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HomeMy WebLinkAboutItem 4.1 San Ramon Valley Hospital Project (2) � Le0 —LOID CITY OF DUBLIN AGENDA STATEMENT MEETING DATE: May 9 , 1983 SUBJECT Presentation by National Medical Enterprises Inc . San Ramon Valley Intercommunity Hospital Project EXHIBITS ATTACHED Letter from Larry Meyer dated May 3 , 1983 ; Information Package RECOMMENDATION 1�Receive presentation FINANCIAL STATEMENT: None DESCRIPTION Mr . Larry Meyer has requested an opportunity to address the City Council regarding a proposal by National Medical Enterprises to build a San Ramon Valley Intercommunity Hospital . --------------------------------------------------------------------------- L/ COPIES TO: Larry Meyer ITEM NO. / THE SAN RAM*q VA o . May 3 , 1983 Ms. Kay Keck Deputy City Clerk Dublin City Council P.O. Box 2340 Dublin, CA 94568 Dear Pis, Keck: t Thank you and the Dublin City Council for the opportunity of i presentincq our proposal for the San Ramon Valley Intercommunity Hospital. Per our telephone conversation, the Council will be meeting at the Dublin Library on Monday, May 9 , 1983 at 7 : 30 p.m. I have enclosed six information packets for yourself and the City Council members as briefing material. Please list out presentation on your agenda as the San Ramon Valley Intercommunity Hospital Project. In reference to the names of our representatives, just indicate National Medical Enterprises, . Inc. Ply associates and myself look forward to seeing you next Monday evening. Sincerely, Larry' L. Me7er Associate Director SRVIH Project Enclosures PROJECT OFFICE O National Medical Enterprises, Inc. 560 So. Hartz Avenue, Suite 425 (415)831-962.6 Danville. CA 94526 - WILL YOU HAVE A CHOICE? I CHOOSE THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL. As an Independent Insurance Agent, it's my policy to place people's lives and property with the best possible carrier. That's a choice 1 like to make. As a 21 year valley resident, that's the same choice I would like to make for my family's health and hospital care. I want to be able to choose the best possible hospital— in my own community. I believe that National Medical Enterprises'full-service San Ramon Valley Intercommunity Hospital will offer the choice we need. The San Ramon Valley Intercommunity Hospital will offer healthy competition. The standards of the hospital will k always be high, due to the fact that it will be a National Medical !'Enterprises' hospital. The staff will be.well trained. The hospital will be conveniently located and will offer the highest quality i „ ,,�, 4i'services and equipment F M� a I choose the SAN RAMON :; ' • x. VALLEY INTERCOMMUNITY HOSPITAL! Robert C(Rusty) Attebery Attebery Insurance Agency, Inc. President, Dublin Lions Club tl' i. e f11; i ;� � t���,�"y�,`�� "� °s` � � aka•,, a �i THE. SAN RAMON VALLEY J h 2 J INTERCOMMUNITY HOSPITAL q Project Office w •560 So. Hartz Avenue, Suite 425 ~ h�a Danville, CA 94526 O O CZ w CZ w (415)831-%26 h Ln ONational Medical Enterprises,Inc. -LONG OVERDUE ! National Medical Enterprises, Inc. is Locating a Full-Service Hospital, Right Here, in the San Ramon Valley! How fast tali I get to the hospital? That's my major concern right now! This will be my third child and more than likely the baby will come quickly! We live in Pleasanton. The doctor I've been visiting is in San Ramon. The hospital he uses is in Walnut Creek. That makes me forty minutes away from my hospital . . . let alone if it's raining, foggy, rush hour or there's an accident! Our other two children will have to be left with someone, so that will take another 15 to 30 minutes. My friend down the street didn't even make it to Kaiser Hospital with her 3rd child! And Kaiser is definitely at the south end of Walnut Creek. I don't know. 1 just don't know if we'll make it. I'm excited about the San Ramon Valley Intercommunity Hospital. The location, within a mile of the Crow Canyon 1680 interchange, is excellent! National Medical Enterprises, Inc. is known for the efficiency of its staff, the most up-to-date equipment and the quality of service. As my family grows, so does our need for the San Ramon Valley Intercommunity Hospital. THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL — 1 expect the best! \ Linda Gilchrist Resident of Pleasanton s c iE°4a � r Y b d �•, Op a N THE SAN RAMON VALLEY z o rtz r_1 INTERCOMMUNITY HOSPITAL w Project office _ . 