STATE SHORTHAND REPORTING SERVICE, INC.

Transcription

1 1 1 NEW JERSEY STATE HEALTH PLANNING BOARD 2 CENTENARY COLLEGE 3 LACKLAND CENTER, SITNIK THEATRE 4 HACKETTSTOWN, NEW JERSEY 5 6 JUNE 30, :00 PM THE PUBLIC HEARING OF: 10 THE APPLICATION FOR 11 CERTIFICATE OF NEED 12 FOR ATLANTIC HEALTH SYSTEMS 13 TO ACQUIRE 14 HACKETTSTOWN REGIONAL MEDICAL CENTER B E F O R E: MICHAEL GROSS STATE SHORTHAND REPORTING, INC. 24 PO Box 227 Allenhurst, New Jersey

2 2 1 I N D E X 2 SPEAKER: PAGE 3 Mayor Timothy McDonough 7 4 Mayor Betty Schultheis 9 5 Mr. Jason Coe 11 6 Mr. James Travis 12 7 Dr. William Austin 14 8 Ms. Eva Turbiner 16 9 Ms. Anne Rooke Dr. William Neigher Mr. Gerald DiMaio Mr. Norman Worth Mayor Maria DiGiovanni Ms. Karen Kubert Dr. Frank Fowler Ms. Joanne Reilly Mr. Michael Lavery Mr. Charles Stackhouse Dr. Annirudh Khanna Dr. Glen Wainen

3 3 1 MR. GROSS: Good evening, ladies and 2 gentlemen, please take your seats. I would ask 3 that you kindly, if you have your cell phone, put 4 it on vibrate or silent mode, please, because 5 everything we're doing up here will be -- our 6 court stenographer will try to record the best we 7 could. 8 Good evening. My name is Mickey Gross. 9 I'm a member of the State Health Planning Board, 10 I'm also the chairman of the State Public Health 11 Council. And in full disclosure, the Director of 12 Department of Health in Middlesex County, and a 13 councilman in the City of South Amboy. I'm going 14 to try to move this as fast as we can. We're 15 going to have a five minute time limit. I 16 understand some folks are a little passionate, but 17 we got to try to move this thing and get you out 18 of here in two hours and get me back to South 19 Amboy before midnight, all right. So just relax, 20 we'll get through this, okay? 21 I have a little disclosure statement 22 that I'm required by law to read. So I'm going to 23 take care of that now, so just be patient. 24 This is a public hearing of the State 25 Health Planning Board in relation to Atlantic

4 4 1 Health Systems to acquire Hackettstown Regional 2 Medical Center. The Department deems the 3 application complete. And in accordance with the 4 requirements of law, the State Health Planning 5 Board is required to hold a public hearing on this 6 application within 30 days of this action. 7 Adequate notice of this hearing has been 8 published in accordance with the provisions of 9 N.J.S.A. 26:2H Notice was sent to the 10 Secretary of State, who posted this notice in a 11 public place. Copies of the hospital's 12 application are available for review at the 13 Hackettstown Free Public Library, the New Jersey 14 State Library in Trenton, and the Department of 15 Health. 16 Information gathered at this hearing 17 will be reviewed by the State Health Planning 18 Board. In addition to reviewing the application 19 from Atlantic Health System, the department staff 20 analysis, recommendations into a public hearing. 21 Although not all members of the State Health 22 Planning Board are present tonight, the community 23 public hearing is being transcribed and the 24 transcript, along with any written comments 25 submitted tonight, will be made available to all

5 5 1 board members along with transcript and written 2 submissions prior to the meeting to review this 3 application. 4 There will also be limited time 5 available at the next public meeting, okay, it's 6 very important that the State Health Planning 7 Board to hear from members of the public. At that 8 meeting, the applicant will present the 9 application and answer questions the board members 10 may have. 11 In the interest of making efficient use 12 of time for tonight's hearing, each speaker will 13 be limited to three minutes -- we'll up that a 14 little bit. If you have longer written comments 15 with you, please provide a copy to the board and 16 they will add it to the record. Anyone interested 17 in speaking should sign up on the speaker sheet at 18 the entrance to the auditorium, okay. I think 19 there's still a sheet out there, but I have the 20 first go around right here. 21 Anyone wants to submit written comments 22 after tonight's hearing is urged to do so. Such 23 comments must be submitted no later than July 7th, 24 right around the corner, should be addressed to 25 the State Health Planning Board in care of the

6 6 1 Department of Health. 2 For those of you unfamiliar with the 3 certificate of need process, the State Health 4 Planning Board will vote on a recommendation as to 5 the decision on this application, which will be 6 submitted to the Commissioner of Health. The 7 State Health Planning Board's hearing is part of 8 the certificate of need process. And your 9 comments will be considered as we review issues 10 related to health planning, hospital and related 11 healthcare services, and access to healthcare 12 services. Your comments are a very important part 13 of this process and will be considered along with 14 the materials submitted by this applicant. 15 The board can recommend approval of this 16 application, approval with conditions, and denial 17 of the application before it. The Commissioner 18 will make the final decision on this application 19 after the board makes its recommendation. 20 With no further ado, I'm going to go 21 right down the list and have you folks come up to 22 the microphone and speak. I would ask that you 23 clearly, clearly before you speak, please give 24 your name, if you'd like, your affiliation, okay, 25 so our transcriber will have a little record there

