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.