UNION COUNTY — The county could be getting out of the hospital business. Although a recently released executive budget forecasts a better overall financial picture dawning over the county, new revenue is “desperately needed,” county Manager Al Faella wrote in a letter accompanying the budget last month.
And a cornerstone of that effort could be the sale of a century-old asset: the Runnells Specialized Hospital.
The hospital, on 45 acres in the Berkeley Heights hills, lost nearly $20 million last year, with the bulk of that attributable to reductions in federal Medicaid and Medicare reimbursements, officials say.
According to a recently completed study by a Pennsylvania management consultant firm, Complete HealthCare Resources, the county could derive between $22.4 million and $25.8 million by selling Runnells.
But either a sale or even a lease would also relieve the county from pension obligations and from providing health benefits to several hundred employees. A sale would also put the facility on the tax rolls.
But longtime employees and hospital advocates, including union representatives, say much more than a building is at stake.
Barbara Egger, a longtime Runnells nurse and president of Local 5112 of the Health Professionals and Allied Employees, fears a sale to a private company would cut into oversight, transparency and, especially, treatment.
“Privatization has more often decreased access and quality of health care and created a decline in working conditions, wages and retirement security of the health-care workforce,” she told the county freeholders last month.
Despite the uncertainty surrounding the facility, its employees remain dedicated to Runnells’ mission, Egger said. That is reflected in what matters most — patient care, she said.
“It’s always been a great place to work,” she said during a recent interview. “And the patients know that.”
She calls the work done by nurses and aides within Runnells’ 300-bed long-term care unit and its 44-bed adult psychiatric facility back-breaking, but ultimately rewarding. It calls for equal parts compassion and dedication, she said. For that reason, staff turnover is minimal, she said, allowing people to build a bond with patients and their families.
But Egger warns those qualities could be lost should the facility transfer to private hands. Because profit margins are so thin, cost-cutting in private care comes by thinning staff and paying less, said Egger, who said she has worked every unit and every shift at the hospital. That results in fewer skilled aides clothing, bathing and feeding patients, checking vital signs and dispensing medications.
“When you cut staff, there’s no way you can’t cut care,” she said.
Egger asked the freeholders to consider several suggestions to bolster the hospital’s bottom line, including leasing space and reopening closed wings.
Freeholder Vice Chairman Chris Hudak said the county can’t ignore the decline in reimbursements, rising expenses and consequent tax burden.
Reimbursements, currently $222 per patient per day, are projected to fall another 10 percent, to about $190, in the coming years, according to the CHR consultants. To break even, they said, Runnells would need reimbursements in the $275 to $300 range.
Although the consultants said “alternative ownership” is the only way for the county to stop essentially subsidizing the facility, the freeholders have said Runnells’ fate won’t be decided in a hurry.
Freeholder Daniel Sullivan said the imminent departure of the hospital’s administrator, Joan Wheeler, on April 1, could augur changes. And he said that Wheeler herself is a repository of ideas.
“Until we hear all those things,” Sullivan said, alluding to the board’s research, “we’re not going to make a decision any time soon.”
Hudak said he and his colleagues would be taking a detailed look at CHR’s conclusions and be diligent in their outreach to staff, patients and their families and other stakeholders.
“This is something that needs to be done with care and correctly to put the county on the best path for the future,” he said. “You don’t do this with an ax, you do it with a scalpel.”
By Richard Khavkine