Policy Changes and More Realistic Planning Can Reduce Size of New San Diego Naval Hospital

The Department of Defense (DOD) plans to build a new naval hospital in San Diego, California, consisting of 900 acute care beds and 300 light care beds. It would replace the existing facility at Balboa Park. The Navy believes that a new hospital is needed at a new location because of structural inadequacies, inefficient arrangement of hospital buildings, noise problems, and safety hazards caused by commercial aircraft near the existing site.

GAO believes that some construction is needed; however, final decisions on size and location should await the policy guidance needed from Congress which could substantially affect hospital size. GAO found that the criteria used by DOD to size the new hospital did not reflect expected use patterns which resulted in a planned facility with 600 acute beds, and 300 light care beds would be needed if the beneficiary categories continued to use the new hospital in the same ratios that they have in the past. However, if the beds provided for retirees and dependents of the retired and deceased members were limited to 10 percent of the bed requirements for active duty members or their dependents, as called for under DOD policy, only 480 acute care beds would be needed. There are opportunities to further reduce the size of the proposed hospital by clarifying existing policy regarding whom new military hospitals are being built for and establishing a policy that would require sharing of excess acute care bed capacity at other nearby Federal hospitals. If Congress decides that a large hospital is needed, GAO believes either Balboa Park or Murphy Canyon would be appropriate. It would be appropriate for DOD to acquire control of the Murphy Canyon site so it can build at either location if Congress decides a large hospital is needed. DOD can reduce medical costs to the Government and be a leader in demonstrating the feasibility of sharing Federal facilities without adversely affecting the medical training program.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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