3,200 Bed Hospitals Anyone?

New York Presbytarian Hospital/Weil Cornell Medical Center is the largest medical facility in the United States, with 2,236 beds.  The largest hospital west of the Mississipi is Babtist Medical Center in San Antonio with 1,414 beds.  The largest hospital in California is Ceder Sinai in Los Angeles at 947 beds.  The big project in the offing in San Francisco--will they or won't they come to terms with the city!--is Sutter's 555 bed Cathedral Hill project.  The venerable Walter Reed Hospital reached a maximum size of 2,500 beds during World War I.

These projects in the United States are dwarfed by the hospital construction program currently under way in Turkey, with less than 1/4 of U.S. population.  The Turkish Ministry of Health has launched a major PPP procurement program to deliver a new wave of healthcare campuses and hospitals for the country.  In an interview, Federico Ferrari, Partner at DLA Piper Istanbul, who is acting as PPP legal advisor to the Ministry, reports that 16 projects have been tendered, including two with more than 3,000 beds.  All of them are larger than projects currently on the books in the U.S. 

The consortia bidding on these projects are predominantly from Italy and Spain.  Some American consulting companies are involved, but not, apparently, any U.S. general contractors.  Ferrari describes that these PPP proposals proceed on parallel tracks, with the final decision being based predominantly on price.  The price is driven down during a final head-to-head auction, which has included as many as 200 rounds of bidding.  The last consortium standing gets the job. 

Kayseri, Turkey, will build a new 3,200 bed hospital

Ferrari discusses currency and inflation risks, which are shared by the Ministry and the successful consortium up to 25% fluctuation; thereafter the ministry takes the risk. 

Apparently the ministry would like to see additional consortia compete for these projects.  Of the 16 projects tendered, 8 have been awarded to date, with six of these still in negotiation and two having reached commercial close. 

So, Turkey anyone? I hear it's a nice place.