HomeMy WebLinkAboutPEC150002 VVMC West Wing Employee Mititgation Report Warren's Comment 030415VVMC WEST WING EXPANSION
Employee Housing Plan
March 2, 2015
Introduction
Expansion plans proposed by the Vail Valley Medical Center Master Plan will create new
employee generation. Chapter 21Commercial Linkage�of the oown(wde requires
redevelopment projects to provide mitigation for net new employees in accordance with
Employee Generation rates found in Chapter 23. These employee generation rates do not,
however, address hospitals, medical centers, clinics or other uses similar to VVMC. In such I
cases the ordinance stipulates that the "the administrator shall determine the applicable
Employee nPra 'mjalLby consultinE the town's current nexus stud)('. In accordance with
s�ction 12 2 B., the purpose of this report is to "provide competent evidence and
information regarding the anticipated employee generation of the redevelopment".
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Specifically, this report includes the following:
• Summary of two underlying factors relative to the expansion of VVMC that will influence
employee generation,
a Baseline inventory of existing uses and employees for all VVMC departments and all
other organizations that operate at the campus,
• Evaluation of specific expansion (and/or contraction or relocation) plans for each
department and organization within the West Wing and how these plans impact
employee generation, and
• Summary of required employee mitigation and how mitigation will be provided for the
West Wing expansion.
A subsequent report will be provided with the CUP application for the East Wing portion of the
VVMC redevelopment that will address employee generation from the East Wing and all other
elements of the project.
Background
While considered one of the world's most advanced mountain -community hospitals, VVMC's
infrastructure is due for modernization. Facilities are at an age, condition and size where they
must be modernized to meet the challenges of modern medicine and to ensure that facilities
provide VVMC staff with the resources necessary to provide the utmost in quality health care.
The VVMC Master Plan involves the addition of approximately 80,000 square feet of floor area.
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This addition will bring the total square footage of the campus to approximately 290,000 square
feet.
The VVMC Master Plan is not, however, a case of pursuing expansion simply to be larger. To
the contrary, this expansion is primarily necessary to bring the size and quality of existing
facilities up to c rrent medical standards. During an internal planning process prior to
presenting the Master Plan to the Town, medical center staff and consultants evaluated all
existing facilities relative to current operations and how these facilities compared to industry
standards.",Based on this evaluation it was found that the following hospital departments were
deficient in ize (square footage): ff I
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• Emergency Department - 140%
• Imaging - 78%
• Patient Care Unit (hospital beds) - 53%
• VVMC Surgery - 32%
• VVSC Surgery - 30%
• Cardiopulmonary - 75%
• Howard Head PT/OT-40%
• Steadman/SPRI - 83%
• Vail Summit Ortho - 167%
• Materials Management - 87%
• Sterile Processing Department - 39%
These deficiencies are significant and these statistics tell a compelling story with respect to the
current size of VVMC departments and other organizations that operate at the Vail campus.
Specifically that today, these and other departments warrant significant increases in square
footage. These increases are necessary to satisfy current needs and to bring facilities up to
contemporary standards. When implemented, VVMC expansion will improve a multitude of
aspects related to patient care, and with only a few exceptions will not drive increased business
or activity, nor will they generate a significant amount of new employee generation.
At a national level medical advances have resulted in shorter hospital stays and more out-
patient procedures that require no hospital stays what so ever. VVMC has observed these
same trends. In addition, facilities like the Surgery Center in Edwards and urgent care facilities
throughout the Valley have shifted patient activity away from the Vail Campus. The result of
this is that overall patient activity at VVMC over the past seven years has decreased. Since
1998 VVMC has seen declines in admissions, births, total patient days, emergency room visits
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and surgeries. These trends further support the premise that expansion to the campus is
necessary to improve the quality of patient care and not to foster more "business".
The underlying purpose of expanding VVMC is "de -compression", enlarging and improving
facilities to provide VVMC staff with the resources necessary to offer quality medical care.
While there are some exceptions, most VVMC departments are not expected to see increases in
activity from this redevelopment. By way of example, more than doubling the size of the
Emergency Department will not increase the number of emergencies treated at VVMC, but it
will improve the quality of care, patient privacy and other considerations. Doubling the size of
the Sterile Processing Department will not result in an increase to the number of surgeries
performed at VVMC, but it will improve the efficiencies of staff operations.
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These two factors are foundational in evaluating information below regarding employee
generation from the West Wing expansion.
