PORTLAND — Maine Medical Center has submitted preliminary plans for a $40 million expansion that would add four operating rooms to its Portland campus.

The 40,000-square-foot addition would have glass walls and be built on top of the hospital’s Lower Bean Building, near the emergency department at 22 Bramhall St. Maine Med also will add 49 positions to staff the building.

“The architecture of the building is compatible with the existing structures within the campus,” the application states. “It is intended to promote healing while providing staff and visitors with a pleasant experience.”

The project comes as the Legislature is embroiled in a battle about how to pay down its $186 million debt to 39 hospitals for Medicaid reimbursements. The state’s reimbursmement would release $298 million in federal funds. Democrats have tied hospital debt repayment to an expansion of Medicaid, which Gov. Paul LePage opposes.

It also comes one month after Maine Med, which is owed $67.7 million in state and federal Medicaid funds, announced a hiring freeze and other spending cuts to make up a $13.4 million operating loss in the first half of the hospital’s fiscal year, which ended March 11. Hospital officials attributed the loss to a decline in patient volumes and an increase in the number of patients who are not paying their bills.

Mitchell Stein is the policy director for the Consumers for Affordable Health Care, a consumer advocacy organization in Maine since 1988. Stein said he was not familiar with MMC’s project, but he did raise questions about hospital spending in general.

“We are concerned with the way hospitals spend their money. They on the one hand cry poverty and they need to do layoffs and have the debt repaid, and yet large building projects keep going on,” said Stein, who also highlighted executive pay as a concern.

“In general, projects like that need to be examined to make sure they’re really improving health care and not just increasing costs,” Stein said.

Mark Harris, MMC’s senior vice president of planning and marketing, said in a phone interview Monday that he could not answer questions about the expansion because the hospital’s board of directors has not formally endorsed the plan, even though it was submitted to the city last week. The board meets again on June 6.

Maine Med isn’t the only hospital moving forward with an expansion project amid uncertainty over Medicaid reimbursements. Eastern Maine Medical Center in Bangor is undertaking the first phase of a $250 million project for a seven-story tower on its campus, adding, among other things, more private patient rooms and more than a dozen operating rooms.

The Planning Board will conduct a workshop on the proposed Maine Med expansion on Tuesday, June 11, according to city Planner Jean Fraser.

Jeffrey Sanders, MMC’s executive vice president and chief operating officer, said in a May 24 letter to city planners the addition “will modernize and upgrade MMC’s surgical facilities by enlarging (operating rooms) to meet standard of care requirements.”

Fraser said the three-story addition would add 69 feet onto the height of the Lower Bean Building, which faces Congress Street.

A glass-walled addition is uncommon in Portland, but not unprecedented, according to Caitlin Cameron, the city’s urban designer. Glass architectural elements have been used to a lesser degree at the Portland Public Library, Ocean Gateway Terminal and several Bedford Street buildings on the University of Southern Maine campus, said Cameron, who hasn’t fully reviewed the proposed design.

“This kind of architectural expression is common in contemporary institutional buildings; we just don’t see a lot of it yet in Portland,” Cameron said.

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