560 So. Hartz Avenue, Suite 425 ti Danville, CA 94526 O 0 W a (415)831-%26 _ ONational Medical Enterprises,Inc. WE'RE HOME FREE National Medical Enterprises, Inc. is Locating a Full-Service Hospital, Right Here, in the San Ramon Valley "Hole, Frt,tT" rllt'alls safe' at horny. Amt to be "home free" is t'Vertybodty`s risht who has madt, tilt' Sall Ramon Valley their home. 1'74t, SI1t'lit IMP111 hours coachlrig tilt' al"t'a'S yollligster;s ill soccer. We'vt, had Solnt, bid' successes like tilt, time our Under 14 Butt's Al Caffodio Soccer Lt,a,�mt, Team finished 3rd, right behind Pleasanton mid Livenmlrc. But soccer, as all sports, has "had breaks". TheIl come in the shape of broker) arras, leas, sprained.ankles, and more. Now we rush them to Walnut Creek. Typically, sports injuries don't need innnedinh' attt,nfian. Bill, injuries to the growth joint lit a bone Should be taken cart' of riNllt away or there could be problems t later on. Thert,"s really no facility in our cotnnunihy to serve us, the �w w r community. Not only will the San Ranlnn Valley Intercommunity ` i Hospital be here to accommodate enter cticies, but t " the hospital will offer lnjuny Education Classes for f �t " �•, coaches, as zoell as Therapy acrd Rehabilitation Services. These special San Ranlnn Valley Inter- A io111llltlllltly Hospital seritlit,s z!'111 t,llSllre ZOt'"Yt' "Iunut,free" at home and orl tilt, playtn�field! i F t II� 7f °• f. t .��. \ �Q ��\� Dave ShU r % •� k .: ti�� Partner Danville 11umr IlrcnrIting tie rcicr. ;' If Dirrihrt nt llhrnitnm. In•hur, Inc VIII I}G ,i f I lj � C CC J N THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL co Project Office h a a 560 So. Hartz Avenue, Suite 425 Danville, CA 94526 O O ``' z (415)831-9626 pq@ National Medical F;iterprises,Inc. "JUST WHAT THE DOCTOR ORDERED" The San Ramon Valley Intercommunity Hospital! Since 1954, I've lived lard practiced ill the Sall Ranum Valletl. file beery active in the curnmunih/ includbig tilt, Danville Rotary as a Charter nn'nrber 111111 Past-President. Those open fields ill tilt, valley lyre fillbig ill). . . . making a good cormmmitl, a Self supporting cornnnnlihl — but UT toorl't be a total connnnnihl without a conumrnihl hospital. There's talk of hnildirrg a Iteallh care fircilihl Ili/ 1992. That's about 10 l/cars from r1ow. 1 think a fill-servict, hospital ahaS ucrdOd in tlu' San Rarmnl Valley 10 years ago! The San Ranunr Valley Interconurnurih/ Hospital is tilt, only hospital planned fit- tilt, valley. Natiomll Medical Enterprises is planning to locate the San Ramon Valley Interiommimity Hospital ill the valley NOW! Blfort, Jolm Muir Hospital or tilt, 680 Frectoay 71)11s built, me'd race for 30 to 40 mimltes to get to a hospital. This was very/ dangerous fin' 7110111t,rl in labor and ellictwerncy health problems. Today, it still takes 30 to 40 minutes during the rush hour or oil a foggy day. I like the idles of'lu'altlnl' competition. 1-Iospi111l costs are going up rapidly. costs lurvr to Ile colrtrolled. Corrrpctitiolr arming 110sl1itals Will ; ensure competitive prices and 111111lih1 \\ tit,l'inet's. YOU NEED THE SAN RAMON VALLEY \ INTERCOMMUNIIY HOSPITAL. \ \ \� \00\0 \ 1 KNOW! \ r\,\ ®� s \\ e, J. C. Forsyth, M.D. ` P O� d � c S� W 7 zt M {, J THE SAN RAMON VALLEY 4J ZZ:N INTERCOMMUNITY HOSPITAL Project Office 560 So. Hartz Avenue, Suite 425 w Danville, CA 94526 ZJ �h h O (415)831-9626 O�IB National Medical Enterprises,Inc. THIS ONE'S GOT MY VOTE National Medical Enterprises, Inc. is Planning to Locate a Full-Service Hospital, Right Here, in the San Ramon Valley! As a long time resident of San Ramon, 1 believe our paramount concern is the control of the San Ramon tray dollar argd the developnamt of a aoell planned, orchestrated and balanced business and residential communihl. Having lived in the Sara Ramon Valley for the past 12 years, I believe the San Ranson Valley needs a full-service hospital that is readily accessible for all situations. The growth of the San Ranson Valley will require and mandate a hospital by the avid-80's that will be able to service local residents and the additional employment base The San Ramon Valley Interconummih_/ Hospital is the hospital that will meet the needs of the San Ramon Valley Community. The San Ramon Valley lutercomumuity Hospital will be a full- service hospital. flag not talking abort just another family medical center or urgent care center. . . but a hospital, with easily accessible 24 hour emergency care service, a fully-trained staff with doctors b •x available at all tinges, quality in-patieut acute services and cost