NEW JERSEY STATE HEALTH PLANNING BOARD - - -

NEW JERSEY STATE HEALTH PLANNING BOARD - - IN RE: Certificate of Need for the Closure of Virtua West Jersey Hospital - Berlin PUBLIC HEARING - - Berl...
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NEW JERSEY STATE HEALTH PLANNING BOARD - - IN RE:

Certificate of Need for the Closure of Virtua West Jersey Hospital - Berlin PUBLIC HEARING - - Berlin Township Municipal Building 135 Route 73 South West Berlin, New Jersey 08091 - - Wednesday, October 22, 2014 6:05 p.m. - - -

BEFORE: JUDY B. BROWN, R.N. New Jersey Department of Health LUISA ALEXOPOULOS, New Jersey Department of Health - - Public Hearing, commencing at approximately 6:05 p.m., at the Berlin Township Municipal Building, 135 Route 73 South, West Berlin, New Jersey, on the above date, before Rose A. Tamburri, RPR, CM, CCR, CRR, National Speed and Accuracy Champion and Notary Public. - - CLASS ACT REPORTING AGENCY Certified Court Reporters 2149 South 3rd Street 133 Gaither Drive, Suite H Philadelphia, PA 19148 Mt. Laurel, NJ 08054 (215) 928-9760 (856) 235-5108

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NJ State Health Planning Board - In re: Certificate of Closure of Virtua WJ Hospital

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SPEAKERS:

MICHAEL KOTZEN

DR. RICK LUDWIN

BOB CARULLO

LOU DEMARCO

VIRGIL JOHNSON

ALSO PRESENT:

CHRISTOPHER A. CHEKOURAS, VIRTUA Senior Vice President, Government Relations

FRED HIPP, JR., VIRTUA Senior Vice President, Government Relations

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I N D E X

SPEAKER:

PAGE

MICHAEL KOTZEN

7

DR. RICK LUDWIN

12

BOB CARULLO

16

LOU DEMARCO

18

VIRGIL JOHNSON

20

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(Whereupon, the proceedings commenced at 6:05 p.m.)

3

CHAIRWOMAN BROWN:

Good evening,

4

everyone.

5

sign in on the speakers' list.

6

going to sit and read this because I feel more

7

comfortable sitting down.

8 9

Okay.

Good evening, again.

I'm

Can you hear

me?

10 11

All persons that want to speak,

(Whereupon, all audience members say yes.)

12

CHAIRWOMAN BROWN:

My name is Judy

13

Brown and I am a supervisor with the

14

Department of Health, Certificate of Need and

15

Healthcare Facility Licensing Program.

16

Joining me tonight is my colleague, Luisa

17

Alexopoulos.

18

and Licensing Program.

19

She is an analyst with the CN

This is a public hearing of the

20

State Health Planning Board in relation to the

21

closure of Virtua West Jersey Hospital,

22

Berlin.

23

complainant, and in accordance with the

24

requirements of law, the State Health Planning

25

Board is required to hold a public hearing on

The Department being the application

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this application within 30 days of this

2

action.

3

been published in accordance with the

4

provisions of NJSA 26:2H-3.8.

5

to the Secretary of State who posted the

6

notice in a public place.

7

Adequate notice of this hearing has

Notice was sent

Copies of the hospital CN

8

application are available for review at the

9

Marie Fleche Memorial Library, the Berlin

10

Township Library, the New Jersey State Library

11

in Trenton and the Department of Health.

12

Information gathered at this

13

hearing will be reviewed by the State Health

14

Planning Board in addition to reviewing the

15

application from Virtua and Department staff's

16

analysis and recommendations in a public

17

meeting.

18

Although no members of the State

19

Health Planning Board are present tonight,

20

this community public hearing is being

21

transcribed and the transcript, along with any

22

written comments submitted tonight, will be

23

made available to all board members, along

24

with the transcript and written submissions

25

prior to the meeting to review this

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application.

2

There will also be limited time

3

available at the next public meeting of the

4

State Health Planning Board to hear from

5

members of the public.

6

applicant will present the application and

7

answer questions the board members may have.

8 9

At that meeting, the

In the interest of making efficient use of the time for tonight's

10

hearing, each speaker will be limited to three

11

minutes.

12

with you, please provide a copy to the Board

13

and they will be added to the record.

14

If you have longer written comments

Anyone interested in speaking

15

tonight should sign in, as I've told you

16

before, on the speaker list at the entrance --

17

and it's not at the entrance, it's actually

18

over here now.

19

written comments after tonight's hearing and

20

before the board meeting is urged to do so.

