State approves pared down expansion at MGH, growth at Brigham Faulkner

A rendering of the recently approved MGH building on Cambridge Street.NBBJ

State regulators approved a pared down expansion at Massachusetts General Hospital and growth at Brigham and Women’s Faulkner Hospital on Wednesday, giving final state sign-off on approximately $2 billion in projects.

The Public Health Council approvals fell in line with staff recommendations from the Department of Public Health, which had recommended the addition of 78 inpatient beds at Brigham and Women’s Faulkner and supported the construction of two connected clinical towers at Massachusetts General Hospital.

DPH staff and the Public Health Council agreed to allow the construction of single-room beds at Mass General Hospital, which will allow staff to move patients from current double-bedded rooms to create more single-bed rooms at the hospital. However, the council voted in line with the staff recommendation to block the construction of 94 additional beds at MGH that would have substantially expanded the hospital’s capacity, saying the applicant hadn’t shown enough of a need. Mass General Brigham can return to the council to request the expansion at a later date.

“While the department finds there is risk of increased costs, this risk can be largely mitigated with conditions and through disapproving MGB’s request for additional inpatient beds,” said Elizabeth Kelley, director of the Bureau of Health Care Safety and Quality at the Department of Public Health.

In April, Mass General Brigham withdrew the most controversial piece of its plans, which included building or expanding outpatient clinics in Woburn, Westborough, and Westwood, saying DPH staff had declined to support the projects. DPH staff have yet to publicly issue the report on the projects, and Public Health Council staff did not discuss the projects.

All 10 members of the 14-member council in attendance voted in favor of both current projects. MGB will be required to submit ongoing data on volume and utilization as part of the approvals.

Mass General Brigham executives said they were pleased the two hospital projects cleared final state regulatory hurdles.

“The two new buildings at MGH and the addition of new inpatient floors at the Faulkner will significantly enhance our ability to provide the highest level of care for patients, increasing access and enhancing the care experience,” said Anne Klibanski, CEO of Mass General Brigham, in a statement after the vote.

At the hearing, Mass General Brigham executives said the growth at Brigham and Women’s Faulkner in Jamaica Plain would help meet the needs of a growing population of patients over the age of 65, and would address high occupancy rates in its inpatient units and increasing backups in the emergency department. Additionally, the project would help address backlogs at Brigham and Women’s Hospital, which often transfers less sick patients to the Faulkner.

Boston University health economist Kathleen Carey, who is a member of the council, questioned the need for a 59 percent increase in inpatient bed capacity at the Faulkner.

Yet David McCready, president of Brigham and Women’s Faulkner Hospital, said the current demand justified the expansion. On Tuesday, there was 101 percent occupancy of inpatient beds at the hospital — showcasing the higher demand than available beds, he said. Brigham and Women’s Hospital emergency room was also on a “code capacity disaster” Tuesday, because it didn’t have enough beds to meet patients’ needs and Faulkner couldn’t take the excess.

“The experience at the Faulkner, just empirical data, reveals an overwhelming case for the need for additional beds,” McCready said.

Councilors also supported two new connected clinical towers on the MGH main campus that would contain private beds, outpatient oncology services, and expanded cardiac services. MGB said the plans would help address capacity constraints, given that, prior to COVID, 30 to 50 beds were blocked each day at MGH because available beds were in rooms with patients who weren’t compatible, due to infection controls, gender, or age, or because patients were exhibiting disruptive behaviors. The MGH project would also relocate the hospital’s cancer and cardiovascular care in one place.

“We had 50 patients in the emergency department this morning waiting for an inpatient bed and another 38 in the [post anesthesia care unit]. And those numbers are routine for us,” said Dr. David Brown, president of Massachusetts General Hospital, in the hearing. “Moving to single rooms is an essential and extremely important element of the new project.”