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Answers to questions regarding CMH Editor's note: MUSC's purchase of Charleston Memorial Hospital raises questions about MUSC's ability to afford it, use of the extra space, the future of CMH employees, and others. The Catalyst has tried to compile as many of these questions as possible and present them to MUSC President Ray Greenberg, M.D., Ph.D., and Marion Woodbury, CEO of University Medical Associates. Here are their answers: Why did Charleston County want to sell CMH? Why did they seek to own it in the first place? What changed? Charleston County decided to sell Charleston Memorial Hospital (CMH) because it wanted to get out of the health care delivery business. This has been the trend for some time now. Very few counties continue to own and operate hospitals. With budget cuts imposed on the university and more on the way, how can MUSC afford to buy a hospital? What are the terms of sale and how will MUSC pay it off? At present, the Medical University operates CMH under contract from Charleston County. Although that contract calls for payments, presently valued at over $5 million per year, to the Medical University, the county is not making those payments. At the same time, the Medical University is making $1.6 million bond payments per year on previous renovations at CMH.   The proposed terms of sale reduce the purchase price of the hospital by the value of the payments that Charleston County owes to the Medical University through the end of the present contract. In other words, instead of paying the Medical University in cash, Charleston County will compensate the Medical University through land and buildings. This helps Charleston County by avoiding further cash expenses and it gives the Medical University equivalent value to the terms of the existing contract.   To bring the purchase price up to the appraised value of the property, the Medical University will continue to assume responsibility for the existing bond debt and will owe the county an additional $7 million. In order to spread this debt over a long period of time, and thereby diminish the annual payments, Charleston County will issue new bonds. Bond interest rates are favorable at present. In paying off these bonds, the Medical University will actually cut its current bond payment in half. Is this purchase of CMH more than just a real estate grab? Is there a real advantage in this transaction? To MUSC? To Charleston County? To the people to be served? There are real advantages to all parties in this transaction. For Charleston County, an exit from the health care business is provided with fair market value for their facilities. For the Medical University, full value for the existing service contract is received and the annual debt payment is reduced. For the community, an amicable transition for CMH is secured on terms that will favor its continued operation. MUSC has a space shortage, especially research lab space. Will the purchase relieve any space shortage? If so, in what area, and how? There will be no restrictions on how MUSC can use the space. It can be used to support research, education or patient care. Careful evaluation will be made of all possible uses of the space and any necessary costs for converting or upgrading it. How does the purchase of CMH fit in the Campus-Wide Facilities Master Plan?  The Facilities Master Plan identifies the property adjacent to CMH, which currently hosts the site of the substance abuse center, as a potential site for the development of a parking structure.   The future use of the existing patient care facilities at Charleston Memorial Hospital will be programmed in conjunction with the medical center’s plans for the clinical enterprise. As we are all aware the demands of today’s clinical environment are taxing on the Medical Center’s 1955 chassis and infrastructure. A phased replacement and renovation of the Medical Center’s existing clinical facilities will undoubtedly influence how we use clinical space at CMH in both the short term and long term. An updated strategic plan for the clinical enterprise of MUSC, which more carefully addresses this issue, is currently under development.   What will happen to CMH employees? Will they be let go, remain where they are, or be reassigned? The reassignment of a substantial number of CMH employees since July 2000 to the Medical Center (Medical University Hospital Authority) was accomplished in a very smooth fashion. This was due to the similar job classification and benefits plans and to the commitment of the CMH and MUSC leadership team. The leadership team stands by its commitment to continue to provide to the CMH employees opportunities as they are available.   CMH employees will maintain their employment and will be converted to the Medical Center’s payroll. Employees who meet minimum qualifications will be placed in comparable pay grades (bands) and job titles. CMH employees will be compensated equitable rates of pay in line with other Medical Center employees.   It is expected that most CMH employees will maintain their current work locations and assignments. While minimal changes to work assignments are anticipated, it is possible that some CMH employees will be given new job assignments to meet workload demands. CMH employees in regular (non-temporary) positions will be entitled to the same benefits as other Medical Center employees. All leave will transfer into the Medical Center's Paid Time Off policy (which includes Paid Time Off and Extended Sick Leave).  CMH employees’ Available Time Off will be credited will credited as Paid Time Off (annual leave, holidays and other personal leave) and accrued Medical time off will be credited as Extended Sick Leave. How will the purchase of CMH affect the delivery of indigent care in Charleston County? There will be minimal effect in the near term. In the long term, the role of CMH in the community relative to all the other resources available will be evaluated. The Medical University supports a communitywide approach to the care of persons who lack medical insurance. The Charleston County Medical Society has been working on such an effort. The Medical University endorses a coordinated strategy that calls upon the resources and capabilities of all providers. What share of the burden in the delivery of indigent care will be bourne by Charleston County and how much by MUSC? Charleston County has not determined how it will spend the proceeds of the sale of the hospital. Some, or all, of these funds might be invested in securing care of the medically uninsured. As previously noted, the Charleston County Medical Society is developing a proposal that will seek support from governmental entities and providers to help support care of the medically uninsured. As previously noted, the Charleston County Medical Society is developing a proposal that will seek support from governmental entities and providers to help support care of the medically uninsured. What will happen to the Emergency Room at CMH? Considering MUSC, Roper and CMH, do we need three ERs in a three-block area?  The future of the emergency room will be determined through an evaluation to be undertaken. The availability of other emergency rooms will be a consideration in that evaluation, and we anticipate discussions with other providers. We lease one of the floors at CMH. Will we continue to lease that floor to the long-term acute care hospital? Will we seek to lease more space at CMH? MUSC will continue to lease space to Specialty Hospitals. This arrangement has worked out well for both parties and is serving an important need in the community. We will consider any space needs of MUSC at CMH when the issue of leasing space to other parties is discussed.