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The 1960s-era building sorely lacks space and modern capabilities, but a plan to relocate west of the city is controversial.
By JEFFREY S. SOLOCHEK
© St. Petersburg Times, published June 10, 2001
BROOKSVILLE -- When Marjorie Dumas of Spring Hill needs hospital care, she chooses Brooksville Regional Hospital.
Dumas, 63, grew accustomed to the hospital because her mother used it frequently. The care, she says, is wonderful.
The building, on the other hand, is "iffy" at best, said Dumas, assigned Friday to one of six overflow beds on a monitored patient floor. Six beds sepa rated by purple-pink curtains fill the converted intensive-care unit, which nursing manager Leslie Dean said she uses only when pressed, adding, "I wouldn't want to be in one of these beds."
"I think we need a little more space. A lot more space," Dumas said, frowning at the blaring voices from a neighbor's television. "It gets a little noisy in here during the night. ... The restrooms are real little. You can't change your mind."
More than anything, that lack of space underlies Hernando HealthCare's proposal to replace and relocate Brooksville Regional Hospital, spokeswoman Cheri Jennison said. Patient rooms, operating rooms, the emergency triage area, hallways and even conference rooms are too small for a modern health-care facility, she said during a tour of the 1960s-era hospital.
"A lot of the things we're talking about can be improved," CEO Tom Barb acknowledged. "But to improve them requires us to do it under the new (building) code. That doubles or triples the cost."
A renovated hospital still would be old, he said. It still would sit in a "hole" that floods when it rains heavily, have two separated patient towers, and lack the land for expansion that parent company Health Management Associates desires, Barb added.
"This is the obvious opportunity for us to move and become successful for the future," he said.
The selected 95 acres on State Road 50 at Lykes Dublin Road, about 4 miles west of the current hospital and outside the city limits, plays into that future, Barb said. The property is the right size and shape, along major thoroughfares, available for purchase and close to the county's growth areas, he said.
Without it, HMA's proposal to Hernando County, which owns the hospital and the licenses for its 91 beds, most likely is off.
"This proposition is based on this site," Barb said. "The only thing that is a real deal breaker is location."
HMA executives did not realize the hospital's many physical restrictions until about a year after signing a 30-year lease to operate Brooksville Regional and Spring Hill Regional hospitals for the county, said Barb, who also worked at Brooksville Regional under the previous operator. The agreement, reached in 1998, brought the hospitals out of lengthy bankruptcy proceedings.
As architects looked at ways to improve and expand the entrance, he said, it became clear that to meet more modern building codes and access requirements, the scope and cost of the project would be exorbitant.
A person in a wheelchair cannot enter the lobby restrooms, for instance, because of their narrow, heavy doors and broom-closet space.
Retrofitting the entire hospital would cost as much as building a new one -- close to $38-million, Barb suggested.
Yet such renovation is necessary, say many of the physicians and nurses who staff Brooksville Regional.
Consider the operating rooms.
The largest of the four is about the size of a master bedroom in a new home. When filled with equipment for a routine surgery, that's not big enough for the circulating nurse to get around without disturbing sterile areas or tripping over wires, nursing manager Betty Hayward said.
Ideally, the two main operating rooms would be about 140 square feet larger, adding the size of a new home's second bedroom, Hayward said. The space would allow the doctors and nurses to do their jobs better, using bigger, more modern equipment.
"It's not the equipment per se that we're saying we don't have," Hayward said. "We need the space to be able to use it."
As it stands now, nurses barely have room to move a patient's bed through the hallways. That's partly because the corridors are scant inches wider than the beds, and partly because the operating area lacks storage.
Surgical equipment, supplies and furniture line the operating-area walls and crowd the alcoves. The tiny lounges, offices and dressing rooms cannot accommodate any more than what they have -- a mix of vintage 1970s and bland hospital furniture.
"We don't have room to get around. But we do our jobs and do them well," Hayward said, making a plug for new digs. "You can go out in a field and do surgery. But that's not optimal."
The patient wings also have their share of problems.
Rooms have window air conditioners that often do not work. Patients in private rooms often complain that they must share a one-person bathroom. When filled with stretchers, lunch carts, walkers and other activities, the halls do not meet codes that require room for patients to pass easily, said Dean, the area nursing manager.
Having rooms in two separated towers also makes it difficult for doctors to easily get to their patients, a physician said as he passed through.
"I think it's about time for some changes," said Paul Rosser, 61, a heart patient in the hospital Friday for some testing. "To me, it's a great hospital, but we need something a little more modern."
A Brooksville resident, Rosser said he thinks the hospital should stay close to the city and not move farther west.
"We need something to take care of the people," he said, noting his children and grandchildren were born at Brooksville Regional. "I think we need one (hospital) on this side of the county."
Concerns from east Hernando residents are understandable, Barb said. In the case of emergencies, however, the more important issue should be where ambulances are located, he said.
County fire-rescue Chief Mike Nickerson said he has scheduled test runs from Ridge Manor to the proposed site to determine whether response time would be compromised.
As for elective surgery, Barb said, many of the east-side residents go to Dade City hospitals anyway.
He also took issue with comments from critics that Brooksville Regional should be more concerned with the eastern half of the county, where the population eventually will grow.
Oak Hill Hospital executives are not rushing to build a clinic or hospital on the east side of the county, Barb noted, although they have been pushing to keep Brooksville Regional to the east.
"Why don't they put (auto) dealerships out there?" he said. "Why did the county offices and county tax assessor put their offices out west? Because that's where the people are. Services are designed for people."
HMA wants to succeed in its venture, drawing in more paying patients so it can continue providing costly indigent care, Barb said.
"Ridge Manor cannot support a clinic," he said. "Is that the reason you punish the rest of the county, because they can't have one next door?"
Expanding on the current site is not viable, Barb added, and other sites that fit HMA's criteria are few and far between. They are not on major roads, have too many owners to make acquisition easy, or have some other problem.
So while other parts of the proposed deal with the county are negotiable, Barb said, "our proposal is dependent on that location."
- Staff writer Jeffrey S. Solochek covers Hernando County government and can be reached at 754-6115.
The Hernando Times has a special hospital topic on its Web-based discussion forum. Visit www.sptimes.com/hernandoforum/ and click on the Brooksville Regional Hospital topic. Members of our forum can post their thoughts about the proposal. We also would be interested in hearing any questions you might have.