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HomeMy WebLinkAbout2015-0511 PECTOWN OF VAIL PLANNING AND ENVIRONMENTAL COMMISSION May 11, 2015 at 1:00pm TOWN COUNCIL CHAMBERS / PUBLIC WELCOME 75 S. Frontage Road - Vail, Colorado, 81657 MEMBERS PRESENT Henry Pratt John Rediker Brian Gillette Webb Martin John Ryan Lockman Kirk Hansen Dick Cleveland Election of Officers ACTION: Henry Pratt as Chair MOTION: Cleveland SECOND: Rediker ACTION: John Rediker as Chair Pro Tern MOTION: Webb SECOND: Gillette MEMBERS ABSENT VOTE: 7 -0 -0 VOTE: 7 -0 -0 Commissioner Cleveland recused himself prior to the hearing of item #1. A request for final review of a Conditional Use Permit condition of approval, pursuant to Section 12 -9C -3, Conditional Uses, Vail Town Code, to determine the employee generation and mitigation rate for the Vail Valley Medical Center healthcare facility, located at 181 West Meadow Drive and 108 South Frontage Road West (Vail Valley Medical Center) /Lots E, F, and 10 Vail Village Filing 2, Lot 2E, Block 1, Vail Lionshead Filing 1 and Lot D -2, A Resubdivision of Lot D, Vail Village Filing 2 (PEC150012) Applicant: Vail Valley Medical Center, represented by Braun Associates Planner: Nina Timm ACTION: Approve* with Conditions MOTION: Gillette SECOND: Hansen VOTE: 4 -2 -1, Cleveland recused, Rediker and Lockman opposed. CONDITION(S): 1. The employee generation rates shall be subject to an audit two years after Certificate of Occupancy and the fees in lieu be adjusted accordingly. * The approval was for the applicant's proposal of 5 employee categories and a proposed generation of 56 employees. Not the staff recommendation of 3 employee categories and a proposed generation of 133 employees. Housing Coordinator Nina Timm provided a power point presentation detailing commercial linkage requirements per Vail Town Code. Nina discussed the proposed employee generation rates, the Vail Town Code and provided background information related to the VVMC. Nina discussed the staff recommendation regarding employee generation rates and walked the commission through staff's rational. Nina provided details on the hospital's proposal and how these numbers differ from staff's as well as staff's concern about "right sizing" and the actual square feet being added by VVMC. Page 1 Commissioner Gillette asked for clarification related to VVMC's compression Nina spoke to staff's analysis of the decompression and its effects on the generation rates. Nina discussed the topic of partial decompression as compared to the "right size" decompression. Commissioner Rediker asked for clarification related to the generation rates and the other communities contacted. Nina provided greater detail on the other communities cited including Aspen and the Stanford Medical Center. Nina spoke of her conversation with Chris Cares of RRC who prepared the Town's rational nexus when Commercial Linkage was adopted. Nina spoke to Chris's feeling that there were no direct comparables for VVMC. Commissioner Hansen asked how the generation rates will impact the different users identified. Commissioner Webb asked Nina for her level of comfort with the staff proposed generation rate. Nina responded that the staff's proposed rates are based on the information provided and are accurate. Tom Braun, representing the VVMC, presented the hospitals proposal. Included in his Power Point presentation were detailed floor plan analysis with projected employee growth on a per square foot basis and by each use. Braun spoke to how expanding the medical center does not equate to more procedures or employees. Commissioner Gillette asked how a future audit of VVMC employees might work. Braun responded that at least a year or two after CO as new employees are not anticipated immediately Commissioner Gillette offered an idea of meeting in the middle in terms of an employee number between VVMC's projected 56 new employees and staff's projected 133 new employees. Doris Kirschner, VVMC's President and CEO, provided the commission with her perspective related to decompression. Kirschner spoke to existing conditions and crowding. Kirschner spoke to this being a qualitative and not a quantitative expansion as no new procedures are proposed. Doris spoke to the movement of VVMC services down valley resulting in reduced patients in Vail. Charlie Crevling, Senior Vice President of Finance and Chief Financial Officer for VVMC, provided his thoughts related to health care, trends and VVMC's compression. Charlie spoke to the need to attract world class staff. Charlie spoke to the movement towards outpatient care and the growth in that area. Charlie discussed how the revenue stream will not support an influx of new employees. Commissioner Lockman requested clarifications on the number of categories and inquired about what the purpose of having two categories with no projected employee growth. Braun provided additional information concerning their proposal for five categories and the need for the two additional categories (surgical suites and patient /intensive care unit beds) in order to track growth and not include them in with other administrative services. Commissioner Rediker requested clarification concerning "right sizing." Page 2 Russ Sedmak, architect for WMC, provided his thoughts related to staff's logic and where he felt there was a breakdown. Russ felt the methodology staff was using resulted in a double counting. Commissioner Webb asked how long the hospital has been operating with below optimal space. Kirschner spoke to the steps the WMC has taken in this respect, including the movement of services down valley. Commissioner Webb asked for clarification about compression and growth, specifically future growth and if that would result in recompression. Braun spoke to this issue and his feeling that the facility is not being built for additional growth but said that there is no guarantee that spaces will not recompress. Commissioner Pratt asked how the Affordable Care Act has impacted the level or number of services provided. Crevling said there was no discernible impact, even with the Medicaid expansion. There was no public comment. Commissioner Pratt asked for comments from the Commission. Commissioner Lockman spoke to the generation rates only applying to new sq. ft. and he supports the three town categories in contrast to the applicant's five, especially when two categories show no g rowth . Commissioner Hansen felt it was premature to vote on a final approval. He agreed with the applicant that this was a unique situation. He was not comfortable with a thumb up or a thumb down at this time. He agreed that there should five categories. He spoke to his experience at the Mayo Clinic and its being dense. He concluded with his feeling that this is not ready for final decision because of the distance between staff and the applicant on numbers and methodology. Commissioner Gillette asked Nina if we trying to establish a rate moving forward? Nina responded that staff has taken factors into account to determine the generation rate including decompression. Commissioner Gillette clarified that his question was more macro. Will the rate carry over to the East Wing? Commissioner Pratt advised that there are times that the PEC is called upon to set the rules because there are no rules in the Town Code for this. Nina explained that a portion of the method used would be used for future WMC expansion (i.e. the 2.77 rate for the over healthcare facility). Jonathan asked Nina if there are any examples of the audit method. Nina was unaware but spoke to some of the logistical challenges of an audit with a phased development. Commissioner Martin mentioned the large discrepancy between staff's numbers and the applicant's numbers. Martin agreed with Hansen that this should be tabled until the numbers get closer. Page 3 Commissioner Rediker had three questions. 1. Have other properties used a basket of rates? Nina: Yes 2. Do you anticipate there are other projects that will have had similar multiple rate issues? Nina: Ever Vail would be an example of multiple uses in one development. 3. Are the other two categories that the applicant broke out typical of a healthcare facility? Nina: Yes. Commissioner Rediker followed up by asking what does the Town think of the right- sizing argument? Nina responded that staff agrees that there is a degree of right- sizing, but it's not exactly what VVMC's MP proposes. Commissioner Rediker provided that he leans towards the net new floor area method as that is what the Code calls for. Nina calculated the total number of existing employees at the Steadman Clinic using a rate of 3.5 employees per 1,000 square feet and that would anticipate 78.83 employees today at the Steadman Clinic. Commissioner Hansen expressed concern with staff's methodology and the effect it would have on the hospital if the rate was applied to 160,000 square feet. Nina clarified that this only applies to net new floor area. Commissioner Hansen inquired as to why Staff used only three categories and asked when did the applicant first propose the five categories? It was determined that the five categories were proposed in early April. Staff reasserted that logic behind three categories was that the Health Care Facility category includes these other two uses. Braun recapped a meeting with the town concerning the categories in late April. Commissioner Pratt agrees that it is unique and there is a huge discrepancy. Staff and the applicant need to work together to come closer to an agreeable figure. He sees both arguments for three and five categories. Pratt spoke to the audit as a possibility. Pratt felt tabling would be prudent so that a more agreeable number can be reached between staff and the applicant. Braun asked for some clarification so that an agreement could be met. He discussed his belief that the code is deficient in that it does not account for changes in use, only new square foot. Commissioner Gillette asked for reconsideration of an audit. The discussion revolved around the logistics and precedence. Commissioner Rediker said it does not account for what the net new floor area calculation. The "right sizing" issue needs to be validated or invalidated. Nina clarified that mitigation is only for 20% of the net new employees generated. Jonathan mentioned complications regarding the fact that the fees in lieu rate is subject to change and that it is difficult to account for all part time employees. Page 4 Commissioner Gillette asked if we were to do an audit, what employee number would Staff would be comfortable with. Nina responded that that is a political decision and that discussion needs to be based on the information submitted. Staff is not comfortable making such a different recommendation at this time. Commissioner Rediker suggested looking at the application as presented based on the language in the code which states the applicant provides competent evidence that their proposed rate is accurate. He surmised about the precedent that this would set by using the applicant's method. Commissioner Pratt suggested a compromise that would increase the ICU /PCU generation rate. Nina stated it would not change the overall employee number as both those categories had no employee growth, according to the applicant. Braun mentioned a couple of areas of agreement between staff and the applicant. Commissioner Hansen asked if that would tie the hospitals hands. Braun stated that that is what they are proposing and spoke to possible suggestions for a subsequent meeting. He spoke to other "true up" provisions being discussed in the DIA. Commissioner Gillette made a motion to approve WMC west wing expansion employee generation rates using the applicant's five categories and employee generation number with condition that the employee generation rates be subject to an audit two years after Certificate of Occupancy and the fees in lieu be adjusted accordingly. 