The proposed $350 million Easton-based UM Shore Regional Medical Center has generated a lot of excitement. The new state-of-the-art facility will encompass 325,000 square feet on six floors featuring 147 beds,122 acute inpatient and 25 observation beds, emergency, surgery, labor and delivery, and support services. It will be located near the intersection of Rt 50 and Longwoods Road only four miles north of the existing hospital. The total projected cost is $550 million.
Before leaving office, former Maryland Governor Larry Hogan pledged a $100 million contribution from the state toward the project. A pledge is excellent but an empty gesture until it becomes part of the State budget. Hogan is gone, leaving that work to Governor Moore, a big supporter of rural healthcare and the Eastern Shore. He and the legislature approved only $10 million for fiscal year 2024 and promised $20 million in 2025. So, a lot of heavy political lifting is still needed to secure all $100 million, especially in light of looming state deficits projected to hit $1 billion by 2028 unless hard choices are made.
The new Medical Center represents the most significant piece of the University of Maryland Medical Systems (UMMS) hub and spoke strategy to create an integrated Mid Shore regional rural healthcare delivery system encompassing Caroline, Dorchester, Kent, Queen Anne’s, and Talbot counties, representing about 175,000 people. The last hurdle is getting the “Certificate of Need” (CON) final regulatory approval from the Maryland Healthcare Commission, which is expected very soon. The hope is the new facility will open in 2028.
UMMS Eastern Shore expansion began over a decade ago. In 2006, UMMS merged with Shore Health Systems, which operated Memorial Hospital in Easton and Dorchester General in Cambridge. In 2008, UMMS merged with Chester River Health Systems, which operated Chestertown Hospital. In 2013, UMMS rolled it all up, forming UM Shore Regional Health. The rebranded UM Shore Regional Health includes UM Shore Medical Center in Easton, a 146-bed acute care facility providing in and outpatient service; UM Shore Medical Center in Cambridge, a free-standing medical facility that provides emergency services and various outpatient services; UM Shore Medical at Chestertown, a rural hospital facility that has flexible capacity for 25 inpatients plus outpatient services to Kent & Queen Anne counties; and UM Shore Emergency Center at Queenstown, a free-standing emergency center. UMMS also operates urgent care sites, acquired from Choice One and rebranded UM Urgent Care, in Denton, Kent Island, and Easton.
As we await the final regulatory approval for a Medical Center that will not open until 2028, it is necessary to focus on the hospital’s current operating performance and significant challenges, which include long ER wait times and nursing shortages, which must be improved immediately.
Emergency Room Wait Time. We are generally free to choose where we want to be treated and from what doctors, except when we have a medical emergency that requires immediate attention or when we call 911. Whether you cut yourself cooking, your child fell and broke his leg, or you are experiencing chest pains, an ER visit is a traumatic moment. If you live in Easton, the ambulance takes you to the UM Shore Medical Center ER. This makes people nervous, especially after Maryland Matters reported that Maryland has the longest emergency room “wait times” in the US, according to the Maryland Health Services Cost Review Commission. And UM Shore Medical Center had the longest emergency room wait time in the State! Clocking in with a median wait time of 1,400 minutes, just under 24 hours, from when patients arrived at the facility to when they were admitted.
We all sensed a problem based on anecdotal reports and personal experience, but having it confirmed by empirical data was shocking. The New Facility with more beds and better equipment will help improve ER performance, but what do you do right now? Hospital management regularly meets with elected officials. However, they need better public outreach (i.e., forums, opinion piece, public meetings) explaining how they will improve out of control wait times and when they expect to approach national medians (under five hours, according to U.S. News). Our elected officials, from the Governor down to the Mayor of Easton, should be asking tough questions.
Improve Nursing Staffing, Reduce Attrition & Improve the Nurse-to-Bed Ratio. Hospitals are struggling with a nursing shortage of 450,000 nurses nationwide and a shortage of doctors estimated to be 120,000. It’s a huge problem, especially for rural hospitals. How does Shore Regional Medical Center’s current performance regarding nurse staffing compare with other comparable hospitals? What is management doing to attract and retain talented nursing staff in this competitive market? Is the issue compensation, more flexible work hours, or both? Nursing shortages affect many aspects of care, including ER wait time. Earlier this year, an EMT told me during a midnight 911 visit to my home that if they took my wife to the ER, it would be many hours before she would get a bed, and even that was not guaranteed. Not because a bed was unavailable but because there were not enough nurses to cover the beds. Management has emphasized that the new UM Shore Medical Center will help attract and retain talent.
