A housewife, a urologist and a financial consultant -- all presidents of private Prince George's hospital organizations -- are caught in a struggle for more hospital beds -- beds that he Southern Maryland Health Systems Agency says are not needed.
Ann Shoch, president of Fort Washington Community Hospital Inc. -- a hospital that has yet to be built -- wants 120 beds. Dr. Francis Chiaramonte, owner of Southern Maryland Hospital Center in Clinton, wants 155 beds to add to the 300 he already has. And Mary P. Hayes, owner of Clinton Community Hospital, wants to replace her 33 beds with a new 120-bed unit. All appeared determined to get them.
But there are 1,482 hospital beds in the county already -- 2.23 for every 1,000 county residents. The Southern Maryland health agency, which reports to the Maryland Health Planning and Development Agency, says there are too many beds, that existing beds are not fully used, and that no community is too far away from a hospital.
Its official plan, updated last December, says no more beds should be built. An empty bed costs 50 percent as much as an occupied one, the local agency says, and this increases the cost of patient care.
When the hospital organizations decided to pursue their applications for additional beds, the agency agreed to review the number of medical-surgical beds allowed. In July, it asked the hospitals to withdraw their requests until the review is finished in February. Shoch and Hayes agreed but Chiaramonte refused. The health agency then recommended that his application be rejected.
Even after the review, said agency Director Robert W. Sherwood Jr., a change of policy is unlikely. "We really consider that we have enough beds in P.G. We'll take another look at it, without prejudice -- actually, it's a normal process -- but it's really not that out of date. Some people just get disappointed."
The hospital presidents and other county hospital officials give several reasons why applications for additional beds are unusually high this summer:
New 1980 Prince George's census data shows the population of the two election districts where the hospital sites are located have increased during the past decade by about 42 percent, while the county has grown by only one-half percent.
The federal government plans to withdraw funding for health systems agencies by 1983 and there is some fear by hospital officials that the state may impose a moratorium on hospital expansion until a new system of supervision is devised.
Fear by hospital officials that a new HSA system would be financed by application fees. (One draft proposal calls for a $10,000 fee for an application for expansion.)
Fear of being "beaten" by other hospitals when hospital beds are being allocated.
This summer is not the first time that the three hospital groups have applied for more beds at the same time.
On this latest round, Chiaramonte fought hard for the additional 155 beds for his hospital. At the HSA hearing in July, he brought a camera and video-taped the proceedings. A day before the hearing, he took a full-page ad in The Washington Star calling on the HSA to approve his application.
When the HSA voted 15-6 against him, he took out another full-page ad to protest. State Sen. Peter Bozick (D-Camp Springs) stood up at the meeting to protest the decision, as did State Del. Charles Blumenthal (D-Oxon Hill).
Bozick, who is Chiaramonte's brother-in-law and a longtime supporter of Southern Maryland Hospital, later arranged a meeting between Southern Maryland Hospital officials and Gov. Harry R. Hughes to discuss the hospital situation.
Bozick said he arranged the meeting at "the request of citizens," and that his first request for a meeting was turned down. But he refused to say more than that. Chiaramonte did not return a reporter's phone calls.
The meeting, which took place Tuesday afternoon, was attended by Bozick, Blumenthal, State Del. Frederick C. Rummage (D-Camp Springs), and several representatives of Southern Maryland Hospital, but not Chiaramonte.
Hughes press aide Norm Silverstein said Rummage told Hughes the group would like him "to cut through some red tape." Silverstein said Hughes replied: "I'll look into it but frankly I can't make any promises."
Hughes then spoke briefly to a group of about 50 Southern Maryland Hospital supporters outside his office, Silverstein said.
Hospital struggles are not new for Mary Hayes, either. She came to Clinton Community Hospital as a financial consultant from Newport News in 1968. Two years later she bought the 33-bed private hospital and bought 41 adjoining acres. From the beginning, she said, she planned to build a large hospital complex. The state said only one hospital should be built in southern Prince George's, and Hayes spent much of the next five years fighting Chiaramonte over who should get that hospital.
The conflict reached its peak in 1974 when Hayes, then 54, was arrested and charged with conspiiring to break into Chiaramonte's office. A private detective hired by Hayes claimed he planned to crash-land a small airplane on Chiaramonte's hospital site to prove it was dangerously close to Andrews Air Force Base. All charges against Hayes were dismissed.
Chiaramonte won permission to build his hospital, and Hayes was left with 33 beds. She said she then changed her plan from a general hospital to a "hospital campus" primarily for the elderly. There were no competing institutions in the area, she said.
Hayes said construction will begin in about 10 months for a 180-bed nursing home, for which she has HSA approval. When this is completed, she said, she plans to build "sheltered housing" for 200 elderly people, an apartment complex for 400 elderly people and offices for 36 physicians.
The 120-bed medical-surgical unit Hayes has been trying to get would round out the project, she said. She hopes to complete the "campus" in 10 years.
"It's a tremendous concept, and it's staggering to think about it," she said. Her project would cost more than $70 million, by 1980 cost figures, she said.
Dr. Warren Dacus, a consultant for both Clinton and Fort Washington hospitals, believes 1980 census data support the arguments for more beds. An empty bed, he said, costs less than 10 percent of an occupied one, rather than the 50 percent figure used by the HSA.
"I am sure it will be approved," said Shoch of her own application to build a Fort Washington Community Hospital. "If you look at the figures you see that we are really underserved."
Shoch lives five minutes away from the empty field off Livington Road where the hospital would be built. Her home is filled with plans and applications.
Sometimes the hospital's board of directors meets in her living room. And when they do, Shoch, housewife, mother of three, organist at St. Mary's Church in downtown Piscataway, presides as president and chairman of the board.
Shoch first heard about the idea for a private, nonprofit hospital in her neighborhood six years ago and attended her first meeting a few days later. Two years later, she was president and thrown into the world of hospital politics.
The first year was spent preparing the application -- three inches thick -- for the 120-bed hospital. It was submitted at the same time that Hayes and Chiaramonte submitted theirs. It was turned down.
The health agency suggested the group apply for an emergency center instead. But as soon as the application was filed, Chiaramonte put in a competing application for an "Indian Head Medi-Surgi Center." The Fort Washington citizens came out on top, and construction of the emergency center is expected to start next year.
"This is the most educational thing I've ever done," Shoch said of her years as a hospital president. "It's a real eye-opener."