WHEELING - When the Most Rev. Mark Brennan came to Wheeling in July 2019 to lead the Diocese of Wheeling-Charleston, he inherited a stand-alone hospital facing the wrath of the U.S. Department of Justice for its past business practices.
Brennan recognized quickly that if Wheeling Hospital is to survive in today’s health care environment, where economies of scale and specialized services and care are key, it needs allies. And he looked no further than the management team in place at the hospital – Wheeling Hospital CEO Douglass Harrison and his staff from West Virginia University Health System, which had taken over operations of the facility in June 2019 following the departure of the prior administration.
Over the past year the two sides have continued working through the details of how a more formalized arrangement would look and work, knowing that a deal could not be struck until the hospital settled the Department of Justice lawsuit.
That happened Wednesday, and with that announcement came the opportunity both sides had been working toward: the signing of a letter of intent this past week for Wheeling Hospital to become a full member of West Virginia University Health System. That was announced Friday.
The letter of intent doesn’t call for a sale of Wheeling Hospital to WVU Health System. Instead, WVU will lease the hospital and its ancillary operations for a minimum of 50 years. The diocese will retain ownership of the land and the buildings, and WVU will operate the facilities as full-member institutions.
Another important aspect contained in the letter of intent is that WVU Medicine Wheeling Hospital will remain a Catholic hospital. This was especially important to Brennan, who noted what was then the Catholic Diocese of Wheeling and a group of local physicians started Wheeling Hospital in 1850 – the same year the Diocese was founded.
Brennan, Albert Wright, president and CEO of WVU Health Systems, and Harrison all sat down with the Sunday News-Register to go through the deal’s particulars.
Becoming part of a bigger health care system
Brennan, who came to Wheeling from the Archdiocese of Baltimore, said upon his arrival here that it was clear Wheeling Hospital would struggle without a partner. Add the Department of Justice lawsuit on top of that, and to Brennan it became clear a change was needed.
“I’m not a doctor, not a lawyer, but essentially a parish priest, and it does seem to me that it’s hard today for a stand-alone hospital to make it,” Brennan said. “So a priority for me has been that this hospital stay viable – especially in an area that saw a hospital a year ago this month … close. People still get sick and get injured 170 years after the founding of this hospital so we have to stay in operation and strengthen the services offered here. And we have found that WVU Health System, which has been managing the hospital since June of last year, has in unusual times done a good job.”
Brennan said talks increased in recent months as a “perfect storm” of factors – the DOJ lawsuit, COVID-19 and the closure of the former Ohio Valley Medical Center and East Ohio Regional Hospital – threatened the hospital’s future.
“When the pandemic hit and the suspension of elective surgeries came, the losses just ballooned,” Brennan said. “How long can you sustain that? And we didn’t qualify for the CARES Act help because of the (Department of Justice) lawsuit. So we were really up against a wall.
“On the positive side, I was seeing the response Doug (Harrison) and his team were making here. They know how to manage not just ordinary hospital care, they’re managing during a crisis, and doing it well. That gives you a lot of confidence in the people managing the place. Can we work out the other agreements? I think I can. But it brought us to this point.”
The work by Harrison and his team led to continued talks between the two organizations. Wright, WVU Health’s president and CEO, said both sides got creative in working through the details of how they could come to an agreement.
He recalled WVU’s entrance into Wheeling Hospital last June, right before what he referred to a “very tumultuous time” with the closing of OVMC and EORH. He credited Harrison for being the “bridge” between WVU Health and the diocese to ensure quality health care in the region.
“Whenever you go into any type of a partnership, you always want to make sure there’s a win-win and a value proposition for everyone,” Wright said. “There’s a win in what we’re going to do for West Virginia University Health System because we have a statewide mission to improve the health trajectory of the state of West Virginia. Wheeling is a critical hospital, this is a critical part of the state, and this is really the regional tertiary hub for everything else up here. So this makes sense for us, it makes sense for the Diocese as Bishop Brennan explained to make sure that this is a viable hospital for decades to come, and it makes sense for Wheeling Hospital to be set up to be successful.”
