For 35 years, Charleston (S.C.) Memorial Hospital has provided healthcare for poor people who could not afford to go anywhere else. But now the hospital is having financial problems, and there's talk of closing its doors.
Just three months ago, the Medical University of South Carolina, which operates the hospital for Charleston County, considered buying Memorial.
Now MUSC is cutting jobs and says it does not know if it can continue running the facility, nor does it know of anyone who can, given the hospital's finances.
"Something is going to happen," said Toi Estes, a county councilwoman. "The status quo is not an option in my opinion."
During the years, MUSC, the county, a hospital board and a private company have taken turns managing Charleston Memorial. MUSC's current contract dates to 1990 and for much of the decade, the county has paid to help the university run the hospital.
But now, with no county contribution and cuts in federal reimbursements, the hospital is expected to post a $7.6 million deficit for its fiscal year ending next month.
As recently as 1996, the hospital had a $6.4 million surplus. That year, it treated about 62 patients a day who required hospitalization. This year, inpatient census is half that. The hospital also treats about 78 patients a day who do not need a hospital stay.
In recent months, the hospital has cut 61 positions, and MUSC has put off its purchase of the hospital indefinitely.
University President Raymond Greenberg wrote to County Council members suggesting, among other things, a change in the management agreement, getting a private contractor to run Memorial or closing the hospital.
"Nobody can run the hospital in the same way it was run five years ago," he said.
With no psychiatric or obstetric services and no operating rooms, it is tough to attract new patients. Doctors do not want to admit patients who may end up needing surgery, officials said.
MUSC has said it cannot run the hospital at a $7.6 million loss and needs more money from Charleston County. The county says that would require raising taxes or cutting services.
"Does Charleston Memorial have value as an acute-care hospital?" asked Charles Wallace, M.D., an MUSC professor and county councilman who has stayed out of the hospital negotiations. "I seriously doubt that."
Greenberg said closing does not necessarily mean ending all services. But he questioned whether Memorial can continue as a full-service hospital.
He said the emergency room and inpatient, outpatient or long-term care might be kept or merged with other services.
Estes said while closing the hospital is an option, the county should investigate whether someone else can run the hospital.
"I don't think our duty is to keep Charleston Memorial open," Estes said. But she added that the county does have a duty to help meet the healthcare needs of the poor.