7 7 1 to go by. I'm going to be a little biased here 2 because I'm an elected official, so I know our 3 mayor is here. So is it Timothy McDonough, mayor, 4 are you here? 5 MR. McDONOUGH: I'm not the mayor of 6 Hackettstown, the mayor of Hackettstown is here. 7 MR. GROSS: Well, I got a Timothy -- 8 MR. McDONOUGH: Yeah, I'm the mayor of 9 Hope. 10 MR. GROSS: Welcome, sir, come on up. 11 All the elected officials, we'll get you 12 out of here. Because I know sometimes there's 13 three meetings a night. Thank you, sir. 14 MR. McDONOUGH: Thank you for that. My 15 name is Tim McDonough, I'm the mayor of Hope 16 Township, as well as a member of the Hackettstown 17 Regional Medical Center board. I also work for 18 the New York Jets, which as many of you may know 19 or may not know, Atlantic Health System is the 20 primary health provider for the Jets. So I have 21 seen the Atlantic Health System up close and 22 personal. On a number of occasions, probably more 23 than I would like to admit, my family has utilized 24 the services of the emergency department at the 25 Hackettstown Regional Medical Center. A family

8 8 1 member, recently a family member had major surgery 2 at the hospital. Each time, the care was 3 excellent. And this positive feeling about 4 Hackettstown Regional Medical Center, as a mayor, 5 I travel around the county and I can tell you the 6 positive feeling for this facility is growing 7 every year. 8 While the township that I come from, 9 Hope Township, is a small community in the 10 northwestern part of the state, our community is 11 part of the Hackettstown Regional Medical Center 12 service area, and I can say with certainty that 13 most of our residents, if not all of them, come to 14 Hackettstown Regional Medical Center for their 15 healthcare, while some of them may go up to 16 Newton, as well. 17 As a board member, I've become familiar 18 with the demands placed on hospitals as a result 19 of the ever changing reimbursement environment, 20 the need for electronic medical record systems and 21 more. And I see how our hospital is challenged 22 each year with decreasing reimbursements from 23 insurance companies and Medicare, yet pushed to do 24 the best they can in this environment. 25 It is clear to me that the Atlantic

9 9 1 Health System has grown and I see the benefits 2 that will be available to Hackettstown Regional 3 Medical Center and to the communities in the area. 4 Atlantic Health System has established itself as a 5 positive recent partnership with smaller 6 hospitals. And, again, I witness this up close. 7 The flagship, Morristown Medical Center, 8 provides specialized surgical services and 9 exceptional cardiac and oncology services, which 10 members of my family that live down in Morristown 11 and Essex county area have partaken of and all 12 very successful. 13 There is no doubt in my mind that the 14 transfer of ownership of the Hackettstown Regional 15 Medical Center to Atlantic Health System would 16 allow for even more health and wellness education 17 within the surrounding communities and further 18 increase the wellbeing and health status of our 19 residents in this part of the state. Thank you. 20 MR. GROSS: Thank you, mayor. Trying to 21 get our elected officials out of here, we have the 22 mayor of Allamuchy Township, mayor? Thanks for 23 coming out tonight. 24 MS. SCHULTHEIS: Hello, I'm Betty 25 Schultheis, mayor of Allamuchy Township, and

10 10 1 president of the board of directors of the Warren 2 County Regional Chamber of Commerce. 3 Allamuchy is a small community of square miles and we have 4,677 residents, we're 5 located just north of Hackettstown, many of our 6 residents have a Hackettstown mailing address. 7 And for many of them, HRMC is their preferred 8 hospital for emergency services, and also for 9 in-patient service. 10 Many of our residents supported the 11 bucket brigade, which was a grassroots effort that 12 raised the first funds used to build Hackettstown 13 Community Hospital. I've spoken to several of my 14 constituents and they are in favor of this merger 15 and very supportive of it. 16 As mayor, I actively work with other 17 communities to save money for our constituents 18 through shared services. And I think we see this 19 as a continuation of that, that through HRMC's 20 affiliation with Atlantic Healthcare, that we 21 might see expanded services and also perhaps lower 22 cost, which we think is very good. And so we're 23 highly in favor of it. 24 MR. GROSS: Thank you, mayor. Jason 25 Coe, president of Hackettstown.

11 11 1 MR. COE: Thank you. Jason Coe, 2 president of Hackettstown Regional Medical Center. 3 I'm also a trustee of Centenary College, member of 4 the Hackettstown Rotary Club, and a member of 5 Warren County Regional Chamber of Commerce Board 6 of Directors. 7 I came to Hackettstown as the chief 8 operating officer in 2003, as we began our largest 9 expansion. Over the last eleven years, I have 10 been part of a growing hospital organization, 11 focused on serving the needs of a service area 12 that covers over 100,000 people. I have witnessed 13 firsthand the caring and professionalism displayed 14 by our staff. 15 As hospital president, I am confronted 16 daily with the challenges to continue to increase 17 quality, reduce cost and improve patient 18 experience. I am proud of the results we have 19 achieved to date. We have received national 20 recognition for our quality scores as a Joint 21 Commission Top Performer, proven to be one of the 22 most financially stable hospitals in New Jersey, 23 according to New Jersey Hospital Association FAST 24 report and won awards for patient satisfaction in 25 areas such as same day surgery, obstetrics and

12 12 1 out-patient radiology. 2 Today, in the health reform environment, 3 the challenges are even greater. By affiliating 4 with Atlantic Health System, a system within the 5 same geographic area, HRMC will be better 6 positioned to deliver integrated healthcare and 7 population-based medicine to the community. HRMC 8 will have access to local resources and expertise 9 which will result in added benefits to the 10 communities we serve. 11 Healthcare is changing and we must 12 change to meet the need the added responsibility 13 we have as healthcare providers, not just 14 sick-care providers. The bottom line is this - we 15 at HRMC want to provide accessible, high quality 16 healthcare to our patients and provide them with 17 the best possible experience they can have to 18 achieve an optimal quality of life. 19 It is for these reasons and more that I 20 strongly support this affiliation with Atlantic 21 Health System. Thank you. 22 MR. GROSS: Thank you. Mr. James 23 Travis? Mr. Travis? 24 MR. TRAVIS: James Travis, I'm with 25 SASCO Insurance in Hackettstown, and current

