Health Care
$2.87 billion in bonds were sold for health-care institutions, and $127.13 million worth of medical and computer equipment was leased.
In the eight years since the Health Care Reform Act de-regulated rates, hospitals
in New York have been vying for patients in a new, competitive marketplace.
To compete, many are renovating or upgrading facilities, providing added patient
privacy, state-of-the-art diagnostic, testing and procedural equipment, and
taking steps to enhance operating efficiencies. At the same time, traditional
mortgage and bond insurers nationwide have been more reluctant to serve health-care
institutions. As a result, the Authority has become more flexible in helping
its clients meet their capital financing needs.
As ever, the Dormitory Authority partners with its clients, providing access
to tax-exempt capital financing and equipment lease rates, and helping customers
with business planning and debt management.
The Authority is proud of its seven-year partnership with the New York City
Health & Hospitals Corporation, the largest public hospital system in
the country. Among the major projects completed during the past few years
are a new Queens Hospital and a new bed tower at Kings County Hospital Center.
Projects in the $1 billion pipeline for HHC include modernization of Coney
Island Hospital and Jacobi Medical Center, a new ambulatory care building
for Bellevue Hospital, and new buildings for behavioral care and diagnostic/treatment
at Kings County Hospital Center.
Work continues on the DNA Laboratory for the New York City Office of the Chief
Medical Examiner. Once completed, the lab will provide forensic facilities
unmatched by any state.
As needed, the Authority works with its health-care clients on their short-
and long-term business management plans to ensure continued viability.
When a hospital board decides to close a hospital, the decision affects the
local community as well as the bondholders and other creditors. On April 4,
2003, St. Agnes Hospital in Westchester County surrendered its operating certificate,
with $36.5 million in Dormitory Authority bonds outstanding. The Authority
has asked the Court to allow it to foreclose on the property, which is owned
by the Hospital. As 2003-04 ended, the foreclosure action was still in process.
The bondholders are expected to continue to be paid from foreclosure proceeds,
reserve funds and, if necessary, State payments made under a service contract
with the Authority.
Bond Financings
Winthrop-University Hospital Association – $43,855,000
This bond issue financed improvements to Winthrop’s physical plant
and campus, including consolidation of the thoracic, cardiac and vascular
patients into one location, construction of an operating room on the Hoag
Pavilion’s fourth floor, addition of a fourth cardiac catheterization
laboratory, and conversion of 32 medical-surgical beds to 22 surgical intensive
care, eight pediatric intensive care and two general pediatric beds. (Sold
April 25, 2003)
Memorial Sloan-Kettering Cancer Center – $488,326,297
The center used these bond proceeds to finance or refinance all or a portion
of the costs of construction of Phase I of the new research building on 68th
Street between First and York avenues in Manhattan, acquisition of the Southtown
housing complex under construction on Roosevelt Island, and other capital
projects. (Sold April 30, 2003)
Kateri Residence – $23,935,000
This Manhattan nursing home financed construction of a rooftop solarium
terrace, refinanced a commercial loan, and refunded its 1995 Dormitory Authority
bonds. (Sold May 2, 2003)
Teresian House Housing Corporation – $40,265,000
This Albany-based nursing home financed construction and equipping of a
full-service retirement community with 152 independent living units, a community
center and common areas. (Sold July 22, 2003)
South Nassau Communities Hospital – $60,000,000
Part of the Winthrop-South Nassau University Health System Obligated Group,
this hospital financed its plan to design, build and equip a five-story patient
care building, with 112 medical surgical beds, a maternity/neonatal facility
with more than 30 beds, and a 30-bed psychiatric unit. (Sold July 30, 2003)
North Shore-Long Island Jewish Health System Obligated Group – $81,230,000
This bond issue financed North Shore University Hospital’s acquisition
of certain facilities of North Shore Community Services Inc., plus plant operation
improvements, building and engineering renovations. The bonds also financed
construction of a new Activities Therapy Building for the Long Island Jewish
Medical Center, plus improvements to roads, sewer and water lines, utility
relocation and redistribution, and the purchase and installation of equipment
for cardiology, respiratory therapy, pediatric intensive care, operating rooms,
and central sterile supply. (Sold July 31, 2003)
New York State Rehabilitation Association – $23,035,000
This bond issue financed or refinanced renovation projects for NYSRA members
F*E*G*S Health and Human Services System in New York City and Nassau County;
St. Christopher-Ottilie in New York City and Long Island; Wildwood Programs
Inc. in Albany, Schenectady and Saratoga counties; and Services for the Underserved
in New York City. Some of the bonds were federally taxable. (Sold August 8,
2003)
Sisters of Charity Hospital of Buffalo – $34,775,000
This issue refunded outstanding 1991 Medical Care Facilities Finance Agency
Project Revenue Bonds, for a net present-value savings of $6.1 million. (Sold
September 15, 2003)
Jewish Board of Family and Children’s Services Inc. – $17,555,000
The Board financed real estate acquisitions, renovations and equipment
purchases, and completed a current refunding of outstanding bonds issued in
1992 by the County of Westchester Industrial Development Agency and by the
New York City Industrial Development Agency. (Sold September 19, 2003)
New York State Department of Health – $255,075,000
A $41,910,000 issue sold on November 14, 2003, partially refunded Dormitory
Authority bonds issued in 1993, 1994, 1995 and 1996. Two issuances of $77,245,000
and $57,050,000 were sold on February 12, 2004, partially refunding 1993,
1994, 1995 and 1996 Dormitory Authority bonds. A $78,870,000 issue sold on
March 19, 2004 partially refinanced the Dormitory Authority’s 1994, 1995
and 1996 bonds. The present-value savings from these refinancings is $10.71
million.
