Grady Memorial Hospital must gut and rebuild three floors where a burst HVAC water supply pipe flooded the facility Dec. 7, the hospital announced in a statement Monday, putting those areas out of commission most of the year. That's longer than the three months originally thought.
Grady is metro Atlanta’s largest safety-net hospital and Level 1 trauma center. CEO John Haupert said the decision came from realizing that a time-consuming electrical upgrade would be legally required to bring the affected areas up to code, and that the damage to drywall, wooden infrastructure, flooring and medical equipment went deeper than thought.
“Almost all of those items were saturated with water or had water in them,” Haupert said. “We really wouldn’t have been satisfied without a full gut renovation to assure us, the public and patients that there wasn’t a risk of mold being within the building.”
Most of the cost of the renovation and the lost business during the time of construction should be covered by the facility’s property insurance company, Zurich Insurance, Haupert said. A spokeswoman for Zurich declined to comment.
‘Raining through the ceiling’
In Grady’s first specific comments on the cause of the flood, Haupert told The Atlanta Journal-Constitution in an interview Monday morning that the 24-inch solid steel pipe did not rust through. Instead, it ruptured where the pipe has an expansion joint that is contained and sealed by a sort of cuff. The pipe has a number of such points, allowing moments of high water pressure a bit of leeway to expand without bursting the pipe. Somehow, one of those cuffs separated from the pipe.
Haupert said he arrived at the hospital quickly after the first reports of a leak that Saturday. “Within the 30 minutes of me getting here, those floors, it looked like it was raining through the ceiling,” Haupert said. “There was at least an inch or so of water on the floors and water coming down through the ceiling.”
He said by the time he arrived all patients in the affected areas had been evacuated.
The resulting jolt jarred the entire pipe down the line. Haupert said the rest of the pipe has since been secured, but out of a sense of caution Grady will replace the entire pipe.
A forensic engineering firm is investigating why the cuff dislodged. Haupert said he believes Grady could not have prevented it. The facility followed its protocol of inspecting the pipe twice a year, he said.
Musical patients
The damage affected about 220 Grady bed spaces.
While Grady guts its 4th, 5th and 6th floors, Emory Healthcare has agreed to make space for 30 inpatients at its Hillandale hospital in Lithonia. Starting Monday, Emory Decatur Hospital, formerly DeKalb Medical Center, will take some patients for newborn deliveries that would have gone to Grady. Between that help and moving patients around within Grady, Grady expects to lose only 60 bed spaces during the work.
“As a leader within our community, Emory Healthcare is happy to support Grady Health System in providing essential health care services during recovery efforts,” Emory said in a statement. “Emory Healthcare views our assistance in this situation as vital to our mission of serving the metro Atlanta community in this time of need.”
Grady will pay Emory per diem for the bed space at Hillandale, and Grady’s own doctors will follow the patients there, continuing to treat them as Grady patients.
While Grady will gut three floors, selective renovation will also be done on the hospital’s first three floors and basement. Part of the third floor with nuclear medicine and imaging will have to be gutted.
A selective renovation for all the floors would have taken longer because the workers would have had to go piece by piece figuring out what to leave and what to replace. Then that would have put those areas out of business longer, knocking out patient revenue for extra time. So the total gut ends up being less expensive.
A complex job
Grady did not release cost estimates, saying it was still too early.
The average cost of new hospital construction is about $400 per square foot, according to the American Society for Healthcare Engineering. That’s more than double the average for regular office buildings.
Doing hospital construction while a facility continues to operate is complex. Firms involved in the work must know the specialized technical requirements of hospital structures. In addition, the demolition and building activity requires its own level of protections from dirt and germs, as well as coordination with health work going on around the clock.
Haupert said the details of the insurance payment had not yet been worked out, but the hospital had a $100,000 deductible. It has a $1 billion coverage limit per incident, and none of the loss is expected to approach that. He said the expenses should pose no risk to the hospital’s other initiatives, such as an advanced surgical center the hospital is building across the street. Grady has raised more than $150 million for that effort.
Grady’s funding sources include patient care revenue, tax allocations from DeKalb and Fulton counties, and community donations.
Haupert said he wasn’t shocked to learn the scope of work to be done.
“Day by day as you’re recovering from this you’re evaluating how much water penetration there is, how much moisture is in the walls, how deep it’s gone into the building,” he said. “Of course, the No. 1 thing in a health care system or hospital is, is there damage that could potentially create mold; and if there is, it has to be remediated. Because mold and hospitals don’t go together.”
PLAN B
As the region’s most important safety-net and Level 1 trauma center deals with a catastrophic flood from Dec. 7, metro Atlanta has shifted its resources to cope.
Ambulances: At first Grady Memorial Hospital stopped taking all ambulance traffic to its emergency room, but then it started taking the more severe and disruptive cases: trauma, stroke, heart emergency, burn, and behavioral health patients. Grady is now taking other patients as well, but it will divert those to other hospitals when it gets too full. It brought in a mobile ER for extra space.
Dispatch: Grady is now operating a regional ambulance routing center within I-285 to filter those cases. Ambulances are no longer routed to hospitals solely based on county lines.
Beds: The flooding affected 220 of Grady's 700 beds. Grady will now essentially rent bed space from Emory Healthcare's Hillandale hospital in Lithonia for 30 patients. Emory is also taking some obstetrics patients. Grady will move other beds within the hospital, and overall, Grady hopes to lose just 60 bed spaces over the course of the construction.
Source: Grady Health System
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