The pain was intense as Kirk Wade hurried to the Shore Medical Center here, where staff told him he might need emergency surgery for a possible intestinal tear.
But there was a problem: The rural hospital had gone through so much downsizing since joining the University of Maryland Medical System there was no surgeon available that day last summer. The closest hospital with a surgeon was more than an hour away in Easton.
And there was another problem: The hospital’s ambulance service wouldn't be available to take him there for hours.
“I could have ended up dead,” said Wade, 74, a retired tax lawyer. “If you live in Chestertown and have a medical emergency that requires surgery, you’re in a crap shoot.”
Wade’s story has a happy ending — he was treated successfully at 3:30 a.m. in Easton, nine hours after his wife rushed him to the Chestertown hospital. Wade was hospitalized for five days on an antibiotic drip, and recovered enough to avoid surgery. But he argues his medical scare underscores the extent to which hospital bosses in Baltimore have let this rural facility atrophy over the past decade, putting residents at risk.
Now, he and other residents of this Eastern Shore town have been incensed to learn that UMMS board members who oversaw the cutbacks at their hospital were themselves winning big-ticket contracts from the medical system.
“They're clearly downgrading services for the northern Eastern Shore, and they're paying themselves millions of dollars,” Wade says. “It’s clearly outrageous.”
The Baltimore Sun reported in March that nine members of the University of Maryland Medical System’s board of directors have business deals with the hospital network that are worth hundreds of thousands to millions of dollars each. The system’s acting CEO met Thursday with the governor and House speaker to give an update on promised reforms.
Some in Chestertown say they were particularly upset to learn that John W. Dillon, an Eastern Shore businessman who was the unpaid chairman of the local hospital’s board, was at the same time being paid hundreds of thousands of dollars by UMMS as a consultant. Residents are suspicious that the payments from Baltimore may have made him reluctant to fight to preserve services at the Chestertown facility.
From the year ending June 30, 2013, through last year, UMMS reported on its tax forms paying a total of $892,000 to Dillon for providing “healthcare consulting services.” Most years show he was paid $156,000, which aligns with the “$13,000 per month” he reported in his disclosure forms filed with state hospital regulators.
Dillon did not respond to requests for comment for this article.
Like other small hospitals, the Chester River Hospital Center was looking for an infusion of cash and services when it agreed to merge with the University of Maryland Medical System a decade ago. The plan bitterly divided the community, and a doctors’ group tried unsuccessfully to block the merger.
Worried that the medical system is focused on bolstering its Easton hospital — where it plans to raise $25 million to help build a new facility — Kent County residents have watched anxiously as their medical staff has shrunk to less than half of its former size, forcing residents to travel more than an hour to other hospitals for key services.
The Chestertown hospital no longer offers maternity or pediatric services. It no longer provides stents for heart patients or dialysis for patients suffering from kidney failure.
In 2009, the hospital had 642 employees. Now it has fewer than 300, county records show.
“Our medical staff has dwindled. We lost specialists and didn’t replace them,” says Dr. Michael Peimer, who practices in town. “Leadership has disappeared. Services have disappeared. It’s been a slow, gradual creep toward a smaller, less effective hospital. So many times people come to our emergency room and have to be transferred. People have lost faith in our hospital being able to provide basic services.”
Residents worry that system leaders in Baltimore are moving to close the community hospital.
Michael Schwartzberg, an UMMS spokesman, said assertions that the hospital network has gutted the facility in Chestertown are “not true.” Rather, he said, UMMS and local administrators are striving to maintain “a sustainable” community hospital.
“We are committed to UM Shore Medical Center,” Schwartzberg said. “Physician and staff positions are being filled, equipment is routinely rehabilitated or replaced, facilities are being upgraded, and essential services continue to be administered at a high level.”
He noted that UMMS added a new multimillion-dollar Emergency Department to the hospital in 2014, and argued that some positions are unfilled because it’s hard to recruit doctors and other health workers to small towns when people leave.
Kent County has the smallest population of any jurisdiction in Maryland — fewer than 20,000 residents — and many rural hospitals across the nation have struggled in the changing health care industry. Since 2010, 106 rural hospitals have closed across the country, according to the North Carolina Rural Health Research Program.