4. A request for a final recommendation to the Vail Town Council of a major amendment to Special Development District No. 4, Cascade Village, pursuant to Section 12- 9A -10, Amendment Procedures, Vail Town Code, to allow for the conversion of one dwelling unit to an employee housing unit within the approved Vail Cascade Residences development and a request for an extension of its approval period for an additional three (3) years , located at 1310 Westhaven Drive /Cascade Village, and setting forth details in regard thereto. (PEC150014) Applicant: Ultimate Cascade LLC, represented by Mauriello Planning Group Planner: Jonathan Spence ACTION: Table to June 8, 2015 MOTION: Cleveland SECOND: Martin VOTE: 7 -0 -0 CONDITION(S): 5. Approval of April 27, 2015 minutes MOTION: Rediker SECOND: Gillette VOTE: 6 -0 -1 (Cleveland Recused) Amended condition to strike "Boiler Fed" from the condition related to snowmelt. 6. Information Update 7. Adjournment MOTION: SECOND: VOTE: The applications and information about the proposals are available for public inspection during regular office hours at the Town of Vail Community Development Department, 75 South Frontage Page 5 Road. The public is invited to attend the project orientation and the site visits that precede the public hearing in the Town of Vail Community Development Department. Times and order of items are approximate, subject to change, and cannot be relied upon to determine at what time the Planning and Environmental Commission will consider an item. Please call (970) 479 -2138 for additional information. Sign language interpretation is available upon request with 24 -hour notification. Please call (970) 479 -2356, Telephone for the Hearing Impaired, for information. Page 6 TOWN OF Vari PLANNING AND ENVIRONMENTAL COMMISSION May 11, 2015 at 1:00pm TOWN COUNCIL CHAMBERS / PUBLIC WELCOME 75 S. Frontage Road - Vail, Colorado, 81657 MEMBERS PRESENT MEMBERS ABSENT 60 minutes A request for final review of a Conditional Use Permit condition of approval, pursuant to Section 12 -9C -3, Conditional Uses, Vail Town Code, to determine the employee generation and mitigation rate for the Vail Valley Medical Center healthcare facility, located at 181 West Meadow Drive and 108 South Frontage Road West (Vail Valley Medical Center) /Lots E, F, and 10 Vail Village Filing 2, Lot 2E, Block 1, Vail Lionshead Filing 1 and Lot D -2, A Resubdivision of Lot D, Vail Village Filing 2 (PEC150012) Applicant: Vail Valley Medical Center, represented by Braun Associates Planner: Nina Timm ACTION: MOTION: SECOND: VOTE: CONDITION(S): 2. A request for a final recommendation to the Vail Town Council of a major amendment to Special Development District No. 4, Cascade Village, pursuant to Section 12- 9A -10, Amendment Procedures, Vail Town Code, to allow for the conversion of one dwelling unit to an employee housing unit within the approved Vail Cascade Residences development and a request for an extension of its approval period for an additional three (3) years , located at 1310 Westhaven Drive /Cascade Village, and setting forth details in regard thereto. (PEC150014) Applicant: Ultimate Cascade LLC, represented by Mauriello Planning Group Planner: Jonathan Spence ACTION: Table to June 8, 2015 MOTION: SECOND: VOTE: CONDITION(S): 3. Approval of April 27, 2015 minutes MOTION: SECOND: VOTE: 4. Information Update 5. Adjournment MOTION: SECOND: VOTE: The applications and information about the proposals are available for public inspection during regular office hours at the Town of Vail Community Development Department, 75 South Frontage Road. The public is invited to attend the project orientation and the site visits that precede the public hearing in the Town of Vail Community Development Department. Times and order of items are approximate, subject to change, and cannot be relied upon to determine at what time the Planning and Environmental Commission will consider an item. Please call (970) 479 -2138 for additional information. Sign language interpretation is available upon request with 24 -hour notification. Please call (970) 479 -2356, Telephone for the Hearing Impaired, for information. Community Development Department Published May 8, 2015 in the Vail Daily. Page 1 TOWN OF qVA1 Memorandum TO: Planning and Environmental Commission FROM: Community Development Department DATE: May 11, 2015 SUBJECT: A request for final review of a Conditional Use Permit condition of approval, pursuant to Section 12 -9C -3, Conditional Uses, Vail Town Code, to determine the employee generation and mitigation rate for the Vail Valley Medical Center healthcare facility, located at 181 West Meadow Drive and 108 South Frontage Road West (Vail Valley Medical Center) /Lots E, F, and 10 Vail Village Filing 2, Lot 2E, Block 1, Vail Lionshead Filing 1 and Lot D -2, A Resubdivision of Lot D, Vail Village Filing 2 (PEC150012) Applicant: Vail Valley Medical Center, represented by Braun Associates Planner: Nina Timm and Jonathan Spence I. SUMMARY On March 23, 2015 the Planning and Environmental Commission approved, with conditions, the Vail Valley Medical Center's (VVMC) request for an amended conditional use permit for an existing healthcare facility to allow for an addition on the west wing of the facility located at 181 West Meadow Drive and 108 South Frontage Road West. The VVMC property is zoned General Use and is therefor subject to commercial linkage requirements per 12 -23, Vail Town Code. One of the conditions of approval was for the VVMC to submit a final Employee Housing Report for review and approval by the Planning and Environmental Commission prior to submittal of a building permit application for the west wing. Upon review of the applicable elements of the Town's planning documents and adopted criteria for review, the Community Development Department is recommending the Planning and Environmental Commission approve employee generation rates for VVMC's expansion of: Type of Use Orthopaedic Clinics Orthopaedic Research Institute Employee Generation Rate 5.72 employees / 1,000 square feet 3.45 employees / 1,000 square feet Health Care Facility 2.77 employees / 1,000 square feet DESCRIPTION OF REQUEST At the March 23, 2015 Planning and Environmental Commission (PEC) hearing, the PEC approved, with conditions, VVMC's request for an amended conditional use permit. A condition of the approval was: "A finding has been made by the PEC to mitigate 100% of the employee generation created by this proposal off -site. The VVMC shall submit a final Employee Housing Report (to determine employee generation rate and required mitigation) for review and approval by the PEC prior to submittal of a building permit application for the west wing." Based on the unique characteristics of hospitals and medical centers there is not a codified employee generation rate for hospitals or medical centers. The Town's adoptec Nexus / Proportionality Analysis for Employee Housing Mitigation Programs does establish an employee generation rate of 3.8 employees per 1,000 square feet of Office (Finance /Banking, Legal, Medical, Professional Services). The applicant is requesting the PEC adopt employee generation rates for VVMC's expansion of: Type of Use Orthopaedic Clinics Orthopaedic Research Institute Health Care Facility Surgery Suites Patient Care & Intensive Care Unit Bed APPLICABLE DOCUMENTS 12 -23, Commercial Linkage, Vail Town Code Employee Generation Rate 3.5 employees / 1,000 square feet 3.0 employees / 1,000 square feet 2.6 employees / 1,000 square feet 16 employees / 1 Surgery Suite 1.4 employees / PCU & ICU Bed Pursuant to 12 -23, Commercial Linkage, Vail Town Code, and in particular 12 -23 -2, Employee Generation and Mitigation Rates: A. The employee generation rates found in table 23 -1, "Employee Generation Rates By Type Of Commercial Use'; of this section, shall be applied to each type of use in a commercial development. For any use not listed, the administrator shall determine the applicable employee generation rate by consulting the town's current nexus study. Town of Vail Page 2 EMPLOYEE GENERATION RATES BY TYPE OF COMMERCIAL USE Type Of Use F1 Employee Generation Rate Accommodation unitl limited service lodge �� 0.7 employee per net new units unit Business office and professional office Unew .2 employees per 1,000 feet of (excluding real estate office) net floor area Conference facility �� 0.8 employee per 1,000 feet of new net floor area Eating and drinking establishment 6.75 employees per 1,000 feet of new net floor area Health club �� 0.96 employee per 1,000 feet of new net floor area Real estate office 5.1 employees per 1,000 feet of new net floor area Retail store /personal service /repair shop 2.4 employees per 1,000 feet of new net floor area Spa _I employees per 1,000 feet of 12.1 new net floor area B. If an applicant submits competent evidence that the employee generation rates contained in table 23 -1 of this section or the nexus study do not accurately reflect the number of employees generated by the proposed commercial development or redevelopment and the administrator finds that such evidence warrants a deviation from those employee generation rates, the administrator shall allow for such a deviation as the administrator deems appropriate. C. Each commercial development or redevelopment shall mitigate its impact on employee housing by providing EHUs for twenty percent (20%) of the employees generated, pursuant to table 23 -1 of this section, or the nexus study, in accordance with the requirements of this chapter. From the Vail Valley Medical Center Master Plan: Goal for Employee Housing — To provide employee housing consistent with the provisions of Chapter 23, Vail Town Code. Town of Vail Page 3 Vail Valley Medical Center West Wing Expansion Employee Housing Plan VVMC has submitted a Vail Valley Medical Center West Wing Expansion Employee Housing Plan dated May 4, 2015 (Attachment A). The purpose of the report is to provide a: • Summary of the proposed redevelopment of VVMC and factors relative to decompression, health care trends and other considerations that will influence employee generation resulting from the master plan expansion, • Baseline inventory of existing uses and employees for all VVMC departments and other organizations that operate at the Vail 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. VVMC's West Wing Employee Housing Plan proposes employee generation rates for five new categories and departments at VVMC. The basis for VVMC's proposed generation rates is their 2013 Space Program Study completed by Heery Design (Attachment B) at the outset of the VVMC master planning process. The 2013 Study was based on, among other things, industry standards for the square footage of medical uses. VVMC West Wing Employee Housing Plan Proposed Generation Rates Town of Vail Page 4 VVMC's New Net VVMC's 20% Type of Use Proposed Sq Ft or New Required Generation Suites Employees Mitigation g Rate or Beds Generated Orthopaedic Clinics 3.50 8,764 30.67 6.13 Orthopaedic Research 3.00 4,222 12.67 2.53 Institute Health Care Facility 2.60 4,915 12.78 2.56 Surgery Suites 16.00 0 0.00 0.00 PCU / ICU Beds 1.40 -3 -4.20 -0.84 TOTAL 12,986 43.34 10.38 Town of Vail Page 4 IV. STAFF ANALYSIS AND RECOMMENDED GENERATION RATES Based on the information contained in the VVMC Employee Housing Plan - Existing Conditions at VVMC The case that the Steadman Clinic and SPRI are decompressing is accurate. The extent of decompression does not correspond with the "right size" square feet identified