[Jtsummers]

At some point you must choose your bottlenecks. Excess physical capacity doesn't have to be used all the time (that is, there's no "currency" for a bed, and other equipment can be rotated through use and maintenance cycles). If you choose to constrain yourself with the number of beds needed for your 99% situation, then you can't expand beyond that without great difficulty. If you have physical capacity for your 99% situation x 2 or even just one or two extra beds, then you don't have to maintain full-time staff for it. You could extend staff hours, or bring part-time staffers to full-time hours, or bring in (with supervision) students from a nearby medical or nursing school to handle what they can and offload the burden for that 1% situation.