Citizens and elected officials packed the Laurel City Council Chamber on Aug. 10 for a town hall meeting to address Dimensions Healthcare’s plans to close Laurel Regional Hospital (LRH) by 2018.
Dimensions, which operates the Prince George’s County hospital system, intends to transition LRH to an outpatient asset focused on the prevention of hospital visits, citing waning patient volume and revenue as factors in the decision.
Overwhelmingly, the community faulted Dimensions’s history of management crises and financial insolvency as the primary cause of the hospital’s problems. Some insiders, however, admitted that local hospital leadership shared culpability in the current situation.
City Councilman Fred Smalls, who serves as chair of the LRH board and has a seat on the Dimensions Healthcare corporate board, said an aging infrastructure and the reluctance of local physicians to send patients to LRH are contributing to declining volumes at Laurel.
“With the number of physicians and the number of services they provide in this area, our hospital really should be thriving,” he said. “The blame certainly is not all with Dimensions; some of it lies with the leadership we’ve had in the hospital.”
State Sen. Doug Peters, meanwhile, observed that this year’s $15 million revenue shortfall at LRH is, coincidentally, the same amount in annual state aid to the hospital system that Maryland Gov. Larry Hogan refused to fund in this year’s budget. Since 2011, Dimensions has been receiving matching funds from both the state and the county through a Memorandum of Understanding (MOU) agreed to by the state, Prince George’s County, Dimensions and the University of Maryland Medical System (UMMS).
The Consequences
Bill Williams, a former Dimensions board chair and former interim president of LRH, said closing the hospital would have wide-reaching consequences in Howard, Montgomery and Anne Arundel counties.
“I think they fail to realize this is a four-county hospital,” he said. “These counties are going to lose also because they’re part of the collective.”
Among the concerns expressed by local residents is the added risk for heart attack and stroke patients requiring longer trips to seek critical timely care, and the added inconvenience and risk for women in labor.
Stuart Kohn, president of the Howard County Citizens Association, and Karen Coakley, president of the Beltsville Citizens Association, warned that ambulance response and delivery times would lengthen considerably in light of large scale population growth planned for Laurel, Konterra, southern Howard County and eastern Montgomery County in the very near future.
“We have another problem with the trustworthiness of Dimensions … saying they’re going to give us ambulance service in 2018 and beyond,” Kohn said. “The question is, can we really believe that, and how much?”
Ironically, Coakley added, the Beltsville community lobbied for decades to improve access to LRH through construction of Route 201 and the I-95/Contee Road interchange. “Here we are 30 years later, we have the roads — and you’re taking the hospital away.”
Economic Issues
Apart from inpatient concerns is the question of how the hospital’s closure would affect regional employment.
Closing the city’s largest employer would displace approximately 600 workers, said Registered Nurse Lorita Waltz, of Landover, a former LRH employee.
“[Dimensions officials] tell us they can avoid layoffs by filling vacancies, yet while we’ve requested the list of vacancies for many months, we still haven’t received them,” she said.
“[W]e know those vacancies don’t really exist,” said Pat Lippold, vice president for Political Action for 1199 SEIU United Health Care Workers East, in Baltimore.
“You’re going to eliminate a lot of nursing jobs, all housekeeping jobs, all dietary jobs,” she said. “These are jobs they’re not going to find at the new hospital [in Largo] because it won’t be built in time.”
Plans for that hospital — a $650 million, 231-bed regional medical center originally conceived to replace the century-old Prince George’s Hospital Center, in Cheverly — also derive from the aforementioned MOU.
For Williams, the bigger issue is not when this hospital gets built, but how it will be financed, particularly in light of Dimensions’s burden of uncompensated care.
“The state put up $200 million; the county put up $200 million; UMMS puts up zero and Dimensions was supposed to come up with $200 million, but they have no money,” he said. “By [2018], that … commitment will increase, and it’s going to cost more.”
Counteraction
Dimensions officials did not respond to a request by The Business Monthly to provide an update on their position or current plan of action.
But as Dimensions continues to develop plans for transition at LRH, those who oppose the decision are beginning to consider their response options.
“The state and county have invested tens of millions of dollars [in this hospital system] over the years,” said State Sen. Jim Rosapepe. “Until I see a plan forward that makes sense for Laurel, I’m not prepared to support any additional state aid for this effort.”
Williams reminded elected officials that Prince George’s County, not Dimensions, actually owns the hospitals, the system and the land. “Dimensions has a lease with the county and has severe restrictions on how it can operate, what it must do and how it must function,” he said.
Laurel businessman Fred Frederick, who chaired the original Prince George’s County Hospital Commission, said he would prefer to see the county reassign the LRH property to the City of Laurel, “then go to a corporation like the Hospital Corporation of America and let somebody that has a proven record come in and run your hospital by real professionals.”
Sen. Peters urged the Prince George’s County Council to use its authority to meet as the County Board of Health to schedule hearings with Dimensions officials, while Del. Joseline Pena-Melnyk suggested the county delegation revisit state law to determine the legal process for closing hospitals. “If there’s no process, then we need to put in a process so this doesn’t happen anywhere else,” she said.
In addition to petitioning the governor and Prince George’s County Executive Rushern Baker, Laurel Mayor Craig Moe pledged to invite Dimensions officials to a future town hall meeting and also met with members of the Prince George’s County delegation later in August to further discuss the issue.
In the mayor’s view, Dimensions’s refusal to consider selling LRH is driven by the new regional medical center.
“They don’t want the competition; this way, all the money stays in [their] system,” Moe said. “Dimensions’s track record is terrible, and we’re right back where we were 10 years ago. The system needs to be broken up. Laurel deserves a full-service hospital, not what they’re planning.”