in the 2013 Space Program Study, indicating a level of compression will remain following the west wing expansion. Currently the Steadman Clinic has 94 employees and the 2013 Space Program Study identifies that it should have 26,838 square feet to be "right sized." The approved VVMC master plan identifies the Steadman Clinic will have 21,667 square feet. This is a 5,171 square foot deficit to be "right sized" for 94 employees. The "right size" square feet does not take into account the planned addition of 30 new Steadman Clinic employees. "Right Existing Existing Emps / 1,000 Sq Ft Emps Emps / Vail Valley Medical Center 168,000 466 2.77 Vail Valley Surgery Center 11,160 50 4.48 Colorado Mountain Medical 4,216 20 4.74 Steadman Clinic 12,903 94 7.29 Steadman Philippon Research 8,828 39 4.42 Vail Summit Orthopaedic 1,617 10 6.18 The case that the Steadman Clinic and SPRI are decompressing is accurate. The extent of decompression does not correspond with the "right size" square feet identified in the 2013 Space Program Study, indicating a level of compression will remain following the west wing expansion. Currently the Steadman Clinic has 94 employees and the 2013 Space Program Study identifies that it should have 26,838 square feet to be "right sized." The approved VVMC master plan identifies the Steadman Clinic will have 21,667 square feet. This is a 5,171 square foot deficit to be "right sized" for 94 employees. The "right size" square feet does not take into account the planned addition of 30 new Steadman Clinic employees. "Right Size" Square Foot Analysis Emps / "Right proposed Sq Ft Deficit User Emps 1,000 Size Sq Sq Ft or Surplus to "Right Sq Ft Ft" Size" Existing Steadman Clinic 94 3.50 26,838 21,667 -5,171 Proposed Steadman Clinic 124 3.50 35,429 21,667 - 13,762 Existing Steadman Philippon 39 3.00 12,977 13,050 73 Research Institute Proposed Steadman Philippon 45 3.00 15,000 13,050 -1,950 Research Institute Town of Vail Page 5 Using the actual square feet and employees for the Steadman Clinic and Steadman Philippon Research Institute the employee generation rates are as follows: Existing Generation Rate Proposed New Generation Rate Orthopaedic Clinic 7.29 employees /1,000 sq ft 5.72 employees /1,000 sq ft Orthopaedic Research 4.42 employees /1,000 sq ft 3.45 employees /1,000 sq ft Institute Per VVMC's Employee Housing Plan, the applicant would like to establish employee generation rates for a Health Care Facility and a separate generation rate for a Surgery Suite as well as a generation rate for a Patient Care and Intensive Care Unit Bed. Staff believes surgery suites and patient care and intensive care unit beds are an integral component of a Health Care Facility and therefore should be part of an overall Health Care Facility employee generation rate. Reconfiguration and repurposing of health care facility space has been a common occurrence at VVMC and based on changing health care trends and technology this can be anticipated in the future. Town staff has found two other communities that have established employee generation rates for hospitals or health care facilities. Aspen has adopted an employee generation rate of 3.7 employees / 1,000 square feet for Aspen Valley Hospital's recent expansion and the City of Palo Alto adopted an employee generation rate of 2.55 employees / 1,000 square feet for Stanford University's hospital and medical school expansion. Today VVMC has 2.77 employees / 1,000 sq ft. Town of Vail Page 6 Existing Existing Emps / VVMC Departments Sq Ft Emps 1,000 Housekeeping 168,000 26 0.15 Facilities Management 168,000 12 0.07 Parking Lot/ Valet 168,000 9 0.05 Security 168,000 8 0.05 Material Management 168,000 3 0.02 Information Technology 168,000 23 0.14 Human Resources /Property Mngt. 168,000 3 0.02 Administration 168,000 11 0.07 Gift/Retail 168,000 11 0.07 Admissions 168,000 15 0.09 Social Services 168,000 2 0.01 Health Info Systems 168,000 2 0.01 Patient Relations 168,000 3 0.02 Quality Assurance /Management 168,000 8 0.05 Utilization Review 168,000 1 0.01 Cafeteria / Nutrition 168,000 13 0.08 Employee / Occupational Health 168,000 3 0.02 Cardio Institute / Cath Lab 168,000 15 0.09 Town of Vail Page 6 Cardio Pulmonary 168,000 7 0.04 Howard Head Sports Medicine 168,000 46 0.27 Mountain Surgical Associates 168,000 11 0.07 Sterile Processing 168,000 13 0.08 Hospital Pharmacy 168,000 13 0.08 Imaging 168,000 13 0.08 Emergency Department 168,000 15 0.09 Ambulance District 168,000 5 0.03 PCU / ICU 168,000 62 0.37 Surgery Suites 168,000 63 0.38 Woman & Children Center 168,000 30 0.18 Lab 168,000 20 0.12 Total Employees 168,000 466 Average Emps / 1,000 sq ft 2.77 Not included in the VVMC employee generation rate are: Vail Valley Surgery Center Colorado Mountain Medical Steadman Clinic SPRI Vail Summit Orthopaedic Existing Generation Rate 4.48 employees / 1,000 sq ft* 4.74 employees / 1,000 sq ft* 7.29 employees / 1,000 sq ft 4.42 employees / 1,000 sq ft 6.18 employees / 1,000 sq ft* *No new net square feet associated with these uses in the west wing. If the Vail Valley Surgery Center, Colorado Mountain Medical, Steadman Clinic, SPRI and Vail Summit Orthopaedic were included in the overall VVMC employee generation rate it would increase to 3.28 employees / 1,000 sq ft from 2.77 employees / 1,000 sq ft. Based on the information provided by VVMC as well as independent research, staff believes adopting three employee generation rates for the west wing expansion is appropriate. The proposed generation rates for an orthopaedic clinic and orthopaedic research institute reflects the proposed level of decompression. The generation rates are: Health Care Facilities Orthopaedic Clinic Orthopaedic Research Institute 2.77 employees / 1,000 sq ft 5.72 employees / 1,000 sq ft 3.45 employees / 1,000 sq ft Utilizing the employee generation rates recommended by staff the VVMC west wing expansion employee generation would be 133.39 employees and the required twenty percent mitigation is housing for 26.68 employees. Town of Vail Page 7 1IF/ Proposed 20% Generation New Net Employees Required Type of Use Rate Sq Ft Generated Mitigation Health Care 2.77 Facilities 24,800 68.70 13.74 Orthopaedic 5.72 Clinics 8,764 50.13 10.03 Orthopaedic 3.45 Research Institute 4,222 14.57 2.91 TOTAL 37,786 133.39 26.68 STAFF RECOMMENDATION Staff recommends the PEC adopt the following employee generation rates for the VVMC expansion: Health Care Facility 2.77 employees / 1,000 feet of new net floor area Orthopaedic Clinic 5.72 employees / 1,000 feet of new net floor area Orthopaedic Research Institute 3.45 employees / 1,000 feet of new net floor area These employee generation rates would be applied to any future commercial linkage obligations of health care facilities, orthopaedic clinics, and orthopaedic research institutes. Should the Planning and Environmental Commission choose to approve this request, the Community Development Department recommends the Commission passes the following motion: "The Planning and Environmental Commission approves the employee generation rates as recommended by staff for a health care facility, orthopaedic clinic, and orthopaedic research institute based upon the review of the applicable elements of the Town's planning documents and Chapter 23, Commercial Linkage, Vail Town Code." Should the Planning and Environmental Commission choose to approve this request, the Community Development Department recommends the Commission makes the following findings: " Based on the evidence and testimony presented, the Planning and Environmental Commission finds. Town of Vail Page 8 1. The employee generation rates for a health care facility, orthopaedic clinic, and orthopaedic research institute are in accordance with the purposes of the Zoning Regulations and the Commercial Linkage Requirements. 2. The employee generation rates accurately reflect the number of employees generated by a health care facility, orthopaedic clinic, and orthopaedic research institute and shall become adopted as new types of uses with associated employee generation rates to be applied to future development requests." VII. ATTACHMENTS A. Vail Valley Medical Center West Wing Expansion Employee Housing Plan, dated May 4, 2015 B. 2013 Space Program Summary prepared for Vail Valley Medical Center by Heery Design, dated May 2, 2015 Town of Vail Page 9 VVMC WEST WING EXPANSION Employee Housing Plan March 2, 2015 revised 4/2/15, 5/4/15, 5/7/15 Introduction Chapter 23, Commercial Linkage of the Town Code requires redevelopment projects to provide mitigation for net new employees generated by new square footage 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 those at the Vail Valley Medical Center (VVMC). In such cases the ordinance stipulates that the "the administrator shall determine the applicable employee generation rate by consulting the town's current nexus study". The purpose of this report is to propose generation rates and to provide: • Summary of the proposed redevelopment of VVMC and factors relative to "de- compression ", health care trends and other considerations that will influence employee generation resulting from the master plan expansion, • Baseline inventory of existing uses and employees for all VVMC departments and other organizations that operate at the Vail 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 • Proposed employee generation rates and the employee mitigation that would be required 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. Housing Plan Conformance with Chapter 23 and Town's Comprehensive Plan Chapter 23 stipulates that all employee housing plans shall provide a "written narrative explaining how the employee housing plan meets the purposes of this chapter and complies with the town's comprehensive plan ". This Plan addresses the purposes of Chapter 23 by proposing employee generation rates for land uses not currently addressed by the Chapter. The VVMC Site Specific Redevelopment Maser Plan is an element of the town's comprehensive plan. This VVMC MP addresses VVMC West Wing CUP Employee Housing Report Page 1 employee housing and states that VVMC provide employee housing consistent with the provisions of Chapter 23. Subject to acceptance of this plan by the Planning and Environmental Commission, it will be in conformance with the town's comprehensive plan. Background on VVMC Existing Vail Campus 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 existing campus includes approximately 200,000 gross square feet of floor area. The VVMC Master Plan involves the addition of approximately 90,000 square feet of new gross floor area, resulting in a campus of nearly 300,000 gross square feet. Floor plans of the existing campus depicting the approximate amount of existing gross square footage are found in the appendix of this report. Existing Space Deficiencies at VVMC During an internal planning process that was completed prior to presenting the Master Plan to the Town, consultants and VVMC staff evaluated all existing facilities and departments relative to current operations, existing patient volumes, existing square footage and other considerations relative to how departments function. The purpose of this effort was to evaluate existing conditions and to define square footage, operational and locational deficiencies that could be addressed by the master plan expansion. The primary result of this effort, referred to as the 2013 Space Program Summary (2013 Summary) was defining additional square footage needed for each department or organization at VVMC, or said another way, the square footage needed to "right- size" each department. Completed by Heery International, the results of the 2013 Study were based on the following: • Detailed evaluation