effective out-patieW surgical services. Along with all of these excellent services, the hospital will meet the w needs of our connnunihl as well as provide a siguificent financial contribution to our local tax base. The Sail Ranson Valley p Intercommunihl Hospital will contribute hundreds of thousands of dollars in property, federal, state and local taxes per year. The hospital Will be directed by a local Board of Directors \ i comprised solely of local commimihl leaders including members of the hospital's active medical staff. THE SAN RAMON VALLEY INIGRCOMMUNITY HOSPITAL— A WINNEW! w, / a ' Mary Lou Oliver Resideut of San Ramon � Wb i y \ d e � q J a\o THE SAN RAMON VALLEY w INTERCOMMUNITY HOSPITAL Lo Project Office h a 560 So. Hartz Avenue. Suite 425 w�' Danville, CA 94526 0 0 0 (415)831-9626 C� National Medical Enterprises, Inc. I'VE NEVER FELT BETTER! ! National Medical Enterprises, Inc. is Locating a Full-Service Hospital, Right Here, in the San Ramon Valley! Having worked in the health industry since 1946, and serving hospitals, specifically, the last 15 years through nnl firm, Blendour, CroWley and Oliver, Inc. (consultants to management on executive and professional selection for the health care industry); I knoW hospitals! 1 have been a resident of Alanio for 21 years. The growth here in the San Ramon Valley Will be phenomenal. 1 ail serving on the San Rarnon Valley Chamber of Commerce's Commercial Development Committee, working with others to monitor the San Ramon Valley's growth. The need for total health care services grows along with businesses and residents. 4 As a Director on the San Ramon Valley Fire Department, I've realized just hour critical the need is or an easily accessible has renal here in the San Rarnon Valley. It's a goal 15-20 minutes or more to the nearest hospital. That could be 15-20 minutes torn tier. Proprietrnt/ hospitals nre et/iciest! You Net better patient care per dollar in a 'profit' hospital. Propricfar.y hospitals can mal�c decisions quickly. The best equipment and ScrviCc:s Can be made available innnediateh/, at no CoSI fo you, the taxpayer. All alone though, the proprietary hospital will be Contributins substantially .,, to the local tax base. This San Rarnon Valley deserves the best. We deserve the best. 1 THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL! t " The Best! r c. c , wrT 'vn�Ey i i Bill Blendow, Owner Blerrdow, Crowlq and Oliver, Inc, Bmnch Offices U.S.A. (Danvillr, Walnut Creek and Lafayette) 4 F^t �+ y y j N w cv a J N J THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL QJ(1- 6- Project Office a 560 So. Hartz Avenue. Suite 425 Danville, CA 94526 �� ZJ (415)831-9626 _ �—' We've ; s' ,'e,, le -o ou. y com mitted W to ul e re the hospi' tal ee • The San Ramon Valley Intercommunity Free enterprise at work- Hospital-planned for you, not your taxes! We don't plan hospitals in an ivory tower; we plan them with Rather than using municipal services for nothing, San Ramon input from the community to be served. Over the last several Valley Intercommunity Hospital will contribute to the eco- months we have met with your community leaders, civic nomic well-being of the community while keeping its rates groups, homeowners associations, and local physicians. We competitive with those of other area hospitals. NME hospitals have conducted community surveys. The responses to all our have to offer superior services at competitive rates--while research have been overwhelmingly in favor of a full-service paying taxes.They do it by cost-effective management, econo- hospital for the San Ramon Valley. National Medical Enter- mies of scale, and the comprehensive know-how and efficient prises is committed to developing the new full-service hospital support services developed by a company that now operates you've asked for and need, a hospital offering medical and 60 acute care hospitals, 25 psychiatric hospitals, and 267 surgical services; critical, intensive, and coronary care; ped- convalescent and rehabilitation facilities. For-profit enter- iatric, maternity, and psychiatric care; and an emergency prise,even in health care,offers consumers the best buy. department open 24 hours a day, seven days a week. It will have all the diagnostic and therapeutic services appropriate to a first-class community hospital. It will be easy to reach close to the Crow Canyon/680 Interchange with ample free parking. Residents of the San Ramon Valley For more information call need more than a satellite of Walter