RMC, MUSC may team up; partnership talks begin

The Medical University of South Carolina is looking at the possibility of formally partnering with the Regional Medical Center.

Officials with the two hospitals met in Orangeburg on Thursday with local lawmakers and Calhoun and Orangeburg county council members. The counties own the hospital.

“We are not interested in the Regional Medical Center just surviving,” said Rep. Gilda Cobb-Hunter, D-Orangeburg.

“What we want to do is to make sure RMC thrives,” she said.

“We believe, given the fiscal situation, the change in the health care landscape, we are going to have to figure out a different way of doing business in order for RMC to not only survive but to thrive,” Cobb-Hunter said.

Charleston-based MUSC and the Medical University Hospital Authority, a component of MUSC, are seeking to enter into a partnership with RMC that would provide RMC with a number of resources, including clinical, educational and research programs with an aim at improving care and the financial outcomes of the hospital.

The proposed partnership is allowed under a budget proviso passed by the S.C. General Assembly allowing MUSC, within its own budget, to enter into the partnership with RMC to help enhance services.

While the proviso only extends through June 30, 2023, it has the potential of extending for years to come depending on the nature and progress of the relationship between the two institutions, Cobb-Hunter said.

The proposal discussed would keep the RMC board in place for quality oversight, medical staff accreditation and community engagement while financial responsibility for RMC would fall under the MUSC board. All RMC employees would remain.

MUSC officials propose entering into the partnership within the next three months or 90 days.

Thursday’s meeting was considered a first step in the partnership, with details to be worked out through the counties’ governing bodies, RMC trustees and community stakeholders, Cobb-Hunter said.

Cobb-Hunter explained the proviso is needed because lawmakers did not approve funds RMC requested during a presentation to the House Ways and Means health care subcommittee.

Cobb-Hunter said when she heard about RMC’s financial challenges, she wanted to make sure the hospital was solvent.

“It is not about selling,” Cobb-Hunter said. “We are not interested in selling the hospital. Leasing is something that may be a part of the conversation, but the important point here is that we have not crossed that bridge here yet.”

“We never discussed selling it with MUSC and they have never asked to buy it,” Cobb-Hunter said.

She said her desire is just to provide RMC with an opportunity to expand services.

MUSC CEO Dr. Patrick Crawley cited the benefits RMC would see through the partnership, including a better market share and pricing for medical supplies and equipment, as well as MUSC’s leadership and experience.

Crawley also said another big benefit of a partnership is in the recruitment of nurses and doctors.

MUSC would discuss if RMC employees would become state employees. MUSC officials say in other partnerships with MUSC, all have been agreeable to becoming state employees.

The relationship would mean all of RMC’s primary care doctors would have an opportunity to join the MUSC network. Crawley said MUSC is not about coming in and bullying local hospitals, but working with local communities.

“It has not been MUSC’s mantra to go into a community and stop all the strategic planning that has been done, stop all the good work that has been done. We build on top of that,” Crawley said.

Under the proposal, RMC would formally become a regional division of MUSC.

Some at the meeting asked if there would be a name change.

“That is putting the cart before the horse,” Crawley said.

He noted that MUSC has partnered with other rural hospitals. In each of those MUSC divisions, the naming format is the MUSC name and then the hospital location. For example, there is MUSC Health Florence and MUSC Marion.

Crawley reiterated that all would be up for discussion.

RMC and MUSC have partnered over the years with the aim to improve health services in The T&D Region.

In 2015, the two hospitals entered into a clinical affiliation, though MUSC leadership says the relationship has not blossomed as expected, except with some collaborative efforts in oncology.

Crawley said MUSC is hoping a new formal engagement will help spur faster and more fruitful progress between the two institutions.

“Trust takes time to build, especially trust in a health care system,” MUSC President Dr. David Cole said.

Negative experiences can outweigh positive experiences, he said. “We want to increase the number of great experiences. We do that to build up where the needs are. It will take some years to get where we all want to be.”