As health care costs continue to rise across the country, hospital networks have found themselves forced to consolidate services to prevent more closures. Even so, state records show the Chestertown hospital is among the state’s more profitable. The facility made a profit of about 15 percent last year — more than double the state average for hospitals.
Residents here say the self-dealing scandal involving the UMMS board of directors, which has resulted in the resignation of the system’s CEO, Robert Chrencik, and several board members, including Baltimore Mayor Catherine Pugh, underscores what they believe was a focus on self-profit, not quality rural health care.
“There’s a culture of lack of responsiveness to community needs,” says Deborah Mizeur, a strategist for a group of Chesterstown area residents and doctors who call themselves Save The Hospital. “They may be a private corporation, but their nonprofit tax status means they’re supposed to be giving back to the community.”
The residents have some powerful allies, among them Maryland Comptroller Peter Franchot, who has blasted the system’s treatment of Chestertown.
“They believe UMMS is going to close their local hospital. They feel the thing is being stripped down to its axles,” said Franchot, a Democrat.
State Sen. Stephen Hershey, a Republican who represents the Eastern Shore, has filed bills aimed at protecting the Chestertown hospital. Hershey recently met with UMMS interim CEO John Ashworth, who told him he is working to bring more mental health services to the hospital.
“We’re trying to figure out a way to make sure our rural hospital remains vital,” Hershey said. “We keep losing services at Chestertown. I think it’s more complex than just blaming it on mismanagement. But the community would like to go back to those days when they had the services they needed. Sometimes it’s just about calling attention to something.”
The revelation of UMMS contracts with members of the medical system board was met with widespread condemnation when The Sun reported it in March. Senate President Thomas V. Mike Miller called the actions a “huge disaster” of “self-dealing.” Gov. Larry Hogan described the contracting practices “unseemly” and “appalling.” And, the late House Speaker Michael Busch, who sponsored emergency legislation to reform the board, said he and some other board members were never informed of the contracts.
The impact was felt on the Eastern Shore as well.
Dillon, of the Talbot County town of Oxford, resigned from both the local hospital board and the UMMS board.
UM Shore Regional Health CEO Kenneth D. Kozel alerted staff in April that the medical system had “taken several actions to address questions regarding its business relationships with certain members of the Board of Directors, including accepting the resignation of John Dillon from the UMMS board.”
Board member Glenn L. Wilson, CEO of Chesapeake Bank & Trust, said in an interview that members scheduled an emergency phone call after The Sun published news about Dillon’s contracts.
“The general reaction was one of surprise. I don’t recall seeing any notification at all that there was contract John had with UMMS for consulting services,” Wilson said. “When that surfaced, we had an emergency board call where this was discussed, and John was removed as chair soon thereafter.
“There’s been a pretty strong reaction from our board to rectify this. We’re going to beef up our disclosure process even before UMMS might do it in Baltimore. There was clearly at least a potential conflict with our chair receiving funds from UMMS while trying to represent us on the Eastern Shore.”
Schwartzberg said Dillon never recommended reducing services in Chestertown.
Meanwhile, doctors in Kent County blasted the selection of Ashworth to serve as the UMMS interim chief executive after Crencik’s resignation.
“It is amazing to the Membership that John Ashworth, who has been the number-two person at UMMS for years, is being allowed to run the system during the crisis,” Dr. Wayne Benjamin, president of the Kent County Medical Society, wrote in a recent letter to Hogan. “We would suggest an outside caretaker be put in to oversee the system while the review you have ordered occurs.”
This month Hogan signed into law legislation sponsored by Hershey that requires a study to assess “the types, quality, and level of services” provided in Chestertown to determine which were reduced or transferred elsewhere. The study is due by Jan. 1.
Members of the Save The Hospital campaign say much more than a study is needed to revive their hospital.
Dr. Gerard O’Connor, the only surgeon remaining at the Chestertown hospital and one of the founders of the campaign, said he’ll know UMMS is committed to rural health care when staff starts to increase and services return.
“They’re allowing us to implode basically,” O’Connor said. “They need to pump some energy and money into this facility.”