Existing Conditions
A baseline inventory of existing employees has been prepared in order to understand the
overall employee situation at VVMC. This inventory includes employees from all VVMC
departments that work at the Vail campus. A number of independent organizations also
operate at VVMC. Examples of these include The Steadman Clinic, Colorado Mountain Medical,
Mountain Surgical Associates and Vail Summit Orthopedics. Employees from these \
organizations are also included in this inventory. In most cases the square footage of space
utilized by each department or organization is also provided. In some cases, however, due to 'lf'
the nature of how departments are organized and how square footage is utilized, it is not
feasible to provide square footage allocations specific to all existing uses.
Emp to ee numbers are presented two ways — the total number of employees that work for any
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given department or organization and the typical number of employees on duty during the day
shift for each department or organization. This distinction is relevant for departments that
have 24/7 employee coverage. Examples of departments with "shift work" include the
Emergency Department and Patient Care/Intensive Care units Fwfi) ja,n;eOn.��� Q
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VVMC employees 436 people who work at the Vail Campus. Other organizations employ a total
of 234 people, resulting in a total of 670 employees. On a typical weekday VVMC employees on
campus total 395 and other organizations employees total 173, resulting in 568 total employees
on a typical work day. The difference between total employees and typical day shift employees
is due to the number of departments that operate shifts 24/7.
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A spread sheet of the employee inventory is provided at the end of this report.
Employee Generation
The following is a summary of how each department and organization in the existing West
Wing will be affected by the West Wing expansion. This summary addresses changes to
location, square footage and operations of each use and how this will influence employee
generation. A number of uses will change with the West Wing expansion — existing uses will be
relocated elsewhere on campus, new uses will be introduced, some uses will get smaller and
other uses will get larger. As described below, each use is unique with respect to if or how it
will experience increased employee generation. Existing and proposed West Wing floor plans
depicting the changes described above and a spread sheet summarizes uses, employees and
square footage in the West Wing are found at the end of this report. StAl"/rkAri si
Basement Level
Existing uses in the basement level include food service/cafeteria, a small office for Facilities
Management and mechanical/back of the house spaces. The main changes at the Basement
Level include:
• The food service/cafeteria will remain virtually unchanged and no employee increases
are planned.
• Mechanical and other back of house functions will remain.
• The Facilities Management office will be removed (relocated to East Wing in the future).
• 3,230sf of meeting room space for VVMC staff will be created. With construction of this
new meeting room approximately 2,000sf of meeting room space in the East Wing will
be removed, resulting in a net gain of just�f of meeting room space.
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Impact on new Employee Generation:
Changes to the basement level will result in no new generation of employees.
Level 1
A variety of uses on Level 1 include the retail pharmacy, gift shop, MRI office, Howard Head
Sports Medicine (HHSM) and Colorado Mountain Medical (CMM). The main changes on Level 1
and how they affect uses, square footage and/or employees include:
• The retail pharmacy and gift shop will be expanded slightly, but will have no incr se to
employees (note, these uses are relocated to the East Wing in 2019
• HHSM will be expanded by 3,342sf. While a significant amount of square footage, this
expansion will result in only a nominal increase to patient treatment areas (from 28 to
30). The bulk of new square footage is to improve patient care by increasing the size of
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patient treatment areas and by increasing areas for patient exercise (and apparatus).
An increase of two employees is planned for HHSM.
CMM will be relocated to the US Bank Building, meaning CMM employees and patient
traffic from 16 exam rooms will be removed from the West Wing. PAI G�&h9f i A S!Ze or
SPRI will utilize the former CMM space and have 5,772sf on Level 1. SPRI will also have OlZrA1OA a5
space on new Level 4. Employee generation from the expansion of SPRI's space is a (4(4(f 0'
discussed below on page 4. re, 6cxfrm►
Impact on new Employee Generation:
Changes to Level 1 will result in the generation of 2 new employees from the expansion
of HHSM.
The new SPRI space will generate new employees, this generation is discussed below.
Level 2
The primary use on the second floor is patient care, or hospital beds. Both the Primary Care
Unit (PCU) and Intensive Care Unit (ICU) are located on this level and expansion of the West
Wing will add a total of 2,487 square feet to Level 2. Of this additional square footage, 1,630
square feet is dedicated to a new Cath Lab. The balance of new square footage will provide
space to enhance other aspects of patient care. The main changes on Level 2 and how they
affect uses, square footage and/or employees include:
• New square footage will be utilized in the conversion of a number of double -bed rooms
to single -bed rooms, this change will having no impact on employees.
• Four hospital beds will be eliminated (reducing the hospitals total bed count from 58 to
54), resulting in a nominal reduction in employees needed to service hospital beds.
• The ICU will be relocated and enlarged, however the number of ICU beds will remain
unchanged (4), rearg no impact on employees.61:2V t A� ?
• The new Cath Lab will generate the need for 3 new employees.
Impact on new Employee Generation:
Changes to Level 2 will result in the generation of 3 new employees from the
development of the new Cath Lab.
