St. Vincent to close to inpatient care Nov. 15 at Cleveland hospital; will keep some outpatient, primary care - cleveland.com

CLEVELAND, Ohio — St. Vincent Charity Medical Center, which has been caring for Cleveland's sick since the Civil War era, announced Wednesday that in mid-November it will stop offering inpatient, surgical and emergency room care.

The 416-bed hospital will transition to ambulatory healthcare services, St. Vincent said in a statement announcing the change.

The announcement comes just weeks after University Hospitals ended inpatient care at two other Cuyahoga County hospitals, in Richmond Heights and Bedford.

After Nov. 15, there will no longer be an emergency department in downtown Cleveland. EMS will instead take patients to University Hospitals, MetroHealth System or the Cleveland Clinic, said Janice Murphy, president and CEO of the Sisters of Charity Health System, which oversees St. Vincent.

Urgent care services remaining at St. Vincent will meet the community's needs, she said.

"After the pandemic, we really saw a decline in patients coming with acute emergencies," Murphy said. "They're already going to those hospitals today. So it's not a change."

Though eliminating all its overnight hospital beds, St. Vincent Charity Medical Center will continue to provide outpatient mental health services; addiction medicine services through Rosary Hall; primary care, and internal medicine and specialty clinics.

Over the next eight weeks, the hospital said, patients can check the St. Vincent website for additional information about the change in services.

"The seismic shifts in health care over the last decade have created a challenging environment for St. Vincent Charity Medical Center to continue as a traditional acute care hospital. The rise in demand for outpatient care, declining inpatient volume and the growth of telehealth, all of which were accelerated by the COVID-19 pandemic, have placed additional financial pressure on the hospital," St. Vincent said in statement.

St. Vincent will still employ about 100 caregivers, including clinical and non-clinical staff, the hospital said. About 600 full-time employees are not being retained, the hospital said. As recently as 2019, according to tax records, the hospital employed 1,442 people.

Medical residents at St. Vincent are invited to move to UH, which plans to conduct job fairs for St. Vincent healthcare workers and other employees seeking new jobs.

The move to discontinue inpatient care comes after the hospital has dealt with years of financial struggle, magnified by the strain of the COVID-19 pandemic.

St. Vincent — located in Cleveland's economically disadvantaged Central neighborhood near downtown — had a net loss of $14.5 million against revenue of $414 million last year, according to online sources.

The hospital operated at a loss every year since 2011, according to federal tax filings. St. Vincent lost $191,951 in 2020, $16.5 million in 2019 and $13.5 million in 2018.

Community concern

The decision to end inpatient services will have a negative impact on African-American communities and the hospital's employees, said Cleveland City Councilman Richard Starr, whose Ward 5 includes St. Vincent.

"I am disappointed by this decision," Starr said in a statement. "However, as leaders, we will take every step possible to right this wrong." He said he plans to work with Cleveland's health institutions to fill the health care void in Ward 5.

The end of inpatient services at St. Vincent isn't surprising, said Tom Campanella, health care executive in residence at Baldwin Wallace University. It's the result of two trends he's seeing locally and nationally — fewer patients admitted for hospital stays, and the growth of outpatient and home health care.

"Inpatient services are much more costly than outpatient and definitely more costly than care in a home setting," Campanella said. "Medical device companies, technology companies and others have known about this trend for years and they have been focusing on providing care in home settings."

Because St. Vincent provided inpatient care to the poor and uninsured, MetroHealth System, UH and the Clinic need to make further commitments to serve to underserved, Campanella said.

St. Vincent last ended a year in the black in 2010, with $11 million in revenue.

The decision to end inpatient care wasn't solely based on economics, Murphy said. "It's not just finances," she said. "I believe that it was the community need. We learned during the pandemic that health care was changing, and we wanted to change with it."

A lack of healthcare workers, which has affected hospitals locally and nationally, was not a factor, Murphy said.

Going forward

Wednesday's announcement said that the walk-in services that St. Vincent will continue offering will be part of the new nonprofit St. Vincent Charity Health Campus. The health campus, organized as a new nonprofit, is developing its initial pilot programs to focus on youth and families, food and nutrition, physical health and behavioral health.

The Sisters of Charity Foundation of Cleveland last year announced plans to create a health campus in its neighborhood, aiming to build up medical and social services around the St. Vincent Charity Medical Center, The hospital, as described under the plan announced then, would anchor the development to be known as the St. Vincent Charity Health Campus.

Recently, St. Vincent worked with an internationally recognized design firm to conduct focus groups to find out the health concerns and priorities of people in the community, said Susanna Krey, president and CEO of the new health campus.

"The top three are the ones that we are advancing most quickly as pilot programs," Krey said. "The vision for this Health Campus will be more aligned with the needs of a community, that is an underserved community, because we are constantly talking to the community."

In its new incarnation, St. Vincent will focus more on the social determinants of health, Krey said.

"An underlying principle is the recognition that improving health outcomes is so much more than what the healthcare system can do, because we know that healthcare delivery really represents about 20% of health outcomes," Krey said.

"The other 80% is the social determinants of health, and the excitement around this vision is the fact that we are listening to the community."

St. Vincent's announcement comes at a time of change in Cleveland's healthcare landscape.

UH ended inpatient care, surgeries and emergency services at UH Bedford and UH Richmond hospitals in August. The health system pointed to a lack healthcare workers for the decisions.

But MetroHealth System is poised to open its new $946 million Glick Tower just a few miles southwest of St. Vincent, expanding healthcare services. Glick, along with the MetroHealth Cleveland Heights Medical Center specializing in behavioral health, are opening in October.

UH Ahuja Phase 2, a $236.1 million project in Beachwood, will expand bed capacity and place a focus on wellness, emergency services and expanded operating room access.

Commitment 'to the healing mission of Jesus'

St. Vincent had billed itself as Cleveland's only faith-based, acute-care teaching hospital. It is a ministry of the Sisters of Charity Health System.

"Faithful to the philosophy and heritage of the Sisters of Charity of St. Augustine, St. Vincent Charity is committed to the healing mission of Jesus, serving with a deep respect for the dignity and value of all persons, practicing with quality care, a dedication to the poor and a commitment to education," the hospital said in a report.

The hospital had been known for its specialty care, including Behavioral Health and Addiction Medicine at Rosary Hall, the Spine and Orthopedic Institute, the Center for Bariatric Surgery and the Health Literacy Institute. It has operated one of the few 24/7 psychiatric emergency departments in the Ohio and has one of the largest dedicated hospital-based detox facilities in northern Ohio.

It has also provided healthcare services in emergency medicine, primary care, radiology, occupational health, oncology, pulmonary medicine and more.

The hospital system had a change of leadership this year, when Dr. Adnan Tahir became president in January. Previously, Tahir was senior vice president/chief clinical and administrative officer for the hospital.

Long history of serving community

St. Vincent's roots go back to its founding in 1865. Milestones includes:

* 1869: School of Nursing founded with six students and the "Charity is Kind."

* 1917: Raises more than $250,000 in six days to build a surgical pavilion, a six-story building with 150 beds, five operating rooms, an X-ray department and other facilities that included living quarters for physicians.

* 1952: Opens $2 million, 112-bed main building facing Central Avenue.

* 2009: Spends $6.9 million to renovate emergency department, modernize psychiatric emergency department and expand the hospital space.

* 2010: After a decade of joint venture with University Hospitals, St. Vincent Charity Hospital returns to sole ownership by the Sisters of Charity Health System. The hospital rebrands itself as St. Vincent Charity Medical Center.

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