NEW JERSEY STATE HEALTH PLANNING BOARD …web.doh.state.nj.us/apps2/documents/bc/Public Hearing...

ecebac7c-2fa9-45db-ad6e-0b81db1814c4

NEW JERSEY STATE HEALTH PLANNING BOARD

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IN RE: Certificate of Need for the Closure of

Virtua West Jersey Hospital - Berlin

PUBLIC HEARING

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Berlin Township Municipal Building

135 Route 73 South

West Berlin, New Jersey 08091

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Wednesday, October 22, 2014

6:05 p.m.

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BEFORE:

JUDY B. BROWN, R.N.

New Jersey Department of Health

LUISA ALEXOPOULOS, New Jersey

Department of Health

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Public Hearing, commencing at

approximately 6:05 p.m., at the Berlin

Township Municipal Building, 135 Route 73

South, West Berlin, New Jersey, on the above

date, before Rose A. Tamburri, RPR, CM, CCR,

CRR, National Speed and Accuracy Champion and

Notary Public.

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CLASS ACT REPORTING AGENCY

Certified Court Reporters

2149 South 3rd Street 133 Gaither Drive,

Suite H

Philadelphia, PA 19148 Mt. Laurel, NJ 08054

(215) 928-9760 (856) 235-5108


NJ State Health Planning Board - In re: Certificate of Closure of Virtua WJ Hospital

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SPEAKERS:

MICHAEL KOTZEN

DR. RICK LUDWIN

BOB CARULLO

LOU DEMARCO

VIRGIL JOHNSON

ALSO PRESENT:

CHRISTOPHER A. CHEKOURAS, VIRTUA

Senior Vice President, Government Relations

FRED HIPP, JR., VIRTUA

Senior Vice President, Government Relations

CLASS ACT REPORTING LLC

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I N D E X

SPEAKER: PAGE

MICHAEL KOTZEN 7

DR. RICK LUDWIN 12

BOB CARULLO 16

LOU DEMARCO 18

VIRGIL JOHNSON 20


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1 (Whereupon, the proceedings

2 commenced at 6:05 p.m.)

3 CHAIRWOMAN BROWN: Good evening,

4 everyone. All persons that want to speak,

5 sign in on the speakers' list. Okay. I'm

6 going to sit and read this because I feel more

7 comfortable sitting down.

8 Good evening, again. Can you hear

9 me?

10 (Whereupon, all audience members

11 say yes.)

12 CHAIRWOMAN BROWN: My name is Judy

13 Brown and I am a supervisor with the

14 Department of Health, Certificate of Need and

15 Healthcare Facility Licensing Program.

16 Joining me tonight is my colleague, Luisa

17 Alexopoulos. She is an analyst with the CN

18 and Licensing Program.

19 This is a public hearing of the

20 State Health Planning Board in relation to the

21 closure of Virtua West Jersey Hospital,

22 Berlin. The Department being the application

23 complainant, and in accordance with the

24 requirements of law, the State Health Planning

25 Board is required to hold a public hearing on


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1 this application within 30 days of this

2 action. Adequate notice of this hearing has

3 been published in accordance with the

4 provisions of NJSA 26:2H-3.8. Notice was sent

5 to the Secretary of State who posted the

6 notice in a public place.

7 Copies of the hospital CN

8 application are available for review at the

9 Marie Fleche Memorial Library, the Berlin

10 Township Library, the New Jersey State Library

11 in Trenton and the Department of Health.

12 Information gathered at this

13 hearing will be reviewed by the State Health

14 Planning Board in addition to reviewing the

15 application from Virtua and Department staff's

16 analysis and recommendations in a public

17 meeting.

18 Although no members of the State

19 Health Planning Board are present tonight,

20 this community public hearing is being

21 transcribed and the transcript, along with any

22 written comments submitted tonight, will be

23 made available to all board members, along

24 with the transcript and written submissions

25 prior to the meeting to review this


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1 application.

2 There will also be limited time

3 available at the next public meeting of the

4 State Health Planning Board to hear from

5 members of the public. At that meeting, the

6 applicant will present the application and

7 answer questions the board members may have.

8 In the interest of making

9 efficient use of the time for tonight's

10 hearing, each speaker will be limited to three

11 minutes. If you have longer written comments

12 with you, please provide a copy to the Board

13 and they will be added to the record.

