Citizens Response and Arguments Opposing New Jersey Department of Health and Senior Services (“NJDH”) APPLICATION – CERTIFICATE

OF NEED FOR HOSPITAL - RELATED PROJECTS Muhlenberg Regional Medical Center (“MRMC”) Union County Plainfield, New Jersey Provide a brief (50 words) description of this project: Muhlenberg Regional Medical Center (Muhlenberg, MRMC) seeks certificate of need (CN) approval to discontinue operations as an acute care hospital. Due to chronic underfunding of charity care and government payment and a disproportionate burden of caring for the uninsured and undocumented, Muhlenberg is not sustainable as an acute care hospital due to escalating multimillion dollar annual operating losses. In 2007, Muhlenberg generated an operating loss of $16.8 million and is projected to lose $18 million in 2008. Despite significant investment in facilities, equipment, physician recruitment and program development over the past five years, Muhlenberg has been unable to attract a sufficient patient base to remain viable. The consolidation of acute care services onto the JFK Medical Center campus in Edison will enable Solaris to apply limited resources to maintain access to a full array of high quality services that can best meet the needs of residents of Plainfield, Edison and surrounding communities. Solaris will continue to offer selected services on the Muhlenberg campus, includinjg a satellite emergency department and supporting ancillary services. Management has developed a thorough transition plan that addresses the needs of the community, employees, physicians and other area institutions and will ensure continuity of care and access for residents of Plainfield. The closure of Muhlenberg will occur immediately upon receiving CN approval and is planned for the summer of 2008. Citizens’ Response: We disagree that MRMC is not a viable facility. We request the NJDH perform a thorough analysis of Solaris’ finances of all related entities in the Solaris Heath Care System. We request the NJDH perform a thorough analysis of the impact of access to health care by the affected populations. Solaris’s claims of disproportionate percentage of uninsured and undocumented has not been substantiated by independent analysis. Citizens argue MRMC should be designated a safety net hospital. Currently there is no safety net hospital for Somerset, Middlesex Counties. Given MRMC location at the apex of three counties (Union, Middlesex, Somerset), designating MRMC as a safety net hospital would provide these necessary services and access to health care to the needy of all three counties, which does not exist now.

Citizens Response and Arguments
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Solaris has not put sufficient attention and efforts into creative marketing and business plans for the tri-county area using MRMC’s facility. Instead, they show a pattern of diverting services to JFK and/or selling off profitable MRMC operations. Solaris’ transition plan has not been disclosed, nor does it apparently exist on paper. Per Reinhardt Report, MRMC should really fall into the category of less viable but more essential. Argument opposing Solaris’ Answer to Question Number F (Project Summary) F. PROJECT SUMMARY (page 7) Muhlenberg Regional Medical Center (Muhlenberg, MRMC) seeks certificate of need (CN) approval to discontinue operations as an acute care hospital. Muhlenberg Regional Medical Center is a licensed 355 bed urban community hospital located in the City of Plainfield, operating at an average occupancy of less than 35% of licensed beds. In 2007, the hospital generated an operating loss of $16.5 million and is projected to generate losses at an accelerating rate. The hospital provides inpatient medical/surgical, obstetrics, and psychiatric services, an emergency department, outpatient surgery, diagnostic imaging and a limited set of specialty diagnostic and treatment services. After non months of extensive deliberations, management and the Board of Trustees determined that no viable alternatives to closure exist and authorized the filing of CN to close. Critical factors in the decision included: Citizens’ Answer to Above: MRMC was licensed for 396 beds in 1997. Beds were lost when Solaris transferred the MRMC pediatric practice to JFK. MRMC has 19 intensive care beds.

Muhlenberg Regional Medical Center is not a financially sustainable hospital. The hospital has consistently generated multi-million annual operating losses due to chronic underfunding of charity care and government payment combined with a disproportionate burden of caring for the uninsured and undocumented. Annual operating losses began to accelerate in 2007, when the operating deficit reached $16.5 million. Losses are projected to grow substantially as charity care and available State support are further reduced:

Citizens’ Answer to Above: Solaris must provide complete financial documentation of all Solaris entities, profit and nonprofit, with outside audit of their financials to prove the $18 million loss per year claim.

