Karen Connors had heard the grumbling.
We don't need your hospital, some doctors griped, both privately and publicly.
And it was hard for many to argue with the doctors' logic. Less than a year after Bay Park Community Hospital in Oregon had opened, Ms. Connors' hospital, St. Anne Mercy, opened in West Toledo.
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Metro Toledo would soon have eight hospitals, some only a mile or two apart. Critics questioned the need for the facilities, complaining that they were the result of a war between the area's two main health-care providers - Mercy Health Partners and ProMedica Health System.
Then the patients started coming.
Less than two months after opening with 72 beds, St. Anne had to add 16. An operating room was added in January. Last month, eight more beds were added. And by the end of this year the hospital will add 14 more, bringing its year-end total to 110 beds in use.
In the first six months of this year, St. Anne had an average occupancy rate of 72 percent for adult patient beds, Ms. Connor says, much better than she expected for a facility just getting started.
By comparison, the two other area hospitals owned by St. Anne's parent company, Mercy Health, have been around for years and have almost the same occupancy levels. Mercy officials say St. Vincent Mercy Medical Center, on average, is 73 percent full, while St. Charles Mercy Hospital's occupancy is 67 percent.
All this means St. Anne officials will have something to celebrate when the facility turns one year old on Tuesday.
“The results speak for themselves,” Ms. Connors, president of St. Anne, says with a smile.
On the eastern side of metro Toledo in Oregon, Terri McLain says much the same thing.
Despite naysayers, the president of Bay Park Community Hospital says her hospital likewise is exceeding expectations. While it hasn't had the rapid growth of St. Anne, Bay Park will soon use all 70 of its beds, ahead of projections. Bay Park turns two years old in November.
However, Ms. McLain would not provide 2003 patient volume numbers like those St. Anne officials provided to The Blade to verify how busy the hospital has been.
According to 2002 figures compiled by the state health department, Bay Park's staffed adult patient beds were 40 percent full last year. Last year's state figures for St. Anne show the hospital's staffed adult patient beds at 52 percent occupancy, although St. Anne officials argue they were only open four months last year. The state's method of calculating hospital occupancy is more conservative than methods used by local hospitals, many of which dispute the state formula's accuracy.
Ms. McLain says the number of patients using her hospital's emergency department has climbed 40 percent from May, 2002, compared to May of this year, and surgery volume has climbed 60 percent in that same time frame.
The Academy of Medicine of Toledo and Lucas County was one group that was critical of the new hospitals. Past presidents of the group, a professional organization that represents most of metro Toledo's physicians, said adding more hospitals would drive up health-care costs and duplicate existing services.
Worries about duplications “were a valid concern,” says Dr. Arthur Mancini, academy president. However, criticism has died down, Dr. Mancini says, because he and most of his colleagues have accepted that the new hospitals are open, so they might as well use them.
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One telling sign of physician acceptance of the facilities is the number of doctors signing up for “privileges” at the new hospitals - meaning they can admit patients to a hospital and treat them there.
Ms. McLain says Bay Park started out with 200 physicians with privileges and now has 400. Ms. Connors says St. Anne has gone from 500 to more than 800.
Dr. David Grossman, health commissioner for Toledo and Lucas County, agrees with Dr. Mancini that most physicians have accepted the new hospitals.
“We protested, and we sure didn't need more beds in this community, and that feeling is still here,” says Dr. Grossman, who also has a private practice in Toledo. “But now they're built.”
While Ms. Connors and Ms. McLain insist each of their hospitals was needed, Dr. Grossman suspects competition drove the decision to build the facilities more than anything else.
St. Anne is owned by Mercy Health, which also owns St. Charles Mercy Hospital in Oregon, located less than two miles from Bay Park. ProMedica owns Bay Park.
Dr. Akinfemi Afolabi, a Toledo kidney specialist, sees patients in both St. Anne and Bay Park and says he's been “very happy” with both hospitals. His patients enjoy the new hospitals too, Dr. Afolabi says.
Still, he believes Toledo has too many hospitals. “If ProMedica has a hospital in one area, then Mercy feels they have to have one also,” he says.
Dr. Grossman points out that St. Anne is about halfway between Toledo Hospital and Flower Hospital, giving Mercy the chance to attract more patients who might otherwise have gone to the other two as well as to pick up more emergency traffic. Although insurers often control where patients may go, patients in ambulances are usually taken to the closest hospital's emergency room.
Ms. Connors says not only was St. Anne needed, it's more of a “replacement” hospital, than a new one.
“We really are, sort of, Riverside reborn,” she says.
Mercy shut down Riverside Mercy Hospital in North Toledo, which was using 135 beds, and then opened St. Anne, which will use no more than 136, she says. Ms. Connors argues that because of that, Mercy hasn't really added any beds to the community.
It's hard to argue that St. Anne's opening hasn't made financial sense.
Ms. Connors says the hospital expected to have a $421,000 operating profit at the end of last month, and instead did five times better, turning in a $2,173,612 operating profit. Riverside, by comparison, lost money every year since at least 1998 before it closed last year.
Doctors have argued that Bay Park, located within sight of St. Charles, was merely a chance for ProMedica to pick up more patients in Oregon, which St. Charles has served for more than 50 years. Ms. McLain disputes that, saying a demographic study before the hospital opened showed 60 percent of patients in the Oregon area went outside Oregon for hospital care.
Whether Bay Park's opening has made financial sense for ProMedica is uncertain. ProMedica officials would not provide financial data for the hospital.
Where Bay Park and St. Anne are getting their patients - and what effect their opening has had on other hospitals - is difficult to measure.
Because St. Anne was only open four months last year, it's hard to compare its state-calculated admission totals against those of other hospitals, although physicians suspect it's drawing from both nearby Mercy and ProMedica facilities.
Bay Park had its first full year of operation last year, meaning it's possible to compare its impact on St. Charles. State figures show St. Charles had 15 percent fewer admissions last year than in 2001.