Each of the area hospitals is different. Each has its own management priorities and scope of services that adapts to its patient population and community characteristics. It is a factor highlighted within each hospital by their mix of licensed beds (Medical/Surgical, Obstetrics & OB/GYN, Pediatrics, ICU/CCU). Therefore when excess bed capacity is discussed, one might ask where the excess beds exist and which type of bed is available?
The suggestion by Valley and Englewood that a purported excess of 300 area beds somehow verifies excess capacity is subjective. It ignores each hospital’s location and market area needs. It assumes the increasing occupancy demands by PVH’s closure can be adapted to. A point that will ultimately require an increase in total licensed beds if an area average of 83% occupancy is the goal, as defined by the State’s Report. Remember, the State’s Report and the financial stability of Valley and Englewood Hospitals is the whole foundation to the opposition’s argument against the reopening of a hospital in Westwood.
Consider all the variables in operating a hospital; general administration, nursing administration, human resource management and development, facility management (e.g., engineering, maintenance, environmental, housekeeping), medical staffing requirements (e.g., internal medicine, pediatrics, cardiologists, anesthesiologists, obstetricians, etc.), level of service decisions (e.g., emergency department, intensive care, respiratory therapy, pharmacy, dietary, occupational health, physical therapy, diagnostic imaging, discharge planning, etc.), information technology, purchasing and materials management, laboratory testing, infection control, disaster coordination, support staffing (e.g., volunteer services, community rep, clergy, coroner, medical examiner, morticians, etc.), security, legal, insurance, risk management, public relations. Do you think if a hospital’s management is unable to manage these various components successfully—forcing increased occupancy opportunities will overcome their systemic weaknesses—OR those in our health system infrastructure?
When you consider Holy Name Hospital’s service area as depicted by the maps in the prior blogs, it becomes apparent that its management is responsible for their opportunities, their successes and any failures. That organization has been successful for the past decade. Successful—because management adapted to its market’s demands—not because they attempted to manipulate one to meet its own needs at a community’s risk.
All hospitals have challenges. It’s the nature of business environments—they change. Health care is no different. Englewood Hospital’s current challenges are of its own making. They failed to plan and tack timely in the changing winds, growing without a credible public need justification. As shown by the map below, Englewood’s service area, as defined by the State’s Report, encompasses an estimated 2009 population of 143,020 residents. A service area 10% smaller then Holy Name Hospital’s, and yet Englewood Hospital has 34% more beds.
When we incorporate Valley and Englewood’s justification for defining a market, Englewood’s 5-mile radius population count rises to 317,737 NJ residents. AND again, if we accept the notion that a perceived 15-minute drive time is not a deterrent, then Englewood’s service area grows to include a partial area across the bridge into New York, increasing their estimated market population count to 955,910 potential patients.
Based upon Englewood Hospital management’s lack of consistency in producing positive revenue, would you blame the existence of a hospital eight miles away in Westwood or could there be other explanations for their challenges? Look at the location of Englewood Hospital within their 5-mile radius. How much of its’ ‘argument’ market area is treading water in the Hudson River? Their 5-mile radius NJ population is almost 28% smaller than Holy Name’s market area and to repeat, Englewood has 34% more licensed beds. Are all of Englewood’s 186 additional beds necessary? How would the DOH define licensed bed need in Englewood vs. Westwood? Maybe Englewood Hospital would be more efficient at a bed count similar to Valley Hospital? The State’s Report did say, “hospitals with low occupancy should reduce the number of beds they staff . . .” (Chap. 4, pg. 50)
The opposition hospitals, and politicians, have decided to put over 100,000 residents at risk. Not because the Pascack and Northern Valley residents don’t have needs, but rather to support a failed assessment on one aspect of New Jersey’s health system. Valley and Englewood argue that a 15-minute drive would not be a distance deterrent to the health care of the area. If such pronouncements were valid then Englewood should have long ago exceeded its occupancy capability. After all, there are an additional half million people across the river from them, within a ’15-minute’ drive. But then those NY residents are served by their own DOH approved hospitals. That’s even a possible question for the politicians. Which DOH will ultimately serve the Pascack and Northern Valley residents if they do not approve the reopening of a hospital in Westwood?