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Solaris must provide proofs of their claims of the disproportionate burden of care of uninsured and undocumented; the cost of this care and the percentage of patients. Per the Kaiser Commission on Medicaid and the Uninsured, March, 2008, page 7, paragraph 3, “In 2005, average annual per capita health care expenditures for non-citizens were $1,797 versus $3,702 for citizens. These differences in expenditures persist among the privately and publicly insured and the uninsured.” If there is in fact a disproportionate burden of care of uninsured and undocumented, this makes a further case for MRMC being designated a safety net hospital. In our analysis of the financials filed to the IRS in 2005, MRMC operated in the black that year. Historically for the last 5-7 years, we note significant disbursements ($8-9 million annually) for unknown reasons. Solaris must provide documentation of the purpose of those disbursements. We challenge Solaris to explain how MRMC went from operating in the black in 2005 to the losses claimed in 2007.

The magnitude of the annual operating losses cannot be subsidized by other Solaris affiliates without jeopardizing the System’s viability and its ability to provide mission critical services to all of the communities served, including Plainfield and the immediately surrounding communities.

Citizens’ Answer to Above: The claim that MRMC cannot be “subsidized by other Solaris affiliates” is irrelevant. When Solaris affiliated with MRMC, it took on the non-profit MRMC’s mission of providing charity care. Solaris benefited by the merger, in that it had access to the expertise of the MRMC staff, the high quality care, high patient satisfaction, MRMC’s of setting the standard of care in the state for cardiac care and angioplasty, lower length of stay, MRMC’s culture of innovation, efficiency and cutting-edge medical technology, as well as the long history, name recognition and assets that MRMC had built up during its 130 years in existence. Citizens demand Solaris provide proof of their claim that they do not have the cash and/or profits from its many for-profit entities to sustain MRMC. Solaris is a parent corporation. There is no reason why a profitable arm cannot support an unprofitable arm. Solaris has a track record mismanaging their resources. For example, an Muhlenberg owned, always-busy Surgicenter in Watchung was sold, Solaris claiming it was unprofitable. It was purchased by hospital physicians who have made it extremely profitable, to the tune that its profits could very well support MRMC current reported losses.
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A dialysis center located on the MRMC, at least 30 years old, was sold by Solaris, again claiming it was unprofitable. Divta currents owns and operates the service on the MRMC campus (currently this portion of the campus was part of a recent division of the MRMC property), paying rent, and despite the center is required to have 10 indigent spots, currently is profitable. If Solaris is allowed to close MRMC and remove the physical assets, foundation assets, endowed beds in perpetuity, and real estate, Solaris will unjustly enrich its other entities at the expense of the good will, volunteerism, cash donations provided by the surrounding population which built and supported MRMC for over a century.

Current and projected volume do not support the continued operation of Muhlenberg as an acute care hospital. Since 2004, acute admissions have declined by 8.8%, reaching an acute average daily census of less than 135 patients and annual admissions of fewer than 10,000, with fewer than 6,900 medical/surgical admissions.

Citizens’ Answer to Above: Solaris must provide a third party independent study supporting their claim that “current and projected volumes do not support the operations of Muhlenberg.” While other area hospitals’ emergency rooms are on divert, and they do not have sufficient bed space to alleviate that problem, MRMC’s bed remain empty. Why? There is a pattern of prejudice and discrimination in that charity care patients are routinely diverted to MRMC, while paying patients are forced to lie on stretchers in hallways at other hospitals for up to 12 hours. This is not providing quality health care to the insured or uninsured.

Despite a multi-million dollar investment in facilities and equipment improvements, physician recruitment and program development over the past five years, acute admissions have declined as noted above. There is little reason to believe that volume declines can be reversed through any further strategic action.

Citizens’ Answer to Above: When Solaris removed the pediatrics practice, that effectively removed private OBGYN and significantly reduced the numbers of private patients with insurance delivering babies at MRMC. Solaris must provide proofs of their physician recruitment program, their incentive programs to recruit and retain physicians and their strategic plan to recruit and retain physicians.