14 Anyone interested in speaking

15 tonight should sign in, as I've told you

16 before, on the speaker list at the entrance --

17 and it's not at the entrance, it's actually

18 over here now. Anyone who wants to submit

19 written comments after tonight's hearing and

20 before the board meeting is urged to do so.

21 Such comments must be submitted no later than

22 Wednesday, October 29th and should be

23 addressed to the State Health Planning Board

24 in care of the Department of Health.

25 For those of you unfamiliar with


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1 the Certificate of Need process, the State

2 Health Planning Board will vote on a

3 recommendation as to the decision of this

4 application which will be submitted to the

5 Commissioner of Health. The State Health

6 Planning Board's hearing is part of the

7 Certificate of Need process and your comments

8 will be considered as we review issues related

9 to health planning, hospital and related

10 health services and access to healthcare

11 services. Your comments are an important part

12 of this process and will be considered along

13 with the materials submitted by the applicant.

14 The Board can recommend approval

15 of the application, approval with conditions,

16 or denial of the application before it. The

17 Commissioner will make the final decision on

18 the application after the Board makes its

19 recommendations. Thank you.

20 MS. ALEXOPOULOS: Michael Kotzen?

21 MR. KOTZEN: Kotzen, thank you.

22 MS. ALEXOPOULOS: I'm sorry.

23 MR. KOTZEN: Good evening. My

24 name is Mike Kotzen, Virtua Executive Vice

25 President for Population Health. I am


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1 representing Virtua at this public hearing to

2 discuss the transformation of our Berlin

3 campus. I want to thank all the members of

4 the State Health Planning Board for their time

5 and the opportunity, if they were here, to

6 speak with Virtua Better Plans.

7 On May 1st of this year, Virtua

8 submitted a Certificate of Need application to

9 the New Jersey Department of Health to close

10 acute care services on its Berlin campus in

11 order to transform that campus into an

12 expanded outpatient and long-term care hub.

13 The proposed campus will continue to provide

14 24/7 emergency service and long-term care and

15 rehabilitation services. Our plans include

16 converting what are now hospital rooms into

17 use for long-term care and rehabilitation

18 patients.

19 Why we are -- why are we proposing

20 these changes? Because of an increased focus

21 on prevention and wellness, fewer people are

22 requiring hospitalization as more healthcare

23 services are being provided in non-hospital

24 settings. Across New Jersey, acute care

25 admissions have declined by more than 10


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1 percent in the past five years.

2 Virtua has been preparing for the

3 transformation in healthcare delivery for many

4 years and we have opened three major health

5 and lung centers, three urgent care centers,

6 partnered with CVS or with Minute Clinics in

7 our region and provide other alternatives to

8 acute care services as may be appropriate,

9 given people's healthcare needs.

10 With an increasingly aging

11 population, the need is growing to provide

12 enhanced services for the senior population;

13 and third, over the course of the last three

14 years, more and more patients have been served

15 by -- more and more patients who had been

16 served by the Berlin Hospital are choosing to

17 go to the Voorhees Hospital or Marlton

18 Hospital.

19 Because of all these factors, the

20 average number of inpatients at Berlin is now

21 about 25. It is no longer reasonable or

22 practical to provide inpatient services for

23 such a low number, with Virtua Voorhees five

24 miles away and Virtua Marlton only seven miles

25 away.


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1 Pursuant to our mission to help

2 people be well, get well and stay well, Virtua

3 will remain dedicated to serving the

4 healthcare needs of the people in Berlin and

5 surrounding communities. That's why we will

6 maintain a vibrant Berlin campus with

7 long-term care and rehabilitation services, a

8 24/7 emergency department and diagnostic

9 outpatient services.

10 Our approach to providing

11 emergency services at Berlin is a model that

12 we use currently at Virtua Camden and is used

13 by other health systems in the State and

14 around the country. The emergency department

15 at Virtua Berlin will continue to be supported

16 by diagnostic services such as lab and

17 radiology.

18 Emergency room patients requiring

19 hospitalization will be transported to other

20 Virtua hospitals free of charge. Because

21 Virtua has electronic medical records at all

22 of its hospitals, patients' medical records

23 will be accessible at any Virtua Hospital.

