2012-10-24 / Front Page

Future uncertain for Burke Medical Center

By Anne Marie Kyzer

Officials say the best bet for Burke Medical Center now is to find someone to lease or buy the hospital.

They’ve already begun pursuing that possibility since learning last week a loan to finance the facility during a turnaround period was denied.

Burke County Hospital Authority members say if that doesn’t happen, they may look for financing under a new plan. The worstcase scenario would be to close the doors on the 60-year-old hospi- tal.

The authority needed about $3.5 million in financing for the coming year and authority chairman Gerald Murray said another $3.5 million or more would be needed in the following two years, after which the facility was expected to begin turning a profit.

But they learned last week the loan was denied, Murray said, based on long-range projected losses.

He said their only two options now are to find a company to lease or buy the 40-bed facility or close it. He later added that the authority would also look for financing with a different plan before they let it shut down.

He called it “a shame” that the hospital is in this position.

“I’m still convinced it can survive,” he said. “We would exhaust absolutely every single avenue before we would close the hospital. None of us, under any circumstance, would want that hospital to close.”

The authority has been working for months with a private management company, Partners First, to right the path of the struggling facility.

They’ve relied on a $2 million line of credit to fund operations since June 1 when they took it back over from the previous leaseholder Health Span LLC.

But the hospital has been losing an average of $370,000 each month, and forecasts presented last week indicate the money will run out by Nov. 22.

They intended to rely on additional loans after that point.

Now, they will look to the county to prop up the hospital while they entertain proposals from at least three entities Murray said are interested.

Though negotiations are not far enough along to be made public, Murray said a promising non-profit and two other companies have expressed interest.

County commission chairman Wayne Crockett said the commission has not had a chance to meet since the news of the loan denial broke last week, but he doesn’t see the county denying help.

“I told (the authority) we need to know about what’s going to happen,” he said. “We are exploring a lot of options but I don’t think the county has any choice but to support the hospital.”

How long that support continues, he said, is what is up in the air.

At a hospital authority meeting last Thursday, Murray said they may be looking at a six month transition period.

In the meantime, a number of cost-cutting measures will be put into place, according to Stephen Shepherd, CEO of Partners First.

He said they are currently looking at a staffing reduction and skill realignment in light of the impending closure of the obstetrics program. Shepherd said looking at closing the OB program became a higher priority after being told local obstetrician Mark Gresham would be closing his practice here. Dr. Gresham said he has not announced such a move yet.

Shepherd said weekday coverage by hospitalists will also be eliminated beginning Nov. 1 and another price increase for services will also go into effect.

Lastly, after announcing recently that a contract had been signed to bring a new pediatrician here, Shepherd said that agreement has been cancelled. They have also cancelled recruitment efforts for an internist who was to begin work at the hospital next April.

The news of the loan denial was announced at a hospital authority meeting last Thursday, where authority members, physicians, hospital employees and others crowded into the board room to hear the latest update on the facility’s progress.

But after reports on finances, cost-saving measures and physician recruitment, Dr. Gresham and Dr. Farnk Carter seized the opportunity to question the course of action that’s been taken.

“We’ve lost over half our medical staff and nobody has asked why,” Dr. Gresham told authority members. “You’ve made it so difficult that you’re losing your local physicians. You might as well close the doors.”

Since June 1, five of the nine local doctors who had served on the medical staff at the hospital have resigned. Dr. Joseph Jackson Jr.’s resignation was effective Oct. 8 and longtime pediatrician Dr. Shelley Griffin made his resignation official several weeks ago. Dr. Griffin had previously resigned months ago but had agreed to stay on while Shepherd tried to stabilize the hospital’s labor and delivery program, which needed a pediatrician to make it feasible. The remaining medical staff includes Drs. Gresham, Carter, Johnny Christian and Bonnie Jenkins, all of whom were at the meeting

Dr. Gresham said Murray had made the doctors look like villains and the newspaper had been biased against them as well.