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In 2005, Solaris took a $18 million bond for facility improvements (Loan Agreement dated as of December 1, 2005 between New Jersey Health Care Facilities Financing Authority and The Community Hospital, Group, Inc. relating to the $18,000,000 New Jersey Health Care Facilities Financing authority revenue bonds (variable rate composite program – The Community Hospital Group, Inc. Project) Series 2005A-3). Solaris must provide receipts and proofs of what portion of the funds borrowed were applied to improvements to MRMC. Solaris, in fact, has driven away physicians. Example, the neurosurgical presence at MRMC was forced to leave, due to a $1 million legal battle, which continues to this day, over a noncompete clause in a physician’s contract. He is one of the best in the state in his area. This is not consistent with a non-profit wishing to retain physicians and services at the MRMC campus. The MRMC dialysis center was also sold off as an “unprofitable business.” Devita, who currently owns it, runs four shifts, six days a week, and it is one of the largest dialysis centers in statement. It located at the Kenyon House on the MRMC campus. Why is Solaris systematically selling off MRMC practices and assets? This is not consistent with a parent company trying to build and develop a struggling entity. In fact, the “word on the street” from the beginning of the merger in 1997, was Solaris’ intention from the beginning was to remove MRMC as a “competitor.”

External benchmarking and third-party evaluation of Muhlenberg’s cost structure and operations suggest that little opportunity exists to further reduce expenses without jeopardizing patient care.

Citizens’ Answer to Above: Solaris must provide the “external benchmarking and third-party evaluations” report in writing and what firm did the evaluation. Muhlenberg is a “lean and mean” facility. MRMC is run extremely efficiently, with minimal administrative overhead and costs. However, the same cannot be said of JFK, nor of Solaris. An investment company which specializes in purchasing health care facilities, Pine Creek Health Care Capital, of Nashville, TN did their initial analysis of MRMC. In their initial evaluation conclusion was MRMC is a viable facility and the reported losses and projected losses were due to financial manipulations by Solaris. Mid-way in their evaluation, Solaris did not allow the investment bank to complete their due diligence nor allowed them to speak to the MRMC board.

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Solaris’ action in this regard is not one showing fiduciary responsibility to the communities surrounding MRMC nor truly desiring to sell. Selling MRMC and it becoming a viable facility would mean JFK would have a “competitor” on the market once again. Solaris’ representatives attended a meeting with Assemblyman Green, mayors of Plainfield and Fanwood with Assemblywoman Joan Quigley approximately six months ago, discussing the possibility of a municipality taking over MRMC. Quigley stated at that meeting Solaris represented that they “shouldn’t worry, we have plenty of buyers.”

.The age and condition of the MRMC physical plant will require a major infusion of caspital over the next 5-10 years to maintain a safe and competitive environment for patients and clinicians. The financial drain due to sustained operating losses prohibits an investment of such magnitude:

Citizens’ Answer to Above: Solaris’ assertion that the MRMC physical plant is aging and jeopardizes patient care is a blatant lie. The head of plant operations and maintenance has been led by Walter Dilts, who has kept the plant in tip-top shape, which any inspection would reveal. Also, Solaris’ has asserted it has invested $18 million into MRMC and other monies. This represents a substantial amount of improvements, that would more than make MRMC an up-to-date facility, if all the funds were truly spent on MRMC.

The consolidation of acute care services onto one campus in Edison represents the most efficient and effective use of limited resources to meet the needs of residents of Plainfield and surrounding communities. Solaris will be better able to ensure sustained access to quality healthcare services for area residents through the creation of a regional medical center operating on a single campus.

Citizens’ Answer to Above: This statement is a complete falsehood. It is instead, a scheme to “weed out” the poorest of the poor and not provide this vulnerable population services, due to inaccessibility. Case in point, JFK cannot currently accommodate the current number of births occurring in Plainfield, most of which are known to be either Medicaid or undocumented/uninsured. Where does Solaris propose where these patients should go? Also, given the Black Infant Mortality Rate has recently improved from 3:1 to 2:1 versus white mortality, the scenario Solaris proposed stands to reverse this trend. JFK’s quality of care does not come close to the quality of care provided currently by MRMC. This consolidation would result in a lowering of quality of care that patients currently receive at MRMC. Further JFK is inaccessible to the population that lives at or
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below the poverty level. There is insufficient public transportation and the cost of taxis is prohibitive. Plainfield rescue squad is typically instructed not to bring patients to JFK for periods of at least 2 hours a day. No study has been performed on all other surrounding municipalities regarding the availability of their emergency rooms. What happens when all municipalities EMTs serves are diverted from JFK? This does not represent sufficient quality of care. It is not clear whether patients’ insurance companies will cover two ambulance trips. It 12 ½ minutes from Plainfield to JFK, with sirens blaring. Plainfield EMTs en route could get a call that someone is in cardiac arrest. They would drop their first patient at JFK, run back for the cardiac patient and return them to JFK. This represents the EMT being unavailable for at least 25 minutes. For a cardiac patient, this 25 minute delay could be fatal, or lead to further, avoidable complications, that would result in further medical expenses. This “consolidation” will actually result in increased costs, due to the lack of timely response to emergencies where time is a critical factor. Also, Solaris has not factored in the geographic limitations to this “consolidation.” 1) There is a a major freight line which blocks access for up to 15 minutes at a time at main, gradelevel access roads between Plainfield and Edison. What explanation will Solaris have to a family when someone dies in an ambulance waiting for the freight train to cross? 2) There is a major flood plain, that even during medium-grade storms, flood roads out. In the event of a real flood emergency, access to JFK would be completely blocked. Solaris told employees recently that they would run a shuttle bus from noon to 8:30pm. Therefore, Solaris is instructing Plainfield residents not to be ill in the morning or after 8:30pm.

