The two Manchester, N.H., hospitals that made up Optima Healthcare are lurching toward independence.
Catholic Medical Center and Elliot Hospital filed paperwork in state probate court late last month outlining how the hospitals plan to go their separate ways.
Although many decisions have yet to be made, the breakup to which both facilities agreed in February is already under way and should be largely completed by year-end, the hospitals said. Already the hospitals are beginning to act like competitors, although they will continue to share some services and joint ventures.
In February, Optima bowed to community opposition to the 1994 merger of the only acute-care hospitals in Manchester, New Hampshire's largest city. Plans to consolidate all acute-care services at 238-bed Elliot sparked outrage among supporters of 242-bed CMC. A 1998 report by the New Hampshire attorney general criticized Optima's governance and consolidation strategy as violating the two hospital's charitable missions.
Already one thing is clear: Breaking up a 5-year-old merger is very hard to do.
"There are big ramifications for both hospitals, and both boards are trying to make thoughtful and considered decisions," said Douglas Dean, chief executive officer at Elliot and previously CEO at Optima.
After years of integrating support services, both hospitals are making decisions about which services should continue as joint ventures and which ones need to be run independently.
Dean said the hospitals are also exploring the possibility of a coordinated medical staff that could serve both institutions.
"There will be some areas in which we compete, but at least intellectually and philosophically we'd like to think there are other areas where we can work together," said Alyson Pitman Giles, CMC's CEO.
The landscape for clinical services is changing quickly. Many of the specialty and general surgeries that had been moved to Elliot are returning to CMC as physicians refer cases there, Giles said.
"We're reopening operating rooms and will be reopening another medical surgical floor within 90 days," she said.
By the end of the summer CMC will re-establish its own sterile processing and central service operation, functions that had been centralized at Elliot, to support the surgery surge.
Giles said CMC would also like to re-establish an OB/GYN service that would include a birthing center. Under Optima, those services had been moved to Elliot.
One important foundation for CMC's future is the retention of the New England Heart Institute, which in recent years has performed about 1,200 open-heart surgeries per year within the CMC facility. Elliot will pursue opening its own cardiac catheterization laboratory, Giles said.