‘White paper’ supports inpatient beds in Chestertown
CHESTERTOWN — The campaign launched in January 2016 when hundreds of people packed the Chestertown firehouse, shouting down plans to shutter the hospital here, appears to have scored its first victory.
University of Maryland Shore Regional Health’s blueprint for the five MidShore counties, contained in a 46-page document made public recently, retains inpatient beds at UM Shore Medical Center at Chestertown — what was established in the 1930s as Kent & Queen Anne’s Hospital and then was known as Chester River Medical Center before joining the University of Mar yland Medical System in June 2008.
This supercedes the assurance Easton-based Shore Regional Health gave last spring that inpatient services in Chestertown would remain only until 2022, when a new regional hospital in Easton would open.
Deborah Mizeur, cochairman of the state Rural Health Care Delivery Workgroup, called the plan “a great first step.”
In addition to inpatient beds in Chestertown, the plan as outlined in the white paper titled “Commitment to meeting the health care needs of our vulnerable rural communities” includes maintaining the full-service emergency department, enhancing the medical office pavilion currently located on Philosophers Terrace, creating an observation unit with observation beds and defined inpatient and outpatient surgery capabilities.
There are two caveats, however.
Chestertown’s hospital would be reclassified as a rural community access hospital. It would be a “short-stay medical unit” with up to 15 beds for mild to moderately complex inpatients. The projected length of stay would be about four days. There would be no pediatrics, no obstetrics, no nursery and no intensive care unit.
The other catch? The Health Services Cost Review Commission, the hospital rate-setting authority in Maryland, would need to create new funding resources.
Physicians, legislators and others who have lobbied to keep inpatient beds in Chestertown are applauding what appears to be a new direction charted by Shore Regional Health and UMMS, but also are cautiously optimistic.
“Despite seemingly making progress to maintain the hospital, there obviously is a lot more work to be done,” Dr. Jerry O’Connor, a surgeon who has been in practice here for nearly 40 years, wrote in an email.
“I think the gains are real,” he wrote, “but I do not want to see us reduced to a minimal service hospital.”
Del. Jay Jacobs, R-36-Kent, said, “We’ve crossed the first hurdle with inpatient services, but there’s a lot of unanswered questions.”
The District 36 and 37 delegations met with the Shore Regional Health board and President Ken Kozel earlier this month, Jacobs said. It was a long, productive meeting, he said, but he wants a follow-up to lobby for “maintaining a level of services” that would include critical care.
Mizeur sees the plan as a “good faith effort,” but “it needs more meat on the bones.”
She is the co-chairman of the workgroup established in the 2016 General Assembly legislative session (Senate Bill 707) to oversee a study of health care delivery in the Mid-Shore and to develop a plan for meeting the health care needs of Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties.
“There needs to be some additional plan for how to create a sustainable facility in Chestertown,” Mizeur said July 17.
“We’re looking at regulatory changes to allow additional services to sustain the building,” Mizuer said. “What other kinds of services could be offered? Certain types of day surgery, palliative care, hospice care, a drug treatment facility, services for geriatric patients. How can we better use the space in the hospital to bring in more revenue?”
Ultimately, patients need to come to the hospital, Mizeur said in a nod to the reality that over the past several years — as services such as obstetrics and pediatrics were eliminated and staff was downsized in Chestertown — some from Kent County and northern Queen Anne’s County have opted to take their business elsewhere.
“If you save the hospital, you have to support the hospital,” Dr. Ona Kareiva, an anesthesiologist who has been working here since January 2012, said July 18.
UMMS and Shore Regional Health would like to discuss with the state the potential for “disincentives for competition and incentives to support sustainability for rural hospitals affected by competition,” as they point out that urban health care providers have been encroaching on the MidShore. “Competition drives up cost,” the white paper states.
The 32-member rural health care study group will hold its final meeting at 1 p.m. Tuesday, July 25, at Chesapeake College. The meeting is open to the public but only as observers. Members of the public cannot comment or participate.
Mizeur said she did not expect Shore Regional Health’s white paper to be discussed.
The workgroup will make its recommendations to the Maryland Department of Legislative Ser vices in Annapolis on Sept. 28.
In fulfilling its charge to define a health care system for the Mid-Shore, the workgroup is studying transportation, physician recruitment, economic impact, primary care, continuum of care, behavioral health, substance abuse, and inpatient and outpatient services, Mizeur said.
Shore Regional Health’s white paper came at the request of the workgroup’s cochairmen, Mizeur and Dr. Joseph A. Ciotola, the health officer for Queen Anne’s County.
Mizuer said they asked Shore Regional Health for its plan for a health care system.
She said the document helps the workgroup make its case that inpatient beds need to be retained in Chestertown and the state should support it financially.
If Shore Regional Health, recognized as the largest health care system operating in the Mid-Shore, had said the plan was to centralize all services in Easton, “we could not have made the case to the state,” Mizeur said.
Deborah Mizeur, left, and Dr. Joseph Ciotola lead the workgroup that requested the white paper by Shore Regional Health.