State and Prince George’s County elected officials joined Laurel Regional Hospital (LRH) workers and Laurel city leaders at an outdoor press conference on Sept. 8 to outline the impact of Dimensions Healthcare System’s (DHS) recent decision to close the hospital.

Later in the month, DHS officials sat before the Prince George’s County Council, convening as the county’s Board of Health, to answer questions about the decision’s necessity, timing and overall process.

DHS plans call for the first phase of hospital closure to begin on Oct. 11 this year with the elimination of the LRH Maternal and Child Healthcare Division, which affects 35 employees.

An additional 83 hospital workers have received pink slips in the time since that initial announcement, bringing job losses at the city’s largest employer to a current total of 118. Of that total, 71 jobs are expected to be eliminated, and 47 are expected to be reassigned to new positions within Dimensions.

Transparency Questioned

Local government officials criticized DHS’s decision-making process, which they said kept other stakeholders in the dark, in addition to blindsiding them.

“The leaders at City Hall, in fact, found out about this plan by watching the news that night,” said Laurel Communications Director Audrey Barnes.

According to Laurel Mayor Craig Moe, an August 2012 update to the Bowie mayor and city council and a December 2014 report to the executive director of the Maryland Healthcare Commission (MHC) both continued to show LRH as a full-service medical facility and claimed a bright future for DHS, despite its financial challenges.

Moreover, he said, DHS CFO Lisa Goodlett filed an affidavit this past February opposing Washington Adventist Hospital’s Certificate of Need application seeking authorization to relocate from Tacoma Park to White Oak/Fairland. The affidavit claimed that the move would have an unwarranted negative impact on LRH.

“What has changed since February 2015?” Moe inquired.

Quick Decision

In March this year, Dimensions hired Chicago-based health care consultancy firm Kaufman Hall to conduct a study targeting financial challenges facing DHS. By July 29, Kaufman Hall turned in a recommendation to close LRH and transition the campus to an asset focused on outpatient care.

Kaufman Hall Vice President Chirag Patel informed the council that the study revealed an oversupply of inpatient beds in the region.

“Given the fact that the Laurel campus is continually producing losses for the system, any plan that would maintain Laurel in its current configuration was really seen as unsustainable, through various analyses,” he said.

Patel said that his firm determined transitioning to an ambulatory center to be the least disruptive option for the community.

“It provides a new injection of capital and investment to the community,” he added.

As to where the $24 million would actually come from, Goodell said DHS has identified a number of “different potential funding sources,” and that four options on the table are being researched for feasibility, but did not specify what those options were.

Prince George’s County Circuit Court Judge Philip Nichols, chairman of the DHS board of directors, argued that it was wrong to consider the decision as being made without community input.

“Five members of our board held public office at one time or another,” he said. “That’s why the board exists, to make these kinds of decisions.”

According to Judge Nichols, LRH has lost $108 million during the past 10 years and is currently losing $50,000 each day, a major factor that influenced the board’s quick decision.

“The least loss that we could see short of the ambulatory care center lost $7 million a year,” he said. “This is a data-based decision that needed to be made.”

Prince George’s County Councilwoman Mary Lehman (D-Dist. 1), however, took a different view.

“If this system has been losing more than $100 million over 10 years, either someone was being dishonest and disingenuous 10 years ago or they’re being dishonest and disingenuous today,” she said. “I don’t think you sustain those kinds of losses and keep that a secret. I really think a lot of things said in front of us by this group in this presentation is, frankly, calling into question your own credibility.”

Local Impact

At the Laurel press conference, Maryland Maternity Access Coalition President Beth Laverick said the need to travel farther for obstetrical health care services would present a greater risk for the 700 women the hospital serves each year and for their unborn children. She urged legislators to move forward to implement a statewide Birth Injury Fund.

According to State Sen. Jim Rosepepe (D-Dist. 21), legislators have approved $153 million in state funds to support DHS during the past nine years, and the county has matched that money.

“Unless and until we have a plan that preserves and expands medical service to this area, I will not support an additional dollar of state money to DHS,” Rosapepe said.

City of Laurel Emergency Services Coordinator William Goddard said the decision would have a “significant impact” on city emergency services.

“If an ambulance delivers someone to Howard County General Hospital, it will not be available for calls in the city because it has to travel longer distances,” he said, adding that the situation would also likely increase the number of Yellow Alerts in which emergency rooms are at capacity and ambulances must divert to hospitals even further away.

“I’ve encouraged the folks at Howard County General Hospital to take a look, because this is going to affect them as well, and it’s going to have an impact on Doctors Community Hospital,” Goddard said.

The decision would also affect pharmacies, laboratories and diagnostic centers clustered around LRH that get business referrals from the hospital, Lehman said.

Executive Silence

Missing in all the discussions about the DHS decision was the voice of Prince George’s County Executive Rushern Baker (D).

“We’ve been asking for a meeting with Mr. Baker, and he hasn’t been responsive,” Lehman said. “As we’re sitting here today [in Laurel], Mr. Baker is in China on an economic development trade mission. He’s busy trying to find business in China, he’s not taking care of business at home.”

According to Barnes, Baker neglected to follow through on placing a scheduled telephone call to Mayor Moe in August to discuss the hospital closure decision.

“We understand the rapidly changing health care needs and the Affordable Care Act have placed pressures on all health care facilities, but Dimensions should provide the community with all the information regarding their long-range plans and not what they want to put out to make their story fit,” said Moe, who called on Baker to engage the community and either keep LRH open as a full-service hospital or allow it to be sold to another medical facility. “An ambulatory care center is not what this region needs.”