Mental Health Services Facilities Improvement Program – $1,791,740,000
The four issues sold provided $183,870,000 in new money from fixed-rate
bonds to finance capital projects at voluntary mental health service providers
and State institutions, and refunded $1,550,775,000 in outstanding fixed-rate
bonds issued by the former Medical Care Facilities Finance Agency and the
Dormitory Authority on behalf of the State Department of Mental Hygiene (consisting
of the Office of Mental Health, the Office of Mental Retardation and Developmental
Disabilities and the Office of Alcoholism and Substance Abuse Services). Of
the refunding bonds, $238,770,000 was issued as fixed-rate bonds and $1,369,100,000
was issued as variable-rate bonds. To lower borrowing costs, the variable
rate bonds were subject to interest-rate exchange agreements (swaps). The
refunding helped diversify the state-supported bond portfolio and resulted
in present value savings of $157,849,114. (Sold July 2, July 14, December
18, 2003 and January 7, 2004)
Tax-Exempt Equipment Leasing Program (TELP)
New York & Presbyterian Hospital Inc. – $2,225,921
The hospital leased MRI scanners. (Lease closed on April 10, 2003)
Mary Imogene Bassett Hospital – $5,300,300
The hospital leased cardiology, surgical and intensive-care equipment,
including a perfusion system, anesthesia machines and management information
system equipment. (Lease closed April 30, 2003)
Lakeside Memorial Hospital – $2,511,746
This hospital leased HVAC equipment and related renovations that included
the installation of a 300-ton water chiller along with lighting upgrades and
window replacement. (Lease closed June 18, 2003)
Maimonides Medical Center – $6,931,799
The hospital leased NOVA biomedical glass analyzers, a harmonic scalpel
and a newborn-hearing testing system. (Lease closed June 26, 2003)
Montefiore Medical Center – $9,955,557
The hospital leased $6,187,682 in imaging, information technology and medical
equipment. (Lease closed July 24, 2003) Oncology, radiation therapy and imaging
equipment, including radiation oncology-low energy linear accelerator, nuclear
medicine equipment and mammo-digital senographers was leased for $3,767,875.
(Lease closed on March 26, 2004)
Hudson Valley Hospital Center $1,455,086
The hospital leased an MRI and a CT scanner. (Lease closed September 5, 2003)
Catholic Health System of Long Island Inc. – $12,300,790
This health system leased radiology, surgical and information technology
equipment. (Lease closed on December 11, 2003)
St. Peter’s Hospital $5,524,750
The hospital leased a CT scanner, MRI and cardiology equipment, including
a beam scanner and ultrasound. (Lease closed December 23, 2003)
Community General Hospital of Greater Syracuse – $3,700,000
The hospital leased a CT scanner, imaging and radiology equipment, such
as a nuclear medicine whole-body scanner and digital X-ray equipment. (Lease
closed on February 25, 2004)
Kaleida Health – $9,941,008
This Erie County-based health care system leased MRI monitoring equipment.
(Lease closed March 31, 2004)
SUNY University Hospital at Syracuse – $20,920,000
This hospital in Onondaga County, formerly known as Upstate Medical Center,
leased cardiology, operating room equipment, information technology and lab
equipment that involved a wireless telecommunications system, and ventilators.
