Carolina Health considering closing
one of its Hatteras medical centers
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:
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.
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.
county would pay $300,000 annually to keep both clinics operating,
on-call services would be reduced and after-hours nursing care would be
Initially, the county was given just two weeks to make its decision,
Outten said. But system representatives later extended the deadline to
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
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
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
“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
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
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.
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
April 13, 2010
Carolina Health considering closing
one of its Hatteras medical centers
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
“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
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
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
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
regular physicians until Dr. Jamie Francis Fountain joined them last
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.