Environment and Real Estate & Retail

Clinic can't pull its weight: Forest Health leaves behind $11M hospital

April 17, 2006

"They're not the most communicative people in the world, so I don't really have a good reason, other than the fact that I think at one point they thought they had a group of doctors to operate the clinic with, and it fell through," said Jack Hogan, a senior vice president for Indianapolis-based Lauth.

Forest Health corporate attorney Marie Paratto referred questions to Laurence H. Lenz Jr., an

A bariatric surgery center built for roughly $11 million a couple years ago at Intech Park closed recently before it could host its first operation.

Barix Clinics of Indiana managed to draw patients from surrounding states for consultations last year, but its owner struggled to attract surgeons to work at the stand-alone specialty hospital. Last month, Ypsilanti, Mich.-based Forest Health Services told executive vice president with the company. Lenz did not return several calls.

Indianapolis doctors told IBJ that surgeons may have been hesitant to work at the specialty hospital because it had no emergency support nearby, a problem if complications arise during operations.

"My opinion is only maverick surgeons would work in an environment that is not fully prepared to provide comprehensive support for patients," said Dr. Samer Mattar, medical director of the Clarian Bariatric Center.

Forest Health operates eight Barix clinics in six states, according to its Web site. The company filed plans in 2003 to build the 37,000-square-foot hospital at Intech, its first Indiana location.

Most of the construction for the twostory building wrapped up in May 2004, and Forest Health originally forecasted opening that summer, letters sent to the state Department of Health show.

But the building, which Forest Health owns, sat vacant for several months after construction ended.

On top of that, the clinic didn't complete all the steps necessary to receive a license to operate as a hospital in Indiana, said health department spokeswoman Jennifer Dunlap. It still needed to file a fire-inspection report and complete a preoccupancy inspection.

Forest Health did hire one local surgeon, Dr. Steven Clark, and he started seeing patients there a couple days a week last June, said Amy Farnworth, Clark's bariatric coordinator.

Another doctor worked with patients on medically managed weight loss at the clinic, but Clark, who could not be reached for comment, was the lone surgeon.

"They had a few staff members but, really, it was bare," Farnworth said.

Clark drew patients from Kentucky, Illinois and across Indiana for consultations, and Farnworth estimated that he saw between 100 and 125 people there. But he never performed surgery at the Barix clinic.

Forest Health told Hogan at one point last year that surgeries would start at the end of 2005 or early 2006.

Last October, the company sent another letter to the health department stating it planned to start admitting patients in mid-January.

However, when January arrived, the clinic's owners told Clark the building would close. He transferred cases to Community Hospital South and St. Francis Hospital-Beech Grove, two other hospitals where he operates.

Bariatric surgery treats patients who've gained a life-threatening amount of weight. In some cases, it involves restricting the size of the stomach or bypassing the intestine. The surgery also can involve severe complications.

Because of that, surgeons may have been hesitant to sign on, doctors say. The full-service hospital nearest Intech, which sits on West 71st Street near Interstate 465, is St. Vincent Indianapolis-more than six miles away on 86th Street.

"I have to tell you, it doesn't surprise me at all that this center shut down," said Clarian's Mattar.

Mattar said morbidly obese patients often suffer from other ailments too, like heart disease, diabetes and sleep apnea. To care for these patients, the surgery center should have access to specialists who treat those problems.

Several bariatric surgery programs already operate in central Indiana, and they're all inside a hospital, said Dr. Dana Lindsay, lead surgeon and medical director of the Johnson Memorial Bariatric Center.

The vast majority of these surgeries involve no complications, and the patient leaves a couple days after the procedure, Lindsay said. But she noted some cases require prompt emergency care and can require equipment like a ventilator.

"The last thing I want is to be in an isolated facility where I don't have a pulmonologist who's right down the hall treating his own patients," she said.

Aside from medical support, a connection to a hospital helps generate referrals to a bariatric program. It might have been difficult to generate enough business without a hospital or physician network affiliation, said Bruce Gordon, vice president of leasing and brokerage for Indianapolis-based Bremner Healthcare Real Estate.

"You need a lot of people referring their patients to that facility before it would work," he said.

David Charles, a partner with the Indianapolis-based accounting firm of Katz Sapper and Miller, agrees. "I think it's problematic to just open a box and expect people to walk in."

The surgery center sits on 7 acres, surrounded by more than 150 empty parking spaces. Forest Health bought the land, then paid Lauth to build the center.

The company never revealed the construction cost, but consultants say a building like that probably cost up to $300 per square foot-or about $11 million.

Its future is uncertain. Forest Health might sell the building back to Lauth, although Hogan said the company hasn't declared its intentions. The company also could sell some of the land. It had bought more acreage than it needed in case it later wanted to expand.

Hogan said the building was specifically constructed for bariatric surgery, complete with 4-foot-wide doorways. Another medical use might be a possibility, although alterations would have to be made.

Intech Park has seven office buildings, and it might add a 150,000-square-foot building this summer, Hogan said.

He said he's fielded a lot of calls about the bariatric center's availability, too.

"We'd like to make sure somebody good ends up in that building," he said.
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