 2008 will be required by law for the East and Central hospital wings. Some has already been done. This could suffice to 2030. Stephen Mayer, the District board's financial consultant, using historical data as a basis, indicated that funding retrofitting should not be a problem for the future.
Where we go now is more complicated than the simplistic approach that I described to make the hospital earthquake safer.
Margaret Sabin, the CEO of the two Sutter Health Marin County hospital operations, wants the lease of MGH to Sutter Health extended ten years to 2025. It expires in 2015. Sabin, in addition, wants to build a new acute-care wing. If acute care is transferred to a new wing, much retrofitting would not be required.
Sabin is adamant that MGH remain part of Sutter's "obligated group." As a member of Sutter's obligated group, Sutter has the right to siphon out any hospital excess cash. What is excess cash? Cash in excess of that needed for 14 days operation. Sutter, not MGH, decides. In addition, MGH now is one of many hospital guarantors of Sutter's aggregate debt. This is even more scary than excess cash transfer. MGH is a winner but some Sutter hospitals are losers.
At this moment in Sacramento, there is a lawsuit by the Healthcare Board to void the hospital lease and return MGH to community control. Currently the suit is sidetracked by a statute of limitations question being heard at the appellate level. The Healthcare board alleges that the 30 year lease of 1985 is illegal.
There are some realities to consider. There are no free lunches. Patient revenue will upgrade the hospital or build a new wing in order to avoid a certain amount of retrofitting.
Suppose only seismic upgrade is done which will carry the hospital to 2030? Money saved could be diverted to such uses as a bonafide stroke center, for example, or other quality improvements. The Sutter Health Marin County Chief Financial Officer, Svend Ryge, pointed out that a decision about building a new wing could be delayed until 2003. Certainly the elected board and its constituents (all of Marin except Novato) will need to know a great deal more than they do now about retrofitting and/or rebuilding.