In the biggest capital investment in its 128-year history, Erlanger Health System and its partners are building more than $100 million of new facilities at four different sites to enhance medical services provided by Chattanooga's biggest hospital.
Over the next decade, hospital planners are dreaming up plans for far more - as much as $1.5 billion of building upgrades and additions and new equipment and programs at or around Erlanger facilities across even more sites.
Most of the cost of the new projects now underway are being borne by Erlanger partners or donors, and are projected to bring more patients, services and employees to Erlanger. But the building boom is also bolstered by the turnaround in the fiscal health of Erlanger, which lost nearly $36 million from 2008 to 2013 but has made an even bigger $39.4 million of net income over the past couple of years.
"We've got a management team in place now that knows how to deliver results and take on these kinds of projects to deliver really, really high-quality health care," said Jack Studer, vice president for EnergyEarth and chairman of the hospital authority that oversees the non-profit Erlanger system. "If we see opportunities where we can deliver that in a broader way and spread the wings of what we provide, we're going to do that where we can in a cost-effective manner. That's not only great for health care delivery but for the economy and for jobs in our region."
What’s being built
› Children’s outpatient hospital on East 3rd Street, $40 million› Heart and Lung Institute on fourth floor of main hospital, $16 million› Erlanger Behavioral Hospital at Holtzclaw and Citico Avenues, $25 million› Erlanger East Outpaient Cencer Center medical office building on Gunbarrel Road, $18 million
A new $40 million children's outpatient hospital is already changing the skyline around Erlanger's main campus where the fourth floor of the main Baroness hospital building also is being revamped to house a new $16 million, state-of-the-art Heart and Lung Institute. A couple of miles to northeast of the main campus, Acadia Healthcare Co., is partnering with Erlanger to build a $25 million, 88-bed mental health hospital. Next to the recently expanded Erlanger East hospital on Gunbarrel Road, Johnson Development LLC is building an 80,000-square-foot, $18 million medical office building.
"Erlanger's four concurrent construction projects represent a major financial investment in this community, with an economic impact of well over $100 million," Erlanger CEO Kevin Spiegel said. "But more importantly, each of these facilities will dramatically change the face of health care in this community for years to come."
The construction projects are all slated to be completed next year and collectively should add several hundred new jobs at Erlanger and its medical partners and providers.
What’s on the drawing board
› Erlanger Sequatchie Valley Regional Hospital in Dunlap› Erlanger Sequatchie Valley Regional Hospital satellite emergency department in Pikeville› Erlanger lease of Murphy Medical Center in western North Carolina, still being negotiated› University of Tennessee at Chattanooga Health Science building at East 3rd Street and Palmetto Ave.Sources: Erlanger Health System, UTC, Tennessee Health Services and Development Agency
But more than the economic gains, Erlanger officials tout the medical and environmental benefits of the new facilities for both patients and physicians.
"We are extremely proud to be innovating new models of care with national and international implications, and doing things for this community other health systems can't or won't," said Spiegel, who has recruited top surgeons and other medical providers to staff some of Erlanger's expanded programs.
Children's hospital gets on track
Bruce Komiske, a veteran hospital designer who joined Erlanger nearly four years ago as vice president of new hospital design and construction, is overseeing construction of Erlanger's new Children's Hospital.
The first phase of the replacement for the 40-year-old existing children's hospital is taking shape across Third Street from the main hospital and the design should be more inviting for children and more convenient, comfortable and efficient for families and health care providers, Komiske said.
Erlanger has committed $11.5 million of hospital funds for the $40 million new children's hospital wing, but most of the project is being funded by contributions from local donors. So far, all but $3.9 million of the $28.5 million sought from donations for the first phase of the Children's Hospital has already been raised.
"It's been very well received by the community and now that the building is up and people can see the building, the excitement is really building," Komiske said.
Spiegel hired Komiske after working with him in Westchester Medical Center in New York to build the acclaimed Maria Fareri Children's Hospital. Similar to the eight previous hospitals across the county that Komiske has helped develop, the new 100,000-square-foot Children's outpatient hospital is designed to reflect features of the local community, including a train from the Tennessee Valley Railroad Museum, a mystery garden donated by Rock City, and hang gliders hovering over one of the waiting areas.
"Every year, we see at least 50,000 children for their asthma, GI problems, neurology treatments and a host of other issues and right now we see them in the basement of an old building in not always very efficient or attractive conditions," Komiske said. "We knew we had to do something different and that was the reason for doing the outpatient facility first."
The new outpatient center will greet patients with a real life, active steam engine in an open and inviting lobby and entrance way.
"Too often, our hospitals have been dark and scary places for children," Komiske said. "But this facility, which was designed by community members to reflect Chattanooga, is an inspiring and inviting place that can really have an impact on the whole experience and what that care is going to be like for each child."
The first phase of the new Children's Hospital at Erlanger was designed after visits to a variety of other state-of-the-art children's hospitals. The three-story complex has no private offices and a large waiting room on each floor supports all of the clinics on that floor. Families enter each exam or treatment area from one side and medical providers grouped in the center of each floor enter from the other side "so it is very efficient, quiet and family friendly," Komiske said.
Komiske employed a similar community planning approach to the $51 million expansion of Erlanger East Hospital, which was completed last year and was recognized last month with top national design awards from both the Healthcare Facilities Symposium and Expo (HFSE) and the International Interior Deign Association (IIDA for its unique, lifestyle design. Erlanger East and the new Children's Hospital were both designed by architects from HKS and built by McCarthy Building Cos.
Building dreams for the next decade
In a construction hut adjacent to the new Children's outpatient hospital site, Komiske and his designers and builders display a map of the entire downtown Erlanger campus with even bigger dreams for hospital improvements.
