Faced with increased costs, stiff competition from small medical clinics, insurance changes, and the need to upgrade technology, hospitals struggle for strategies to keep them in business and have a purpose in the community that they did not in the past.
Some of these changes involve expanding their connections with larger medical institutions to leverage resources they would not have had as stand-alone hospitals, or to develop new models for providing additional services.
While the future of the federal Affordable Care Act (sometimes colloquially known as “Obamacare”) is still unclear, its impact on local institutions is unmistakable. It has led hospitals to branch out into a variety of new services – not merely giving physicians practicing privileges as was done in the past, but in some cases taking over or embracing closer business relationships with other providers while helping doctors maintain their private practices.
Regardless of what happens on the federal level, New Jersey will still retain its own version of the Act, creating a statewide individual mandate to require residents to have insurance coverage or pay a fee. This would continue the good news for local hospitals, which have benefited under the federal plan, as it took a significant burden off the state which had subsidized Charity Care for the poor in the past.
Still, in 2018, hospitals will still need to be creative in developing approaches to medicine beyond traditional services offered in the past. In Hudson County, each hospital is taking a unique approach.
RWJ Barnabas Health Jersey City Medical Center
Perhaps the best known hospital system in Hudson County, Jersey City Medical Center began its transformation when it moved from Montgomery Street to its current location on Grand Street, walking distance from the light rail, in 2004.
Although it has satellite facilities throughout Hudson County, including the former Greenville Hospital in Jersey City and the recently opened emergency room facility in Bayonne, its main campus includes three facilities: the Wilzig Hospital, the Provident Bank Ambulatory Center, and the Christie Kerr Women’s Health Center.
Although a regional referral and teaching hospital (an affiliate of Mount Sinai School of Medicine, the New York College of Osteopathic Medicine, and St. George’s University School of Medicine), upcoming plans include a new partnership with Rutgers University that will bring a whole new dimension to research and academic aspects of the medical center.
Designated by the state as a regional trauma center in the early 1990s, the medical center saw more than 4,000 trauma cases in 2017.
JCMC is currently the only hospital in Hudson County that is authorized to do open heart surgery. A 2009 New Jersey Department of Health Hospital Performance Report scored JCMC in the top 10 percent of hospitals in the state for heart attacks, surgical improvements, and heart failure.
With 90,000 emergency room visits in 2017, JCMC is in the process of implementing a massive expansion of its current ER. “We’ll be doubling the size,” said Joseph Scott, chief executive officer of JCMC. This will include increased rooms for impatient and other services.
JCMC has a number of programs that cover everything from behavior health and inpatient detoxification to bariatric and children’s services.
With an already well-established ambulance and paramedic service, JCMC worked with the city to develop a volunteer first responder program.
In another innovative program currently underway, JCMC is working with the city to help deal with what is called “food deserts” in Jersey City where vegetables, fruits and other fresh produce is not easily attainable. Greenhouses using hydroponics grow these needed items for distribution in those areas without them.
Embracing the new technological world, JCMC has also begun a teleconferencing program that allows already established patients to contact physicians via smart technology to diagnose and potentially treat medical problems as they emerge.
“We are one of only two hospitals in Hudson County to be recognized as an OMNIA Tier 1 provider.” – Dr. Anthony J. Passannante Jr.
CarePoint Health, which operates Hoboken University Medical Center, Bayonne Medical Center and Christ Hospital in Jersey City, is a prime example of how a company brought hospitals back from the brink of economic disaster over the last decade.
CarePoint Health is the largest private employer in Hudson County, with three hospitals and four neighborhood health centers.
Over the past year, CarePoint Health has launched a number of new initiatives to expand health care access to the community, including opening neighborhood health centers, extensive primary care-focused initiatives, expanding outreach through community health screenings and education events, as well partnering with local non-profits to reach the community.
The emergency rooms at all three hospitals are the first in the New York metropolitan region to use a technology-enabled follow-up program. This allows patients a “video-visit” with an emergency room clinician one to two days after their ER visit.
Telestroke technology is utilized at all three hospitals to provide remote diagnosis and treatment by a neurologist for a stroke victim who arrives at the emergency room. This allows the neurologist, who may not be on the premises, to evaluate, diagnose, and prescribe via the emergency room physicians.
Across all three hospitals, admitted patients have access to the Lincor bedside technology platform, a patient engagement tool to provide them with bedside TV, digital computer access and other information during their stay.
Christ Hospital launched the second Emergency Department program in the country that uses alternatives to opioids for pain treatment in the ER, and has expanded the number of detox beds from eight to 12. It has an in-patient and outpatient detox and mental health program.
Christ Hospital recently partnered with Hudson Pride Center to expand health care access to the LGBTQ+ community and provide sensitivity training to doctors, physicians, and staff. It recently installed a new bone density machine which can diagnose osteoporosis before a broken bone occurs.
Hoboken University Medical Center recently expanded its women’s surgical care, including minimally-invasive Davinci robotic surgery for conditions of the abdomen and pelvis. The Family Birth Units fully supports women and their families during childbirth.
The Institute for Women’s Health, located on the first floor, offers services from various providers with unique expertise in the treatment of endometriosis, pelvic pain, urinary incontinence, post-pregnancy pelvic problems, infertility, and more.
For those patients undergoing joint replacement surgery at Hoboken University Medical Center or Christ Hospital, bi-monthly pre-hab classes educate and provide information about the surgical and recovery periods.
Bayonne Medical Center cardiac care includes the newly-implemented Impella program that provides for enhanced care to help save lives for those patients suffering from severe heart attack and heart failure.
