When Premier Health announced it would close Good Samaritan Hospital later this year, one big question was what would happen to the 58,000 patients who annually enter the emergency room at the northwest Dayton hospital’s main campus.
Those patients may soon have other options, including one that surfaced last week.
Although Premier says it has the capacity to handle all the ER visits at its other locations, Grandview Medical Center — operated by competitor Kettering Health Network and located just three miles away from Good Sam — announced on Monday that it is beginning a $25 million expansion that will double the size of its emergency department.
The Good Sam closing may spur other changes as community leaders work to ensure that people in the neighborhoods around the hospital at 2222 Philadelphia Drive have adequate access to health services.
The Greater Dayton Area Hospital Association and Public Health - Dayton & Montgomery County have put a rush on a study to assess what the health needs are in the city of Dayton, which could shed light on what heath gaps there are and how those services could be met.
Five Rivers Health Center’s board is exploring how the community health center could expand services. The center serves patients regardless of their ability to pay and is a separate non-profit headquartered on Good Samaritan’s campus that will remain after the hospital closes.
Kettering Health also says it will continue looking at how it can fill any void left by the Good Sam closing.
“We’re going to work with GDAHA,” Roy Chew, Kettering Health’s president, said in an interview last week. “We’re going to do an in-depth study of exactly what the community needs are and how we can best partner with everybody to meet those needs.”
In a meeting with Dayton Daily News reporters and editors Thursday, Premier CEO Mary Boosalis said the network couldn’t comment on Grandview’s plans, but said Premier’s network has the ability to meet the community’s needs. The city’s birth rate is down, hospital stays are down and Miami Valley Hospital — just five miles down the road — has extra room, she said. At the same time other options like home visits are on the rise.
In meeting with members of the health care network’s emergency medicine services staff recently, Boosalis said one employee pointed out that it’s just a three-minute ambulance drive from Good Sam to Miami Valley.
“It is not relevant in the clinical world,” she said.
Although it is closing Good Samaritan, Premier is looking to building elsewhere. On Thursday, it announced plans for a $24 million, 60-bed rehabilitation hospital in partnership with Encompass Health. The Rehabilitation Institute of Ohio is expected to open in early 2020 on the campus of Miami Valley Hospital.
Premier and Kettering Health have long engaged in a fierce battle for customers in the competitive health care market.
Tension between the two non-profits was on rare display during a recent panel discussion on the future of health care.
While saying that Dayton is “over-bedded,” Boosalis said all adult care hospitals in the region are at 50 to 54 percent occupancy, or essentially half-full.
That’s when Kettering’s Chew jumped in. and said, “I just wanted to clarify one issue. Kettering hospitals are nowhere near 50 percent occupied.”
Chew said all Kettering hospitals are at around 70 percent full, which leaves them room in case there is a sudden surge in hospitalizations.
“What Mary is saying is absolutely true for Premier and what they are experiencing,” Chew said, “but that is not the case with Grandview and our other hospitals.”
Boosalis said the information came from hospital industry association data and “they must have some misinformation. We’ll have to check that. Where I see the growth is in the suburbs, not in the city.”
Responded Chew: “We started as a suburban hospital system and expanded into the city, into the city of Dayton and also into the city of Hamilton. And I don’t know what statistics you’re looking at, Mary, but please don’t try to tell me what we’re seeing on a daily basis. I’ll take you over to Grandview hospital today if you’d like.”
Boosalis said she sent a letter to Chew this week explaining how Premier calculates its data. She said there were different ways to measure hospital beds, such as using staffed beds or licensed beds.
Changing health needs
The closing of Good Sam shows some of the pressures hospitals face in an increasingly complex and changing health care environment.
Dayton’s population has been in decline at the same time as hospital stays have fallen. Fewer patients spend the night in a hospital as technology improves, home health becomes more available and insurance companies work to limit extended visits.
The result is that hospitals like Good Samaritan, which has 491 beds, have struggled to fill them. That brings in less revenue, but their costs continue because while the hospital may be half-full, doctors are still performing operations, delivering babies and providing health care to thousands of patients.
When Good Sam closes, those patients will have to make other choices.
Premier said it can handle the needs coming and its locations are accessible to residents living near Good Samaritan. Its data shows that about one-third of the patients at Miami Valley Hospital — more than 13,000 annual inpatient cases — already come from Good Samaritan, and about 1,700 of Miami Valley’s employees live near the Good Sam campus.
Bryan Bucklew, CEO of the Greater Dayton Area Hospital Association, said the hospitals, community health centers and public health departments do regular mandated assessments of the health needs of the communities they serve, and those assessments help determine what services to provide.
After the last assessment, he said, the organizations created more services for mental health and opioid addiction treatment based on the information. Bucklew said Public Health and GDAHA will expedite the study of the city of Dayton in light of Good Samaritan closing.
“I think everyone has the same end goal of how do we have a successful health care system that meets the needs of the community in a changing environment,” he said.
Bucklew said one of challenges facing Premier and Kettering is the high percentage of people in the Good Samaritan service area paying with Medicaid and Medicare. Government insurers pay less than what the hospitals say it costs them to provide services, making it difficult to shift those costs onto private-pay patients.
Kim Bramlage, marketing and communications manager at Five Rivers Health Center, which is across the street from Good Samaritan, said the center is doing its own needs assessment and listening to people about how it might help.
“We’re going to really concentrate on this area of town and the area by Good Samaritan,” Bramlage said.
Kettering Health’s decision to expand Grandview was based entirely on Good Sam’s decision to close and to shut down its ER, Chew said.
The expansion plans were announced just five weeks after the Good Sam announcement sent shock waves throughout the community.
At the expansion project’s kickoff last week, Chew said the move was made with the community in mind.
“If we don’t do anything, we’re either being foolish or we’re being cold-hearted because there’s going to be patients from that area who seek care at our hospital,” Chew said. “We are now the only hospital left in Dayton city limits of West Dayton.”