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Surviving the End of a Hospital by John Birkner, Jr., Mayor Borough of Westwood

For 53 years residents in the northeastern part of New Jersey, encompassing a service area of 23 towns,

What had once been a thriving corridor for commerce, office, and light manufacturing slowly began to transform into not much more than a pass through zone dotted now with "office sapce for lease" signs and empty parking lots.

were able to receive medical treatments at Pascack Valley Hospital. On November 21, 2007 that hospital closed its doors forcing tens of thousands of people to seek alternatives to meet their healthcare needs.
What exactly happens when a hospital closes? Do patients simply go elsewhere? After all, Bergen County is a densely populated area of the state. It is also home to four other hospitals. Surely they could handle the patient load from a hospital that in its last years of operation suffered from a bad reputation and reduced patient admissions. At least that is what the State Department of Health surmised in its project summary, analyses, and recommendations regarding the closure of Pascack Valley Hospital.

What we have since found in Westwood was that the closure of Pascack Valley Hospital had a profound effect not only on our own municipality, but on the broader community consisting of our neighboring towns throughout our region. What had once been a thriving corridor for commerce, office and light manufacturing slowly began to transform into not much more than a pass through zone dotted now with “office space for lease” signs and empty parking lots.

Consider the Impact Seven hundred jobs from the hospital were eliminated from the local economy. Seven hundred people that shopped in the area, filled up their gas tanks and had their cars serviced at local repair shops were no longer consumers. Now take away the thousands of patients, visitors and doctors. All of a sudden the once thriving diners and restaurants that offered comforting meals were struggling with empty tables. Employee spending, institutional spending, patient, family and visitor spending were all removed from the local economy. In the downtown business district, one flower shop owner I spoke to told me revenues were down by $50,000, and that was only in the first eight months since the hospital closed. The effect on other retailers was similarly devastating.

An Economic Blow The full effect of the closing has not yet been felt by the Pascack Valley business community. More than 300 former employees reside in Westwood and hundreds more in surrounding municipalities. All still have rent or mortgage payments, car payments, food, children to support, etc. Although some of the hospital staff has found employment elsewhere, many others have not been so fortunate. With unemployment benefits running out, bills are piling up for these families. Those that have found jobs in other areas are now faced with increased commuting costs, sometimes decreased salaries and overall less money for their needs due to the increased costs of fuel, utilities and food. Additionally, much of the spending that they had done nearby is now outside of the local business district. Therefore, the amount of money removed from the local economy could be several million dollars annually.

How long will doctors continue to maintain office space near a vacant hospital? As leases expire, medical offices are closing up and moving closer to hospitals in other areas of the county because it is not of economic benefit for doctors to keep multiple office spaces open. When Pascack Valley Hospital closed their doors for good there was much speculation on what would happen to the property. Would a new hospital ever open, or would perhaps, a “medical mall” take its place? The reality was that developers were eager for the opportunity to buy the property for non-medical commercial use. After all, twenty acres of prime Bergen County real estate was now up for grabs. Speculators were lining up with plans for townhouse developments, strip malls, and office complexes. None of those were attractive to the Borough of Westwood where a thriving central business district would suffer further with the proposed new retail centers taking customers out of the downtown area. New residential development would only serve to burden a school system already bursting at the seams. And just exactly who would be occupying office space when the single largest economic engine in the region was gone?

Meeting Medical Needs Now for the real question. What about the medical needs of our residents? The remaining hospitals in Bergen County are claiming that the closure of Pascack Valley Hospital has strengthened the existing hospitals without harming access to care in any significant way. Their claim is that this region has been given a “gift.” Those statements can only be viewed as reflective of a callous and uncaring attitude and one that clearly is putting their profits before the patients needs. We are seeing patients that had previously been able to obtain medical treatments and therapies locally, particularly those provided as outpatient services at Pascack Valley Hospital now traveling elsewhere. The impact has been significantly borne by the elderly who either do not have the available transportation to get to other hospitals or doctors offices, or who simply have difficulty navigating the congested roadways and unfamiliar surroundings outside of their own local communities. When Pascack Valley Hospital was open, a Community Outreach van service with a fleet of wheelchair accessible vehicles was available for senior citizens and the disabled to get to local medical appointments. Without the hospital in operation, that service is gone. This increases the burden on our municipal-run shuttle van which is now used to transport those same patients to medical appointments so they can receive necessary treatments.