13 13 1 member of the Hackettstown Regional Medical Center 2 Board of Directors. 3 In my business, we broker insurance 4 plans for many small and medium-sized businesses. 5 As a result of the Affordable Care Act, employers 6 who once had health insurance plans that they were 7 quite satisfied with, now are faced with the task 8 of finding new plans at higher costs. The health 9 insurance climate is changing as rapidly as 10 healthcare itself. And hospitals are continually 11 challenged to do more with less. 12 Just as employers are working to keep 13 employees healthier to reduce costs, hospitals are 14 changing their systems of care toward illness 15 prevention - a proactive rather than reactive 16 approach. 17 Hospitals must now find alternative ways 18 to reduce costs when providing inpatient care at 19 the same time incur increased costs to educate 20 patients and promote healthier lifestyles. 21 Just as the employers are finding ways 22 to group together to obtain better healthcare 23 plans, hospitals are looking toward affiliations 24 to increase access to care, foster healthier 25 community programs and develop delivery systems to

14 14 1 share in these costs. The Affordable Care Act not 2 only impacts employers, but also individuals in 3 our communities, who may no longer have health 4 insurance plans in place. I believe affiliating 5 with a well-respected, local health system is 6 necessary to meet all the many challenges I just 7 named. 8 Therefore, I support the transfer of 9 ownership of Hackettstown Regional Medical Center 10 to Atlantic Health System. Thank you. 11 MR. GROSS: Thank you, sir. Mr. William 12 Austin? 13 DR. AUSTIN: Good evening. My name is 14 Dr. William Austin, I'm president of Warren County 15 Community College, I've honorably served there for 16 over ten years. And I'm a past member of the 17 Hackettstown Regional Medical Center Board of 18 Directors. 19 For several years, the Warren County 20 Community College nursing students have received 21 valuable hands-on clinical education as a result 22 of their partnership with Hackettstown Regional 23 Medical Center. And I think it's safe to say that 24 the quality and strength of our program is 25 directly related to the quality and strength of

15 15 1 this hospital. In the mid-2000's, we began a 2 cooperative effort with Hackettstown Regional 3 Medical Center, with the conceptualization of a 4 health education center built directly on the 5 hospital campus, which would function as a branch 6 of Warren County Community College. From my 7 perspective, an affiliation between HRMC and 8 Atlantic Health System would provide more 9 opportunities for students to learn an even 10 broader variety and depth of clinical skills and 11 strength in the partnership we had with the 12 hospital. 13 I see this as a win-win for the future 14 of the hospital. They will be a member of a New 15 Jersey-based health system known for providing 16 quality care, offering excellent services and 17 cooperating with a number of organizations to 18 improve the health status of the community. 19 Professionally, as president of the 20 college, I endorse the transfer of ownership of 21 HRMC to Atlantic Health System. And I know it 22 will be very beneficial to the hospital and the 23 communities it serves. 24 Now, speaking as a private citizen, 25 before entering the public sector, I was in the

16 16 1 private sector with a business I owned in terms of 2 geo-demographic research, done for hospitals 3 mainly in Pennsylvania, such as Geisinger Health 4 System, in mergers and acquisitions of hospitals. 5 Having lived here for ten years and knowing this 6 community, its demographics, its geography well, I 7 couldn't more -- as a professional from that walk 8 of my life -- more highly endorse this partnership 9 and this transfer of ownership. It will be very 10 beneficial to the residents who live here. It 11 will be very essential to the growing elder 12 population we have in this county. And it will 13 strengthen both the hospitals in this community. 14 And I couldn't be more strongly in favor of this 15 partnership. 16 MR. GROSS: Thank you, sir. Forgive if 17 I have -- is it Eve Turbine -- I apologize if I'm 18 hacking the name here. Good evening, ma'am, how 19 you doing? 20 MS. TURBINER: I'm good, thank you. 21 Good evening. I'm Eva Turbiner, I'm the president 22 and chief executive officer of Zufall Health 23 Center. We are a federally qualified health 24 center with eight office and a mobile medical van, 25 serving six counties in Northwest New Jersey. In

17 , our health center served almost 21,000 2 patients with 70,000 visits for primary medical, 3 dental, and supportive services. Our patients are 4 among the most vulnerable and medically 5 underserved in the region. More than 65 percent 6 are uninsured, 90 percent have incomes under percent of the federal poverty level, and more 8 than half need services in a language other than 9 English. We are the family doctor for the 10 underserved. 11 Zufall has sites offering adult and 12 pediatric primary car in both Morris and Warren 13 Counties. As a result, we work very closely with 14 Hackettstown Regional Medical Center and 15 Morristown Medical Center and we accept referrals 16 from their emergency departments and discharge 17 planners for individuals who do not have a primary 18 care provider. However, Zufall does not provide 19 specialty services and we see a lack of specialty 20 and surgical services for the low income, 21 predominantly, minority population in the region 22 as a major contributor to disparate health 23 outcomes. 24 We look to our partner hospitals to 25 provide services that, as a primary care provider,

18 18 1 we are unable to offer. In Morris County, we have 2 actively worked with Atlantic Health to provide at 3 least limited access to specialty and surgical 4 services for Zufall's patients, but appointments 5 there are in short supply and waits are long. In 6 Warren County, there is currently virtually no 7 access to special and surgical services with the 8 exception of prenatal and substance abuse. 9 It is clear that Atlantic Health's 10 existing specialty network cannot accommodate the 11 low income patients of HRMC's service area. 12 However, with this affiliation between HRMC and 13 Atlantic Health System, we see an invaluable to 14 expand services within the Hackettstown community 15 and provide care to individuals who do not have 16 access to the transportation necessary to travel 17 for needed services. As a result, we are 18 supportive of the merger. 19 MR. GROSS: Thank you. 20 MS. TURBINER: Thank you. 21 MR. GROSS: Anne Rooke, welcome. 22 MS. ROOKE: Hello, my name is Anne 23 Rooke, that's R-O-O-K-E. Thank you for the 24 opportunity to speak tonight and express why I 25 feel the partnership between Atlantic Health and

