‘White pa­per’ sup­ports in­pa­tient beds in Ch­ester­town

Record Observer - - News - By TR­ISH MCGEE pm­cgee@thekent­coun­tynews.com

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.

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