OP-ED by Alan Abrams, La Prensa Senior Correspondent
It has become an all-too-familiar scenario played out in a score of struggling lower income communities across the country.
A large hospital, often the only provider of medical care for the population, closes a local facility putting the population it served at even greater risk.
Usually, there is one voice of courage who leads the public outcry while the hospital tries to convince the media and the public that it is all in the name of progress.
Last week’s events regarding the Cleveland Clinic Foundation’s imminent decision to close Huron Hospital in East Cleveland were a textbook example.
The heroine of this story is Northeast Ohio’s courageous Congresswoman Marcia L. Fudge (D-OH 11) who stepped forward immediately to lead the crusade to get answers and results for her constituents.
As soon as the congresswoman learned of the June 6, 2011 decision to end inpatient services at Huron Hospital she called for action. Terming the decision “detrimental to the community,” Fudge gave the following statement to media:
“I am deeply disappointed that the Cleveland Clinic is abandoning a critical component of health care for thousands of constituents in Cleveland and East Cleveland by eliminating in-patient service in an area where it is desperately needed. Quality care must be accessible care.
“While the opening of the Cleveland Clinic Huron Community Health Center in October is important for meeting the needs of residents, it should not be viewed as a replacement for emergency room care and inpatient medical care,” said Congresswoman Fudge.
“I will be holding a meeting with civic and faith leaders, and Dr. Delos (Toby) Cosgrove, M.D, at the Cleveland Clinic on June 7th. At that time, I expect to learn more details of the Clinic’s announcement.”
Congresswoman Fudge believes that the clinic and the community need to come together during this time to talk about how losses to the community can be mitigated. She doesn’t believe the community or the clinic should close the door on further discussion.
She is concerned about the potential harm the closing might cause to the community and wants to avoid the Huron hospital building remaining vacant for years, causing blight in the community and dragging down the local economy. She is also concerned about the loss of jobs, but has high expectations for employees to stay in the clinic system.
She plans to meet with the Clinic again within 60 days, but will continue to monitor progress in the meantime.
La Prensa has since learned that the results of Congresswoman Fudge’s June 7 meeting were inconclusive.
But where are the voices of local community activists? This type of unilateral action needs to be met with a chorus of organized protests.
Frankly, we are not surprised that the efforts of the Congresswoman to get answers has been temporarily stymied. The Cleveland Clinic Foundation has stonewalled this reporter’s attempts to interview any of the principals at Huron Hospital.
Instead, we were given the same June 6 PR handout provided to other media. In a nutshell, here’s what they are saying:
Cleveland Clinic’s Board of Directors announced it will end operations at Huron Hospital within 90 days. After an extensive evaluation of data and ongoing efforts to preserve the hospital, a special committee of Cleveland Clinic’s Board of Directors and hospital leadership concluded that Huron
Hospital is not sustainable for a long-term future. Cleveland Clinic will continue to provide outpatient care at the hospital until the new Cleveland Clinic Huron Community Health Center opens Oct. 3 on the hospital’s campus.
The hospital claims that this center is “better designed” to meet the community’s changing health needs.
Cleveland Clinic will offer round-trip transportation services from the Huron campus to Cleveland Clinic’s main campus, as well as Euclid, South Pointe and Hillcrest hospitals. Cleveland Clinic will also provide ongoing communication to patients, and hold community information meetings on access to care in the future.
As one of Cleveland’s first hospitals, Huron Hospital has a 137-year history of serving patients. But the Cleveland Clinic now maintains that over the years “many factors negatively impacted this once-thriving hospital, including a steady decline in patient use, a rapidly shrinking population, costly maintenance of the hospital’s aging facilities, and substantial fixed costs that were much higher than the hospital could maintain.”
And this is the main bone of contention.
“This is a difficult day for Cleveland Clinic, but we are firmly committed to caring for this community and supporting our employees affected by this decision,” said Delos M. Cosgrove, M.D., Chief Executive Officer and President of Cleveland Clinic. “We are facing challenges in healthcare today never seen before, including a dramatic shift toward outpatient care, a difficult economy, a declining population, and the uncertainty of healthcare reform. These challenges require us to adapt to best meet the needs of our
patients. Our investment in the new Huron Community Health Center and our work to regionalize trauma will allow us to have more of an impact on the community’s health.”
