As West Penn Allegheny Health System officials ponder the future of the Suburban General Hospital campus in Bellevue, questions have arisen about possible legal constraints on what actions they can take.
The Post-Gazette has obtained a copy of the September 1994 affiliation agreement between a then-independent Suburban General Hospital and West Penn Hospital that states that Suburban must remain an acute care facility with its own medical staff, inpatient beds, operating rooms and emergency room.
West Penn Allegheny officials have said they don't intend to close the 59-bed hospital, but there has been discussion of scaling back services and even converting it into an urgent care center with no inpatient care because of a decreasing patient census.
The 1994 agreement would seem to preclude that.
In a section of the original agreement headed "Assurances - Operation of Suburban General Hospital," the document states, "Suburban General Hospital shall remain an acute care community hospital providing inpatient and outpatient medical care through its current emergency room, operating rooms and such other facilities to the residents of the North Boroughs, and the North Hills, and surrounding communities. ..."
No time limit is mentioned. One passage mentions that "changes in the health care environment generally may over time dictate changes and/or reconfiguration of its existing facilities," but adds that those changes will be "consistent with the commitment to preserve Suburban General Hospital as an acute care community hospital."
Keeping Suburban General intact clearly was the intention, said James Pinkerton, a Suburban Health Foundation signatory to the agreement. The foundation raises funds for Suburban General programs.
"The need for that kind of service in the community is very important. The urgi-care level just doesn't provide the level of service we would need," said Mr. Pinkerton, who is no longer affiliated with the board.
The question may be: Is the 1994 agreement still valid?
"A lot has happened since then that would no longer make it relevant," said Kelly Sorice, spokeswoman for West Penn Allegheny, citing the absorption of Allegheny General Hospital following the bankruptcy of its parent corporation, leading to formation of the West Penn Allegheny Health System.
Also, she said, since its incorporation with Allegheny General about five years ago, "It's no longer Suburban General Hospital. It's Allegheny General Hospital, Suburban Campus." The affiliation agreement, she said, "has not been a factor."
However, Suburban Health Foundation Board Chair Dawn Landis said Monday that board members "are in the process of reviewing" the agreement. "We're not entirely sure" that the document is no longer valid, she said.
"We're hoping in the next couple of weeks to get a good sense what this really means with regard to the future of the hospital. We're exploring all our avenues on this. It's really the interests of the community that we're looking to uphold."
WPAHS officials earlier had said they would make some decisions about Suburban this month but Ms. Sorice said they are not going to rush the decision "to meet some artificial deadline." She said meetings on Suburban are scheduled all this week.
The health system has been in the process of systemwide restructuring and consolidation as it tries to right its financial ship. So far, the major moves have been between the two flagship facilities, AGH and West Penn, but services at its other campuses also are under review.
Bellevue Council President Kathy Coder has praised the health system's President and CEO Christopher Olivia and other top administrators for meeting with her, Mayor George Doscher and other top officials to discuss the future of Suburban General. Ms. Coder said health system executives also have met with top borough officials from Avalon, Ben Avon, Ben Avon Heights, Kilbuck and Emsworth.
But Council Vice President Linda Woshner says the rest of council and residents are still largely in the dark, and concerned citizens have been contacting her to ask what is going on. She is trying to organize a town hall meeting in the next two weeks.
"People are concerned. They feel this is important to the borough to have a working hospital here."
There's an economic impact, too, she said, in tax revenue from hospital workers and sales at local restaurants and other businesses. "I want them to realize the people of this community believe this is an important part of the community, not just for Bellevue but for other North Borough communities, too."
Ms. Coder said Suburban General will be on tonight's council agenda, and, "We are certainly having town hall meetings with the citizens. This is not to keep them in the dark at all. This is just doing it in an organized fashion."
She said the key immediate question is whether the facility should continue offering inpatient services, which she said represents about 4 percent of the hospital's revenue. "They have to look at the financial piece and do what makes sense."
Mr. Pinkerton said Suburban General entered into the affiliation with West Penn in 1994 because it was losing money and it wanted to provide its patients access to a major urban hospital.
"Traditionally, community hospitals do a lot of good things, but if you're really sick you want the bigger, better hospital."
He wants WPAHS to thrive, believing it is important for the region to have a major health system alternative to the University of Pittsburgh Medical Center. But he wonders if scaling back Suburban would really help.
"I think they would also have to look at the proximity to UPMC Passavant [hospital]. If they were to close Suburban General, I don't think all of those patients would migrate to the city hospital. They may migrate to the suburban hospital."
Steve Twedt: firstname.lastname@example.org or 412-263-1963.