Miami-Dade County

Jackson Health unveils ambitious $1.4 billion building proposal in Miami

Jackson Health System’s future will rise from a cloud of construction dust over the coming decade, according to an ambitious $1.4 billion building plan unveiled Wednesday by trustees for Miami-Dade County’s public hospital network.

The plan details how Jackson’s leaders will spend $830 million in public financing approved by voters last fall, and an additional $550 million generated by the public hospital network and other sources.

The more than 200 proposed projects, including new construction and infrastructure improvements, would transform Jackson’s main campus in Miami while broadening the hospital system’s geographic reach with new urgent care centers and nearly $150 million in improvements to satellite hospitals in North Miami Beach and South Miami-Dade.

“These are very exciting times for Jackson,” said Darryl Sharpton, chairman of the Public Health Trust that runs Jackson. “Things are finally coming together, and we’re ready to go.”

Acknowledging how far Jackson has come from the financial crisis that nearly bankrupted the hospital system in 2011, Chief Executive Carlos Migoya noted that the plan is to “transform a system that for many people was ready to be sold off for parts just a few years ago.”

Migoya distilled Jackson’s appeals for more public funding to help the hospital system upgrade in order to better compete with other medical centers in South Florida: “We cannot just be treating patients. We have to be delighting them.”

Most of the work detailed in the plan will take place at Jackson Memorial, the sprawling main campus in Miami, where Jackson leaders want to spend $1.2 billion to build new hospitals, consolidate emergency services, and reorient the campus layout so patients and visitors can more easily find their way.

The Miami Transplant Institute one of Jackson’s most profitable and well-regarded programs, will be centralized in a new building with 108 beds, an intensive care unit, outpatient clinics, research and faculty offices.

Projected cost: $115.7 million, funded only by the hospital system’s capital improvement budget. The county’s taxpayer-owned public hospital system, Jackson receives about $350 million a year from Miami-Dade through a half-penny sales tax and property taxes to help fund operations, which are budgeted at $1.5 billion for the year ending Sept. 30.

“We’re on course to be one of the busiest and best-performing transplant centers in the entire country,’’ Migoya said.

Also in the works for Jackson Memorial: a new, 180,000-square-foot Intensive Care Unit tower with 120 beds, a new pediatric outpatient center and a new rehabilitation hospital. There was no project budget available for the ICU tower.

A new rehabilitation hospital, to be constructed on the site of Jackson’s existing rehabilitation center, would cost an estimated $117.4 million, using about $80 million in bond money plus $37 million from Jackson’s capital projects budget.

For Jackson North Medical Center in North Miami Beach, plans call for $81 million in improvements to the interior and exterior of the hospital.

“Every room will be refurbished, operating rooms will be expanded … we’re going to strip that facility from top to bottom,” said Mark Knight, chief financial officer for Jackson.

At Jackson South Community Hospital in South Miami-Dade, about $63 million will be spent to add patient rooms, expand labor and delivery services and upgrade nursing units.

Other proposed projects include new urgent care centers throughout Miami-Dade, at a cost of about $40 million, though locations have not been identified; a new pediatric outpatient center, at a cost of about $40 million; and about $173 million to renovate every patient room and operating room in the Jackson system.

All that work will require a significant investment beyond the $830 million in bond funds that Miami-Dade voters approved in November. Jackson will need to generate about $448 million in surpluses over the next decade to cover the additional projects, according to the plan.

“Financially, we need to consistently generate at least $50 million a year in operating surpluses to invest directly in this operational plan,” Migoya said, adding that much of that surplus can be achieved through annual depreciation of assets.

The projects will be built in phases beginning in the fall or winter. Financing for the entire package of projects breaks down this way: $830 million borrowed through bonds payable with increased property taxes, about $448 million from Jackson’s capital projects budget, about $83.6 million from prior years’ revenue bonds, about $5 million from the Jackson Foundation, plus other sources.

The proposed projects follow the recommendations of private consultants, including architectural and engineering firm HOK, which drafted the master plan and suggested reconfiguring the layout of the main campus to improve patient flow and make it easier to navigate.

Hospital finance consultants, who met with Jackson trustees Wednesday during a closed-door session, also have recommended that Jackson invest in so-called “centers of excellence,” such as the transplant institute and Ryder Trauma Center, and that the system broaden its reach across Miami-Dade.

Sharpton, the board chairman, said the process of synthesizing all the consultants’ advice, together with staff recommendations, was complex but had a simple goal: attracting more insured and paying patients to help offset the cost of Jackson’s mission to treat all Miami-Dade residents, regardless of their ability to pay.

The hospital system treats more uninsured patients and Medicaid beneficiaries than any other medical center in the state, primarily at the Jackson Memorial campus.

“Unless we are able to improve our facilities,” Sharpton said, “unless we are able to expand geographically, we don’t have the ability to expand our payer mix, which is what we have to do.”