24 This ensures a smooth transition --

25 MS. ALEXOPOULOS: Excuse me. It


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1 has lapsed, the three minutes.

2 MR. KOTZEN: Seriously?

3 CHAIRWOMAN BROWN: We only have a

4 few speakers.

5 MS. ALEXOPOULOS: Okay. All

6 right. I'm sorry.

7 MR. KOTZEN: I was going as fast

8 as I can.

9 This ensures a smooth transition

10 for Berlin Hospital patients in other Virtua

11 hospitals.

12 I would like you to know that we

13 are making this transformation without

14 employee layoffs. In fact, more than 300

15 employees will remain on the Berlin campus

16 after the transition to provide emergency,

17 long-term care and rehabilitation services and

18 necessary support services.

19 For employees who are affected by

20 the changes at Virtua Berlin, from the outset,

21 we have been committed to placing them in

22 other positions throughout our health system.

23 In fact, while continuing to meet the needs of

24 patients at Virtua Berlin, we have found new

25 positions for the majority of employees. A


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1 few have opted to retire or seek employment

2 elsewhere.

3 We believe we have put a plan into

4 place that ensures the continuity of care for

5 the patients that have been served by our

6 Berlin Hospitals and for residents' future

7 needs. We will continue to provide the

8 highest quality healthcare and customer

9 service on the Berlin campus. We will help

10 our patients access in our network of

11 facilities and services to address their needs

12 in the most responsive way possible.

13 Once again, thank you for your

14 time and consideration.

15 MS. ALEXOPOULOS: Thank you.

16 CHAIRWOMAN BROWN: Thank you.

17 MS. ALEXOPOULOS: Rick Ludwin.

18 DR. LUDWIN: Good evening. My

19 name is Dr. Rick Ludwin.

20 MS. ALEXOPOULOS: Doctor, sorry.

21 DR. LUDWIN: I'm the Medical

22 Director of the Emergency Department at Virtua

23 Berlin. I also serve as the Chairman of the

24 Department of Emergency Medicine and the

25 President of the Medical Staff for Virtua


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1 South.

2 I am here this evening to extend

3 my full support for Virtua's plan to

4 transition the Berlin campus from an acute

5 care facility to an outpatient and post-acute

6 campus.

7 As an emergency room physician for

8 over 31 years, I've observed and been part of

9 significant change in healthcare.

10 I commend Virtua's administration

11 for leading change to continually provide

12 better care, promote health and wellness, and

13 increase the number of access points for

14 residents to receive care through a network of

15 physician offices, urgent care centers and

16 outpatient facilities.

17 About 14 years ago, with the

18 approval of the Department of Health, Virtua

19 discontinued acute care services at its Camden

20 location and transformed that facility into a

21 robust campus with a wide range of outpatient

22 and community services that better meet the

23 needs of the people we serve in Camden.

24 As an emergency room physician, I

25 experienced firsthand the value of maintaining


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1 a satellite emergency department in the

2 community, just as Virtua did in Camden and

3 just as Virtua plans to do in Berlin.

4 Last year, Virtua's Emergency

5 Department in Camden saw over 36,000 patients,

6 which is significantly more than when that

7 facility provided inpatient care.

8 We believe that Virtua's satellite

9 emergency department in Berlin will offer a

10 similar benefit to the community when

11 inpatient services are no longer provided at

12 that location. And to support this satellite

13 emergency department, the Berlin facility will

14 continue to offer diagnostic imaging with CAT

15 scan, X-ray and laboratory services.

16 Following what we hope will be the

17 New Jersey Department of Health approval to

18 close the acute care services at Berlin, we

19 will be fully prepared to continue emergency

20 services that same day that we implement that

21 closure.

22 Critical to the success of any

23 emergency department, including a satellite

24 emergency department, is having a strong

25 business partnership with a medical


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1 transportation company. Over the years,

2 Virtua and its patients have benefited from

3 such a relationship with exceptional medical

4 transportation, ensuring the smooth transfer

5 of patients to neighboring facilities when

6 necessary.

7 It is also important to note that

8 all of the physicians caring for patients at

9 Virtua Berlin have the ability to care for

10 patients at our sister sites, ensuring

11 continuity of care for their patients.