Level 3
Existing uses on Level 3 include the Surgical Suites and The Steadman Clinic. The Steadman
Clinic's 6,502 square feet of space will be relocated to the new 4th Level and with the
completion of the West Wing expansion Level 3 will be devoted entirely to the Surgical Suites.
Total square footage on Level 3 increases from 16,344sf to 21,780sf, an increase of 5,436sf.
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The main changes on Level 3 and how they affect uses, square footage and/or employees
include:
• There will be no increase to the four existing operating rooms. This is significant
because the number of operating rooms is the main driver in patient activity and
employees.
• The majority of new square footage on Level 3 (3,925sf) will be used to relocate the
Sterile Processing Department (SPD) to the West Wing from two areas of the East Wing.
The new SPD will be located adjacent to the Surgical Suites (a much improved location)
and will increase is size by roughly 40%. There will be no increase to SPD employees
(note that the space needs study described above concluded that the existing SPD is
deficient in size by 39%).
• 8,013sf will be added to the Surgical Suites. The bulk of this square footage will be used
to significantly increase the size and privacy of pre-op and post-op areas. Significant
enhancements will also be made to support space within the Suites. Examples of these
spaces include waiting areas, staff showers and lockers, staff lounge, offices,
consultation rooms and storage. With no increases to the number of operating rooms,
these enhancements will have no impact on employee generation.
Expansion of Level 3 is an excellent example of de -compression.
Impact on new Employee Generation:
Changes to Level 3 will result in no new generation of employees.
Level 4
Level 4 is a new level and will provide 17,165sf of space for The Steadman Clinic and 7,278sf for
SPRI. With 5,772sf on Level 1, SPRI will have a total of 13,050sf of space. At the completion of
the West Wing, The Steadman Clinic will vacate 8,401sf (on the 3rd and 2nd levels) and SPRI will
vacate 8,828sf (on the basement and 1st levels). As a result, the net increase of new square
footage for these organizations is 8,764sf for The Steadman Clinic and 4,222sf for SPRI.
The Steadman Clinic currently operates out of five offices located throughout the Vail campus.
The new 4th level will consolidate two of these offices (an MRI on the main level of the hospital,
an administrative office and a small clinic in the US Bank Building will remain). New space on
Level 4 will provide additional space for the Clinic, however much of the new square footage
will involve de -compression of existing uses or providing new space for uses not currently
provided for by existing facilities. The main changes to The Steadman Clinic on Level 4 and how
they affect uses, square footage and/or employees include:
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• Increased square footage will provide new space for many functions that are not
currently provided (or adequately provided) by existing space. Examples of these uses
include offices for all physicians and other staff members, space for athletic trainers,
PRP room, MDV rooms and a dedicated IT room.
• The Clinic currently operates with 30 exam rooms. 36 exam rooms are proposed on
Level 4. These rooms alone account for 5,210sf and reflect a significant increase when
compared to the size of existing exam rooms.
• The Steadman Clinic expects that the new West Wing will give them the flexibility to add
2 physicians to their practice. On average each physician will have 4 support employees,
resulting in up to 10 additional employees. The existing number of support employees
(billing, scheduling, etc.) can accommodate these additional physicians.
SPRI currently operates in under -sized facilities lacking in many basic elements necessary for
the organization's operation. While new space is designed to accommodate new programs, the
bulk of new square footage for SPRI will address existing space deficiencies. The main changes
to SPRI on Levels 1 and 4 and how they affect uses, square footage and/or employees include:
• Increased square footage will provide new space for many functions that are not
currently provided by existing space. Examples of these uses include meeting rooms for
educational programs and other uses, staff lockers, rest rooms, bio -hazards, IT, and
offices for staff and researchers. These predominantly "back of the house" uses will not
contribute to new employee generation.
• Increased square footage will decompress a number of existing uses, including but not
limited to bio skills, clinic research, bio -motion and surgical labs, bio -mechanical
research and machine shop. Increased space for these uses address the existing space
deficiencies outlined above.
• Improved and enlarged work stations will be created for staff, along with enhanced and
more controlled circulation patterns and reception/lobby areas.
• SPRI plans to expand research efforts to include regenerative medicine. Increased
square footage will allow this to happen. Employee growth from this expansion would
include one lead researcher and support staff, or six new employees.
Impact on new Employee Generation:
Changes to the SPRI space on Level 4 (and Level 1) will result in the generation of 6 new
employees.
Changes to The Steadman Clinic on Level 4 will result in the generation of 10 new
employees.
