Hahnemann Hospital is Dying Putting Hundreds of Residency and Fellowship Spots At Risk

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Because of what's going on with Hahnemann, I'm posting on here for the first time since I was a resident. I was actually in the first graduating class from Drexel in 2003, so I went through the whole Allegheny collapse. From a medical student perspective I wouldn't think this is as bad, because Allegheny owned the medical school, while this really only pertains to the one hospital.

I suppose it's because of community guidelines now, but I have to say, I'm really impressed by the tone of the commentators now on this thread. Twenty years ago, there was much more of a gunner mentality on this site, and people were TRASHING the school and its students mercilessly back then, which wasn't warranted at all, and definitely very rude and unprofessional towards future colleagues. Just wanted to say kudos to those who post here now.
 
rokshana said:
So how many rotated at HUH?
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It's usually approximately 1/2 of the annual class I'd say for the core MS3 rotations. Obviously less for MS4 given away rotations and more specialized electives. HUH was certainly Drexel's 'main' hospital and while the remaining facilities MAY be able to absorb the med student volume, it may not.
 
ciestar said:
Other than lack of home programs, I see no reason why I won’t match somewhere next year.
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Nahh not the M4s, I mean Drexel matching new soon-to-be PGY1s into their residency programs.
 
notatall said:
Are any psych residents effected?
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Also wondering - with Friends being a primary site, seems like psych may be the most likely to be spared... though they'd have a lot of C/L and IM/neuro required rotations to find somewhere to house.
Have they published anywhere in writing that they're not accepting apps this cycle for residency spots? Their Freida page for psych was just updated 6/25/19 and still does indicate that they are indeed accepting apps for 20-21 PGY1 spots. Probably slow to update but Freida is indeed run by the AMA...
 
Haven't posted in ages but if you are currently a resident, fellow or trainee who is working or has matched at Hahnemann there is now a reddit for us to get together. Trying to get the word out.

We need all hands on deck to help each other out here. This is a disaster of historic proportions for all of us.

Reddit - Dive into anything

www.reddit.com www.reddit.com
 
Good luck everyone!! I pray you all find spots at other hospitals, don’t give up! The ACGME has made it official.

Hahnemann University Hospital Closure

The ACGME has been notified that Hahnemann University Hospital will file for Chapter 11 Bankruptcy on or about June 28, 2019 with the intention to wind down hospital operations and subsequently close.
acgme.org
 
CLAF211 said:
Also wondering - with Friends being a primary site, seems like psych may be the most likely to be spared... though they'd have a lot of C/L and IM/neuro required rotations to find somewhere to house.
Have they published anywhere in writing that they're not accepting apps this cycle for residency spots? Their Freida page for psych was just updated 6/25/19 and still does indicate that they are indeed accepting apps for 20-21 PGY1 spots. Probably slow to update but Freida is indeed run by the AMA...
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They're more focused on finding homes for their current residents than prepping for the next Match.

Freida data went in for all of us in early June. This announcement was made the morning of June 26.
 
 
Rhandhali said:
Hahnemann/AAHS is negotiating for residency training spots independently of Drexel. To me it seems like they're treating these federally funded academic spots like assets to be disposed of as part of their bankruptcy. AAHS controls the GME funding and has not released it even for people that have secured spots at other locations.

This is going to be long, ugly and drawn out.
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That article is a bunch of legal fear mongering. These spots are not Drexel's to have any say over. Hahnemann can figure out where these resident funding slots go. Transferring those slots to other PHL hospitals is the most humane thing they can do. The fact that many of those programs are Drexel's competitors is too bad. There's nothing in the article to suggest that they are selling spots, and since the spots are only temporary they aren't of much value.

rokshana said:
Maybe @APD can address this, but unless the residency program is wholesale taken over by a different program, the cms funding goes with the individual resident.
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Unfortunately, I've written that in the past but it turns out to be incorrect.
 
aProgDirector said:
That article is a bunch of legal fear mongering. These spots are not Drexel's to have any say over. Hahnemann can figure out where these resident funding slots go. Transferring those slots to other PHL hospitals is the most humane thing they can do. The fact that many of those programs are Drexel's competitors is too bad. There's nothing in the article to suggest that they are selling spots, and since the spots are only temporary they aren't of much value.