21

Such comments must be submitted no later than

22

Wednesday, October 29th and should be

23

addressed to the State Health Planning Board

24

in care of the Department of Health.

25

Anyone who wants to submit

For those of you unfamiliar with

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the Certificate of Need process, the State

2

Health Planning Board will vote on a

3

recommendation as to the decision of this

4

application which will be submitted to the

5

Commissioner of Health.

6

Planning Board's hearing is part of the

7

Certificate of Need process and your comments

8

will be considered as we review issues related

9

to health planning, hospital and related

10

health services and access to healthcare

11

services.

12

of this process and will be considered along

13

with the materials submitted by the applicant.

14

The State Health

Your comments are an important part

The Board can recommend approval

15

of the application, approval with conditions,

16

or denial of the application before it.

17

Commissioner will make the final decision on

18

the application after the Board makes its

19

recommendations.

The

Thank you.

20

MS. ALEXOPOULOS:

21

MR. KOTZEN:

22

MS. ALEXOPOULOS:

23

MR. KOTZEN:

Michael Kotzen?

Kotzen, thank you. I'm sorry.

Good evening.

My

24

name is Mike Kotzen, Virtua Executive Vice

25

President for Population Health.

I am

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representing Virtua at this public hearing to

2

discuss the transformation of our Berlin

3

campus.

4

the State Health Planning Board for their time

5

and the opportunity, if they were here, to

6

speak with Virtua Better Plans.

7

I want to thank all the members of

On May 1st of this year, Virtua

8

submitted a Certificate of Need application to

9

the New Jersey Department of Health to close

10

acute care services on its Berlin campus in

11

order to transform that campus into an

12

expanded outpatient and long-term care hub.

13

The proposed campus will continue to provide

14

24/7 emergency service and long-term care and

15

rehabilitation services.

16

converting what are now hospital rooms into

17

use for long-term care and rehabilitation

18

patients.

19

Our plans include

Why we are -- why are we proposing

20

these changes?

Because of an increased focus

21

on prevention and wellness, fewer people are

22

requiring hospitalization as more healthcare

23

services are being provided in non-hospital

24

settings.

25

admissions have declined by more than 10

Across New Jersey, acute care

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percent in the past five years.

2

Virtua has been preparing for the

3

transformation in healthcare delivery for many

4

years and we have opened three major health

5

and lung centers, three urgent care centers,

6

partnered with CVS or with Minute Clinics in

7

our region and provide other alternatives to

8

acute care services as may be appropriate,

9

given people's healthcare needs.

10

With an increasingly aging

11

population, the need is growing to provide

12

enhanced services for the senior population;

13

and third, over the course of the last three

14

years, more and more patients have been served

15

by -- more and more patients who had been

16

served by the Berlin Hospital are choosing to

17

go to the Voorhees Hospital or Marlton

18

Hospital.

19

Because of all these factors, the

20

average number of inpatients at Berlin is now

21

about 25.

22

practical to provide inpatient services for

23

such a low number, with Virtua Voorhees five

24

miles away and Virtua Marlton only seven miles

25

away.

It is no longer reasonable or

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Pursuant to our mission to help

2

people be well, get well and stay well, Virtua

3

will remain dedicated to serving the

4

healthcare needs of the people in Berlin and

5

surrounding communities.

6

maintain a vibrant Berlin campus with

7

long-term care and rehabilitation services, a

8

24/7 emergency department and diagnostic

9

outpatient services.

10

That's why we will

Our approach to providing

11

emergency services at Berlin is a model that

12

we use currently at Virtua Camden and is used

13

by other health systems in the State and

14

around the country.

15

at Virtua Berlin will continue to be supported

16

by diagnostic services such as lab and

17

radiology.

18

The emergency department

Emergency room patients requiring

19

hospitalization will be transported to other

20

Virtua hospitals free of charge.

21

Virtua has electronic medical records at all

22

of its hospitals, patients' medical records

23

will be accessible at any Virtua Hospital.

24

This ensures a smooth transition --

25

MS. ALEXOPOULOS:

Because

Excuse me.

It

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has lapsed, the three minutes.

2

MR. KOTZEN:

3

CHAIRWOMAN BROWN:

4

MS. ALEXOPOULOS: right.

Okay.

All

I'm sorry.

7 8

We only have a

few speakers.

5 6

Seriously?

MR. KOTZEN:

I was going as fast

as I can.

9

This ensures a smooth transition

10

for Berlin Hospital patients in other Virtua

11

hospitals.

