published Friday, July 30th, 2010

Hutcheson looks for life support


by Emily Bregel
Audio clip

Mike Williams

  • photo
    Staff File Photo by John Rawlston/Chattanooga Times Free Press - Registered Nurse Carolyn Anderson takes care of an infant in the nursery at Hutcheson Medical Center in Fort Oglethorpe.

Sinking deeper into the red, Hutcheson Medical Center in Fort Oglethorpe is facing a critical shortage of admitted patients, according to physicians and hospital board members.

An eroded local referral base and the loss of employed specialists and attending physicians hit the community hospital at the same time the recession depleted patient volumes.

The 195-bed hospital’s daily patient count, or census, has averaged just 42 so far this year, and Hutcheson is losing more money than it has in years, Chief Financial Officer Gerald Faircloth said.

Dr. Carlos Baleeiro of Battlefield Pulmonology, a practice employed by Hutcheson, described the hospital’s challenges as “the proverbial perfect storm.”

“It’s an unfortunate financial situation and such a bad combination of everything that I don’t have a good fix,” he said.

Jim Emberson, a member of Hutcheson Medical Center’s board, which governs the hospital’s daily operations, said many community hospitals have similar problems.

“We’re facing some hard times due to the economy, and as a result our census has been down for quite some time,” said Emberson, a former Catoosa County commissioner.

But local doctors say that more than the economy has played a role in Hutcheson’s recent struggles.

Over several years, the hospital has lost many of its referring and admitting physicians and specialty coverage.

“The doctors have left so they’re not getting the admissions,” said Don Oliver, a trustee of the Hospital Authority of Walker, Dade and Catoosa counties, which leases the hospital building to Hutcheson Medical Center Inc. “As a member of the board of trustees, I’m very, very concerned about what’s happening right now.”

Several doctors formerly associated with Hutcheson said privately they wished administrators had worked harder to cultivate relationships with local and employed physicians.

Martha Attaway, chairwoman of the hospital’s board, did not return calls seeking comment.

Hutcheson President and CEO Charles Stewart declined to be interviewed for this story, and the hospital’s communications staff did not respond to questions submitted by e-mail.

Hutcheson officials said this week they plan to hire Plano, Texas-based Community Hospital Corp. to help wade through the financial problems and consider whether Hutcheson should enter a relationship with a larger hospital.

Hutcheson faces the same challenges as community hospitals across the country in retaining market share and competing for patients with larger metropolitan hospitals, said Mike Williams, president and CEO of Community Hospital Corp.

“This is not just in Chattanooga; this is across the country,” he said.

SPECIALISTS LEAVING

Diagnostic Cardiology Group split with Hutcheson in October, shortly after helping the hospital get state approval for an interventional cardiac lab. The $1.7 million catheterization lab would allow the hospital to perform interventional cardiac procedures such as balloon angioplasty.

The hospital said in December it hoped to have an interventional cardiologist on staff in three to six months, but none has been hired and the plan now is on hold. Hutcheson’s sole on-call cardiologist does not perform interventional cardiology procedures.

Hutcheson has no neurology coverage and has 10 days a month of on-call orthopedic coverage from Dr. Peter Mulhern, an orthopedic surgeon.

Orthopedist Dr. Chad Smith, who used to provide an additional 10 days a month, recently stopped taking emergency calls at Hutcheson after a five-year contract ended.

There are two pulmonologists, Dr. Baleeiro and Dr. Nathan Mull with Battlefield Pulmonary.

Other primary care physicians who had been a major source of Hutcheson’s patient referrals have become employed by larger hospitals.

Two years ago, Dr. David Bosshardt, a major source of patient admissions, went to HCA, which owns Parkridge Medical Center in Chattanooga.

This summer, Battlefield Internal Medicine physicians Tiku Bhutwala, William Horton and Terri Jones affiliated with HCA as Parkridge Medical Associates of North Georgia. The practice still treats patients at Hutcheson.

