Cutbacks At Large Hospitals Could Sour Perception Of Construction Projects
More than 10 years ago—before the Affordable Care Act, before reimbursement changes, before the tide really shifted toward more outpatient care—Palomar Medical Center (PMC; Escondido, Calif.) was in the works. As I wrote about last December, PMC started taking patients in August 2012, an impressive $1 billion project with myriad innovations.
Recently, PMC’s owner, Palomar Health, announced plans to lay off 84 workers. President and CEO Michael Covert cited lower Medicare payments, declines in reimbursement, concern over a drop in patient satisfaction scores, and lower census levels as reasons for the move during a May board meeting.
Large hospitals across the country are facing the same concerns, and Palomar certainly isn’t the first (or the last) to resort to layoffs to close the gap. Palomar’s announcement, however, comes with a little extra sting for our industry.
Susanne Philips, a Palomar nurse and member of the California Nurses Association, questioned the message Palomar was sending in an interview with Modern Healthcare: Referencing PMC, she said, “Meanwhile, we have a new hotel-like building. I'm not sure we needed that.”
Considering that PMC was partially funded by a voter-approved $496 million bond issue, comments like this have the potential to create quite a ripple effect. Covert defended Palomar’s move: “I understand how this might look to people, but there are much larger consequences if we don't position ourselves and manage all of our facilities in the future,” he told Modern Healthcare.
Looking at some of the technological advances and evidence-based design initiatives employed at PMC, there’s certainly a lot to be said for how a hospital like this is poised not only to improve patient care and outcomes but to provide real guidance for other facilities going forward. And while large, acute care hospitals’ influence on the healthcare landscape may not be as all-encompassing as it used to be, it’s hardly negligible.
It’s unfortunate that necessary healthcare facility improvements—and even future new-build projects that will genuinely serve an unmet community need—may be endangered as administrators shore up the bottom line and workers/shareholders/community members question the true value of changes to the built environment. That’s not to say these questions aren’t important; they’re critical, actually. There’s a legitimate argument against investing in big-budget, big-footprint hospital projects in the future.
But everything needs to be considered case by case, and our industry has the inside perspective to help facilities determine and articulate what’s really appropriate and necessary to meet their current healthcare needs. While this has always been the case, as more facilities inevitably lay off workers—affecting the community in an immediate, tangible way—that perspective is more important than ever.