Ellenville Regional Hospital is planning a $100 million project to replace its outdated 58-year-old facility from the ground up instead of embarking on a renovation, almost a decade after a similar plan stalled because of a lack of funding.

“It’s a very modern design and very energy efficient,” President and CEO Steven Kelley said in an interview with the Shawangunk Journal, as Chief Operating Officer Ashima Butler displayed renderings of the 25-bed, three-story building. It could be up and running within five years once financing is secured.

The estimated $100 million project breaks down as follows: $83 million for construction, $9 million for architectural and planning fees, and another $8 million for new equipment. Hospital executives considered renovating and expanding the existing building, but the cost estimate was the same as starting from scratch, and a renovation would be disruptive for patients and employees, said Butler.

Funding depends heavily on the hospital receiving a $50 million “transformation” grant from the New York State Department of Health. The grant is crucial: The hospital’s failure to secure it in 2016 throttled its earlier plans. Applications for the grant are due April 10, and the state will announce the awards by July 1. Many needy hospitals across the state are likely to apply for a piece of this year’s $250 million pool of available money.

“We have a much better case now because in 2016, we didn’t have enough savings to really make a meaningful contribution,” Kelley said. “And in 2016, we were still building community support. We are one of the finest small hospitals in America, by any metric, whether it’s innovation, quality, execution or financials.”

The hospital and its aligned foundation have committed to contributing $25 million through donations and from savings the hospital has accumulated during 18 years of surpluses, said Kelley. The hospital would borrow the remaining $25 million, although borrowing could be less if the hospital is able to raise more money elsewhere. For example, Kelley said U.S. Representatives Patrick Ryan and Marcus Molinaro have each promised to seek $5 million in so-called Community Project Funding.

“We are fortunate to have a locally owned and operated hospital like Ellenville Regional Hospital, serving the needs of our communities,” said Ulster County Executive Jen Metzger. “Our residents in the southwestern region of the county deserve a modern facility that conforms to current codes and standards, and we look forward to learning more about plans for a new hospital building and expanded services that a new hospital could provide.”

Kelley has met with the New York commissioner of health and five of six deputy commissioners, and “we made our case, and we talked about our successful rural model,” he said.

Architectural renderings call for the facility to be located near the rear of the property. Once it’s completed, the existing hospital, also with 25 inpatient beds, would be demolished.

Patient rooms in the existing building are about half the size now required, and doors to attached lavatories are only 22 inches wide. “That is not wide enough for someone to navigate in with a walker,” Kelley said. “That is a huge liability.”

In addition, the building doesn’t meet electrical codes or standards of the National Fire Protection Association, Butler said. Its boilers and pipes are corroding, which has resulted in flooding. In response, Chubb, a large property and casualty insurer, dropped the hospital’s coverage.

“We had to pay more than double when we finally were able to find someone who was willing to write us [insurance] because our facility is so old,” said Kelley.

Aging infrastructure isn’t the only factor driving the hospital’s plans. While the building was designed with inpatients as its central mission, advances in technology and medicine mean many surgical procedures can now be completed in a day. About 80% of the hospital’s revenue is from outpatient services, and inpatients are mostly there for rehabilitation after surgery or a major illness that took place elsewhere.

Kelley said the new design would reflect that change, with improved parking, drop-off and movement between outpatient departments. Inpatients would be on a separate floor with more privacy.

More hurdles need to be overcome before the hospital could break ground, including approval from the Wawarsing planning board. It would also have to submit a certificate of need to the state to justify the project.

“This is an important step for our town and our area,” said Wawarsing Town Supervisor Terry Houck. “Ellenville Regional Hospital is a major employer and provides essential services for our people. I want to assure Steve Kelley and the hospital board that we will be with them during this process and will be backing them one hundred percent of the way to the new hospital that they seek to build.”