Despite recent hospital closure(s) in the region, Union county and the region continue to have an excess of inpatient beds relative to patient need, such that the closure of a marginal acute care hospital will strengthen the viability and efficiency of the remaining hospitals in the region, contributing to the orderly development of healthcare services in the region:

Citizens’ Answer to Above: The problem with assertion is Solaris is closing MRMC, which the population served is one of the poorest communities that have the least access to health care. Many of the population in the Plainfield area are depend on public transportation. By closing MRMC, this will result in the removal of accessible care. This is depriving accessible beds in an economically depressed community.

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Solaris has contributed to the “excess of inpatient beds” by its expansion of JFK beds. Why did Solaris expand JFK when it already had 355 beds in its inventory in an underutilized facility? This makes no sense on any level.

The determination that Muhlenberg Regional Medical Center can no longer be supported as an acute care hospital was an extremely difficult decision. Muhlenberg has a distinguished 130 year history of serving the Plainfield community with high quality heathcare services and every effort was made to find an alternative to closure, including sale. The lack of a viable offer to purchase the hospital reinforces the factors that make closure the only viable option: declining volume, challenging local demographics, changing physician practice patterns, declining reimbursement and government support, increased competition and shift of volume from hospital settings to freestanding, physician and ambulatory care facilities. All of this is exacerbated by rising operating costs, including supply, insurance and labor costs. The decision to close MRMC as an acute care hospital was made to avoid the need for more precipitous and disruptive action such as bankruptcy. Although difficult for all involved, closure permits an orderly transition that can minimize the impact and disruption on patients, employees, physicians and the community at large. Citizens’ Answer to Above: Solaris received bids for MRMC, and has not disclosed those offers. By making this CN, and the resultant public hearing. Citizens demand these bids be made public. Also, the investment bank Pine Creek, was seriously performing its due diligence process, when Solaris refused to cooperate mid-way in that process. The six month period of time MRMC was for sale is insufficient for this magnitude of a transaction to occur. The process was a sham and we suspect the intention was never in good faith, nor representing its fiduciary duty to MRMC mission and the surrounding community. This action requires patients to seek out new physicians. This is very disruptive to individuals’ lives and especially if they have built a relationship of trust with their physician. In the merger of JFK and MRMC, the medical staffs were never commingled between campuses. Solaris has not provided documentation on where current MRMC staff will practice when MRMC is no longer opened. Solaris has encouraged the “free standing physician-owned ambulatory facilities” in its sale of the SurgiCenter and Dialysis Center. Solaris also moved the Diabetes Center off the MRMC campus, resulting in a highest cost for patient transportation to that facility. If the state of New Jersey is going to mandate charity care service be provided at hospitals and not for a freestanding medical facilities, one could argue New Jersey should change laws
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that charity care be provided by public health clinics only and not require this service of hospitals, so all hospitals could be solvent. The state as set up an unworkable scenario. Or the state could levy a surcharge on freestanding facilities not burdened with charity care, to support charity care provided elsewhere. Employer-sponsor health care coverage has declined significantly since 2001. Therefore, not just the unemployed or undocumented are without health care. Solaris must provide documentation of the purported $50 million investment spent since 2001. Solaris must provide all documentation supporting the claim that 70% adult acute admissions are Medicare, Medicaid, charity care, or without insurance. Per the Kaiser Report, in March 2008, nationally, 78% of uninsured non-elderly were citizens, and 22% were non-citizens. PUT STATS HERE for Length of stay stats Muhlenberg Regional Medical Center is not a financially sustainable hospital Like a high percentage of hospital [sic] in the State of New Jersey, Muhlenberg has been operating at a loss for several consecutive years. In 2006, Accenture completed a study of the financial performance of NJ hospitals that concluded that NJ hospitals represent an industry in crisis. Urban hospitals that do not qualify as