Bon Secours DePaul Medical Center has removed 30 beds from service, according to The Virginian Pilot. The removal means that there are about 135 staffed beds out of the total 238 licensed beds for the facility. Interesting, as that figure is almost identical to the 134 beds that the city’s consultant determined was appropriate and which the DePaul Emergency 134 group endorses. Heading into next week’s public hearing, whose position does such a move improve?
Buried at the end of the story is a comment by Mayor Paul Fraim regarding a meeting that he participated in on Monday with Bon Secours officials.
“They did not mention anything about the downsizing that was announced today,” he said Wednesday.
How can you announce a downsizing that was effective Wednesday, including the relocation of the staff, and not have that mentioned in a meeting held just two days prior? It’s no wonder, then, that Norfolk officials don’t believe that Bon Secours has been upfront and truthful with the city.
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Since I wrote the initial story last week on the DePaul situation, I have gotten a number of emails and phone calls from people on both sides of this issue. Yesterday, I participated in a taping of Norfolk Perspectives (which, after a whole lot of effort, I managed to capture the live stream and post here). Over the course of time, a couple of things have become clear to me.
First, the decision by Bon Secours to downsize DePaul to 64 beds was one done mostly out of the public eye. Like so many things, the public seemed to only become aware of this in recent weeks, although it was first brought to my attention some time ago. Despite the fact that Bon Secours has quietly engaged certain citizens, including some members of council, the city seems to have dropped the ball on this, not heeding the warnings of those like DePaul Health Foundation board member Bruce Holbrook, who now heads the DePaul Emergency 134 group.
Second, I don’t think Norfolk residents realize what the ultimate cost of the downsizing may be. In our taping yesterday, Fire Chief Loy Senter brought up the fact that a smaller DePaul hospital with fewer services will result in the routing of emergency patients to a hospital that is further away from them – either Leigh or Norfolk General. That will mean longer wait times for service. Ultimately, Norfolk citizens will have two choices: wait longer or pony up more money for more rescue positions. We all know how that will turn out.
The saving grace for Norfolk residents is that Bon Secours’ initial plan was denied by the decision-makers in Richmond. But time is running out. Let your voice be heard. If you can’t make the public hearing on July 18, by all means contact those who will be making the decision.
VIVIAN J. PAIGE | All Politics is Local 
When I took my daughter out to lunch the other day, the Bakers Crust was so crowded we had to go someplace else to eat. I think the Norfolk City Council should require the Bakers Crust to enlarge their restaurant and hire more staff, regardless of the business viability of that decision, to accommodate me. If that requirement drives them out of business, oh well.
Sounds silly, doesn’t it?
How does government telling the owners of a hospital how many beds and staff they must provide make any more sense?
Is Baker’s Crust a non-profit entity?
If Bon Secours wants the benefit of being a non-profit hospital (their choice, BTW), then along comes with the the responsibility.
Vivian – You know I don’t approve of non-profit anythings. 🙂
But even non-profits have to break even and DePaul isn’t even coming close. Non Profit does not mean money pit.
If DePaul is required to operate in the red then the loss will have to be made up by overcharging patients in Bon Secours other operations. That would be wrong.
Were I running Bon Secours, I would sell DePaul for whatever I could get to a for-profit operator and run hospitals only in cities that did not interfere in my business decisions. .
Because that is what healthcare is really about – making a profit.
Don, let me know when you switch. I think I need some new bookcases downstairs. Thanks.
Actually, Don, if you have been following the reports, there is some concern that DePaul is not being forthright about the losses. Some folks believe that the losses only started occurring once they decided to downsize; others believe that the losses aren’t even real. I’ve not seen the books so I can’t comment either way. However, take a look at the report from the state denying their application. Surely those folks have access to information that we don’t.
As for the system – well, when you’re in charge, you can change it. But until then, we work with the system we have. Norfolk (and all the cities) have no official role in the decision-making process for the hospitals. That is left up to the Virginia Department of Health. And so far, they have said no.
The article in the Pilot stated that Depaul is only averaging 70 beds. If that is true, 64 beds seems more logical than 134.
Why doesn’t the “mayor” and his cronies put their money where their mouth is and help subsidize the cost of a new hospital that they feel is needed to their specifications based on their vast experience in health care instead of wasting funds on a light rail system that isn’t needed for where it is headed(right to Sentara’s front door…hmmmm?? Interesting thought when you think about it).HRT and it’s bus system works just fine.Why don’t all you so called “expert layman” (who are clueless about health care) come spend a day with me in the operating room at DePaul and see what our world involves and what we deal with,and how skillfully and expertly we manage whatever faces us.Walk around the hospital.Talk with the administrator.He’ll show you the numbers on his computer.He pullled me into his office and showed me how we are running in the red and loosing money.Not last week or a month ago.I’m talking the spring of 2008.And it hasn’t gotten any better.You can speculate all you want,all of you who are not a part of what we do.You are just too far from the center of the truth so hense the more skeptical you are.We have nothing to hide.Come and see for yourself.We are not going to endanger the citizens of Norfolk because of the type of hospital we want to build.They can go to Sentara.Maybe that’s endangering them indirectly because of the stories of poor care their at that faciility that have been related to us by patients who have come to DePaul for care.Wakeup people.Present day economics and the cost of health care and the nursing shortage have an impact on the design of treatment facilities.We have to be smart in the utilization of our resources,not only in health care,but global industry wise and in government.The sooner government,industry and citizens wakeup to this fact maybe we can do something positive.There is no ulterior motive on the part of DePaul or Bon Secours.Look at what you have allowed that neighborhood bully Sentara to do with it’s monopoly on health care here in Tidewater.Chew on that.
