3 hospital projects vie for approval

All would upgrade women's services in Wake County

Bold may be better if you're trying to bring new medical services to fast-growing Wake County.

WakeMed wants to build the county's first women's hospital in North Raleigh. Novant Health proposes a community hospital in Holly Springs to improve health care in the southern part of the county. Rex wants to expand on its main Raleigh campus.

But regulators, based on growth projections, have approved just 41 new hospital beds for Wake County, so only one hospital has a chance of getting what it wants.

How will regulators decide?

Cost, ease of access and quality of care will be important. As will community support. But each of the hospitals has so much experience in writing these proposals, they know how to meet state requirements and present their cases well.

So regulators look for something more.

"A decision has to be based on some discriminative factor," said Mike McKillip, a project analyst for the Department of Health and Human Services. "Something that's different. Something that stands out."

McKillip is one of the analysts who could review the proposals Rex, WakeMed and Novant submitted to the state's Certificate of Need Office, which regulates hospitals' expansion plans in an effort to keep down medical costs.

Here are the proposals being considered.

What they want

Novant, a Winston-Salem hospital chain itching to get a toehold in the Triangle, wants to build a community hospital in Holly Springs, where residents from the southern part of the county could go to see an emergency physician, get their tonsils removed, have their sports injuries repaired and give birth. A hospital is on top of many residents' wish list, according to a survey Holly Springs conducted about two years ago.

The Holly Springs Hospital is proposed for the south side of town, just off N.C. 55. The 180,200-square-foot facility would include an emergency department with 16 treatment rooms, four intensive care beds, 10 labor and delivery rooms and four surgical operating rooms. It would offer diagnostic imaging services and physical and occupational therapy.

The hospital would open in mid-2012 and reach a projected occupancy rate of 90.1 percent within two years.

WakeMed wants to build a women's hospital on its North Raleigh campus. The four-story addition would have 61 beds, including 20 acute care beds that WakeMed plans to relocate from its main campus on New Bern Avenue, and two surgical operating rooms.

The facility is proposed to open in October 2011 and is projected to reach an occupancy rate of 74.8 percent within two years.

Rex Hospital wants to build a three-story addition on its Raleigh campus to create capacity for labor and delivery and surgical services. The expansion would be completed in January 2012 and is projected to reach an occupancy rate of 77.3 percent within two years.

What they have

All three proposals want to boost health care services for women in fast-growing areas of the county.

Women incur about two-thirds of the annual medical bills in the United States because they live longer and have medical issues such as pregnancy and childbirth, certain cancers and conditions stemming from menopause.

All three hospital systems also submitted letters and e-mail from Wake County residents, elected officials and business owners supporting their proposals.

Where they differ

At a projected cost of $100 million, Novant's proposed Holly Springs Hospital is the most expensive. It would create the most jobs, about 370, and Novant has the money on hand.

WakeMed's women's hospital would cost an estimated $34 million and create about 215 jobs.

Rex estimated that renovation and construction would cost $20.4 million and create about 50 jobs. WakeMed and Rex plan to sell bonds to pay for their expansions.

As they compare the proposals, regulators will look at the cost of each. But the analysis will also pay close attention to the cost of medical services at each facility and how much each provider spends on care for the uninsured and underinsured.

Other factors

Only Novant conducted a traffic study and a phone survey to gauge support for its proposal. But there's also opposition to its plan. Colleen Cargill, who lives near the proposed site of the Holly Springs Hospital is worried about noise and increased traffic. Echo Idalski, another Holly Springs resident, withdrew her support of the Novant proposal because she believes a community hospital won't be able to provide the services the town really needs.

Among the thousands of signed support letters and e-mail the three proposals elicited, Rex submitted the only hand-written letter of support. Regulators pay particular attention to those, McKillip said. "Those I read word for word."