In 1994, TCFPA Family Medical Center, an eight-physician group in the Hutcheson on the Parkway physicians building, became a part of the Memorial Hospital physicians group, Memorial Health Partners.

Magdalena Kowalski, a TCFPA physician, emphasized that the group steadfastly has supported Hutcheson over the years and noted that patient preference often dictates admissions.

“Our practice has supported the community. This is our community,” she said. “We go to both hospitals. We go to Memorial, we go to Hutcheson.”

IN THE SHADOW OF LARGER HOSPITALS

The relationship between larger metro hospitals and county-owned suburban hospitals has shifted in recent years, said Williams of Community Hospital Corp.

Historically, suburban community hospitals such as Hutcheson found their niche in obstetrics and gynecology, primary care and general surgery cases, while larger metro hospitals handled highly specialized surgeries and trauma care, he said.

But a squeeze on insurance reimbursements and rising numbers of uninsured patients put added pressure on larger hospitals, Williams said.

“Safety net hospitals,” which treat a large share of patients who can’t pay for their care, were particularly strained, he said. That sent urban hospitals looking for paying patients in the territory of community hospitals, he said.

“They have needed to look to the suburbs to balance their payer mix,” Williams said.

Hutcheson board member Emberson emphasized that Hutcheson and its officials are committed to maintaining local ownership and control.

“We have not discussed, and are not considering, a selling of the hospital,” he said. “This is a community hospital. It serves the five-county area of North Georgia. We’re dedicated to continuing that relationship with the people of North Georgia.”

A relationship with another hospital does not have to mean a “merger” or a takeover, Williams said. But a collaboration of independents could save costs by cutting duplicate services and could benefit from referrals that go in both directions, he said.

And partnering with a larger facility could aid recruitment efforts, he said.

“I have absolutely no question about the viability and the need for a community hospital” in Fort Ogle-thorpe, Williams said.

“The question the board will have to address is, ‘What is the model of delivery of care, organization structure, et cetera, which will allow them to optimize the situation they find themselves in?’”

about Emily Bregel...

Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...

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whitney29 said...

You guys should stop complaining cuz one the health care we have now isnt as good as it was supposed to be. also the law has just been signed give it a try u guys are too hard on democrats they went to college and we voted for most of these people.so if u want to say u have the right to choose tell that to ur congress men or state official. as for obama people are just tryin to make it look like america made a mistake he has done things to help us and we had a full 8 years of a terrible president and i will be so as happy as ever when a obama fixes bush's mistakes. You can find full medical coverage at the lowest price from http://bit.ly/chE6zp . obama has to put up with the world judging his every move and trying to fix the mess we are in we are lucky anyone wants to be our president. STOP COMPLAINING AND GIVE HIM A BREAK. i wanna see one of yall do what he has done. some people are just so ignorant.

July 30, 2010 at 1:19 a.m.
GeorgiaRebel said...

After my daughter was given almost $5000 worth of unnecessary treatment and two of my friends developed infections while at Hutcheson, I will not willingly use this hospital for anything.

July 30, 2010 at 2:55 a.m.
littleoleme said...

Hutcheson has a bad reputation because of horror stories that continue to circulate about incorrect diagnoses and treatment, and uncaring staff. This hospital is still called "Die County Hospital", in place of its former name, TriCounty Hospital, by many of the local residents.

If Hutcheson was the only hospital available in the community, then it might survive. However, since there are other options like Parkridge, Erlanger, and Memorial, then patients will continue to choose these facilities over Hutcheson.

Also, WHY, WHY, WHY did Hutcheson when it had ONE profitable year, choose to spend an outrageous sum of money to remodel the front lobby? The problems within this facility lie much deeper and cannot be fixed by throwing money into cosmetic renovations.

Once a reputation is ruined, it is hard to improve it, and I believe that Hutcheson's low census numbers prove that.

