O'Fallon Progress

Hospital wars: St. Elizabeth’s, Memorial fighting over whether another hospital needs to happen

St. Elizabeth’s Hospital leaders say the only reason Memorial Hospital is fighting their move to O’Fallon is because Memorial wants to put St. Elizabeth’s out of business.

“What Memorial really wants is for St. Elizabeth’s to continue to have to provide care in an old, out-of-date building that is difficult to access. This will allow Memorial to expand and modernize at its 96-acre campus (versus St. Elizabeth’s current landlocked 17 acres), leverage its modern satellite facility in Shiloh and over time drive St. Elizabeth’s out of business,” St. Elizabeth administrators say in a letter to state regulators. “The only ‘negative’ impact this project will have on Memorial is that Memorial will not be able to achieve that very objective.”

Memorial Hospital’s chief operating officer, Michael McManus, refuted those claims in his own letter to regulators.

“St. Elizabeth’s statement is inflammatory and grossly misstates the consistent position of Memorial Hospital,” McManus wrote.

The letters are new parts of the battle over whether the state should give St. Elizabeth’s permission to move from its 60-year-old building in downtown Belleville to a new site in O’Fallon—just 5 minutes away from where Memorial is building a second hospital.

For the second time this year, St. Elizabeth’s is set to go before the state Health Facilities and Services Review Board and ask for approval for the move. The board meets Tuesday in Bolingbrook.

Both supporters and opponents of St. Elizabeth’s $253 million project have submitted letters and written arguments to the board.

McManus, in his letter, accused St. Elizabeth’s officials of having a “win at all costs” mindset. “The result has been to build a great divide within our community and to put at risk access to healthcare for our most underserved residents,” he wrote.

Whether St. Elizabeth’s can move forward with its plans to construct a replacement hospital is up to the nine members of the review board.

The state board heard the hospital’s proposal at its meeting in January, but the plan didn’t get enough votes. However, under state law, St. Elizabeth’s had an opportunity to submit additional information and ask the board to reconsider.

McManus is asking the board to deny the proposal: “Approval of this application will forever change the healthcare delivery system in our metro-east region and is likely to set a grave precedent for the delivery of care in Illinois, favoring a system that benefits the haves at the expense of those who have not.”

St. Elizabeth’s president and CEO Maryann Reese said St. Elizabeth’s looks forward to again presenting its project to state board members.

At the January hearing, the project received a majority of “yes” votes but fell one vote shy of getting its approval, called a Certificate of Need. Under Illinois law, a hospital project needs at least five favorable votes from the board. Only five board members were present at the January meeting, and one cast a “no” vote.

“If all the board members had been there, I think we would have got our CON,” Reese said.

St. Elizabeth’s chances are likely improved this time, just by the fact that the board now has nine members, rather than eight. In January, the board had a vacancy, due to the death of a board member, but on Friday, Gov. Bruce Rauner named an appointee to fill the vacancy: former state lawmaker J. Bradley Burzinski of Rochelle.

Duplication of services?

Opponents of St. Elizabeth’s plan say moving to O’Fallon will duplicate services provided by Memorial Hospital-East, which is being built on Cross Street in Shiloh, and will put the hospital farther away from a majority of its patients.

“We want them to build a new hospital, but it doesn’t have to be off (Interstate) 64 in O’Fallon,” said Stephanie Dorris, a Belleville resident who is active with an opposition group, Oppose The Move.

St. Elizabeth’s officials contend in their application that “the location in O’Fallon places St. Elizabeth’s closer to approximately 70 percent of its patients, based on their respective ZIP code origin.”

Reese, in a letter to the board, wrote that “access to the level of services that St. Elizabeth’s provides will be enhanced in the region generally once it moves to Interstate 64.”

According to figures provided by St. Elizabeth’s, there are 554 inpatient hospital beds currently in Belleville, which has a population of 42,895, while O’Fallon and Shiloh have a combined population of 42,025 but no inpatient beds. The St. Elizabeth’s replacement hospital would bring 144 inpatient beds, and Memorial East will bring 94, for a total of 238.

Ruth Holmes, administrator of Memorial Hospital-East, said the hospital’s satellite campus is 5 minutes away from the proposed site for St. Elizabeth’s replacement hospital, and both would be using the same exit off Interstate 64.

“Memorial is of the position it is a direct duplication (of services),” Holmes said. “Many of the things they will be offering we would already be offering at the site.”

Reese disagrees. She said Memorial East, being a satellite facility, won’t provide “high-risk services” such as cardio vascular and neurological surgeries and high risk obstetrics.

“You can’t compare them to each other; they are different types of facilities,” Reese said.

Holmes said that’s not entirely true.