Unfortunately, I've written that in the past but it turns out to be incorrect.
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@aProgDirector, is there an official place for affected residents to register for new placements, beyond the home hospital's program director?
It looks as if a few residency programs in the immediate vicinity have reached out.
 
iatrogena said:
Hi, I'm an internal medicine resident at Hahnemann. It's important to point out a few of the assumptions here and set the record straight.

Facts:
-Hahnemann hospital is currently a privately owned hospital that has partnered with Drexel College of Medicine for the education of hundreds of residents.
-This privately owned company, American Academic Healthcare, is pursuing its best interest, which is profit margin.
-While it is always possible for a hospital to close, it is highly unlikely and probably the biggest lose-lose scenario for everyone involved

Why does it not make sense for the hospital to close?
1. Current company CEO loses money by not receiving any compensation for his costly endeavor of having bought a new hospital system one year ago, investing money into upgrades and changes, then reportedly losing millions a month.
2. The nature of Philadelphia's hospital system and patient population. Hahnemann hospital is instrumental in providing high-quality care to the underserved, uninsured, underinsured population, particularly in Northern Philadelphia. This region has already been stressed by the closing of a smaller hospital in the area. See: St. Joseph’s Hospital In North Philadelphia To Close In March 2016 . This is why there have been discussions with the city government regarding possible public funding to help Hahnemann stay afloat (as St. Joe's was publicly funded and Hahnemann now bears some of that patient load). The city and people have much at stake.
3. This is not the first time Hahnemann has been in financial distress. 1993 - Purchased by Allegheny. 1998 - bankruptcy declared, BUT NOT CLOSED. Purchased by Tenet. 2017 - Purchased by American ACademic Healthcare. Even in 1998 when the company went completely bankrupt, the hospital continued operations.
4. Talks are ongoing, currently, between interested parties to acquire Hahnemann. One of those companies, allegedly, is Tower Health, a company that has already partnered with Drexel College of Medicine on a 20-year contract at other Pennsylvania hospital sites. There are rumors that even the CEO would convert the hospital to a non-profit status to incentivize its sale, which would be a big win for the residents (present and future).

Is it possible for the hospital closes? Yes. Is it likely? Not at all. While I do not blame some of the people who are pessimistic about the situation given the tumultuous last few years, I think it is highly misleading to assume the hospital is "very likely to close".
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Sorry to hear that
I wish you found another place to countiue your training
I am currently working in Capital Health Regional Medical Center as pgy2 and
We will have (open house)for Hahnemann residents in the next couple weeks.
You are welcome to attend.
The GME already approved 21 residents to join our program if you have any question or concerns you can email me
[email protected]
 
rokshana said:
The good thing is that there are a lot of training programs in the Philadelphia area and many times have approval for more residents than they have money so can usually take on extra residents without a problem...and probably will welcome the help.
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Sorry to hear that
If you know any IM residents who still trying yo find a slot ,please share this with them:
I am currently working in Capital Health Regional Medical Center as IM pgy2 and
We will have (open house)for Hahnemann residents in the next couple weeks.
You are welcome to attend.
The GME already approved 21 residents to join our program if you have any question or concerns you can email me
[email protected]
 
Dr.Umali said:
Sorry to hear that
If you know any IM residents who still trying yo find a slot ,please share this with them:
I am currently working in Capital Health Regional Medical Center as IM pgy2 and
We will have (open house)for Hahnemann residents in the next couple weeks.
You are welcome to attend.
The GME already approved 21 residents to join our program if you have any question or concerns you can email me
[email protected]
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There is a Reddit thread that this info could be helpful

Reddit - Dive into anything

www.reddit.com www.reddit.com
 
aProgDirector said:
That article is a bunch of legal fear mongering. These spots are not Drexel's to have any say over. Hahnemann can figure out where these resident funding slots go. Transferring those slots to other PHL hospitals is the most humane thing they can do. The fact that many of those programs are Drexel's competitors is too bad. There's nothing in the article to suggest that they are selling spots, and since the spots are only temporary they aren't of much value.



