City to review Tuality master plan that would quadruple facilitys size

by: COURTESY PHOTO: TUALITY HEALTHCARE - The Tuality Forest Grove expansion would add some four-story buildings to Maple Avenue -- one of them a parking structure (top right) -- and quadruple the hospitals current square footage.After a tough financial year for Tuality Healthcare, the largest health care provider in western Washington County — for another month at least — has submitted a plan to quadruple the size of its Forest Grove hospital and double the staff.

As Kaiser Permanente gets set to open its westside medical center in Hillsboro Aug. 6, the city of Forest Grove’s planning commission will review Tuality Healthcare’s master plan July 15. If approved, the whole block on which Tuality’s Forest Grove branch sits could be completely renovated.

An approved master plan gives Tuality permission to make any changes agreed upon in the plan without hassle from the city in the future.

Tuality’s primary hospital, Tuality Community Hospital, is located in Hillsboro. The Forest Grove branch is mainly for day and emergency visits, acute care, and lab and X-ray services. The only patients staying overnight live in the 22-bed geriatric psychiatry unit. All these services would get new facilities, according to the master plan.

Tuality officials say they created the master plan to prepare for a potentially massive growth in population. Forest Grove’s population has spiked 19 percent in the last 10 years, and experts say it’s not slowing down anytime soon.

By 2030, Forest Grove is predicted to have 31,561 residents — a 10,000-person increase. Steve Krautscheid, director of facilities and properties at Tuality Healthcare, knows the current hospital wouldn’t be able to serve that number.

“Changes really hinge on population and need,” said Krautscheid.

Renovations would come in four phases and make for some of the biggest buildings in Forest Grove’s history.

Other than on the Pacific University campus, a four-story building is unheard of in Forest Grove. This master plan would allow building structures up to a maximum of four stories tall in the appropriate zone. The south portion of the master plan zone, near Maple Street and 18th Avenue, has a height maximum of 85 feet, which is fitting since hospital ceilings are generally taller than in normal buildings.

Tuality Forest Grove is conveniently located on the same block as the Maple Street Clinic, a family medicine center, three private practices, the Marquis Care center and Marquis Forest Grove Assisted Living. The master plan proposes to include every business on the block, giving them the option to opt-in to the hospital’s proposed changes.

“Maple Street Clinic has agreed to join the master plan zones,” Krautscheid explained. “They’d have the option to have taller buildings. We are keeping our options open and it gives them more options.”

While higher buildings would be one of the most obvious changes, nearly everything about the current hospital and surrounding area would be completely redone, with an eye to promoting preventative care.

Now 42,800 square feet, the hospital would more than quadruple in size to 179,600 square feet, including 107,600 square feet for inpatient and outpatient hospital services such as radiology, surgery, emergency, respiratory therapy and inpatient rooms.

The second largest area of the hospital would be outpatient medical offices: 30,000 square feet would be dedicated to dialysis, physical and occupational therapy, lab services, a sleep lab and support functions.

Gerry Ewing, director of corporate communications for Tuality, said similar space for facilities in Hillsboro has had positive results.

“Changes in the master plan make it more convenient to provide preventive care,” said Ewing. “We want to provide education and classes to not clog up the ER.”

With nearly 39,000 emergency room visits between both ERs in 2011 alone, preventive care seems to be the answer.

The list of changes continues.

Currently, Tuality Forest Grove has 114 parking spaces, but would add a four-story parking structure with 150 spaces — the first of its kind in Forest Grove. The parking structure would use motion-activated lighting and would be designed to minimize headlights shining onto other structures.

A focus in building would be on sustainability. The possibility of garden roofs, drip irrigation and harvesting rainwater are all detailed in the plan. The hospital would include a heliport. Currently, helicopters use the back field.

“This service supports not only the hospital but the entire community, providing an adequate landing pad for sending patients out quickly for critical medical conditions,” said Krautscheid.

