Expanding while contracting

The healthcare options in South Philadelphia are about to change again, leaving the community with one less emergency room but with better-focused facilities, according to officials.

Executives from the companies that own St. Agnes Medical Center and Methodist Hospital announced last week they are working on an agreement that would consolidate services at the two facilities and hopefully secure the future of both hospitals.

The plan calls for St. Agnes, at Broad and McKean streets, to close its emergency room and stop performing surgeries in favor of expanding its long-term intensive-care and skilled-nursing capabilities. Conversely, Methodist Hospital, just three blocks south at Broad and Wolf, would increase its surgical and emergency-room facilities.

Officials are hopeful the agreement will end the economic woes both hospitals have suffered in recent years. The two facilities combined lost more than $10 million between 2002 and 2003, said Gavin Kerr, president and CEO of Mercy Health System, which owns St. Agnes.

Thomas J. Lewis, president and CEO of Thomas Jefferson University Hospitals Inc., said his company realized a change was inevitable as it assessed Methodist’s future.

"Given the economics and the demand, it clearly doesn’t make sense for there to be two short-term, acute-care hospitals in South Philadelphia," said Lewis.

Mercy’s assessment of St. Agnes found similar results — that the two facilities were "nearly mirror-image hospitals three blocks apart from each other," Kerr added.

The last major change in South Philly’s healthcare landscape came in May 2002, when Methodist stopped delivering babies; St. Agnes hadn’t made a delivery since late 1983.

By becoming a long-term intensive-care hospital, St. Agnes would offer a service currently not available anywhere else in South Philly or Center City, Kerr said.

Long-term patients are those who require in-hospital care longer than 30 days, compared to typical short-term patients whose stays don’t exceed five days. Long-term patients often suffer from multiple illnesses or need to use medical machinery, such as a ventilator, said Kerr.

"These are patients who need longer-term care but are clearly more acutely ill than a patient who would be discharged to a nursing home, for instance," he said.

St. Agnes also would expand its skilled-nursing, hospice and home-healthcare services.

Under the proposal, both facilities would require renovation. Methodist plans to reconfigure its existing space, allowing it to expand from 120 beds to 200 to handle the influx of patients.

The changes also would affect St. Agnes’ Center for Advanced Burn and Wound Care. In the last 20 years, Kerr said, the number of burn patients in the city has decreased dramatically. In addition, Temple University Hospital and other facilities have opened burn units.

St. Agnes would no longer handle burn patients in need of short-term care but continue to treat burn victims requiring longer hospital stays, which Kerr said comprises a significant portion of such patients.

The future of St. Agnes’ new same-day surgery unit, funded in part by a $500,000 donation from Comcast-Spectacor, is yet to be determined. Kerr said it could remain at St. Agnes if Methodist does not have room. He added that Comcast has been informed about the possible changes and has agreed to continue to support the unit wherever it ends up.

The rising cost of Pennsylvania’s medical malpractice insurance has contributed to the South Philly hospitals’ financial difficulties, said Lewis and Kerr, adding, however, that it is just one of many factors. They also listed the city’s nursing shortage, the increasing expense of new medical technology and the rising cost of energy.

Both officials said they were unsure whether the consolidation would result in a loss of jobs at either hospital.

"We are very committed to the employees in the community and we are working hard to figure out how to make that work for everybody," Lewis said. "It works best if both of those facilities are occupied and employing people."

If there are cuts, he said, the companies would try to place workers in other vacancies within the Jefferson and Mercy health systems.

"We’re not looking to lose anybody here," said Lewis. "It’s not like we have an overabundance of healthcare workers in the city or in South Philadelphia."

Many St. Agnes surgeons already work at both hospitals, he said, adding those who do not would be welcome to make the switch.

Meanwhile, it could take months to finalize the deal between the facilities. Once it is done, both executives said, the hospitals would conduct outreach programs to further educate residents about the changes.