City Council Approves First Read of Hospital Expansion Plans
There will be a second read and final approval of plans to build a new medical clinic and training facility, and remove the building currently housing Kids' Station, later this month.
by Adele Uphaus
MANAGING EDITOR AND CORRESPONDENT
Fredericksburg City Council on Tuesday unanimously approved a first read of a rezoning request from Mary Washington Healthcare that will permit the demolishment of the on-campus daycare facility and the construction of a two-story medical clinic in its place.
The expansion plans also include the construction of a three-story office and conference center and a 6,000-square-foot addition to Snowden House.
The rezoning is “essential” to the hospital system’s plans to grow its new Graduate Medical Education (GME) program, Eric Fletcher, senior vice president and chief strategy officer, told City Council Tuesday evening.
The new office and conference center will have training spaces and simulation labs for the residents and both it and the new medical clinic that will replace the existing daycare center—Kids’ Station—must be in close proximity to the main hospital building for ease of access, Fletcher said.
Fletcher and numerous hospital board members who spoke Tuesday and at previous public hearings on the proposed rezoning said the GME program will solve the community’s need for more healthcare providers by bringing up to 157 resident physicians to the area by 2029.
The residents see patients at the hospital’s internal medicine and family medicine residency clinics while they are completing their education, and the goal is that many of them will choose to stay and practice in the area once the three-year program is over, Fletcher said.
Access to care was one of the top three needs identified as part of the 2022 Community Health Needs Assessment. The Affordable Care Act requires nonprofit hospitals to conduct a CHNA every three years in order to maintain tax-exempt status.
According to the IRS, the CHNA must define the community it serves and assess the needs of the community by gathering input “from persons who represent the broad interests of that community.” It must be presented in a written report that is adopted by the hospital’s board and “made widely available to the public.”
Tuesday’s Council meeting included a public hearing on the hospital’s expansion plans. Speakers and written letters in support of the plans mainly came from those affiliated with the GME program or the hospital board, while those in opposition mainly questioned the rationale for removing the on-campus daycare facility, which is used by about 50 hospital employees and has been in operation for 30 years.
“To have childcare where we live and work is the gold standard,” said Joe Snigier, the parent of two children who attend Kids’ Station, which is operated by the national corporation KinderCare.
Bruce Davis, Chair of the MWHC Board of Trustees, said on Tuesday that Council has “a commitment from the Board” to work to ensure that KinderCare finds a new location near the hospital campus and that “there will be no lapse” in services for the families who attend Kids’ Station.
But this language does not appear in the proffers and several speakers on Tuesday said there is no formal, written commitment from the hospital to relocate the daycare center.
“What guarantee do we have that they will keep their word once they get this rezoning?” Tegan Snigier asked.
During a public hearing earlier this year, Planning Commission Chair David Durham asked Fletcher why the expansion plans can’t include a daycare center on one floor of the proposed new medical clinic, and Councilor Jason Graham asked this same question during a Council work session last month.
Fletcher didn’t address the question directly on either occasion, except to say that the entirety of the hospital campus needs to be devoted to medical use.
Councilor Janaan Holmes asked Fletcher if patients attending the new medical clinic would need to pay the extra “facility fee” that the federal government allows physician practices that are considered “hospital departments” to charge.
Fletcher said the new medical clinic will be considered a department of the hospital and that “the fee is not uncommon at all.”
“It’s not aberrant or abnormal,” he said.
Holmes, Graham, and fellow Council members Tim Duffy and Will Mackintosh—as well as Mayor Kerry Devine—said they are unhappy that the expansion plans call for the removal of Kids’ Station from its current location, but that they support MWHC’s plans to increase the supply of physicians in the area.
“I wish all the pieces aligned better,” Devine said.
Mackintosh asked that Council explore ways to incentive the establishment of more childcare facilities in the city, and Holmes said childcare is “part of the community’s health.”
Holmes also said she hopes the MWHC Board’s commitment to relocating Kids’ Station was made in good faith.
“I will hold you to this,” she said.
There will be a second read and final approval of the rezoning request later this month.
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MWHC has a problem with intellectual honesty. I wish our elected officials would question what’s being presented. It’s 2024, we can (and should) fact-check. There were many examples of distorted facts at last Tuesday's City Council meeting but I'll give one.
In response to the community's questions about community benefit obligations, the MWHC rep told the room that this is calculated according to IRS guidelines and then proceeded to give a number 3 times higher than what IRS Form 990 Schedule H allows.
The representative proudly stated that it is $64.9m. It’s not. That’s the number MWHC likes to claim. But that’s not the number the IRS allows them to claim. Shave $51m or ~80% off their stated number and you get $13.9m which is the allowable amount.
MWHC’s 2022 annual report boldly states the incorrect number and then defends its version of the truth with a disclaimer that while the IRS doesn’t recognize their inflated number that includes unreimbursed care to medicare patients they believe it’s the right number.
https://www.marywashingtonhealthcare.com/documents/2022-AnnualReport-MWHC.pdf
Other issues included how MWHC presented the number from the economic impact study. When I think back to my economics training it was always drilled into our heads that we should never present a raw number without explanation. How it was presented leads us to believe the economic impact is larger than it is. The methodology wasn’t shared with us but if it’s your typical economic contribution study then they’re measuring expected dollars, income, jobs, taxes, and a few other economic activities. The big asterisk with this methodology is that it usually double or triple counts the dollars. All or part of the dollars from the study are likely attributable to other non-MWHC activities in the region and would exist without the proposed plan.
And we were told to always include a warning that the study does not take into account negative (or positive) environmental, social, cultural, or community impact of the proposed intervention.
MWHC is trying to be like Carillon and Innova. The CEO cares nothing about our conmunity or the people who work for him.