Hankwitz 828-7901 another hospital, NATIONAL MEDICAL You need and deserve your own freestanding, full-service ENTERPRISES, INC. facility with its own governing board made up of your 188 com- munity's civic leaders and doctors. San Ramon Valley Inter- community Hospital will be your hospital-directed by a local 1 1 V board, staffed by local physicians, hiring local employees, buying from local firms. Dublin, California 94568 A true Community Hospital — like the 29 other NME o hospitals in California, o NME hospitals are part and parcel of their communities,from o p O Redding to Calexico. Each one contributes much more than o care for acute illnesses and injuries. San Ramon Valley Inter- O community Hospital will: O • Be a center for community health education. Programs selected by your local board may include fitness courses, O Lamaze training,nutrition and wellness seminars,and sessi- 0 ons on substance abuse, care for the aging, anti-rape def- O 000 ense, problems of today's adolescents, and other topics. 000 O •Offer free screening tests for cardiovascular problems, o 0 glaucoma,and other,often unrecognized conditions. Locations of o 0 •Offer opportunities for volunteers'involvement. National Medical Enterprises •Help local young people who want to enter the health care field. California•Bring new jobs and new business to the Valley. Community Hospitals in C •Add hundreds of thousands of dollars to the local tax base. J Y THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL 'HE SAN ZAMON VA RC OSP T FACTS ABOUT THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL PROJECT A new 174-bed full-service acute care hospital planned to service the growing population of the San Ramon Valley. SERVICE The cities,towns and communities of Alamo,Diablo,Danville, San Ramon,Dublin and AREA Pleasanton. LOCATION Within a 2-mile radius of the Crow Canyon/680 Interchange. SERVICES The major services planned for this 174-bed hospital include:general acute medical and surgical, critical, maternity, pediatric and psychiatric care.Ancillary services planned include: 24 hour emergency,CT scanning, outpatient surgery and related diagnostic and therapeutic services. GOVERNED NME believes in local control.Every NME hospital has its own local Board of Directors BY LOCAL composed solely of members of the hospital's active medical staff and other local community BOARD leaders.No NME employee sits on the Board at any NME hospital as a voting member.The local Board provides direction to hospital operations and is responsible for all phases of hospital governance. CONTRIBUTION The contribution to the San Ramon Valley residents will not only be a local hospital tailored to TO THE the needs of your community,but a significant financial contribution to the local tax base.As an COMMUNITY investor-owned hospital,we anticipate that your hospital in the San Ramon Valley will contribute hundreds of thousands of dollars in property,federal,state and local taxes per year. COMPLETION Final design and construction will begin immediately upon approval of our Certificate of Need DATE (CON) application from the California Department of Health Services.The completion of the hospital will take approximately 21/2 years following CON approval. EXPANSION As the Valley continues to grow,future expansion will be predicated upon the needs of the San Ramon Valley as determined by your local hospital's Board of Directors with input from local residents and physicians. NATIONAL National Medical Enterprises owns or operates in excess of 60 acute care community hospitals, MEDICAL 25 acute psychiatric hospitals, 270 nursing homes,as well as numerous dialysis clinics, ENTERPRISES, pharmacies,home health care agencies and other entities supportive of the total health care INC. concept.NME is a totally integrated health care corporation; an international leader in the provision of high quality care to the hundreds of communities we service. NME is a publicly held and publicly accountable corporation traded on the NYSE.With a FY'82 net worth of approximately$450 million and about$1.4 billion in annual revenues,NME can not only finance the total development of a new hospital in the San Ramon Valley,but can and will support a program of modernization and growth as needs are determined by the hospital's local Board of Directors and medical staff. CONTACT For more information regarding NME's San Ramon Valley Intercommunity Hospital, please contact: Project Office 560 So. Hartz Avenue, Suite 425 Danville, CA 94526 (415) 831-9626 ONational Medical Enterprises, Inc. I THE SAN RAMON VA III RC OSPJIT 0 r. HOW YOU CAN SUPPORT THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL I . SEND A LETTER OF SUPPORT TO : THE SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL PROJECT OFFICE 560 S . HARTZ. SUITE 425 DANVILLE, CA 94526 AND A COPY TO : MARTHA KESSLER ALAMEDA/CONTRA COSTA HSA 235 W . MACARTHUR BLVD . , SUITE 700 OAKLAND . CA 94611 2 . SIGN THE ENCLOSED ENDORSEMENT CARD AND MAIL IT PROMPTLY! 