Bon Secours Baltimore Health System said yesterday that it plans to end inpatient care at Liberty Medical Center as it consolidates all inpatient beds at Bon Secours Hospital.
Liberty, which is owned by Bon Secours, would retain its emergency room, outpatient services and medical offices. It would also add a dialysis unit, a geriatric psychiatry program and senior day care and housing units. The two hospitals are less than three miles apart.
The consolidation, slated to take place next fall, would eliminate about 275 jobs, the health system estimated, and reduce health costs by $85 million over five years.
"We need to consolidate to achieve a volume level that's effective from a cost point of view and a clinical point of view," said Jane Durney Crowley, chief executive officer of Bon Secours Baltimore.
Liberty, licensed for 282 beds, had 88 patients on an average day in the fiscal year ended June 30 while Bon Secours, licensed for 208 beds, averaged 79. And, Crowley said, the system expects occupancy in all Baltimore hospitals to drop by another 30 percent over the next few years as Medicare moves more beneficiaries into managed care plans.
Both hospitals show operating profits, but barely so; Bon Secours had a margin of four-tenths of 1 percent for the fiscal year.
Operating so far below capacity, the hospitals are expensive for patients. Bon Secours is 15.8 percent more costly than the state average, and Liberty is 10.3 percent higher than the average, according to state regulators, who have been pressuring both hospitals to bring costs down. Beyond cost considerations, Crowley said, it is difficult to offer some specialized services, such as nuclear medicine, in a hospital with fewer than 100 patients, so both were in danger of losing services.
Money saved in the consolidation can be used to develop and subsidize other services for needy communities, Crowley said. According to a study done by the health system, the six ZIP codes in West and Northwest Baltimore from which the hospitals draw the most patients have an average per capita income of $9,920 per year.
The consolidation requires regulatory approval. Pamela Barclay, acting executive director of the Health Resources Planning Commission, said her board would review the impact on access, cost and quality, and would conduct a public hearing, probably in December or January. Action is possible by February, she said.
"Clearly, the current state health plan identifies excess acute beds," she said. "We see reducing that excess as having a positive effect."
Larry Grosser, executive director of the Professional Staff Nurses Association, which represents 140 nurses at Liberty, said, "We don't believe those communities can support both hospitals." However, he said, the union believes that it might have been better to consolidate the inpatient beds at Liberty.
Bob Moore, president of Local 1199E-DC of the Service Employees International Union, which represents about 150 workers at Liberty, said his union and the nurses would be meeting with health system officials to understand the rationale for the consolidation and to make sure employees are treated fairly.
Del. Howard P. "Pete" Rawlings, who represents West Baltimore and chairs the House Appropriations Committee, said he also was skeptical, but after meeting with health system officials, concluded, "They ought to be applauded for making a tough business decision and being supportive of people."
The health system said it chose Bon Secours as the inpatient site because the hospital has undergone extensive renovations recently. Liberty would have required some $20 million in improvements were it to get all the beds, the system said, while Bon Secours will need just $2.7 million.
The sisters of Bon Secours (French for "good help") came to Baltimore in 1881 to provide nursing care. The sisters opened a hos- pital in West Baltimore -- the original building, on Fayette Street, is still in use -- in 1919.
Liberty is a successor to Provident, the city's traditionally black hospital that began in 1894. In financial trouble, Provident was essentially taken over in 1986 by Lutheran Hospital in a merger that formed Liberty. Liberty merged into the Bon Secours system in 1996.
Anne Emery, a member of the Liberty board, said she had "mixed feelings" about the consolidation. She said she was pleased that the plan would provide more resources for good programs at Liberty, but had nostalgic feelings for an institution "that opened its doors to African-Americans" and trained many of the city's black physicians.
Emery, who is also president of the Ashburton Area Association, said, "I don't anticipate a lot of resistance to the plan" from neighborhoods near Liberty's campus.
Pub Date: 11/07/98