Modernizing Milford Medical

With the prickly issue that health care has become – from rising costs to primary care shortages to the question of whether it should even be a political issue – there is positive news coming out of the industry in MetroWest.

Milford Regional Medical Center has affirmed its commitment to the southern portion of the region and, at the same time, underscored its own vitality and success, with a planned $40-million expansion and upgrade.

"We look at this project as another major step in the overall evolution in our health care system," said Francis Saba, CEO of the nonprofit community and teaching hospital. "It's meant to address some of the more critical needs that we have, and that our community has."

If the planned expansion is an indicator, those critical needs include emergency and intensive care. The preliminary proposal is a two-story, 60,000-square-foot standalone building that would complement the center's current 283,000-square-foot, 121-bed facility, which sits on 14 acres at the junction of routes 140 and 16 in Milford.

The ground floor of the new building would contain a new emergency room – effectively doubling the size of the existing ER – with the second floor housing an intensive care and telemetry/medical surgery units. The space that's being used for all three services would be vacated and reused for other purposes yet to be determined, according to hospital officials.

Hospitals officials expect the new building to be functional within about three years. Meanwhile, the hospital's full- and part-time staff of 2,000 may eventually grow to meet demand.

"We're really just starting out on this project," said Saba. But, he added, "we're definitely moving along."

As of March, the hospital was interviewing potential architects to help firm up the fine details, he said. In the coming months and years, there will also be regulatory hurdles to clear.

As for financing, Saba said the hospital aims to raise the estimated $40 million cost through a capital campaign. That campaign is still in a silent phase, he said, which means the hospital has not yet appealed to the general public for contributions.

In trying to provide what its customers want, the hospital has expanded in other ways, as well. In 2007, it opened a 54,000-square-foot cancer center, partnering with Dana-Farber/Brigham and Women's Cancer Center for services (including radiation therapy). It has also expanded and renovated its maternity center.

Ultimately, according to experts and officials, Milford Regional Medical Center's growth and success highlight the importance of smaller, short-term hospitals now and into the future.

"At the end of the day, they'll play a diverse role," said Tim Gens, executive vice president and general counsel of the Massachusetts Hospital Association, a nonprofit member organization.

That role will likely also be quite varied in the future, he said, predicting the creation of more networks, affiliations, and hospital mergers.

"Much is changing," he said, "and they're adapting as they go."

Challenges going forward for smaller hospitals, Gens said, will ultimately come down to whether they have, and can maintain, certain resources – the most notable of those being staff, capital, and data.

"Community hospitals, yesterday, today and tomorrow, are a viable part of the health care delivery system," Gens said. "They're important not only because they deliver care to local communities, but they're also a part of the local economic engine."

Others agree with that. First, said Feingold, Milford Regional Medical Center is one of the region's largest employers, and many businesses supply it with services and products.

"As they grow," he said, "it has a positive impact on our business community."

Meanwhile, the hospital has many tendrils the community, including student-based health clinics, as well as partnerships with the Hockomock Area YMCA, local senior centers, nursing homes and rehabilitation facilities.

"We have a responsibility beyond the walls of the campus" Saba said. "We work very hard at connecting with our community."

And in turn, he said, "the community has been incredibly helpful to the hospital, and very supportive of our plans. We could not be successful if we didn't have a community that really cared."

Need Drives Growth

As hospital executives and local officials explained, the institution is growing along with the region – both physically and financially. According to its most recent annual report, the hospital's 2011 revenues were $238 million, while profits were $6.6 million. That represents 3.5-percent growth over 2010 revenues of $230 million and a sharp increase in profits, which came in last year at $666,000.

The hospital's location - triangulated between Providence, Worcester and Boston, and near the Massachusetts Turnpike, Interstate 495 and routes 16, 140, and 85, has allowed it to capture and cater to a large swath of patients over the years. It has broadened its services to residents in 20 towns in three counties – Worcester, Middlesex and Norfolk – which have grown to a combined population of about 230,000, according to hospital officials.

"It's a fairly substantial market that we deal with here," Saba said. "The towns that we serve have experienced significant growth over the last couple of decades."

The expansion makes perfect sense to Barry Feingold, president and CEO of the Milford Area Chamber of Commerce.

"We've seen growth in MetroWest," Feingold said. "More people seem to be moving west from Boston. (The hospital) has to grow as the community grows. It's a very necessary and natural next phase for them."

To meet the needs of surrounding communities, the hospital has honed in on and strengthened its core function as a provider of basic primary and secondary care, while referring higher-end cases to Worcester or Boston.

"We have a niche in this industry," said Saba. "People need good, solid, basic primary care."

And, because access to traditional primary care doctors is a problem around the country, many patients continue to turn to the ER for basic services, he said.

In 2011, for instance, Milford Regional Medical Center's emergency department tended to 55,213 patients, an increase of roughly 5,000 in just five years. All told, according to hospital president Edward J. Kelly, ER activity has grown about 33 percent over the last 10 years.

It has managed those gains over the years through "patchwork" upgrades and a "series of add-ons." But now, there just isn't enough space, and sometimes patients overflow into hallways, he said.

The new emergency department would accommodate roughly 80,000 visits a year, Kelly said, and will have more functional rooms.

"The goal at the end of the project is very basic in just being able to provide a modern emergency room," he said.

"We need to develop bigger and better space for our emergency care," agreed Saba. "It's not appropriate for us to have patients on stretchers in hallways."

The ICU, meanwhile, which caters to more than 565 patients a year, is operating with rooms built in 1981. The revamp will double its size, increase its numbers, provide more privacy, and provide rooms that can accommodate a variety of equipment. Now, when patients are hospitalized, they often stay in rooms with two, three or four beds.

"Folks really want privacy," said Saba. "We're trying to address what the community needs and wants, and also keep up with the developments in our own industry."

Not All Upgrades Have Been "Patchwork"

In trying to provide what its customers want, the hospital has expanded in other ways, as well. In 2007, it opened a 54,000-square-foot cancer center, partnering with Dana-Farber/Brigham and Women's Cancer Center for services (including radiation therapy). It has also expanded and renovated its maternity center.

Ultimately, according to experts and officials, Milford Regional Medical Center's growth and success highlight the importance of smaller, short-term hospitals now and into the future.

"At the end of the day, they'll play a diverse role," said Tim Gens, executive vice president and general counsel of the Massachusetts Hospital Association, a nonprofit member organization.

That role will likely also be quite varied in the future, he said, predicting the creation of more networks, affiliations, and hospital mergers.

"Much is changing," he said, "and they're adapting as they go."

Challenges going forward for smaller hospitals, Gens said, will ultimately come down to whether they have, and can maintain, certain resources – the most notable of those being staff, capital, and data.

"Community hospitals, yesterday, today and tomorrow, are a viable part of the health care delivery system," Gens said. "They're important not only because they deliver care to local communities, but they're also a part of the local economic engine."

Others agree with that. First, said Feingold, Milford Regional Medical Center is one of the region's largest employers, and many businesses supply it with services and products.

"As they grow," he said, "it has a positive impact on our business community."

Meanwhile, the hospital has many tendrils the community, including student-based health clinics, as well as partnerships with the Hockomock Area YMCA, local senior centers, nursing homes and rehabilitation facilities.

"We have a responsibility beyond the walls of the campus" Saba said. "We work very hard at connecting with our community."

And in turn, he said, "the community has been incredibly helpful to the hospital, and very supportive of our plans. We could not be successful if we didn't have a community that really cared."