of the existing campus that included measuring all existing spaces, defining square footages allocated to or used by respective departments, and understanding locational relationships and other considerations relative to specific uses. This step established base line conditions at VVMC. • Surveys of staff to understand case /patient loads, how they perform their jobs, how existing space is used, the need for additional space or other changes that could improve operations and the level of health care provided. • Interviews with key staff to further discuss survey results in order to better understand existing deficiencies and to discuss potential solutions. VVMC West Wing CUP Employee Housing Report Page 2 • Application of industry standards relative to the desired (or in some cases required) square footage for specific uses and activities. Examples of this would be minimum standards for exam rooms, offices, hallway widths, etc. In addition to standards for specific uses, standards for "multipliers" or "conversion factors" were also considered in defining space requirements for related support spaces. • Heery International has extensive experience in the design of health care facilities and this experience was applied to this exercise. • The potential for future employee growth was considered in defining the right -size for each department. At this early stage in the design process there were not specific determinations or estimations made regarding the potential number of future employees. This is because with only a few exceptions the square footage necessary for providing actual employee work areas is a relatively small percentage of the whole. A much more direct driver, or influence in defining the need for square footage are patient treatment areas (beds, exam rooms, etc.) and the multitude of support spaces necessary for operations. The 2013 Summary found that the existing square footage of nearly every department is significantly deficient. Below is a sampling of departments and their existing square footage deficiencies: • 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 Clinic - 108% • SPRI — 47% • Vail Summit Ortho - 167% • Materials Management - 87% • Sterile Processing Department - 39% The square footage deficiencies in the 2013 Summary provided a benchmark, or baseline condition that was used in defining how the needs of each department could best be addressed by VVMC's master plan expansion. The right -size square footage represents an "ideal" condition, or what could be achieved in a perfect world for meeting the space needs of VVMC. In some cases VVMC expansions will address the space deficiencies of departments with square VVMC West Wing CUP Employee Housing Report Page 3 footage very similar to what was identified by this analysis. Examples of these are the Sterile Processing Department (right -size square footage of 3,796, actual proposed square footage of 3,925 square feet) and the Steadman Philippon Research Institute (right -size square footage of 12,977 and proposed square footage of 13,050). With a remodel /expansion of an existing facility it is far more challenging to achieve right- sizing square footage (as compared to totally new construction) and at VVMC there are cases where expansion plans do not provide the full square footage defined by the 2013 Summary. Examples of this are the Steadman Clinic (right -size square footage of 26,838, actual proposed square footage of 21,677 square feet) and the Patient Care Unit (right -size square footage of 25,014 and proposed square footage of 17,216). This is due to a number of factors inherent in remodel /expansions (factors not evident in new construction) that collectively necessitate that compromises must be made with respect to where and how square footage is allocated. Examples of these include the spatial relationships of existing uses, space limitations for potential expansions, covenant restrictions and budget. The Patient Care Unit provides a good example of how it is infeasible to achieve the right -size square footage. Complication is doing so include: • Limitations to how far expansion could go to the south (toward Meadow Drive) • Covenant restrictions that prevent expansion to the north • The need to maintain (or add on to, not fully re- design) the basic existing layout of this Unit • Budget Existing space deficiencies are significant and the results of the 2013 Summary 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 necessary to "right size" departments based on today's needs and to bring facilities up to current standards for medical space. The VVMC Master Plan is not a case of pursuing expansion simply to create a larger hospital. To the contrary, the focal point of this expansion is to bring the size and quality of existing facilities up to current medical standards. When implemented, VVMC expansion will improve a multitude of aspects related to patient care, and with only a few exceptions will not create increased business or activity, and as a result will not generate a significant amount of new employee generation. The West Wing departments listed below demonstrate the extent to which new square footage is necessary to right -size these departments. The blue columns indicate existing employees, existing square footage and the ratio of employees /1000sf. The red columns indicate the VVMC West Wing CUP Employee Housing Report Page 4 existing square footage deficiency (as defined in the 2013 study expressed as a percentage), the amount of square footage necessary to right size departments and the resulting employee /1000 square foot ratio. This data is a major consideration in defining the employee generation anticipated from the West Wing expansion (see section below). VVMC Existing Space Deficiencies/West Wing Uses and Departments 4/2/2015, rev 5/2/2015 Industy Std. Industry Std. Existing Appx Existing SF Existing SF Industy Std. Existing DEPARTMENT /ORGANIZATION Employees of Work Place Em0110005 f Deficiency Necessary SF Emo /1000sf Patient Care - Primary/Intensive Care 57 16,349 3.5 53% 25,014 2.3 Hospitalists - Red and Adult 5 130 38.5 200 25.0 total 62 16,479 3.8 25,214 2,5 Surgery Suites/Pre -0p 46 9,842 4.7 98% 19,487 2.4 Sterile Processing 13 2,731 4.8 39% 3,796 3.4 Apollo /Anesthesiologists 17 791 21.5 1,099 15.5 total 76 13,364 5.7 24,383 3.1 Fa c i I iti es/O perat i o ns Facilities Management 12 727 16.5 89% 1,374 8.7 Valet/Parking Lot /Concierge 9 n/a n/a Security 8 100 80.0 200% 300 26.7 House Keeping 26 1,502 173 28% 1,923 13,5 Material Management 3 909 33 87% 1,700 1.8 total 58 3,238 17.9 5,296 110 Cafeteria/Nutrition 13 4,163 11 72% 7,160 1.8 ports Medicine 46 6,667 6.9 40% 9,334 4.9 e Steadman Clinic 5111 94 12,903 7.3 108% 26,838 3.5 39 8,828 4.4 47% 12,977 3.0 National and Local Trends 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, at a local level facilities like the Surgery Center in Edwards and urgent care facilities throughout the Valley have shifted patient activity away from VVMC's 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 annual declines in: • admissions, • births, • total patient days, • emergency room visits and • surgeries. The items listed above are the major drivers in activity at the hospital and directly influence the number of employees necessary to provide medical care. These trends further support the VVMC West Wing CUP Employee Housing Report Page 5 premise that expansion of the campus is necessary to improve the quality of patient care and not to foster more "business ". The underlying premise of the VVMC expansion is "de- compression" - enlarging and improving facilities to provide VVMC staff with the resources necessary to provide quality medical care. While there are some exceptions, most VVMC departments are not expected to see increases in patient activity as a result of the master plan expansion. For this reason most departments are not anticipating increases to current staffing levels. By way of example, the Emergency Department will more than double in size. This increase is size will not increase the number of emergencies treated at VVMC, but it will improve the quality of care, patient privacy and other health care considerations. This consideration, when coupled with decreases in Emergency Department visits over the past seven years would indicate that the Emergency Department expansion will not result in an increase in employees. By the same token, increasing 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. VVMC's existing square footage deficiencies and national and local trends are very significant considerations and are foundational in evaluating the information provided in this report regarding employee generation from the West Wing expansion. Existing Conditions at VVMC Campus A baseline inventory of existing employees at the Vail campus has been prepared in order to understand the overall number of employees 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 the square footage associated with or used by some departments is not available or is not relevant. This is due to the nature of how certain departments operate. An example of this is with Hospitalists — VVMC physicians who have disproportionately small office space because they work throughout the hospital, primarily in the Patient Care Unit. In this case Hospitalists have been included in discussions of Patient Care facilities at VVMC (in following section of this report). Employees from a number of other departments have been consolidated in a similar manner. VVMC West Wing CUP Employee Housing Report Page 6 VVMC employees 496 people who work at the Vail Campus and other organizations employ 183 people, resulting in a total of 679 employees. These reflect all employees on the Vail Campus. On a typical day significantly fewer employees are on campus. This is primarily due to "shift work" from departments such as the Emergency Department and Patient Care Unit that have 24/7 coverage. The spread sheet below summarizes VVMC departments and other organizations, their existing number of employees, existing square footage of their workspace and the ratio of employees per 1,000 square feet. Departments and organizations impacted by the West Wing expansion are highlighted in "yellow ". The data above establishes a baseline condition of existing employees at VVMC and the calculations of employees per 1,000 square feet provide a relative indication of the spatial requirements of each department or organization. This data indicates a very wide range of employees per 1,000 square feet for many departments. This is due to a number of considerations: • Some departments have a disproportionately low amount of square footage which artificially inflates the employee /sf ratio, • Due to the nature of their operations some departments have disproportionately high square footage requirements (the Patient Care Unit is an example of this due to the amount of floor area required for patient beds, etc.), and • Due to the nature of their operations some departments or organization have uniquely high employees /sf ratios, due to current space deficiencies. Ratios can vary among what might otherwise be considered similar uses. Examples of these are the Steadman Clinic and Colorado Mountain Medical, all function as "medical clinics" but with different employee /space characteristics. • De- compression — a number of employee /sf ratios are disproportionately high as a function of how services and employees have been added over the years with no change to available square footage. VVMC West Wing CUP Employee Housing Report Page 7 WMC Total Employees - Existing /Baseline and Proposed Conditions 3/112015, revised 312412015, 412/2015 Appx Existing SF Existing