Leasing the property and operating the hospital as a full member of the health system isn’t unprecedented, Wright said. In fact, WVU Health struck a similar deal in its recent integration of Wetzel County Hospital.
“To the naked eye, this institution will have all the capabilities of a fully owned and operated WVU Hospital system. … But a lot of times — we just did this with Wetzel County Hospital — when you take over a county institution it is very hard to unwind that, so sometimes you just do a long-term lease with the county — this effectively solved the same problem,” he said.
Protecting Wheeling Hospital’s Catholic identity
Wheeling Hospital being successful is only part of the equation for Brennan, though. He also sought to have its Catholic identity protected, and got what’s known as a Catholic Identity Agreement included as part of the lease.
He said the Catholic Church has been involved in health care for centuries, and has much to offer patients and the community.
“We’re involved in health care. We have experience and wisdom to offer. Why should that be lost?” he said of the church. “There’s no reason for it to be lost. We know how to give good health care. … We’re not coming out of the dark ages in our medical practices. But we do carry some of the wisdom of the ancient world of what is good medical ethics. So I’d like to see the Catholic identity and practice preserved — not just a crucifix on the wall and my mugshot on the wall, but more than that, the things we have found that work to give people good health care. If we can do that in collaboration with WVU, then I think we have a happy marriage.”
Wright agrees, noting the two sides got creative in structuring the deal so it would preserve Wheeling Hospital’s Catholic traditions. He said along with the letter of intent, both sides have signed the Catholic Identity Agreement.
“The second document (we have signed) is a Catholic Identity Agreement about the things our health care system will do to ensure this remains a viable, practicing Catholic institution. It actually gives some teeth to the diocese that should any of my successors not live up to that word — the example that Bishop Brennan gave me is he was part of a transaction like this in Maryland that went well, but there was always anxiety on what to do if the health care system didn’t live up to the Catholic Identity Agreement. There wasn’t a lot the church could have done to rectify that situation. So this is a situation where we will be able to run this hospital as a full member, it will have the full support and capabilities of the West Virginia University Health System … and this Catholic Identity Agreement will transcend all of us to make sure the hospital remains a Catholic institution at or above the level it is today.”
Wright said WVU Health System already has a Catholic Identity Agreement in place for St. Joseph’s Hospital in Buckhannon. That hospital was founded by the Pallottine Missionary Sisters and is not part of the Diocese of Wheeling-Charleston.
Creating a true health care network for patients
Once the transaction is complete, WVU Medicine Wheeling Hospital will become part of a health system that includes an integrated network of doctors, hospitals, clinics, and specialized institutes across West Virginia, southwestern Pennsylvania, western Maryland, and Ohio. The WVU Health System has more than 20,000 employees; 2,815 providers; 22 member, managed, and affiliate hospitals; and more than 2.5 million patient visits annually.
What does that mean for patients in this region? For one, better access to specialists – both here in Wheeling and also at Ruby Memorial Hospital in Morgantown. It also means a consistency of service that will follow patients wherever they go in the state at a lower cost.
“One of the things that’s important here is the electronic medical records,” Wright said. “We’ve got a fantastic system that we can slide in here in a cost-effective way that will integrate care throughout the state. Anyone that goes from Reynolds to Wheeling to Morgantown to back here — all of your prescriptions, images, labs, physician progress notes, they all flow. That creates safer healthcare because all of your providers can see everything. It decreases the cost of health care because you stop duplicating. We’re blessed that Bishop Brennan is comfortable to work with us as a partner, and I think we can make a really good value statement as to why we’re a partner that makes sense.”
The quality of patient care also will increase, as protocols developed at WVU Health’s institutes in Morgantown will be put in place at Wheeling Hospital. “If you look at West Virginia University Health System, there are institutes within the health system — neuroscience institute, cancer institute, heart and vascular institute. What you’re going to see here is a duplication of that institute concept,” Harrison said. “Taking that leadership, the quality protocols, how we manage patients at the institute level and bringing that to Wheeling. The cancer program will be an integrated, clinical affiliate of the WVU Cancer Institute. The heart and vascular program will be integrated into Morgantown. You’ll see a lot of that.”
