By Stephen Spotswood
WASHINGTON — VA is known for going beyond deadline and over budget on hospital building projects, leaving patients and medical staffers wondering when they will get the modern medical center they were promised.
It was not until recently, however, that congressional overseers have gotten an insider’s view of why such delays occur, at least in the case of the still-unfinished Orlando VA Medical Center (VAMC).
Poor communication and lack of preparation on VA’s side are being blamed for what will be a considerable delay in the facility’s opening, leaving legislators and longtime VA contractors angry and frustrated.
In 2008, VA broke ground in Orlando with a scheduled completion date of October 2012. Projected to cost $656 million, the 1.2 million square foot center will include 134 inpatient beds, 120 community living center beds and a 60-bed domiciliary when it is completed. When that might be remains unknown, however.
Legislators were informed, not by VA, but by the contractor working on the project, that delays will certainly push the completion date back. Rep. Jeff Miller (R-FL), chair of the House VA Committee, went to Orlando to see for himself what the contractor — Brasfield & Gorrie — was referencing.
“What I saw was startling and unacceptable,” Miller said at a recent hearing on the topic. “There’s a disconnect between VA Central Office and what they were telling me about the delay and the day-to-day reality on the ground. There are problems with the design, problems with specific medical equipment and problems with change orders and how they all fit together.”
|VA Secretary of Veterans Affairs Eric K. Shinseki toured the site of the new Orlando VA
Medical Center in January 2011 and met with construction workers. Construction of the facility has been beset with delays. VA photo by Simon Pierre
A “change order” in construction is when work is added to or deleted from the original order, which would alter the original cost or completion date.
Miller was filled in on the problems in Orlando by Miller Gorrie, chairman of Brasfield & Gorrie, a Birmingham, AL, general contractor whose 40 years of experience in major construction includes 15 years of experience in building healthcare facilities. His firm was selected to build the VA hospital in Orlando.
“Shortly after beginning the job, we realized that we did not have enough information to complete the job,” Gorrie told committee members at the hearing. “We learned that the medical equipment lists that were included in the documents VA provided had been discarded, and VA was allowing the medical center [staff] the opportunity to select their equipment on their own.”
It is customary to design a hospital around medical equipment, Gorrie said. Building designers were unable to complete plans because the equipment had not been selected or was changing.
“We were obligated to coordinate this medical equipment, but when the list began to change, we had no way of doing so,” Gorrie said. “We began construction and got the structure up, but then we got to the interior portion of the hospital. We couldn’t finish the work without the medical equipment information.”
Tim Dwyer, president of the South Region of Brasfield & Gorrie, said that, during the bidding process, VA had chosen about 25,000 pieces of equipment, and the contractor had based their bid on that. Not only has much of that equipment changed, but the list has grown to about 28,000 pieces.
“What was lacking was the discipline of the VA administration to lock down that equipment,” Dwyer said. “They allowed the medical center in Orlando to go out and basically rechoose their equipment.”
The company originally started with 4,800 drawings blueprinting the project. Including the many drafts received, that number eventually reached 10,000.
Asked how this compared with other projects, Dwyer said it doesn’t. “It’s unprecedented for us, in our 48 years of doing business.”
Brasfield & Gorrie attempted to communicate with VA headquarters earlier in the process about the problems they were seeing on the ground. A meeting in May 2011 at VA’s Central Office with the contracting officer ended with the contractor being told to stay the course. A second meeting in November, this time at the job site, resulted in the same message.