The emergency room and most other major departments at Wheaton Franciscan Healthcare’s St. Michael Hospital, 2400 W. Villard Ave., closed recently, a move that is sending ripples through the city’s few remaining hospitals. And officials from other hospitals aren’t optimistic about what those ripples will bring.
St. Michael lost about $23 million in fiscal 2005, and lost about $24.6 million in fiscal 2004.
The hospital’s emergency room served more than 24,000 people in 2005, many of them without insurance and unable to pay medical bills. Wheaton officials say they will encourage all of the former St. Michael patients to go to St. Joseph Regional Medical Center, 5000 W. Chambers St. St. Joseph is another Wheaton facility, and about four miles from St. Michael.
However, they acknowledge that some of those patients will go to other hospitals, particularly Aurora’s Sinai Medical Center, 945 N. 12th St., in downtown Milwaukee, and Columbia St. Mary’s Hospital, 2323 N. Lake Drive, Milwaukee.
“St. Michael served a broad geographical service area, and when we look at that area, because of its geographical proximity, some will be served at Sinai and Columbia St. Mary’s, some in the far northern area might go to St. Mary’s Ozaukee campus,” said Wheaton CEO John Oliverio.
“Our goal would be to serve as many patients at St. Joe’s as possible, while recognizing that some will be served by other facilities.”
Officials from both Aurora and Columbia St. Mary’s said they are expecting to see 8,000 to 10,000 more patients per year. They said those new patients, many of whom lack insurance and will not be able to pay for their services, will put added financial strains on their facilities.
“We’re very disappointed that Wheaton chose the path that they did,” said Paul Nannis, vice president of government and community relations for Aurora Health Care. “Three years ago, when we had $25 million in losses (at Sinai) we made a conscious, deliberate decision to keep Aurora Sinai open and fully staffed.”
Even though things have improved at Aurora Sinai, the hospital is still losing $10 million per year, Nannis said. Despite that, it won’t be closing any time soon, he said.
“We’ve worked hard to get our house together over the last three years,” Nannis said. “We’re committed to keeping Sinai open. We will do that, but we’re disappointed that we have to react to this closing.”
The Aurora system is expecting to see many more patients because of where its Sinai Medical Center is located. Sinai had about 38,000 emergency department visits last year, and it may get an additional 10,000 visits from St. Michael’s former patients, Nannis said.
“Some of them will migrate to St. Joseph’s, some will go east to Columbia-St. Mary’s,” he said. “But we think most of them will get on the freeway and will get off at the Highland Avenue off-ramp, at Sinai’s door.”
Depending on the levels of increases, Aurora will increase staffing at Sinai, Nannis said. Additionally, Aurora will increasingly send patients coming to its emergency department that are only in need of routine medical care to clinics operated by Milwaukee Health Services Inc. Aurora Sinai routinely sends patients who come to its emergency room who do not need emergency care to Milwaukee Health Services Inc.’s MLK Heritage Health Center at 2555 N. Dr. Martin Luther King Jr. Drive.
Aurora also helps financially support that clinic, Nannis said, which will soon expand.
“We know that 60 to 70 percent of the patients in the ER really need primary care,” he said. “But there are so many that have nowhere to go that they come to the ER.”
Aurora recently helped Milwaukee Health Services Inc. develop a new clinic near North 82nd Street and West Silver Spring Drive, Nannis said. The new clinic will have as many as 15 doctors, and can help serve St. Michael’s former patients.
With the news of St. Michael closing released just a few weeks ago, Nannis said the King Drive clinic’s expansion and the new Silver Spring clinic are more important than ever.
About 18,000 of the patients served by St. Michael live within the area served by Columbia St. Mary’s, said Leo Brideau, chief executive officer. His analysis shows that Wheaton’s St. Joseph will get the largest share of patients, with the remainder split between Aurora Sinai and Columbia-St. Mary’s.
To ease the impact on the emergency rooms of its hospitals, Columbia St. Mary’s has expanded urgent care hours at the former Heart Hospital of Milwaukee in Glendale, Brideau said.
“We’ve turned it into a full-service ambulatory center,” he said. “We’re going to run it much later in the evenings and longer on the weekends. And we will publicize it to divert patients there who need urgent or primary care.”
Like Aurora’s work with the Milwaukee Health Service Inc., Columbia St. Mary’s goals are to have fewer people visiting emergency rooms for primary or urgent care needs.
Every hospital operating in metro Milwaukee, other than Children’s Hospital, treats a significant portion of patients who have no insurance or use Medicaid, which does not fully pay for treatments, Brideau said.
“We all have about the same proportions of low-pay patients,” he said. “We all have to deal with it. The issue is, can you operate the rest of your system with enough of a margin to offset your losses? It appears that Wheaton’s (losses at St. Michael) got to be too much to offset.”
To prepare for additional patients coming to St. Joseph’s, Wheaton has expanded the hospital’s emergency room and other operations. Those expansions and upgrades are set to be finalized by June 14, Oliverio said. Additionally, the inpatient areas at St. Francis Hospital, 3237 S. 16th St., have been expanded to handle mental health patients that were formerly taken care of at St. Michael.
“As we were planning, some work was done ahead of time, so it was seamless at the time of closure,” Oliverio said.
While where was no formal decision, there was long-running speculation that Wheaton would close St. Michael for several years.
“We had been evaluating St. Michael for a number of years,” he said. “The final decision, which was the go-ahead to close the hospital, was done on the date of the announcement (May 7).”
One Milwaukee area health care executive, who asked not to be named, speculated that the only other hospital in metro Milwaukee that might close in the next several years would be Wheaton’s St. Francis Hospital, largely because the group is building a new, larger, $80 million hospital about five miles away on 55 acres in Franklin. That hospital is set to open in late 2007.
Some services will continue at the former St. Michael campus, including outpatient surgery, imaging and pain management. Those will become outpatient services operated under St. Joseph, Oliverio said. The professional office building and family care center on the campus will also remain open.
Wheaton has contracted with Irgens Development Partners to find uses for the rest of the campus, Oliverio said. Ideally, the hospital group would like to retain ownership of the campus, leasing space to another entity. One of those potential uses is moving the Milwaukee County mental health complex there, he said.
“Irgens is working with community leadership to determine appropriate uses of the campus,” Oliverio said. “They’ve not presented us with any (opportunities) at this point. But they did not start work until after our announcement, and that’s just a few weeks.”
