July 23, 2019

Hahnemann University Hospital in Philadelphia is winding down after almost 200 years of service, leaving clinical staff, patients, and medical students at Drexel University, the hospital's long-time partner, uncertain about their futures.

About the impending closure

Hahnemann University Hospital—which is a Level I trauma center, a medical training facility, and a public safety-net hospital that has been in operation since 1848—on June 25 announced that it would cease operations on Sept. 6, after filing for Chapter 11 bankruptcy.

The Philadelphia Inquirer reports that Hahnemann was already struggling financially when its former owner, Tenet Healthcare, last year sold the hospital, as well as St. Christopher's Hospital for Children, to Joel Freedman, a California investment banker and CEO of American Academic Health System, in a $170 million deal. According to the bankruptcy documents, Hahnemann faced greater-than-expected losses and other financial disputes, losing $69 million in pre-tax dollars last year, the Inquirer reports.

The impending closure has garnered national media attention, and several Democratic presidential nominee candidates have weighed in on the matter. Drexel University, which employs hundreds of physicians at the hospital and uses it as its medical school's main teaching hospital, filed a lawsuit to halt the closure, and state and city regulators have called on the American Academic Health System to keep the facility open until a plan to close the facility is approved.

Philadelphia Common Pleas Judge Nina Padilla recently ruled that the hospital must remain open. She said Hahnemann is prohibited "from closing, ceasing operations, or in any way further reducing or disrupting services … without a closure plan authorized by the [city's] health commissioner."

The impact on providers, hospital staff

However, plans to close the hospital appear to be moving forward. About a week after the ruling, Drexel University President John Fry announced about 40% of the university's physicians and clinical staff will be laid off as a result of the hospital's closure.

Jill Tillman, CEO and associate dean of Drexel University Physicians, said about 800 workers received severance notices, including 245 physicians and hundreds of lab technicians, medical assistants, oncology nurses, and patient navigators. According to the Inquirer, Drexel's medical students who were training at Hahnemann have been moved to other locations. The program trains nearly 1,900 students annually.

Fry said the unexpected closure announcement forced the university "to make extremely difficult decisions." But he added, "[P]lease know that the long-term goal is to preserve as many clinical faculty and professional staff jobs as possible."

To that end, Drexel is pursuing a new partnership with Tower Health Medical Group to replace Hahnemann as the university's main teaching hospital. Tillman said many of the physicians will be rehired under the partnership with Tower. According to the Inquirer, Tower is planning to meet with Drexel's physicians and clinical staff in cardiology, emergency medicine, surgery, and other specialties "about employment opportunities" within the health system.

Drexel indicated, however, that not all health-care service lines will be retained as part of the new deal.

Clinical staff bear the weight of hospital's closure

Nurses at the hospital have reported seeing a significant drop in the number of patients they treat since the closure first was announced. As of July 19, 30 patients were left at the 496-bed hospital, the Inquirer reports.

"We come to work. Some of our units don't have patients, but we're coming to work anyway," said Sue Bowes, an RN who has worked at Hahnemann for 14 years and is president of the Hahnemann local chapter of the Pennsylvania Association of Staff Nurses and Allied Professionals union.

The hospital is now "down to two floors," Bowes said. "They've closed three or four floors already, and consolidated all the patients," she said, adding, "We went from doing 15 or 16 cases a day down to two or three."

The hospital also combined four of its critical care units into one unit, Medscape reports.

According to Naitik Patel, a hospitalist at Hahnemann and an assistant professor of general internal medicine at Drexel's College of Medicine, the declining conditions have had an impact on the hospital's patients, as well. "Some of our patients we call 'frequent flyers' essentially live at this hospital because they don't have adequate resources," Patel said, noting, "A lot of our patients do not have insurance and cannot even afford electricity in their house. And this hospital was designed to take care of these types of patients."

"We're all pretty sad. It's very depressing, and we're all scrambling to try to find employment. It's just very sad for us and for our patients," Bowers said (McNamara, Medscape, 7/19; Snyder, Philadelphia Inquirer, 7/20; Snyder/McCullough, Philadelphia Inquirer, 7/18; Gantz/ McCullough, Philadelphia Inquirer, 7/9).

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