“The concept here is not MUSC lands out of the blue and tells people what is going to happen,” he said. “That will not happen. We work hard to be respectful and partner with the local community and doctors who are a part of this community.”

Sen. Vernon Stephens, D-Bowman, asked how MUSC would deal with the hospital’s debt in the partnership.

At the end of the 2021 fiscal year, the hospital had a deficit of between $32 million and $35 million.

“Would services be limited because of that debt?” Stephens asked.

“In general we would just accept that and go forward,” Crawley said. “That is not anything different than we have done in other places. You can’t magically wish that away. We will work together.”

Crawley said MUSC has worked with a number of hospitals across the state that have had challenges.

“We would plan on more services,” he said. “I think that is how to get people back. I am not overly worried about the debt. We will get back to that.”

Crawley said MUSC would not seek to change any strategic plans of RMC or its outreach plans to rural communities.

RMC Board Chair the Rev. Dr. Caesar Richburg expressed his concern that hospital trustees were not properly kept abreast of any such proposed partnership with MUSC until the time of the meeting.

“This sounds like – and I don’t want to be abrasive – but it almost sounds like a hostile takeover,” he said.

Richburg said there is a need for quality health care, “but I think there is a way to do it. If this is something that Orangeburg County Council desires, I think the board needs to know.

“We should have been told about it. We should have been told that so that we can know the direction we are heading in and not doing a lot of things we are doing.”

“There are a lot of facts out there that we don’t know,” Richburg said. “And possibly everything is not being told to us, which is understandable. That really troubles me as an individual.”

Richburg said he thinks there should have been further discussion between the RMC Board of Trustees and lawmakers about the proposal beforehand.

“We do need quality health care in South Carolina, but more in particularly in our service area,” Richburg said. “We do need the very best that is offered.”

“I think it has been disrespectful to the board on how this has been done,” Richburg said.

Richburg questioned why MUSC would handle fiduciary responsibilities when the RMC board has been appointed to have that role.

Richburg said the entire board wants what is best for the community.

“No, it ain’t about Caesar,” Richburg said. “It is about the very best that can be offered to the citizens of these areas that we serve and that is quality health care.”

Orangeburg County Council Chairman Johnnie Wright said there has been no desire on the part of council to disrespect the hospital board.

“We just felt there are some opportunities to listen and see if there is something that can be good for our citizens,” Wright said.

Council felt that because MUSC has state affiliation, it could help RMC.

“Nobody said today we would come here today to make a direct decision on what we would do,” Wright said.

“Nobody is trying to take over,” Wright said. “This is good information. I think it is worth looking into.”

Cobb-Hunter said, “Respect is a two-way street, not one way.”

She noted RMC has a governmental relations team to pass along legislative information to the board.

“If your governmental relations team did not share with you that there was a proviso added to the budget that dealt with RMC and MUSC, then I would strongly suggest that you go back to your governmental relations team and ask them why that information was not shared with the board,” Cobb-Hunter said.

“If you are feeling like this is a hostile takeover, I certainly will share with you of some examples of what a real hostile takeover looks like,” she said. “What we are here for is about the business of moving the hospital forward.”

Cobb-Hunter said the matter was taken to those elected by the community and the decision makers on the county councils.

“In Orangeburg County, we can no longer do business as usual. We can no longer have an entity that is more concerned with protecting turf than it is with providing access to care,” Cobb-Hunter said.

“I am not going to be Nero fiddling while Rome is burning and I am not going to wait until the hospital has dropped even more services,” Cobb-Hunter said.

Rep. Russell Ott, D-St. Matthews, said most of the feedback he has heard has been positive about the potential partnership.

“Takeover” has not been a word used, he said.

“This is not the time to look backwards,” Ott said. “This is the time to look forward at the opportunity that we should all be celebrating that we have.”

“We can continue to have turf battles and we can miss out on an opportunity or all come together as a community with a common goal of making this hospital what it can and has to be for the people we represent,” Ott said.

The meeting was held for discussion only. No action was taken. The matter will be further discussed formally by both Orangeburg and Calhoun county councils going forward.