Hospital Executive Holds Out No Hope
Pr. George's Leaders Say Efforts to Save System Continue
By Rosalind S. Helderman and Ovetta Wiggins
Washington Post Staff Writers
Wednesday, April 11, 2007; A01
Surrounded by scores of grim hospital employees, the chief executive of the ailing Prince George's County hospital network said yesterday that he saw no option but to close the system, as state and local officials traded blame for the failure of a compromise to save it.
After a deal collapsed in the waning moments of Maryland's 90-day legislative session Monday, state officials said the three hospitals and two nursing homes in the county-owned system could close as soon as June, and they pledged $20 million toward an "orderly" shutdown. Gov. Martin O'Malley (D) and many lawmakers blamed the County Council for foiling the deal.
County Executive Jack B. Johnson (D) and council members said they will continue working to keep the facilities open.
"I cannot throw in the towel," Johnson said at a news conference yesterday.
Across the Washington region, health-care providers began to sound alarms about a closure's effect on the region's hospital network. The Prince George's system treats 180,000 patients a year -- many of them uninsured. Where would they go? What would happen to the 3,100 trauma patients a year taken to Prince George's Hospital Center's busy emergency room in Cheverly? And what about the 3,500 babies born each year at the hospital?
"The closing is going to upset the equilibrium of the entire [trauma] system," said Ronna Borenstein, a spokeswoman for Suburban Hospital in Bethesda
G.T. Dunlop Ecker, president and chief executive of Dimensions Healthcare System, which manages the hospital system, said he will convene an emergency meeting of the board of directors Monday to consider bankruptcy court protection or closure. He said that the hospital system does not have enough money to survive bankruptcy proceedings and that he will advise shuttering instead.
"I agree that it's hard to believe we're going to shut down, but at the moment, I see no other alternative," he said.
State Secretary of Health John M. Colmers said that county health facilities could close as early as June and that his office has been working with the Maryland Hospital Association and the organization that coordinates the statewide emergency medical services on reallocating patients.
But Johnson said he was looking for the $30 million necessary to keep the hospital running for the next year. He pledged to keep working with the nine-member council to reach an agreement on the best way to proceed. He said talk of a closure was "not appropriate."
O'Malley (D) did not share Johnson's optimism. He said that he is "always willing to continue to talk" but that discussions at this point must take place between the council and the county executive.
O'Malley had hoped the General Assembly would pass a bill to establish a state-appointed authority to manage the hospital. The authority would have shepherded the hospital through a transition period, taking over from Dimensions and eventually selling the system to another company. The authority would have taken over the hospital's land and buildings, which are owned by the county and leased for $1 a year to Dimensions.
The deal would have cost $329 million over eight years, with $170.3 million from the county and $158.7 million from the state. O'Malley and Johnson both indicated their support for the deal. Legislative leaders said they, too, were willing to tackle the procedural machinations necessary to pass the bill in the final hours of the session.
But Council Chairman Camille Exum (D-Seat Pleasant) said early Monday evening that the council could not commit to the deal. State lawmakers said they were unwilling to endorse the package without the approval of the council, which would be responsible for yearly appropriations to the hospital.
The County Council "apparently didn't realize the importance of coming together," O'Malley said yesterday.
A chorus of officials yesterday blamed council intransigence for the failure to reach a deal. Ecker called the council's actions a "profound breach of public trust," and Senate President Thomas V. Mike Miller Jr. (D-Calvert) said council members had "performed a great disservice" to county residents. Del. Doyle L. Niemann (D-Prince George's) accused them of "sabotage."
All nine council members stood together at a news conference yesterday afternoon and defended their actions. They said the deal had been put together hastily, left unanswered questions about hospital assets and did not provide a comprehensive, long-term solution for the hospital's problems.
"We believe this was a bigger Band-Aid, and we will not be supportive of those efforts," Exum said.
Council members said they also could not agree to an eight-year plan because it would tie the hands of future officeholders.
Exum called on all sides to "come back to the table" to discuss the next steps -- although she insisted that the hospital system's future would be determined by Dimensions, a private company, and not the county or state.
Health-care providers from across the Washington region worried about the ripple effect a closure would have on their hospitals and on the delivery of health services, especially to the county's uninsured residents.
Michael J. Chiaramonte, chief executive of Southern Maryland Hospital in Clinton, said a shutdown at Prince George's could create a "medical malady." Longer trips might discourage some sick people from seeking treatment, he said, and might delay treatment for people who are critically ill.
James F. Caldas, president of Washington Hospital Center, said his hospital and others in the area are already "under siege" because of the closure of D.C. General in 2000. Washington Hospital Center has had a 46 percent increase in admissions through the emergency room, from 13,000 to 19,000. "The safety net is at its breaking point," Caldas said.
Prince George's Hospital Center also has a neonatal unit that treats some of the region's most fragile premature babies.
"If the hospital closes . . . I don't know what in the name of God we'll do. It's the only show in town," said Mary Jelacic, executive director of the Pregnancy Aid Center in College Park, which provides prenatal care to about 600 poor and uninsured women a year.
Hospital employees said they are still hoping for good news.
"We're in a state of shock and denial," said Kathleen Walker, who has worked as an administrator at the hospital for 32 years.
Staff writers Nelson Hernandez, Mary Otto and Lisa Rein contributed to this report.
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Q & A
How soon might the hospital close?
Unclear. The board meets Monday to decide on a bankruptcy filing or a shutdown. State officials say as early as June.
Who uses the hospital system?
180,000 patients a year, 80 percent from Prince George's County; 50 percent are uninsured. System specialties: trauma care, obstetrics, seniors, long-term patients.
Who works in the hospital system?
2,300 doctors, nurses and other staff; $175 million annual payroll.
Why are the system's trauma centers so important?
Prince George's Hospital Center handles 48,000 emergencies a year; Laurel, 36,000; Bowie Health, 38,000. Doctors warn of longer trips to other hospitals and increased crowding at remaining trauma centers.
Where else could patients go?
Suburban in Bethesda, Anne Arundel Medical Center, Washington Hospital Center in the District, Holy Cross in Silver Spring, Washington Adventist in Takoma Park, Southern Maryland Hospital Center, Doctors Community in Prince George's, and trauma centers in Baltimore and Washington.
How full are nearby hospitals?
At or near capacity. When a hospital is over capacity, it has a "yellow alert." Washington Adventist had 20 yellow alerts last month; Doctors Community, 20; Suburban, one.
Sources: Dimensions Healthcare System, Maryland Institute for Emergency Medical Services Systems, Maryland Health Care Commission, Maryland Hospital Association, Washington Hospital Center.
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By Mary Kate Cannistra, The Washington Post - April 11, 2007
