The Struggle to Save (or Close) Lakewood Hospital Is a Circus Act with No Signs of Ending

Under the big top

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And it's not as though this sort of maneuvering is new to the Clinic's Northeast Ohio empire. In 2011, the health care system closed Huron Hospital, a 211-bed institution in East Cleveland. Huron was a major eastside trauma care center.

At the time, the Clinic pushed through a plan to shut down the hospital without input from city stakeholders. The hospital was replaced with a $25-million community health care center, which features outpatient care and mental health services. The Clinic kept its spot in East Cleveland, and the expansion into the exurbs continued.

In August 2014, two inspectors from the Ohio Department of Health visited Lakewood Hospital and looked into the state of its adult cardiac catheterization lab and its open-heart surgery program. They found that the hospital "failed to utilize the required on site adult open heart surgical suite or maintain qualified staff on the facility's cardiovascular surgical staff roster." This is one example, touted often as debate continues, of the Clinic rearranging its own chess pieces.

Hospital leadership insisted that the announcement of the hospital's closure and the subsequent barrage of news stories precipitated anxiety and, inevitably, financial losses across the board. But state documents show that the Clinic had, for instance, arranged for the losses in heart surgery patients in Lakewood. The last open heart surgery at Lakewood Hospital was performed in 2007; all surgery patients since then had been sent to Fairview Hospital, even as both open heart suites at Lakewood remained "fully operational" and were "always kept ready." The staff had been sent to Fairview, as well.

"[T]he dedicated and qualified cardiac open heart surgical team for the facility were in fact all on their sister facility's (Fairview Hospital) staff roster," according to a Department of Health document. An on-site interview conducted by health department employees with a staff member at Lakewood Hospital confirmed that the Clinic had designated Fairview Hospital as the open heart surgery site for the area. "Patients who underwent cardiac catheterization at Lakewood Hospital and required subsequent open heart surgeries were all transferred to Fairview for cardiac surgery."

Despite having functional heart surgery suites on-site, the Clinic had been shuttling patients — some in need of emergency surgery, others less so — 3.3 miles to Fairview Hospital.

In response, the hospital administration decided to shut down the programs in February 2015. EMS staffers and drivers were notified thereafter.

The termination of the program has been discussed often at council meetings lately. Councilman Tom Bullock, a member of the LHA, has defended Lakewood Hospital's termination of the cath lab.

"An inspector came ... and took a different view of the fitness of Lakewood Hospital's cath lab, which had no medical emergency problems providing the services for some years — since 2007, I believe, through 2014," he said Sept. 8. "Nevertheless, this inspector said, 'It's not up to the rules. I'm going to go back to Columbus and point that out.'"

During the May 13 meeting of the LHA board, Lakewood Hospital president Shannan Ritchie said that there was "no appeal" against the Department of Health review.

The cath lab review and termination — and subsequent debate — is a distillation of how Lakewood leaders and residents have blended opinion and fact into today's circus act. Regarding public assets, multiple stories have spun out into the community.

"There is a perception that Cleveland Clinic chose to invest in Avon and Fairview, and not in Lakewood. What do we say when people voice this?" Monique Smith, a city employee, said at a Feb. 3 meeting of the Active Living/Recreation Taskforce, the same meeting during which the mayor insisted that keeping the hospital open is "just not an option."

He replied: "There have been lots of factors that have contributed to the Hospital shutting down. People have moved away, wealth has shifted. Furthermore, there is history with the Clinic's involvement with the Hospital. When they took over in 1996, it was not an easy transition, but it probably added another several years to the Hospital's operations that wouldn't have otherwise existed. Furthermore, Lakewood sits on the Lake — it limits potential patrons in terms of lack of service area to the north."

It's an explanation, but not one that gets very far with the opposition and concerned residents, especially when informed by the decanting process.

"It's been eight months since this was announced and we still do not have a decision here," Carl Culley said, addressing City Council. Culley is an internist at Lakewood Hospital and a member of the hospital's board of trustees. His exasperation at the delay is not unique.

The Tuesday after Labor Day brings another big crowd to council chambers. Culley is one of dozens of stakeholders who have spoken at City Council meetings this year on the hospital matter. On council's agenda for this evening is a resolution that would authorize law director Kevin Butler and the city's attorneys to begin "negotiations" with the Cleveland Clinic and the Lakewood Hospital Association. The measure passes unanimously.

Whatever plan these negotiations produce will still have to earn five votes from council to be enacted.

Dr. Terry Kilroy, a pulmonary specialist practicing in Lakewood, insists that each side in a negotiations process comes to the table with an argument, an end. The Clinic's end, he tells council, is clear; it's spelled out in the letter of intent. The city's end, however, remains unknown. He says it's unclear what claims the city's representation will stake on matters like property values, asset/equipment values, distribution of residual assets (cash), parameters of the function of the building — the entirety of any forthcoming deal.

One side of the room applauds his questions, the other side groans. This is how these meetings go now.

Elsewhere, Save Lakewood Hospital continues to meet. Members brief one another on the lawsuit's progress and on how many signs have been installed in front yards across town.

"When I get into things, I get into things," Monahan says. "And I'm really working my tail off on this one to see it through. I envision us having a great community hospital at the end of this, staffed by independent doctors who want to practice medicine and not the art of gathering money."

The closure of Lakewood Hospital isn't a done deal but, in certain corners of the city, it's been treated as such. One only has to look at the city's own website to know that: In a timeline of Lakewood Hospital's history published there, the "Fall 2015" entry reads: "After public review and discussion and if definitive agreement is approved, Cleveland Clinic breaks ground on the new Lakewood Family Health Center."

About The Author

Eric Sandy

Eric Sandy is an award-winning Cleveland-based journalist. For a while, he was the managing editor of Scene. He now contributes jam band features every now and then.
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