DEPARTMENT /ORGANIZATION Employees of Work Place Emp /1000sf Patient Care - Primary /Intensive Care 57 16,349 Hospitalists - PedandAdult 5 130 38.5 total 62 16,479 3.8 Surgery Suites /Pre -op 46 9,&42 Sterile Processing 13 2,731 4.8 Apollo /Anesthesiologists" 17 791 21.5 total 76 13,364 5.7 Emergency Department 12 5,503 2.2 WEMPhy* 3 a, 15 5,503 2.7.1 Vail Valley Surgery Center 50 11,160 4.5 l Womans and Children Center 30 11,135 2.7 , Lab 20 2,918 6.9 Imaging (Rad, CTS, MRI) 13 5,515 2.4 Employee /Occupational Health 3 850 3.5_ Diversified Services (Cardio Institute) 12 1,615 7.41 Cath Lab 3 1,620 1.9 . total 15 3,235 4.6 Mtn Surgical Assoc./ Trauma 11 2,532 4.3 „i Cardio /Pulmonary 7 2,001 3.51 Hospital Services i Social Services 2 123 16.3. Health Info Systems 2 Patient Relations 3 390 7.7, Quality Assurance /Vgmt. 8 1,047 7.61 Utilization Review 1 total 16 1,560 10.3 Admistration 11 3,208 3.4 HR /Property Mgmt 3 1,131 2.7 total 141 4,339 3.2 IT 231 3,359 6.8 Facilities /Operations Facilities Management 12 727 16.5 Valet/Parking Lot/Concierge 9 Security 8 100 80.0 House Keeping 26 1,502 17.3 Material Management 3 909 3.3 total 58 3,238 17.9 Misc Hospital Departments Gift Shop 0 528 Retail Pharmacy 11 912 12.1 Admissions 15 589 25.5 total 26 2,029 12.8 Cafeteria /Nutrition 13 4,163 3.1 Howard Head Sports Medicine 46 6,667 6.9 SPRI* 39 8,828 4.4 The Steadman Clinic* 94 12,903 7.3 Vail Summit Orthopeadic* 10 3,798 2.6, Hospital Pharmacy 13 1,267 10.3 CMM* 20 4,216 4.7 Ambulance District* 5 3,828 1.3 679 134,887 { 136 Notes * = non -WMC employees Gfft shop employees are volunteers Cels highlighted in "yellow' cels indicate departments in the West Wing. VVMC West Wing CUP Employee Housing Report Page 8 The baseline data above demonstrates that it is not feasible to use one uniform employee /sf ratio for all uses at VVMC and that a number of generation rates will be necessary to accurately reflect the varying uses throughout the campus. This is similar to how the Town's current employee generation rates are used. By way of example, for a mixed -use hotel project up to five different employee generation categories could be used to determine employee generation — hotel rooms, conference facilities, eating and drinking establishments, retail and spa. Employee Generation Rates This section proposes employee generation rates for five new categories that will address uses and departments at VVMC. Proposed categories of employee generation rates for the West Wing expansion and the uses /departments they will address include the following: Surgery — this category will be used to define employee generation for the Surgical Suites (Level 3) and for the Vail Valley Surgery Center. Employees from the Sterile Process Department are also included in the Surgery category (due to their role being to primarily support surgery). Patient Care Unit — this category will be used to define employee generation for the Patient Care (Level 2) department of VVMC. It will include both patient beds and Intensive Care beds. Orthopaedic Clinic — this category will be used to define employee generation for the Steadman Clinic and with the development of the East Wing is expected to be used for Vail Summit Orthopaedics. Orthopaedic Research — this category will be used to define employee generation for the Steadman Philippon Research Institute (SPRI). Health Care Facility (HCF) — this category includes all other hospital uses not addressed by other categories. The purpose of this report is to address departments and uses associated with the West Wing expansion. It is anticipated that with the CUP review of the East Wing additional employee generation categories will be proposed. These categories will address the Emergency Department and (potentially) the Imaging Department. Information provided below for each of the categories proposed for the West Wing includes: VVMC West Wing CUP Employee Housing Report Page 9 • The departments and /or uses that are addressed by the category, • Background on the specific departments and /or uses, how they are changing with the master plan expansion and how de- compression influences employee generation for each department and use, • Existing employee /square footage ratios, employee /square footage ratios based on the "right- size" square footage from the 2013 Summary, and employee /square footage ratios based on proposed square footage, • An analysis of the square footage to be provided for each department or use, and • Where available, information on comparable uses or departments that would support or provide a point of reference for the proposed employee /square footage ratios. As described below, the basis for a number of the proposed employee /square footage ratios is the 2013 Summary that was completed by Heery International at the outset of the VVMC master planning process. The 2013 Summary defined the amount of additional square footage currently needed at VVMC in order to provide space for existing employees, or the "right- size" square footage. A ratio based on the right -size square footage and existing employee numbers is a valid indicator of employee generation from new proposed square footage. The 2013 Summary was based on, among other things, industry standards for the square footage of medical uses. A memo explaining the 2013 Summary has been prepared by Heery International and is included in the appendix of this report. Surgery — Proposed Employee Generation Rate Surgical Suites currently occupies 9,842sf on Level 3. The primary function of Surgical Suites that generates both patient activity and the need for employees is the four operating rooms. Pre -Op /Post -Op space is an important element of Surgery as are other associated support spaces. The Steadman Clinic currently occupies 6,502sf on Level 3. The Clinic will vacate this space when Level 4 is constructed, at which time Level 3 will be devoted exclusively to the Surgical Suites and the Sterile Processing Department (SPD). Total square footage on Level 3 will increase by 5,436 square feet, from 16,344 to 21,780 square feet. Surgical Suites will occupy 17,855 square feet, (an increase of 8,013sf) and the Sterile Process Department will occupy 3,925 square feet (discussed below). The number of operating rooms will remain unchanged at four. The 2013 Summary indicated 19,487sf is needed today to right -size the Surgical Suites. The proposed square footage of 17,855 is very close to this figure. Square footage in and around the four operating rooms remains basically unchanged. The increased floor area is dedicated primarily to much larger and improved Pre -Op and Post -Op spaces (2,196sf today, 6,451sf VVMC West Wing CUP Employee Housing Report Page 10 proposed), along with significant increases to storage and staff support spaces (1,097sf today, 4,579sf proposed), and staff offices (0 sf today, 1,123sf proposed). A floor plan comparison of existing and proposed uses on Level 3 is found in the appendix of this report. Currently 76 employees work in the Surgical Suites, this includes 46 VVMC employees, 17 anesthesiologists (who spend the majority of their time in Surgical Suites) and 13 employees of the Sterile Processing Department (while SPD provides some support to other departments, the bulk of their work is to support surgery and for this reason SPD is included in the Surgery category). Due to the nature of Surgical Suites, square footage is not an appropriate metric for determining employee generation. In lieu of square footage, the number of operating rooms is a more appropriate measure for determining the employee generation. 76 employees and 4 operating rooms would equate to 19 employees per operating room. As a point of comparison, the Vail Valley Surgery Center has four operating rooms and 50 employees, or 12.5 employees per operating room. The variation in Surgical Suites and the Surgery Center is primarily due to anesthesiologists and SPD employees being included in the total employee count for Surgical Suites. Collectively the 126 employees and 8 operating rooms would equate to 15.75, or 16 employees per operating room. With the number of operating rooms remaining at four, the West Wing expansion is not expected to generate any new employees. 16 employees per operating room is proposed for the employee generation rate for the Surgery category. Patient Care Unit (Primary Care and Intensive Care) — Proposed Employee Generation Rate The Patient Care Unit (PCU) includes both Primary Patient Care (hospital beds) and Intensive Care and currently occupies 16,349sf on Level 2 of the West Wing. With West Wing expansion the total square footage of Level 2 increases to 18,836sf. With the exception of 1,620 square feet used for the Cath Lab, all of Level 2 will be dedicated to patient care. While the increase to square footage is nominal, it does provide valuable benefits by increasing space for improvements to intensive care rooms and for the conversion of some 2 -bed patient rooms to single -bed patient rooms. VVMC West Wing CUP Employee Housing Report Page 11 The PCU employs 57 people in both the primary care and intensive care units. In addition, 5 VVMC Hospitalists work primarily in the PCU and are included with PCU employees for a total of 62 employees. By their nature a patient care unit has relatively high square footage needs and the best metric for employees needed to serve PCU is not square footage, but rather the number of patient beds. Currently the PCU has 47 beds. This number will be reduced to 44, a net reduction of 3 beds. 44 beds and 62 employees equates to 1.4 employees per patient bed. 1.4 employees patient bed is proposed for the employee generation rate for the Patient Care Unit (PCU) category. Orthopaedic Clinics — Proposed Employee Generation Rate The Steadman Clinic currently occupies five locations throughout the campus that total 12,903sf. Three of these spaces will be retained (a 1,511sf MRI room on Level 1 of Central Wing, and a 1,612sf administrative offices and a 1,379sf clinic space in the US Bank Building) and two spaces will be vacated (a 2,212sf clinic in Central Wing and 6.189sf of clinic space on Level 3 of the West Wing after completion of the West Wing. The Steadman Clinic will occupy 17,165sf on Level 4 of the new West Wing. With the existing spaces to be retained the Steadman Clinic will have a total of 21,667sf, or a net increase of 8,764sf. The 2013 Summary indicated that 26,838sf is needed to right -size the Steadman and 21,667sf is proposed. The deficit identified by the 2013 Summary quantified the extremely under -sized facilities the Steadman Clinic currently operates in which are lacking in many basic elements necessary for the organization's operation. While new space is designed to accommodate growth in the number of physicians, a significant portion of new square footage will address existing space deficiencies and in doing so reflect the de- compression of the organization's offices. The Steadman Clinic has experienced significant growth over the past decade and as demonstrated by the 2013 Summary, the Clinic is currently operating in extremely undersized spaces. Increases in square footage are spread among a variety of uses including storage /staff support, physician offices, exam /x -ray rooms and new uses such as VIP exam rooms and viewing /dictation rooms. The single largest increase of space is actually from expanded waiting areas, restrooms, lockers and circulation (currently 2,830sf dedicated to these uses and VVMC West Wing CUP Employee Housing Report Page 12 proposed is 7,216sf). A floor plan comparison of the Steadman Clinic's existing and proposed uses is found in the appendix of this report. The Steadman Clinic currently has 94 employees at the Vail Campus. The following employee /sf ratios provide a point of reference for the understanding employee generation that may result from expansion to the Steadman Clinic space: • Based on existing square footage, 94 employees equates to 7.3 employees /1,000 square feet. • Based on the 2013 Summary that indicated 26,838sf is needed to right -size the Steadman Clinic, the 94 existing employees would equate to 3.5 employees /1,000sf. • Based on the total 21,667sf that is proposed and assuming no change to employees, the 94 employees would equate to 4.3 employees /1,000sf. An employee generation rate of 3.5 employees /1,000sf is proposed. Based on 8,764 net new square feet, this rate would generate 30.4 new employees. Research has been done to identify employee generation rates for similar orthopaedic clinics; however no comparable examples were found. Nor were any employee generation rates specific to orthopedic clinics found in other municipal employee housing regulations. The following information is provided to offer perspective or validation for this 3.5/1,000sf ratio: Quantifying de- compression The 3.5/1,000sf rate is 48% of Steadman's existing employee generation ratio based on existing square footage and existing employees (7.3/1,000sf). This difference is significant and indicates the extent of how space will be decompressed by the expansion of Steadman space. 