Improve Hospital Culture. Elizabeth H. Bradley, President of Vassar College, author, and former Faculty Director of Yale University’s Health Leadership Institute, speaking about organizational culture, once said, “It’s how people communicate, the level of support, and the organizational culture that trump any single intervention of any single strategy that hospitals frequently adopt.” I am curious how Shore employees rate their hospital as a workplace and management’s performance. Internal employee engagement (satisfaction) surveys are standard, as are 360-degree evaluations that ask employees to rate managers, including the President & CEO. Comments about what it is like to work at UM Shore Medical Center on job websites like Glassdoor and Indeed are not great. I know several experienced nurses who have worked at the hospital for decades. They say nurses are burnt out, some looking to retire, and many unhappy with management after several brutal and stressful years dealing with the COVID-19 pandemic and long hours due to nursing shortages and other factors.
I hope members of the UMMS and UM Shore Health boards aggressively monitor and demand improvement in these areas long before the new hospital opens. More stringent patient satisfaction and operating metrics focused on these issues should be included in management’s annual performance review and bonus awards, including for President & Chief Executive Officer Ken Kozel.
Maryland is blessed with great hospitals. Luminis Health Anne Arundel Medical Center appears on Newsweek’s 2024 list of best in-state hospitals at number (4), along with (1) Johns Hopkins Hospital, (2) Johns Hopkins Bayview Medical Center, (3) University of Maryland Medical Center, (5) Saint Joseph Medical Center, and (6) MedStar Union Memorial. Anne Arundel is currently the best hospital within 50 miles of Easton and a UMMS competitor located right over the Chesapeake Bay Bridge. Luminis Health is a non-profit health system formed in 2019 when Anne Arundel Medical Center acquired Doctors Community Medical Center. Luminis serves Anne Arundel, Prince George’s Counties, and parts of the Eastern Shore. I am hopeful UM Shore Medical Center will appear on this list soon.
Hospitals are sensitive to ratings from well-known hospital rating organizations and publicize good ratings and downplay bad ones. For 2022, The Leapfrog Group, a national non-profit healthcare rating organization, gave an “A” grade rating (A-F) for overall hospital safety to UM Shore Medical Center and Luminis Anne Arundel Medical Center. Medicare.gov also provides a “Star Rating,” representing overall “Hospital” and “Patient” performance. Shore did not do as well.
Medicare.gov Overall Hospital Star Rating*
UM Shore Medical Center 3 out of 5 stars
Luminis Anne Arundel Medical Center 4 out of 5 stars
* Rating represents an overall performance across different areas of quality, such as treating heart attacks and pneumonia, readmissions, and rates of safety of care.
Medicare.gov Patient Star Rating*
UM Shore Medical Center 2 out of 5 Stars
Luminis Anne Arundel Medical Center 4 out of 5 Stars
*Recently discharged patients were asked about doctor and nurse communications, how responsive hospital staff was to their needs, and the cleanliness and quietness of the hospital environment.
Looking forward, UMMS must still raise hundreds of millions of dollars for the Medical Center. Potential donors will soon be asked to contribute big bucks as part of an upcoming capital campaign. They will ask the same performance questions I have, and management must have the answers. Residents should not worry when taken to the ER or wait five years for the new Medical Center to have an impact.
Replacing our aging hospital with the new Medical Center will not magically solve every operating problem. Just like trading in your aging Honda Civic for an expensive Tesla does not magically make you a better driver. Transformational change is always challenging, and management must rise to the occasion. We all are rooting for them to succeed.
Hugh Panero, a tech & media entrepreneur, was the founder & former CEO of XM Satellite Radio. He has worked with leading tech venture capital firms and was an adjunct media professor at George Washington University. He writes about Tech and Media for the Spy.
Helen Davis says
On Monday, October 2, 2023 my life partner and I received both Covid and Flu Vaccinations at Walgreens pharmacy, in separate arms. Later, that evening, I experienced a fever, and as the night progressed, I felt both dizzy and anxious. By 5:00 AM, I felt I would pass out from the panic /stress sensations. The next step was a visit to Easton Hospital’s Emergency Room.
The Emergency Room medical personnel asked about my symptoms. A doctor appeared to order tests for me. I NEVER saw him again. I was then asked a series of questions concerning depression and suicide. MY BIG MISTAKE WAS BEING HONEST IN MY REPLIES. I said that depression occurs occasionally because of my Charcot Marie Tooth neuropathy disability and an arthritic hip, for which surgery is not an option because of the CMT. I am 82 years old, and have suffered with the disease for 47 years, walking only with braces and coping with the degenerative nature of the disease. My quality of life has been severely affected, within this past year, as walking is nearly impossible.
