Hospital sees a wider role in Howard

Expansion plans include focus on women, seniors

`We need to be a bigger hospital'

Health centers envisioned on a larger campus


August 11, 2002|By Tricia Bishop | Tricia Bishop,SUN STAFF

Howard County General Hospital, buoyed by its Johns Hopkins affiliation, is in the middle of a $34 million expansion spree, but it's nothing compared with what's on the way.

It opened a high-tech intensive care unit last year and stocked it with massaging beds. Last month, it unveiled a emergency care department triple the size of the old one. A maternal child facility arrives next month. And next year, expect the diagnostic imaging department to appear between April and June.

That's phase one of the strategic master plan, which envisions the hospital as a major player in health care.

Ahead is phase two, which will cost more than $50 million. It includes such projects as building comprehensive women- and senior-focused health centers on the 10 acres the hospital bought from the Rouse Co. The $4.25 million acquisition, finalized in June, brings the campus to 29 acres.

That is a long way from the 59-bed, short-stay HMO service provider that the hospital started as in 1973. Today, it is the fourth-largest employer in Howard County, has an operating budget of $139 million, has 170 operational beds and pays $45 million a year in salaries and benefits.

"Howard County is a growing population, and Howard County General Hospital needs to keep pace with that growth," said Judy Reitz, vice president of operations integration for Johns Hopkins Health Systems, which acquired Howard County General in 1998.

The merger with Hopkins is almost wholly the reason that pace is possible, said Victor Broccolino, the hospital's president and chief executive officer. But not necessarily for obvious reasons.

The Hopkins relationship added renowned medical expertise and local access to a range of specialty services -- including many for at-risk babies and mothers -- that are not typical of a community hospital. But the most valuable component it brought to the table was borrowing power.

"We were too small and too highly leveraged to keep growing," Broccolino said of the hospital before the affiliation with Hopkins. "We'd grown over the years since 1973, but we grew by borrowing money. And [in 1997] we saw the end of the line for us in terms of borrowing."

So, the hospital solicited high-profile partners that would help it continue to develop, remain competitive and improve its health care offerings, while giving lenders more collateral. Sixteen responded, were whittled to 11, then five and then three, until Johns Hopkins was selected. The deal was finalized June 30, 1998.

Construction, partially funded by the sale, got under way almost immediately. But the bulk of the $142 million price paid -- which took the form of debt assumption, including the $57 million the hospital owed bondholders -- went to the creation of Horizon Foundation.

"That's one of the best things to come out of the merger," said Helen Ruther, who has been in Columbia longer than the hospital. "It's an important part of the community."

Horizon, created with $70 million, is an independent foundation dedicated to promoting health and wellness in Howard. It distributes about $3 million in grants annually to area organizations, including Howard County General, which recently received $40,000 to help with planning.

Ruther had doubts early on, when the hospital was looking for a parent organization. She and her husband were original residents of Columbia and helped finance the hospital years ago by investing in its bonds.

She was not sure a merger would be good for the hospital's community roots. But it turns out Hopkins had roots in the hospital, helping to develop it in 1973.

And though Ruther said today's hospital is not quite as folksy as it was in the 1970s, she calls the relationship with Hopkins a success.

"It used to be I knew all the nurses and doctors and really felt they were part of the community," said Ruther, who recently spent time at the hospital having a blood clot treated. "But the community has grown, and we're not what we used to be 35 years ago."

Since the 1990 census, the county has grown by almost 74,000 residents, to 261,134, which drives Howard County General's development.

"It's that kind of growth rate we're playing catch-up with," said Paul Gleichauf, senior vice president for managed-care planning.

People are slowly fleeing cities for the suburbs, and part of the reason Howard County is so attractive is that it is between Baltimore and Washington, which Reitz said made the hospital attractive to Hopkins.

"The most important reason for considering the Howard County acquisition was its geographic location," Reitz said. "It provides a wonderful long-term opportunity to strategically position ourselves in the Baltimore-Washington corridor."

The relationship, which is largely an advisory one, also enables Hopkins medical residents to get nontrauma experience and allows Hopkins to expand its patient base in a lucrative market.

"Having a presence here gives Hopkins an automatic billboard constantly flashing to the community," Gleichauf said.

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