Wright likened patient care in the WVU system to McDonald’s French fries.
“Whether you’re in Moundsville, Morgantown or Martinsburg, the french fries at McDonald’s taste exactly the same,” Wright said. “… If you’re coming to a WVU Medicine facility, and you’re seeing an oncologist or a cardiologist, I want those oncology protocols … to be the same throughout the system. You may have to come to Morgantown for an initial surgery or some type of special imaging, but once we send you back home … we want to make sure those french fries are salted the same so that a patient receiving care or therapy here, you shouldn’t feel like you need to be in Morgantown because it’s the same level of care.”
WVU Medicine Wheeling Hospital’s role in the system
Once the deal is complete, Wheeling Hospital will be the third-largest hospital in the WVU Health network, behind Ruby and United Hospital in Bridgeport, West Virginia. It also will be the northernmost hospital in the WVU Health System.
For Harrison, building up Wheeling and investing in physicians and clinical care will help stop what he sees as the “outmigration” of care in this region.
“I’m a native West Virginian, and spent several years (in hospital administration) in Pittsburgh. The outmigration of care leaving the state of West Virginia, taking our Medicaid dollars and spending them in Pennsylvania and Ohio, has got to stop. Thus the reason for building a true academic center in Morgantown where we can keep our local dollars in our state,” he said. “In order to do that you’ve got to get people to feel comfortable that they can receive the same level of care — that there’s not a need to go to Cleveland, not a need to go to Columbus. Building up the network, keeping that care at the state level, it’s going to increase jobs, increase physician capabilities and services and make us all better.”
For Wright, Wheeling’s role also will be to serve as the tertiary hub for the Northern Panhandle. “There are folks in Ruby that don’t need to be in Ruby. Ruby needs to be true tertiary, high-level, very sick patient care. We want Ruby to focus on people who are really sick and need to be there.
“The Wetzels, the Reynolds, the Barnesvilles, you’d rather they send patients to Wheeling if they’re not able to remain local. Wheeling would be the tertiary hub and then move to Morgantown if need be. This is the place for this part of the state where you try to keep as many folks here as possible.”
For that to work, Wheeling Hospital will need the right mix of physicians and clinicians. Wright said Harrison has done a stellar job in recruiting doctors to the area.
“If you just look at the year we’ve been working here, Doug’s done a great job … bringing in physicians from all around the country. We just hired a cardiac surgeon from Iowa, a new cardiology head from Pittsburgh, a new neurosurgical leader from Toledo … we’re bringing great doctors in,” he said.
What the future will hold
For Harrison, the boots-on-the-ground leader of Wheeling Hospital, future success will come once this deal is done and, just as important, when the community is ready to move past the issues surrounding former diocesan bishop Michael Bransfield and the Department of Justice lawsuit.
“We’ve got to stop living in the past and talk about the brighter day, what it’s going to look like moving forward. This is going to be so good for this region and this community. … Let’s talk about the future,” he said following a question concerning Bransfield and former Wheeling Hospital administrator Ron Violi.
Part of the new future of Wheeling Hospital will be an increased focus on what services are offered at the main campus, and what outpatient services can be relocated to areas such as downtown Wheeling. Not only will this help with the growth of Wheeling, but it also will alleviate some of the parking crunch that currently exists at Medical Park.
“This campus really needs to be focused on in-person surgical based services, and move as much outpatient as we can off. … My hope and intent is that if we can move enough off this campus outpatient-wise, maybe we can put off building a parking garage for another five years or so. But as we bring more services here, and the inpatient and surgical volume grows, we’re going to have to add more operating rooms and possibly down the road add additional beds,” Harrison said.
For Brennan, he said his work moving forward also will include explaining the deal to the faithful in the church.
“I will try to make clear to them that this truly is not a loss,” he said of the hospital. “We still have the property and the buildings, and we’re leasing them to some folks who have been doing a really good job for us the last year. We have confidence in the agreements we’re making to continue maintaining the full Catholic identity, and to offer better services than if we were just standing alone. … we’ll work through that as it comes up.”