12

I would like you to know that we

13

are making this transformation without

14

employee layoffs.

15

employees will remain on the Berlin campus

16

after the transition to provide emergency,

17

long-term care and rehabilitation services and

18

necessary support services.

19

In fact, more than 300

For employees who are affected by

20

the changes at Virtua Berlin, from the outset,

21

we have been committed to placing them in

22

other positions throughout our health system.

23

In fact, while continuing to meet the needs of

24

patients at Virtua Berlin, we have found new

25

positions for the majority of employees.

A

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few have opted to retire or seek employment

2

elsewhere.

3

We believe we have put a plan into

4

place that ensures the continuity of care for

5

the patients that have been served by our

6

Berlin Hospitals and for residents' future

7

needs.

8

highest quality healthcare and customer

9

service on the Berlin campus.

We will continue to provide the

We will help

10

our patients access in our network of

11

facilities and services to address their needs

12

in the most responsive way possible.

13 14

Once again, thank you for your time and consideration.

15

MS. ALEXOPOULOS:

16

CHAIRWOMAN BROWN:

Thank you.

17

MS. ALEXOPOULOS:

Rick Ludwin.

18

DR. LUDWIN:

19

Thank you.

Good evening.

My

name is Dr. Rick Ludwin.

20

MS. ALEXOPOULOS:

21

DR. LUDWIN:

Doctor, sorry.

I'm the Medical

22

Director of the Emergency Department at Virtua

23

Berlin.

24

Department of Emergency Medicine and the

25

President of the Medical Staff for Virtua

I also serve as the Chairman of the

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South.

2

I am here this evening to extend

3

my full support for Virtua's plan to

4

transition the Berlin campus from an acute

5

care facility to an outpatient and post-acute

6

campus.

7

As an emergency room physician for

8

over 31 years, I've observed and been part of

9

significant change in healthcare.

10

I commend Virtua's administration

11

for leading change to continually provide

12

better care, promote health and wellness, and

13

increase the number of access points for

14

residents to receive care through a network of

15

physician offices, urgent care centers and

16

outpatient facilities.

17

About 14 years ago, with the

18

approval of the Department of Health, Virtua

19

discontinued acute care services at its Camden

20

location and transformed that facility into a

21

robust campus with a wide range of outpatient

22

and community services that better meet the

23

needs of the people we serve in Camden.

24 25

As an emergency room physician, I experienced firsthand the value of maintaining

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a satellite emergency department in the

2

community, just as Virtua did in Camden and

3

just as Virtua plans to do in Berlin.

4

Last year, Virtua's Emergency

5

Department in Camden saw over 36,000 patients,

6

which is significantly more than when that

7

facility provided inpatient care.

8 9

We believe that Virtua's satellite emergency department in Berlin will offer a

10

similar benefit to the community when

11

inpatient services are no longer provided at

12

that location.

13

emergency department, the Berlin facility will

14

continue to offer diagnostic imaging with CAT

15

scan, X-ray and laboratory services.

16

And to support this satellite

Following what we hope will be the

17

New Jersey Department of Health approval to

18

close the acute care services at Berlin, we

19

will be fully prepared to continue emergency

20

services that same day that we implement that

21

closure.

22

Critical to the success of any

23

emergency department, including a satellite

24

emergency department, is having a strong

25

business partnership with a medical

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transportation company.

2

Virtua and its patients have benefited from

3

such a relationship with exceptional medical

4

transportation, ensuring the smooth transfer

5

of patients to neighboring facilities when

6

necessary.

7

Over the years,

It is also important to note that

8

all of the physicians caring for patients at

9

Virtua Berlin have the ability to care for

10

patients at our sister sites, ensuring

11

continuity of care for their patients.

12

I feel confident that Virtua has

13

the necessary experience, commitment and

14

skills to ensure an effective transition of

15

the Berlin campus to serve the community by

16

enhancing its emergency department, long-term

17

care and rehabilitation facilities, while

18

maintaining lab and imaging services.

19

For all of these reasons, I fully

20

support Virtua's Certificate of Need

21

application to discontinue Virtua Berlin acute

22

care services.

Thank you.

23

CHAIRWOMAN BROWN:

24

The next speaker will be Robert

25

Thank you.

Carullo --

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MR. CARULLO:

Carullo.

2

CHAIRWOMAN BROWN:

Carullo.

3

Sorry.

Thank you very much, but before you

4

begin, Mr. Carullo, there were several persons

5

who just came in.

6

speak, please raise your hand.

7 8

(Whereupon, there is no response from audience members.)

9 10

If any of you would like to

CHAIRWOMAN BROWN:

Okay.

