Joe Winick

Through almost 13 years of working at Erlanger North, emergency department nurse manager Eileen Shrum has seen the hospital's life cycle peak and plummet.

Today Erlanger North, the Red Bank facility of Erlanger hospital, is in a bit of a dip, she said. Following the March decision to stop taking admissions in medical and surgical services at North, hospital employees have worried about the future of their hospital, she said.

"Everybody gets really concerned when you see (volume) numbers drop," she said. "I think this is a wonderful facility. I think it's got a lot of promise. I just want everybody to know that we are here, that we didn't close."

Hospital executives emphasize that Erlanger North, which still operates an emergency room and geriatric psychiatric unit, among other services, is not the "forgotten hospital," as employees there have lamented.

"That may be a perception that people have had in the past," said Dawn Blackwell, administrator at Erlanger North since December 2008. But ceasing admissions in some services is "not the be-all, end-all of North."

In fact, the hospital could reopen some beds if the flu hits hard this winter, said Joe Winick, Erlanger's senior vice president of strategic planning.

And a long-term plan to establish a niche in geriatric medicine seems close to coming to fruition, he said.

"Erlanger North is a top priority for the Erlanger Health System, and we are actively engaged and intending to get those beds opened as soon as possible," he said.

CLOSED TO ADMISSIONS

In March, Erlanger North stopped admitting medical and surgical patients. Due in part to the economic recession, the hospital was averaging only five to 10 filled beds on a daily basis. Executives decided to consolidate services at Erlanger's East Third Street campus.

About half of the 100-person staff was cut at Erlanger North. Most of those employees accepted employment at the downtown campus, Ms. Blackwell said.

Other services at the hospital, including 24-7 emergency care, an inpatient geriatric psychiatric unit and sleep disorder center, are still running.

The March changes at North unnerved some employees, Ms. Shrum said.

"It does take a huge blow when, out of nowhere, you lose two units. The med/surg and the ICU closing really did hurt everybody's morale," she said.

Erlanger North has faced challenges since 2004, when Galen Medical Group moved its six-doctor practice to Memorial North Park, taking almost half of Erlanger North's internal medicine physicians.

At the time, the doctors attributed the move to a lack of 24-hour anesthesiology services at North, services that were later reinstated there, the Chattanooga Times Free Press reported.

Patient visits at North dropped by 45 percent the year after the doctors departed, according to newspaper archives.

"The Galen hit was the biggest hit," Ms. Shrum said.

Since the March changes, ER visits have dropped at North, she said. The hospital is now seeing an average of 41 emergency department patients a day, compared to 58 to 60 visits before March, though visits still reach about 1,300 per month, she said.

The hospital is reaching out to the community with special programs to let more people know services are still available, Ms. Blackwell said. For instance, a new exercise and screening program for seniors was launched recently at a nearby community center, she said.

"We're not going anywhere," she said.

PLANS FOR FUTURE

In 1988, Erlanger Health System purchased Erlanger North, formerly Red Bank Community Hospital, for $2.4 million. Officials then invested in two expansions, building a 30,000 square-foot addition in 1996 and purchasing the Red Bank Professional Office Building behind the hospital for $575,000 in 2001, the Times Free Press reported.

At the time of the initial purchase, board members and hospital management had high hopes for Erlanger North, said Dr. Wayne Shearer, a retired Red Bank optometrist who was a board member at the time.

The status of Erlanger North today is "disappointing," Dr. Shearer said.

"Right now, it's just sort of sitting there, but the potential of growth in serving patients and serving the needs of the people out in there is still here," he said.

But Erlanger officials say they have talked with staff and residents in the area to develop a strategic plan to make the hospital a center for geriatric and senior care.

""That's what really has driven our focus," Mr. Winick said.

More than 100 elderly care facilities are within a 50-mile radius of the hospital, and 30 percent of the area's population is 55 or older, Ms. Blackwell said.

"There aren't any (medical) facilities that focus primarily on senior population," she said. "If we could provide those services here that would be a tremendous bonus for the seniors in this area and would probably draw people from outside the area as well."

Though the geriatric-focused strategy for North was introduced to the board three years ago, it has taken longer than expected to implement, Mr. Winick said.

"We were challenged in our execution," he said. The plans in place today are stronger, he said.

"I would call it a reaffirmation and a commitment to our strategy at Erlanger North," he said.

Under current plans, fellows in the new geriatric fellowship at University of Tennessee College of Medicine in Chattanooga eventually will do their training with elderly patients at Erlanger North, Ms. Blackwell said.

North already has brought on two new primary care physicians, plans to add gastrointestinal services and is looking to expand the geriatric psychiatry program, she said.

Hearing about new options for the campus and the focus on geriatric care has boosted employees' outlook, Ms. Shrum said.

"At least knowing there is a plan for us to go forward, instead of just leaving us floundering," she said.