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Marin General Hospital in Greenbrae[/caption]

GREENBRAE -- The Marin Healthcare District approved a new plan for the $500 million rebuild of Marin General Hospital that will reconfigure – not necessarily reduce – the number of staffed beds at the facility.

The new plan takes into account a shifting health care landscape that is increasingly leaning away from inpatient hospitalizations and more toward outpatient services, prompting an anticipated decline in patient volumes in the future, officials said.

[caption id="attachment_89491" align="alignleft" width="173"] Lee Domanico[/caption]

“We work closely with leading industry analysts to advise us on the effects that changes in the population will have on utilization of hospital services over time,” Marin General CEO Lee Domanico told the Business Journal.

Both the current facility and the planned hospital are licensed for 235 beds. The hospital currently has 171 staffed beds, and the new plan approved by the district calls for 194 staffed beds, of which 174 will be private and 20 that could be semi-private, according to Mr. Domanico.

The original environmental impact report for the planned new hospital called for 218 staffed beds and 235 licensed beds, a distinction that means Marin General, if need be, could up the bed count to 235 but will typically staff a number below that, a common industry practice.

“We’re not reducing the number of beds, we’re just not increasing the beds by the amount of the original proposal,” hospital spokeswoman Jamie Maites told the Business Journal. “So we’re actually going to have 23 more inpatient beds, which we believe is more than sufficient and adequate for this community.”

Said Mr. Domanico: “The increase in beds mirrors the projected increase in population hospital utilization. We are confident that this proposal will serve our community well for many years.”

The new plan also reduces one full story from the original proposal and will lower the square footage from 300,000 square feet to 259,000 square feet, while making significant changes to the proposed parking structure.

Mr. Domanico said the cost of the project will likely decrease, though he did not specify by how much. The health care district last fall won voter approval for $394 million in general obligation bonds that will cover the bulk of the $500 million rebuild, which will bring the level 3 trauma center in line with state-mandated seismic safety standards. It faces a deadline of 2030 for such standards.

Changes to the parking structure came in response to community feedback during the ERI process, leading the district to modify plans.  “To avoid having a large structure along Bon Air Road, we have moved the parking structure up the hill away from the main road. The structure will have approximately 450 parking spaces and will resolve our current shortage of parking,” Mr. Domanico said.

Asked about the general shift toward outpatient services and what it means for Marin General, Mr. Domanico said: “As the healthcare landscape shifts, technology becomes more advanced and accountable care organizations mature, the role of hospitals will evolve. Because of these innovations and advancements in health care, more patients will be treated in an outpatient setting and hospitals will treat higher-acuity patients."

Nonetheless, he added that “while there is a trend for increasing outpatient services, the aging of our community will maintain the demand for higher-acuity inpatient hospital care. Our long-term planning has taken this into account.”