More than 200 people joined a candlelight vigil outside Bayonne Medical Center on Sept. 20 to highlight the downsizing of services and the impact on community.
For more than a year, Bayonne Medical Center as been shutting down some of its less profitable services, and may be in the process of changing to focus less on the poor than on more elaborate medical service.
The Coalition to Save Bayonne Medical Center – a group of doctors, nurses, residents and public officials – claim the changes are hurting the poor, the elderly, and residents of Bayonne who would have to scramble to find the services elsewhere.
Since its formation in late August, the coalition has gathered more than 18,000 signatures on a petition to the state to secure a state-appointed monitor to oversee BMC’s operations and its finances.
Spokesperson Mary Jane Desmond said the hospital may not be doing anything wrong but there has been no independent body to determine if the process if correct or what the potential impact will be on the community.
“The state has agreed to send in a monitoring team,” said Mayor Joseph Doria, who has supported the coalition’s demands for accountability by hospital staff.
Last month, at the urging of Doria, Dr. Fred Jacobs, commissioner of the state Department of Health, visited the hospital where he reviewed some of the issues and heard some of the complaints. The appointment of the monitor appears to have resulted from that visit.
Doria, who also serves as state senator, was accompanied by Assemblyman Louis Manzo, Councilman Anthony Chiappone other public officials, said the team would survey the hospital at some point over the next few months.
Downsizing hospital services
Over the last year, BMC has closed its senior center, reduced the size of its psychiatric wing, and eliminated other services within the hospital. But the most obvious change to the public came when the hospital announced it would begin sending expectant mothers to St. Vincent’s Hospital in Staten Island in September and closing down birthing operations in Bayonne – at least temporarily.
Dr. Tobi Ippolito, one of 32 physicians in the coalition, claims BMC is turning its back on the most vulnerable people in the community and pleas and protests have “fallen on deaf ears” with hospital administration.
Robert Evans, president and chief executive officer for BMC, said the administration is open to communication. “Bayonne Medical Center welcomes an open dialogue on issues with any person or group, as has always been our policy,” he said. “However, sometimes well meaning and sincere people have to agree to disagree on certain matters, while simultaneously treating one another with courtesy and respect.”
While the hospital is building new services to help navigate some of the worst financial times in the healthcare industry, Evans said, “We plan on continuing to build the mission of Bayonne Medical Center for the residents of this city for the next 100 years.”
A national problem for hospitals
While critics claim BMC is abandoning services to poor people, BMC administration says the changing environment has made it impossible for the hospital to compete.
In the past, hospitals were the major provider for numerous services that are now done in small clinics – drawing away from hospitals a significant part of their revenue.
Also with significant lower expenses, such as rent and salaries, small clinics can operate in with reduced pay back that private insurance and federal programs offer. Burdened with significant expenses of maintaining whole departments complete with staff and upkeep and a loss of revenue, hospitals such as BMC must scramble to find new revenue sources – such as highly technical or sophisticated medical procedures small clinics cannot do. But even with additional revenue, BMC administrators say the hospital must close down some operations to cut costs.
While critics claim BMC has abandoned poorer patients, hospital officials say they have simply referred those patients to other venues that can provide services BMC cannot afford to provide.
This may mean that a mother will have to go to St. Vincent’s for delivery or to local clinics for prenatal care. This might also mean that poor people might be sent to small clinics for follow up services rather than returning to BMC for aftercare.
This has resulted in some disorientation, but BMC administrators say the poor are still getting the services, just not directly from BMC.
The purchase of St. Vincent’s Hospital questioned
These changes come at a time when Bayonne Medical Center is seeking to purchase St. Vincent’s Hospital. “If our hospital is struggling to survive, what is going to happen with St. Vincent’s Hospital?” asked Donna Benjamin, president of the union representing many of the workers.
While critics claim the purchase of St. Vincent’s Hospital will increase BMC’s overall debt, Evans said additional revenues resulting from St. Vincent’s will more than make up the cost of purchase.
BMC is borrowing $89 million from the New Jersey Health Care Facilities Finance Authority and is expected to expend about $103 million to upgrade the St. Vincent facilities.
While critics claim the purchase comes at the expense of basic services, BMC officials claim the purchase is necessary for the survival of BMC center, not only will it provide BMC better discounts on supplies, it will more than triple the base of potential patients.
Is this a labor issue in disguise?
Perhaps disguised by the intense emotions and sharp rhetoric is the fact that the biggest impact of the closings is the staff as the hospital lays off managers and other employees with the closing of each service.
Although the committee opposing the changes has many well-meaning people involved, those most vocal, hospital officials said, are people who have been denied promotions or whose jobs have been somehow otherwise impacted by the changes.
Patients – while may be inconvenienced by needing to travel to other venues – still get the services they need. While public officials have taken the side of the protestors, state officials seem to believe that the changes are less a matter of health than a matter of business, and that the Department of Health, while reviewing the medical impact, cannot oversee its business decisions.
BMC, meanwhile, got mixed results in the New Jersey 2006 Hospital Performance Report – which assesses the state’s 81 acute care hospitals. While Bayonne rated as the best four northern counties in this report for response to heart attacks, it tied with Jersey City Medical Center as the worst for pneumonia.