Unfortunately, I've written that in the past but it turns out to be incorrect.
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First post from a long time lurker, I apologize for the length but I tried to research this as heavily as possible. I think that the rules may have changed after the ACA, in that residency slots can be permanently moved after a closure, and that residencies cant be sold strictly, but money can change hands to acquire faculty.


I saw you reference to 66 FR 39828. being possibly out of date and the potential for there being some more current guidance. I dug up this web page from CMS.gov that has forms (scroll to section 5506 at the bottom of the link) regarding how Resident placement is prioritize. The form was updated in 2016, and there are placement result in Zip Files from what I think are prior closures up through 2018.

The form titled Preservation of FTE Cap Slots from Teaching Hospitals that Close , its much shorter, and more clearly written than the FR from 2002 that you cited. It does not say anything about being able to buy or sell residency slots. But it does appear that there are rules in place for having programs be transferred wholesale permanently to a new hospital without CMS redistributing slots, and possibly without and choice by the residents themselves.

The from outlines several criteria in section B for the level of priority for where a residency program is transferred to, and in section C the ranking criteria within that level of priority.

The recent agreement with Tower Health seems to indicate that ACGME thinks that Residents can go wherever they choose to, but looking at the form above Tower health qualifies for the highest priority in section b (its amazingly considered to be in the same Statistical Area as Philadelphia) and then has the highest ranking criterion in section C for having a program permanently moved in its entirety to their hospital system. The key phrase from the ranking criterion:


"The applying hospital is requesting the increase in its FTE resident cap(s) because it is assuming (or assumed) an entire program (or programs) from the hospital that closed, and the applying hospital is continuing to operate the program (s) exactly as it had been operated by the hospital that closed (that is, same residents, possibly the same program director, and possibly the same (or many of the same) teaching staff) " (I added the underline)

So perhaps the issue is that Drexel is working to buy up (in conjunction with Tower Health) the PDs and faculty to qualify under the rules set forth by CMS for moving all the residencies at once and permanently? So maybe its not that Hahnemann is trying to sell the residency slots, but they are selling the faculty and PDs?

I dont know enough about whom the PDs are employed by, or what their contracts are like etc. So I was wondering if @aProgDirector had any thoughts or clarifications on this?
 
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To choose Tower or not...

“
Hahnemann acknowledged residents’ right to choose, and said it would begin release any residents who want to complete their training at other hospitals.

For those that choose to go to Tower, CEO Clint Matthews said he wants the transition to be “as easy as possible.”

The health system said it would provide free onsite housing at Reading Hospital and free meals at Tower hospitals, among other amenities.”

www.inquirer.com

Medical residents scramble as Hahnemann, Tower plan to transfer training program

Hahnemann and Tower said they had signed a letter of intent for Tower to take over most of the training programs, placing residents in one of Tower Health’s six hospitals.
www.inquirer.com www.inquirer.com
 
Hopefully all the residents can choose...
“Hahnemann officials, noting residents are free to choose other sites to complete their training, said they will begin releasing any program participants who wish to go elsewhere. To ensure that every resident and fellow receives Medicare reimbursement funding, Hahnemann is confirming the relevant cap on reimbursement for each individual. Residents will be released from the Hahnemann program upon confirmation of the cap value for every participant in the training program.”

 
Sarnor said:
First post from a long time lurker, I apologize for the length but I tried to research this as heavily as possible. I think that the rules may have changed after the ACA, in that residency slots can be permanently moved after a closure, and that residencies cant be sold strictly, but money can change hands to acquire faculty.


I saw you reference to 66 FR 39828. being possibly out of date and the potential for there being some more current guidance. I dug up this web page from CMS.gov that has forms (scroll to section 5506 at the bottom of the link) regarding how Resident placement is prioritize. The form was updated in 2016, and there are placement result in Zip Files from what I think are prior closures up through 2018.

The form titled Preservation of FTE Cap Slots from Teaching Hospitals that Close , its much shorter, and more clearly written than the FR from 2002 that you cited. It does not say anything about being able to buy or sell residency slots. But it does appear that there are rules in place for having programs be transferred wholesale permanently to a new hospital without CMS redistributing slots, and possibly without and choice by the residents themselves.