"We're trying to look at the next 10 years and how do we upgrade a relatively old, tired physical plant and bring it up to world-class standards to match a lot of the world-class programs and people we have and are recruiting to Erlanger," he said.
The Children's outpatient complex is the first phase of an even bigger upgrade of Erlanger's Children's Hospital and the dreams of hospital planners for further facility upgrades at Erlanger, the University of Tennessee at Chattanooga, the Hamilton County Health Department and the Chattanooga School for Arts and Sciences in the area. Komiske said planners are looking at new entrance ways and facilities for Erlanger' Centers of Excellence as part of the vision for new and updated hospital facilities, UTC health instructional buildings, parking decks, a hotel and apartment structures and new equipment, training and treatment services throughout the Erlanger campus and surrounding neighborhood.
"If everything happens that we think is going to happen, there is $1.5 billion of future investment in this part of the city going to happen over the next 10 years," Komiske said.
Adjacent to the new outpatient center across Palmetto Avenue, the University of Tennessee at Chattanooga is already developing plans to build a new Health Science building in conjunction with Erlanger and its Children's Hospital.
The proposed 204,000-square-foot UTC building would be developed near the Erlanger campus over five years, pending state funding of the project. The project would also include a 500-car parking garage and the structure would house UTC's Physical Therapy, Occupational Therapy, the School of Nursing, Health and Human Practices and other departments.
The Heart and Lung Institute
Across Third Street from the new Children's Outpatient Center under construction and UTC's planned Health Science building, Erlanger is converting the fourth floor of the Baroness main hospital into Erlanger's Heart and Lung Institute.
The $16 million project will bring a complete upgrade and renovation of Erlanger's interventional suites and the building of three new dedicated operating theaters for cardiotheracic surgery in a hybrid structure.
"We're trying to create an environment in which the surgical, medical and instructional arms of our field are in a position to collaborate so our imagers, our interventionists and our surgeons are all together making decisions to ensure we have really good opinions and advanced care," said Dr. Charles Campbell, chief of cardiovascular medicine and co-director of Erlanger's Heart and Lung Institute.
For the first time, an elite team of heart experts from all over the world is working in collaboration - not competition, like at most heart centers - to create better outcomes for patients in Chattanooga.
"From a physical plant standpoint, what we're trying to accomplish is really a hospital within a hospital," said Dr. Judy Tingley, vice president and CEO of Erlanger's new Heart and Lung Institute. "The fourth floor of the Baroness main campus will be the Heart and Lung Institute physical palnt, but our services will reach out and hit all of our campuses in different ways across the care continuum."
Erlanger created the Heart and Lung Institute three years ago to upgrade its cardiac care and, in the process, win more of the area's heart patients away from CHI Memorial, traditionally the local hospital where most heart procedures are performed. Already, Erlanger has doubled its number of cardiac surgeries and grown the staff working in the institute by about a third, Campbell said.
"I don't compete with [CHI] Memorial so much as I want to be mentioned in the same breath as Vanderbilt and Emory," Campbell has said. "I can turn south and go to Emory, but if I can do it just as well closer to home, that is good for the area."
Erlanger Behavioral Hospital takes shape
Because of all the growth in and around Erlanger's main Baroness campus, Erlanger had to find another site when it decided to expand its behavioral health and mental health services.
Rather than build its own facility, Erlanger partnered with Acadia HealthCare, a Franklin, Tenn.-based network off behavioral health facilities that already operates 576 facilities in 39 states. Acadia and Erlanger have formed a joint venture to build a $25 million, 88-bed psychiatric hospital at Holtzclaw and Citico Avenues, just a couple of miles from Erlanger's main campus.
The Erlanger Behavioral Health Hospital is scheduled to open by next August and will employ about 200 workers providing child, adolescent, geriatric and dual diagnosis care.
Acadia Group Chief Executive Officer Dr. Jeffrey Woods said with the cutbacks in state psychiatric hospitals in the 1990s and growing recognition of the need for mental health treatment, demand for psychiatric inpatient care is far outstripping the supply.
"There is a real crisis in Tennessee and a definite need for this new facility," Woods said. "We can't get it done too soon."
Dr. Jennie Mahaffey, medical director of Erlanger Behavioral Health, said Erlanger often has to hold some patients needing inpatient psychiatric care for days in its emergency department until bed space opens at either the Moccasin Bend Mental Hospital or Parkridge Valley hospital.
"There is a growing need for this facility and this will help address a real need in our community," she said.
The new 75,000-square-foot facility, which is being built by Layton Construction, will feature a gymnasium, courtyard and four separated wings of semi-private rooms for inpatient care, as well as outpatient treatment facilities.
Erlanger East Outpatient Cancer Center
Adjacent to the recently expanded Erlanger East Hospital, a private developer is building an 80,000-square-foot office medical office complex. Erlanger will lease three of the four floors of the new $18 million medical complex for expanded cancer treatment services.
Johnson Development LLC, of Birmingham, Ala., is building the 4-story medical office complex on a site Erlanger is leasing to the developer just west of the Erlanger East hospital on Gunbarrel Road near Hamilton Place Mall.
The hospital expects to add about 50 infusion nurses, medical technologists, geneticist, nurse practitioners, radiation therapists and other employees as part of the new facility, which is scheduled to be completed next summer.
Tanner J. Goodrich, vice president of operations for Erlanger Health System who joined Erlanger in 2013 as administrator of oncology services, said the facility will house a new linear accelerator and radiation oncology clinic as well as additional outpatient imaging services.
"This allows us to have a more comprehensive outpatient center at Erlanger East to serve many of our patients closer to where they live and in an easier and more accessible manner," he said.
Another floor of the new building will be leased for private physician services to help continue to grow the Erlanger East campus.
Contact Dave Flessner at email@example.com or at 757-6340