19 19 1 Hackettstown Regional Medical Center would be 2 beneficial to both Morris and Warren County 3 communities. I am vice chair of the Board of 4 Trustees for Atlantic Health, I'm a nurse with an 5 advanced degree in nursing, my master's degree in 6 nursing. 7 My father is a retired general surgeon; 8 my mother was an operating room nurse and a great 9 volunteer for the local community where I grew up. 10 The importance of giving back to our local 11 hospital was instilled in me at a very early age. 12 Since I moved to Morris Township in 1982, I've 13 directed most of my volunteer efforts to 14 Morristown Medical Center. It is with great with 15 pride that I am associated with Atlantic Health 16 which became the parent organization for 17 Morristown and Overlook Hospitals in 1996, Newton 18 Medical Center was added in 2011, and most 19 recently Chilton in 2014 was added -- joined 20 Atlantic Health System. During my tenure as a 21 hospital trustee, I want to ensure that all of our 22 hospitals will continue to serve their local 23 communities and have access to the best clinical 24 care. 25 As it becomes more difficult for local

20 20 1 community hospitals to remain independent, the 2 Board of Trustees has been exploring the 3 possibility of partnering with other hospitals. 4 The main reason for this was to ensure our 5 financial viability and to better our hospital. 6 As reimbursements are reduced and fewer patients 7 need to be admitted, we needed a way to flourish. 8 We needed targeted sustainable growth during times 9 of pressing resource constraints. However, we 10 have a reputation to uphold. And while we 11 conducted our search, we had certain criteria and 12 standards that had to be met. These included a 13 medical center that shared our vision, mission, 14 and values. More specifically, it had to be a 15 hospital that placed an emphasis on exceptional 16 care and services. Hackettstown Regional Medical 17 Center has a service area that covers over 100, lives. When we considered HRMC, there was much 19 similarity in our values. It was a shared 20 synergy. We knew this would be a vital component 21 to the integration of our system. 22 Another factor we considered was how 23 well we could work together. We are fortunate to 24 have a working relationship with Hackettstown 25 since HRMC has its own transportation

21 21 1 company, but when their service is unavailable, 2 they have outsourced the trip to Atlantic 3 Ambulance. 4 As a community hospital, HRMC does not 5 provide certain services. Transferring patients 6 to Atlantic Health has been something that they've 7 done for many years, through the coordination 8 services of Atlantic's Patient Transfer Center. 9 They make all the arrangements for all types of 10 patients, trauma, surgery, pediatric, neurologic, 11 and cardiac. Since 2011, nearly 1,100 patients 12 have been transferred to Morristown and Overlook 13 Medical Center. More than half of the transfers 14 were for cardiac care at the Gagnon Cardiovascular 15 Institute at Morristown Medical Center. And over 16 one hundred children have been transferred to the 17 Goryeb Children's Hospital, also part of the 18 Morristown Medical Center. 19 So based on our working relationship in 20 the past, the Board of Trustees in Atlantic Health 21 is confident that partnership will be successful. 22 Thank you for the time and opportunity 23 to speak. I trust that you, too, will see the 24 partnership between these two institutions will 25 strengthen and expand access to the best clinical

22 22 1 care for our communities while maximizing cost 2 efficiencies. Thank you. 3 MR. GROSS: Thank you. William Neigher. 4 DR. NEIGHER: Very close. I'm Dr. 5 William Neigher, N-E-I-G-H-E-R, and I'm chief 6 strategy officer and vice president for system 7 development at the Atlantic Health System. On 8 behalf of the senior management, thank you for the 9 opportunity to express why we are in support of 10 this is merger. 11 On a personal note, as a psychologist 12 and as the AHS officer responsible for mission 13 development and community health, I want to help 14 ensure that all patients have access to care, that 15 they receive quality services, and that it is 16 affordable. In fact, it is the very first element 17 of our mission statement, deliver high quality, 18 safe, affordable patient care within a healing 19 culture. 20 As you know, it's become much more 21 difficult for community hospitals to remain 22 financially viable unless they join or affiliate 23 with a hospital system, which is why 70 percent of 24 New Jersey's hospitals have become part of a 25 multi-system. Our trustee representative, Anne

23 23 1 Rooke, just gave you several reasons why we feel 2 this merger is good for our communities and both 3 institutions. Here are three more: 4 Improving access to care. By joining 5 the Atlantic Health System, Hackettstown Regional 6 Medical Center will be included in a patient 7 focused care continuum, from hospital bed to home, 8 emphasizing health promotion and illness 9 prevention as the essential principles of healing 10 and wellbeing. 11 Value based purchasing. All payers, 12 including the federal government's CMS, and 13 commercial carriers, have begun to select and pay 14 providers based on value, defined as quality over 15 cost. On the quality side of the equation, for 16 example, Morristown Medical Center's mortality 17 rates continue to decrease each year, and its 18 infection markers are lower across all sources 19 than national academic benchmarks, according to 20 MedMined. Equally important is controlling costs, 21 and through the merger, our combined organizations 22 can leverage strategic sourcing options to reduce 23 our supply and pharmaceutical expenses. 24 Finally, community benefit. Based on 25 the most recent available data, AHS contributed

