Bergan Mercy Medical Center would become a teaching hospital and trauma center under a scenario being considered by hospital and Creighton University officials.
If that happened, Creighton University Medical Center would become an outpatient center and give up its teaching and trauma roles.
1. Spend $270 million to upgrade and renovate CU Medical Center. Alegent Creighton leaders say that would take seven to eight years because it would have to be done in steps.
2. Improve and expand Bergan Mercy Medical Center so it could take on the job of trauma center and academic medical center. That would cost $115 million to $135 million, and possibly up to $200 million. This and Option 3 could lead to Creighton University Medical Center becoming an outpatient clinic, possibly with an emergency room.
3. Build a brand new academic medical center, including a trauma center, at a site that hasn't been chosen. That would cost $400 million or more.
One other option under consideration would renovate the Creighton hospital, enabling it to maintain its existing services. A third option calls for building a new hospital to handle teaching and trauma.
The three options all have pluses and minuses, officials told The World-Herald on Thursday. No matter which is chosen, the overall goal is to “create the best academic medical center that we can,” said Richard Hachten, Alegent Creighton's chief executive officer.
Creighton University's president, the Rev. Timothy Lannon, said, “We're talking about something greater and better than we have today.”
The least expensive option would be to renovate Bergan Mercy, at 75th Street and Mercy Road. The move would mean further consolidating the health system's top-end medical services at that hospital and moving the trauma center now at the Creighton hospital to Bergan. It also would mean converting Creighton, at 30th and California Streets, to an outpatient clinic that may include an emergency department.
Officials estimate that the Bergan plan could cost $115 million to $135 million, but it could be up to $200 million, depending on what's done.
Renovating, expanding and upgrading the Creighton site would cost an estimated $270 million, take seven to eight years to accomplish and be “extremely disruptive,” Hachten said.
Building a new hospital somewhere in the metro area would cost $400 million or more, he said.
About 60 physicians and others met Wednesday night to discuss the options. The meeting wasn't focused on money, said Dr. Stephen Lanspa, a gastroenterologist who works at the health system's Creighton, Bergan and Lakeside hospitals and who also serves as a Creighton professor.
“You always have to worry about costs,” he said, but “you first decide what it is you're trying to accomplish. What's the vision?
“I was impressed with the amount of detail that they had to give us. Not just the financials, but you could tell that they had done some planning about what each scenario would look like. ... It was all about what's going to be best for patients, for education, for Omaha, and not, sort of, 'What are we going to do to save the old homestead?' ”
Richard Brown, chief executive officer of Charles Drew Health Center in northeast Omaha, said his federally funded community health center has a close relationship with Creighton University Medical Center. Many of his patients go there for specialty care and hospitalization.
For patient convenience, he said, it's better to have a hospital in the area.
“But Omaha is not so large that people have to travel long distances to get their health care needs met,” he said.
If Creighton University Medical Center became an outpatient clinic, Brown said, “in the long run, I don't think it would be devastating” to northeast Omaha.
Last month, Hachten and Lannon told The World-Herald that Alegent Creighton must adapt to the changing health care landscape, which finds Omaha with an excess of hospital beds as Medicare devalues inpatient services and penalizes hospitals with high readmission rates.
Alegent Creighton, which employs 10,400 people and oversees six metro area hospitals, already had conducted a study of facilities, services, staffing, hospital occupancy rates and other elements.
Hachten, Lannon and other officials said Thursday that leaders first are focusing on where to put the health system's academic medical center before they decide on the configuration of other services.
“It's the flagship of the system, and the things that happen there must benefit the whole system,” said the Rev. Jim Clifton, an associate vice president at Creighton who serves on the newly configured board that oversees the system made up of Alegent Creighton Health and Catholic Health Initiatives Nebraska.
Hachten said the Creighton hospital doesn't have the capacity “to fully support the academic teaching needs of Creighton University.”
In addition, he said, the services that would need to be renovated and expanded all are land-locked within the building. “So you start expanding the emergency department, as an example, and you have nowhere to go except the intensive care unit. Then that needs to go somewhere else.”
Creighton also hasn't had much money invested in it since it was built in the late 1970s, Hachten said, whereas Alegent Creighton Health has put $200 million into Bergan over the years.
The health system took over operations at the Creighton hospital last year from Tenet Healthcare, the previous owner. Alegent Creighton has since spent $5 million to upgrade equipment and facilities.
The Creighton hospital also was built using what's now an outdated layout, said Dr. Don Frey, vice president for health sciences at Creighton. “The way patients move through hospitals, the amount of space that's needed for intensive care services vs. your basic hospital room, that's changed drastically,” he said. “There are a lot of open atrium areas where rooms are kind of built around. It's not something that lends itself to transitioning to the health care model of the future.”
Omaha City Councilman Ben Gray, who represents northeast Omaha, has spent a lot of time at the Creighton emergency room in connection with his gang-intervention work.
“I would agree with them that the trauma center is outdated,” he said. “It needs to be upgraded in some fashion, and I don't know if you can do it in that building, the way the building is situated.”
Gray said he would need more information about officials' plans to render a thorough response.
The city's other teaching hospital and trauma center is at the Nebraska Medical Center, which each day alternates with Creighton as the designated trauma center.
Lanspa said the way medicine is practiced now is “more of a team concept. The patient rooms that were acceptable 10 years ago, they're too crowded now” when you must accommodate all the medical residents, a social worker and a pharmacist who all go on patient rounds.
The physicians didn't vote on the three options, but Lanspa said that if it were up to him, he would start from scratch.
“We want the availability of the most in-demand technology for our students and our patients,” he said. “The way other communities have solved this effectively is by building new facilities.”
Going to Bergan also has some drawbacks, Hachten said. Access from the Interstate isn't as good as it is at the Creighton hospital, he said, notably because access to Bergan from the 72nd Street exit is via two-lane Mercy Road. But Bergan has a lot of unused space next to the emergency department, Hachten said, that would allow for expanding that department, the construction of a trauma department and expansion of a clinical laboratory.
Previous remodelings and expansions at Bergan, he said, also left unoccupied an area that could be used as a 35-bed ICU.
The new Alegent Creighton/Catholic Health Initiatives Nebraska board will make the call.
That board meets Nov. 21, after two late October sessions involving a community advisory group made up of community, business and civic leaders who would discuss health needs and what the health system could do to improve the delivery of health care.
“Our goal all along has been to bring as much as we can to the board on Nov. 21,” Hachten said. “The board's going to have to determine if there's additional work that we need to do, more information that they require to make the most informed decision they can.”