Thank

you.

11

MR. CARULLO:

Members of the State

12

Health Planning Board, good evening and thank

13

you for this opportunity to address you about

14

supporting Virtua's plans to support --

15

supporting Virtua's plans to transform its

16

Berlin campus to focus on outpatient,

17

long-term care and rehabilitation services.

18

I'm Bob Carullo.

I currently live

19

in Shamong, but I was raised in Voorhees

20

Township and attended school and played my

21

sports in Berlin, so I know the town quite

22

well.

23

many times.

And my family has used Berlin Hospital

24

I'm the Executive Director of

25

SMART, a consortium promoting science and

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technology in the Mid-Atlantic Region, and I

2

wanted to note that Virtua is a member.

3

However, I'm speaking tonight as a

4

South Jersey resident who relies upon Virtua's

5

healthcare services for my family and me,

6

again, many times.

7

I am aware that healthcare

8

providers like Virtua are focusing more and

9

more on keeping people healthy and that they

10

are increasingly expanding alternatives to

11

acute care hospitalization, whenever that's

12

appropriate, given a person's particular

13

medical needs.

14

I know that Virtua has been a

15

leader in this healthcare evolution by growing

16

its network of primary and specialty

17

physicians and opening urgent care centers and

18

health and wellness facilities.

19

Given my professional interest in

20

science and technology, I closely followed the

21

development and opening of the new Virtua

22

Hospital in Voorhees, a facility that provides

23

high quality care supported by the latest

24

technology.

25

I applaud Virtua for working hard

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to stay ahead of the curve to meet people's

2

needs in new and better ways.

3

reasons, I fully understand and support

4

Virtua's plans to discontinue acute care

5

services at its Berlin campus.

6

For these

At the same time, since that

7

campus is about 11 miles from my home, I'm

8

glad that they intend to keep this location in

9

operation with vital health services for the

10

community.

11

appreciate that Virtua plans to continue those

12

services in Berlin.

13

Should we need emergency care, we

Should my family and I need

14

hospitalization following the closure of acute

15

care at Berlin, we would not hesitate to use

16

Virtua's Voorhees or Marlton Hospitals.

17

Again, thank you for this opportunity to

18

speak.

19

CHAIRWOMAN BROWN:

Thank you.

20

MS. ALEXOPOULOS:

Lou DeMarco.

21

MR. DEMARCO:

Good evening.

22

name is Lou DeMarco.

23

Berlin Emergency Medical Services.

24

9-1-1 EMS provider for Berlin Borough and

25

Berlin Township.

My

I'm the Captain of We are the

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Through a conversation with Scott

2

Kasper, who we deal with through Virtua's MIC

3

program, he asked me to come out tonight and

4

just voice a little bit of our concerns, if

5

there were any.

6

Just as background, since 2010, we

7

average roughly about 1800 transports of

8

patients a year; approximately 40 percent of

9

those patients go to Virtua in Berlin.

10

Currently, we do transport

11

patients not only to Virtua Berlin, but we do

12

use other area hospitals or specialty care,

13

such as Cooper for our trauma patients, our

14

burn patients would go to Cooper Temple,

15

pediatric patients are currently going to

16

Virtua in Voorhees or Cooper, our OB-GYN would

17

be transported to Virtua in Voorhees or to

18

Kennedy Stratford, and our cardiac patients

19

would go to Virtua in Marlton or Our Lady of

20

Lourdes.

21

Approximately, the distance from

22

the furthest part of our response area in

23

Berlin Borough to Virtua in Voorhees is

24

approximately 4.6 miles, with about a

25

13-minute trip.

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We've sat down since Virtua came

2

to us with their plans and we've met.

3

staff has looked at what type of impact it

4

would have on us.

5

impact us or our patients in a negative way.

6

Our

We do not feel that it will

We will still continue to use

7

Virtua Berlin for any patients that would not

8

require in-hospitalization, but the majority

9

of the patients we're seeing more and more

10

commonly are asking to either go to Virtua in

11

Voorhees or to Marlton.

12

So I just wanted to reach out and

13

let you guys know that was where our stance

14

is, the local department that could be

15

affected by this.

Thank you.

16

CHAIRWOMAN BROWN:

17

MS. ALEXOPOULOS:

18

Dr. Virgil Johnson, please.

19

DR. JOHNSON:

20

opportunity to address the Committee.

21

of all, let me apologize.

22

phone call that blue suits were required for

23

this evening's comments.

24 25

Thank you. Thank you.

