The last few paragraphs of “Freeholders stay on sidelines in Westwood hospital battle” (Page L-14, Dec. 12) caught my attention and raised my ire.

The CEO of the private equity investor that is partnering with Hackensack University Medical Center was quoted as saying that his company thinks “there’s a good opportunity in Westwood.” He said further, “We may take business away from Englewood, we may take business away from Valley,” then added, “We certainly wouldn’t expect it would adversely impact them to the point that they won’t be in business.” And finally, he said, “It’s the real world,” of the potential hospital competition. “This is the environment that most of America works in. Other franchises aren’t protected by certificate-of-need laws like they are in this state.”

Are you kidding me? When will the CEOs of corporate America, and all others who read the article and nod their heads in agreement, get the message that we can no longer afford the luxury of excess? How many times have we heard from one auto dealer opening up next door to another dealer that competition is good? How many doughnut and coffee shops do we need around the corner from each other? How many household goods stores, restaurants, banks, office buildings, hedge funds and investment banks do we need just because there is a good opportunity?

Is this really a good opportunity, or is it just another investor trying to create a market where one does not really exist? Sound familiar to all those sub-prime fans?

Unless the opening of a full-service hospital in place of Pascack Valley Hospital rises to the level of absolute need, as in life or death and true public health and safety requirements, let’s deal with the inconvenience of traveling a bit farther for the sake of the hospital industry. If Legacy Hospital Partners brings with them the philosophy that “this is the environment that most of America works in,” they should go back to Texas and stay out of New Jersey. We have enough problems here.

Bergen County’s Freeholder Board has decided not to take sides in the fight over whether Hackensack University Medical Center should be allowed to reopen the former Pascack Valley Hospital with a private investor.

After a work session crowded with employees of two hospitals that oppose Hackensack’s plan, the seven-member board decided to “recommend that all parties involved reach an amicable resolution for the benefit of pertinent stakeholders, in particular the Northern Valley region residents,” said Wendy Martinez, a spokeswoman.

“At this time there is no immediate plan to introduce a resolution,” one way or the other, she said.

Executives from Englewood Hospital and Medical Center and The Valley Hospital in Ridgewood made a presentation to the board on Wednesday, and Hackensack medical center officials made their case last month.

The freeholders have no official responsibility to endorse or oppose Hackensack’s proposal, but would have lent their voice to the growing public outpouring, which may be considered by state Health Commissioner Heather Howard when she makes a decision on the application.

The board’s declaration of neutrality came as each side continued its efforts to build public and political support. Also this week, local mayors visited the state Department of Health to plead for approval of the hospital, and Hackensack executives and an investor in the proposed hospital made their case to newspaper editors.

The state is reviewing Hackensack’s application, and has asked for additional information before it starts the clock on a schedule of hearings.

Read the complete article at NorthJersey.com

ENGLEWOOD — The possible reopening of the Pascack Valley Hospital in Westwood is a highly controversial issue, with the debate surrounding the proposal emotional and personal.

The opposition comes primarily from surrounding Bergen County hospitals. Valley Hospital in Ridgewood and Englewood Hospital and Medical Center claim that New Jersey hospitals are already facing a difficult financial environment: there is an oversupply of hospital beds, and at the same time, government funding is diminishing. They say adding another acute-care facility will only exacerbate their struggle.

Both EHMC and Valley support maintaining an outpatient emergency room at the Pascack Valley site.

Read the complete article at NV Suburbanite

“To build a new facility at the site of the former Pascack Valley Hospital would be a mistake, one that could end up providing worse — not better — care for local residents.”

AS MAYOR of Englewood, I strive continuously to ensure that my constituents receive quality services and care in all areas of life here in Bergen County. There is no area where quality is more important than in health care, and for the people of Englewood, having a hospital in our city provides a valuable facility for everyone in our community.

However, as a mayor with a hospital in my community, I can’t limit my concern to what it means to the people of Englewood. I have to look at what it means to the people who come from other parts of Bergen County. Englewood Hospital and Medical Center serves people from all over Bergen County and the financial strength of the hospital is critical to people in our neighboring towns and to Bergen County as a whole.

According to the January 2008 Final Report of the New Jersey Commission on Rationalizing Health Care Resources (also known as the Reinhardt Commission), New Jersey faces an oversupply of hospital beds, a problem that is particularly concentrated in the Hackensack-Ridgewood-Paterson area.

In part because of this oversupply, Pascack Valley Hospital suffered from low occupancy rates, filed for bankruptcy and ultimately closed in November 2007.