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Employee Mitigation
Employee Generation from West Wing
Based on the analysis above, 21 new employees will be generated from the West Wing
expansion. These employees are a result of the following:
6 employees at SPRI - addition of new regenerative medicine research program
10 employees at The Steadman Clinic — two new physicians and support staff
3 employees at Cath Lab — staff to support new facility
2 employees at HHSM — addition of therapists
Method of Mitigation
Employee housing mitigation is to be provided by payment cash -in -lieu based on current cash in
lieu rates.
50% On-site Requirement
Section 12-23-6 of Chapter 23 stipulates that in cases where employee generation exceeds 1.25
employees, 50% of required mitigation must be provided on-site, provided however that at the
sole discretion of the applicable governing body, "an exception may be ranted based upon one :kw�� �S
e^���of the following findings". Based on the response to findings below, a request for an exception
118 y, the on-site requirement is proposed.
a. Implementation of the on-site unit mitigation method would be contrary to the intent and
�b purpose of the applicable zone district.
Response
N/A
b. Implementation of the on-site unit mitigation method would be contrary to the goals of the
applicable elements of the Vail comprehensive plan and the town's development objectives.
Response
A waiver to the on-site requirement is consistent with the VVMC Master Plan. This plan
states that 'for two reasons all required employee housing will be provided off-site."
These reasons include:
• VVMC is an intensive, institutional land use. Introducing a residential land use on
the site would not be compatible with the primary purpose of the site, which is toM66
accommodate a hospital and relate medical uses. �k t for
• VVMC has very limited land area. The primary purpose of this site is to COU
accommodate the medical center's existing needs as well as to retain
opportunities for future expansion to the medical center. Introducing residential
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land use would conflict with the intended use of the site, limit future expansion
opportunities and not be consistent with the town's comprehensive plan.
c. Exceptional or extraordinary circumstances or conditions apply to the site that prevents the
implementation of the on-site unit mitigation method.
Response
VVMC is a unique land use and an "extraordinary circumstance". With VVMC's limited
land area, introducing housing to the site would compete with the need to accommodate
medical uses (now and in the future) and in doing so conflict with the Town's goal for
this site to be used for medical purposes.
d. The method of mitigation proposed better achieves the intent and purpose of this chapter
and general and specific purposes of this title than the on-site mitigation unit method.
Response
Addressing employee impacts with off-site mitigation provides a more workable solution
for addressing not only the goals of the housing regulations, but also the town's master
plan goals for VVMC.
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W MC Total Employees -Existing Baseline Condition
3/1/2015
Typical Peak
Total Location of Emp
Appx Existing SF
DEPARTMENT/ORGANIZATION
Day Shift Emp
Employees Work Place
of Work Place
VVMC
Patient Care/Intensive Care
39
WW/1.2
16349
Cardiatric Area
7
CW/L1
2001
Specialty Clinic/Avanti
12
US Bank Bldg
1615
Womans and Children Center
11
CW/1-2
11135
Surgery Suites/Pre-op
46
WW/1-3
9842
Sterile Processing
12
EW/
2731
Mtn Surgical Assoc./ Trauma
14
EW/1.2, US Bank
2532
Emergency Department
12
CW/L1
5503
Hospitalists - Ped and Adult
6
EW/1-1, WW/1-2
130
Lab
9
EW/1-1, CW/1.2
2918
Rad, CTS, MRI
14
WW/L1
5515
Gift Shop
3
WW/L1
528
Retail Pharmacy
6
WW/L1
912
Hospital Pharmacy
8
EW/1.1
1267
Howard Head Sports Medicine
33
WW/L1, US Bank Bldg
7301
Vail Valley Surgery Center
38
CW/1-2
11160
Social Services
2
Health Info Systems
2
Patient Relations
5
WW/L1
390
SHC, MSOff, UtilRev, QRMgmt. PtRel
17
US Bank Bldg
1047
Cafeteria/Nuitrition
18
WW/Bmt
4163
Facilities Management
8
WW/Bmt, ?
727
Valet/Parking Lot/Concierge
7
WW/L1
Security
3
CW/L1
100
House Keeping
9
EW/BMT
1502
IT, Comp., PatFinS
25
EW/Bmt, WWBmt, USB
3359
Admissions
13
CW/L1
589
Admistration
10
EW/1-2
3208
Material Management
3
EW/L1
909
HR/Property Mgmt
3
EW/L1 and 1.2, USB
1131
395
436
98564
Other Organizations
VV EM Phy
3
3
Apollo
10
17 CW/1-2, WWL3
791
CMM
17
20 WW/L1
4216
The Steadman Clinic
98
114 WW/1.1/3, CW/1-2, USB
12903
Vail Summit Orthopeadic
10
40 US Bank Bldg
2844
SPRI
32
35 CW/1-1, EW/Bmt, EW/L1
8828
Ambulance District
3
5 Separate Bldg
3828
173
234
33410
dill
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