24 24 1 over 103 million dollars in community benefit to 2 the communities in northern New Jersey. This 3 included charity care, subsidized health services, 4 uncompensated Medicaid services, community health 5 activities, and financial contributions to our 6 communities. Community health activities, 7 combined with HRMC's initiative, we can focus our 8 joint contributions on population-based 9 healthcare, improving the health status of the 10 communities we serve for generations to come. 11 The intent of pursuing the merger is to 12 increase clinical collaboration and expand 13 programs to better meet the healthcare needs of 14 all residents in Morris and Warren Counties. This 15 merger will strengthen Hackettstown's capabilities 16 and ability to provide care in the current and 17 future health care environment. 18 In closing, we want to thank my 19 colleague, John Calabria, and the staff of the 20 Department of Health for their support and 21 direction as we have moved through this 22 certificate of need process. Thank you. 23 MR. GROSS: Thank you, sir. Gerald 24 DiMaio. 25 MR. DiMAIO: Good evening. My name is

25 25 1 Gerald DiMaio, senior. And I was born and raised 2 in Hackettstown and come from a very large family, 3 since then, many have passed away. However, in 4 addition to my son and daughter and grandchildren, 5 there are many nieces and nephews who still live 6 in the area. 7 And over the years, I have served 8 Hackettstown in different areas, as a member of 9 the Hackettstown Board of Education for over years, served as president for twelve years. I've 11 been on the Hackettstown Planning Board for over years, I've been president for quite a bit of 13 time on that planning board. 14 And also, when I worked, I was the 15 president of DiMaio Brothers, Incorporated, our 16 construction business, for over 45 years with my 17 brothers Al, Sam, and Andrew. 18 In 2012, I was inducted in the 19 Hackettstown area senior hall of fame. This is a 20 program started by HRMC in 1999 to recognize 21 seniors, 60 years of age or older that make 22 volunteer contributions to the Hackettstown area. 23 Each year, ten or twelve deserving seniors are 24 recognized for their exceptional volunteerism. It 25 is yet another way of many that Hackettstown

26 26 1 Regional Medical Center reaches out to the 2 community and in a positive manner. 3 I remember firsthand how hard many area 4 residents fought decades ago to, along the highway 5 they had the buckets out, and collecting money to 6 raise funds to bring this hospital to 7 Hackettstown, to our community. And over the 8 years, that hospital has never disappointed us. 9 Personally, I've been a patient in the hospital 10 for many, many times, beginning in 1981, then all 11 the way through 2011, I was there seven times. My 12 brothers were there, my two sisters were there. 13 In fact, many of my family was there. And I know 14 they'll say the same that I say, they can tell you 15 firsthand quality of care at Hackettstown 16 Community Hospital, Regional Hospital, that care 17 is tops. They make you feel that you're in good 18 hands. 19 In fact, personally -- I recall times 20 when people came by the hospital, they would stop 21 at your bed, make sure you were all right, the 22 food was warm enough. In fact, one time, I was 23 getting some tests and I didn't get back until 24 1:30. The lady came and saw me and said you got 25 to keep that warm, heat that food up for him, he

27 27 1 can t eat that cold food. 2 The reason why when they come around 3 and see you, it's a nice feeling when you're 4 laying in the hospital bed to have the personal 5 feeling like that. 6 So based on everything that I know, 7 everything I read, I see the prospect of transfer 8 of ownership of Hackettstown Regional Medical 9 Center to Atlantic Health System as a true benefit 10 to us, a true benefit. And I strongly support 11 this as I view it as a way to ensure HRMC will 12 continue to meet the healthcare needs of our 13 community and the surrounding areas for many, many 14 years to come. I respectfully ask that you 15 approve the requested change in ownership. I 16 thank you for this opportunity. 17 MR. GROSS: Thank you, Mr. DiMaio. 18 Thank you for all your years of volunteerism up 19 here in the area MR. DiMAIO: Thank you. I learned a lot 21 myself. Thank you for that. 22 MR. GROSS: Thank you, sir. Norman 23 Worth, Mr. Worth? 24 MR. WORTH: Good evening, sir. My name 25 is Norman Worth, I'm the president and general

28 28 1 manager of the WRNJ Radio, and a longtime member 2 of Hackettstown Regional Medical Center and HRMC 3 foundation boards. 4 As a board member, I've chaired HRMC 5 Professional Practice and Strategic Planning 6 Committees and have been an active member of the 7 Foundation Golf Classic Committee for as long as I 8 can recall. I currently serve on the Centenary 9 College Board of Trustees and am an active member 10 of other area clubs and organizations. 11 In my profession, I meet many people 12 from all walks of life, who may have received many of whom have received healthcare from HRMC, 14 Newton Medical Center and Morristown Medical 15 Center. Over the years as the board member, I've 16 visited HRMC patients to determine the -- learn 17 directly about the quality of care they were 18 getting. Rarely would I hear an unkind word. And 19 far more often than not, patients would go on at 20 length about the staffs' competence and 21 compassion. 22 I've lived in this community since 1977, 23 and I've seen the growth of HRMC from a small 24 local hospital with stylish turquoise front panels 25 to an expansive medical center that has not only

29 29 1 grown in terms of the size of the facility, but 2 also in the range of services being offered. All 3 by caring staff who never allows an elderly 4 patient without family be alone near the end of 5 their life. 6 Over the years, I've seen growth of 7 HRMC's Center for Healthier Living. In the 8 beginning, only a few screening, programs and 9 vaccination initiatives were offered. And now, 10 there are multitude of choices, including 11 corporate health programs, special programs for 12 seniors, childcare education classes, outreach 13 services, health fairs, flu clinics, and a full 14 slate of CPR classes for all ages and abilities. 15 How fitting it is that Atlantic Health System's 16 vision statement is, quote, empowering our 17 communities to be the healthiest in the nation, 18 end quote. 19 I have no doubt that Atlantic Health 20 System can support and fortify HRMC in the 21 continued mission of healing and leading the way 22 to a healthier community. 23 MR. GROSS: Thank you, sir. 24 Mayor, I hope I didn't miss you before 25 when I was doing elected officials, but Maria