The from outlines several criteria in section B for the level of priority for where a residency program is transferred to, and in section C the ranking criteria within that level of priority.

The recent agreement with Tower Health seems to indicate that ACGME thinks that Residents can go wherever they choose to, but looking at the form above Tower health qualifies for the highest priority in section b (its amazingly considered to be in the same Statistical Area as Philadelphia) and then has the highest ranking criterion in section C for having a program permanently moved in its entirety to their hospital system. The key phrase from the ranking criterion:


"The applying hospital is requesting the increase in its FTE resident cap(s) because it is assuming (or assumed) an entire program (or programs) from the hospital that closed, and the applying hospital is continuing to operate the program (s) exactly as it had been operated by the hospital that closed (that is, same residents, possibly the same program director, and possibly the same (or many of the same) teaching staff) " (I added the underline)

So perhaps the issue is that Drexel is working to buy up (in conjunction with Tower Health) the PDs and faculty to qualify under the rules set forth by CMS for moving all the residencies at once and permanently? So maybe its not that Hahnemann is trying to sell the residency slots, but they are selling the faculty and PDs?

I dont know enough about whom the PDs are employed by, or what their contracts are like etc. So I was wondering if @aProgDirector had any thoughts or clarifications on this?
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There are two issues at play here:

1. When an orphaned resident moves to a new program, if the closed program allows it the funding temporarily transfers with the resident. When that resident graduates from the program, the funding addition ends. This is in the old law, which I quoted above.
2. Prior to the ACA, once a program closes and after any temporary funding is completed, those funding slots are lost. New funding slots can be created by new institutions starting residency programs, but established programs couldn't permanently increase their funding. But the ACA (which is what you have quoted above) added a process to do that. As you've noted, the process is designed such that the spots stay in the same field and in the same geographic area, if possible.

It appears that HUH has come up with a deal with Tower to transfer all/most of their slots. What will happen (theoretically) is that residents who transfer to Tower will bring their funding with them. Those that transfer elsewhere will bring their funding temporarily to their new site IF HUH allows it, and then when that resident graduates and the slot becomes a "free agent", then Tower will be able to claim it. Realistically, I expect HUH will NOT release any funding to anyone else, and just let Tower claim all of the funding up front.
 
aProgDirector said:
There are two issues at play here:

1. When an orphaned resident moves to a new program, if the closed program allows it the funding temporarily transfers with the resident. When that resident graduates from the program, the funding addition ends. This is in the old law, which I quoted above.
2. Prior to the ACA, once a program closes and after any temporary funding is completed, those funding slots are lost. New funding slots can be created by new institutions starting residency programs, but established programs couldn't permanently increase their funding. But the ACA (which is what you have quoted above) added a process to do that. As you've noted, the process is designed such that the spots stay in the same field and in the same geographic area, if possible.

It appears that HUH has come up with a deal with Tower to transfer all/most of their slots. What will happen (theoretically) is that residents who transfer to Tower will bring their funding with them. Those that transfer elsewhere will bring their funding temporarily to their new site IF HUH allows it, and then when that resident graduates and the slot becomes a "free agent", then Tower will be able to claim it. Realistically, I expect HUH will NOT release any funding to anyone else, and just let Tower claim all of the funding up front.
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Through internal announcements they have claimed that residents that wish to go to other programs will be released. Whether this works out in practice is unclear. They have also said to talk to the DIO and ACGME if we feel "pressured" into taking any kind of deal. This sounds like "pressure" to me.

What is clear is that trainees are now a LOT less attractive to other programs since they now just represent a short term increase to a program instead of an opportunity for growth. On top of that none of the residents I've spoken to have the slightest interest in moving to a place like Reading, PA - myself included.

The first notice anyone got about this was in the media through articles like the above. They are promising that residents will continue their training with Drexel faculty; no faculty I've spoken to has even been approached and I get the impression none of them would go.

The media is spinning this like it's a great deal for the residents and I really don't think it is. Great deal for Tower Health, sure. Great deal for Drexel which won't be put in the position of being a medical school with no affiliated training programs - most certainly. But for residents who might get put in a position where they have no choice in what happens to them? Not so much.

