Published in the Courier News, Saturday, February 23, 2008
Muhlenberg to close most hospital units
ER, nursing school remain open
By CLEM FIORENTINO
PLAINFIELD -- Muhlenberg Regional Medical Center will close its acute-care hospital facility, most likely by the end of the summer.
Solaris Health Systems, the nonprofit parent company of Muhlenberg and JFK Medical Center in Edison, will file a certificate of need with the state Department of Health and Senior Services next week, citing "overwhelming financial losses" at the Plainfield location.
Some services will remain.
"While there will no longer be acute-care hospital services provided at the Plainfield campus, we are committed to operating a satellite emergency room and home care, as well as keeping the Muhlenberg School of Nursing open," said John McGee, president and CEO of Solaris. "We have an opportunity to work with local and state health officials to identify and reduce barriers to accessing health-care services for residents of Plainfield and the region, following the closure of acute-care services."
Acute-care services include operating rooms, medical-surgical units, intensive care, coronary-care units, obstetrics and about 180 beds in use.
The cutbacks will affect about 1,000 of Muhlenberg's 1,100 employees.
If a patient receives emergency-room care at the satellite facility and then requires either additional treatment or a hospital admission, he or she would then have to be transported to nearby facility with acute-care capabilities.
"Muhlenberg has been a part of the Plainfield community for more than 130 years, faithfully serving a diverse population with clinical excellence and compassion. This was the very last option we wanted to consider," said Thomas Sharp, chairman of Solaris' board of directors.
Assemblyman Jerry Green, D-Plainfield, predicted the worst in a statement released earlier this week after a private meeting he attended with officials from Solaris, municipal officials and a representative from the state Department of Health and Senior Services.
Based on that meeting, he has asked for a regional task force to deal with the impending health-care crisis.
"I will do everything in my power to keep some services there," Green said. "There is a need for Muhlenberg to be in the community. It's not only Plainfield. It services Fanwood, Scotch Plains and other areas. Plus, we have 1,100 people who work there."
As for the task force, Green said he has reached out to officials at Somerset Medical Center in Somerville and St. Peter's University Hospital in New Brunswick. Green said the surrounding medical facilities (including JFK Medical Center, another Solaris site) realize that the burden might fall on them.
"I'm trying to get people who understand the process," Green said. "I'm not out to undermine Solaris. There is no money available. Why should I lay back? Why waste time? We want to prepare for the worst. We're running out of money. It doesn't take a rocket scientist to figure out what's going to happen."
Green already has two recruits.
"I have accepted Assemblyman Green's invitation to serve on a task force to explore viable options to meet the health-care needs of the communities currently served by Muhlenberg Regional Medical Center," said Kenneth Bateman, president and CEO of Somerset Medical Center in Somerville. "Given the complexities facing health care in our state today, working toward a solution is going to take a collaborative effort. For this reason, I have suggested to Assemblyman Green that he consider a broad spectrum of community and health-care leaders for his task force."
Later Friday, St. Peter's issued this statement:
"We are pleased to explore opportunities that enhance our mission of providing health-care services to those in need, particularly the underserved," said Ronald C. Rak, president and CEO of St. Peter's Healthcare System. "We will work with Assemblyman Green and the task force to help identify those areas where Saint Peter's may collaborate in providing essential services to the affected communities."
Perhaps the one culprit issue is the amount of charity-care funds the state is able to give to hospitals across the state. Muhlenberg alone lost $10 million in charity-care deficits last year.
"Whatever charity-care dollars are left on the table, those dollars should go to programs that survive (at Muhlenberg)," Green said.
That, however, might not be as simple as it sounds because the funding sources -- charity care, Medicaid and Medicare -- reimburse at less than hospital cost, and none of those funds figure to increase anytime soon.
All eyes will be on Gov. Jon S. Corzine's state budget proposal next week. Much will depend on the formula under which the governor and his advisers delineate the formula for charity care.
At issue is whether special funds should be earmarked for distressed or "safety-net" hospitals -- those that provide the lion's share of care to the poor and underserved -- and whether hospitals neighboring those facilities that close should receive more aid.
"We are prepared for a very difficult state budget," said Kerry McKean Kelly, vice president of communications for the New Jersey Hospital Association in Princeton. "It's no secret that the governor is looking to freeze programs. It's a very real concern. Borderline hospitals might be pushed over the edge because of charity-care cuts."
Kelly also points to deep cuts at the federal level as well, including $246 million in Medicare cuts in the president's budget proposal.
