Same-Day Care Services Leaving Town For Bourne

SANDWICH- A Department of Public Health Hearing held at Sandwich Health Center on Wednesday morning drew only two residents, but they had many questions and concerns.
The purpose of the public hearing was to gather feedback from residents about the permanent cancellation of same-day care at the facility.
Same-day services have only been offered at the Falmouth Hospital satellite in Sandwich for a few hours per week since April, and Cape Cod Healthcare plans to eliminate them entirely.
Patients who were accustomed to using the Sandwich Health Center are now being encouraged to use the Bourne Health Center, another of Falmouth Hospital’s ancillary facilities.
Ultimately, the fate of same-day services for non-emergency illnesses and injuries lies in the hands of the Department of Public Health.
However, for those in attendance, the elimination of those services in Sandwich seemed like a foregone conclusion.
Ellen J. Swain, of Route 6A, said it seemed too late to be holding the hearing, considering that the number of hours that same-day services were offered at the facility had already been cut so drastically.
“You’re only open a couple hours a week for a couple days, so I don’t understand how this can be a meeting about intent to close,” she said. “It doesn’t make much sense to me. It seems kind of after the fact.”
Carol A. Summersall, director of community relations for Cape Cod Healthcare, which oversees Falmouth Hospital and its satellites, said that the hearing had been advertised extensively.
She added that she had also spread word about the changes on the horizon at the Sandwich facility with the Sandwich Council on Aging.
Both Ms. Swain and Hope L. Anderson, of Quaker Meetinghouse Road, said that they had taken advantage of the same-day services offered at the Sandwich Facility in recent years, and were not ready to see them go.
“I think it is very sad that this has come to pass,” Ms. Anderson said. “I got very good care here.”
“I used it when needed,” Ms. Swain said. “It was terrific, the people were terrific.”
Ray Cryan of the Department of Public Health said that the complete elimination of walk-in services was not yet set in stone.
“We still have yet to make a decision,” he said.
Susan M. Wing, chief operating officer of Falmouth Hospital, explained that a number of regulatory factors had made providing same-day services at the Sandwich Health Center unsustainable.
Ms. Wing said that Falmouth Hospital first stopped offering emergency walk-in services about a year ago, when Medicare regulations required them to either increase staffing and hours of availability or change their business model.
Ms. Wing said that Medicare providers and health maintenance organizations had required the change, as they could not afford to the pay $75 to $100 emergency reimbursement rates for what were not truly emergency services.
By-appointment visits come with a much lower reimbursement rate, Ms. Wing said.
She said that the change in business model eventually made offering same-day care at the Sandwich Health Center financially impossible.
Medicare patients were not required to get a referral from the primary care physician to receive same-day care at the facility, but HMO patients were.
Ms. Wing said that, for whatever reason, patients stopped coming to the Sandwich Health Center in droves, once they were required to seek a referral from their primary care physician.
Between 2005 and 2007, the number of patients who received same-day care at the Sandwich Health Center dropped from 8,000 to 4,000, Ms. Wing said.
“It was a difficult decision to make,” Ms. Wing said. “If we could afford to have satellites everywhere, we would,” she said.
Ms. Wing added that though same-day care would likely no longer be offered in Sandwich, she was committed to making sure the health center on Trowbridge Road in Bourne stayed open long into the future.
“We’re going to make it sustainable,” she said.
Ms. Wing said that the Bourne Health Center is only nine miles away from the center in Sandwich and is on the same side of the Cape Cod Canal.
Ms. Summersall added that all of the services that are offered at the Sandwich Health Center, including laboratory testing, imaging, rehabilitation services ,and primary care, are also available in Bourne.
Ms. Wing said that Falmouth Hospital would not likely continue to oversee the Bourne Health Center far into the future, and that the facility would instead be staffed almost entirely by primary care physicians and fall under the general purvey of Cape Cod Healthcare.
However, she promised a smooth transition, and said that Medicare patients would continue to be able to receive same-day care in Bourne.
“The transition for Medicare patients will be clean,” she said.
Cape Cod Healthcare recently cut 169 people from its payroll earlier in the month to compensate for a $25 million shortfall in operating costs and a $15 million loss in net income for the 2008 fiscal year.
Ms. Summersall said that while the current financial health of the company did influence its decision to try to eliminate same-day care at the Sandwich facility, the move was really necessitated by older causes.
“The thought processes behind this decision started at least two years ago,” she said.