All of this is being negotiated in bankruptcy court by parties that I don't think have resident interests at heart. Say what you like about unions but having a resident and fellows union would probably be a huge help right now.
 
Uh oh, hope everyone lands a spot! Praying for u guys
“Hahnemann University Hospital on Wednesday said it plans to transfer the majority of its medical residents and fellows to Tower Health, a six-hospital system that does not have all the accredited training programs it would need to accommodate Hahnemann’s 500-plus residents.

An influx of at least 570 new residents and fellows would dwarf Tower’s current resident program, which has 118 doctors-in-training in only five of the 15 specialties with accredited programs at Hahnemann. Tower’s only Philadelphia property is 148-bed Chestnut Hill Hospital; its largest facility is Reading Hospital, with 716 beds in Berks County.”


www.inquirer.com

Medical residents scramble as Hahnemann, Tower plan to transfer training program

Hahnemann and Tower said they had signed a letter of intent for Tower to take over most of the training programs, placing residents in one of Tower Health’s six hospitals.
www.inquirer.com www.inquirer.com
 
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Its amazing. And brilliant. And horrifying. All at the same time.

HUH sells their slots to Tower for $7.5 million. New cash for them to use any way they want. HUH is happy.

Drexel is panicking that their major teaching hospital is closing and they will have nowhere to send students. Now Tower becomes a major teaching site(s). Drexel is happy, they didn't want to see these slots go elsewhere.

Tower will likely get the slots permanently -- as linked above, the ACA created rules for how slots are reassigned. The top ranking criterion is a new program absorbing an entire closing program. Unclear if this will really work out this way, as Tower doesn't have many of the specialties represented, and although they might apply for "expedited review" from the ACGME, this will still take months and if the ACGME thinks this is a bad plan, they are unlikely to rush it. But it might not matter -- the rules seem to suggest that just applying for a program might qualify an institution to claim the slots. Once they have the slots, they can do anything they want with them -- CMS slots are not specialty specific, so they can just reassign them to any program they want.

Amazing how Drexel spins this as a huge win for the residents.
 
Should residents just petition ACGME to shutter programs forcibly and immediately? A significant number of the programs right now don't meet their training requirements.

Endoscopy closes Friday but is functionally closed now. Surgery is not doing cases. There is no cath lab. There are less than 50 patients in the hospital. Emergency medicine visits are in the single digits. The clinics are working as usual but that's about it.

It's a gamble, but we'd become proper orphans that way at the mercy of the ACGME instead of Drexel which is treating us like commodities for sale.
 
aProgDirector said:
No matter what you do, HUH needs to release your funding for you to use it elsewhere. The ACGME can't change that.
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Wow, so we are just screwed and totally at their mercy then. I have absolutely no faith in Drexel or Hahnemann or this Tower Health outfit actually following through with their promises to release our funding. I and many others have letters of intent.

At this point everyone I've talked with is in agreement - Drexel does not deserve to operate graduate medical education programs in any way shape or form. They've lied to us. They've deliberately stopped those of us who have spots from moving on. Resident training spots are being swapped around in bankruptcy court like they're a bunch of office equipment. It's disgusting.

There really is no way out at all is there?
 
iskander07 said:
Wow, so we are just screwed and totally at their mercy then. I have absolutely no faith in Drexel or Hahnemann or this Tower Health outfit actually following through with their promises to release our funding. I and many others have letters of intent.

At this point everyone I've talked with is in agreement - Drexel does not deserve to operate graduate medical education programs in any way shape or form. They've lied to us. They've deliberately stopped those of us who have spots from moving on. Resident training spots are being swapped around in bankruptcy court like they're a bunch of office equipment. It's disgusting.

There really is no way out at all is there?
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It’s residency...your time is not your own and the pace that things get done is not in your control...even without these issues.
Drexel or any med school/hospital is going to think about what is in their best interest and having the ability to hold onto teaching sites for their med students and residency programs is going to trump individual resident needs...they let that funding go...well that serves them no purpose.

Hopefully the place you have a letter of intent will be patient or there is a place for your class at tower health...either way you will be able to finish your training.
 
