A state-appointed task force led by George S. Malouf Sr. recommended this month that Prince George's County relinquish ownership of its public hospital system to Dimensions Healthcare System. Dimensions, a financially troubled nonprofit corporation, runs the facilities, which include the 284-bed Prince George's Hospital Center in Cheverly, Laurel Regional Hospital and the Bowie Health Campus.

Malouf, an ophthalmologist and former Dimensions board member, answered questions from staff writer Nancy Trejos.

QDimensions Healthcare has lost $45.8 million over the last three years. The firm is now looking for a buyer to rescue the hospital system. What caused those financial difficulties?

AThe one particularly in dire trouble is the Prince George's Hospital. It has a very high number of patients who are on Medicaid, and the pay from Medicaid is very, very low. Sixteen percent of the patients are self-pay [uninsured]. . . . Ninety percent of the time, self-pay is equated with no pay.

Also, these are patients that are difficult to manage. They come to the emergency room; they are not patients that doctors are familiar with. There's a bigger risk taking care of these patients. Doctors don't want to go there. So hospitals have to pay them [enough].

Why did the task force recommend turning ownership of the hospital system over to Dimensions?

In order to be able to borrow money, which the hospitals need, they have to have some assets. The assets continue to be part of the county. The county is the owner of the physical structure of the hospital and everything that belongs to it. All that they [Dimensions] have is a lease with the county that will last about 40 more years. At the present time, Dimensions has borrowed all it can -- down to the point that no additional money can be obtained, because who will lend them money if they don't have some assets. If they own the physical structure, that will give them the benefit of borrowing money.

What are some of the other recommendations that the task force made?

The county has to subsidize the hospital for several years so that the hospital can get back on its feet. We're recommending also that the state come up with some money. The reason for that is we're serving more than Prince George's, especially the shock trauma [department]. The state has a certain responsibility to come and help us. With Medicaid, the physicians are getting paid an amount of money that is not enough for them to practice. The state has to increase the pay.

Dimensions is fielding at least six proposals from prospective buyers. What kind of buyers should the firm look for?

They have to come with the understanding that they are willing to accept the responsibility of serving those that cannot afford [health care]. . . . They should have ability and experience in management. Number three, they should have a history of high-quality care because, after all, we have the responsibility to take care of our patients.

How are these financial troubles affecting patient services?

The hospital has continued to function very nicely. The quality of care rendered should be the envy of other hospitals. The quality has not suffered.

You have been closely involved with Dimensions. Now you are observing it, sort of as an outsider, as the chairman of this task force. How do you feel about the situation, and what do you think the outcome will be?

I feel terrible for what's happening. But I'm a positive person. You cannot permit the hospital to go down the drain. I believe the local community, Prince George's County and the state government are going to be responding in a positive fashion. I don't think they have a choice.

GEORGE S. MALOUF

. . . led hospital task force