A hospital comes to an end

Each year a handful of hospitals in New Jersey and Pennsylvania close.

In Philadelphia recently, the list includes Graduate Hospital, Temple Children's, and the Medical College of Pennsylvania.

To their communities, this can be a devastating economic blow.

But for a regional healthcare system, it might be simply — survival of the fittest.

WHYY's health and science reporter Kerry Grens visited one hospital on the brink of closure.

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Transcript:

Dolly Aliano Chappine has been a volunteer at Kessler Memorial Hospital for forty four years.

Chappine: Now I do 50 hours a week. That's here, in the gift shop.

Chappine's tenure may soon come to an end.

The small hospital in Hammonton New Jersey, about half-way between Philadelphia and Atlantic City, is teetering on the edge.

Chappine: It's kind of sad because like I said we had a good hospital here. What happened? I have no idea.

Kessler Memorial's situation is common among small community hospitals, says David Nash, dean of population health at Thomas Jefferson University.

Nash: It's a victim of trends out of its own control.

But the hospital's CEO, Jim Rossi, says the hospital's own mistakes are contributing to its downfall as well.

Investing in high-interest loans, racking up fifteen million dollars in debt, and not getting properly billing insurance companies.

Rossi stepped in in October to give the hospital one last chance to avoid shut down.

Rossi: For a while we thought we were going to make it. But it doesn't look like we are going to make it. And now the question is, where do we go from here?

Rossi is discussing possibilities with neighboring health systems that may be able to buy the hospital and convert it to something more profitable, like extended care for seniors.

Rossi: I am sure this will not remain a hospital long term.

Any day, says Rossi, a decision could be made as to the hospital's fate.

On this day, 60 of Kessler Memorial's 130 beds are occupied, and some patients are being treated in the emergency room.

Bill Zweibel, the medical director of the E. R., says closing could mean some people would die.

Zweibel: Three to five people a month would die, month after month after month, needlessly of stupid things. Stupid things like beestings, allergic reactions, asthma, congestive heart failure. That extra 25 minutes it takes to get to another tertiary care hospital just way too much.

Zweibel says already patients are starting to avoid Kessler Memorial, if they have a choice.

Zweibel: People have figured maybe I shouldn't go to that hospital, what happens if it closes, what's going to happen to my records, what's going to happen to my follow up care.

The hospital's CEO is working with the state's health department to make sure any essential services for Hammonton are maintained.

But businesses get no such soft landing.

Like many community hospitals Kessler Memorial is the largest employer in its town.

According to the New Jersey Hospital Association, Kessler pays sixteen million dollars in salaries and spends five million dollars on services like labor, laundry, and utilities.

Restaurant owner Alfonzo Iliano expects a hit to his business.

Iliano: I seen it in the past with a big company like Whitehall going out of town. Right at first as soon as they got out of it, we looked into a 7-8% decrease in business right after just by a single place.

People in the community donated about two million dollars to keep Kessler operating, but it didn't meet the five million necessary to leverage a loan.

David Nash at Jefferson says even if the hospital did get the money, that would only have prolonged the inevitable.

He says living in the shadow of the Delaware Valley hospital giants makes little Kessler Memorial untenable.

Penn, Temple, Cooper, Christiana…all can do complicated and money-making procedures like open heart surgeries and hip replacements.

Nash: No matter how good their so-called payor mix if they're unable to deliver these higher tech services I'm not sure I could see a way for their ultimate survival.

This culling of the small community hospital has been happening for about a decade in this region.

Nash says the Delaware Valley has too many hospital beds for its needs, and the market is simply downsizing.

Dolly Chappine, Kessler Memorial's long-time volunteer, says the consequences are frightening.

Chappine: It still has to be here because I don't know what they're going to do. Especially like seniors. Where are they going to take? By the time they get any other hospital, they're gone.

But some good may come out of hospitals closing down.

David Nash says studies show zip codes with fewer hospitals doing more procedures have better care.