(Lease closed October 23, 2003)
SUNY University Hospital and Medical Center at Stony Brook – $21,160,000
The hospital leased radiology, cardiac catheterization and nursing equipment,
including a nuclear camera and a Medrad medical radiology injector. (Lease
closed December 30, 2003)
SUNY Downstate Medical Center at Brooklyn – $25,200,000
The hospital leased cardiology and radiology equipment, including radiology
therapeutic equipment, an ECG system and a dual-headed gamma camera. (Lease
closed February 18, 2004)
New Construction Projects
Jacobi Medical Center – $78,842,000
Three projects began during the fiscal year at this hospital in the Bronx.
The first is the $71,252,000 design and construction of a new four-story outpatient
ambulatory care building. The four-story building will house most clinical
services for medical, pediatric, women’s health and surgical subspecialty
ambulatory care. Approximately 28,000 square feet of adjacent vacated space
in the former inpatient tower will be renovated to house outpatient services.
(April 2003) For the next, $3,590,000 in renovations on the main building’s
fifth floor will create a cardiac catheterization laboratory. (July 2003)
The third project is a new $4,000,000 corporate training center, being designed
and built for the New York City Health & Hospitals Corporation. (October
2003)
Kings County Hospital Center – $183,696,500
Two projects are under way for this Brooklyn hospital. The first is the
$140,000,000 Phase 4 of the Center’s modernization, consisting of construction
of a new Behavioral Health Center, with an ambulatory care program, day treatment
programs, an inpatient and comprehensive psychiatric emergency program to
serve adults, adolescents, children and people with addictive diseases, and
support spaces for the center’s staff. (November 2003) The second is
Phase 3, the $43,696,500 renovation of the E Building to provide ambulatory
care services. The work consists of renovation of the basement and the first,
fourth, fifth, seventh and eighth floors. The mechanical, electrical and plumbing
infrastructure will be replaced and two courtyards will be filled in. A new
one-story concourse will connect the E Building to the S Building. (July 2003)
Queens Hospital Center – $48,556,160
A new 120,000-square-foot ambulatory care pavilion will accommodate behavioral
health administration, clinics and day programs, primary medical and pediatric
clinics, the diabetes center and staff education. (July 2003)
Elmhurst Hospital Center – $8,000,000
A four-story building at 77-01 Broadway, Queens, will be demolished, with
new construction of a five-story medical building adjoining the hospital.
(December 2003)
North Central Bronx Hospital – $2,164,000
The 12th floor will be renovated to establish a 23-bed Geriatric Psychiatric
Nursing Unit in this hospital in the Bronx. (May 2003)
Rockland Psychiatric Center – $1,535,000
The roof will be replaced with a modified bitumen roofing system. (November
2003)
Queens Children’s Psychiatric Center – $12,265,823
A 37,000 square foot Community Service Building will be constructed to
house day treatment programs, outpatient clinic, and intensive case management
services. (October 2003)
New York Psychiatric Institute – $5,279,000
A second rooftop generator will be installed, as well as a new emergency
power riser system, a second elevator operating on emergency power, and additional
loads of emergency power transfer switches. The 900-kw generator at this Manhattan
facility will be replaced. (January 2004)
Office of Mental Retardation and Developmental Disabilities – $1,123,000
Boilers and system components will be replaced in Building 3 of the Broome
Developmental Disabilities Services Office. (September 2003)
Office of Mental Retardation and Developmental Disabilities – $1,035,000
At the Brooklyn Developmental Disabilities Services Office, approximately
43,000 gross square feet of single-ply roof membrane will be removed and asbestos
abated. A multi-layer built-up roof system will be installed. (October 2003)
Office of Alcoholism and Substance Abuse Services $1,820,000
The project is a full rehabilitation of a four-story brownstone adjacent to
Anchor House’s women’s residential program on Park Place in Brooklyn.
The project will connect and upgrade the buildings. (January 2004)
New York State Veterans’ Home at Oxford – $60,000,000
A new building will be constructed at this veterans’ nursing home
in Chenango County to replace the current facility. (February 2004)
Roswell Park Cancer Institute Corporation – $9,000,000
The infrastructure is being renovated throughout the Institute, located
in Erie County. (September 2003)
Griffin Laboratories – $1,600,000
Construction will be undertaken of a 7,500-square-foot freezer repository
and a shipping receiving/facility at the Labs, which are operated in Albany
County by the New York State Health Department. (November 2003)
Completed Construction Projects
Harlem Hospital Center – $7,827,317
Fire alarm systems in two buildings have been replaced at a cost of $3,116,643.
