A petition drive has started in Rutland to save the local hospital’s inpatient rehabilitation unit.
But hospital officials say they have no choice. They’re grappling with a $7 million budget shortfall, and closing the rehab unit will save $3.5 million.
Rutland’s 12-bed inpatient rehab unit helps people recover from strokes, head or spinal injuries, joint replacements and some long-term ailments.
It’s one of only three acute rehab facilities affiliated with a hospital in the state. So if it closes, patients will have to travel to Burlington or Mount Ascutney Hospital for such care. Dr. Dan McCauliffe, a Rutland dermatologist, says he understands that cutting the unit will save money for the system.
"But if you take into account the inconvenience and lost productivity of people traveling back and forth – family to visit a great distance from one’s home – then you’re saving money for the system, yes, but you’re not doing a service for the community," he said.
Tom Huebner, president of Rutland Regional Medical Center, says he doesn’t want to close the rehab unit. But he says with federal Medicare reimbursements expected to decline and a smaller state imposed revenue cap for hospitals, there is no easy way to mend their current budget shortfall.
"We have not been able to identify another program that is not central to the services of the organization or as central," Huebner said. "Here are the big things that lose money at the hospital – the emergency department – inpatient medicine in general – the labor and delivery birthing suit, pediatrics – all of those are money losers but they are so central and vital to the needs of the community that you can’t think of closing them."
To rein in health care spending and force cost containment, the state sets yearly caps on how much hospital budgets can increase.
Huebner says over the years, those caps have pushed the hospital to trim as much as possible. But he says they’re now at the point where more drastic cuts are needed. He says inpatient rehabilitative care is already available in Rutland at area nursing homes and those facilities provide care much more cost effectively than hospitals.
But Dr. Mike Kenosh, director of rehab services at Rutland Regional Medical Center, says the level of care is not the same. While nursing homes do good work, he believes closing the hospital’s rehab unit will lead to higher costs and worse outcomes for the neediest patients.
"We can see complications sooner and treat them before they get out of hand," Kenosh said. "If we move this care outside the hospital – to a skilled nursing facility for instance – they don’t have the ability to manage those complications, especially the serious complications we get. So people are going to be coming back through the emergency room. Or they’re going to be staying longer at the hospital. That’s what’s going to cost the hospital more money."
Kenosh also worries about the long-term consequences. He says it will become more difficult to attract physicians to Rutland. He isn’t alone. Many Rutland area doctors worry that this is just the first of many health care cuts for the community.
Dr. Dan McCauliffe says he can appreciate how difficult it is for the Green Mountain Care Board to design a statewide health care program that ensures cost containment. But he says communities outside Burlington, that may lose specialists, need to understand what that may mean.
"Rutland Regional is a major employer of this community," McCauliffe said. "And if you start cutting services and cutting employment, it’s going to have a significant local impact on our economy. So again the health care system saves money, but what it’s going to do patients, providers and what’s it going to do to local communities?"
Hospital President Tom Huebner says these are the kinds of tough decisions he faces every day and they’re not getting easier. But he says that if the rehab unit is not closed, the hospital will be forced to cut $7 million from somewhere – which could mean a reduction of about 85 jobs across the board, as well as several million dollars worth of non-labor costs.
Rutland Regional Medical Center’s board of directors will decide this week whether to go along with the plan to close the rehab center or to try a different approach.
But hospital officials say they have no choice. They’re grappling with a $7 million budget shortfall, and closing the rehab unit will save $3.5 million.