Uninsured Help Sap Finances Of Hospital

Hospital leaders suggest major renovations would be a start.

The needs are immense, going beyond aesthetics. For example: $1.7 million to replace a CT scanner that takes 30 minutes to produce pictures that other hospitals can take in five; 24 top-of-the-line intensive care beds that rumble and vibrate to prevent bedsores, at $30,000 each; and eight fetal monitors at $16,000 each.

At the Cheverly facility, where a county-run hospital first opened in 1943, the doors of one set of elevators have a dull shine from decades of use. An elevator sometimes shuts down, trapping hospital staff members and the occasional patient between floors. A boiler room holds a noisy ventilation system installed in 1957. Strips of insulation hang from the pipes, and a makeshift pan collects water that regularly drips from joints.

Small repairs will not be enough, hospital leaders said. A $2.5 million renovation in February to the labor and delivery wing brought private rooms with individual showers and two birthing suites designed for natural childbirth, rarities for the region. The walls were covered with deep wood paneling, and shaded lamps that cast a soft glow in the hallways were installed to appeal to expectant mothers with insurance.

"It looks like a hotel," said Tanya Mitchell, a nurse who directs the unit.

But it has still not been enough. Most of the estimated 3,000 women who will give birth at the hospital center this year still will not have private insurance, she said.

County Executive Jack B. Johnson (D) said he thinks replacing Dimensions, which he has accused of mismanagement, is a key to restoring the hospital system to financial stability. He has said he is negotiating with a company that could take over, but a deal is not at hand.

Johnson and the County Council members also think state leaders should do more to help the facility, given its importance to health care across the region. And the county executive has proposed that the system consider declaring bankruptcy in hopes that a court-ordered restructuring will help wipe out long-standing debts and help the system start anew.

Dimensions leaders say they, too, think new managers are needed. With major advertising, a new name -- preferably that of a well-known organization such as the University of Maryland or Johns Hopkins -- could convince more affluent residents that the hospital system was doing something new.

But Johnson and other negotiators have found that Dimensions is not a tempting offer for other companies. The county owns the hospital's land and buildings, meaning the system brings few assets to the table.

Payments Dimensions makes each year bite deep into reserves: $7 million to repay bond debt that helped build a surgery wing in 1995 and $18 million to support a 1970s-era pension plan.

"The underlying financial infrastructure is so fragile that the periodic incremental payments of $5 million here or $5 million there is not sufficient to solve the problem," said Ecker, who advocates a regular and stable source of yearly government funding to pay for the uninsured, on top of money for improvements.