(April 2003) Roofs and the masonry facade at the Martin Luther King Jr. Pavilion
were repaired in a $3,267,674 project. (August 2003) In a $1,443,000 project,
three boilers in the Martin Luther King Jr. Pavilion were rehabilitated. (August
2003)
Woodhull Medical and Mental Health Center – $2,372,500
Seventy-six bathrooms were renovated within the psychiatric department
at this Brooklyn facility. (December 2003)
Lincoln Health & Mental Health Center – $4,263,245
The fire alarm system was replaced throughout this hospital in the Bronx.
(May 2003)
North Central Bronx Hospital – $6,632,679
Roofs and masonry facades were rehabilitated. (June 2003)
Jacobi Medical Center – $10,083,000
A state-of-the-art $4,985,000 neonatal intensive care unit was completed
in May 2003. Also, the hospital’s data center was moved from 230 W. 41st
St. to Jacobi’s nurses’ residence in the Bronx in a $5,098,000 project.
(December 2003)
Queens Hospital Center – $6,256,000
The A Building was demolished, with site work performed to prepare for
the new ambulatory care pavilion. (May 2003)
Corona Oral Health Clinic – $689,000
Renovations were completed to bring this clinic in Queens into compliance
with the Americans With Disabilities Act, and to improve the fire alarm and
suppression systems. (June 2003)
Lower Manhattan Health Clinic – $705,300
Renovations were completed to bring the clinic into compliance with the
Americans With Disabilities Act, and to improve the fire alarm and suppression
systems. (May 2003)
New York Psychiatric Institute – $12,065,790
The Kolb Research Building at the institute in Manhattan was converted
to compatible energy services. (March 2004)
Elmira Psychiatric Center – $946,000
Building 1’s generator was replaced with a medium-voltage model and
transfer switch at this Chemung County facility. (May 2003)
Manhattan Psychiatric Center – $1,215,737
A personal duress alarm system was installed. The system notifies security
personnel when staff members remotely indicate that personal assistance is
required. (August 2003)
Creedmoor Psychiatric Center and Queen’s Children’s Psychiatric
Center – $724,433
A personal duress alarm system was installed, providing coverage at Buildings
40, 100, 14 and 21. The system will alert campus safety personnel when staff
members remotely indicate that personal assistance is required. (January 2004)
Buffalo Psychiatric Center – $7,277,000
In a $3,839,000 project completed in June 2003, the Center’s eight-story
Building 52 was demolished, and the site was restored. This will make room
for a future project to expand the recreation center at this facility in Erie
County. A sheltered workshop, built with a steel frame and concrete block,
was constructed on a $1,747,000 budget, including a loading dock, office/conference
rooms and landscaping improvements. (July 2003) A $1,691,000 personal duress
alarm system was installed to protect staff in both facilities, part of a
statewide program by the Office of Mental Health. (November 2003)
Pilgrim Psychiatric Center – $9,159,000
A new power plant was constructed at this mental health institution in
Suffolk County. (October 2003)
Middletown Psychiatric Center – $2,539,200
Unlicensed coal ash storage was remediated at this site in Orange County
by consolidating, covering and capping the material, and restoring the site
with topsoil and grass. (December 2003)
Office of Alcoholism and Substance Abuse Services – $2,000,000
The administration/clinical office building of the Genesee Council on Alcoholism
and Substance Abuse Services was rehabilitated, including an addition to provide
administrative space. The building, in the center of Batavia, Genesee County,
is a historic building and was renovated in keeping with the surrounding community.
(October 2003)
McPike Alcoholism Treatment Center – $868,101
This treatment center in Oneida County underwent renovation to improve
the plumbing, electrical, heating, ventilation and air-conditioning systems;
replace the roof and fire alarm; and improve offices, the detoxification area,
staff lounge, dining areas, men’s rooms and showers in the C wing, and
women’s rooms in the B wing. (November 2003)
Helen Hayes Hospital – $2,625,000
The emergency power system was upgraded at this state-operated hospital
in Rockland County. (November 2003)
New York State Veterans’ Nursing Home at Oxford – $1,510,300
At this Chenango County facility, a new single-story central billing office
was constructed with slab-on-grade foundation and wood clapboard exterior.
The $820,300 project, including landscaping, and was completed in November
2003. In addition, the nurse call system was replaced for $690,000. The new
system can track staff members during an emergency through a device that can
be activated remotely to indicate their location. The system also routes calls
from bedsides, bathrooms, and calls from staff for assistance or “code
blue.” (February 2004)
Western New York Veterans’ Nursing Home – $611,579
A new multi-purpose room was constructed in this veterans’ nursing
home in Batavia, Genesee County. (June 2003)