To its credit, the new Cleveland Clinic Huron Community Health Center will continue Huron Hospital’s dedication to preventive care and chronic disease management, which is a critical need in East Cleveland and its surrounding area. Because of Huron Hospital’s successful chronic disease management practices, 37 percent of all hospitalized patients in 2009 had a first or secondary diagnosis of diabetes, down from a high of 57 percent five years earlier. It is one of 30 hospitals in the nation to receive certification from The Joint Commission as an inpatient diabetes center.
And that’s one of the key factors the Cleveland Clinic Foundation claims motivated their decision.
According to Gus Kious, M.D., President of Huron Hospital, “Through better management of chronic disease and less dependence on emergency care and hospital stays, the East Cleveland community now has a greater need for a health center than a hospital. Today, healthcare is delivered largely on an outpatient basis. A community of this size – located within three miles of two major hospitals – can no longer sustain, nor is there a need for, its own hospital.”
“Huron Hospital has given a diverse group of physicians, nurses and employees the opportunity to do great things, and what we’ve accomplished for a socioeconomically challenged patient population will be carried on,” Kious added. “The dedication of our people has never wavered, but we can no longer stand up against external forces that will begin to challenge our ability to provide quality care.”
The Cleveland Clinic Foundation did detail several of the key factors that led to the board’s decision:
In the first half of 2010, only 17 percent of patients from Huron Hospital’s primary market went to Huron for key inpatient services, including heart care, oncology and pulmonology. The vast majority of patients (83 percent) are already choosing other hospitals, with the largest number (35 percent) going elsewhere in the Cleveland Clinic health system. Further, only 38 percent of East Cleveland patients use Huron Hospital for inpatient services. Declining patient volume creates potential challenges to maintaining quality and patient safety.
There’s been a 10 percent decrease in discharges since 2003, and a 16 percent decrease in surgical procedures. Huron Hospital currently has less than 100 patients a day and less than 60 percent of the 185 staffed beds are occupied. The decline has accelerated this year with some units closed temporarily; on some days the hospital has held as few as 47 inpatients.
According to the 2010 U.S. Census, the population in East Cleveland has declined 34 percent (from 27,217 to 17,843 residents) since 2000.
The Cleveland Clinic Foundation says Huron Hospital’s facilities are aging and have required extensive resources over the years. “The hospital has sustained continued financial losses and Cleveland Clinic anticipates losses at the new facility, as well. Cleveland Clinic officials plan to reach out to City of East Cleveland officials in the near future to discuss transitional issues and to determine the future use of the property. “
Cleveland's Huron Road Hospital was founded in 1856 and incorporated in 1874. It became a founding member of the Meridia Health System in 1984. In 1997, the Meridia Health System became part of the Cleveland Clinic health system.
Among its many accomplishments, Huron Hospital was the first community hospital in the Cleveland Clinic health system to fully implement electronic medical records. Huron Hospital has been recognized by the U.S. Department of Health and Human Services for success in saving lives by increasing organ donation rates.
Huron Hospital patients can get more information at 216-761-2955. Information also is available at www.huronhospital.org.
At press time, La Prensa received another written statement from Huron Hospital, reading “Our commitment to our patients in East Cleveland has not changed. We’re transitioning the way we care for patients to better meet their healthcare needs. We are building a new Cleveland Clinic Huron Community Health Center that will focus on chronic diseases that are prevalent in this patient population. Inpatient care will be moved to Cleveland Clinic’s main campus, 2.5 miles from Huron Hospital, or other hospitals within our system. Transportation will be provided for those patients who need it.
“After efforts to preserve Huron Hospital over the years, multiple factors led to the difficult decision to end inpatient services there. A declining population, reduced usage of the hospital, and a shrinking need for inpatient services required us to evaluate the best way to provide high-quality care to our patients, while using our resources responsibly.
“Further, with the formation of the Northern Ohio Trauma Service (NOTS), we firmly believe that a regionalized approach to trauma will improve care and access to our communities across Northeast Ohio.
“We are planning to hold open forums to engage the community about the transition of the Hospital and about the new Cleveland Clinic Huron Community Center in the near future.”