If Inova Health System thought the release of the Southeast Planning Task Force's final report would afford them some breathing time on what to do about Inova Mount Vernon Hospital, CARE has some different ideas.
Meeting at the Mount Vernon Government Center March 8, in the shadow of IMVH, just one week after the release of the Task Force findings, the Citizens Alliance Rescue Effort (CARE) Executive Committee, made it clear they do not want to be stonewalled by Inova Health System (IHS).
They want a response to the Task Force recommendations in no more than 60 days. However, it was not certain when the IHS Board is scheduled to meet. "I am assuming it will be no later than mid- April," said Mount Vernon District Supervisor Gerald Hyland and chair of CARE.
CARE's Executive Committee was adamant in seeking a response from the IHS Board of Trustees "not Knox Singleton," IHS president and CEO. They suggested the Mount Vernon Community Citizens Association take a definitive position with regard to the Task Force report and also seek a response from the IHS Board with a like deadline.
At the start of the meeting Hyland announced that the report had been received by IHS and was on the agenda for the IHS Service Board, scheduled to meet March 10. Hyland was recently named a member of that body.
"I will ask what is the timetable for a decision to be rendered by the IHS Board of Trustees when we meet on the 10th," Hyland promised the group. "However, this fight is not over. We must continue to convince IHS not to move the hospital."
At the March 1, Task Force meeting, H. Patrick Walters, IHS senior vice president, was asked when IHS would respond to the report. He answered, "Probably by the end of the year."
His explanation for the elongated time frame was, "We will bring this up as part of our assessments across the system. It will be considered when the Board [IHS] takes some action on our capital plans."
Prior to the release of the Task Force report, Lee District Supervisor Dana Kauffman had cautioned, "There is no language in the report requiring IHS to respond within a certain time frame." It was this fact that hung over CARE's deliberations Monday night.
Hyland pointed out, "We engaged in a massive outreach to IHS over the past 13 months. We distributed 4,000 petitions to IHS Board members. Now we have to decide how to keep the pressure on IHS and what should be our next step."
He also noted, "If I had to characterize where we were when we started, I would have to say they [IHS] had pretty much decided to build a new hospital. We have certainly slowed that process."
IN RESPONSE, Khosrow Matini, MD, a Task Force and CARE member, insisted Inova hasn't done anything which they promised to do. "They are throwing up requirements for IMVH not applied to other hospitals in the Inova system. They are going to let it fail by neglect."
Herbert E. Harris II, countered, "There has been a discernable change in Inova's attitude over the last several weeks. This was largely due to coverage of the Task Force in the press. It's extremely important that all decisions be made in public."
Harris saw the most important element of the Task Force report as that "recommending the adoption of a long-range plan with a time schedule." This was buttressed by Dr. Stephen Goldberger, a member of IMVH medical staff.
"We should not spend time trying to make the hospital more profitable. We should not spend time looking at the hospital's losses. We should spend our time on where Inova Mount Vernon Hospital will be in five, ten, fifteen years," Goldberger said.
Louise Cleveland, a Task Force member, added, "There has never been a satisfactory response by Inova to the investment question. Medical procedures are escalating and income is diminishing. Issues involving reimbursements are very important."
Hyland pointed out, "At the very first meeting of the Task Force, I asked Singleton, "What can you do to turn the hospital around, to make it profitable?" He never answered me. Inova has never answered that question."
Returning to the suggestion of a long-range plan, Golberger said, "We should hire a group to help us decide how to build onto this hospital. It should look at the entire area not just this immediate area. With the opening of the new Woodrow Wilson Bridge people will be able to get here from Prince Georges County."
CITING A GOAL of IMVH in 2016, Goldberger said, "We should ask the original architects of the hospital to analyze what can be done. IHS created this loss. They don't want to know what can be done. They are incapable of planning for the future of this hospital because they want to move it."
Golberger suggested the Fairfax County Board of Supervisors play a major role to help with the funding of such a study. It was also suggested the $1 million, now included in the federal budget through the efforts of U.S. Rep. James Moran (D-8) to help the hospital, might be tapped for such a study.
The intended use of those funds was to develop a relationship between IMVH and the military to allow such personnel, active and retired, and their dependents, to utilize IMVH in addition to or in place of U.S. Army DeWitt Hospital at Fort Belvoir. If successful, those funds could increase, based on annual budgetary analysis, to as much as $10 million in a given year, according to Moran's original proposal.
Cleveland cautioned, "We should not count on the military proposal. Things are changing too rapidly for them and the game of disinformation can be played too many ways."
Former State Senator Joseph Gartlan, another member of both bodies, said, "We have to step back and look at the realities. No group of citizens is going to be in a position to dictate to Inova management what to do with this hospital. The major threat to IHS is for a for-profit hospital group to get a foothold in Fairfax County."
Gartlan pointed out, "What the Task Force did, for the first time, was suggest a way Inova could deflect a threat from a for-profit hospital group by establishing a Healthplex in the Lorton area — rent free, the same as the hospital. It's the exact same thing Inova did to deflect HCA in the Springfield area."
Gartlan stressed, "It's a question of where can our clout be applied most effectively. It is making sure Inova can defend itself effectively from any threat from a for-profit organization."
This was seconded by Dr. Howard Lando, an officer of the hospital medical staff. "I think giving IHS a quid pro quo is absolutely right."
However, the creation of a new Healthplex in Lorton, licensed by IMVH, as recommended by the Task Force, would also need to carry with it "the promise of good, quick, accessible transportation" means and access." Upon this, they all agreed.
As for Inova's interest in such a Healthplex, there was disagreement. "I'm not so sure Inova wants a Healthplex in Lorton. I'm not so sure they want the county to own the land. They want to be in control of their own land and buildings," Goldberger said.
"I'm still not convinced Inova is telling us everything in their plans," Harris added. "I think they have their own agenda. They weren't counting on the Task Force staying alive."
"Our goal should be Mount Vernon hospital alone. HCA really wants to be in Loudoun County, not in this end of Fairfax County. If we could get in the newspaper a proposal and drawing of Mount Vernon hospital 2016, IHS would be running behind," Goldberger insisted.
"Build it and they will come. The hospital field of dreams," he said. "What if we asked Inova to transform this hospital into all private rooms?"
CLEVELAND HAD pointed out that during Task Force deliberations a question had been raised about the number of beds at IMVH. It presently has 232. Another five will be added with the addition of psychiatric services being transferred from Inova Alexandria Hospital.
"That number of beds is far in excess of what will be needed well into the future," she told the group. "The real money today is in outpatient services."
At the conclusion of the two hour meeting, Hyland suggested that he and Kauffman bring to the Fairfax County Board of Supervisors "that Laurel Hill be the site of a Healthplex and that the county consider financing the project through the bond process."
He also noted, since he is now a member of the IHS Board structure, that he relinquish the chair of CARE. "I will be writing letters to myself," he said. Instead, it was decided that co-chairs would be appointed. They are now Matini and Laing Hinson.