Residents should not be treated like chattel, which is essentially what Hahnemann, Drexel, and Tower are doing here.

Moreover, that hospitals are allowed to leverage their GME funding in this way seems like a major oversight. Antics like these will also make it a harder sell to keep GME funding at current levels the next time it comes up on the chopping block.
 
rokshana said:
It’s residency...your time is not your own and the pace that things get done is not in your control...even without these issues.
Drexel or any med school/hospital is going to think about what is in their best interest and having the ability to hold onto teaching sites for their med students and residency programs is going to trump individual resident needs...they let that funding go...well that serves them no purpose.

Hopefully the place you have a letter of intent will be patient or there is a place for your class at tower health...either way you will be able to finish your training.
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Spare us your lecturing. I am fully aware of what being a medical trainee means for me. What you don't seem to understand is what it means for Drexel. They have abandoned their end of the bargain in order to take us to market like livestock. It's been over two weeks now without patients, without procedures, without anything vaguely resembling medical education.

There are people, myself included, that had places to go within 48 hours of the closure.
 
Oh hey, this just got posted.

ACGME Submits Court Filing in Support of Hahnemann Residents

On July 8, 2019, the ACGME filed a response in the United States Bankruptcy Court regarding the Hahnemann University Hospital closure. A hearing on the motion is scheduled for July 16, 2019. (Updated July 11, 2019.)
acgme.org

They also posted the Drexel's official closure policy. This policy has been persistently ignored and disobeyed. This has not been made publicly available until now.


A copy of the brief filed by ACGME in court today is linked in the article which can be found at

In it, ACGME accuses Hahnemann and Drexel both of stonewalling residents. This is unequivocally true.

ACGME is coming Friday. There is a meeting in 625 Bobst at 11AM. You should be there. If you have a signed letter of intent bring a copy with you - I will have mine. We need to talk to these people and tell them just how bad things are. There has not been any clinical training here in the past two weeks. We are being held hostage so that Drexel can sell us and maintain the programs they no longer deserve to operate.

Pass on everything you can to ACGME to give them the evidence they need for summary revocation of Drexel's training accreditation. That is the only way you might have any choice in where you go. I for one did not sign up to go to a place like Reading; calling it the "Greater Philadelphia Area" is patently absurd. Even if you want to go you deserve the option to choose. There are over 1000 spots available for trainees across the country; don't let Drexel rob you of a chance to go where you want to go.
 
iskander07 said:
Spare us your lecturing. I am fully aware of what being a medical trainee means for me. What you don't seem to understand is what it means for Drexel. They have abandoned their end of the bargain in order to take us to market like livestock. It's been over two weeks now without patients, without procedures, without anything vaguely resembling medical education.

There are people, myself included, that had places to go within 48 hours of the closure.
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Not lecturing and not pointed at you personally...it is beyond incredible at what is happening and can’t even imagine what you are going through, but you asked in a previous post was there any way out and I’m sorry but the answer is no...there are a lot of things you have no control over and this one of them. You have done what you can by getting that letter of intent...the last major hospital closure that comes close to the magnitude of this is when St Vincent in NYC was abruptly closed...mid year ...And I believe all but 2 of the residents and fellows were able to go somewhere...it may take time , but there is spotlight on this, places are willing to reach out, and a hospital system seems to be able to take over programs wholesale so hopefully things will work out
 
iskander07 said:
All of this is being negotiated in bankruptcy court by parties that I don't think have resident interests at heart. Say what you like about unions but having a resident and fellows union would probably be a huge help right now.
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Maybe.... but it’s not every day an union wants to break up instead of staying together.

I do hope that most of you will get to where you want to be.

Calling Reading, greater Philadelphia area, is a little f -ing ridiculous.
 
iskander07 said:
Oh hey, this just got posted.

ACGME Submits Court Filing in Support of Hahnemann Residents

On July 8, 2019, the ACGME filed a response in the United States Bankruptcy Court regarding the Hahnemann University Hospital closure. A hearing on the motion is scheduled for July 16, 2019. (Updated July 11, 2019.)
acgme.org

They also posted the Drexel's official closure policy. This policy has been persistently ignored and disobeyed. This has not been made publicly available until now.


