Medical merger uproar Cumberland hospitals unite, causing worry over layoffs, services

October 25, 1997|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

Sitting atop opposing mountains in Cumberland, the city's two hospitals have been rivals for decades. Evenly matched in size and finances, they dueled in billboards. They tried to outdo each other in technology.

But as with hospitals all over the country, Memorial Hospital, a historic community institution, and Sacred Heart, a Catholic hospital, have started to do what was once considered heresy -- merge. Board members cite declining revenues and numbers of hospital patients.

Their actions have started a storm of controversy among Cumberland's residents, physicians and staff. Their fears are basic: that people will lose their jobs, that quality may drop, that women's health services prohibited by Catholic doctrine won't be available anymore.

A citizens group is trying to block the hospital changes, asking federal officials to investigate and putting pressure on their city officials to act or face election defeats.

"I'm wired up, and I'm tired, and I don't have to worry about going to sleep at night because I wake up thinking about this," said Mayor Ed Athey, 62, who says he hasn't seen an issue this big in a decade. He's engulfed by questions wherever he goes.

On Tuesday night, a planning committee will make its final recommendation on the most hotly debated issue -- how the two hospitals should combine their clinical services. Of the several models being considered, the committee's preference is for consolidating inpatient and outpatient care at Sacred Heart.

That means Memorial Hospital -- the one in the most densely populated part of town and the one with the trauma center -- would close, and a building would be constructed at Sacred Heart. Memorial would be used for a nursing home or other purposes, something that stings longtime workers.

"Both medical staffs, both employee staffs, they really feel like they're sort of fighting for their lives now," said Dr. William Lamm, president of the medical staff at Memorial.

"Whoever wins this battle and wherever the new hospital ends up -- that's the group that's going to have control."

At its heart, the fight in the Western Maryland city exposes divisions over religion, class, what part of town people come from -- and worry that the national chain of Catholic hospitals that owns Sacred Heart may control the area's only source of health care for 100 miles.

Memorial Hospital is located in South Cumberland, in an older, poorer neighborhood. Its land and buildings are owned by the city, which has leased them to a non-profit board. Doctors and staffers describe a creative atmosphere that is sometimes chaotic, the kind of place where workers say they could go to the front office with a problem and get an honest answer.

Sacred Heart, on the other hand, is located on the city's northwest end, in a more affluent neighborhood of professionals. Until recently, every room had a crucifix, and evening prayers were broadcast over the public address system. Some describe its culture as more top-down.

"We looked at each other's mission, and they're very compatible," said Sister Vincentia Goeb, chairman of the board at Sacred Heart. "What we failed to do is to really understand the two different cultures."

With at least one hospital changing hands every day nationwide, this painful debate is being repeated in cities all over the country. Hospitals are affiliating and merging to eliminate costly excess beds and duplicate services in order to get contracts with managed care companies.

In Maryland, roughly 30 percent of the hospital beds are considered excess. In Baltimore, experts estimate that roughly half the total beds in the city's more than a dozen hospitals aren't needed.

In Cumberland, those who believe in the merger say the facts back them up.

Edward Dinan, president and CEO of Western Maryland Health System, the parent company formed by the two hospitals last year, points to declining numbers of hospital patients and revenue.

The combined daily census of Memorial and Sacred Heart has dropped from about 400 patients in 1990 to 277 last year. At the same time, the hospitals get most of their revenue -- about 75 percent -- from Medicaid and Medicare, the federal programs that are increasingly moving their poor and elderly into managed care plans.

Western Maryland Health System has already merged some departments from the two hospitals, including accounting and public relations. Officials say they'll save as much as $6 million a year by eliminating other redundancies.

Addressing public concerns, Dinan emphasized that women's health services such as tubal ligation and family planning would still be available. If Sacred Heart is selected as the campus, a building would be constructed on an adjacent piece of property where the women's services would be offered.

The health system will also be making every effort to avoid lay-offs, retraining staff and relying on attrition to reduce the ranks, Dinan said. But he said he could not guarantee that no one would lose his or her job.

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