July 30, 2010 at 7:13 a.m.
enufisenuf said...

WHitney, when it comes to ignorant, your the pot calling the kettle black.Your a typical dumbocrat. You have no problem whinning about Bush when you idiot has done more to wake up and anger the working class American and degradr this country with his brash, un American, socialist antics, attitude and agenda. Obamacare is not a solution but only adds to the economic downfall of this country. Your messiah has done more damage in a year and a half than you brain dead mind could imagins Bush did. I will give him credit tho, him and his band of bozos has hurt the democommie party to the extent that we won't be seeing their antics again in power for quite some time. I know several people who actually admit to the democratic thought process and they are all blindly ignorant with seemingly no hope of ever having a rational, logical political thought.

As for Hutchinson, even people working there call it die county instead fo tri county. They have made some major blunders that cost lives, and the cost is ridiculouus. They mede their bed, let them lie in it. I will bypass them and go to Memorial or Erlanger before taking my chances at Hutchinson.

July 30, 2010 at 8:27 a.m.
deltenney said...

I guess I see Hutchinson in a different light than some of my friends. I did find the staff caring and experienced. I appreciate having a hospital in the Fort Oglethorpe community that is not a huge conglomerate, that may have struggled along financially but still is hanging in there and trying hard. I do not think the institution deserves the condemnation heaped upon it at a time it is experiencing the financial crush that many other hospitals face as well. I hope you folks will lighten up a bit and appreciate this smaller community hospital for what it does right.

July 30, 2010 at 10:25 a.m.
mkelley said...

It's all management. The economy wasn't the cause. Healthcare has ups and downs, been in the industry for 16 years and it's cyclical. Had a downturn in 2000, but management did ok. But the current group ran off Docs and others who "feed" patients into HMC. IMHO, the HMC, INC needs to be dissolved and the Catoosa, Dade, Walker Hospital Authority needs to oust those responsible. I was there as a patient (ICU) in November and it wasn't the HMC I loved.

July 30, 2010 at 5:09 p.m.
alohaboy said...

Glad they called those bonds I had a few years ago.

July 30, 2010 at 10:55 p.m.

HMC came a long way with there reputation for it to fall apart again. Some of the comments here hit the nail on the head....THE MANAGEMENT is the issue. It all began to fall apart when Charles Stewart entered the picture. I am not sure how the board can sit back and let this man continue to let this hospital dwindle to nothing. Poor decisions... sending staff to the rooms of the sick patients to collect their out of pocket $$, outrageous amount on unnecessary renovations, pouring out tons of $$ for unqualified consultants ( so called consultants that are friends of upper mgt). He has ran off the hospitals admitting doctors (Bosshardt and Wilson and MANY others) They have sold their Home Health (haven't seen that in the news), got rid of their ambulance services, closed the Doctor's offices in Rossville, what else? It is SAD. The fastest growing county in the state of GA has the hospital that falls easier than a house of cards!

The economy is not the issue here! The economy has an effect on elective procedures, that should have some effect on a hospital but to go from a full house to average of 42 patients, I would bet the other 156 empty beds are not empty due to people not choosing to have elective surgeries but making the choice not to go to Hutcheson due to poor management. People are choosing to have better care from a hospital that can keep qualified specialist and other doctors on staff and treat their patients with respect and honesty.

There, I said it. I feel better!

July 31, 2010 at 10:02 p.m.

As a member of the community my family has dealt with Hutcheson frequently, as well as the many other area hospitals and basically there is no real difference in the actual care given. The same staff may even be found at each. Hutcheson saved my Husbands life and I've never had any complaints there any more than anywhere else. I'd rather be cared for in my community cared for by neighbors and in turn support those neighbors.They DO however need to get their ADMINISTRATIVE act together! P.S. I hear it was the volunteers NOT the hospital who paid to renovate the lobby.

August 3, 2010 at 7:52 a.m.
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