Council Questions Hospital Planner on Community Inclusion, Outpatient Services

The Ridgewood Village Council spent much of the most recent questioning the planning board's medical planning expert over the community's say during the process as well as the classification of inpatient and outpatient services.

Medical planing expert Raymond Skorupa concluded Thursday night that Valley "was lagging behind" other hospitals, which he speculated was because of a lack of residential support. Skorupa said Valley would have to modernize to "be a 21st century hospital."

The expert conceded Thursday night that the three stakeholders – Valley, residents and the planning board – were not given equal weight as to the controversial planning board decision to amend the Master Plan and potentially give Valley a new $750 million 454-bed facility that will double its size in a tight, angry residential neighborhood.

"No we did not," Skorupa said in response to Councilman Paul Aronsohn's line of questions. "Clearly, I think we tried to give equal importance to the concerns of the community and the concerns of the hospital."

"Our whole strategy was to satisfy both," he added. "We recognize the legitimate concerns of the community in terms of noise, in terms of mass, in terms of traffic and we also recognized the legitimacy of the hospital and what we tried to do is craft a product that would protect both of those and protect many of the legitimate concerns each of those communities had. I don't think we 100 percent satisfied either [party]."

Are you satisfied?

Some members of the community said in response that the notion they were given equal weight was simply not true. They pointed to Skorupa's earlier statement that four "work sessions" were held with Valley officials, when the final plan (whittled down from half a dozen) was chosen.

Though CRR reps had two "community" meetings with Skorupa and others, CRR attorney John Lamb said they were never consulted when plans were suddenly decided, nor was the rest of the community, even beyond the CRR's reach.

Half a dozen plans were vetted through, but because of cost considerations, "Option 6" was ultimately selected after the four work sessions, Skorupa said. It does not feature underground parking or mechanicals underground as he would have preferred. He considered those changes "compromises" on Valley's side.

Skorupa maintained the plan chosen was something he hoped both parties would be "80-85 percent" satisfied with. If both could not "live with it," he said, "I think I failed in my service to the planning board."

Council members also continued its barrage of questions regarding the process, with Aronsohn asking if in an "ideal world" the current location of the main campus would be where it's situated.

"We were never asked the question in this way," Skorupa told Aronsohn. "We were never asked that. We were asked the question this way: 'If you were to upgrade the hospital, what would you do?' We were never asked, 'Should the hospital be in this location?'"

What's in and what's out, patient?

One of the other main points of contention centered around the classification of outpatient and inpatient services.

Skorupa – who was also grilled as to his credentials and the fact that he typically represents hospitals and design firms – said he didn't look at outpatient functions on the main campus because they were, he claims, done off site. Yet Councilwoman Bernadette Walsh appeared confused as to what was considered inpatient and what qualified as outpatient care.

The planner said the only outpatient services currently on site were there because "there was a clinical need" for them. "These are not really outpatient in my view because they require preparation and recovery and sometimes admission...clearly the predominant outpatient clinical functions have been moved to off site locations," Skorupa said.

Because practice changes quickly in the ever-changing medical industry, it's "not a static definition," he said. For instance, same day surgeries like a colonoscopy would be considered inpatient because of the clinical nature, he explained. The patients, he said after Walsh questioned him, would be lined with a few other patients in a room. Those beds don't count by current definitions of "beds" nor would they in the future, Skorupa told the council.

"That currently happens and the Master Plan permits that to continue to happen," he replied. Skorupa said 450,000 square feet in a 1.7 million square foot proposed facility are dedicated to "clinical support." He said this would , just the amount of space.

He did not know the number of beds or the volume this comprises off hand, though he said pertinent data was provided by Valley. Megan Fraser, spokeswoman for Valley, said after the meeting that she did not immediately have the number of those beds or the volume available. Fraser said the hospital currently operates at around an 80 percent occupancy rate, which is according to the hospital is "peak efficiency."

"Clinical support activities, that people drive to and drive back from . . . they call that outpatient," said CRR chairman Pete McKenna, "I don't call it that."

I don't think there's ever been enough clarity on the planning board level; the existing activity at the hospital has never been clarified for us," McKenna said after the meeting. "We need to see that activity as it exists now, [and] what it would be projected to be in its impact. That needs to be validated."

The council will hear from the geotechnical expert at its next hearing, on Monday, Oct. 24.