by Joan Tupponce
Patients in Mecklenburg County will have one less option for obstetric and psychiatric care at the end of this month. That’s when the obstetrics program and psychiatric unit at Community Memorial Healthcenter in South Hill are scheduled to close.
The Jan. 6 decision to end the services follows a trend in smaller, more rural hospitals that concerns Katherine Webb, senior vice president at the Virginia Hospital & Healthcare Association. “Since 2003 we have had 14 closures of obstetrics units [in Virginia],” she says. “That’s a lot.”
One of the factors contributing to the shutdown of obstetric services was a decision by a local medical practice, South Hill Family Medicine, to phase out inpatient pediatric coverage. “Pediatric care for newborns is a requirement to operate a hospital obstetric program,” says McKinley Perkinson, public relations and marketing manager for Community Memorial.
The hospital also has seen a decline in births. During the 2010-11 fiscal year, Community Memorial’s obstetrics program averaged 23 deliveries a month, 45 percent of total deliveries from the service area. “Seventy-two percent of those deliveries were for patients for whom the Healthcenter was paid less than the cost of providing care for mother and baby,” Perkinson says.
Many hospitals complain that reimbursement from private insurers, Medicare and Medicaid often fall short of covering the cost of care. “Medicaid losses for all health systems across all services in Virginia totaled $318 million in fiscal year 2010 and has only worsened since then,” says Webb. “In 2012 hospitals will be paid 64 cents for every $1 of cost they incur to take care of a patient.”
The decision to close Community’s psychiatric unit was driven not only by low reimbursement but also low patient volume. “On average fewer than seven patients per day were being treated at the CMH Pavilion” that houses the psychiatric unit, Perkinson says. “We were required to provide 24-hour-a-day, 365-days-a-year coverage with staff and board-certified psychiatrists.”
Webb sees the closings as both a health services and a jobs issue. “Both are very important for the community,” she says. “Communities where these type of units have closed can least afford to lose those jobs.”
As of late January, seven of the 54 employees affected by the closings had accepted other positions at Community Memorial. Another worker has found employment outside of the hospital and several others are considering job offers. The hospital also is working with the Community College Workforce Alliance in assisting employees affected by the changes.
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