safety net hospitals are among those most at risk and MRMC is no exception. The combination of declining volume, shifting demographics, heavy dependence on government funding sources and rising costs results in substantial operating losses. Event with significant special government funding support, MRMC has generated operating losses in the range of $2-5 million annually since its merger with JFK Medical Center in 1997. Recently operating losses have escalated to $16.5 million in 2007 and are projected to reach $18 million in 2008, clearly an unsustainable level for subsidy from other Solaris affilities Since 2001, Solaris has invested $50 million in facilities, equipment, physician recruitment and program development with the objective of increasing the patient base and growing revenue. Despite success in attracting a total of 19 primary care and specialty physicians, recruitment was not sufficient to outpace declining volume and revenue. Adult acute admissions have declined by 8.8% since 2004. In 2007, over 71% of Muhlenberg’s admissions were dependent upon government payment (Medicare, Medicaid, Charity Care) or were without insurance, compared to the State average of 59%. A small and declining patient base combined with under-funding of government payment results in adequate revenues to cover expenses. At the same time, MRMC engaged outside consultant support to evaluate supply and labor costs in order to optimize efficiency and costs effectiveness. Although there is room for limited improvement to reach peer benchmarks, the magnitude of the improvement opportunity is nto sufficient to reverse the financial condition of the hospital and is not attainable at the current scale of patient volume. Similarly, Medicare average length of stay declined from 7.63 to 6.43.
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Although further decline is possible to reach state averages, the feasibility of such improvement is slight given patient demographics and social conditions, payer mix, and the scale of operations. Citizens’ Answer to Above: Solaris contends it invested $50 million into MRMC since 2001. Citizens demand to see the receipts, invoices and other proofs of such investment. Citizens ask why Solaris never petitioned the state to designate MRMC as a safety net hospital. Given MRMC’s central location intersecting three counties, two of which do not have a safety net hospital, and given the criteria the state has for a safety net hospital, which MRMC more than meets, it appears Solaris neglected to pursue this important designation, which would have resulted in additional state funding. Citizens request the names of the outside consultants and the reports they provided. Citizens also ask whether a similar analysis was performed on JFK, and if so, Solaris to provide same for scrutiny. If no analysis was performed, Citizens ask why. Citizens assert that MRMC operates extremely efficiently and rather than it needing to “improve to reach peer benchmarks,” it has in fact by its stellar performance, set the standard for acute care hospitals in the state for performance and efficiency.

Over the 10 year period that Muhlenberg and JFK Medical Center have operated in concert under the ownership of Solaris Health System, operating losses at MRMC have been subsidized by the acute care operations of the Anthony M. Yelensics Community Hospital (AMY) and the acute rehab operation of the JFK Johnson Rehab Institute (JRI). The increased magnitude of Muhlenberg’s operating losses now threatens the financial viability of the other Solaris affiliates. Significant changes in the reimbursement, regulatory and competitive environment for acute and rehab services, limit the ability of AMY and JRI to fund MRMC operating losses. The magnitude of MRMC losses threaten the viability of the Solaris Health system and requires decisive and rapid action to preserve the viability of the health system and prevent any compromise in quality or regional access to healthcare services. In order to preserve Solaris’ ability to provide healthcare services to residents of Muhlenberg’s service area, consolidation of acute operation onto one campus is the only financially viable option. Citizens’ Answer to Above: Historically the Plainfield Muhlenberg Foundation has provided significant financial support. In 2007 it is projected that they will contribute $4.5 million, which would offset the reported $18 million losses. Why is this contribution not being taken into account? According to the foundation center website, Muhlenberg Foundation in 2006 had total assets
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of $15.4 million dollars, compared to JFK Medical Center Foundation total assets of $4.4 million dollars. Solaris has systematically sold, moved or otherwise eliminated profitable practices associated to MRMC before the 1997 merger. Therefore, Citizens conclude that Solaris has engineered the “financial crisis” currently facing MRMC.