 Many senior citizens are choosing to cancel appointments for treatment rather that drive in poor weather to more distant healthcare facilities. Or, for other factors that make driving difficult. This is the real impact. For these residents who for so long counted on accessible healthcare in a familiar local environment, the disruption in daily routine and what they were capable of doing is a tremendous stress. A case in point is a woman I met last fall. She was 84 years old and the sole caregiver for her 89- year -old husband. Her husband was chronically ill and needed respiratory therapy treatments three days a week. Since they lived only a few blocks from Pascack Valley Hospital she could manage to get her husband out of bed, dressed, into the car, and over to the hospital for his therapy sessions. It was not easy for her, but she could manage because it was local. Now with the hospital gone, in order to receive the treatment needed, she must drive her husband 12 miles away through heavy traffic to an enormous medical center and navigate its multi-level parking garage. Add in the component of North Jersey winter weather, and it is easy to see how difficult that would be for a person of any age. That is only one example. There are hundreds more in similar situations.

Effect on Volunteer Services The burden on our volunteer emergency service personnel can not be overstated. Volunteer Ambulance Corps across the region have seen a dramatic increase in run times since the hospital closed. Instead of traveling only a few minutes to reach Pascack Valley Hospital, the typical round trip can take two to three hours because of the greater distances to other hospitals, delays in emergency rooms for patient admissions, and the common practice of emergency rooms diverting patients because of overcrowding.

In December of 2007, Westwood gave up 2 bays in its DPW garage so that Mobile Intensive Care Units (MICA) would still be able to serve 18 towns in our area. These units had previously been dispatched by Pascack Valley Hospital. The service was taken over by Hackensack University Medical Center which needed a location to position these life saving vehicles. Since Pascack Valley Hospital closed in November of 2007, over 3,500 runs have been completed. That averages out to over 16 life-saving runs per day.

In 2007 one of the hospitals that claims to be able to handle the patient load had its ER on divert for a total of 452 hours. Fully 151 of those hours were for the month of December alone. A full one-third of all time spent on divert for the year was directly due to the closing of Pascack Valley hospital for only one month. In the first six months of 2008 that same hospital has been on divert for 1,693 hours compared to 301 hours on divert for the first 11 months of 2007 when Pascack Valley hospital was opened. That is only one hospital, the anecdotal evidence provided by the ER staff nurses, physicians, and patients at other hospitals is similarly chilling.

When it comes to hospital admissions, delays for patients to get from the emergency department and admitted into a room have also increased as a direct result of the increased patient load. Reports of patients lying on gurneys in hallways are all too real. This is another example of patient service suffering across the region. Administrators at these remaining hospitals don’t seem to mind. That influx of new patients is good for their business. Patient care has suffered because of the closing of Pascack Valley Hospital. It affects them in terms of accessing treatment, and in the process of receiving treatment. It affects their loved ones whose support is counted on for recovery.

Community Action There has been one positive that has come from the closing of our local hospital. Our regional community has been galvanized into action. The citizens of the 23 communities served by the hospital are working together to see that a hospital will once again open on that site to serve our region. From the Borough Council in Westwood, to the Governing Bodies and citizens throughout the community that is northeastern New Jersey, all have banded together to send a clear and strong message that we don’t simply want a hospital, we NEED a hospital to serve the citizens of our greater community.

The healthcare crisis in the United States is real. Competing hospitals want the business even if that means the inefficient delivery of services to residents in a geographic area that for half a century enjoyed the “luxury” of accessible medical care. When Pascack Valley Hospital in Westwood closed, the impact on the region was devastating. Having access to quality medical care can not be overemphasized in the 21st century. Our citizens deserve quality health care. Not just in our remote corner of New Jersey, but throughout the state, throughout the country, and throughout the world.







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