The University of Vermont Medical (UVM) Center is seeking permission from state regulators to construct a large new outpatient surgery center, which hospital officials describe as necessary to replace aging operating rooms and meet an expected growth in demand.
The medical center sent a "certificate of need" application to the Green Mountain Care Board on Feb. 10 for an 84,000-sq.-ft. facility on Tilley Drive in South Burlington, next to several other specialty clinics. State statute requires the care board to approve the proposal, a process intended to reduce health care costs by preventing "unnecessary duplication" of services, reported VT Digger, a statewide news service.
"The need for the [surgical] center is actually there right now," Stephen Leffler, the medical center's president and CEO, said during a press briefing.
In terms of the hospital's outpatient surgery volume, both its main campus in Burlington and its Fanny Allen campus in Colchester are often full, he said.
"We're at capacity most days," Leffler explained.
UVM Places Need Over Cost
The cost of land purchase, permitting, construction and outfitting of the new center is estimated at almost $130 million, with $100 million financed through bonding, UVM noted. The project, which would add eight multi-purpose operating rooms, 12 pre-operation rooms and 36 recovery spaces, is the detailed version of a conceptual plan approved by the Green Mountain Care Board in September 2021.
However, all new construction across the UVM Health Network came to a halt in early 2022 when officials forecast large operating deficits. The network ended its last fiscal year $90 million in the red.
While the network remains focused on its financial issues, "we really can't afford to wait," UVM Health Network CEO Sunil "Sunny" Eappen told VTDigger.
Access to care is already challenging, Eappen said. But projections suggest that demand for surgical procedures will exceed the region's ability to meet them by almost 5,000 cases in 2030, due both to general population growth and the increasing percentage of people who are older than 65 years old.
"We need to invest now in order to meet our future demand," Eappen added.
Modern Facility to Allow for More Complex Surgeries
The new UVM Medical Center facility, projected to take two years to complete after regulatory approval, would replace all five outpatient surgical rooms at the Fanny Allen campus in Colchester. Some outpatient surgeries now performed on the main campus also would move, opening space for more complex surgeries, Leffler said.
The Green Mountain Care Board previously approved two independent outpatient surgical centers, both in Colchester, but has limited their offerings: the Green Mountain Surgery Center, and a connected facility, the Collaborative Surgery Center. The first was approved in 2017 and opened in 2019, while the second center had its certificate of need approved by the board in March 2022
Another independent surgical center, Vermont Eye Surgery Center in South Burlington, has been open since 2008.
The certificate of need application for the new outpatient surgery center in South Burlington suggests that planners believe most of the procedures at the facility would, at least initially, be in the areas of orthopedics, ear, nose and throat health, and ophthalmology.
VTDigger noted that the new UVM facility would include enough interior space to easily add another four operating rooms and supporting space in the future. That type of growth is not currently possible at Fanny Allen, where surgical rooms were built in the 1960s and are too narrow to allow for certain kinds of procedures and collaborations, Leffler said.
The new outpatient surgery center would need to staff 166 employees, with the majority coming from within the UVM Center as the operating rooms move. However, fully staffing the new center would require adding 78 positions, which the hospital plans to begin recruiting for 18 months prior to opening.
UVM leaders said that they do not anticipate either staffing or financial concerns to stall the project.
Additionally, the outpatient surgery center would allow the hospital to provide the same service it currently does at a lower cost. As a result, it is expected to begin to pay for itself within six months, Leffler told VTDigger.
Network officials expect the ultramodern facility would serve as a draw to clinicians and others, plus, jobs at outpatient surgery centers are typically easier to fill, according to Eappen.
"People want to work in ambulatory surgery centers," he explained. "[In general, it's] considered to be a very positive place to work."
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