Don’s obviously not Catholic.
Bon Secours “had” a deep history of serviing the community and this was the vocation of the Sisters of Mercy (who previously ran this). Sadly, the mission has changed- less “community based” and more “profit based”. They cannot have it both ways!
I’m glad the city called them out and disappointed in the Richmond Diocese trying to make this a “moral” issue. The Bishop has been a cheerleader for the downscaling- which I just don’t get.
Maybe they should reclassify as “not for profit” but with the deep pockets the diocese has, something needs to be done!
It doesn’t matter if DePaul is run by the Dali Lama and Mother Theresa, it still has to bring in enough income to cover its expenses and staffing.
Non profit doesn’t mean it doesn’t have to pay its bills.
Don – you don’t live in Norfolk. You are not the one who will have to suffer the consequences. I’ll ask again: have your read the report from the state? Do you know something they don’t know?
Vivian- No, I don’t live in Norfolk, though principles apply everywhere or nowhere, but I operate a health care business in Norfolk, so I am very much involved in the issue.
I take exception with the notion that because one makes his living in the health care field, other people with political agendas gain some power to meddle in your business decisions. The State may be the regulatory agency in this case, but local hands are on the levers.
The size of the hospital determines staffing needs and costs. That is a business decision, not a social concern. As to the consequences, what would be the consequence of meddling regulators driving DePaul out of business altogether?
How easy would it then be to attract another non-profit operator to take over, knowing that their every business decision will be second guessed by politicians whose motivation is to pander to the voters who understand nothing about operating a hospital but demand everything they see on TV?
This is exactly how big cities wind up with First Class private hospitals that most people’s insurance companies won’t cover and which do not accept Medicare or Medicaid, on one side of town, and government run hospitals for everyone else which are understaffed, under-equipped, overcrowded, hell holes.
When I lived in New Orleans, I went through rotations at Charity Hospital. If you want to see third world health care in the United States, all you need do is visit a government run hospital in a major city (though were I in NOLA and had a gun shot wound, Charity would be the place to go, simply because they get so much practice).
Even non-profits have to pay their bills and pay their staff well enough to attract good people. Just because the hospital is non-profit does not mean the doctors and administrators should not be paid competitive wages.
No regulator knows how to run DePaul, or any other hospital, as well as those who work there and on which their livelihood depends. Meddling by politicians who see the hospital only as something on which they can demagogue to stay in office is a sure way to destroy that hospital.
Do I know something they don’t know? Yep. I know the limitations of government.
Don – you show how little you’ve followed the issue when you make statements like this:
At the time the state rejected the Bon Secours plan, Norfolk was in favor of it. So much for those “local hands on the levers.”
And repeating the mantra of “non-profits have to make money” just further demonstrates that you have not bothered to read the state’s report.
So what you “know” is, well, nothing. You have an opinion ~ and haven’t let the facts get in the way of that.
I hate repeat myself, however, in both Pilot articles about this situation, the hospital is only averaging 70 beds. If this is true, a 134 bed hospital is not necessary and a smaller (64) bed hospital makes better financial sense. Also, are we to believe everything the state reports as accurate?
rlewis – the articles are reporting what DePaul is saying. Their positions are being rebutted by those who say that DePaul is deliberately keeping the number of patients low in order to bolster their claim that they are losing money.
The reason I keep pointing to the state report is that there is a tremendous amount of detail in there, including many issues that the newspaper has not reported. Read the report and judge for yourself. The report is available here (pdf).
Vivian – I did read the report, well, at least part of it, the cover letter and the supporting sections dealing with DePaul, and they basically are just Mr. Burns’ opinions of what serves the community. I really don’t care, as I see no more justification in state interference than local.
Regarding ‘local hands on the levers,’ note that on Burns’ one day fact finding tour, (which certainly qualifies him as an expert on the day-to-day operation of DePaul), he was accompanied by Norfolk’s legal counsel and a representative from EVHAS and has had input from Sentara’s counsel, which has contrary interests in the DePaul plan which seeks to expand other Bon Secours facilities in competition with Sentara facilities in Suffolk and VA Beach. Forcing a larger DePaul serves their interests in suppressing competition in the more affluent areas. Bon Secours cannot expand in those areas if it is compelled to overbuild at DePaul.
The only opinion that should matter in determining what kind of hospital is built at the current DePaul location is that of Bon Secours, as it its their capital at risk. Giving government bureaucrats power to force those investment decisions leads only to corruption. Remember that it was selling COPN’s that put Louisiana governor Edwin Edwards in prison.
But you have never answered the question of why government should have power to regulate business decisions made by those who provide health care but not those who provide food or clothing? Would you support a bureaucracy that forbids Farm Fresh from opening a store too close to Bloom? Or one that required building one in Park Place as a condition of opening one in Ghent?
Why is health care different? Where has government regulation brought better service and lower costs to anything on a long term basis?