12 I feel confident that Virtua has

13 the necessary experience, commitment and

14 skills to ensure an effective transition of

15 the Berlin campus to serve the community by

16 enhancing its emergency department, long-term

17 care and rehabilitation facilities, while

18 maintaining lab and imaging services.

19 For all of these reasons, I fully

20 support Virtua's Certificate of Need

21 application to discontinue Virtua Berlin acute

22 care services. Thank you.


24 The next speaker will be Robert

25 Carullo --


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1 MR. CARULLO: Carullo.

2 CHAIRWOMAN BROWN: Carullo.

3 Sorry. Thank you very much, but before you

4 begin, Mr. Carullo, there were several persons

5 who just came in. If any of you would like to

6 speak, please raise your hand.

7 (Whereupon, there is no response

8 from audience members.)

9 CHAIRWOMAN BROWN: Okay. Thank

10 you.

11 MR. CARULLO: Members of the State

12 Health Planning Board, good evening and thank

13 you for this opportunity to address you about

14 supporting Virtua's plans to support --

15 supporting Virtua's plans to transform its

16 Berlin campus to focus on outpatient,

17 long-term care and rehabilitation services.

18 I'm Bob Carullo. I currently live

19 in Shamong, but I was raised in Voorhees

20 Township and attended school and played my

21 sports in Berlin, so I know the town quite

22 well. And my family has used Berlin Hospital

23 many times.

24 I'm the Executive Director of

25 SMART, a consortium promoting science and


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1 technology in the Mid-Atlantic Region, and I

2 wanted to note that Virtua is a member.

3 However, I'm speaking tonight as a

4 South Jersey resident who relies upon Virtua's

5 healthcare services for my family and me,

6 again, many times.

7 I am aware that healthcare

8 providers like Virtua are focusing more and

9 more on keeping people healthy and that they

10 are increasingly expanding alternatives to

11 acute care hospitalization, whenever that's

12 appropriate, given a person's particular

13 medical needs.

14 I know that Virtua has been a

15 leader in this healthcare evolution by growing

16 its network of primary and specialty

17 physicians and opening urgent care centers and

18 health and wellness facilities.

19 Given my professional interest in

20 science and technology, I closely followed the

21 development and opening of the new Virtua

22 Hospital in Voorhees, a facility that provides

23 high quality care supported by the latest

24 technology.

25 I applaud Virtua for working hard


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1 to stay ahead of the curve to meet people's

2 needs in new and better ways. For these

3 reasons, I fully understand and support

4 Virtua's plans to discontinue acute care

5 services at its Berlin campus.

6 At the same time, since that

7 campus is about 11 miles from my home, I'm

8 glad that they intend to keep this location in

9 operation with vital health services for the

10 community. Should we need emergency care, we

11 appreciate that Virtua plans to continue those

12 services in Berlin.

13 Should my family and I need

14 hospitalization following the closure of acute

15 care at Berlin, we would not hesitate to use

16 Virtua's Voorhees or Marlton Hospitals.

17 Again, thank you for this opportunity to

18 speak.


20 MS. ALEXOPOULOS: Lou DeMarco.

21 MR. DEMARCO: Good evening. My

22 name is Lou DeMarco. I'm the Captain of

23 Berlin Emergency Medical Services. We are the

24 9-1-1 EMS provider for Berlin Borough and

25 Berlin Township.


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1 Through a conversation with Scott

2 Kasper, who we deal with through Virtua's MIC

3 program, he asked me to come out tonight and

4 just voice a little bit of our concerns, if

5 there were any.

6 Just as background, since 2010, we

7 average roughly about 1800 transports of

8 patients a year; approximately 40 percent of

9 those patients go to Virtua in Berlin.

10 Currently, we do transport

11 patients not only to Virtua Berlin, but we do

12 use other area hospitals or specialty care,

13 such as Cooper for our trauma patients, our

14 burn patients would go to Cooper Temple,

15 pediatric patients are currently going to

16 Virtua in Voorhees or Cooper, our OB-GYN would

17 be transported to Virtua in Voorhees or to

18 Kennedy Stratford, and our cardiac patients

19 would go to Virtua in Marlton or Our Lady of

20 Lourdes.

21 Approximately, the distance from

22 the furthest part of our response area in

23 Berlin Borough to Virtua in Voorhees is

24 approximately 4.6 miles, with about a

25 13-minute trip.


