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SYDNEY, N.S. — Health officials haven’t given any indication how much a planned redevelopment of Cape Breton’s health-care system is expected to cost, but an internal Nova Scotia Health Authority document shows that the replacement value of the four hospitals involved is currently more than $800 million.

The redevelopment plan announced in June by Stephen McNeil’s Liberal government and the NSHA included new health centres for New Waterford and North Sydney minus emergency departments, and expansions to ERs at the Cape Breton Regional and Glace Bay hospitals.

There have been no projections offered of the potential cost of the projects, as the province won’t release anticipated costs before going to tender.

As for the current value of the buildings as they stand now, the individual asset report dated Jan. 24, 2018 was obtained by the Cape Breton Post under Freedom of Information. It evaluates the current state of the sites of the Cape Breton Regional, Glace Bay, New Waterford Consolidated and Northside General hospitals.

Details of the funding that would be needed by requirement type and year for each facility are redacted from the document.

The current replacement value of the Cape Breton Regional Hospital, which is 577,000 square feet, is listed as $519.3 million. The current replacement value of the 110,000-square-foot Glace Bay Hospital is set at $82.5 million; the 72,100-square-foot New Waterford Consolidated Hospital is $56.36 million; and 201,500-square-foot Northside General Hospital is $151.125 million.

A draft facility review summary report was prepared by Kasian Architecture for the Department of Transportation and Infrastructure Renewal and the NSHA based on site visits between March 5-7 of this year. The report is dated July 2018. It was also obtained under Freedom of Information. Kasian was to “visually inspect each facility, document the more salient pros and cons associated with the facility infrastructure, mechanical and electrical equipment.”

The report lays out the positive aspects and the deficiencies identified at each hospital site.

At the Cape Breton Regional Hospital, which was built in 1994 with a major addition in 2005 for the Cape Breton Cancer Centre, Kasian found that the mechanical and electrical infrastructure are near their end of life and reconfiguration of the overcrowded emergency department should be considered.

“The facility is in need of renewal,” Kasian wrote.

“The exterior envelope of the building continues to present a significant risk to the building fabric as the masonry is failing and permitting water and moisture infiltration into the exterior assembly.”

Among the building’s pros are that its planning grid “will easily accommodate renovation” and the report identifies there being a good deal of available space and it also lists “lots of parking.” It also states that the site has capacity for expansion, with existing parking.

Among the cons, the hospital’s ER and morgue are small, its interior needs updating, its long corridors provide what is described as an intimidating path of access to patients, and high turnover in the facilities department signals “no apparent pride of ownership.”

“Correction of the envelope is essential in order to maintain safe interior and exterior environments,” the report states.

At the Northside General in North Sydney, Kasian noted that that visitors have to travel a steep hill from the parking lot and then access the emergency department to enter the building, with the sloped access presenting “a significant risk to all who access the site,” and the entrance doesn’t meet any current accessibility standards.

While it notes the hospital is well-maintained, the report also states the Northside General lacks privacy, confidentiality, and doesn’t meet standards for heating and ventilation. The way it is constructed also makes renovations “difficult and expensive,” Kasian wrote. The mechanical and electrical work in the building “is in need of major capital renewal” and don’t meet current codes and standards.

The report also includes photos outlining water damage, jerry-rigged ventilation solutions and corridors being used as waiting rooms.

Among the building’s pros are that a new emergency generator was installed in 2016, the hospital is well-maintained and sprinkler and medical gas systems have been upgraded. Among its cons, the report notes there is no land available for expansion, there is no central air conditioning so window units are used, and the motor that runs the cast-iron radiators is 60 years old, with no backup.

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Kasian notes that the New Waterford Consolidated Hospital offers no accessible access at its main entrance and the emergency department lacks privacy as the public and staff use the ambulance entrance to access the hospital. There is ventilation only in the corridors.

Much electrical infrastructure has been replaced, the report states, but mechanical system upgrades are needed. The concrete masonry structure also makes renovations difficult.

The chimney and front entrance canopy need repairs and the building can’t be expanded vertically. The building has no loading dock, and the 1975-era boiler will soon need to be replaced. Among the building’s advantages are that an upgrade to the sprinkler system was to be completed, it is well-maintained and a handwashing station has been added for infection control.

Kasian found that the Glace Bay Hospital can easily accommodate renovation. A review of the elevator system is recommended as there currently is no segregation of clean and soiled materials and service or public use, and that presents confidentiality and infection control risks.

“With some re-planning and ongoing renewal investment the Glace Bay Hospital can continue to service the community for many years,” the report states.

ER patient flow is a problem and the department needs renovations, Kasian found. There are mechanical equipment issues that need to be addressed, the lab needs updating and the windows and roof also need updating.

nancy.king@cbpost.com