Princeton HealthCare strategic plan urges expansion of programs and services to remain a top facility.
By: David Campbell
Princeton HealthCare System’s 2004-2007 Strategic Plan, which was distributed to Princeton officials early this week and released to the public Thursday, appears to draw a rather urgent conclusion about the challenges facing the hospital system.
Stated in simplest terms: It must grow or else fall behind.
"The issue is for us to remain a state-of-the-art facility in the future," said PHCS President and CEO Barry Rabner. "We’ve got to expand our programs and services. You can’t remain a state-of-the-art facility without growth. You’re at risk of falling behind."
As a result of declining use and escalating operating costs, the strategic plan states, the hospital on Witherspoon Street has sustained "significant financial losses" in recent years. In the past, it has witnessed diminishing patient and doctor loyalty, and a declining market share among five other community hospitals as well as "prestigious" medical centers in New York and Philadelphia, the plan notes.
It lists "major facility replacement" as a "fundamental requirement" for future success, and describes the current Witherspoon Street campus as "insufficient" to accommodate its goals.
It cites "several major reasons" why renovating and expanding the Witherspoon Street facility would pose challenges, while suggesting that relocation to a different site in the Princeton area could "positively impact" the health-care system "for decades to come," provided it’s done in a way that’s financially feasible.
Expanding at the current campus could cost up to $190 million, not including land-acquisition costs, and would result in a "very dense site" with only about 30 percent of the campus functions in new facilities. The construction and renovation projects would also be more costly and take longer due to having to keep the existing facility up and running during the work, the plan says.
Already inadequate parking would be an impediment to growing in place, as would neighborhood opposition and the legal costs, construction delays and damage to community relations that would result, the report says.
It would also not be possible to raise capital for expansion that could otherwise be raised through the sale of the Witherspoon Street site if the hospital were to grow in place.
If the hospital were to relocate, it would cost approximately $15 million to acquire the land, and up to $230 million to construct the new hospital, ambulatory-care center and parking, the strategic plan says.
But Marvin Reed, chairman of a special Princeton task force convened to evaluate the plan and make recommendations, said he wouldn’t jump to conclusions that the PHCS plan is leaning toward leaving town.
For one thing, he said, a move would depend on how much money PHCS could raise through sale of the Witherspoon Street campus. Possible neighborhood opposition at other sites is another variable that has not yet been weighed.
"Traditionally, they’ve had neighborhood resistance at the current location," Mr. Reed said. "To some extent they are gun-shy as to whether they would be permitted to do the extensive amount of both addition and reconstruction they feel they would have to do.
"On the other hand," he continued, "while they’ve looked at sites in other locations, I don’t think they’ve actually tested those sites as to whether they would meet with neighborhood opposition there."
Mr. Reed said he was struck reading the report by the hospital’s assessment it will have to do an extensive expansion program simply to maintain its current position in the region.
"If they aren’t able to do that, we run into a problem in Princeton," he said. "It’s very clear there aren’t enough patients simply out of Princeton itself to maintain a full-scale, first-rate hospital facility. In order to succeed they’ve got to grow and expand. If we can’t maintain that in this area, we’re reduced to going to Trenton, Hamilton, New Brunswick or Somerville."
Mr. Rabner said there are pros and cons to both options. He said feedback from residents when the strategic plan is presented at a forum this fall, as well as input from the Princeton task force, will help PHCS move closer to a decision on whether to grow in town or move.
"It’s clear there are challenges to expanding our programs on the current site," Mr. Rabner continued. "But on the other hand, there are clearly benefits to us remaining where we are and expanding there, and there are benefits to expansion on a new site. There are plusses and minuses in each."