30 30 1 DiGiovanni, mayor of Hackettstown. Welcome, 2 mayor. Did I miss you before? I certainly 3 apologize. 4 MS. DiGIOVANNI: You're forgiven because 5 you got the name right. 6 MR. GROSS: So I get points for that? 7 MS. DiGIOVANNI: Absolutely. 8 MR. GROSS: Again, I apologize. 9 MS. DiGIOVANNI: That's okay. 10 MR. GROSS: Try to get the elected 11 officials out. I know what it's like. Welcome, 12 Mayor. 13 MS. DiGIOVANNI: Thank you. Good 14 evening. I'm Maria DiGiovanni, mayor of 15 Hackettstown and president of the Hackettstown 16 Regional Medical Center Foundation Board of 17 Directors. 18 Healthcare needs are evolving and 19 changing everywhere, and Hackettstown is certainly 20 no exception. HRMC is meeting many of the 21 healthcare needs of our community -- from the 22 emergency department to out-patient services to 23 many wellness and education programs offered in 24 the community -- but there's more potential for 25 expanded services to enhance the accessibility to

31 31 1 quality healthcare and improve the overall patient 2 experience. 3 As president of the Foundation Board and 4 a member of the HRMC Board of Directors, I'm well 5 aware of the many challenges that all hospitals 6 now face as a result the Affordable Care Act. 7 Hospitals are expected to deliver high quality 8 care at lower costs. It is for these reasons that 9 I fully support HRMC's affiliation with Atlantic 10 Health System. 11 HRMC was conceived and founded by 12 members of this community, beginning with a wish 13 for healthcare closer to home back in the 1940s. 14 The Seventh-day Adventist church stepped forward 15 decades ago to help fund this dream and since then 16 Adventist Healthcare has provided a number of 17 benefits for HRMC and patients in this region. 18 As healthcare has evolved in recent 19 years, I believe that a strong partnership with a 20 reputable system in our own state would enable 21 HRMC to offer even more benefits and services for 22 our patients. This affiliation would benefit 23 HRMC's medical staff by giving them access to 24 advanced practices and a broader network of 25 medical staff professionals.

32 32 1 In summary, it is critical that HRMC 2 keeps pace with all the changes that are happening 3 within healthcare reform. And I believe that HRMC 4 will be better able to keep up with this pace 5 because of the many advantages an affiliation with 6 Atlantic Health System would offer. Thank you, 7 sir. 8 MR. GROSS: Thank you, mayor, and I 9 apologize to you. Kevin Kubert? Karen, I 10 apologize. 11 MS. KUBERT: You pronounced my name 12 correctly. 13 MR. GROSS: I apologize for that. 14 MS. KUBERT: No, no, you did very well, 15 thank you. 16 MR. GROSS: Thank you. 17 MS. KUBERT: My name is Karen Kubert, 18 I'm the Director of Community Services for Warren 19 County and also the County of Chester. But I'm 20 here today to represent the Warren County Board of 21 Chosen Freeholders. And they have already sent a 22 letter to the Commissioner back in February, but 23 Freeholder Director, Ed Smith, felt it was so 24 important, that we read this letter into the 25 record, so I will do that.

33 33 1 Dear Commissioner O'Dowd, 2 I have the Warren County Freeholder 3 Board assignment to oversee matters that impact 4 health and human services in the County of Warren. 5 I have researched the services that will be 6 provided subsequent to the transfer of ownership 7 of Hackettstown Regional Medical Center from 8 Adventist Healthcare to Atlantic Health System, 9 and see that the change will enhance the 10 capabilities of the facility. 11 I am particularly impressed with the 12 expanded access to the clinical expertise of the 13 Regional Trauma Center. The stronger network for 14 pediatrics, emergency care, and cardiac treatment 15 will also provide significant ongoing benefits to 16 the citizens of Warren County. 17 I am pleased to offer this letter of 18 support for the Certificate of Need application to 19 help facilitate a seamless transition to a new 20 "non-profit" ownership of this fine medical 21 facility that so many Warren County residents rely 22 upon. Thank you very much for your time. 23 MR. GROSS: Thank you, Ma'am. Mr. Frank 24 Fowler. 25 DR. FOWLER: Good evening.

34 34 1 MR. GROSS: Reverend, I'm sorry. 2 DR. FOWLER: My name is Frank Fowler, 3 senior pastor of Trinity United Methodist Church 4 in Hackettstown. Trinity has a large active 5 congregation of over 1,800 parishioners. 6 I, along with other members of our 7 clergy team frequently visit patients at both 8 Hackettstown Regional and in Morristown Medical 9 Centers. Some are admitted directly to Morristown 10 Medical, while other patients start their medical 11 journey in HRMC and have been transferred to 12 Morristown Medical Center. 13 The proposed transfer of ownership of 14 HRMC to Atlantic Health System will, from my 15 perspective, provide increased access to 16 specialists and services that could be provided 17 closer to home rather than traveling to 18 Morristown. 19 In my experience both as a pastor and in 20 my contact with patients at hospitals, I've 21 observed how similar the missions of Atlantic 22 Health System and HRMC are. They both focus on 23 delivering high quality, safe, affordable patient 24 care within a healing culture. And for these and 25 many other reasons, I enthusiastically support the

