Cleveland's St. Michael Hospital to Close
Originally published in the Cleveland Plain Dealer
Saint Michael Hospital to close
09/17/03
Diane Solov and Regina McEnery
Plain Dealer Reporters
St. Michael, the small Slavic Village hospital that became known as the "Miracle on Broadway," will begin a phased shutdown in December - but it is unlikely to go down quietly.
University Hospitals Health System, which owns St. Michael, announced yesterday that the hospital will stop providing services Dec. 19. Through an arrangement with MetroHealth Medical Center, primary care will be offered in St. Michael's emergency room until March 1, when MetroHealth will open a community health center in a former Kmart on Broadway, a mile down the road.
Rep. Dennis Kucinich, the Cleveland Democrat who made St. Michael a cause celebre when it seemed doomed to close three years ago, yesterday vowed to renew the fight to keep the tiny hospital alive.
Rep. Stephanie Tubbs Jones, Democrat of Cleveland, called the announcement another indication of problems delivering health care to the poor.
She called a meeting for Monday at St. Michael at a time to be announced.
"I'm going to challenge this," Kucinich said.
"I'm not just going to sit by and let the poor in the inner city have to fend for themselves while these large hospital systems move away from their obligations."
Thomas Zenty III, UHHS chief executive officer, said low community use and high operating losses led to the decision, which the hospital system's board approved during a morning meeting at the Union Club.
Zenty said St. Michael's small and aging physician staff drew few patients, and he cited Cuyahoga County's declining population in general as the drivers behind St. Michael's dwindling use. The hospital's acute-care beds average fewer than 25 patients a day, and its operating rooms see only 10 surgeries each week, he said.
"All that just pointed in the direction that the hospital was unable to sustain itself," Zenty said. "We did our best to invest in the things that appeared to be the most applicable to this particular geography."
St. Michael, which began 119 years ago in a nascent immigrant neighborhood, was dubbed the "miracle" after Kucinich, other politicians and neighborhood groups rallied to rescue the hospital from closing in 2000.
At the time, St. Michael's parent, Primary Health Systems, was in bankruptcy and the Cleveland Clinic had quietly negotiated a deal to buy PHS' coveted Beachwood outpatient center - and St. Michael and Richmond Heights General Hospital - after PHS closed them. The secret deal sparked public outcry and opened the door for archrival UHHS to buy the hospitals at public auction, endearing it to the Slavic Village community.
UHHS had long eyed the Richmond Heights hospital as a way to boost its presence in the eastern suburbs, but it couldn't appear as if it was cherry-picking. The fast-paced bankruptcy schedule gave UHHS little opportunity to fully assess the hospital's prospects, but Farah Walters rode in as a white knight, further embarrassing the Clinic.
Kucinich, who years ago worked as an orderly at St. Michael, organized bus trips to the Delaware bankruptcy court and candlelight vigils on the Clinic's front stoop to protest the deal.
Now running for president, Kucinich will take aim at the rescuer this time.
"Current management reversed the community-spirited approach of Farah Walters and instead has opted to place profit above people's health," he said. "This is a cold and calculated business decision by University Hospital executives who were more interested in dumping any kind of expenses for indigent care in the inner city. This is a moral issue."
Kucinich accused UHHS management of starving St. Michael of patients by capping admissions and steering patients away from its emergency room, dooming the hospital to failure. He said UHHS did little to recruit doctors and nurses.
The issue of patient volume and staffing may be a matter of perspective. Like any hospital, St. Michael adjusts staff levels to patient volume and diverts ambulances at times when resources are too tight to adequately care for patients, said Richard Frenchie, St. Michael president. "We have not artificially restricted beds," he said.
The hospital had 240 licensed beds, but it staffed only 107.
As for recruiting, Frenchie said the hospital has tried to attract nurses and physicians. St. Michael subsidized physicians in the hopes of drumming up more patients, and despite intense recruiting, was forced to rely heavily on temporary nurses.
Zenty, who took the helm of Cleveland's second-largest health system in March, said the community would be well served by MetroHealth. Keeping a hospital open that was not being used served no one, he said.
Despite spending $8 million on improvements since June 2000, Zenty said St. Michael has lost $16 million and is expected to lose another $8 million this year.
The handfuls of patients it cares for in its specialty units - skilled nursing, geriatric psychiatry and drug detox - can easily be absorbed by nearby hospitals. St. Michael's emergency room, which sees about 1,700 patients a month, is primarily handling health problems that are more appropriately served by primary-care physicians like pediatricians and internists.
That's where MetroHealth, the sprawling county-owned health system, steps in. At UHHS' request, MetroHealth agreed to provide primary care at St. Michael's emergency room between the hospital shutdown and the opening of MetroHealth's 45,000 square-foot community health center. The center is at Broadway Shoppes at East 68th and Broadway, a mile south of St. Michael.
The center, the culmination of $6.7 million renovation of a shuttered Kmart, will be large enough to accommodate 60,000 patient visits annually in a neighborhood MetroHealth deems short on primary care.
"We tried to bring into real focus what the community needs there," said Terry White, MetroHealth chief executive officer.
Probably the last thing the old ethnic community needs is a vacant hospital. Zenty said he has offered to donate St. Michael's 14-acre campus, the 222,000 square-foot hospital, a parking garage and other buildings, to Cleveland. If the city doesn't want it, UHHS will offer it to Cuyahoga County or any other government that would take it.
Cleveland Mayor Jane Campbell said that city architects were looking at the hospital and that her administration would explore the costs of maintenance and clean-up or demolition, an effort in which the city will look to UHHS as a partner.
Zenty said UHHS has job openings at its other medical facilities that may match about three-quarters of the roughly 400 full- and part-time employees who work at St. Michael. Meanwhile, it will boost pay10 percent to employees to encourage them to stay until the hospital closes.
Employees unable to find another UHHS job will receive 12 weeks' severance, although different benefits may be negotiated for about 100 members of Local 47 of Service Employees International Union.
"I just hate to see all these neighborhood hospitals going by the wayside," said Mike Murphy, president of SEIU Local 47, which represents practical nurses and service and maintenance workers at St. Michael. "As more and more of these inner-city hospitals close, there is just less and less options for the poor."
Patients and their families with questions or concerns can call 216-429-8074 or 216-429-8075 between 8:30 a.m. and 5 p.m.
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