Sun Chronicle
Andrew Rice arice@keepmecurrent.com
Bigger is just better,’ say hospital officials on merger
BIDDEFORD – The top officials at Goodall Hospital in Sanford and Southern Maine Medical Center in Biddeford reassured the public during a series of forums that the upcoming merger of the two facilities will expand health care in York County and improve both hospitals.
Beginning Jan. 1, 2014, the two hospitals will officially become Southern Maine Health Care, effectively making it the fifth largest health-care system in the state, with 2,200 employees.
“It is especially difficult for small hospitals with low volumes (of patients) and fixed costs,” Ed McGeachey, CEO of Southern Maine Medical Center, told the group.
The presentation cited the impact of further government cuts in fiscal year 2014. The so-called government sequestration will take away $1.5 million, on top of MaineCare cuts of $1.6 million and a state hospital tax of $1 million.
“At the same time we’re seeing decreases in reimbursement, we’re also seeing an increase in bad debt and free care,” said Patsy Aprile, CEO of Goodall Hospital.
In the health-care realm, free care is defined as care given to those who cannot afford to pay, while bad debt is accumulated from care given to those who do not pay. Aprile added that Southern Maine Health Care projects the combination of bad debt and free care to cost $33 million next year.
Aprile said during the presentation that it is no secret that Goodall has struggled during the last decade, including a round of layoffs in 2008 and benefit cuts in 2009, but that merging with Southern Maine Medical Center will only help Goodall, which, she said, has not had the necessary funds to invest in infrastructure.
“At the Sanford campus we need a new roof, which is over $1 million, and new boilers, which are about $1.2 million,” she said.
With the merger, hospital officials are hoping to combine the assets of both centers, effectively creating an economically sound system.
“The merger between Goodall Hospital and Southern Maine Medical Center combines the strengths of both organizations to give Southern Maine Health Care the scale necessary to be economically viable,” said Aprile.
However, with these changes come questions, including whether staffing levels will remain the same, and what services will shift to different locations. Among changes announced during the presentations is the consolidation of two sleep labs, making one lab in Kennebunk offering longer hours six days a week, and a consolidation of labor and delivery.
Starting in January, all pre-natal and post-natal care will remain in Sanford, but all births will be in Biddeford’s birthing suite. Aprile and McGeachey presented numbers in defense of this decision, stating that 56 percent of Sanford mothers are already going elsewhere for care, including 25 percent to Biddeford and 22 percent to Portland.
“Making this change alone will save us $2.1 million on an annual basis,” Aprile said.
As of now, the organization plans to downsize by seven nurses between both hospitals.
Questions from Springvale residents included the availability of primary care physicians, as well as the reasons for Southern Maine Medical Center to accept the merger, given Goodall’s current financial status. Currently, Southern Maine Medical Center’s budget is financially sound, but Goodall faces a $4.3 million shortfall. However, McGeachey said, “bigger is just better” in health care.
McGeachey said that because Southern Maine Medical Center is larger and has been part of the MaineHealth system longer, it has been able to remain steady financially. “But, if you put together these organizations, you have something that’s bigger, and therefore more sustainable,” he said.
McGeachey added that a larger system will give both hospitals access to services and technology that otherwise wouldn’t be available, including more access to cardiology and pulmonology specialists in Sanford and walk-in care in Kennebunk.
During a forum Oct. 3 in Biddeford, attended by only a half-dozen residents, questions ranged from whether the hospital plans to work further with the University of New England to study the effects of The Affordable Care Act, which Southern Maine Health Care endorses.
“We already have a close relationship with UNE, but there will be more opportunities now with the campuses in Sanford, Waterboro and Kennebunk,” McGeachey said. “Many of our clinical staff are also UNE graduates.”
Another change taking place is the reduction of surgery hours at Goodall, from 7 a.m.-5 p.m. This prompted Susan Riding of Springvale to ask what happens if a Sanford resident required surgery at night.
“They would be transported to Biddeford,” Aprile said.
She added that Goodall already transports many patients to Southern Maine Medical Center, depending on the surgery. McGeachey again cited the low volume of patients requiring the type of care into making the decision.