May 22, 2019
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Hospital encouraged by support for new rehab center, despite concerns by rival

York Hospital President Jud Knox said this week that he is pleased with the outcome of a public hearing held last week on a proposed 20-bed acute rehabilitation center on the hospital campus.

“It allows me to feel we are on target” with the regional need for the center, he said.

“I feel we really do have a good partner and a good project that fits the needs of the community, fits the demographics and fits the needs of medical providers throughout the Seacoast,” he said. “I think we have to understand that the hearing was a step in the process, but I feel good about where we are.”

On June 7, some 80 people attended the hearing at the York Public Library, called by the Maine Department of Health and Human Services. Among those testifying were current and former chief executive officers at New Hampshire’s Portsmouth Regional Hospital, Wentworth-Douglass Hospital in Dover and Frisbie Memorial Hospital in Rochester. All said there is a great need for more acute rehabilitation hospital beds in the Seacoast. And they told a DHHS official Thursday they strongly support a proposed facility at York Hospital.

The hearing was conducted by Larry Carbonneau, a manager in the licensing and certification division of DHHS. York Hospital and New Hampshire-based Northeast Rehabilitation Hospital Network (NRHN) have applied to DHHS for a required certificate of need to build a 20-bed acute rehabilitation facility on the York Hospital campus.

The hearing was requested by New England Rehabilitation Hospital of Portland (NERHP), which operates a 100-bed acute rehabilitation hospital in Portland. A team of administrators and doctors from the hospital outlined their concerns about a new facility in York.

“This is an important matter to New England Rehabilitation Hospital patients, staff and physicians,” said Jeanine Chesley, CEO for the hospital. “It should not be surprising that I and the staff are concerned.”

She said while NERHP is licensed for 100 beds, it operates with 90 beds. “We’re not strong enough to open those 10 additional beds” because there is not enough need for them. “So I question the need for 20 more beds in southern Maine.”

She also said 25 percent of its patients are from York County. If there is a need for NRHN to expand, “wouldn’t it make more sense to expand in Portsmouth? More homework needs to be done” before DHHS makes a decision.

Dr. Elissa Charbonneau, chief medical officer at NERHP, said “due to our large size and expertise, we do have significant specialty training” in several acute care areas. But she questions how the hospital will be able to attract and retain qualified staff with a decreased need for beds — especially with 20 more in southern York County.

Maine Medical Center senior vice president and NERHP board member Marjorie Wiggins said in the 15 years she has been on the board, “I have seen a need for decreased capacity. We have seen a daily census of 55 patients, leaving a lot of excess capacity, and the trend is likely to continue.” She also questioned the “inefficient and unnecessary use of staff” at a new facility. “Whether you have one patient or 20 you still have to staff it 24 hours a day, 365 days a year.”

But Seacoast hospital administrators made clear they have more patients in need of acute rehabilitation hospital services than can be filled at the NRHN inpatient facility in Portsmouth — the only such facility in the Seacoast.

Wentworth-Douglass CEO Gregory Walker said of 228 hospital patients this year in need of inpatient acute rehab services, 190 were sent to the NRHN facility in Portsmouth. The reason not all patients could go to Portsmouth “is that most days, it’s full. There is no doubt in my mind that this is needed. I strongly support this.”

Portsmouth Regional CEO Dean Carucci said this year alone, Portsmouth has placed 353 patients into acute rehabilitation, and NRHN in Portsmouth has only been able to accept 283. “This means the remainder had to leave our community for care,” he said. “Portsmouth Regional Hospital alone could fill 40 percent of this new center today. I support this project. I support this hospital and I support Northeast Rehab.”

Recently retired Frisbie Hospital CEO John Marzinzik said, “one takeaway I want to make sure we understand is there’s a significant cost savings in shortening the lengths of stays of patients. Having friends, family and loved ones close by has a dramatic impact on patient recovery. This affiliation is a very strong, smart, positive, financially sound move to make. The more care we can keep local, it’s only going to be more cost effective.”

Dr. Melvin Prostkoff, a neurologist at Great Bay Neurosurgical Associates, said the Seacoast has a “porous” border and is marked demographically by a dense and growing older population. He said he alone sees doctors who practice in three different hospitals, including York Hospital. “And it’s helpful for Seacoast area people to go to Northeast Rehab” in Portsmouth.

Carbonneau also heard from a number of people who were patients at NRHN, sent there by one of the regional hospitals in the Seacoast. All of them said the fact they could have family close by made all the difference.

“I’m totally in favor of this project,” said Kittery Point resident Susan Emery. She said when her late husband needed rehabilitation services “an hour drive (to Portland) would have been way, way too much for most people” to visit him. She said she has never heard of NERHP. “Perhaps they haven’t been extending themselves out to the greater southern York County community.”

There is now a 30-day period for written comment on this certificate of need application. Comments may be sent to Licensing and Certification, Certificate of Need, Station House Station #11, Augusta, Maine 04333. All comments must be submitted by 5 p.m. July 8.

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