3 . HELP ON A VOLUNTEER BASIS BY PASSING OUT ENDORSEMENT CARDS CARDS TO YOUR FAMILY AND FRIENIDS . � . ATTEND LOCAL NSA MEETINGS ON OUR BEHALF . WE WILL NOTIFY YOU AT LEAST 1 WEEK IN ADVANCE OF THE MEETING DATE . WE NEED YOUR ACTIVE SUPPORT AND ENDORSEMENT OF OUR CERTIFICATE OF NEED APPLICATION TO BUILD YOU THE HOSPITAL YOU DESERVE ! PROJECT OFFICE O National Medical Enterprises, Inc. 560 So. Hartz Avenue, Suite 425 (415)831-9626 Danville, CA 94526 i THE SAN RAMON VA 10S T SAN RAMON VALLEY INTERCOMMUNITY HOSPITAL PROJECT SUMMARY National Medical Enterprises , Inc. proposes the construction of the San Ramon Valley Intercommunity Hospital (SRVIH) , a full service general acute care hospital that will provide a broad range of primary and secondary medical services. Specifically, the SRVIH will be comprised of the following bed complement: Medical/Surgical 119 Intensive/Coronary Care 12 Perinatal 11 Acute Psychiatric 32 TOTAL 174 In addition to, and in support of, the above inpatient services , the hospital will provide the following ancillary sevices : Cardiopulmonary Clinical Laboratory CT Head Scanning EEG/EMG . Emergency (24 hours) Outpatient Services Pathology Laboratory Surgery Physical Therapy Radiology Recreational Therapy Nuclear Medicine Ultrasound The proposed San Ramon Valley Intercommunity Hospital is a basic community hospital that has been designed to meet the needs of the San Ramon Valley. This area will experience dramatic population growth that will eclipse the growth of other areas within all of the "applicable" planning areas in HSA 5. Separated by a county and HFPA bounday line, this area has been identified as a natural market area by Alameda and Contra Costa Counties. Serious consider- ation must be given to this anticipated sub-regional population growth and development. PROJECT OFFICE O National Medical Enterprises, Inc. 560 So. Hartz Avenue, Suite 425 (415)831-9626 Danville, CA 94526 The major components of this project are justified either directly in the existing State Plan, indirectly in the State Plan, or as necessary services to support a basic community hospital . These components are as follows : o It is proposed that SRVIH include 142 general acute care beds. The State Plan indicates a need for 151 general acute beds , and that a need for 191 beds exists when the beds that are licensed but not ; set-up at the County Hospital are considered. o As proposed , SRVIH includes 32 acute psychiatric beds . While the State Plan indicates a 1985 excess , a 1990 need for 54 psychiatric beds can be demonstrated when the overstated existing inventory is corrected and needs are projected to a date after SRVIH commences operation. o Basic emergency services have been included in the proposed SRVIH. Though there is a 1985 excess of stations in the State Plan , the Plan does not address 1990 need, nor does it give appropriate con- sideration to accessibility of the services. The existing 25-40 minute combined response and transport time and the longer times that will result from increased congestion related to population growth justifies the need for these services. o CT head scanning services have been included since this diagnostic modality has become the standard of medical practice for even basic community. hospitals. o The other services proposed are basic services that have been in- cluded to meet state codes or are necessary given the scope of sevices proposed and the projected volumes of service. The development and operation of the proposed San Ramon Valley Intercommunity Hospital will not adversely effect existing hospitals located in Health Facility Planning Area (HFPA) 411-Concord or HFPA 419-Livermore due to the existence of a large and rapidly growing population concentration in the San Ramon Valley corridor between Alamo and Pleasanton as well as population increases in the immediate communities served by existing hospitals . Existing systems for inpatient acute and psychiatric care are essentially at capacity and future