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VOL. 124 | NO. 208 | Thursday, October 22, 2009

The MED Plans ER Closure

By Tom Wilemon

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Still dealing with millions of dollars worth of red ink after implementing numerous cost-cutting measures, the board of the Regional Medical Center at Memphis on Wednesday proposed shutting down its emergency room.

The trauma center would not be affected by the move, which is intended to improve the patient-payer mix because the ER is a gateway to the county-owned hospital for the uninsured. The date for the proposed closure is Feb. 1 unless the hospital can come up with $32 million in additional operational funding.

The board for The MED voted to put the matter on the agenda for its next meeting after discussing options in a closed session. After the hospital board formally approves the closure, it also would have to be approved by the Shelby County Commission. The hospital board is expected to take its vote next week at a yet-to-be scheduled meeting.

The hospital said it planned to release more information about the plan, such as potential cost savings.

Gene Holcomb, the chairman of the hospital board, said the action is not one the members wanted to take.

“This is a damaging blow for health care in the community, and we all take this very, very seriously,” Holcomb said. “Nobody wants to do this, but it’s either we have to get more money or we have to start cutting.”

The MED is in a unique situation with its patient mix, he said. If the closure goes forward, more uninsured patients will wind up going to other hospitals and health care providers.

“It’s just the simple matter that we’re down to less than two days of (operating) cash, and if we don’t do something, next spring we’re going to run out of money,” Holcomb said. “It’s irresponsible of us to sit back and fiddle. We have to tell the community in advance, the community at large and the political community, that, ‘Hey, something has got to give.’

“We’ve got to give them sufficient warning to be able to respond. That’s what we’re trying to do.”

The decision comes after several months of deliberation.

“We looked at every conceivable way and everything pointed to this by the process of elimination,” Holcomb said. “To have a trauma center, you have to have a vast array of services, so eliminating services in their entirety is not an option. We are talking with (Methodist Le Bonheur Healthcare) about working out a collaboration, if you will, for burn (cases) and perhaps for sickle cell (treatments).”

Other essential services the hospital wanted to continue are women’s and children’s services and the neonatal intensive care unit.

One of the reasons for the drastic measure is the $25 million in uncompensated care for treating trauma patients from Arkansas and Mississippi. But Holcomb admitted the closure of the ER will primarily cause hardships for Shelby County residents. He said it should weigh on the consciences of officials in the two states that Shelby County residents will suffer while out-of-state residents receive free services.

However, The MED also merits more funding from Tennessee than it receives, Holcomb said.

“When we generate in the $80 million-plus range from federal funds for Tennessee and only get $30 million-something of it back, when we’re getting reimbursed by Shelby County essentially the same thing we were getting 15 years ago – and everybody knows what health care inflation has been – then all of a sudden, $32 million doesn’t look so outrageous,” Holcomb said.

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