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Lovelace position on new UNM hospital unclear

Copyright © 2017 Albuquerque Journal

When the University of New Mexico made a push five years ago to build a new hospital, Lovelace Health System emerged as one of the most vocal critics.

Lovelace President and CEO Ron Stern challenged the need for the hospital, suggesting that Lovelace’s Downtown Albuquerque hospital could take patients to ease UNM’s crowding.

In the years since, UNM has increased its coordination with the Lovelace organization, transferring hundreds of patients to Lovelace in fiscal year 2017.

But as UNM resumes its quest for a new hospital, it’s unclear whether it has done enough to assuage Lovelace, because the health care provider – which has its own hospitals – is not saying where it stands on the new proposal.

Lovelace has on multiple occasions declined to answer Journal questions seeking its position on UNM’s current pursuit to build what it calls a “modern medical facility” to boost capacity and replace current facilities its administrators say are outdated and inefficient.

“No one was available to comment,” spokeswoman Katherine Cox wrote the Journal on July 20 in response to questions about whether Lovelace would object to the new proposal. Asked whether it would help to give the company until the next week to answer, she responded, “No, I’m sorry.”

Asked again about Lovelace’s position Aug. 2, Cox responded “I’m sorry, we don’t have anyone to speak to this at this time.”

Lovelace was not so quiet a few years ago when UNM presented a similar proposal.

UNM in 2012 sought approval to build a 96-bed hospital. In a letter from Stern to a Bernalillo County commissioner that was made public in early 2013, he wrote, “We can tell you this as far as Lovelace is concerned – given the current health care environment, a new big hospital in the downtown area is not what is needed at this point.”

That UNM proposal ultimately died; the State Board of Finance, led by Gov. Susana Martinez – which had the final say – never held a vote on the project.

But UNM has since renewed its quest. It has sought approval from UNM’s regents to hire an architect to design a 120-bed hospital and medical office building – the first phase of a longer-term project that could eventually replace all of its existing adult-care units. The regents are scheduled to hear the planning request at Tuesday’s meeting.

UNM has coordinated more closely with Lovelace in recent years. The UNM Medical Group and Lovelace in May even partnered to open the Lovelace UNM Rehabilitation Hospital. The partners share patients, doctors and money in the joint venture.

UNM has also dramatically increased the flow of patients from UNM to Lovelace.

UNM transferred 413 patients to Lovelace in fiscal year 2017, according to numbers provided by the university. That’s up from 158 in fiscal year 2016.

Those figures include patients transferred from the emergency departments at UNMH and the Sandoval Regional Medical Center, plus transfers via Access UNM – a physician access line service (PALS) that accepts calls from providers around the state.

Software purchased about three years ago helped PALS evolve, according to Dr. Irene Agostini, UNMH chief medical officer. Originally used so that providers in more rural areas could call to consult with UNMH’s network of subspecialists, PALS is also now a patient transfer center and bed-management system.

It has greatly improved efficiency, Agostini said.

While UNM has long accepted patients from other hospitals due to its status as New Mexico’s only Level 1 trauma center and its range of subspecialists, it had not always actively redirected patients into other hospitals. It now works closely to put some patients into Lovelace and Presbyterian, preserving some of its own space to serve the most complex cases.

UNM averages 97 percent full, Agostini said, not including the patients waiting in the emergency room or waiting to transfer in from another hospital elsewhere in New Mexico.

Agostini said she did not know if UNMH and Lovelace officials have had conversations about whether the new arrangement is enough to end Lovelace’s objections to a new UNM hospital.

But she said the motivation for the coordination was mostly about improving patient care.

“We don’t have enough space, so that taking a lower-acuity patient and sending them to Lovelace is a win-win for UNM, Lovelace and the people of New Mexico,” she said.

Agostini said she expects the number of transfers to keep growing. There is no set target number, though UNM would like to reach a point where it never had to turn away any patients. It declined 1,000 transfer requests from around New Mexico in the last year, 250 of them critically ill or injured, according to officials.

Asked if it was possible to fill that need without a new hospital, Agostini said, “I think at this point, with our physical plant, the answer is no,” she said.

Agostini also noted that UNM still accepts far more patients from Presbyterian and Lovelace than it sends out – 1,211 from Presbyterian facilities and 571 from Lovelace facilities in 2017 alone.

“We have increased our efficiency at UNMH as well as adding at Sandoval Regional another 50 beds,” she said. “Despite that, we still cannot meet the needs (of New Mexico).”