Dimensions Healthcare System

By Eugene L. Meyer
Staff Writer - The Washington Post

Hospital Change Is Urged

A state-appointed task force recommended yesterday that Prince George's County relinquish ownership of its public hospital system to the financially troubled nonprofit corporation that operates the facilities for the county.

Such a step, the panel said, would help Dimensions Healthcare finance needed capital improvements for the system, which provides medical care for the county's poorest residents, including the uninsured and Medicaid recipients.

Dimensions runs 284-bed Prince George's Hospital Center in Cheverly, Laurel Regional Hospital, the Bowie Health Campus, two nursing homes and an assisted living residence. The company has lost $45.8 million over the last three years and at the end of October had only nine days' worth of cash reserves on hand. In the last several months, Dimension's directors have been trying to find a buyer for the system.

The 22-member panel, which will hold a public meeting on its report tonight, took no position on whether Dimensions should continue to own and operate the system, merge or sell it. But it urged that any potential buyer be required to "continue its mission to serve those most in need."

"When the day's done, the issue is that the poor can't pay for themselves, and if we want health care for everyone, we have to pay for it," said Samuel Wynkoop, chairman of the board of directors of Dimensions Healthcare, which operates the facilities to which the county retains title.

For the short term, the task force said, the county should provide $3 million to secure a matching state grant this year, and those funds should be used "exclusively to fulfill its mission to the public" of serving the poor.

Wynkoop said the board has been sifting through six proposals from prospective buyers but wanted to wait until after the fall elections, since the new county executive and council must approve any decision.

One of the proposals is from Arizona-based Doctors Community Healthcare Corp., which owns Greater Southeast Community Hospital in the District and recently filed for Chapter 11 reorganization. That fact, Wynkoop said, eliminates the corporation as a viable bidder. With the others, he said, "you've got to go to the next stage to figure out if it will really work." That could come in January, when the Dimensions board will meet and rank the proposals, he said.

The system is projecting a small net profit of $250,000 this fiscal year, attributed to improved billing and collection. Despite the problems, it could be attractive to a buyer, Wynkoop said.

"It does have a market share," he said. "Somebody who comes in who's new could bring to the table a big infusion of capital, improve the plant, maybe close down some sections, bring in practitioners and a better payer mix" with more privately insured patients.

But there are ways to save the system without selling it, Wynkoop said. "Doing nothing [about a sale] is one of the options," he said, "if there is government willingness to step up in a serious financial way."

Direct subsidies are not the only option, Wynkoop added. The county could agree to float bonds in the future for capital improvements.

"There are a lot of ways they could go at this thing, if they believe the basis of the report, that this is an important institution for the viability of health care in this area," he said.

Former county executive Winfield Kelly, Dimensions' chief executive officer, said the company was "in great shape" until 1997, when the state froze Medicaid payment rates for three years. On top of that, he added, "we had several small HMOs that went bankrupt on us. We had just such a large disproportionate share of the poor. The last five years have been so difficult, we haven't been able to put it back on a financial track to survive."

George S. Malouf Sr., an ophthalmologist and former Dimensions board member who headed the panel established by the General Assembly, said, "I believe [the system] should survive, but there is not one single answer."

Among other recommendations, the task force urged the county to "renew its commitment" to an annual payment for indigent care, and it recommended restructuring the Dimensions board to include more business and community members.

The task force, staffed by the governor's office and the Maryland Department of Health and Mental Hygiene, has been meeting regularly since July 27.

Tonight's public meeting on the report will be held in the Prince George's Hospital Center's Deitz Memorial Auditorium from 6:30 to 8:30 p.m. The report is available online at www.dhmh.state.md.us under "Hot Issues."

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