Upon Pascack Valley Hospital’s closing, all the hospitals in Bergen County experienced an increase in their respective occupancy rates. This increase confirmed that there had been too many acute care beds in Bergen County. But, more importantly, this change represents progress for the people in the region, as numerous studies, including one by Dr. Elliott Fisher at Dartmouth University, have shown that having an oversupply of acute care beds actually can have the effect of worsening health care.

A mistake

That’s why I believe that Hackensack University Medical Center and its for-profit Texas-based partner, Legacy Hospital Partners, should not be allowed to open a new acute care facility on the former Pascack Valley Hospital site in Westwood.

To open this facility would be a mistake, one that could end up providing worse — not better — care for local residents.

Read the complete article at NorthJersey.com

While operating margins were up slightly, almost half of New Jersey’s hospitals still lost money last year, according to a financial status report released Monday by the state hospital association.

The year-end operating margins for the state’s hospitals in 2007 was 0.9 percent, compared with 0.6 percent in 2006, the report said. It was the eleventh-consecutive year margins have been under 2 percent, and officials said it may only get tougher for hospitals as the economy worsens.

In the past year, five New Jersey acute care hospitals closed — Barnert in Paterson, Saint James and Columbus in Newark, LibertyHealth Greenville in Jersey City and Muhlenberg Regional Medical Center in Plainfield. That came on the heels of three other hospitals closings in 2007, as well as five more filing for bankruptcy.

“This data underscores the long-standing challenges New Jersey hospitals face in remaining financially sound in the face of insufficient reimbursement from Medicare, Medicaid and the state charity care program,” Betsy Ryan, the group’s president and chief executive, said. “A serious situation is rapidly turning critical.”

Compiled from audited financial data submitted by the association’s 59 acute care, specialty and rehabilitation hospitals, the report shows total 2007 hospital revenues were $18.263 billion, while total expenses were $18.026 billion, for an operating margin of 1.3 percent.

Nearly half the state’s hospitals posted losses in 2007, three closed, and five filed for bankruptcy, according to a report released Tuesday.

And that’s the good news. The data released by the New Jersey Hospital Association don’t reflect the recent economic downturn, which is likely to cause even more turmoil in an industry on shaky financial ground, experts say.

“It’s truly troubling to think that this is the foundation from which our health care facilities entered our new economic struggles,” said Betsy Ryan, president of the association.

Read the complete article at NorthJersey.com

REOPENING a hospital in Westwood would have a devastating impact on Bergen County’s health care system. We believe this is not about politics, the welfare of select communities or one hospital, but about ensuring that all Bergen County hospitals remain healthy and strong to serve all Bergen County residents.

There are many compelling reasons we feel our position is a sound one.

1) We support the satellite Emergency Department.

The Valley Hospital and Englewood Hospital and Medical Center support the opening of a satellite Emergency Department in Westwood. When we jointly bid on the hospital last winter, we stated our intentions to offer emergency care. We fully understand and support the need for Pascack Valley residents to have urgent care close to home.

2) New Jersey hospitals are already in peril, why add a new one?

A recent study by the American Hospital Association found that while U.S. hospitals had strong profits in 2007 – with an average operating margin of 4.3 percent — New Jersey had a string of hospital failures and bankruptcies.

Nearly 20 hospitals in New Jersey have closed since 2000, and five more are in bankruptcy.

Last year, more than half of the state’s hospitals lost money. Reasons range from declining reimbursement to increasing charity care and excess capacity.

The question we must ask is: Why would New Jersey consider reopening a hospital and risk further destabilization and diminishment of its current health care system?

3) There are too many hospital beds in Bergen County.

Last January, Governor Corzine’s Commission on Rationalizing Health Care Resources concluded that New Jersey – and specifically the area that includes the former Westwood hospital — has too many hospitals and too many hospital beds.

Regardless of recent hospital closures, that remains true today. Studies have shown that an oversupply of beds raises costs and diminishes health care quality. It makes no sense to reopen a hospital when the result will be increased health care costs and reduced health care quality.

4) Area hospitals have ample capacity for Bergen County patients.

A new hospital is not needed. The five hospitals within a 12-mile radius of the former Pascack Valley Hospital have ample capacity.

Using Department of Health data, Englewood, Holy Name Hospital and Valley reported occupancy rates of 47 percent, 62 percent and 86 percent, respectively for the second quarter of 2008. And these numbers include the absorption of patients previously cared for at Pascack Valley Hospital.

