February 27, 2012 | last updated June 4, 2012 11:47 am

Yale-New Haven hospital pushes for expansion

Yale-New Haven Hospital is bursting at the seams with increasing patient loads, creating the need for the addition of 70 new beds on its Elm City campus as well as a major acquisition of a cross-town rival, officials said.

The hospital is asking state regulators for permission to add 70 beds to its New Haven campus over the next two years in order to alleviate capacity issues being spurred by a spike in patient volume, particularly for inpatient services.

But the additional beds are only a first step, said Vin Petrini, the senior vice president of public affairs at the hospital.

Yale's proposed $160 million acquisition of cross-town rival St. Raphael's hospital also aims to provide Yale-New Haven with more capacity to move patients. If that deal, which is awaiting regulatory approval, falls through for some reason, Yale-New Haven Hospital would have to readjust its plans, and potentially move forward with the construction of a new $400 million patient tower on its campus to meet projected future patient demands, Petrini said.

The additional 70 beds are slated be located on the East Pavilion portion of Yale-New Haven hospital's campus, which is partially vacant. It would require a $1.4 million investment.

"This allows us to address our short-term capacity issues," Petrini said. "We are getting more patients from across the state and outside the state because we've become a destination hospital."

Petrini said the hospital has broken patient volume records recently, including holding 1,020 patients in a single day. The hospital's average daily census has increased by 35 patients a day.

With about 1,000 beds right now, the hospital is reaching its capacity.

According to Yale's application to the Office of Healthcare Access, which is responsible for approving hospital expansions, the optimal level of occupancy at a hospital is about 80 percent, but Yale-New Haven has been operating above that level for the past few months.

Occupancy levels in Yale's medical/surgical areas, which have about 65 percent of the hospital's inpatient beds, have hit as high as 90 percent, officials said.

The growth is being driven by inpatient volume, Petrini said, which is bucking the statewide trend that has existed in Connecticut in recent years.

Michele Sharp, a spokeswoman for the Connecticut Hospital Association, said inpatient volume in Connecticut has essentially been flat and even dropped slightly at some hospitals since 2009, likely due in part to the economy.

As people have lost jobs and/or medical insurance, they have put off elective procedures, leaving surgical suites less active.

But Petrini said Yale-New Haven is seeing growth in in-patient volume as the hospital increasingly attracts patients outside its geographic footprint and even beyond Connecticut's borders.

The recruitment of new physicians and the opening of its Smilow Cancer Hospital in 2009 have had a lot to do with the growth, he said.

So has a new "Y Access Line" initiative the hospital recently adopted, which facilitates the direct admission and inter-facility transfer of acutely ill patients from physician's offices, smaller community hospitals, and other health care facilities to Yale-New Haven for tertiary levels of care.

The program, which started in 2010, has increased patient transfers to Yale-New Haven by 29 percent. The hospital is seeing almost 4,000 patient transfers a year, Petrini said.

The request for 70 additional beds is only the most recent expansion request by Yale-New Haven Hospital. Last year, the health care giant submitted a request to build a new $25 million ambulatory care center in North Haven, but state regulators rejected the request, saying the hospital failed to demonstrate that volume in its emergency department is "increasing significantly more than originally projected."

In response, Yale-New Haven withdrew its application, but pledged to re-work its plan.

Petrini said the North Haven project remains on uncertain ground. He said the hospital still hopes to have some kind of presence in that town, but officials are in the process of reevaluating what clinical services would be offered there.

Across the state, several hospitals have embarked on expansion projects in recent years, mainly to accommodate growth in their emergency departments rather than in-patient service suites.

St. Francis Hospital, for example, recently opened a new 385,000-square-foot state-of-the-art patient tower that doubled the size of its emergency department and is able to accommodate up to 100,000 patients a year. Danbury Hospital is working on a $150 million expansion that will greatly expand its emergency department.

Meanwhile, Hartford Hospital is making a multimillion investment to nearly double the size of its emergency department, which sees more than 100,000 patients annually.

Sharp said besides increased patient demand recent construction projects are being spurred by other factors including aging hospital facilities, technology changes, and needs for new equipment.

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