The name of Mohan Kirtane, the official responsible for the reorganization of Prince George's Hospital Center, was misspelled in an Oct. 27 Metro article. (Published 10/30/04)

Nearly a year after the state and county stepped in with a bailout plan, Prince George's Hospital Center is still limping along financially and expects to announce layoffs by the end of the week, hospital administrators said yesterday.

"Our team is going to try to move the hospital forward and stabilize it," Mohan Kitrane, who is in charge of the hospital's restructuring, told the County Council.

About three weeks ago, hospital officials presented a preliminary staff-reduction plan to union leaders that included leaving vacant positions unfilled, decreasing the hospital's use of temporary workers, reducing overtime and laying off staff.

Tony Jones, interim president of Dimensions Healthcare System, the nonprofit organization that runs the hospital, would not comment on how many jobs would be cut, but said every staff, including nursing, probably would be affected. He said the Dimensions board could take action on the plan tomorrow.

Hospital officials told County Council members, sitting as the Board of Health, that the financial support from the county and state has helped, but that the Cheverly facility, where many of the area's poor and uninsured receive care, continues to face challenges to its survival.

"We expect to break even his year," said Kirk Blackman, chairman of the Dimensions finance committee. "Without the outside assistance, we would be operating at a deficit."

In February, Maryland Gov. Robert L. Ehrlich Jr. (R) and County Executive Jack B. Johnson (D) took the first steps toward rescuing the hospital by signing an agreement setting up an independent oversight committee, hiring a "turnaround" company and providing $45 million to the hospital over five years.

The state allowed Dimensions to raise rates by 3 percent, an increase that is expected to generate $10 million. The state also has appropriated $5 million to pay for capital improvements, but the money has not yet reached Dimensions, officials said.

The county gave $5 million to the hospital in March and $5 million last month, a hospital spokesman said yesterday.

In August, Cambio Health Solutions was hired by the oversight committee to review the hospital system and make changes. That led to the resignation this month of Patrick Mutch, Dimensions' president, and Noel Cervino, the chief financial officer.

Council Chairman Tony Knotts (D-Temple Hills) said it is apparent that, despite the money, the agreement with the state and county left unanswered the question of how to improve the hospital's long-term outlook.

"We need more than a $20 million fix," Knotts said. "We need a long-term strategy."

Officials said part of that plan must include increasing the number of paying patients who use the hospital. "The gas that drives our car is admissions," Blackman said. "And right now we're 6 percent below budget in admissions."

Council member Thomas R. Hendershot (D-New Carrollton) told hospital officials that he found out firsthand why the hospital has trouble getting on solid financial ground. Hendershot is scheduled to go into the hospital at the end of the week for an angiogram and "possibly some level of heart surgery as well."

He told his surgeon he wanted to have the procedure at Prince George's, where the surgeon has privileges. But the doctor set it up for Washington Hospital Center instead.

"Hospitals make money off of hearts, and if anybody is going to make money off my heart, it's going to be Prince George's," said Hendershot, who insisted on going to the county hospital.

Jones said Hendershot's experience was "classic."

"Doctors are telling their patients not to go to Prince George's Hospital," he said. Dimensions will have to "work extremely hard to get physicians on board."

Another challenge for Prince George's, Jones said, is that it has no affiliation with a major medical school. Such teaching hospitals have a steady stream of young, relatively low-paid residents to help provide care. Dimensions officials say many members of its physician's network are near retirement. As they leave, their paying patients go elsewhere.