News

Contact: Sarah Bello

The announcement of the BuildCMH Expansion Project has led to many questions in the community, including why the hospital would choose to stay at 25 beds. On Thursday, a guest editorial from CMH Board President, Dr. Robert Holland, will run in The Astorian. You can read the full editorial below.

Space is a premium in hospital expansion
The recent announcement of a major remodel of Columbia Memorial Hospital has generated considerable local interest. The effort will be one of the largest single construction projects for Clatsop County and will propel Columbia Memorial into one of the most modern small hospitals in the country.

Many questions have been received as to why the Board of Trustees decided to retain the 25 inpatient bed size, rather than expanding. With the cost of hospital construction now exceeding $1,000 per square foot, every inch of space must be scrutinized.

As a clinician with nearly 40 years’ experience, I have witnessed a revolution in how medicine has developed and seen a giant shift away from inpatient care to extensive application of outpatient treatment and surgeries. When I trained, patients undergoing gallbladder surgery or hysterectomy could anticipate spending three to five days in the hospital recovering.

Now, those having gallbladder removal, hysterectomy, knee and hip replacements, as well as many other procedures, go home the same day and recover quickly. Change in surgery procedures, alone, remove much of the need for inpatient beds.

Powerful antibiotics that can be administered to outpatients, infusion centers, endoscopy clinics and increased office procedures have irreversibly changed the needs for inpatient admission. Patients are admitted now only with more serious conditions, not yet amicable to outpatient therapy.

Columbia Memorial is considered a critical access hospital by Medicare, a designation which provides cost-based reimbursement allowing smaller hospitals in rural areas to be able to afford providing lower volume care in essential geographic areas. Requirements for this designation include limiting bed size.

With this background, the Board employed due diligence to evaluate countywide demographic and market share for inpatient bed needs. We took into account that the current average daily inpatient census is 12 patients and the average length of stay is three days.

We felt that between Columbia Memorial and the capacity of the Providence Seaside Hospital, the county would have access to 50 beds.

Rather than increase beds, the Board decided to add five dedicated observation beds, which allow stays of up to 48 hours, add additional emergency department and outpatient surgery pre and post operative rooms and expand our telemedicine and virtual care options.

With these plans, Columbia Memorial can modernize and serve community needs without necessitating any change in Medicare designation. We can add high tech, state-of-the-art medicine in a Planetree atmosphere within appropriate fiscal limits.

Robert Holland, MD, PhD
CMH Board President