35 35 1 proposed transaction. Thank you. 2 MR. GROSS: Thank you. Reverend. We 3 have a Irish name here finally. Joanne Reilly. I 4 wasn't going to screw that pronunciation up, I 5 promise. 6 MS. REILLY: That's fine. I'm Joanne 7 Reilly, I am a concerned resident. First of all, 8 this a public hearing and I wanted to know why the 9 public has not been notified? Do you have any 10 idea? 11 MR. GROSS: Ma'am, the best I can tell 12 you is that the Commissioner of Health's office 13 met all the requirements that are required by law 14 as far as advertising and all that. And I would 15 certainly say that if you're questioning that, the 16 best answer would be to call the Commissioner's 17 office on that. 18 MS. REILLY: Okay, I will. 19 MR. GROSS: In all fairness. 20 MS. REILLY: The other thing is my 21 concern is I have been a patient at the hospital 22 for many years. And just like everyone else has 23 said, the service, my care has been wonderful. 24 Except, I was there just the last few 25 days as a patient. And that's how I found out

36 36 1 about this meeting. Someone came to me and told 2 me about the meeting and said they need help to 3 tell the people what the problems are within the 4 hospital. 5 My concern is that we are -- 6 Hackettstown Regional Memorial Hospital is a 7 community hospital. It's been an excellent 8 hospital, but today with the conglomeration of 9 Atlantic Health, I'm afraid it's going to be lost 10 in the shuffle. Now, I hear everybody saying how 11 wonderful it's going to be, but what I noticed 12 just in the last few days is the quality of the 13 care has went down. They have a lot of young 14 people right out of high school doing things. 15 Now, I have written all the things that 16 have happened to me just in the last few days for 17 you to take a look and take it back. 18 MR. GROSS: Is that a letter you'd like 19 to see put into the record? 20 MS. REILLY: Yes, it could be put in the 21 record. Thank you very much for your time. 22 MR. GROSS: Thank you, ma'am. Mike 23 Lavery. 24 MR. LAVERY: Good evening. I'm Mike 25 Lavery, I'm a practicing local attorney, partner

37 37 1 in a local law firm, former mayor of Hackettstown, 2 former president of the HRMC Foundation Board and 3 current member of the HRMC Board of Directors. 4 I've raised my family in Hackettstown, and with 5 four children, have utilized HRMC's emergency 6 department on numerous occasions. Also three of 7 my four children were born at HRMC. 8 Being a healthcare provider today is 9 very different than it was when the hospital first 10 opened its doors in You've heard from many 11 people here tonight, all expressing the many 12 positives of the proposed transaction. For HRMC 13 to be able to continue excellent service and 14 individualized care, HRMC needs to be part of a 15 well-respected, local healthcare system that 16 shares the same commitment to consistent, quality 17 care, and is forward thinking and proactive, 18 offering access to clinical trials, and advanced 19 outreach services to keep individuals healthy. 20 Atlantic is that system. Our seniors need support 21 services to be able to live independently and with 22 a high quality of life. 23 I see a shared commitment to healthier 24 communities by HRMC and Atlantic Health System and 25 believe that HRMC's affiliation with Atlantic

38 38 1 Health System will provide a seamless continuum of 2 care for our residents and allow access to world 3 class care and an optimal patient service, whether 4 it be at HRMC or any other hospital within the 5 Atlantic Health System family. Thank you. 6 MR. GROSS: Thank you, sir. Charles 7 Stackhouse. Mr. Stackhouse? Good evening, sir. 8 MR. STACKHOUSE: Good evening. My name 9 is Charles Stackhouse. After 45 years as a 10 clinician and administrator at Greystone Park 11 Psychiatric Hospital, I now proudly serve as a 12 volunteer at Hackettstown Regional Medical Center. 13 Every Monday afternoon, you will find me at the 14 information desk in the front lobby of HRMC. 15 I am not only a volunteer, I am also a 16 grateful patient of HRMC, as was my dear late wife 17 Eppie, who lost her brave battle with cancer in Both Eppie and I have experienced high 19 quality care at both HRMC and Morristown Medical 20 Center, and I can see where well coordinated 21 collaboration happens regularly. I love HRMC 22 because it is small enough that people know your 23 name, while also large enough to offer great care 24 and having the resources necessary to send you to 25 a higher level facility when you need services

39 39 1 beyond their scope. I support HRMC's affiliation 2 with Atlantic Health System. 3 It appears from everything I know about 4 Atlantic Health System that Atlantic has a broad 5 array of physician specialists that could assist 6 patients here without having to travel too far. 7 When my wife needed radiation treatments, we 8 initially went to Morristown. When additional 9 radiation was needed, as well as chemotherapy, we 10 stayed in Hackettstown with her oncologist, and 11 had radiation treatments at HRMC's Joan Knechel 12 Cancer Center. We didn't have to travel any 13 distance for quality care. And for that, we were 14 grateful in every way. 15 When Eppie was near the end of her life, 16 everyone went above and beyond to make her 17 comfortable and very well cared for. I must add, 18 for me, as well. From lovingly making her custom 19 grilled cheese sandwiches Eppie's way, to being 20 there for me every step of the way, it was all 21 given from the heart, for which we were profoundly 22 grateful. 23 In the final week of her life, I had the 24 difficult task of telling Eppie that there was 25 nothing more that could be done to address her

40 40 1 cancer and that we would face her death together. 2 I will never forget the encouragement I received 3 from one of the nurses at HRMC. The nurse spent 4 an hour with me offering me comfort and strength 5 so that I could face the difficult task of telling 6 Eppie the disappointing news and help her accept 7 that nothing more could be done. 8 It was from the eight year battle, which 9 unfortunately Eppie didn't win, that I learned and 10 experienced what true compassion and caring meant. 11 For this is what we received from all the staff at 12 HRMC. As a result, and with additional training, 13 I now serve as a bereavement counselor and 14 volunteer with hospice patients, as well as 15 serving as a volunteer at HRMC. 16 I'm certain that everything possibly 17 will be done to maintain the family atmosphere at 18 HRMC. And I look forward to seeing the hospital 19 grow and thrive with Atlantic Health System as a 20 partner, offering even more services and benefit 21 to patients in this region. Thank you. 22 MR. GROSS: Thank you, Mr. Stackhouse. 23 You're a very special person. Your hours of 24 volunteerism is certainly something we should all 25 thank. Thank you.