A copy of the brief filed by ACGME in court today is linked in the article which can be found at

In it, ACGME accuses Hahnemann and Drexel both of stonewalling residents. This is unequivocally true.

ACGME is coming Friday. There is a meeting in 625 Bobst at 11AM. You should be there. If you have a signed letter of intent bring a copy with you - I will have mine. We need to talk to these people and tell them just how bad things are. There has not been any clinical training here in the past two weeks. We are being held hostage so that Drexel can sell us and maintain the programs they no longer deserve to operate.

Pass on everything you can to ACGME to give them the evidence they need for summary revocation of Drexel's training accreditation. That is the only way you might have any choice in where you go. I for one did not sign up to go to a place like Reading; calling it the "Greater Philadelphia Area" is patently absurd. Even if you want to go you deserve the option to choose. There are over 1000 spots available for trainees across the country; don't let Drexel rob you of a chance to go where you want to go.
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Interesting. Unfortunately, I am concerned the ACGME has little power here.

The linked policy doesn't really apply. First of all, it's really talking about what happens if the GMEC decides to close a program, not if the entire hospital closes abruptly. Most of the bullet points in that document make no sense in the current situation.

Even if it does apply, the bullet points at the end saying that resident must be released with 30 days notice, says nothing about the funding. "Releasing" you just means that they must allow you to terminate your contract without penalty.

Even if the ACGME pulls HUH's institutional accreditation, it doesn't free up the funding, I think.
 
aProgDirector said:
Interesting. Unfortunately, I am concerned the ACGME has little power here.

The linked policy doesn't really apply. First of all, it's really talking about what happens if the GMEC decides to close a program, not if the entire hospital closes abruptly. Most of the bullet points in that document make no sense in the current situation.

Even if it does apply, the bullet points at the end saying that resident must be released with 30 days notice, says nothing about the funding. "Releasing" you just means that they must allow you to terminate your contract without penalty.

Even if the ACGME pulls HUH's institutional accreditation, it doesn't free up the funding, I think.
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After reading the brief to the court, i think what ACGME is getting at is the notion that HUH cant sell something it doesnt have, a residency program. Until the bankruptcy is approved by the court Tower Health hasnt received anything other than the promise of funding from CMS (extremely valuable and important I know) but only usable (i think) if they have accredited residency slots and a program to administer them, which is what they are trying to buy for 7.5 million.

So ACGME is saying to the court that they cant use the accredited programs as salable assets to satisfy creditors, if we the ACGME, say they dont have any accreditation to sell.

So no it doesnt free up the funding, it just means it cant go to a hospital that needs to buy a program instead of adding resident to their own. (Though i think i saw Tower has some residents already and it could still accept additional resident from HUH who choose to go there, they just cant buy a program wholesale that doesn't exist)

Maybe I'm being too optimistic, and ignorant since im not a lawyer, but its generally a good sign for people trying to block a bankruptcy action when the Judge insists things take more rather than less time.


Footnote: It feels bizarre to be discussing whether or not an accreditation is a salable asset....
 
demoticcurette said:
I'm partway through a training program at Hahnemann. The hospital is in financial crisis and is very likely to close. This is the source of a great deal of stress and angst among the residents and fellows here.

In April, the CEO called out Cardiology and medical training programs as "money losers", stating the hospital is losing 5 million dollars a month. “We are hopeful we won’t have to close the hospital, but it will require the help of others.”

175 people woke up one day without a job. Nurses and ancillary staff. At least two hospital floors are shuttered overnight without warning, bringing down admission capacity to around 200 from a nominal 500+. They continue to ask for volunteers to be laid off. Overhearing conversations in the hallways it's always about "who's left" and "who's next" in terms of losing their job.

Now the unions are suing them for not meeting pension obligations.

So far, at least one program director has openly advised trainees to go on a month to month lease if they can. Other program directors have openly asked for trainees to submit lists of places they would like to go when the hospital closes. One department circulated copies of an article describing what happened when St. Vincents closed. I have heard rumors that other hospitals are making changes to handle the extra patient burden that will come with Hahnemann's closure.

