Karim Aquil Sharif has been a patient at every hospital in Newark. He knows all the emergency room doctors.
“I used to know them all on a first name basis,” Sharif said. “And all the ambulance drivers because that’s how often I would go to the hospital, like every other day I was a patient at a hospital.”
At one point Sharif weighed 460 pounds.
Saint Michael’s Medical Center, which serves about 150,000 patients a year, was the only hospital in and near the city that approved him for bariatric surgery. The rest either don’t offer the procedure or don’t accept Medicaid.
“They all turned me away," Sharif said. "They wouldn’t even let me come to the seminar because I didn’t have the correct insurance."
But the 150-year-old Catholic hospital is about $230 million in debt and struggling to retain staff and stay open. It put itself up for sale more than two years ago. There’s a willing buyer and a seller, but the state hasn’t approved the deal yet.
"We've found that the regulatory process in New Jersey can drag on a bit much compared to other states," said Fred Ortega with Prime Healthcare Services, a for-profit hospital chain out of California which takes over distressed hospitals.
Prime offered the highest bid for Saint Michael's — $50 million. New Jersey taxpayers could be on the line for the rest of the debt.
Prime has agreed to keep the hospital open, as is, for at least 5 years, to keep the 1,400 jobs and maintain the level of existing charity care. But the mayor of Newark and advocacy groups worry Prime will drive up costs and shut down after the agreement.
Prime said it won’t.
“Since the company was founded in 2001, we’ve never closed or sold a hospital. That’s not what we do,” Ortega said. “Our job is to build hospitals up and maintain them as the community institutions they have been in the areas that they serve.”
But India Hayes Larrier, a healthcare organizer with New Jersey Citizen Action wants those promises outlined in the contract.
“To me if it’s not in writing it’s your word, which I don’t trust,” Hayes Larrier said. “They have been in the past known to cut services, cut insurance contracts [and] there’s a pending Medicare billing fraud investigation at the federal level.”
She wants Saint Michael’s to renegotiate a better deal.
But Central Ward councilwoman Gale Chaneyfield Jenkins said that would set the process back years and could cause St. Michael's to close its doors, like many hospitals in Newark already have.
“I’ve seen the closure of United Hospital, I’ve seen the closure of Saint James and Columbus hospital and I know the devastation it brings to a community,” Chaneyfield Jenkins said. “The real estate, the morale, the decay, they blight.”
If Saint Michael's were to close, the remaining hospitals in the city would either be run by or have a contract with one single provider, Barnabas Health.
“So literally Barnabas would be controlling all the healthcare aspects of the city of Newark,” Chaneyfield Jenkins said.
Saint Michael's meets the needs of patients that other hospitals in the city do not, such as treatment for AIDS, drug addiction, psychiatric problems and diabetes, she said.
“Maturity onset Type II diabetes is the major cause of kidney disease in our patients,” Dr. William Chenitz said. “It has an extremely high rate in the inner-city population and we’ve achieved a level of personal familiarity and expertise in managing that type of patient.”
Chenitz has been at Saint Michael’s since the 1970s. Retaining and attracting seasoned physicians like him has been a problem for the hospital. Doctors are walking away because they aren’t sure the hospital will stay open much longer.
The state has already approved Prime to take over five other hospitals in the state. In addition to the 6,000 page application to sell Saint Michael's, the hospital has gone through ten rounds of additional questions from the New Jersey Department of Health and the Attorney General, and has paid for an evaluation and a fairness opinion that the Attorney General wanted.
Saint Michael's CEO David Ricci says he expects the sale to be approved soon. If it is still stalled, then he says he'll be ready to complain publicly.
“If you come back in 5 weeks or 6 weeks and ask me about what my view is of the regulatory process I will probably have a different perspective as to what is happening.”