Hospital Crises Could Buckle Area Network
Sunday, July 22, 2007
Greater Southeast Community Hospital and Prince George's Hospital Center serve thousands of the region's most vulnerable people, many of whom cannot afford medical care. But the issues that have pushed the two institutions to the edge of failure go far beyond the burden of poor and uninsured patients.
According to local officials, health policy experts and past hospital administrators, strikingly similar circumstances underlie the parallel free falls this year of the District and Prince George's County facilities. Some stem from changes largely out of the hospitals' control, some from leadership and funding questions long ignored or inadequately addressed. Still others trace to poor management or protracted political acrimony.
"There's fault all over the place," said Thomas Chapman, chief executive of the HSC Foundation, who headed Greater Southeast from 1982 to 1992.
"Plenty of blame to go around," noted John M. Colmers, secretary of the Maryland Department of Health and Mental Hygiene.
As the hospitals' futures became more tenuous during the spring, worries about care and fiscal ultimatums resurrected painful memories of the unwinding of D.C. General Hospital, which the city shuttered in 2001. They also renewed a fear: What if the institutions collapse?
Losing another emergency room in Southeast Washington would be troubling, health leaders agree. Losing a busy trauma center in Cheverly would be crippling. But losing both -- and diverting thousands of patients -- would be devastating. In an increasingly regional health system, the repercussions could overload many hospitals.
"I've called it heading for a perfect storm," said Sharon Baskerville, executive director of the D.C. Primary Care Association and a former member of Greater Southeast's board. "I don't think either government is going to let that happen, but my concern is that millions and millions of dollars could get thrown at it without a long-term solution."
That solution is nowhere in sight, but the dual crises, which have been building for decades, could be nearing pivotal decisions.
Thursday, a judge will consider a lawsuit filed by the nonprofit company that runs Prince George's Hospital Center in Cheverly and two health campuses in Laurel and Bowie. All are owned by the county, and if Dimensions Healthcare System does not get a bailout, it says it will have no cash left by early September. Its board of directors is threatening to declare bankruptcy or close the hospitals.
Greater Southeast is in better shape, because District health officials recently pressured its for-profit parent corporation to pay $2 million a month to remedy severe staffing, equipment and supply shortages. It remains far from a full-service hospital, however. And if the money stopped tomorrow, the turnaround would, too.
"We're sending, from a public policy perspective, perhaps all the wrong messages we can send," said Michael Barch, a longtime health care administrator and former chief executive of the city's Public Benefit Corp.
The Washington area's changing composition, especially the growing number of low-income residents, has squeezed hospitals in every jurisdiction. Still, few have faced the same emergency. Institutions in Northern Virginia have been cushioned by a broader distribution of uninsured patients, the strength of the Invova Health System and stability in governance. Potomac Hospital, for example, where nearly a third of care delivered is uncompensated, has had the same chief executive since 1978.