The state of Illinois has approved a $17.77 million expansion of OSF St. Joseph Medical Center in Bloomington. The hospital will add 25 beds to the current 152-bed total; 10 of those will be medical-surgical care beds and 15 will be for intensive care patients.
Interim hospital president Jennifer Ulrich said the community needs the extra beds, adding the pandemic boosted demand for health care, and although some of that has receded, it's not enough.
"We found ourselves becoming a major referral center almost overnight," said Ulrich.
The nature of health care also is changing as rural medical services erode.
"Especially in downstate Illinois, what we're seeing is facilities close their doors which then puts more pressure on the remaining hospitals, in particular those with specialized services, or like we refer to ourselves, as a regional referral center," said Ulrich.
The addition of thousands of people to the community from business expansion in the last few years — think Rivian — also helped OSF St. Joseph make the case to the State Health Facilities and Services Review Board.
"Over 200 times, for example, in the course of the last two years where OSF St. Joseph has had to turn away patients or send them to other facilities, not having capacity to care for patients," said Ulrich.
Initially, the review board questioned OSF’s population estimate method that relied on employment, school district, and census data. The board usually uses birth and death numbers to assess the need for a new or expanded service. The board suggested OSF’s cost estimates for the project were too high, and that average occupancy rates for the medical center did not meet the standard to expand.
At a recent hearing, Ulrich said OSF was able to satisfy those concerns.
In 2021, facility use was about 76%. In 2022, it was just under 64%. Ulrich said the blended averages do not tell the whole story about the space crunch. For the ICU, they target around 60% occupancy. For medical/surgical, Ulrich said a good goal is 80-85%.
“At St. Joe's, that can be really difficult to come by because we do not have all private rooms. If you don't have all private rooms, you have issues with gender mix. You are not going to put people of different genders in the same room. We also have isolation, so patients who have certain conditions can't share a space with anyone else because of the need for personal protective gear to be worn by anyone who's in proximity to those patients,” said Ulrich.
She said Bloomington-Normal is one of the few areas of the state to have significant population growth and the review board accepted the non-standard population methodology. The new beds also will move OSF St. Joseph forward on its longer-term plan to put every patient bed in the facility in a private room, said Ulrich.
The project will rehab some existing space and build a small addition to the hospital. The services formerly in that space already have moved out, or can do so with little notice.
“The Center for Healthy Lifestyles was a large part of the footprint of where this expansion is going to go," said Ulrich. "When the YMCA was built here on the campus of St. Joseph Medical Center, a number of those exercise services became available in the community there. We also have a few other programs that are using that space today, but we have other space to be able to move them to for the majority of the space that we're talking about. It is not it is not impacting any patient care area.”
The 25 new beds will require more staff to tend to those patients on three shifts. Many medical service providers have experienced staff shortages as pandemic-related burnout accelerated retirements and exits from the field and diminished interest by younger workers in entering health care.
Ulrich acknowledged the issue, but said efforts to address workforce supply are going well.
"We are working really closely with a number of schools of nursing. I'm very proud that over the course of the last six months we have brought in 50 new nurses….I was very excited to see those recruitment numbers,” said Ulrich. “They've also started a very innovative program with Heartland [Community College] to be able to grow interest in nursing.
"We are implementing a ‘career ladder,’ where we can offer an introduction into the health care industry. Someone who's interested in health care right after high school can join employment as a nursing assistant and then through many programs that OSF offers, can complete their education cost-free, all the way up to an RN. Beyond an RN, there are pathways where the majority of education can be funded through different programs within OSF.”
For some time, the overall industry trend in health care has been expected to be fewer beds occupied and more outpatient and quick turnaround rehab facility beds. Ulrich said that shift has not fully arrived in Bloomington-Normal because of capacity at longer-term care facilities and complex insurance acceptance rules.
“Yes, there is this desire for us to have shorter lengths of stay, or shorter numbers of visits, because we expect things to migrate to the outpatient setting or to longer-term care facilities," she said. "On the other hand, we do have population growth happening in this community, which is rare for the state of Illinois. There are increasing demands on our services because of the population growth, but also because of the fact there are fewer facilities around and patients who present to a smaller critical access hospital need to be transferred somewhere often for specialty services. That's what we're responding to.”
OSF expects the project to finish and the new beds to be available by the end of 2026.