On any given day, there are on average 390 hospital beds available for Bergen County residents, and these hospitals can add beds if necessary. There are also two hospitals nearby in New York, Nyack Hospital and Good Samaritan Hospital, which have the capacity to serve Pascack Valley.

5) We are taking proactive steps to welcome new patients and assist local ambulance squads.

Since Pascack Valley’s closing last November, our hospitals have taken many steps to welcome new patients. We have been increasing Emergency Department staff, as well as extending physician coverage and hours.

Emergency Department divert times — times when ambulances need to go to other hospitals – have come down steadily through 2008.

Englewood’s Emergency Department recorded an average of three hours of diverts per month since February, with just two hours in September and none in October – one of the lowest divert rates in the county.

Most importantly, both hospitals have welcomed new patients while improving patient satisfaction. Patient satisfaction at Valley’s Emergency Department is at the 92nd percentile nationally.

We also understand the closure of Pascack Valley has resulted in some ambulance squads experiencing longer drive times, so both hospitals stand ready to assist the squads with patient transport.

6) Pascack Valley residents already choose Valley and Englewood hospitals.

The people of Pascack Valley have long chosen Valley and Englewood hospitals for their care. In fact, in five of the 14 towns identified as Pascack Valley’s service area, more people who needed hospital care in the year prior to Pascack’s closing chose Valley over Pascack.

In all 14 towns, 36 percent of those who needed care chose Valley and Englewood, while only 30 percent chose Pascack Valley.

7) For-profit hospitals vs. non-profit hospitals: Area residents should know who is caring for them.

Hackensack’s partner, Legacy Hospital Partners, is also a concern. Legacy is a for-profit investment company located in Texas. Hackensack’s proposed hospital would be a for-profit facility with profits returned to investors, rather than back into new technology and services to meet the community’s health care needs.

Another concern is that the staff of the new hospital would not even be Hackensack employees. And, as with any for-profit corporation, Legacy’s Board of Directors would be accountable to investors, not the community.

We are proud that our non-profit hospitals have served the Pascack Valley region for a combined 182 years, and we look forward to continuing to do so in the future.

WESTWOOD, N.J. - Leaders of both of Rockland’s acute-care hospitals are opposing a plan for a new for-profit facility just over the county line in Bergen County, N.J., where Pascack Valley Hospital operated until it went bankrupt a year ago.

Both David Freed, chief of Nyack Hospital, and Michael Schnieders, executive vice president of Good Samaritan Hospital in Suffern, have written to New Jersey officials urging them not to approve a plan by Hackensack University Medical Center and a private Texas company to open a new, for-profit hospital at the Pascack location.

Both maintain that a new, 128-bed hospital just miles from the Rockland border is unnecessary and will make it harder for the Rockland hospitals and other area facilities to provide care in an increasingly difficult and competitive financial environment.

“I strongly believe that patients are not well served by opening a new hospital in Westwood,” Freed wrote in his letter to the New Jersey health commissioner. “It will only exacerbate the regional oversupply of hospitals and hospital beds and, in turn, negatively affect the quality of health care delivery throughout Bergen and Rockland counties.”

In its plan submitted to New Jersey regulators, Hackensack denies that its plans for a new hospital will have an impact on other hospitals competing for the same patients.

The new hospital, “will serve the 14 communities immediately surrounding the hospital, while at the same time ensuring that there will be no negative impact on other existing hospitals in Bergen County,” Hackensack wrote in its application to the New Jersey Department of Health and Senior Services.

Hackensack said that its joint venture with Legacy Hospital Partners of Plano, Texas, will enable the new hospital to be run without any public funding.

In documents, Hackensack said it will be able to make a financial success of the proposed hospital and maintains that the old Pascack Valley Hospital went out of business because of poor management and overexpansion.

Read the complete article at LoHud.com

The mayors of 10 Pascack Valley towns have told hospital executives who oppose the reopening of Pascack Valley Hospital in Westwood to back off — or else.

“We take extreme offense to the tactics put forth by each of your hospitals,” said a letter to Presidents Audrey Meyers of The Valley Hospital in Ridgewood and Douglas Duchak of Englewood Hospital and Medical Center. If “you continue to thwart the efforts of Hackensack University Medical Center to bring a hospital to our community, we are prepared to use our collective resources to respond in kind.”

The four-page letter was signed by the mayors of Emerson, Montvale, Oradell, River Vale, Westwood, Hillsdale, Old Tappan, Park Ridge, Washington Township and Woodcliff Lake.