2013 Space Summary The proposed 3.5 ratio is based on the "right size" square footage number provided in Heery International's 2013 Summary. Explanation of how industry standards were used in defining the right -size square footage is provided in a memo prepared by Russ Sedmak and found in the appendix of this report. Proposed floor plans Detailed floor plans of Steadman's 4t" floor space are provided in the appendix of this report. These plans indicate physician offices, shared staff offices and other employee work stations that are being designed in this space. These work VVMC West Wing CUP Employee Housing Report Page 13 stations total 106. Other Steadman employees at the Vail Campus total 16 (4 at MRI, 7 in clinic space in US Bank Building and 5 in administration in US Bank Building) for a grand total of 122 employees. This figure is virtually identical to potential 124 total employees (based on the 94 existing employees and 30.5 new employees from the planned expansion). Proposed floor plans validate the use of the 3.5 employees /1,OOOsf ratio. Comparable SF ratios for medical uses The Town of Vail's adopted employee generation rates include a ratio of 3.8/1,OOOsf for office use. While not specifically a ratio for medical offices, the nexus study that generated this 3.8 ratio did include medical offices. As such it is somewhat of a benchmark when considering the proposed 3.5 ratio for orthopedic clinics. The 3.8 ratio would tend to validate the proposed 3.5 ratio. The City of Aspen recently reviewed and approved plans for expansion of the Aspen Valley Hospital. In determining employee generation from this expansion a ratio of 3.7 employees /1,000 net square feet was used. The ratio provides a solid point of reference for the 3.5 ratio proposed for Orthopaedic Clinics. Other Clinics /Comparables The Steadman Clinic's Edwards office is 2,900sf and accommodates 6 full time employees. This equates to an employee ratio of 2.0 employees /1,OOOsf. The Edwards office is unique in that it is sized to accommodate Vail -based physicians who periodically work at the Edwards office. For this reason this comparison has little relevance to Vail employee ratios. Vail Summit Orthopaedics (VSO) operates clinics in Frisco, Vail and Edwards. VSO has 57 total employees at these clinics and the total square footage of the three offices is 17,131 square feet. This equates to a ratio of 3.3 employees per 1,000 square feet. The employee ratios of each office varies — Frisco is 2.5/1,000, Vail is 2.7/1,000 and Edwards is 4.1/1,000. Another unique aspect of these clinics is that on occasion physicians work in multiple offices. For this reason the collective ratio of these offices is the best measure, or comparable to this analysis. VSO's ratio of 3.3 provides a solid point of reference for the 3.5 ratio proposed for Orthopaedic Clinics. Steadman Clinic's plans for future growth The Steadman Clinic currently has 9 doctors who office at the Vail Campus. Plans for the new Level 4 space include 14 physician offices, or an increase of up to 5 VVMC West Wing CUP Employee Housing Report Page 14 additional physicians. On average, each physician will have 4 staff support /physician assistant employees, meaning five new doctors could generate a total of 25 potential new employees. Applying the 3.5 employee /1,OOOsf ratio to the 8,764 square feet of net new Steadman space equates to 30.5 employees. The additional 5.5 employees could be attributable to incremental staffing increases in HR, billing, scheduling, or other functions. The Level 4 floor plans coupled with Steadman's long term plans to add physicians validates the use of the 3.5 employee /1,OOOsf ratio. 3.5 employees /square feet is proposed for the employee generation rate for the Orthopaedic Clinic category. Orthopaedic Research — Proposed Employee Generation Rate Orthopaedic Research category will provide an employee generation rate for the Steadman Philippon Research Institute (SPRI). The Institute is known throughout the world for their research into the causes, treatment and prevention of orthopaedic disorders. SPRI functions somewhat like a traditional office, but unlike a traditional office, significant amounts of SPRI's space is devoted to education, labs and research functions such as biomedical engineering, regenerative medicine and surgical skills. SPRI is not a medical clinic as it does not see patients. SPRI currently occupies two locations on the Vail campus that total 8,828sf. Both of these spaces will be vacated with construction of the West Wing. SPRI will occupy 7,278sf on Level 4 and 5,772sf on Level 1 of the new West Wing, for a total of 13,050sf and a net increase of 4,222sf of new space. The 2013 Summary indicated 12,977sf is needed to right -size SPRI and virtually that same amount of square footage is proposed. The deficit identified by the 2013 Summary quantified the extremely under -sized facilities SPRI currently operates in which are lacking in many basic elements necessary for the organization's operation. While new space is designed to accommodate some new programing, the bulk of new square footage for SPRI will address existing space deficiencies and in doing so reflect the de- compression of the organization's offices. VVMC West Wing CUP Employee Housing Report Page 15 SPRI currently has 39 employees at the Vail Campus. The following employee /sf ratios provide a point of reference for the understanding employee generation that may result from expansion to SPRI's space: • Based on existing square footage, 39 SPRI employees equate to 4.4 employees /1,000 square feet. • Based on the 2013 Space Program Summary that indicated 12,977sf was needed to right -size SPRI, the 39 existing SPRI employees would equate to 3.0 employees /1,000sf. • Based on the 13,050sf that is proposed and assuming no change to employees, the Steadman Clinic would have the same 3.0 employees /1,000sf generation rate. An employee generation rate of 3.0 employees /1,000sf is proposed. Based on 4,222 net new square feet, this rate would generate 12.6 new employees. Research has been done to identify employee generation rates for similar orthopaedic research centers; however no comparable examples were found. Nor were any employee generation rates specific to orthopedic research centers found in other municipal employee housing regulations. The following information is provided to offer perspective or validation for this 3.0/1,000sf ratio: Quantifying de- compression The 3.0/1,000sf rate is 68% of SPRI's existing employee generation ratio based on existing square footage and existing employees. This difference in essence reflects the decompression of space that will result from the expansion of SPRI space. Evaluation of SF being added A significant portion of SPRI's 4,222 net new square footage is devoted to the decompression of support -type spaces, or square footage not directly attributable to employee generation. New space or increases to the existing spaces for meeting rooms, lobbies /circulation, storage, IT rooms, and staff lounge /locker room collectively total 2,266 square feet, or 53% of SPRI's total net new square footage. This increased square footage can be attributed to de- compression with the balance (1,996) of net new square footage attributable to new employee generating space. Understanding how new square footage will be used provides some perspective for how the expansion SPRI space will decompress existing spaces and how only a portion of new floor space will be directly related to future employee growth. VVMC West Wing CUP Employee Housing Report Page 16 3.0 employees /square feet is proposed for the employee generation rate for the Orthopaedic Research category. Health Care Facilities — Proposed Employee Generation Rate Health Care Facilities (HCF) provides a general category for hospital uses and /or departments that are not addressed by other categories. Departments and uses that are addressed by other categories include The Steadman Clinic, SPRI, Patient Care (including Hospitalists), Colorado Mountain Medical and Surgical Suites /Vail Valley Surgical Center (including Sterile processing and anesthesiologists). The following table lists the VVMC uses and departments that would be addressed by the HCF category. VVMC West Wing CUP Employee Housing Report Page 17 VVMC Employees - Health Care Facility Category 5/2/2015 Total DEPARTMENT /ORGANIZATION Employees VVMC Cardiatric /Pulmonary 7 Specialty Clinics 12 Womans and Children Center 30 Mtn Surgical Assoc./ Trauma 11 Div Services /Cardio Inst. /Cath Lab 15 Emergency Department /VV EM Phy 15 Ambulance District 5 Lab 20 Other Uses /Departments SF Imaging (Rad, CTS, MRI) 13 Patient Care /Intensive Care 16,349 Gift Shop (volunteers) 0 Surgery Suites /Pre -op 9,842 Retail Pharmacy 11 Sterile Processing 2,731 Hospital Pharmacy 13 Hospitalists - Ped and Adult 130 Howard Head Sports Medicine 46 Vail Valley Surgery Center 11,160 Social Services 2 CMM 4,216 Employee /Occupational Health 3 The Steadman Clinic 12,903 Health Info Systems 2 Vail Summit Orthopeadic 2,844 Patient Relations 3 SPRI 8,828 Quality Assurance /Mgmt. (3) 8 Apollo 791 Utilization Review 1 69,794 Cafeteria /Nutrition 13 Facilities Management 12 VVMC Gross SF 200,000 Valet /Parking Lot /Concierge 9 SF of uses above 69,794 Security 8 130,206 House Keeping 26 IT (2) 23 Admissions 15 Admistration 11 Material Management 3 HR /Property Mgmt 3 340 The square footage used to define an employee /1,000 ratio for HCF is based on VVMC's +/- 200,000 gross square feet minus the square footage of the uses and departments listed above. These uses and departments total 69,794 square feet resulting in 130,206 square feet associated with HCF. With 340 employees, this equates to a ratio of 2.6 employees /1,000 sf. New square footage in the West Wing that would fall within the HCF category is limited to 2,437 square feet of meeting room space in the basement level and 2,478 square feet of space for Howard Head Sports Medicine on Level 1. The balance of all other new square footage in VVMC West Wing CUP Employee Housing Report Page 18 the West Wing is addressed by other employee categories. HCF space in the West Wing equates to 12.7 employees. 