A Crushing Good-Bye to 110 Years of Healthcare

  By Frederick Schultz

You are probably not likely to meet a finer, more decent, friendly and dedicated group of leaders than the folks who represent the Seventh Day Adventist community in Takoma Park. This is especially the case with Washington Adventist Hospital, based on my many years working with them.

So how do we reconcile this picture with the reality that in January, these same folks plunged a dagger into our hopes and expectations of a future “health village” delivering a range of reliable health services to our residents?

Services that were to be especially targeted to lower income residents in this corner of the Washington region. An area replete with many thousands of immigrants, people with limited mobility and modest incomes. Medical care sustained for 110 years since the hospital’s founding, severing once and for all what seemed like an immutable bond; and discarding years of thoughtful mutual consultations between the City Council and the hospital’s top people. I remind myself that this is where my big sister was born in 1933, and where I have been an inpatient more than once.

You can read here the City’s official press release on this matter: https://takomaparkmd.gov/news/hospital-considers-leaving-fewer-health-facilities-in-takoma-park/

Last month I met with Robert Jepson, Vice President for Business Development for Washington Adventist  Hospital (WAH). He said they expected to file in a week or two with the State of Maryland’s Health Care Commission their formal request to move certain facilities out of Takoma Park. Their removal would effectively vacate the hospital campus. Meanwhile, the hospital, pending State approval, has already begun negotiating the sale of their entire 13-acre campus to Washington Adventist University.

So, how did this happen? Why so suddenly? Perhaps the most important question is what does this mean for the future?

First, to be clear, I do not believe that the hospital leadership negotiated with us (the City) in bad faith. I realize there is lots of room for disagreement on this point, not to mention anger, disgust and disbelief. For one thing, the Mayor, City Council, city staff and attorneys have spent a lot of time and expense fighting for the best deal possible to preserve the Adventist’s health services in our city.

Is the WAH decision a total loss cause? I can’t answer that question. Politics can play a role in these sorts of situations. But, I am assuming for now the hospital’s decision is irreversible.

Second, let’s understand the hospital is fundamentally a business. Notwithstanding its mission statements and piety to the contrary, it has to be profitable in the long run to sustain itself.

Third, hospitals in Maryland operate in a competitive environment fighting to fill beds, to be efficient, and to comply with Maryland regulations governing hospitals, which are unique in the United States, and which obligate all hospitals in Maryland to operate under fixed global budgets. Layer on top of that the political chaos in Congress enflamed by the Trump Administration that generates confusion and uncertainty for insurers, for Medicaid and Medicare programs and for ObamaCare enrollees.  Plus, add another layer of rapidly changing medical technology and science; the role of third party physician practices and imaging services all of whom are trying to make a buck off their affiliations with hospitals, and “big pharma” affecting costs. It gets complicated.

With this as context, here’s my interpretation of what happened. Think of dominos falling.

We know that in December 2015 the MHCC (Maryland Health Care Commission) approved WAH’s Certificate of Need (CON) application with provisos that WAH had to staff and operate a 24-hour walk-in urgent care center and must keep its inpatient behavioral services in place for a minimum of four years.

WAH’s president Erik Wangsness publicly committed to a list of eight medical services that would either remain in situ or be added to the medical campus including its inpatient behavior (psychiatric) services and its physical rehabilitation units. The City argued strenuously to the MHCC to mandate WAH to sustain all of these other medical services in Takoma Park. The MHCC didn’t agree with our position. The loss of that argument in 2015 seems to have been our Achilles Heel in this saga.

The City leadership trusted the hospital’s commitment to maintain a medical campus here. Mr. Wangness’s predecessor as president, Joyce Newmyer,was also wholly committed to this goal through their first CON application, which was denied, and the second CON that was approved. The second CON greatly strengthened WAH’s long-term commitment to and stake in its Takoma Park campus.

According to Mr. Jepson, WAH’s plans for Takoma Park changed in late 2017 when WAH figured out that it could reduce costs and increase revenues by merging its Takoma Park behavioral unit with a similar unit at Shady Grove Hospital. That unit had been losing money. In turn, the relocation of the behavioral health unit led to the realization that maintaining its rehab unit by itself in Takoma Park would no longer be cost effective with regard to security and property maintenance costs. These beds will  therefore likely be moved to the new hospital in White Oak. As the dominos fell, it apparently followed that maintaining the other medical services, including a possible free-standing emergency room made no financial sense at all.

Why it took the hospital more than two years since CON II was approved to figure out these cost saving maneuvers is anybody’s guess.

So what of the future of the campus?

Assuming the MHCC approves WAH’s changed plans, should we say to WAH, in effect, “Good bye and don’t let the door hit you on the way out.” Yes, I am dismayed by the hospital’s breach of faith. But maybe we should look at it another way.  We can instead consider this misfortune as an extraordinarily unexpected opportunity to address other serious needs our city has. Like a new MCPS elementary school for our mushrooming school age population (if the School Board is willing); or perhaps a site for a high quality, year-round aquatic center? What about the need for more affordable housing and some small retail amenities? Also, shouldn’t there be something in this for the enhancement of Washington Adventist University? Or perhaps a combination of the above.

13 acres means not only room to preserve and protect woods, green space and the Sligo Creek watershed, but also nine acres for demolition of old buildings and for developing uses the City desperately needs. Imagine, 10 years down the road, maybe we will be adjusted to receiving care at Holy Cross Hospital; having our kids walk to a new public school, the City benefitting from an increased tax base and others of us enjoying new housing and amenities we never imagined. Maybe we can turn misfortune into our lucky day.

Bruce Baker, president of CHEER, probably has more grass-roots familiarity than anyone with the health care needs of our community. I asked him his views.  “We as a community need to think about the best uses, something that will help make us all healthier.” He meant healthier in the broadest sense of the word. He added he “hopes for some sort of process” to be set up to figure this out.

WAH will move into its new building on Plum Orchard Drive in the summer of 2019, says Mr. Jepson. That’s not long. We are already well into planning the move, he added.

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