Fin­gers crossed

Record Observer - - Opinion -

The de­sire of Univer­sity of Mary­land Med­i­cal Sys­tem and UM Shore Re­gional Health to main­tain in­pa­tient beds at UM Shore Med­i­cal Cen­ter at Ch­ester­town is great news.

While we tr y to be op­ti­mistic that this goal, spelled out in a white pa­per ti­tled “Com­mit­ment to Meet­ing the Health Care Needs of Our Vul­ner­a­ble Ru­ral Com­mu­ni­ties,” will come to fruition, a full read­ing of the re­port shows that there are a lot of vari­ables at play.

The 46-page white pa­per was sub­mit­ted May 23 to the state’s Ru­ral Health Care De­liv­ery Work­group. A full copy was made pub­lic re­cently on the work­group’s web­site.

“Our goal is to en­sure ev­ery pa­tient is re­ceiv­ing the right care in the right place and at the right time. How­ever, re­mote ge­o­graphic lo­ca­tion, small size, lim­ited work­force, physi­cian short­ages and con­strained fi­nan­cial re­sources pose a unique set of chal­lenges for ru­ral hos­pi­tals,” the white pa­per states.

For sev­eral years at least, res­i­dents have feared that UMMS and Shore Re­gional Health planned to dis­con­tinue a num­ber of ser­vices, get rid of in­pa­tient beds, even shut down the en­tire Ch­ester­town hos­pi­tal. At the very least, it ap­peared the hos­pi­tal was headed in the di­rec­tion of be­com­ing one big emer­gency room.

The Gen­eral Assem­bly stepped in and re­quired Shore Re­gional Health to main­tain in­pa­tient care at the Ch­ester­town hos­pi­tal through 2020. UMMS and Shore Re­gional Health tacked an­other two years onto that.

What we have now is a re­port from Shore Re­gional Health stating that it and UMMS want to “Cre­ate a Short-Stay Med­i­cal Unit with up to 15 beds for mild to mod­er­ately com­plex in­pa­tients” re­quir­ing stays of four days or less, cre­ate an ob­ser­va­tion unit, keep the full-ser­vice, full-time emer­gency depart­ment, main­tain de­fined “in­pa­tient and out­pa­tient surgery ca­pa­bil­i­ties” and en­hance the ca­pa­bil­i­ties of the med­i­cal pavil­ion.

All that sounds like we can take a deep breath and re­lax. The hos­pi­tal is stay­ing. There will be in­pa­tient beds. This is in­deed good news, if it comes to pass.

There are very im­por­tant de­tails to keep in mind, first and fore­most be­ing that these state­ments are be­ing made in a white pa­per — a study say­ing what UMMS and Shore Re­gional Health would like to do. And this white pa­per is part of a larger ef­fort by the state work­group to re­view ru­ral health care. As much as we would like for this to be a done deal, it is not. What Shore Re­gional Health is ask­ing for here is that the state cre­ates a new hos­pi­tal model — “Ru­ral Com­mu­nity Ac­cess Hos­pi­tal” — and re­de­fines Shore Med­i­cal Cen­ter at Ch­ester­town as such. That is reg­u­la­tory hur­dle num­ber one.

Reg­u­la­tory hur­dle num­ber two is the call from UMMS and Shore Re­gional Health for the state to en­hance the fund­ing sys­tem for hos­pi­tals cur­rently un­der a Cen­ters for Medi­care and Med­i­caid Ser­vices waiver. That in­cludes ask­ing the Mary­land Health Ser­vices Cost Re­view Com­mis­sion to “cre­ate new fund­ing re­sources” for the Ch­ester­town hos­pi­tal.

We are happy to read that UMMS and Shore Re­gional Health do not want to close the hos­pi­tal, but, in fact, would like to keep a num­ber of in­pa­tient beds and ser­vices. While we seem to mov­ing in the right di­rec­tion, there is still much work to be done.

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