Prince George's County Council acted like the Board of Health Tuesday, questioning the timing and decision-making process behind Dimensions Healthcare Systems plans to replace Laurel Regional Hospital with a $24 million ambulatory care center.
The transition is expected to be completed by 2018; the hospital's maternal and child health unit will close Oct. 11.
At Tuesday's meeting, Dimensions President and CEO Neil Moore ensured that the multi-facility organization was not "vacating Laurel community," but instead, following the changes in healthcare systems across the country. The national focus, or "triple arm," is designed to improve health of the population, improve quality care and patient experience, and reduce the per-capita cost of healthcare.
"The reason why we're here at this juncture with Laurel Regional Hospital is because we have seen significant decline in volume that has seen decline in revenues," Moore told the council. "We sought assistance from a nationally known company, Kaufman Hall, to come in and assess the declines we've seen in revenues."
Kaufman Hall and Associates Vice President Chirag Patel said that having the hospital transition to an ambulatory care center will reduce readmissions, effectively cutting costs.
Kaufman Hall representatives later presented Dimensions with five options for Laurel Regional, including keeping the hospital open, repurposing the facility as a specialty hospital or "exiting the Laurel market."
Patel explained that the market is currently over-supplied with inpatient beds.
"Typically, the hospitals didn't have to worry too much about the volume they served to keep the beds filled and the competencies high," he said. "Frankly, inpatient care is decreasing in demand with the increases in technology."
County Councilwoman Mary Lehman later asked how much Kaufman Hall's study cost; Moore told her it cost $400,000.
The study is ongoing. While Moore said Dimensions has "always posted our finances," Lehman said she still did not find the process easily accessible.
"If I could've seen the losses, am I supposed to interpret that, 'Oh, well, Laurel is going to close any day now?'" Lehman asked. "Where did this come from? How did this happen? Either someone was being dishonest and disingenuous 10 years ago or they're being dishonest and disingenuous today."
Prior to the presentation, Laurel Mayor Craig Moe said he understood that Dimensions is on a path of their choosing, but that now is the time for state, local and city officials to sit down with Dimensions' representatives to discuss other options.
"I think there are a lot of smart people out there who, if we could bring people to the table, we could come up with a solution," Moe said. "That's just never been done. This was done behind closed doors by management. I think the city and the northern end of Prince George's County need an acute care hospital 24/7."
Likewise, Maryland state Del. Joseline Peña-Melnyk said the state delegation and senate have submitted their own request to sit down with Dimensions Healthcare Systems.
"We all feel very strongly that what they did was a mistake; that they should have never voted to close the full-service facility," Peña-Melnyk said. "We also requested a bill that would require a hearing at both the county and state level in the future for future instances."
Philip Nichols Jr., Dimensions Board of Directors chairman, said they've done everything possible to try to keep Laurel Regional afloat, including bringing in current hospital President John Spearman and other personnel changes.
"Why did we decide so quickly? We're losing $50,000 a day. We've lost $108 million in the last 10 years," Nichols said. "We can't invest in the system. Every day when you walk out to your car, you hear four or five advertisements for hospitals. We can't do that."
Having compared Dimensions' actions to "a thief in the night," Peña-Melnyk said there's a lot of work among the elected officials to analyze all possible angles and directions.
"They should have tabled [the decision]," Peña-Melnyk said in a previous interview. "They should have come to us and discussed it. ... Everything just looks very orchestrated from their part and it's very sad because it has a real public health impact."
During a question-and-answer session later in the meeting, council members Dannielle Glaros and Todd Turner both agree that Dimensions' communication to elected officials and the community was poor.
"This was a failure with respect to notification and explanation and bringing stakeholders into the process," Turner said.
Regarding the closure of the hospital's maternal and child health unit next month, Spearman said the decision was based on doctors' relationships with other hospitals in the area. Since most of the hospital's maternal medicine doctors have other practices elsewhere, such as Holy Cross, Spearman said patients will follow the doctors.
1199SEIU union Vice President Jennifer Epps disagreed.
"It can take up to 50 minutes to get to a full-service hospital in rush hour," Epps said. "We're concerned about our workers who will lose their jobs, but we're also concerned for the patients we've cared for. At every turn, we've been met with obstacles and delays to receive information. If the decision to close the hospital is a sound decision, why the secrecy?"