Placid medical facility scaled back slightly

LAKE PLACID — Adirondack Health has revised the plan for its proposed Lake Placid Health and Medical Fitness Center due to delays, higher-than-expected bids and a funding shortfall.

The Lake Placid-North Elba Joint Review Board approved a slightly scaled-back version of the project Tuesday. Adirondack Health CEO Sylvia Getman said the hospital received final state Health Department approval last week to begin construction of the Old Military Road facility.

“I think you know as well as we do that it’s been a very long haul, well over two years, to get to that point,” she told board members. “So that barrier has been removed, and we’re feeling pretty good about that as we go into construction season.”

The Health and Medical Fitness Center would house all the services currently provided at Adirondack Health’s Church Street hospital: a part-time emergency room, doctors’ offices, laboratory and radiology. It would also feature a gymnasium, a 75-foot lap pool, a hydrotherapy pool and larger physical rehabilitation space.

Once the current hospital is vacated, the Church Street property would go to the town of North Elba, possibly to be used as part of a “Global Center for Sports Excellence” to add to the two-time Olympic village’s capacity to host international athletes.

Adirondack Health CEO Sylvia Getman (Photo provided)

Following a six-month review, the board approved the Health and Medical Fitness Center in September. Adirondack Health hoped to start construction last year on what then was a 42,000-square-foot facility to be located next to the Elderwood of Uihlein nursing home, but its consultants asked the state for an extension in November. The extension was needed because the plans for two pools that would be located in the building were still being reviewed by the Health Department’s Bureau of Community Environmental Health and Food Protection, according to documents obtained earlier this year by the Enterprise through a Freedom of Information Law request.

Review of the pool plans, which have now been approved, was the last of four contingencies that had to be satisfied before the project’s Certificate of Need could get final DOH approval.

Getman said the amount of time it’s taken to get that approval has created a “cost escalation” on the project, although she didn’t give specific numbers. The Health Department lists the project’s total cost as $13.7 million.

“The bids are coming in higher than estimated,” Getman said. “That’s been a significant issue for us.”

The project has also been affected by the 21st Century Cures Act, legislation approved by Congress in November 2016 that changed how the federal government pays hospitals. Now, if a hospital has an outpatient facility or doctor’s office more than 250 yards from its main campus and it makes any changes to that practice, “they change the way they pay you, which results in a 40 percent cut in our Medicare payment,” Getman explained. Adirondack Health’s main campus is in Saranac Lake.

“So with both of those things happening over that time frame, costs higher and projected revenue lower, we did go back to the drawing board to take a look at the project overall,” she said.

The biggest change is the removal of Adirondack Health’s Medicaid dental practice from the new building, which allowed it to be reduced by 5,500 square feet, lowering its roof line, Getman said. She didn’t say where the dental practice would be relocated, but she said there are “other options,” including one in Lake Placid, that won’t be as costly.

Shrinking “swing space” for medical practices on the building’s second floor also let the roof line be lowered, Getman said. The parking lot for the facility has also been reduced from 146 to 130 spaces.

“What isn’t changing is everything else,” she said. “The emergency department is the same footprint you’ve seen before. Lab, radiology, our orthopedic space, the rehab center, the med fit with the therapy pool and exercise pool — all of those components are still there overall.”

Review board members raised no major issues with the revisions.

“Since the overall footprint has not changed substantially, and it actually decreases, and since the position of the building is the same — it won’t be any closer to the neighbors — and since there’s a reduction in the total land disturbance, I’m not sure we need to go through the process of notifying everybody,” said board Chairman Bill Hurley.

The only question, he said, was whether to approve the project Tuesday or wait until the board’s next meeting to give the public a chance to weigh in on the changes.

“I think the public has had plenty of time to comment on this project, and it’s getting smaller,” board member Emily Kilburn said.

The board approved the revisions as presented, with one condition. Hurley asked for a “decorative detail” to be added to the lower gable on the building’s southeast side, to break up a large open space.