BMC also recently established a neuro-intervention program, which is new to the facility, allowing doctors to perform certain minimally invasive procedures like carotid stenting, and will be expanded to create a comprehensive stroke program that includes the telestroke technology.
BMC has a hyperbaric wound care center offering patients complex wound care services for both the local community as well as the county. Over the last few years, BMC also established a Radiation Oncology Center in Bayonne treating a variety of cancers using advanced technology, such as LINAC machines and evidence-based protocols.
Hackensack Meridian Health Palisades Medical Center
Hackensack Meridian Health Palisades Medical Center (HMHP) on River Road in North Bergen was previously known as Palisades Medical Center. It is a 202-bed hospital affiliated with the Hackensack Meridian Health Network and the Harborage, a 247-bed nursing home and rehabilitation center.
The hospital, which moved to its present location on the Hudson River in 1978, provides a range of surgical, radiology, and ob/gyn services and new technologies. It offers various free screening and education programs throughout the community.
Palisades has been recognized by the state’s annual healthcare report card as one of the best in the state.
It was ranked by Inside Jersey magazine and Castle Connolly Medical Ltd. at No. 4 for hospitals with 350 beds or less. It also received a Gold Seal of Approval from The Joint Commission for patient care. HMHP also earned The Joint Commission’s Gold Seal of Approval and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers.
“This past year has been a truly extraordinary time to be a part of Hackensack Meridian Health Palisades Medical Center,” said hospital president Dr. Anthony Passannante Jr.
In collaboration with Hackensack Meridian Health network resources, HMHP conducted an update of its pre-merger strategic plan. “This will allow Palisades Medical Center to make thoughtful investments to improve the quality and breadth of services required by our diverse community,” Passannante said.
HMHP became a Tier 1 provider for Horizon OMNIA Health insurance, one of two in the area, along with JCMC.
“We are making headway in improving our nursing staff ratios looking to meet Magnet standards, a recognition given by the American Nurses’ Credentialing Center (ANCC),” he said. “We also recently implemented a new Vocera Communications tool that is already working to improve patient engagement and satisfaction by standardizing rounding and providing real-time request-tracking capabilities and service recovery interventions.”
He said Palisades Medical Center’s Community Outreach Program continues to expand.
“We constantly form new relationships with key local partners and stakeholders to provide awareness, education, health screenings and access to healthcare resources that are relevant to their lifestyle and cultural needs,” Passannante said.
He boasted about partnerships with the community and local schools, through the Community Service Merit Scholarship Program.
“Working hand-in-hand with high school administrators and guidance counselors, we have been able to provide eight high schools in our primary service area with 15 scholarships to recognize graduating seniors for their outstanding community service efforts,” he said. “During the past year alone, our community outreach efforts received awards from Save Latin America, El Cambio, Rotary Club of North Hudson, West New York Leones Cubanos de Hudson Lions Club and the Gold Coast Chamber of Commerce.”
Hudson Regional Hospital (formerly Meadowlands)
Until Jan. 1 of this year, Meadowlands Hospital (now known as Hudson Regional Hospital) in Secaucus struggled to survive. Despite an improving financial climate for hospitals over all, the hospital -- under two previous owners -- appeared unable to find the right formula for success.
Then, it was purchased by real-estate developer Yan Moshe, owner of Excel Surgery Center in Hackensack, who had experience in the medical field in New York and elsewhere in the state. Moshe promised to maintain the 200-bed hospital and improve its level of service.
“The new owner is extremely supportive, and experienced in medicine in New York City as well as New Jersey,” said Dr. Nizar Kifaieh, who took over as the hospital’s chief executive officer in June, replacing Felicia Karsos, who will oversee nursing. “He’s very smart and dedicated to building this hospital.”
Kifaieh comes out of the CarePoint system, which rescued and restored three hospitals in Hudson County several years ago. He hopes to bring similar success in restoring Hudson Regional to full health.
“Our focus is to become a leading community hospital,” Kifaieh said.
Poised on the edge of the Meadowlands, the hospital has the potential to draw from several areas. “We’re in a perfect location, right off the highway, and have a lot of access,” he said. “We want the community to trust us.”
As part of the agreement in purchasing the hospital, Moshe is committed to maintain the hospital as an acute care facility and is expected to invest at least $3 million in upgrades within the first five years.
Under this vision, the hospital would modernize the exterior and interior of the building itself, as well as seek innovative ways to upgrade its services, and increase its technology. “The old owners were focused on surgery,” Kifaieh said.
While the hospital will retain surgical services, its focus will be family care and more community-oriented healthcare programs.
Among its plans, the hospital is seeking to create an integrated program of ob-gyn and pediatric services. The hospital has purchased Mazor Robotics Renaissance Surgical Guidance system for its spine surgery program. HR would be the only hospital in Hudson County to have the Mazor system, which would cut complications associated with more traditional surgery in half.
The hospital also established a community advisory board to work along with community leaders, including the mayor of Secaucus, to educate residents on health and provide free services.
Some specialty surgeries will include bariatric surgery and Maternal-Fetal Medicine for women with complications during pregnancy.
The hospital also opened a new radiology lab on April 1 in conjunction with its limb saving program.
“We are also looking to become a stroke-accredited medical facility,” Kifaieh said.
The hospital is also expanding its network of insurance providers as an in-network facility for Aetna, Horizon Blue Cross and Shield commercial plans, and Horizon NJ Health. It is currently seeking other providers.
The hospital is aggressively seeking to bring in many new local physicians and has recently brought back as many as 40 physicians.
Al Sullivan may be reached at firstname.lastname@example.org.