Thank you for the First

I didn't get the

I suppose someone must rise in opposition, and I guess I'm that individual.

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I've lived in Berlin since 1967 and I have

2

spent a number of evenings as a patient in

3

West Jersey Southern, as well as Virtua

4

Southern Division.

5

I don't have any written notes or

6

statistics.

7

extent, emotional, I suppose.

8

however, that Berlin Borough has increased in

9

its population in the past decade.

10

My concerns are, to a great I do know,

The Sewer Moratorium in nearby

11

Winslow Township has just been lifted, which

12

would imply there's going to be some

13

significant building going on there, as there

14

is here in Berlin, referring to homes.

15

Kessler Hospital in Hamilton has

16

been closed for a number of years.

17

no hospital between Voorhees -- Virtua in

18

Voorhees and Atlantic City, and it just seems

19

like I would much -- would be much more

20

comfortable standing here if we were talking

21

about expanding Virtua Southern Division than

22

closing it.

23

right thing to do.

24

are sorry to hear that it's closing.

25

There is

I just don't feel that it's the I think a lot of people

I have no doubt in my mind that

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since the Board of Directors and the higher

2

executive levels have decided this is the best

3

thing to do, I am sure the Board of Health and

4

the governing bodies in the State will

5

probably approve the closing.

6

I just personally think, along

7

with a lot of other people I've spoken with,

8

that it's not the right thing to do at this

9

time; that expanding Virtua Southern Division

10

would be more applicable at this time.

11 12

Thank you for the opportunity to making these comments.

13

MS. ALEXOPOULOS:

Thank you.

14

CHAIRWOMAN BROWN:

15

There are no further speakers on

Thank you.

16

our speakers' list, but we must remain here

17

until 8 p.m.

18

changed your mind and you want to speak now,

19

all you have to do is sign the speakers' list

20

and you may speak.

21 22 23 24

So if you came in later and you

(Whereupon, there is no response from audience members.) CHAIRWOMAN BROWN:

We thank all of

those who did come out and speak.

25

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NJ State Health Planning Board - In re: Certificate of Closure of Virtua WJ Hospital

23 1 2

(Whereupon, the proceedings stood in recess at 6:26 p.m.)

3

- - -

4 5

(Whereupon, the proceedings resumed at 6:57 p.m. as follows:)

6

CHAIRWOMAN BROWN:

Ladies and

7

gentlemen, excuse me.

If there are any

8

persons who came in after I made the

9

announcement, we do have a speaker list.

In

10

order to speak, you have to sign your name on

11

the speaker list.

12

8 p.m.

We will be here until

13

So if you came in and you want an

14

opportunity to speak, please come and sign in

15

and you may speak.

16

though.

17 18 19 20 21 22 23

We'll call your names,

Thank you. (Whereupon, there is no response

from audience members.) (Whereupon, the proceedings stood in recess at 6:57 p.m.) - - (Whereupon, the proceedings resumed at 7:31 p.m. as follows:)

24

CHAIRWOMAN BROWN:

I don't really

25

see any new faces, but we are at 7:31 now.

We

CLASS ACT REPORTING LLC 215.928.9760 856.235.5108

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NJ State Health Planning Board - In re: Certificate of Closure of Virtua WJ Hospital

24 1

will be calling last call for anyone who wants

2

to sign up to speak.

3 4 5 6

So feel free to come up.

(Whereupon, there is no response from audience members.) (Whereupon, the proceedings stood in recess at 7:31 p.m.)

7

- - -

8

(Whereupon, the proceedings

9

resumed at 8 o'clock p.m., as follows:)

10 11 12 13

CHAIRWOMAN BROWN: now adjourned.

The hearing is

Thank you.

(Whereupon, the proceedings concluded at 8 o'clock p.m.)

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CLASS ACT REPORTING LLC 215.928.9760 856.235.5108

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NJ State Health Planning Board - In re: Certificate of Closure of Virtua WJ Hospital

25 1

C E R T I F I C A T I O N

2 3

I, Rose Tamburri, a Certified Shorthand

4

Reporter and Notary Public of the State of New

5

Jersey, do hereby certify that I reported the

6

testimony in the above-captioned matter; that

7

the foregoing is a true and correct transcript

8

of the stenographic notes of testimony taken

9

by me in the above-captioned matter.

10 11

I FURTHER CERTIFY that I am not

12

an attorney or counsel of any of the parties,

13

nor a relative or employee of any attorney or

14

counsel in connection with the action, nor

15

financially interested in the action.

16 17 18 19 20

ROSE TAMBURRI,

21

License No. 30X100189500

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