Last year, it looked as if three Cleveland hospitals would be closing their doors forever. Community activists and political leaders fought -- and won -- a battle to keep two of the hospitals open. But city hospitals aren't the only ones struggling to make ends meet in today's health care industry. In Lorain County, the small college town of Oberlin recently came close to losing its nearly 100-year-old facility -- a loss that would have affected thousands of low-income and rural residents as well. 90.3's Karen Schaefer has this report.
Karen Schaefer- For nearly a hundred years, the first experience many people had of the Allen Memorial Hospital was the birth of a child. In a small waiting room, this family is keeping busy while Mom keeps an appointment with her obstetrician.
But it will be a while before the cries of newborns echo through these corridors again. For sixteen years, Jan Koepp was the nurse manager of the Oberlin Birthing Center. A month ago, she and her staff of 15 lost their jobs. The OBGyn Department was shut down in a cost-cutting measure to keep the hospital from closing altogether.
Jan Koepp- Oberlin has had birthing facilities as long as I can remember, probably since the hospital opened. It's very sad. I'm sad for the community, I'm sad for the hospital, I'm sad for my staff.
KS- The Oberlin facility is one of three hospitals in Lorain County. The other two are in the much larger communities of Lorain and Elyria. While Oberlin's Allen Memorial Hospital saw a relatively low volume of patients each year -- only 350 admissions and 11,000 emergency room visits -- Koepp says her staff prided themselves on individual, personalized service.
JK- Our teaching was one on one with the patient in her own room with her family there -- to bather her baby, to learn about handling and feeding and caring for her baby. And that was always one of the big patient satisfaction issues from our patients, was that they really liked the personalized care. We always said, we're open 24 hours a day, you're not waking us up at 2 o'clock in the morning.
KS- Hospital officials say that small-town atmosphere hasn't been lost, even though a recent restructuring has closed obstetrics, skilled nursing and occupational health facilities. In all, about 70 workers -- nearly a third of Oberlin's hospital staff -- lost their jobs when it became apparent that the non-profit medical center could no longer make ends meet.
Ed Oley- The hospital was exhausting about $500,000 in cash a month, to the tune of about $6 million in losses over last year.
KS- Ed Oley is the hospital's new CEO. He believes the root causes of the hospital's financial woes form a snapshot of the nation's health care crisis.
EO- It's attributed to several reasons. One of which is the reimbursement issues that all hospitals in the country have been trying to overcome in the past few years. The Balanced Budget Act of 1997 took significant reimbursement from our Medicare carrier, which is about 50% of the business. We had to downsize and downsizing included the discontinuance of service in the sub-acute facility and in the obstetrics because those two areas were not able to cover their basic costs.
KS- In order to save the remainder of the hospital's services, Oley says the stakeholders got together and hammered out a plan. A reorganized hospital board accepted a 5-year management contract with Community Health Partners hospital in Lorain, another non-profit facility. Another partner in reorganization was the city of Oberlin. City Manager Rob DiSpirito says keeping the hospital open was a regional concern.
Rob DiSpirito- This is not an Oberlin city issue, this is clearly a regional and even a county issue, maybe even more critically so for those communities further removed from other hospitals in the county. Having a hospital that's reachable within 8-12 minutes, as opposed to 20 to 30 minutes, is going to be the difference between life and death, frankly, for some people.
KS- The hospital provides essential services for Oberlin's 8,000 people, nearly a quarter of whom live at or below poverty level. But it's also the nearest hospital for many rural residents in the southern part of the county. DiSpirito says the city helped by transferring ownership of the hospital buildings and grounds back to the Medical Center. But one of the most important pieces of the restructuring came from another Oberlin source -- Oberlin College.
Nancy Dye- The college has always been a major stakeholder in the Allen Memorial Hospital. In fact, it was originally built as the college infirmary a hundred years ago.
KS- Oberlin College President Nancy Dye says at one time, the college owned the buildings and grounds the hospital now occupies. Just last week, the college re-purchased that property for $2 million and plans to lease it to the hospital for a dollar a year. She says the rationale behind the college's philanthropic gesture was fundamentally an issue of survival.
ND- But much more important than any of that history, actually, is the fact that I think most colleges and universities like Oberlin have realized in the last decade or so that their health really depends on the health of the communities that they're in. And that we cannot thrive as an institution of higher education if community institutions fail.
KS- Hospital officials and other stakeholders say the cutbacks at the Oberlin hospital are temporary. The plan is to expand some revenue-generating services -- like surgery, CT's and CATscans -- while at the same time offering more insurance provider options to physicians and patients. The hope is that increased demand and personalized service will keep the Oberlin Medical Center healthy for the next hundred years. In Oberlin, Karen Schaefer, 90.3 WCPN, 90.3 FM.