The number of employees would increase from 173 to 400. The staff would allow for an increase in classes, support groups and health care fairs. Related outpatient facilities on Tuality-owned property would employ an additional 75 to 100 people as well.

Krautscheid said the potential changes are not an attempt to compete with Kaiser’s new facility.

“We supported Kaiser’s presence in the community so members have local options,” he said, noting the two hospitals’ customer bases don’t overlap.

Generally, only those enrolled in Kaiser health plans can go to Kaiser hospitals, while Tuality serves people on Blue Cross Blue Shield and other health plans.

The success of Tuality’s Forest Grove expansion depends on the hospital’s financial picture — which has been rocky recently.

Tuality’s Forest Grove and Hillsboro facilities had a rough year financially in 2011, the last year in which data was available. The Lund Report, an online news source focused on health care systems, has kept track of many hospitals’ finances, including Tuality’s.

In the Lund Report’s April 5 review of hospital finances, reporter Courtney Sherwood reviewed Oregon Health & Science University, Kaiser, Adventist and Tuality, citing a net loss of $5.8 million for Tuality in 2011. Net patient revenue was $170.8 million, down 1.4 percent from 2010. Tuality’s profit margin was negative 3.3 percent in 2011 compared to a positive 2.1 percent in 2010, according to Sherwood.

Ewing said such statistics are standard for nonprofit hospitals and are driven by low interest rates and pension-liability adjustments. They’re nothing to worry about, he said.

And Tuality’s plans are still fluid, he said. “There’s not a date to start this.”

Tuality hopes to get more patients next year, Ewing said, with the start of Obamacare, which highlights preventive care and gives many more people access to health insurance.

And to spike the population growth that could catalyze the Forest Grove expansion, he said, “all it would take is one large business.”

“There are a lot of unknowns in the medical world right now,” Krautscheid said. “I see an increasing role in small community hospitals.”

Long history of hospitals

Originally, co-workers in Forest Grove hospitals had to work closely together, mainly because there wasn’t much room.

A long time before Tuality bought the facility in 1982, Forest Grove’s main hospitals performed services out of homes.

One of the first recorded hospitals was the Ward Clinic in the rectangular one-story building at 1916 21st Ave., run by Dr. Daniel Ward from the late 1880s to the early 1900s.

Dr. William Via arrived in Forest Grove in 1888 to open a medical practice in a mansion at 1810 Pacific Ave. Via also served as mayor and civic leader to Forest Grove.

Another doctor of the time worked out of his house as well. Dr. Charles Large served as Washington County’s coroner from 1896 until 1908 and practiced medicine at 2017 21st Ave.

In 1911, the News-Times announced, “Forest Grove Is To Have a Sanitarium.” And in 1912 the Forest Grove Hospital was open for business. The home-based hospital, at Cedar Street and 12th Avenue, was headed by Anna Paul, a graduate nurse from the Los Angeles Orthopedic and General Hospital.

The house now belongs to Mary Jo Morelli, president of Friends of Historic Forest Grove.

“When I first moved into that house, a woman who has since passed told me she had her tonsils removed in my dining room,” said Morelli.

In 1924, Dr. Guy Via followed in the footsteps of his father, William Via, and opened his own hospital about two miles west of town in a home known as the Frank Johnson Place. It had 17 beds, with space for major and minor surgery, and was the only hospital in the county registered with the American Medical Association.

In the 1940s, the Alpha Zeta fraternity house at 1806 Elm Ave. was made into a hospital, doubling as a veterans' home during World War II.

It wasn’t until three osteopathic physicians — Dr. Fred Richards, Dr. John Wood and Dr. A.V. Jackson — came together that the Forest Grove Community Hospital was created. In 1963, they finalized their purchase of the hospital for $412,000. They sold it in 1967 to a group of businessmen, who in turn sold the hospital to American Medical International. In 1982, Tuality bought the hospital and by 1990, the name Tuality Forest Grove Hospital was official.

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