Fortunately, my life has been full. I have travelled the world, lived in the NY Metro area for 70 years, taking advantage of all the cultural opportunities/events. I am still, after 50 years, a Systems Analyst/Programmer, with a client on Long Island. I work 5-6 or more days per week.
When I look ahead, when my quality of life is nothing FOR ME, I will end my life. I have told my partner, my sons, my friends. If you sit around, with a group of 80+ year olds, their topics of discussion are primarily about depression and suicide. It is the norm, at this stage in life. No one younger seems to comprehend how “NORMAL” this is
.
All red Emergency Room restriction flags were raised by my replies. Immediately, security guards placed metal detectors over my body, looking for suicide implements. My wallet, cell phone, clothes, watch and jewelry were taken away from me. Nurses connected me to an IV solution to alleviate my dizziness symptoms. I was wheeled into a separate room, with two women guarding the door. Everything was removed from the room, so that I could not endanger myself. Some joke! My partner had a previous appointment and had to leave me there, alone. He asked how I would get home and was told someone would call a taxi. I was denied the ability to make phone calls, for I had no phone, and all the personnel refused to make any calls on my behalf. My client, for whom I work 5 – 6 days per week, would be expecting my communication, but I had no way of contacting him. I looked up to see that IV drip had completed. No one cared to notice. It was now 11:00AM. Finally, after I yelled for a nurse, the unit was disconnected. I still had the needle in my arm. I asked to have the needle pulled out so I could exit the hospital. I felt better: no dizziness, no anxiety. The personnel told me that I wasn’t going anywhere, but that I would be transferred up to the second floor. I replied that I would NOT remain in the hospital. I asked to see the doctor about my blood test results. No doctor! A nurse read me the results. All was okay. It was time for me to exit.
I sat up and got off the bed. I brazenly headed past my women guards. They were trying to stop me. I went out into a corridor and yelled “POLICE, FIRE, VACATE,” as loud as I could. I was very aware of what I was doing, definitely of “sound mind.” Immediately, 5/6 security guards came running to subdue me. Me, 5 ‘3”, 105 lbs. They wrestled me and forced me backwards onto a bed. I started screaming in pain as they twisted my body. I thought my back would snap. Then, they drugged me with something.
I awoke hours later to find myself, again isolated in a room with a guard. Now, I was more anxious than when I first arrived at the hospital. I have a close friend who is in Nursing Administration, at the hospital. I asked for her, but was told that she was not working, that day. I begged with people to call her at home. I asked to see someone from administration. Everyone “yessed” me, but they were lying. Late that afternoon, I was involuntarily committed to the Psychiatric Ward, on the second floor of the hospital. I broke down and cried. I was scared stiff. I was breathing abnormally.
A social worker came to visit me and to collect details of my life, from childhood to the present. I filled her in on the significant moments in my life, related to emotional turmoil. At the conclusion of her visit, her words to me were, ”I understand.” She said there was no indication that any changes to my “imprisonment” would occur at any time, soon.
So, there I sat, with no indication of how much time had passed, with no food in my system, since that 5:00AM arrival.
I could not get my braces back, so walking was very precarious. I started to feel extremely uncomfortable: pains in my stomach, heart palpations. If I died then, whose fault would it be? Surely, not suicide. It would be “Death By Hospital.” No doctor, no one to make phone calls for me. No toilet paper, nor paper towels, in the bathroom. The evening passed. I had no idea of the time. At one point I walked to an exit door and banged really loud and hard. Naturally, everyone came running to subdue me, again. No drugs this time, just a reprimand. I asked about making a call to my partner, but was told that the phones were “off” until 8AM.
I waited and waited by some phone, so I could be the first person to connect to the outside world, when 8AM arrived. At that time, I was told that the nurse had to make the phone call for me. She dialed my partner, who was frantically awaiting news about my condition. He had been to the hospital, but was not allowed any contact with me. I told him to call the police, an attorney, and one of my sons. That’s all I had to say, for it looked like I would be in that ward, forever.
The day progressed. I deteriorated with the anxiety. Everyone had lied to me about making contacts on my behalf. At one point, I even wrote down the name of Rabbi Peter Hyman, at Temple B’Nai Israel and asked the staff to contact him and to tell him I was in the hospital. Again, they lied and said “yes they would.”
At about 3:00PM, a psychiatrist came in to visit me. Her first words were: “On behalf of all of us, at this hospital, I apologize for the way we have treated you, these past two days.:” By this time, I was weak. I couldn’t believe what I was hearing. She had read all the psychological reports of the two professional who had preceded her. She asked if I wanted to discuss anything extra with her. I answered “No.” She then gave me the news, that the hospital was discharging me. Wow!