Tom Slater, a spokesman for the state Department of Health and Senior Services, said there will be public hearings and that the process should take about six months before the department rules on the application.
Slater also said state officials will act as a resource for any community effort to ensure quality of care and access to services.
"We were aware Muhlenberg was struggling," Slater said. "We acted as a resource. We will continue to work with the community."
The financial situation at Muhlenberg has been impacted by declining patient volumes and competition from free-standing outpatient surgery centers in Central Jersey, Solaris said in its statement.
In November, Solaris engaged Cain Brothers, a New York-based investment banking firm, to attempt to sell the facility. After outreach to more than 60 potential buyers and despite preliminary interest by several out-of-state and local health-care organizations, Solaris said that no formal offers were submitted.
"In 2007, with further reductions in state funding, annual operating losses at Muhlenberg reached more than $18 million. We have done everything in our power to keep Muhlenberg open," McGee said. "The escalating losses at Muhlenberg, coupled with the lack of offers to purchase the facility, have left us no other alternative but to file a certificate of need for closure."
Solaris officials said they will remain committed to assuring that high-quality health-care services are provided during the closure process at Muhlenberg.
Once the state approves the application, Muhlenberg will begin a "wind down" period, where services will be phased out and discontinued at the hospital. The wind down will ensure that patients continue to receive care while programs are relocated or transferred to other providers in the region.
"We are concerned in general by the rash of hospital closures ... that there will become an access-to-care crisis in our state," Kelly said. "In the last 18 months, four acute-care hospitals have closed and five have filed for bankruptcy protection. This in not unique to any one community."
When facilities close, Kelly points out, folks have to find health care at the next hospital over.
"Not all closures are bad," Kelly said. "Sometimes the system has to take a look at the needs of the community and make a sound decision. We worry about the wrong hospitals closing for the wrong reasons."
In 1997, Muhlenberg merged with JFK Medical Center in Edison to form Solaris Health System, which also includes the JFK Hartwyck long-term care centers and the JFK Johnson Rehabilitation Institute.
Also a part of the Solaris system is the Dorothy A. & Harold B. Snyder Schools of Nursing, Medical Imaging and Therapeutic Sciences located on the Muhlenberg campus.
"Solaris will continue to serve the health-care needs of Plainfield and surrounding communities through the services available at our other entities (including JFK Medical Center in Edison) as well as by working with area health-care providers to provide expanded primary and urgent-care services," McGee said.
Solaris officials said they are working on initiatives to address transportation services for area residents, to and from JFK Medical Center, including advanced life support and primary/urgent-care transportation services, not typically available through area rescue squads.
"Unfortunately, Muhlenberg now finds itself on a growing list of New Jersey hospitals who have been forced to close services in light of these insurmountable financial challenges," said Ronald West, chairman of the board of directors of Muhlenberg. "For decades, our physicians and employees have remained committed to serving this community. This is a heart-breaking outcome for one of the finest institutions in the area."
"Just plain 'sad' is not the word," Green said. "This is the biggest defeat in my career. I have taken it personally. It's all about life and death. If patients are forced to go someplace else, that half-hour could make the difference between living and dying."
Solaris officials met throughout the day with hundreds of employees.
"Every hour on the hour, standing-room only," McGee said. "The sense from the employees was heart-breaking."
Officials also met with the medical staff, community leaders, clergy and representatives from the Plainfield Health Center and the Red Cross.
McGee said Solaris would do everything they could for the employees. He said Solaris has been holding back on filling permanent positions at its other locations. Out of the 1,000 affected employees at Muhlenberg, he estimated that Solaris might be able to retain one-third of them.
"It's very early in the process," McGee said. "We will be talking with employees about what their severance packages will be."
McGee said Solaris will look to the state for help with the logistics and for guidance through the transitional period.
After the state approves the closures, Solaris will have to file public notices to makes sure everyone knows which services will no longer be available.
"We have had a commitment to this community for 11 years," McGee said. "This has been a very emotional day."
Clem Fiorentino can be reached at (908) 707-3150 or firstname.lastname@example.org.
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- Plainfield resident since 1983. Retired as the city's Public Information Officer in 2006; prior to that Community Programs Coordinator for the Plainfield Public Library. Founding member and past president of: Faith, Bricks & Mortar; Residents Supporting Victorian Plainfield; and PCO (the outreach nonprofit of Grace Episcopal Church). Supporter of the Library, Symphony and Historic Society as well as other community groups, and active in Democratic politics.