Available bed capacity exists at other regional hospitals sufficient to maintain access to care. As referenced in the Accenture study on the NJ Acute Care Hospitals – Financial Status, low occupancy levels contribute to ongoing financial losses. Other academic and policy research studies validate that New Jersey continues to have an excess of hospital beds relative to demand for inpatient services and that counties ni the northern region of the State are particularly overbedded relative to the central and southern portion of the state. This trend is reinforced by the occupancy rates of 9 hospitals all located within a 10-12 mile radius of MRMC. Occupancy rates on maintained beds range from a low of 45% to a high of 87%, indicating available capacity to absorb additional patient volume without jeopardizing access. MRMC former patients are estimated to required 125 beds at peak season. This volume cn be readily absorbed at the 6 hospitals closest to Muhlenberg. JFK Medical Center is the closest provider to Muhlenberg Regional Medical Center and maintains significant service area overlap. JFK’s service area encompasses all of the zip codes in Muhlenberg’s primary service and all but two zip codes in the hospital’s secondary service area. Solaris estimates that between 25-30% of current Muhlenberg patients will be admitted to JFK after the closure of Muhlenberg. Based on current JFK utilization and capacity, MRMC patients can be accommodated in existing JFK units and in one reopened medical/surgical unit currently not staffed. Citizens’ Answer to Above: Solaris must provide the documentation related to research studies which claim that New Jersey has excess hospital beds. Solaris by its over-expansion of JRK has contributed to the excess of beds. We argue it is not the number of beds, but the accessibly of beds which is at issue. The Reinhardt Reports specifically mentions the Northern part of the state has the excess of beds. MRMC is truly located in central New Jersey and has no physical geographic relationship to the Morristown area. The demographic and economic population makeup between Northern and Central New Jersey is significantly different. Northern New Jersey is more dense, more wealthy, and a more homogenous population.

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The nine hospitals cited as being within a 10-12 mile driving radius, per Solaris’ table 6.1, page 16, in fact shows two to three of the hospitals are more than 12 miles away. Also, driving distance is not correct measure of accessibility for a population that primarily does not drive, but uses mass transportation. One could argue Solaris wishes to remove a competing hospital with 125 bed usage to fill its own 119 bed surplus. In reality and historically, MRMC was in existence long before JFK, so therefore JFK overlaps MRMC service areas. Solaris’ assertion that JFK covers the primary service areas of MRMC is incorrect, because the table 5.2 on page 14 does not take into account townships MRMC covers such as: North Plainfield, Warren, Watchung and Green Brook. An Edison population at zip code 08820, 08817 will be significantly impacted by MRMC closure because they are geographically challenged due to the Norfolk Southern Railroad line that intersects at a grade crossing on a major thorough fares such as Inman Avenue and Talmag Road. When freight cross these major roads, for periods of up 15 minutes, traffic is at a standstill, impeding all emergency care transports, putting these citizens at significant at risk. Historically the population in this geographic location in Edison patronize MRMC. Edison council passed a resolution R190-042006 on April 9, 2008 calling for the “continued support, funding and operations of Muhlenberg Regional medical Center.” We would argue that it makes no sense to close a viable, efficiently-operating medicalsurgical unit in an long-standing acute care facility to re-open a “currently medical surgical unit re-opened but not staffed” in Edison.

In addition to area hospitals, there is a large Federally qualified Health Center (FQHC) with six sites operating within the Muhlenberg service area and an adequate supply of primary care physicians to meet the healthcare needs of the service area. There is also a proliferation of freestanding imaging centers and ambulatory surgery centers within the hospital’s service area to serve patients formerly treated at Muhlenberg.

Citizens’ Answer to Above: The health centers in the MRMC service area are located Myrtle Avenue, 427 Darrow Avenue, 950 Park Avenue, 1200 Myrtle Avenue, Clinton Avenue, 201 West 4th Street are all located in schools (one high school, four elementary schools), which means they are not accessible by the general public. So, Solaris’ assertion that these public health centers will take care of the needs of the population currently services by MRMC, is patently false.
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The current Plainfield Health Center (FQHC), now located on Rock Avenue, was started in the 1960s under Model Cities program with MRMC as a partner to service the medically underserved population of Plainfield. The Plainfield Health Center was partially staffed by internal medical residents affiliated with MRMC. The interns’ salaries were paid by Medicare through MRMC. Recently, as part of Solaris’ premature closure actions, the interns were to be transferred to JFK, but the residency program cannot be moved to JFK due to the legal problem caused by Solaris’ attorneys. Therefore the Plainfield Health Center will be without medical residents to perform critical tasks and it is unknown who will perform these duties and will this jeopardize the FQHC status of the health center.