“I hope you’re proud of yourself, Mr. Murray,” Dr. Gresham’s wife Candy told him.

Dr. Gresham questioned whether the hospitalists, doctors who have been contracted to cover the floor and cover call, are paying their way or putting the hospital in the red.

“Local physicians were called to develop a call schedule and they were told they weren’t trustworthy,” Dr. Gresham said furiously. “I have never not shown up when I was supposed to and I think I can speak for every physician in this room.”

Authority members later said having hospitalists on call seven days per week was necessary, considering the possibility that all the physicians could walk away from the hospital one day, a threat Shepherd felt was real over the summer. Authority members said it was irrelevant whether they thought it was likely or not, it was a chance they couldn’t take for the sake of the hospital.

While much of their arguments centered on the hospitalists, many of the comments focused on the tension that’s been a factor since last October when the hospital fell into dire financial trouble.

“We can sell or lease this hospital or we can lock the doors,” Murary said. “So you can argue about call pay or you can argue about anything else, but this hospital is in trouble.”

Dr. Carter, who served as Chief of the Medical Staff, told the group “it’s time for all the players to sit down and see what can be done. So much of what’s been done has been an energy-wasting peeing contest.”

Dr. Carter went on to announce that he’s resigning as chief of the medical staff but will remain on staff at the hospital. He added that the breakdown all along has been the lack of mutual support.

“We’ve been here every day but there’s been no support,” he said. “I’m not lobbying for our pay but these hospitalists have been union busters. They were hired to create friction and anxiety.”

“There has to be a different tone set by different leadership,” he said, specifically referring to Murray.

Dr. Gresham said it was never about the money, “it was about the willingness of the community to come together and fix the problem.”

Meanwhile, Murray said some local physicians have been resistant to any plans for progress at the facility.

“They need to quit being resistant,” he said. “I wish they could see it’s to their benefit to bring these new doctors in. If the hospital closes, they’re out in the cold.”

He said Dr. Jenkins, who affirmed in the meeting that she was on board to do whatever necessary, has been the only physician who has refused to take a dime of her call-pay.

When County Commission Chairman Wayne Crockett asked Dr. Christian, who has served on the authority since August, what his thoughts were, Dr. Christian said the hospital had already been losing $200,000 per month and is now losing $370,000 and saw the medical staff go from nine physicians to four.

He later suggested that if the hospitalists and Partners First management agreements were eliminated, the hospital would see $150,000 savings per month immediately.

Authority vice chairman Chris Collins noted, however that the hospital needs management to move forward.

“The biggest expenses we have are the hospitalists and the management company,” he said, noting a consultant could provide management for a lower fee.

Steps have been taken to only utilize the hospitalists on the weekends but authority members agreed that Partners First needs to remain on board until the hospital’s path has been planned.

Aside from the management services, Murray said they have too much in motion to let them go now, such as an anticipated $1.7 million incentive payment due to the hospital for implementing electronic medical records.

The one thing they have all been able to agree on is that there is still plenty worth saving at Burke Medical Center.

“Those department heads are all still so committed,” Shepherd said after meeting with them last Thursday afternoon.

He noted the staff at the hospital is highly qualified and many are working for salaries that are far below the industry standard.

“I have never worked with such a dedicated group of people,” he said.

Dr. Carter said there’s a “good product there that needs to be nurtured, not alienated,” referring to the facility as well as the employees.

“I’ve never seen anything as destructive as the last year,” he said. “There’s a lot of suffering but the biggest suffering is by any employee who loses their job.”

He added that the real enemy of them all is the environment in the healthcare industry, where reimbursements continue to decline and more and more uninsured need care that can’t be paid for.

“You can blame this on individuals, you can blame it on Gerald, me or Stephen Shepherd,” he said. “Let’s don’t get lost in individuals. The enemy remains the ability to pay and collect and the amount of uninsured out there. Plenty of places work with discord. Money is the root of this.”

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