Beebe to keep inpatient services in Lewes

As Beebe Healthcare prepares to celebrate its 100th anniversary next year, the hospital has affirmed its commitment to keeping its inpatient facilities in Lewes.

Following a recent consultant review and extensive administrative and board discussions, officials have decided Beebe Healthcare can best serve the community’s healthcare needs by remaining financially independent, locally governed and keeping its inpatient facilities on the 14 acres it owns in the heart of Lewes.

Beebe has employed Gaithersburg, Md.-based Wilmot Sanz Architecture Planning, a firm specializing in compressed-site healthcare facilities development, to provide an engineering and architectural analysis that could result in complete renewal of the Lewes campus over the next 20 to 30 years.

That plan, said Beebe officials, would likely include a new, five-story building on the site of the former Lewes Convalescent Center, where many Beebe administrative offices are now located.

“That site has a couple of important advantages,” said Alex Sydnor, vice president of external affairs. “The first is that it is down a little hill and is actually 17 feet lower than Savannah Road. That gives us some ability to go higher than we might otherwise."

"The second," he said, "is that it is on the corner farthest from surrounding residences and looks out over Blockhouse Pond and the George H.P. Smith Park, which I see as a real amenity.”

Beebe President Jeff Fried said the plan will also have to include additional parking, which is currently maxed out. The architectural and engineering analysis for how to best maximize the 14-acre Lewes site is expected to be complete in about eight months.

Although Beebe has extensive outpatient facilities and 35 undeveloped acres on Route 24, a few miles west of the Route 1 intersection, officials estimate that moving the inpatient operation from Lewes would cost more than $300 million.

“We simply can’t afford to do that on our own,” Sydnor said. “There was discussion of possibly phasing in a new inpatient facility on Route 24, but our operating profits couldn’t sustain the duplicate services that would be needed for two inpatient facilities."

Sydnor said during a recent retreat, the hospital board decided it can best care for people by maintaining financial independence, with local governance by people who live here. He said Beebe would likely have neither if it had to join forces with a larger healthcare system to afford such a move.

Beebe Healthcare, with its 1,700 employees and $350 million annual budget, is a community-owned, not-for-profit medical facility governed by a local board of trustees.

Building a new structure on the Lewes campus to provide more private inpatient rooms and other new facilities will take a few years. But other moves will also be taken to consolidate inpatient services in Lewes while consolidating outpatient services and certain administrative functions at the Route 24 complex.

Sydnor said cardiac rehabilitation, for example, could be moved to Route 24 along with many of the administrative offices now housed in the Beebe Office Building, which would be razed to make way for the new five-story clinical building.

Visionary way to move forward

Sydnor said given national trends, Beebe’s managers say focusing more on the community’s health using technology and knowledge, rather than on a bricks-and-mortar approach, represents a visionary way to move forward. Nationally, he said, demand is going down for inpatient care, with inpatient services moving toward outpatient services.

“Overall, population health is improving, though it’s not happening yet here because of our growing retiree numbers. They are the people who require more intensive care. But we’re not waiting for the national trends to show up here; we’re working to make them happen by investing in the health of the community," Sydnor said.

"We’re working to get more mid-level and primary-care providers in our system," he said. "Right now we need about 13 more primary-care physicians. We’re expanding our nursing school to get more providers online, and by the end of this year, we plan to open a fourth walk-in center where people can be treated more quickly and closer to home.”

Beebe already operates walk-in centers in Millville, Georgetown and Millsboro. The fourth will be located in the Route 24 complex, to offer a facility closer to the Rehoboth population.

“That should keep a lot of people from having to drive to the emergency room so much,” said Sydnor. “We’re also investing in care coordinators and outreach to help people avoid being readmitted after discharge."

Discharging the patient isn’t the last thing a hospital does, Sydnor said. "We’re working to bridge the gap between acute care and post-acute care to keep people healthier," he said. "It’s all about wellness follow-ups. These aren’t high-cost items. They’re not as cost-intensive as inpatient services."

Overall, Sydnor said, "Our goal is to keep people healthier and in the hospital less. We’re expecting the hospital to shrink relative to other operations.”

Over the past 10 months, Beebe has seen 10,000 inpatient stays and 4,500 inpatient observations of 48 hours or less. During the same time, Beebe has recorded 450,000 outpatient visits - everything from drawing blood for laboratory testing to minor surgical procedures - and an additional 130,000 patient visits to Beebe-employed physicians.

“That doesn’t include visits to private physicians in the area served by Beebe,” said Fried.

Sydnor said changes in the way Medicare pays and its emphasis on reducing hospital stays are drivers in these decisions along with area growth, shifts in the way medicine is being practiced, and technology. “It’s a very complex project, especially challenging with all of these moving parts,” he said.

Key recommendations

• Board affirms intent to remain financially independent

• Beebe cannot afford, on its own, to move hospital to Route 24

• Beebe operating margin won't support costs of duplicate services if a portion of inpatient beds are built on Route 24.

• Sufficient land exists at Savannah Road to renew campus

Beebe Healthcare's Board of Directors

The Hon. William Swain Lee, Chair
Jacquelyn O. Wilson, EdD, Vice Chair
Jeffrey M. Fried, FACHE, Secretary
Paul T. Cowan Jr., DO, Treasurer
Gregory A. Bahtiarian, DO
James D. Barr
James W. Bartle
J. Kirkland Beebe, MD
Wilson C. Choy, MD
R. Michael Clemmer
Thomas J. Cooper
Frank Czerwinksi
Stephen M. Fanto, MD
David A. Herbert
James P. Marvel Jr., MD
Janet B. McCarty
Terry A. Megee
Paul H. Mylander
Esthelda R. Parker-Selby
Paul C. Peet, MD
Wesley E. Perkins
Anis K. Saliba, MD
Michael L. Wilgus