July 28, 2010

East Carolina Health considering closing
one of its Hatteras medical centers


Two health centers on Hatteras Island are bleeding money, and Dare County has less than six months to decide whether to pay lots more money to keep them open, look elsewhere, or close one or both facilities.

But even if Greenville-based University Health Systems of Eastern Carolina ends up pulling out of the Avon and Hatteras locations, county officials promise they will find another health provider.

“We’ve got to have care down there,” Dare County Manager Bobby Outten said this week.

Outten said that UHS representatives told the county at a meeting earlier this month that it had to choose between three scenarios:

  • The health system, which runs Pitt County Memorial Hospital in Greenville and is a partner in The Outer Banks Hospital in Nags Head, would leave Hatteras Island altogether.
  • The county would continue to pay about $100,000 a year to provide for reduced on-call services, and to keep one clinic open. After-hours nursing care would also be discontinued.
  • The county would pay $300,000 annually to keep both clinics operating, on-call services would be reduced and after-hours nursing care would be cut.

Initially, the county was given just two weeks to make its decision, Outten said. But system representatives later extended the deadline to Jan. 1.

Some interest has been shown from other health providers that Outten declined to name. But the manager said the county budget is in no shape this year to cough up the additional costs to run the clinics. 

Beth-Anne Atkins, a UHS spokeswoman, said that the cost-saving measures are needed to address a $400,000 to $500,000 budget deficit.

Atkins said a combined total of about 11,500 to 13,000 patients are seen every year at the HealthEast Family Care clinics in Hatteras and Avon.

Opened in the early 1960s through efforts by villagers, the property on which the Hatteras clinic is located was given to the county by the federal government on the condition that it will be used only as a health clinic.  University Health Systems pays no rent on the Hatteras building, and many of the costs of utilities and upkeep are paid by the county.

The Avon clinic was built 10 years ago and is leased by the system for a cost that is said to be about $125,000 a year.

Island residents have formed an ad-hoc committee to study the options and to provide feedback to the county, said Allen Burrus, vice-chairman of the Dare County Board of Commissioners and a Hatteras resident.

Although the county has been talking to health system representatives for more than a year, Burrus said it was only recently that the county got a definitive answer about its options.

“Every time we meet with them,” he said, “things move around.”

Burrus said he was puzzled that the UHS representatives seemed to prefer that if only one clinic is shut down, that it should be in Hatteras.

“My question is,” he said, “if you’re going to close one, why would you close the one that doesn’t cost you anything?” 

Bobby Owens, formerly the chairman of the county commission and a former 10-year member of the health systems board, as well as the current chairman of the board of The Outer Banks Hospital, said he was asked to serve informally as liaison between the county and the health system.

As a businessman, Owens said he can understand where the UHS is coming from --the clinics are only about 15 miles apart, and some say there’s a duplication of services.  But as a native Outer Banker who has a soft spot for Hatteras Island, he said he has a clear preference.

“I do not want them to close either facility,” Owens said.

With finances stressed among many of the smaller health care facilities, Owens said that it’s not surprising that there could be a degree of flux in area health care providers. But still, he believes there is money to be made on the Outer Banks, he said.

Albemarle Hospital in Elizabeth City, for instance, has been talking to The Outer Banks Hospital about leasing Albemarle’s Regional Medical Center in Kitty Hawk.

Studies have shown, Owens said, that the arrangement would be profitable for the Nags Head hospital.

Although the future of the Hatteras Island clinics has yet to be determined, Owens said he is all for putting any and all ideas on the table, including new partnerships.

“Nobody has locks on health care services,” Owens said.

(Catherine Kozak, a former reporter for The Virginian-Pilot in the Nags Head office, is now a freelance writer for The Island Free Press and other publications.)

April 13, 2010

East Carolina Health considering closing
one of its Hatteras medical centers


East Carolina Health, which owns two medical centers on Hatteras Island, is considering closing one and consolidating its operations in the other.

“At this point, we are assessing the options,” said Roger Robertson, president of East Carolina Health, which is part of University Health Systems, based in Greenville, N.C.

“At this point, we haven’t made any decisions.”

In a telephone interview on Monday, April 12, Robertson provided few other details of the process of assessing the health of the island’s health care centers, which he said has been an ongoing process at the company.

He did confirm that closing one of the medical centers -- HealthEast Family Care in Hatteras village and HealthEast Family Care in Avon – was an option.

However, Dare County officials who have talked with East Carolina Health representatives think the possibility is very real and that the office closed will be in Hatteras village.

Bobby Outten, Dare County manager, said that the company met with county officials earlier this year and that the company said that the medical centers on the island were losing money and that “they had to change the model” for delivering health care here.

“They said that they planned at some point to consolidate all of the medical services in one office, probably in Avon,” Outten said.

“They asked to meet with us,” said Warren Judge, chairman of the Dare County Board of Commissioners. He said the discussions centered around the fact that East Carolina Health was losing money on its operations here and thought that recruiting physicians to come to the island would be an even greater problem in the future.

Robertson said he could not provide the loss figures immediately, but Judge said the county was told losses were in the range of $400,000 to $500,000 over the last few years.

Allen Burrus, the commission’s vice chairman and Hatteras Island representative who has met with East Carolina Health officials in the past said he also understood the losses to be about $500,000 recently and that the company made it pretty clear in meetings that closing a center was likely.

Burrus also believes it is clear that one center will close and it will be in Hatteras village.

Also, at issue is whether the county can provide more funding for the medical centers on the island.

Currently, East Carolina Health uses the Hatteras medical center building, which the county owns, free of charge. The county also pays for maintenance and some other costs.

East Carolina Health leases the center in Avon.

Judge noted that the county provides funds to compensate the three Hatteras doctors, all employees of East Carolina Health, for covering calls after hours.

He said that East Carolina Health has asked the county in the last few years to increase its funding to medical care on the island.

Both Burrus and Judge said the county was willing to work with the company, but, given the current economy, the amount of additional funding available would be limited.

“I don’t know that we can do anything at this point,” Judge said.

Burrus said he is probably going to get some village business people and residents together in early May to talk about continuing operations if East Carolina Health pulls out of Hatteras village.

Hatteras villagers built the medical center in the mid-1960s after a public health facility in Buxton was closed, according to Ernie Foster of Hatteras village whose father Capt. Ernal Foster was in the group. The village provided the building to a number of different practitioners over the years.

In 1990, Dr. Seaborn Blair, a family physician just out of East Carolina University Medical School, came to Hatteras to take over the practice.  In 1993, he was joined by Dr. Al Hodges, also a graduate of ECU medical school.

In 1998, Blair and Hodges sold the practice to HealthEast, which is now East Carolina Health.

Blair has said in past interviews that the job of providing round-the-clock health care in an isolated community took a toll on the physicians.  There was also the problem of running a business in a tourist area, where there are more patients than the medical centers can handle in the summer and barely enough to pay the bills in the winter.

Dr. T. Bentley Crabtree joined the practice in 2000, after the sale.

In 2007, Blair left Hatteras to practice medicine on Topsail Island in southern North Carolina.  Hodges and Crabtree were the only two regular physicians until Dr. Jamie Francis Fountain joined them last year.

Judge and Burrus said they were not happy with thinking about losing one of the island’s two medical centers and would continue working toward solutions.

“We’ll continue to assess health care on Hatteras Island and enhance it whenever we can,” Burrus said.

Ernie Foster said he finds the possibility of closing the Hatteras medical center “very distressing,” both as an islander and village resident and because of his father’s personal involvement in making it a reality.

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