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.