Construction on VA’s biggest failure is almost done, but with some exceptions

After years of scheduling delays and more than $1 billion in cost overruns, construction on the beleaguered Rocky Mountain Regional Medical Center in Aurora, Colorado, is 98 percent complete, and the department expects that patients can begin using the new medical center in August.

But design flaws mean that the new Rocky Mountain hospital will have fewer primary care teams and twice the square footage than the existing medical center has now. And because the new Denver hospital is positioned to handle fewer primary care teams than before, VA will need to keep the existing medical center open for another three-to-five years until the department has a path forward.

All told, the final price tag on the new facility is roughly $2 billion. In total, the new facility will have 3,208 personnel, more than the total number the old medical center has now.

The new building is 1.2 million square feet, compared to the existing facility’s 600,000 square feet of space. The new hospital will have four more ICU beds than the previous medical center, but it’s losing nine medical beds and some psychiatric units. In addition, the new hospital won’t have the Post-Traumatic Stress Disorder Residential Rehabilitation Program that the previous Denver hospital has, and VA will have to buy another building to accommodate it and the seven primary care teams that it doesn’t have the space for in the new facility.

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Members of the House Veterans Affairs Committee, many of whom have sat through similar, if not more dismal hearings on this construction project in the past, were frustrated when they discussed the news at Wednesday’s hearing on the project.

“So we have a dramatic increase in personnel, we have double the square footage, but in effect we have less capability,” said Rep. Mike Coffman (R-Colo.), who represents the district where the new hospital is located.

VA doesn’t have a clear plan or timeline for when it will buy another building and eventually dispose of the current Denver hospital.

“The timelines are somewhat estimated at this point,” Stella Fiotes, acting principal executive director for VA’s Office of Acquisition, Logistics and Construction, told the committee. “That’s why the number three-to-five years has been put over. I can tell you that we are collectively looking for solutions to allow us to do it sooner rather than later. We do want to get out of this facility, but it does take some time, not knowing when we’re going to be able to build the new PTSD [space], not knowing exactly when we’re going to get the new clinic space.”

When pressed, Fiotes said the department would have a better understanding of its plan in the next six to 12 months.

“If it does stay open, there’s an estimate that they’ll be $350 million of work to a campus that you’re going to get rid of,” committee Chairman Phil Roe (R-Tenn.) said of the existing Denver hospital. “None of this makes any sense.”

The current contractor, Kiewit-Turner, will spend the next few months putting the finishing touches on the building’s construction. The department has hired another contractor to fix hundreds of small design flaws and other mistakes in the new facility.

“There are also hundreds of errors individually small, but which add up to a significant problem that must be corrected,” Roe said. “Things like a sink in an operating room, surfaces that cannot be cleaned, inadequate air conditioning systems, voltage problems and an entire data center that must be rearranged. There are always mistakes to be fixed at the end of a construction job, but I have to wonder whether the clinicians who treat veterans in this facility ever scrutinized its specifications.”

In addition, the department will spend the final few months hiring new personnel. VA has 421 full-time equivalents (FTEs) authorized for the new medical center. So far, the department has filled 257 of those positions. It’s struggling to hire new talent more quickly, because the Denver metropolitan areas has a highly competitive labor market, said Ralph Gigliotti, director of the Veterans Integrated Service Network for the region.

Gigliotti said he was confident the department would meet its staffing targets by the August open date.

Both VA and the U.S. Army Corps of Engineers, which took over the hospital’s construction back in 2015, insist they won’t make the same mistakes again on future projects.

“The design, we can all agree, was probably more complex than it needed to be,” Fiotes said. “The design was prepared a long time ago. Requirements have evolved over time, and that probably is part of the reason that the capacities are smaller right now, including in the primary care, patient-aligned care teams, which were not in existence when the building was originally designed.”

The department needs to define their project requirements more clearly and quickly at the beginning of future developments, Fiotes added.

The Army Corps of Engineers said it’s also collecting a series of lessons that it’s learned from this project.

“Early involvement by the construction agent is critically important to define the scope of the project and to determine how that project will be executed,” said Lloyd Caldwell, director of military programs for the Corps of Engineers. “In that process, determining what are the mission critical requirement dates that have to met so that you can set up an acquisition strategy?”

But VA’s promises fell short for Coffman, who’s long been frustrated by VA’s handling of this project,

“I’m very disappointed,” he said. “President [Donald] Trump ran on the fact that he was going to clean up Veterans [Affairs]. He’s certainly made progress, but this is an area that’s very critical. I see no change. I see absolutely no change. Those who have their fingerprints on this hospital, it’s virtually the same bureaucratic incompetence and culture of corruption. So I will ask Dr. [David] Shulkin and ask the president to clean house. That’s what he should have done from day one.”