http://ipraudio.interlochen.org/CMHClosure.mp3
There are no plans to bring emergency care back to Cheboygan. The emergency room, and all of Cheboygan Memorial Hospital, was shut down unexpectedly Tuesday, after a sale to a Flint-based health system fell through.
It was an unexpected twist for a bankrupt hospital that was supposed to be salvaged by a quick sale to McLaren Health Care.
Instead, the tourist town has lost both the only emergency room for miles around, and its largest employer. All 400 Cheboygan Memorial Hospital employees are out of a job.
Details Trickle In
Tuesday was already expected to be a rough day in Cheboygan. A 70-year-old institution was to wind down and, though few details had been released, steep cuts and immediate layoffs were expected as CMH's assets were sold off to McLaren.
But the sale would have brought with it some medical services, including emergency care at the former CMH facility.
The nurses union was prepared for heavy layoffs Tuesday, says Shela Khan-Monroe of the Michigan Nurses Association. The union had 38 members in Cheboygan at the beginning of March.
"The last word that we had heard was, they were going to be retaining approximately 13 of our RNs to ensure that health care was going to be provided, at least through emergency services here in Cheboygan," she says that's what she knew at 8:00 Monday night, when she left the hospital the night before the expected sale.
Worst-Case Scenario
"Now our concern has widened because there isn't even going to be emergency services here in the community," she says.
The nearest emergency room is now St. Ignace, which requires crossing the Mackinac Bridge. Khan-Monroe says, depending on where people live in the region formerly served by CMH, it may take 45 minutes or even and hour-and-a-half to get to an emergency room.
"Those are life-threatening distances, and in some situations it will mean the difference between life and death," she says.
Leaders with would-be buyer McLaren Health Care now say McLaren will not be providing hospital services in Cheboygan, not emergency or surgical care. They released a statement through CMH late Tuesday afternoon. They say the plan is now to work with doctors to make sure Cheboygan patients have access to their physicians "in a familiar environment."
Emergency medical response and transport is still available to the Cheboygan community through local ambulance dispatch by calling 9-1-1.
Why did the sale fall through?
Hospital leaders in Cheboygan say the sale fell through because the federal government refused to let McLaren immediately operate emergency services and outpatient surgery at CMH and to bill Medicare for the services. They say the government decision forced a process that would take six weeks to six months to complete.
The federal agency involved sees the problem differently.
"McLaren chose not to accept assignment of Cheboygan's existing Medicare provider agreement, which would have allowed McLaren to continue to provide health services to the community, and bill Medicare for covered services," says Public Information Officer Elizabeth Surgener with CMS, the Centers for Medicare and Medicaid Services. She reads from a prepared statement.
Hospital officials at both CMH and McLaren also spoke only though press releases Tuesday, but federal bankruptcy court documents show Cheboygan owed money to the federal Medicare program. The hospital had been overpaid for services. So the heart of the issue could be money. By refusing the existing agreement McLaren, as the buyer, may have been attempting to protect itself from that debt.
But Surgener at CMS says the fix McLaren wanted wouldn't work under federal law.
"McLaren requested that CMS circumvent established Medicare law and processes to allow them to bill Medicare for emergency and surgical services without interruption. CMS cannot do so legally," she said in the statement.
Economic Fallout
Regardless of the cause, a local community is now without a hospital or an emergency room and Cheboygan Area Chamber of Commerce Executive Director Matthew Friday says the loss is a big blow to a retirement hot spot where access to quality healthcare is an important draw.
CMH is also the largest employer by far in Cheboygan. These were good, year-round jobs in a region where unemployment soars through the winter months when tourism dies down.
"Obviously discretionary spending for these 403 employees is going to go down and that's going to affect everybody - on Main Street and throughout the area. With less discretionary income you're buying fewer items, you're depositing less money in the bank, you're hiring fewer services.
"So, it's pretty significant and this is something that affects every single person in this community, whether you work at the hospital or not," Friday says.
The President of the Board at Cheboygan Memorial says he was stunned by the news late Monday when he learned the sale had fallen through. Jamie McClurg says he was called on at the last minute to make an awful decision, to vote to close the hospital without a buyer.
"People have worked so, so hard to secure health care for the long-term in Cheboygan," he says. "And so to receive this news was a shock. I was very sad. It's a very hard time for the community right now and for people in the hospital who are now going to be unemployed.
"It's very, very disappointing. It was totally unexpected."