McCready's emergency department, other services under review

Posted 10/3/22

CRISFIELD — Leaders of TidalHealth, which acquired the former McCready Memorial Hospital in 2020, are on a “listening tour” to determine what services work best for the fiscal …

You must be a member to read this story.

Join our family of readers for as little as $5 per month and support local, unbiased journalism.


Already a member? Log in to continue.   Otherwise, follow the link below to join.

Please log in to continue

Log in

McCready's emergency department, other services under review

Posted

CRISFIELD — Leaders of TidalHealth, which acquired the former McCready Memorial Hospital in 2020, are on a “listening tour” to determine what services work best for the fiscal health of the institution and the physical health of residents who need the services.

Attracting the most attention is the emergency department — which since 2011 has suffered a compounded annual decline is usage of 6% — and despite the ebb of the coronavirus pandemic is still not at utilization levels last seen in 2019.

“Everything’s on the table, I will be blunt honest about that,” said Chris Hall, chief business officer and vice president of Strategy & Business Development for TidalHealth.

“We’re looking at the data, trying to talk to the community on how they’re utilizing services, but we know services need to be here,” he said.

McCready was absorbed by TidalHealth on March 1, 2020 just two weeks before the COVID-19 outbreak. Plans then were for a freestanding medical facility (FMF) in Hopewell but utilization dropped, and while it’s bounced back somewhat it’s still 10 to 12 emergency visits per day when it was 14 per day in 2019.

Mr. Hall said the day of the week with the highest volume is Monday, followed by Sunday, Tuesday and Friday with most patients arriving between 7 a.m. and 9 p.m. As it was before the merger, over 80% of McCready’s business is from the Crisfield-Marion area.

For statistical purposes patients are categorized into five priorities. Five is the least urgent, which may include not feeling well or a prescription refill, while 4 ranges from a sprained ankle to sore throat to a toothache.

Priority 3 represents urgent care such as abdominal pain, shortness of breath or general weakness. Angie Brittingham, senior director of the emergency department for TidalHealth, said the levels represent “not just about how sick you are, but it’s about what kind of resources are needed to diagnose and treat you.”

In 2019 McCready’s emergency room saw 76 level 2 patients and five patients required resuscitation. For that year there were 4,967 total visits of which 1.63% were ill to the point that without treatment there was a high chance of extreme impairment.

To determine the health of the emergency department the analysis of service is not limited to patient acuity but reimbursement for those services, that is, whether insurers or federal government payors feel it was a “true emergency” and will pay the bill. “We have to have the volume to cover the fixed costs,” Mr. Hall said.

Cindy Lunsford, TidalHealth’s executive vice president and chief operating officer, acknowledged that the numbers are surprising, and might indicate there is more of a need to access primary care “like a family practice provider.”

In addition, the Crisfield-Marion area represents around 5,100 people of which 20% are under the age of 14. “That was a surprise for us,” especially when there are no pediatricians in the immediate area.

Although no decisions have been made, Mr. Hall suggested a reimagined facility could include a place for low-level emergency visits handled as walk-ins during the hours of 7 a.m. to 9 p.m. “Is it more primary care, is it telehealth, is it weight loss and wellness services, is it diabetic care, is it dialysis, what are all the services that can help the community become healthier….all these balls are in the air,” he said.

Mr. Hall said when he met with Dr. Mike Atkins, a former city councilman, Dr. Atkins suggested diabetic ophthalmology, and restarting a schedule for appointments in Crisfield with a cardiologist.

During TidalHealth’s update last month to the City Council Mayor Darlene Taylor said she would like to know what the numbers have to be to support the emergency department, or what it would look like if it was “reimagined.” She said the administration’s goal is to bring new residents to Crisfield and retirees are a target population which look favorably on having nearby access to emergency and medical care.

For Councilwoman LaVerne Johnson it was more personal as she’s had family members brought back to life in the emergency room, including her daughter “who would not be here today” were it not for McCready and its presence in Crisfield.

“We have an aging population,” she said, “I just think the emergency room is a must,” especially for residents coming from the islands. It is the only facility in Maryland with a dock opposite its emergency entrance.

Councilman Eric Banks said besides the economic advantage to Crisfield if the emergency department closed, then 5,000 people “get crammed where? Salisbury.”

“Let’s find ways to make it work,” he said, with Councilman Casey Goldsborough suggesting more marketing to drive business from Westover or even Princess Anne which represents 58% of the county’s total population compared to Crisfield and Marion at just 28%.

Ms. Johnson is a former McCready employee with 27-years service and recommended the empty second floor that was formerly the hospital be converted to provide dialysis services. Ironically that was a plan pursued some 20 years ago by a former CEO with a facility even built to house it, now used for physical therapy.

“It’s important to us, the health care of Somerset County and particularly Crisfield,” Ms. Lunsford said. “We may not be able to do everything, but we can work together in partnership with others to provide services that make the most impact on the community.”

She said the listening tour has heard from politicians and EMS and is now moving forward to find church and community groups. City leaders also want to be sure there’s a communitywide meeting held as well.

“We need to have that service available,” Mayor Taylor said about the emergency department, “even if another service is brought in to help pay for it.”

Added to the mix of things to consider are the results of a community-based health needs assessment, conducted every three years, with the latest showing major gaps in access and health equity, behavioral health (including substance abuse treatment), dental care, and disease management.

Diabetes is a number one concern in Somerset County, followed by weight/obesity, and wellness lifestyle, the survey found.

“One thing I can promise you, is TidalHealth is not going away,” Mr. Hall said. “Their services are going to be offered, we just have to figure out what is the compliment of services that is commensurate with the population.” And emergency care, “is on the table.”

During public comments at the end of the city meeting Tim Howlett said shutting down McCready’s ER “will devastate Crisfield” and the EMS system. He said the representatives from TidalHealth were telling the community, “The writing is on the wall….‘That hey folks, it’s not working,’ they don’t make enough money.”

Mr. Howlett, a Republican candidate for County Commissioner, urged residents to come out to the public meeting when it’s scheduled.

Members and subscribers make this story possible.
You can help support non-partisan, community journalism.

x
X