The decision to close a suburban Maryland hospital has triggered a series of heated hearings in the state capital, demonstrations by union members, and allegations of betrayal from residents and politicians.
Dimensions Healthcare System stands by its decision to convert the formerly full-service Laurel Regional Hospital into an ambulatory-care facility, with company officials saying the change is vital to curbing millions of dollars in operating losses and improving the delivery of health care in Prince George’s County. The company has announced plans to eliminate inpatient services at the facility by 2019.
But those who live, work and govern near the hospital, as well as those who used to work at the facility, say the decision was made without sufficient public notice or input and without regard to community needs.
The planned closure — and the outcry that has accompanied it — illustrates a broader shift that is underway in U.S. health care, with providers trying to consolidate expensive inpatient services within larger, more centrally located facilities.
“The model of medicine is changing,” Dimensions’ chief financial officer, Lisa Goodlett, said in an interview. “We understand their sentiment and frustration,” she added. “However, this was a business decision. We saw the writing on the wall.”
Dimensions, which runs the Laurel facility, Prince George’s Hospital Center and several health centers in the county, is leading the effort to build a regional medical center in Largo that would anchor the county’s health-care network. The $651 million public-private project is awaiting state approval.
Converting the Laurel hospital to a more modest outpatient facility would stem financial losses there, officials say, and improve the fiscal outlook for the planned regional hospital.
A majority of Prince George’s residents go outside the county for hospital treatment, according to a 2009 study conducted by the nonprofit Rand Corp. Those who do use county hospitals are disproportionately poor and uninsured, which means Dimensions has to absorb a significant amount of uncompensated care.
One of the goals of the regional hospital in Largo — a joint effort by Dimensions, the University of Maryland Medical System and the county — is to keep Prince George’s residents in the county when they need hospital care.
At the Laurel facility, admissions have declined steadily since 2013, with about 5,300 visits in 2015 compared with 7,200 in 2006. The maternity ward has gone from delivering 1,000 babies in 2012 to fewer than 700 in 2015.
Dimensions chief executive Neil J. Moore told state lawmakers at a recent hearing that the facility was losing up to $50,000 a day because it was not fully utilized.
Said Goodlett, “The customers have voted with their feet.”
The facility also faced financial pressure from the planned move of Washington Adventist Hospital in Takoma Park to the White Oak section of Montgomery County, less than 10 miles from Laurel. Last winter, Goodlett wrote a letter to the Maryland Health Care Commission opposing the project’s application, saying it would jeopardize the existing hospital’s “long-term viability.”
In July, the Dimensions board voted to reduce services at the hospital, an effort that began this past fall.
A total of 105 hospital employees lost their jobs in the fall. Sixty-four were rehired at other Dimensions facilities. The maternity ward has closed, and 27 of the hospital’s medical and surgical beds were eliminated. Although the board that voted on the closure included Dels. Barbara A. Frush (D-Prince George’s) and Tawanna P. Gaines (D-Prince George’s) and County Council member Andrea C. Harrison (D-Springdale), elected officials and community leaders in Prince George’s say there was no notice that the decision was on the table and no opportunity for public input.
At a Health and Government Operations Committee hearing in Annapolis in November, Del. Joseline Peña-Melnyk (D-Prince George’s) asked Moore, the Dimensions chief executive, a battery of questions, including about his $600,000 salary, and she accused the company of failing to alert the community that the hospital’s future was uncertain.
“I have sat here for nine years, and not once have you said that Laurel was in trouble,” Peña-Melnyk said, to nods of approval from activists in attendance.
“You look incompetent,” she added. “It is really not in the public health interest to close this hospital.”
Peña-Melnyk and Sen. James C. Rosapepe (D-Prince George’s) have filed a bill that would prohibit the closure or partial closure of hospitals under certain conditions. The bill also would authorize the county Board of Health to hold public hearings on proposed closures and give the board the power to stop them.
Union leaders who represent the hospital’s workers said they, too, felt blindsided. They unsuccessfully sought a restraining order to stop the closure.
At community meetings, angry senior citizens accused Dimensions of intentionally leading the hospital to financial ruin.
“It is an important commentary on what happens when a huge health system decides that they want to change health care and not include the community,” said Jennifer Epps, a vice president of Local 1199 of the Service Employees International Union. “To just drop this bomb is just not fair.”
Laurel Mayor Craig A. Moe accused Dimensions of a “chronic failure to manage a quality facility.” Noting that the local population is projected to grow, he has suggested the county allow another company to buy the property and operate it as a full-scale hospital.
As the uproar intensified, Dimensions issued news releases and submitted an op-ed to the Laurel Leader newspaper to explain its decision. The company said it was under no obligation to engage the public in its deliberations, even though the hospital receives public subsidies. But officials said they plan to seek community input before building the new facility.