In a joint statement, spokeswomen for the two hospitals said they had just received the letter and had questions about its overall accuracy.

“This issue is not about politics, but about ensuring that all Bergen County hospitals remain healthy and strong to serve all Bergen County residents,” said the statement from Megan Fraser at Valley and Maria Margiotta of Englewood hospital.

Hackensack has applied for state permission to reopen the former Pascack Valley Hospital as a 128-bed community hospital. The new facility, Hackensack University Medical Center North at Pascack Valley, would be operated in a joint venture with Legacy Hospital Partners of Texas as for-profit hospital.

Pascack Valley closed one year ago after declaring bankruptcy. Residents of the Pascack and Northern Valley towns were forced to go elsewhere for treatment, traveling six extra miles to Valley or eight extra miles to Englewood in emergencies.

Since Oct. 1, the former Pascack Valley emergency room has been open as a satellite emergency department of Hackensack University Medical Center to treat non-life-threatening emergencies.

The letter from the Pascack Valley Mayors’ Association is the latest salvo in a public-relations and political battle over the proposed reopening of the former hospital.

Hospital officials at Englewood and Valley support the satellite emergency room, but they oppose the reopening of a full community hospital in Westwood because they say the region has enough hospital beds. Englewood, for example, has the capacity to open 150 additional beds, if needed.

Opening a new hospital would have a “devastating impact on the financial stability” of Englewood, its executives have told state officials.

Read the complete article at NorthJersey.com

Garden State Stands Apart in Hospital Closures and Bankruptcies
PRINCETON — New data released by the American Hospital Association shows that U.S. hospitals enjoyed healthy profits in 2007 — the same year that New Jersey hospitals experienced an unprecedented rash of hospital bankruptcies and closures.

According to AHA Hospital Statistics — 2009 Edition, released last week, the nation’s hospitals posted an average operating margin of 4.3 percent in 2007. Operating margins measure profits or losses based purely on operations, not investment income.

That margin reflected the largest single-year jump in at least 15 years, according to the healthcare trade journal Modern Healthcare.

The contrast for New Jersey’s hospitals is dramatic. In New Jersey, the average operating margin was 1.3 percent, according to NJHA’s analysis of audited financial data. Nearly 50 percent of the state’s hospitals lost money in 2007. Five filed for bankruptcy protection. And three acute care hospitals ceased operations.

That troubling trend has continued in 2008, with an additional five acute care hospitals closing their doors.

“The contrast is striking between the financial health of the nation’s hospitals overall and the grim picture here in New Jersey,” said NJHA President and CEO Betsy Ryan. “Garden State hospitals are struggling to survive in a very unfriendly landscape compared with their counterparts across the country. It’s a problem that needs to be carefully examined before our patients face an all-out access-to-care crisis.”

Hospitals officials cautioned that 2008 promises to be an exceptionally difficult year for hospitals, both in New Jersey and nationwide. The nation’s ongoing economic woes not only threaten hospitals’ investment income and credit costs, but also increase the demands of the uninsured as more Americans face layoffs and the loss of their health insurance coverage.

AHA reports that the total amount of uncompensated care delivered by the nation’s hospitals reached $34 billion in 2007, a 5.8 percent increase.

Two recent reports have identified government underfunding of New Jersey’s hospitals as a key factor in their fragile finances. In New Jersey, Medicaid — the state program that provides healthcare to the poor - pays hospitals an average of just 69 cents for every dollar of care provided. Medicare, the federal program that provides healthcare to seniors, also reimburses New Jersey at less than cost — 89 cents on the dollar.
New Jersey’s charity care program is another burden that sets the Garden State apart. While most other states have designated hospitals that provide care to the poor and uninsured, New Jersey law requires all the state’s hospitals to care for charity care patients. While the cost of that hospital care reaches $1.3 billion annually, the state will reimburse hospitals less than half that total, or $605 million.

The January 2008 report from the state’s Commission on Rationalizing Health Care Resources identified government underfunding as a key source of hospitals’ shaky finances. And a 2006 report from the financial consulting firm Accenture, which was commissioned by NJHA, showed that poor payments for charity care, Medicaid and Medicare all are key reasons behind hospitals’ deteriorating bottom lines.

“There’s no surprise revelation behind this new data,” said NJHA’s Sean Hopkins, senior vice president of health economics. “New Jersey hospitals, quite simply, are crumbling under the burden of inadequate reimbursement. The new data merely re-enforces what we’ve witnessed here for quite some time.”