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1 We've sat down since Virtua came

2 to us with their plans and we've met. Our

3 staff has looked at what type of impact it

4 would have on us. We do not feel that it will

5 impact us or our patients in a negative way.

6 We will still continue to use

7 Virtua Berlin for any patients that would not

8 require in-hospitalization, but the majority

9 of the patients we're seeing more and more

10 commonly are asking to either go to Virtua in

11 Voorhees or to Marlton.

12 So I just wanted to reach out and

13 let you guys know that was where our stance

14 is, the local department that could be

15 affected by this. Thank you.



18 Dr. Virgil Johnson, please.

19 DR. JOHNSON: Thank you for the

20 opportunity to address the Committee. First

21 of all, let me apologize. I didn't get the

22 phone call that blue suits were required for

23 this evening's comments.

24 I suppose someone must rise in

25 opposition, and I guess I'm that individual.


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1 I've lived in Berlin since 1967 and I have

2 spent a number of evenings as a patient in

3 West Jersey Southern, as well as Virtua

4 Southern Division.

5 I don't have any written notes or

6 statistics. My concerns are, to a great

7 extent, emotional, I suppose. I do know,

8 however, that Berlin Borough has increased in

9 its population in the past decade.

10 The Sewer Moratorium in nearby

11 Winslow Township has just been lifted, which

12 would imply there's going to be some

13 significant building going on there, as there

14 is here in Berlin, referring to homes.

15 Kessler Hospital in Hamilton has

16 been closed for a number of years. There is

17 no hospital between Voorhees -- Virtua in

18 Voorhees and Atlantic City, and it just seems

19 like I would much -- would be much more

20 comfortable standing here if we were talking

21 about expanding Virtua Southern Division than

22 closing it. I just don't feel that it's the

23 right thing to do. I think a lot of people

24 are sorry to hear that it's closing.

25 I have no doubt in my mind that


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1 since the Board of Directors and the higher

2 executive levels have decided this is the best

3 thing to do, I am sure the Board of Health and

4 the governing bodies in the State will

5 probably approve the closing.

6 I just personally think, along

7 with a lot of other people I've spoken with,

8 that it's not the right thing to do at this

9 time; that expanding Virtua Southern Division

10 would be more applicable at this time.

11 Thank you for the opportunity to

12 making these comments.



15 There are no further speakers on

16 our speakers' list, but we must remain here

17 until 8 p.m. So if you came in later and you

18 changed your mind and you want to speak now,

19 all you have to do is sign the speakers' list

20 and you may speak.



23 CHAIRWOMAN BROWN: We thank all of

24 those who did come out and speak.

25


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1 (Whereupon, the proceedings stood

2 in recess at 6:26 p.m.)

3 - - -


5 resumed at 6:57 p.m. as follows:)

6 CHAIRWOMAN BROWN: Ladies and

7 gentlemen, excuse me. If there are any

8 persons who came in after I made the

9 announcement, we do have a speaker list. In

10 order to speak, you have to sign your name on

11 the speaker list. We will be here until

12 8 p.m.

13 So if you came in and you want an

14 opportunity to speak, please come and sign in

15 and you may speak. We'll call your names,

16 though. Thank you.





21 - - -


23 resumed at 7:31 p.m. as follows:)

24 CHAIRWOMAN BROWN: I don't really

25 see any new faces, but we are at 7:31 now. We


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1 will be calling last call for anyone who wants

2 to sign up to speak. So feel free to come up.





7 - - -


9 resumed at 8 o'clock p.m., as follows:)

10 CHAIRWOMAN BROWN: The hearing is

11 now adjourned. Thank you.


13 concluded at 8 o'clock p.m.)

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1 C E R T I F I C A T I O N

2

3 I, Rose Tamburri, a Certified Shorthand

4 Reporter and Notary Public of the State of New

5 Jersey, do hereby certify that I reported the

6 testimony in the above-captioned matter; that

7 the foregoing is a true and correct transcript

8 of the stenographic notes of testimony taken

9 by me in the above-captioned matter.

10

11 I FURTHER CERTIFY that I am not

12 an attorney or counsel of any of the parties,

13 nor a relative or employee of any attorney or

14 counsel in connection with the action, nor

15 financially interested in the action.

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20 ROSE TAMBURRI,

21 License No. 30X100189500

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