2.6 employees /square feet is proposed for the employee generation rate for the Health Care Facility category. West Wing Employee Mitigation Based on the proposed employee generation ratios outlined in the previous section, the West Wing expansion will generate 56 new employees. These employees are a result of the following: 12.6 employees Orthopaedic Research (expansion to SPRI) 30.7 employees Orthopaedic Clinics (expansion to The Steadman Clinic) 12.7 employees Health Care Facilities (additions to HHSM and other hospital square footage) Method of Mitigation 100% off -site employee housing mitigation is proposed and 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 granted based upon one of the following findings ". Based on the response to findings below, a request for an exception to the on -site requirement is proposed. a. Implementation of the on -site unit mitigation method would be contrary to the intent and 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 VVMC West Wing CUP Employee Housing Report Page 19 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 to accommodate a hospital and relate medical uses. • VVMC has very limited land area. The primary purpose of this site is to accommodate the medical center's existing needs as well as to retain opportunities for future expansion to the medical center. Introducing residential 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. In essence, any portion of the site that was to be used for housing would result in less site area available for future medical uses. This situation is exacerbated by existing covenant restrictions that limit VVMC's future expansion potential. 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. VVMC West Wing CUP Employee Housing Report Page 20 APPENDIX VVMC Campus Floor Plans /Gross Square Footage West Wing Floor Plans /Existing and Proposed Conditions Surgical Suites Square Footage Analysis /Existing and Proposed Conditions Steadman Clinic Square Footage Analysis /Existing and Proposed Conditions SPRI Square Footage Analysis /Existing and Proposed Conditions Steadman Clinic Detailed Level 4 Floor plans Explanation of "right- sizing" methodology /2013 Space Summary Report VVMC West Wing CUP Employee Housing Report Page 21 VVMC Campus Floor Plans /Gross Square Footage VVMC West Wing CUP Employee Housing Report Page 20 Lij 0 0 Lf•) 00 N II w• w c� cn o�N00 VO m CIS �N OC) \D 0 Ln � °NON Ln V � r�1 r--•o N c7 rl f� WaaaC)�F° 3 C W W x E- z w LU Q m of w Z W U J U� pZ W p rD Wm <Z >�o J � N > W Q G' U h C7 Z U co It w ;E_ wJ �w w cn �I I w o _ O r cJ A it •w r U Z _ Z G7 � C7� w 6 z -- L�L IM , d x W W x w LU Z 0 J W LL J W F— Z LU C] U _ C7 pZ wO 2 J_ LLD [0 J CD QZ > F o —, U N �w a ra w cn 00 00 Lij O M >n II III V .r r J W W J J U� c W � J W m J CJ QZ d � o J (n N c W ra w e 1 (D w w ry w w J w z z w C) J Q U C7 � z W J_ W m J Q z J F o <X Q W Q ra West Wing Floor Plans /Existing and Proposed Conditions VVMC West Wing CUP Employee Housing Report Page 21 CIS 0 cOc ' N rl 4-j w p 1 9i m s8 � M Age_ 5�v z y I �IJ � W a Ya Fi I £R- N NO �t 4 M Ll � v ev w v C. m U .. O 3 .r H Q v 4- j 1MV� 1� �I rT V J 1� CIS O 1 ITIR 10 .,I 4-j X 41 Un U) yam, N ti of 0, 10 u-, I FI F-47 -1--" T s I _Y ti of 0, 10 u-, u u F Aux oc CL Q U- V M ts uj of LU oc LU fr < OZU,1°., 0 Lu ti of 0, 10 rq x 10 u-, rq x 10 0 u u F Aux 0 7� O O . r-I 4-j US X UL PI-i LL LLI Of N N4w, �EO .................................... ............... .......... ------ UL PI-i LL LLI Of N N4w, �EO 1—I 4r-^j UJ X W ILA F IF�• 1 7L !� 1. I �_ 10 � m V M O �m N 0 V i L, ri �I tc X �� �x r � W 1 1 r w LL o 8 0 gg e Z TT U Li wL _ ¢ o -D Cl) O.: k J C� O �N F- C.0V a 3 10 � m V M O �m N 0 V i L, ri �I tc �x r � W _ >U-� m m N N l m V M O N ' V i L, ri �I 8� c� 4� 4� b�J .w CIS 0 0 1--I N -j /1 X 41 I N � � O O G U W TS O �I r� V J Surgical Suites Square Footage Analysis /Existing and Proposed Conditions VVMC West Wing CUP Employee Housing Report Page 22 C/1 T 0 r TWo 1� ^J ` V r V J X W O O x� o �m w� - 0 "F — O O o VV O � LLO F w O F � f N 3C1hC m � — o 'dais o � z y I < w G G N a O .cr cn r c: O in L] 00000 v o�. � cn cn G O c'in 0000 0 � J W W Steadman Clinic Square Footage Analysis /Existing and Proposed Conditions VVMC West Wing CUP Employee Housing Report Page 23 V J VJ ` V �W 4-j 0 0 w V�Jn w 0 bD �' CO � CO w 6i m _ w _ � w LL g Cis a d 3 Q a m m II II II II 'I I I I O O R Li O x C O � 0-0 C X W w (] U] I i i bA m II II II II II II II I CO o U) to v � � o X bD L o N V oo o o � o a o ° x E m bjD E O 3 00 a CO Ir 11 00000000 U V J m wy � X 00 00 0 0 00 W U V J VJ �W O Igo 1� r ^� V J W O O n� E 1 h ajo 7- m 0 cn � o �o N ri uj II II O R ii 0 x Ep 00000000 bjD II II II II II II II II •� o 0 o�o b -p A a v U a 9 0 0 o m o 2 ❑❑ ,❑ ❑ ❑ ❑❑ m m II II II II 0 II II II II 0 U � � � o X 1 M I - �o N ri uj II II O R ii 0 x Ep 00000000 bjD II II II II II II II II •� o 0 o�o b -p A a v U a 9 0 0 o m o 2 ❑❑ ,❑ ❑ ❑ ❑❑ a ❑❑❑❑ ❑ ❑ ❑E • '..� • U W V J m m II II II II 0 II II II II 0 U � � � o X 0 w D O a ❑❑❑❑ ❑ ❑ ❑E • '..� • U W V J SPRI Square Footage Analysis /Existing and Proposed Conditions VVMC West Wing CUP Employee Housing Report Page 24 11 r .............. .. ......... .......... i U,y O bjD r. u -i 77 L DIC-1 ------ ------ --- bO ;2 5 000000 0 �5j �22 000011110 NMJM s3d bl ----------- -i 77 L DIC-1 ------ ------ --- bO ;2 5 000000 0 �5j �22 000011110 Steadman Clinic Detailed Level 4 Floor plans d a o - - -- A - -- C) i - - - -- �s - -- - - - -- - - - -- � z -� 7 vg - i : - I_ + N' � 9 - V !u <� I 0 0 4 rti Z t1y O W o W, T VVMC West Wing CUP Employee Housing Report Page 25 Explanation of "right - sizing" methodology /013 Space Summary Report VVMC West Wing CUP Employee Housing Report Page 26 design WMC Programming Narrative May 2, 2015 Architecture Engineering The Master Facilities Plan for WMC is based on a program which is the Interior Design result of several months of analysis of the existing facility, which included Progst m Management interviews with staff and physicians, surveys, and a Lean Process Facilities Management Improvement project. The goal of these exercises was to develop the most space and cost - effective way to right -size the hospital to meet contemporary standards for health care facilities. These industry standards include national healthcare design guidelines which are also adopted by most state health departments, including Colorado. These same guidelines are used in the accreditation of hospitals by the JCAHO, which regulates minimum space and performance standards, including at WMC. Codes and standards required to be followed include the International Building Code, the NFPA Life Safety Code, the AIA/AHA Guidelines for Healthcare Facilities, and the Colorado Department of Health Regulations (which largely follows the AIA Guidelines and the LSC, primarily. Due to the need to accommodate all of these codes, the most stringent variation among them, needs to be followed. In addition, the Health Information Patient Privacy Act or HIPPA, is a Federal Law which affects the design of licensed healthcare facilities and is enforced by national health insurance plans and the US Department of Justice. One of the discoveries made during space programming is that a number of spaces and functions at WMC are deficient when compared to contemporary national standards for healthcare environments. Among these is a lack of private rooms for patients of all types and services and the floor space required to accommodate private rooms, a lack of patient and family waiting areas, lack of patient restrooms and ADA compliant restrooms, and a significant number of exam and procedure rooms which are undersized for modern healthcare delivery. In addition to the square footage deficiencies of specific uses and functions (such as those listed above), WMC is deficient in other spaces necessary to support medical operations. Industry standards define a "conversion factor" or "multiplier" (typically 1.4 — 1.6) that is used to determine the total square footage needed to provide adequate support space for specific healthcare uses. This conversion factor would capture space necessary for support space including corridors, utility rooms, and interior walls. Heery International, Inc. A group of professionG. OFFICES NATIONWIDE www.heery.com 1- 800- 52HEERY design For example, any departments which accommodate hospital patients must have minimum 8 ft. wide corridors, so these areas tend to need the higher conversion factors. These factors used in defining the program for WMC were then tested by the space planning and adjusted to reflect the actual design. Due to the inefficiency of working around an existing building, the actual conversion space is slightly higher than industry standards and what is typically used for projects using new construction. In addition to this factor, an overall building grossing factor of 1.2 is applied to the departmental totals to accommodate public corridors, lobbies, elevators and stairs. Below are brief summaries of some of the current space deficiencies at WMC. Storage Space and Circulation Due to the compression that has taken place since the building was constructed over 30 years ago, storage closets have been repurposed as offices and copy rooms, and storage is taking place either within treatment areas or in hallways. The program for expansion plans includes adequate storage for the long term, to coincide with adequate office and staff support space, to a void a "recompression" effect over time. Separation of public and service circulation is also a contemporary standard which will be met with the Master Plan. For the West Wing, 2 new public elevators will be added and a supporting lobby extension will take place on the northwest side of the building. Once the East Wing is complete, the existing 3 hospital elevators will be converted to service use only, with the exception of providing public access to the basement conference and dining areas as well. This separation of elevators and corridors creates the need for additional space but is essential for the efficient and user - friendly modernization of any hospital around the nation. The Steadman Clinic With respect to the West Wing Project, one of the major stakeholders in need of new space is the Steadman Clinic. Presently, the clinic is decentralized in multiple locations around the campus and in substandard space. The typical exam room size is approximately 10' x 9' or 11' x 8', depending on which portion of the campus the clinic occupies presently. Contemporary standards design for orthopedic exam rooms include room dimensions of 11' x 10' on average, in order to accommodate patient examinations treating lower extremity injuries. This is especially the case with the sports medicine orientation of the Steadman Clinic, which treats world -class athletes of all sizes. The Steadman Clinic also conducts teaching, and this requires additional space in exam rooms, clinic support areas, and research work/storage rooms. Presently, these work spaces are very cramped and result in a high degree of sharing and schedule management. A typical office accommodating several MD Staff may be the same size as one of the existing exam rooms, or 8' x 11'. Some of these offices are as small as Tx 10', and have 4 -5 small desks jammed into the space. Even the main waiting room at the Steadman Clinic is undersized. At 16'x 16', it accommodates about 18 chairs supporting 15 exam /treatment areas. Contemporary standards require a 1.5 ratio of waiting chairs to exam rooms, or approximately 23 in this case. Using a normal SF factor of 20 SF /pp in a waiting room, the room needs to be about 460 SF, or 200 SF larger than it is presently. Once the various clinics are combined into the new 4th Floor of the West Wing, the number of chairs needed, will increase to 54, and