population growth will have to be accomodated by additional health service capacity. Total general acute care utilization in existing facilities will experience more that a 20% increase in patient days , even if SRVIH is approved and operational . The project will be optimally utilized in a reasonable time frame and is financially feasible. Optimal utilization levels will be achieved for all hospital services between the second and third full calendar year after com- mencement of operations and the proposed project will attain an economic breakeven level during the second year of operation. San Ramon Valley Intercommunity Hospital will not duplicate expensive tertiary services but will instead develop transfer agreements with other hospitals offering such services as cardiovascular surgery, intensive care newborn nursery, burn care and radiation therapy. John Muir offers cardiac catheteri- zation services, Merritt offers a complete cardiovascular surgery program, and Eden provieds. burn care and radiation therapy services , while Kaiser- Walnut Creek and Childrens have intensive care newborn nurseries. Transfer arrangements will be made to assure timely patient referrals to patients in need of these regional services. Three alternatives to the proposed project were considered but were determined to be less desirable. To not develop a hospital was an alternative that was rejected because this alternative disregards the fact that the San Ramon Valley is a rapidly growing distinct community with a population base of sufficient size to support a full-service general acute hospital . The concept of expan- ding existing acute care hospitals to accommodate the health care needs of the San Ramon Valley was rejected as a second alternative in that the development of inpatient services in the San Ramon Valley will avert the future maldistri- bution of medical facilities, expansion of existing facilities does not address issues of travel time, distance and cost, and the costs associated with such expansions are as expensive as new construction in many instances. Development of a lesser hospital was rejected as a third alternative. A lesser facility might be less costly in the short term, but in the long term, its ultimate price tag would be substantially higher. The size of this facility has been programmed to meet 1990 needs , that is , the needs of the population during the third full operational year of SRVIH. As with all facilities owned and operated by NME, the San Ramon Valley Inteh- community Hospital will be constructed and operated so as to maintain full compliance with all applicable federal , state, and local standards and regu- lations. The internal organization of SRVIH will emanate from the authority vested in a local Board of Directors. The hospital will have an elected Board of Directors comprised of physicians practicing in the hospital as will as persons representing the residents of the San Ramon Valley Service Area. Consumers will be involved in the decision-making process thereby ensuring that the Board responds to the health care needs and demands of the local population. Through the employment of qualified personnel , San Ramon Valley Intercommunity Hospital will be able to provide the highest quality of medical care. The hospital will be an equal opportunity employer and hire individuals based on their ability, training and , when indicated, requisite licensing and certifi- cation. An ongoing inservice education and training program will afford maintenance of required skills and cognizance of the latest advances in patient care techniques and medical technologies. r. The proposed San Ramon Valley Intercommunity Hospital will provide care and treatment to any and all persons regardless of ability to pay or other non-medical factors. In summary, the San Ramon Valley Intercommunity Hospital is being proposed to meet identified needs for a basic community hospital . Given the rapid growth in the San Ramon Valley corridor and moderate growth in other areas in Contra Costa and Alameda Counties , development of the proposed hospital will not have an adverse effect on existing facilities that are currently operating at capacity. The project is financially sound at rates that are commensurate with other hospitals in the area. For these general reasons and other more detailed information provided in the certificate of need application, the San Ramon Valley Intercommunity Hospital proposed by National Medical Enterprises should be approved.