“Memorial Hospital East will provide a full complement of high-risk interventional cardiology and vascular procedures in our two cardiac catheterization suites, excluding open-heart surgery, which will be offered at Memorial Hospital in Belleville,” she said. “Neurosurgery will not be offered when Memorial East opens but that service can be added in the future as the need arises. In terms of our OB/GYN procedures, both Memorial Hospital in Belleville and Memorial Hospital East will have high-risk level II nurseries and neonatologists staffed 24/7.”

Divided community

St. Elizabeth’s is asking the state for approval to close its 303-bed hospital in downtown Belleville and open a replacement 144-bed hospital 7 miles away off Interstate 64 on North Green Mount Road. The cost of the project is $253 million. St. Elizabeth’s also plans to build a $34 million ambulatory care center adjacent to the new hospital, which will need separate approval by the state board.

Officials at St. Elizabeth’s say a replacement hospital is needed because its current 60-year-old building is obsolete.

Analysts for the state board agree that discontinuation of the existing St. Elizabeth’s is warranted. In a report, the analysts noted the “age and obsolescence of the existing hospital.”

St. Elizabeth’s leaders say it’s cost-prohibitive to modernize the existing hospital, at an estimated cost of $365 million. And building a new facility on its existing site would cost approximately $353 million.

Supporters of St. Elizabeth’s plan have submitted nearly 50 letters to the state board since the Jan. 27 meeting.

Local religious leaders also are divided. Some spoke in favor of the move during the last state board meeting. They included Bishop Geoff Dudley with New Life in Christ Interdenominational Church in Lebanon and the Rev. Jim Deiters, an O’Fallon priest who serves on St. Elizabeth’s board.

However, the Rev. Monsignor John Myler, rector to St. Peter’s Cathedral in Belleville, wrote a letter in opposition to the move.

“Only 7 miles is quite a distance for the poor who have no means of transportation,” Myler wrote. “It is contrary to Francis to ask those in need to travel to him; rather, Franciscans are—and have been for centuries—right among the people...not in a well-to-do place, asking the people instead to come to them.”

St. Elizabeth’s is under the ministry of the Hospital Sisters of the Third Order of St. Francis and is run by the Hospital Sisters Health System, which consists of 14 hospitals.

All about the money?

Opponents believe St. Elizabeth’s is more interested in the bottom line than serving the community’s most needy.

But St. Elizabeth’s officials have said a majority of the hospital’s patients come from outside Belleville, and it’s the non-Belleville residents who are more likely to be Medicaid patients.

New information submitted to the state board includes three affidavits dated April 1: one from Belleville Mayor Mark Eckert; another from Dorothy Meyer, liaison to St. Clair County Board Chairman Mark Kern; and one from Craig Steiner, who was employed as administrative director of marketing and communications for St. Elizabeth’s until July 2010.

All three affidavits state that Jim Burke, HSHS senior counsel/vice president for administration, said in 2010 that St. Elizabeth’s needs to move to a location with a better “payer mix” in order to survive.

But St. Elizabeth’s, in its application, argues: “The payer mix at the O’Fallon campus is not predicted to be any different than the current payer mix, because St. Elizabeth’s serves the region, and its patients’ ZIP code by origin is not anticipated to change, other than to pull more patients from currently under-served areas.”

Dorris, with Oppose The Move, said it appears St. Elizabeth’s is more concerned with profits and moving to an area with higher incomes.

The median household income in Belleville is $47,348, and in O’Fallon, it’s $75,021, according to the latest information provided by the U.S. Census Bureau.

“The concern is they are trying to leave where they are most needed, and it looks to be from the standpoint of greed and not most need,” Dorris said.

Reese said that is not the case.

“That’s just not true; we’re not leaving for a better payer mix,” she said. “When we replace our hospital 7 miles away, our payer mix does not change. There’s no truth to the fact that the sisters are leaving their mission or ministry.”

Adjustments to proposed hospital

Following the state board’s denial in January, St. Elizabeth’s made some adjustments to its plan, mostly involving the types of patient rooms that would be offered.

As a result of those changes, St. Elizabeth’s amended application states it meets 32 of the 38 criteria used by the state board to evaluate applications.

“Of the remaining six criteria not met, five are due to the fact that the project is measured against criteria for a new hospital which treats the project as if it were adding beds and services in the planning area, whereas this project proposes a replacement hospital that reduces beds within the planning area by 159 beds and does not add any new services,” the application states.

If approved, St. Elizabeth’s expects to have the new hospital finished by the end of 2017. “It will be a gem for all of the region,” Reese said.

St. Elizabeth’s plans to demolish the current hospital, if no new tenant can be found. Hospital leaders say an outpatient medical campus would remain in downtown Belleville, including an urgent care center, doctor offices, labs and therapy services.

“We are committed to Belleville,” Reese said.

If the move is not approved, Reese said St. Elizabeth’s has a year to try again with the state board.

“We are looking forward to the future of the next 140 years of our ministry” she said.