To be continued . . . .
How could Senator Weinberg or Governor Corzine not support a hospital in Pascack Valley? How does Assemblyman Johnson colorize these details? Typical politics. It’s not what’s right or wrong, its what gathers votes. Why hasn’t this stuff been voiced sooner?
Comment by Jes2jes — September 15, 2009 @ 6:33 PM
Those are some interesting numbers. Why haven’t the Hackensack Legacy people brought these forward. What are the numbers for Valley Hospital?
Comment by Dirk — September 15, 2009 @ 6:48 PM
What a change in perspectives. Is the DoH aware of these considerations? Were they the reason they granted the CN extension? How does the Democrat echelon in Trenton turn their back on the residents in Pascack with information like this?
Comment by John Rush — September 15, 2009 @ 7:12 PM
I said once before how can facts, politics and healthcare be so misaligned from the peoples needs. I read this and wonder how all the rhetoric got so far not to consider the points expressed here.
Comment by randoff123 — September 15, 2009 @ 7:12 PM
This is good to see. Good questions. The location and type of extra beds is important.
Comment by Lucy J — September 15, 2009 @ 8:29 PM
Is the town planning any more walks in the five mile radius?
Comment by robertphillips12 — September 15, 2009 @ 9:43 PM
Politicians do what politicians do, they make speeches and noise. Behind the scenes business and lobbyists make things happen. Who do you think is writing the health-care bill in Washington? That bizarre protest walk was just some thoughtless noise. Forget about it.
The market info here is scraping the surface, the obvious. HUMC and Legacy have already crunched the numbers. They wouldn’t have proposed reopening PVH if there wasn’t a financially supportable need. They surely also considered the competition in any equity risk assessment.
The last to put the need together on big issues is usually government so why shouldn’t this hospital concern be anything different. The DOH probably recognized it, granting the delay so politics could catch up with reality. How else would you prep a decision in contrast to a sitting Governor’s commission report?
What is surprising is that Corzine was a businessman. He must of had somebody who understood the market parameters of health-care needs. What’s offered here is the basic start for a risk analysis on residents as both patients and voters. With bloated inefficient business models under attack nationally, Englewood Hospital’s own decision prowess questionable, a State report recommending financial reviews of institutions and the possible adjustment of bed capacity to area needs, the decision to support a HUMC North concept shouldn’t have been difficult.
Comment by hedgevestor — September 16, 2009 @ 11:31 AM
You’d think nonprofit hospitals would appreciate the costs of competitive rivalry or the savings and value potential in some cooperative collaborations. Valley and Englewood are as competitive as any forprofit institution. They’ve thrown money and the kitchen sink at growing their market share since PVH closed. If they lose their bid to keep a hospital from reopening they’ll probably pitch for patients with a give-away campaign. The first 10 stitches free when you drive yourself to the ER. (100 stitch minimum required)
Comment by Stockbroker — September 16, 2009 @ 4:21 PM
Wonder how many times the Englewood Hospital directors have watched that movie Field of Dreams. It must be an indoctrination film for joining their board. They’re advertising their new bigger ER. How does the state authorize these tax exempt hospitals to spend money if their struggling with low usage? Do they plan on the state’s support to bail them out?
Comment by Sallyann — September 16, 2009 @ 8:21 AM
They built the Panama Canal and they came. What’s that old saying? Location, location, location.
Comment by Gill — September 16, 2009 @ 12:03 PM
You have saved your best work for last.
Englewood’s politicians are rowing with only one oar in the river.
Comment by CC — September 16, 2009 @ 10:43 AM
Why hasn’t HUMC been out in front with these kinds of analyses?
Walk to Ridgewood? That “Valley Girl” would have to walk on water to refute your findings.
Comment by Hello! — September 16, 2009 @ 10:50 AM