The nurse let me call my partner. He thought I was in hiding, somewhere, having magically escaped. He, naturally, was overjoyed. He mentioned that he had come back to the hospital, several times, and was not allowed to see me. They were very rude to him and escorted him out of the facility. He requested to speak to the psychiatrist and they again refused this request. The hospital returned my shoes, braces, clothes, jewelry, watch, wallet, cellphone. They walked me to the exit. My partner arrived to take me home. Yes, I was exiting, but in a more fragile condition, than when I arrived. My downhill journey toward “the end” was precipitated by this uncaring and harmful institution, Easton Hospital. During those two days, I had lost not only my possessions, but my dignity, my mental health, and my general faith in humanity. The cost could have been my life. Easton Hospital betrayed me.
In the ensuing days, I have suffered with nightmares of this inhuman treatment that I was made to endure. Easton Hospital has CAUSED suffering, not CURED suffering. I want to worn everyone to think twice before entering this Institution. Patient care is non-existent. An investigative report should be initiated.
Jim Moses CDR, USN (Ret.) says
Having been in the Easton ER several times in the past few years, and most recently in their ICU, I can offer some first-hand observations. First of all, Mr. Panero is on the money. Our nurses are workng their collective tails off, and to their forever credit, you have to really press them to admit that they are short-staffed and stressed. They are giving 110%+ and yet are grateful for the chance to help you. He touched on management: here he is also spot on. While in the ER a couple of years ago, the patient in the next room was clearly in crisis. A lot was happening fast, yet a civilian hospital manager chose that time to ignore the entire hospital chain of command and insert himself into what he felt were procedural, not medical shortcomings, distracting the staff from their first priority of keeping that patient alive. I observed to my nurse that the gentleman “needed to work on his people skills;” her response: “you can say that, we can’t.” I finally got so mad I got out of bed, walked into the hallway and dressed him down.
I think some delays could be mitigated through expanding the triage process. Given that it originated in the Navy’s Hospital Corpsman rating, I am naturally a firm believer in the physician’s assistant (PA) concept, and a PA in triage could, for example, save some time by immediately initiating blood, XRAY or other orders.
Health care, like any other large institution, operates under tremendous inertia. Overlaid on this is the constant fear of lawsuits. All that said, it is time to think even more creatively, figure out how to make nursing attractive again, and rid the industry of deadwood managers.
Louisa L. Griffin says
Unfortunately, building a new hospital will not solve the bigger issue: there are not enough doctors let alone qualified nursing staff. UMD has the ER doctors & PA’s we see staying at a local hotel and they rotate shifts: “Traveling medical staff”. Many of our nurses have left and are being paid very well as these traveling nurses.
Once again – building a new hospital won’t actually solve the personnel problem. It just moves it to a new location.
Jerry Craig says
So are you actually suggesting they don’t build it and stay in a 100 year old hospital that continues to suffer massive facility costs from failing infrastructure? You must not care about receving care at a new, safe facility. And everyone knows staff enjoy a nice hospital and aesthetics. Its ez to be critical from afar with zero inside knowledge. This is a REPLACEMENT hospital project needed due to AGE!!! Every single health system is facing the same personnel challenges. The staff isn’t sitting on their butt doing nothing.
Louisa Griffin says
No one said they weren’t doing anything. It’s that there aren’t any “they” there. The emergency room is in fact newish. The people who work at the hospital are great, hard working folk who got us through the worst (Covid) and have to deal with the worst. But they aren’t being compensated enough to stay and a new building will get old soon enough.
Hugh panero says
Jerry — I am a big fan of the new hospital project and said I was rooting for management to be successful. However we can’t ignore persisting issues. And we cannot believe that a new building will solve everything. Thank you for your comment.
Norma Lynch says
I was a patient at the hospital this past July; a five day in-patient stay and a two-day stay. The nursing care I received was wonderful. Yes, both times I spent over 24 hours in the ER until I was moved upstairs into a room. But once in my room, the nursing staff took great care of me. I am currently participating in the Cardiac Rehab program and the nurses and staff there are terrific. Yes, the hospital has some problems, but they got me well and pointed me itoward a healthier future.
Christina Woodard says
Three weeks ago, I spent five days in the hospital after being brought in via ambulance for a possible pulmonary embolism. I spent 32 hours in the emergency room before being finally admitted. Easton hospital is a nightmare. While the nursing care I thought was very good. I was not happy with the physician care at all.