41 41 1 MR. STACKHOUSE: Thank you. 2 MR. GROSS: I m going to get in trouble 3 with this name and I guarantee this guy has to be 4 a doctor. Annirudh Khanna K-H -- 5 DR. KHANNA: Not even close. 6 MR. GROSS: I want to know if you're a 7 doctor or not, I apologize. 8 DR. KHANNA: Don't worry about it. Hi, 9 I'm Dr. Annirudh Khanna. 10 MR. GROSS: Doctor? 11 DR. KHANNA: That's right. 12 MR. GROSS: Figured that one out. 13 DR. KHANNA: I'm a board certified 14 interventional cardiologist. I practice both at 15 Hackettstown Regional Medical Center as well as 16 Morristown Medical Center. 17 At the present time, all my cardiac 18 catheterization procedures are done at Morristown 19 Medical Center in the cardiac catheterization lab. 20 My private practice is located in Hackettstown, 21 where I've been in practice for 14 years. Through 22 this transfer of ownership of HRMC to Atlantic 23 Health System, I see positive opportunities, 24 particularly for cardiac patients, those newly 25 diagnosed, as well as patients with chronic

42 42 1 congestive heart failure, as well as heart 2 disease. 3 A couple years ago, HRMC started a 4 program to prevent readmissions of patients with 5 congestive heart failure. The program has evolved 6 into a new support group called Healthy Hearts. 7 The goal of the program is to educate not only CHF 8 patients, but those with high blood pressure, 9 coronary artery disease and other cardiac 10 diseases. My patients appreciate how the 11 cardiopulmonary staff know them by name, know 12 about their families and truly cares about their 13 healthcare and wellbeing. 14 Through this affiliation with Atlantic, 15 I will have the opportunity to offer a larger 16 selection of support and surgical services to help 17 patients in our community improve their quality of 18 life. I see the partnership with Atlantic Health 19 System as helping all physicians to greatly expand 20 services we currently provide. 21 Personally, I enjoy the opportunity to 22 meet with and learn from the very dedicated 23 colleagues within Atlantic Health System who are 24 involved in clinical trials and advanced medical 25 and surgical care. Morristown Memorial Center is

43 43 1 recognized as one of the top cardiac hospitals in 2 the country. For HRMC to be affiliated with an 3 institution with a reputation like this will not 4 only benefit my patients, but all patients in the 5 region by providing high quality, accessible 6 healthcare that will inevitably lead to a 7 healthier community. Thank you. 8 MR. GROSS: Thank you, Doctor. Glen 9 Wainer? Is that correct? Good evening, sir. 10 DR. WAINEN: Hi, I'm Dr. Glen Wainen, 11 I'm a board certified orthopedic surgeon. I'm a 12 three time chairman of the Department of Surgery 13 at Hackettstown Medical Center and presently two 14 term president of the medical staff at 15 Hackettstown Regional Medical Center. I'm also on 16 staff at Morristown Medical Center and I was on 17 staff at Newton, when Atlantic Health took over. 18 And I've seen, firsthand, the specialized clinical 19 services that could be made available to our 20 residents closer to home. 21 I also see the opportunities for 22 physician education and development within a 23 larger network of colleagues. The recent changes 24 in healthcare are really such that it's 25 interesting that -- very challenging for single

44 44 1 practitioners to stay in private practice without 2 becoming a member of a group. And it s also true 3 of community hospitals. 4 Being part of a system located within 5 the State of New Jersey is becoming more and more 6 important to the future of healthcare services at 7 Hackettstown Regional Medical Center. 8 I also see the potential for mutual 9 respect and recognition of what physicians at HRMC 10 could offer Atlantic Health and vice versa, 11 sharing of clinical information, peer to peer 12 collaboration are integral to the successful 13 management of the complex medical and surgical 14 cases. 15 So on behalf of the medical staff at 16 HRMC, we support the transfer of ownership of HRMC 17 to Atlantic Health. I personally look forward to 18 seeing all the benefits of this affiliation with 19 Atlantic Health and what we would be bringing to 20 the patients in this region. Thank you. 21 MR. GROSS: Thank you, Doctor. 22 Is there anyone else who would like to 23 speak or like to be heard that's present in the 24 room here? Is there anyone else? Okay, with 25 that, what I'm going to do is take a break here.

45 45 1 We are going to be, by law, here to eight o clock. 2 But I'll ask our stenographer to go off record, 3 we'll shut down for a little period of time here. 4 If there is some people that want to come up and 5 speak, please, by all means, I'll put the 6 clipboard over there. And we'll take a little 7 break, but we'll definitely be here to eight 8 o'clock. All right. Thank you, everyone (Whereupon a short recess was taken.) MR. GROSS: It is eight o'clock. And at 13 this point, we will be closing testimony for 14 Atlantic Health Region acquisition of the 15 Hackettstown Hospital. Everyone who was present 16 who signed up to speak or wanted to speak was 17 given the opportunity to speak. It's eight 18 o'clock. At this point, I am officially closing 19 the meeting. Thank you. Everyone, have a safe 20 trip home (Whereupon the matter was concluded.)

46 46 1 C E R T I F I C A T E I HEREBY CERTIFY that the foregoing is a 7 true and accurate transcript of the testimony and 8 proceedings as taken stenographically by me at the 9 time, place, and on the date hereinbefore set 10 forth C:\TINYTRAN\Susan Bischoff.bmp SUSAN BISCHOFF, CCR, RPR LICENSE NO. 30XI Dated: July 3,