The low occupancy levels at nearly all area facilities which have historically served the MRMC service area indicates that the closure of the Medical Center will contribute to the rationalization and orderly development of healthcare services in the region. Redirecting existing MRMC patient volume to the remaining hospitals will help to strengthen the financial viability of those institutions and create a more stable regional healthcare delivery system. The ability to redirect volume to other area institutions through an orderly and well planned transition represents sounds public and health policy and is significantly preferable to a chaotic and disruptive situation that occurs in a bankruptcy and unanticipated closure. MRMC seeks through the CN to close to assist in maintaining access through an orderly and well planned transition.

Citizens’ Answer to Above: Solaris makes an argument that MRMC’s closure will strengthen other area hospitals. However, they have yet to produce a written “well-planned transition” plan. Solaris makes an esoteric argument for the rationalization of health care, when in fact no alternative has been publicly offered for scrutiny and comment. Their argument has holes, and it is a poor argument to close a superior and efficient facility to benefit less accomplished medical facilities. Also, given Solaris’ assertion that 70% of the patients at MRMC are non-paying or at very low levels of compensation, how will this business diverted to other hospitals strengthen them? If this assertion is indeed true, it would be a weakening of these hospitals, taking on this burden. Citizens assert that, in reality, MRMC is viable and has historically struggled but paid its bills. Solaris’ sole goal is to remove a competitor and fill its own excess beds with business. Insert hospital performance tables here

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McGee stated in his testimony to on April 21, 2008 to the Plainfield City Council that they did not know where or how the 600 beds for deliveries were to be provided. This does not indicate a well-planned transition. In addition, JFK have no provisions or facilities for physiciatric patients currently serviced by MRMC. Solaris’ veiled threat of declaring MRMC bankrupt is ludicrous, given the size of the network of non-profit and for-profits it controls and owns. Solaris has plenty of cash, or needs to prove otherwise by disclosing every all of its entity holdings and balance sheets .. both onshore and offshore, realty holding companies, for profit and non-profit. Implementation Plan; Facilities Plan, Human Resource Plan, Physician Plan, Communications Plan, Service Transaction Plan Citizens’ Answer to Paragraphs related to Plans: Solaris must provide the written Implementation plan for public review and comment before MRMC closure is granted. Solaris has not made public the members of the “task force,” what the process is for the public to provide input to that task force, and there is no accountability to the public for the implementation of recommendations and demands of citizens. This is a prime example of the “power touch” of Solaris, not the “healing touch” of MRMC. The Facilities Plan has not been made public, nor has Solaris explained the reason for dividing the MRMC property in February 11, 2008, to the public’s satisfaction. If MRMC were not closed, 749 people would not lose their jobs and the region would not lose $40 million in wages, directly impacting the economic stability of the region. Solaris must provide the Communication Plan to public for its review and comment before MRMC closure is granted. Solaris has throughout this process not been forthcoming with information nor been transparent in its activities. Community leaders have repeatedly reached out to Solaris leadership, and there has been no response. It is very apparent the MRMC board has been told to stay silent. Solaris has consistently made untruthful statements – from comments at a meeting with Assemblywoman Quigley to comments to the media about assets not being actively removed from the MRMC campus before a CN decision is reached. Citizens do not understand the urgency to close MRMC since MRMC’s license isn’t due to expire until 12/31/2008. This urgency has caused Solaris to start the active closure and transfer of assets before the Department of Health and Seniors Services process has been completed. This seems premature and unwarranted and in violation of the state’s own process. In fact, it appears high level officials have already rubber-stamped MRMC’s
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closure without due process. Citizens deem this action due cause to involve the Attorney General to investigate. Solaris must define what “asset transformation” actually is related to the MRMC’s closure and the request to borrow $70 million. Why is Solaris borrowing $25 million for a substandard nursing expansion when purportedly they are strapped and cannot support MRMC? It is unconscionable that a premier acute care facility be closed, MRMC used as collateral for a $70 million bond, part of which will go to expand and another Solaris facility – JFK. It is unclear what requirements must be met by MRMC and Solaris related Hill-Burton funding. This information must be provided.

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