the waiting room is programmed to be over 1,200 SF in order to handle that occupant load and its required circulation, exiting widths, restrooms, ADA clearances, etc. Steadman Philippon Research Institute (SPRI) The existing SPRI functions are split between two locations in the existing facility. The lab spaces are located in the basement of the existing parking structure, and the research offices are located on the 11;t floor of the main hospital. The lab functions have outgrown their current space in terms of accommodating new equipment and storage, and do not have space for research "touch- down" work space. In the new facility plan, the labs will meet their actual program requirements, and will accommodate biomotion/bioskills research work space on the 4th floor. Research work space on the 11;t floor will consist of bullpen areas and private offices. Surgical Suites One of the most important improvements being made to the West Wing is the creation of private patient treatment areas for surgical prep and recovery. These areas will be developed on the 3rd Floor of the West Wing, in the area vacated by the relocation of the Steadman Clinic to the new 4th Floor. In design addition, the southernmost expansion of the floor plate at this level, will help to accommodate the additional space require for these private rooms. Presently, the WMC Surgery Department includes a prep /recovery room with a total of 10 bed spaces within it, all separated by only a curtain between the beds. Not only is this a compromise of HIPPA standards, the number of beds is deficient by about 50 %. This deficiency causes additional negative patient care impacts including inefficiency and loss of revenue and OR capacity, premature admission of patients to the PCU or other observation areas, and general patient and physician dissatisfaction with the facility. The program for the West Wing includes 19 beds for surgery prep /recovery, 10 of which will be in private rooms, including one dedicated for infectious isolation (which is also a current deficiency). While each of these rooms needs to be a minimum of 120 SF clear, the private accommodations allow for the required privacy and separation by case type, age, gender, and length of stay required. These private rooms can also swing between prep and recovery depending on the caseload and time of day or evening, which reduces the overall number of rooms by avoiding redundancy. Summary Information provided above explains the factors used to define the expansion program for WMC. In summary, the program and the plan for the new West Wing is optimized to provide a "right- sizing" of all existing rooms and the identification of new rooms that are not currently provided at WMC. The "right- sizing" square footage that has been identified reflects the space that WMC needs today in to provide quality health care. Industry standards and codes played a major role in defining the program for WMC's expansion and the specific improvements that are required to meet the community's healthcare needs for the present and the long term success of WMC. TOWN OF VAIL THIS ITEM MAY AFFECT YOUR PROPERTY PUBLIC NOTICE NOTICE IS HEREBY GIVEN that the Planning and Environmental Commission of the Town of Vail will hold a public hearing in accordance with section 12 -3 -6, Vail Town Code, on May 11, 2015 at 1:00 pm in the Town of Vail Municipal Building. A request for a final recommendation to the Vail Town Council of a major amendment to Special Development District No. 4, Cascade Village, pursuant to Section 12- 9A -10, Amendment Procedures, Vail Town Code, to allow for the conversion of one dwelling unit to an employee housing unit within the approved Vail Cascade Residences development and a request for an extension of its approval period for an additional three (3) years , located at 1310 Westhaven Drive /Cascade Village, and setting forth details in regard thereto. (PEC150014) Applicant: Ultimate Cascade LLC, represented by Mauriello Planning Group Planner: Jonathan Spence The applications and information about the proposals are available for public inspection during office hours at the Town of Vail Community Development Department, 75 South Frontage Road W. The public is invited to attend site visits. Please call 970 - 479 -2138 for additional information. Sign language interpretation is available upon request, with 24 -hour notification. Please call 970 - 479 -2356, Telephone for the Hearing Impaired, for information. Published April 24, 2015 in the Vail Daily. Ad Name: 11172816A PLANNING AND ENVIRONMENTAL COMMISSION Customer: TOWN OF VAIL /PLAN DEPT /COMM May TOWN COUNCIL CHAMBERS O NCI CHAMBERS Your account number is- 1OP2P 33 / PUBLIC WELCOME 75S. Frontage Road - Vail, Colorado, 81657 Vail Daily MEMBERS PRESENT MEMBERS ABSENT 60 minutes 1.A request for final review of a Conditional Use PROOF OF PUBLICATION Permit condition of approval, pursuant to Section 12 -9C -3, Conditional Uses, Vail Town Code, to determine the employee generation and mitigation rate for the Vail Valley Medical Center healthcare STATE OF COLORADO } facility, located at 181 West Meadow Drive and 108 South Frontage Road West (Vail Valley Medical Center) /Lots E, F, and 10 Vail Village Filing 2, Lot lss 2E, Block 1, Vail Lionshead Filing 1 and Lot D -2, A II Resubdivision of Lot D, Vail Village Filing 2 COUNTY OF EAGLE } (PEC15 Applicant: nt: Vail Valley Medical Center, represented by Braun Associates Planner: Nina Timm 1, Don Rogers, do solemnly swear that I am a qualified ACTION: MOTION: SECOND: VOTE: representative ofthe Vail Daily. That the same Daily newspaper CONDITION(S): 2.A request for a final recommendation to the Vail printed in whole or in part and published in the County Town Council of a major amendment to Special Eagle, State of Colorado, and has a general circulation g g Development District No. 4, Cascade Village, pur- suant Amendment to Section Code, dures, Vail Town code, to for the therein; that said newspaper has been published continuous) p y allow all conversion version within one dwelling unit to l employee housing unit within the approved Vail Cascade Residences de- and uninterruptedly in said County of Eagle for a period of velopment and a request for an extension of its ap- proval period for an additional three (3) years , lo- more than fifty -two consecutive weeks next prior to the first cated at 1310 Westhaven Drive /Cascade Village, and setting forth details in regard thereto. (PEC150014) Ppublication of the annexed legal notice or advertisement and g Applicant: Ultimate Cascade LLC, represented by er that said newspaper has published the requested legal notice h h 1� q g Mauriello Planning Group Planner: Jonathan Spence ACTION: Table to June 8, 2015 and advertisement as requested. COND TION(S): VOTE: 3.Approval of April 27, 2015 minutes The Vail Daily is an accepted legal advertising medium, MOTION: SECOND: VOTE: 4.Information Update only for jurisdictions operating under Colorado's Home 5.Adjournment Rule provision. MOTION: SECOND: VOTE: The applications and information about the propos- als are available for public inspection during regu- That the annexed legal notice or advertisement was lar office hours at the Town of Vail Community De- velopment Department, 75 South Frontage Road. published in the regular and entire issue of every The public is invited to attend the project orienta- tion and the site visits that precede the public hearing in the Town of Vail Community Develop - number of said daily newspaper for the period of I ment Department. Times and order of items are consecutive insertions; and that the first publication of said approximate, subject to change, and cannot be re- lied upon to determine at what time the Planning Environmental Commission notice was in the issue of said newspaper dated 5/8/2015 and and will consider an item. Please call (970) 479 -2138 for additional in- formation. Sign language interpretation is available that the last publication of said notice was dated 5/8/2015 in upon request with 24 -hour notification. Please call (970) 479 -2356, Telephone for the Hearing Im- the issue of said newspaper. paired, for information. Community Development Department Published May 8, 2015 in the Vail Daily. (11172816) In witness whereof, I have here unto set my hand this day, 05/12/2015. General Man ager/Publisher/Editor Vail Daily Subscribed and sworn to before me, a notary public in and for the County of Eagle, State of Colorado this day 05/12/2015. � 2M 4,& 9. -V-� Pamela J. Schultz, Notary Public My Commission expires: November 1, 2015 �pRY PUe/ ' PAMELA J. SCHULTZ 9�� COt -ARP$ My Commismn Expires 1110112015 Ad Name: 11133447A Customer: TOWN OF VAIL /PLAN DEPT /COMM Your account number is- 1 OP2P 33 Vail Daily PROOF OF PUBLICATION STATE OF COLORADO } }SS. COUNTY OF EAGLE } I, Don Rogers, do solemnly swear that I am a qualified representative ofthe Vail Daily. That the same Daily newspaper printed, in whole or in part and published in the County of Eagle, State of Colorado, and has a general circulation therein; that said newspaper has been published continuously and uninterruptedly in said County of Eagle for a period of more than fifty -two consecutive weeks next prior to the first publication of the annexed legal notice or advertisement and that said newspaper has published the requested legal notice and advertisement as requested. The Vail Daily is an accepted legal advertising medium, only for jurisdictions operating under Colorado's Home Rule provision. That the annexed legal notice or advertisement was published in the regular and entire issue of every number of said daily newspaper for the period of 1 consecutive insertions; and that the first publication of said notice was in the issue of said newspaper dated 4/24/2015 and that the last publication of said notice was dated 4/24/2015 in the issue of said newspaper. In witness whereof, I have here unto set my hand this day, 04/24/2015. General Man ager/Publisher/Editor Vail Daily Subscribed and sworn to before me, a notary public in and for the County of Eagle, State of Colorado this day 04/24/2015. � 2m.&& 9. -V-� Pamela J. Schultz, Notary Public My Commission expires: November 1, 2015 �pRY PUe/ ' PAMELA J. SCHULTZ 9�� COt -ARP$ My Commismn Expires 1110112015 THIS ITEM MAY AFFECT YOUR PROPERTY PUBLIC NOTICE NOTICE IS HEREBY GIVEN that the Planning and Environmental Commission of the Town of Vail will hold a public hearing in accordance with section 12 -3 -6, Vail Town Code, on May 11, 2015 at 1:00 pm in the Town of Vail Municipal Building. A request for a final recommendation to the Vail Town Council of a major amendment to Special Development District No. 4, Cascade Village, pur- suant to Section 12- 9A -10, Amendment Proce- dures, Vail Town Code, to allow for the conversion of one dwelling unit to an employee housing unit within the approved Vail Cascade Residences de- velopment and a request for an extension of its ap- proval period for an additional three (3) years , lo- cated at 1310 Westhaven Drive /Cascade Village, and setting forth details in regard thereto. (PEC150014) Applicant: Ultimate Cascade LLC, represented by Mauriello Planning Group Planner: Jonathan Spence The applications and information about the propos- als are available for public inspection during office hours at the Town of Vail Community Develop- ment Department, 75 South Frontage Road W. The public is invited to attend site visits. Please call 970 - 479 -2138 for additional information. Sign language interpretation is available upon re- quest, with 24 -hour notification. Please call 970 - 479 -2356, Telephone for the Hearing Im- paired, for information. Published April 24, 2015 in the Vail Daily. (11133447)