Worst-Case Search for Places to Put Patients

Teams from the Little Rock District of the Army Corps of Engineers evaluated 15 properties selected by state officials for consideration as alternative care sites in the event Arkansas hospitals were overwhelmed by COVID-19 patients.

Private-sector properties were part of the early scouting mix of potential alternate care sites that could be quickly developed to augment the statewide hospital bed count.

Arkansas officials made cursory inquiries in March regarding privately owned properties such as the 10-story, 370,566-SF AT&T Building at 1111 W. Capitol Ave. in Little Rock. But those initial queries didn’t result in many private properties making the state’s list for on-site inspections when federal resources were brought to bear for a thorough assessment later that month.

Public facilities dominate the Arkansas list of 15 alternate care site candidates identified by state officials and evaluated by the Army Corps of Engineers and the Federal Emergency Management Agency. (See Potential Alternate Care Sites.)

“The locations come at a cost,” said Jay Townsend, chief of public affairs for the Little Rock District of the Corps of Engineers. “We looked at the locations to assess the cost.”

The cost analysis reflects an intention by the state to use the alternative care sites for non-COVID, non-acute patients should coronavirus hospitalizations overload the Arkansas health care system.

That plan is tied in part to the steep financial cost of developing alternative care sites to accommodate COVID-19 patients.

To appreciate that economic reality, Arkansas planners need look no farther than across the Mississippi River to downtown Memphis. Tennessee officials opted to develop a 401-bed alternative care site equipped to treat non-acute COVID-19 patients in the former home of the Commercial Appeal newspaper at 495 Union Ave.

The cost for the whirlwind, around-the-clock build-out accomplished in less than 30 days: $51.3 million. Ongoing costs for a yearlong lease of the privately owned property include monthly rent of $70,000 plus utilities and more.

Completed in mid-May, the alternative care facility remains unused and on standby as backup bed space should a surge in COVID-19 cases prove too much for western Tennessee hospitals.

The prospect of investing so much in such a temporary and possibly unnecessary project provides a fiscal backdrop to Arkansas officials trying to contain coronavirus patient beds on hospital campuses.

States bear the heaviest share of the 75-25 cost-sharing with the federal government to develop alternative care sites. Such financial equations influenced the Arkansas focus on public buildings as potential sites for non-COVID-19, non-acute patients.

Making the Grade

The only two private properties on the state’s consideration list are the Jones Center in Springdale and the 20-story Little Rock Marriott, with 396 rooms, 22 suites and 21 meeting rooms totaling 44,747 SF. And technically, the hotel is a public facility owned by the city of Little Rock and leased to private enterprise.

Both properties made the cut of 12 properties recommended by the Corps as alternative care sites among the 15 chosen for evaluation by state officials. Among the dozen recommended, the Little Rock Marriott ranked No. 11 and the Jones Center ranked No. 12 in terms of estimated cost per patient bed.

According to the Corps facility suitability assessment, the substantial building in downtown Little Rock would yield only 398 patient beds at an estimated cost of $14.7 million.

Making the changes necessary to house COVID-19 or acute care patients in those beds would require even more extensive and costly modifications.

“The goal was to provide the governor with multiple locations around the state so he could increase bed capacity if the need arises,” Townsend said. “He’s done a good job preplanning. If the need ever arises for more beds, he has the assessments, and he can say, ‘Go.’”

To date, the state’s network of 8,917 hospital beds has proven sufficient to handle the extra patient load caused by the coronavirus.

Greg Williams

Conway’s Nabholz Construction Corp. was among the companies to plug into the bureaucratic pipeline for possible development of alternate care sites.

“We did have several conversations with the Corps of Engineers,” said Greg Williams, CEO of the general contracting firm. “We reached out to let them know about our capabilities, but nothing ever came of it. We also submitted a proposal for a turnkey facility.”

Another Tennessee alternate care project is portrayed as unique among the 37 developed nationwide.

At Nashville General Hospital, demolition and renovation work on the eighth floor and remodeling on the second floor created space for 67 non-acute COVID-19 patients.

Price tag for delivering the project in about a month: $7.2 million. It too awaits overflow use.

Tasked with retrofitting buildings around the world for military hospital use during the past 10 years, the Corps of Engineers was positioned to provide the logistical know-how for such expedited projects.

“It’s a super unique mission,” said the Corps’ Townsend.