The new Riverside Shore Memorial Hospital will be smaller and will open months later than originally planned, according to a letter sent by hospital officials to Eastern Shore residents and hospital employees.

According to the July 22 letter, the facility will have 52 beds down from the 69 announced when ground was broken in October 2013.

The letter was signed by Riverside's Chief Operating Officer Wade Broghman, Shore Memorial Administrator Susan McAndrews and Eastern Shore Medical Chief Dr. David Jones.

Accomack County Administrator Steve Miner said he has been assured that construction of the hospital will proceed despite postponements and a size reduction.

'The local hospital board had been told the hospital will be built. We have been told the same,' Miner said, noting the county was not told Riverside's reasons for building a smaller facility than was first announced.

The plan is to begin site preparation in the fall, the letter said. But it noted, 'There are a few remaining issues to be solved with regard to permitting and site preparation.'

The issues were not detailed in the letter.

Construction should take 24 months, meaning the hospital will likely open in the latter part of 2016. A winter 2015 opening was anticipated at the time of the groundbreaking.

Asked whether the fact Virginia has not approved Medicaid expansion played a role in the hospital's downsizing, Shore Memorial Administrator Susan McAndrews said, 'It is a factor.'

Last year the hospital provided over $12.2 million in charity care to residents who were unable to pay, McAndrews said in a column published in the News in April 2014.

About 75 percent of Shore Memorial's patients are enrolled in Medicare or one of Virginia's Medicaid programs.

Under the Affordable Care Act payments to hospitals which provide services to an above average number of poor patients were phased out last fall; Shore Memorial is projected to lose over $1.3 million this year due to those cuts and other reductions.

The losses were to be offset by increased revenue from Medicaid expansion, but Virginia lawmakers opted not to expand Medicaid.

McAndrews this week noted the hospital's average daily census is only 32. 'Thus, overbuilding is always a mistake,' she said, adding, 'We believe we have right-sized the building and by doing so we can continue with the plans to add a cancer center and the Medical Office Building.'

McAndrews went on to say the average daily census for the ICU is five and the census for labor and delivery is three.

'(L)ike most facilities our size and congruent with the intentions of accountable care, we are primarily (an) outpatient business model,' she said.

Of the 52 beds in the redesigned hospital, 10 will be critical care beds for the sickest patients, the letter said.

More than half the facility will be dedicated to outpatient care. McAndrews said all outpatient functions were retained and none were downsized in the reworked plan.

Both the Riverside letter and McAndrews noted the health care provider recently instituted Saturday hours for urgent needs at its Cape Charles center.

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