The last time this happened pretty much everyone landed on their feet. Which is fine, but it's maddening not knowing what's going to happen. I can't get a month to month lease and my lease is running out soon. I cannot imagine what is going through the head of anyone who matched here.

So if anyone hears anything, knows anything or has any questions as to what happens this would be the place to post.
Click to expand...

I guess you called it!

www.medscape.com

Nearly 600 Residents Scramble for Positions as PA Hospital Closes

Other programs are working to get additional GME spots approved for displaced Hahnemann University Hospital residents. "This is almost unheard of," one program director said.
www.medscape.com www.medscape.com
 
Sarnor said:
After reading the brief to the court, i think what ACGME is getting at is the notion that HUH cant sell something it doesnt have, a residency program. Until the bankruptcy is approved by the court Tower Health hasnt received anything other than the promise of funding from CMS (extremely valuable and important I know) but only usable (i think) if they have accredited residency slots and a program to administer them, which is what they are trying to buy for 7.5 million.

So ACGME is saying to the court that they cant use the accredited programs as salable assets to satisfy creditors, if we the ACGME, say they dont have any accreditation to sell.

So no it doesnt free up the funding, it just means it cant go to a hospital that needs to buy a program instead of adding resident to their own. (Though i think i saw Tower has some residents already and it could still accept additional resident from HUH who choose to go there, they just cant buy a program wholesale that doesn't exist)

Maybe I'm being too optimistic, and ignorant since im not a lawyer, but its generally a good sign for people trying to block a bankruptcy action when the Judge insists things take more rather than less time.


Footnote: It feels bizarre to be discussing whether or not an accreditation is a salable asset....
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Legal issues are always complicated. As you mention, HUH is not selling an accredited resicency program. It's selling CMS funded slots, which the "buyer" can only actually claim if they have accredited positions. They would need to earn those positions on their own. If the ACGME doesn't accredit a bunch of new positions/programs at Tower, then the whole thing is moot and Tower wasted their money. I can't tell if this is a brilliant or foolish strategy. Time will tell.
 
iskander07 said:
Oh hey, this just got posted.

ACGME Submits Court Filing in Support of Hahnemann Residents

On July 8, 2019, the ACGME filed a response in the United States Bankruptcy Court regarding the Hahnemann University Hospital closure. A hearing on the motion is scheduled for July 16, 2019. (Updated July 11, 2019.)
acgme.org

They also posted the Drexel's official closure policy. This policy has been persistently ignored and disobeyed. This has not been made publicly available until now.


A copy of the brief filed by ACGME in court today is linked in the article which can be found at

In it, ACGME accuses Hahnemann and Drexel both of stonewalling residents. This is unequivocally true.

ACGME is coming Friday. There is a meeting in 625 Bobst at 11AM. You should be there. If you have a signed letter of intent bring a copy with you - I will have mine. We need to talk to these people and tell them just how bad things are. There has not been any clinical training here in the past two weeks. We are being held hostage so that Drexel can sell us and maintain the programs they no longer deserve to operate.

Pass on everything you can to ACGME to give them the evidence they need for summary revocation of Drexel's training accreditation. That is the only way you might have any choice in where you go. I for one did not sign up to go to a place like Reading; calling it the "Greater Philadelphia Area" is patently absurd. Even if you want to go you deserve the option to choose. There are over 1000 spots available for trainees across the country; don't let Drexel rob you of a chance to go where you want to go.
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@iskander07 I hope you have time to update us on the ACGME meeting you mentioned. Thanks for all the info!
 
wysdoc said:
@iskander07 I hope you have time to update us on the ACGME meeting you mentioned. Thanks for all the info!
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It was very much not a bang but a whimper.

They were pretty well in the dark; they didn't know that ER was effectively closed. They didn't know that Labor and Delivery was closing that day; all of these were in the news. They had no idea how small the census was (47 for the whole hospital - that's like more than 10 trainees per patient!).

One entertaining bit was seeing a standing room only auditorium shout, "NO!" in unison when asked if anyone wanted to go to Reading with Tower Health.

Mostly it was disappointing, very much a fact finding mission for people that had no idea.

Psychiatry was complaining that they had been totally forgotten by all their leadership who were spending their time gearing up for Reading when none of the current residents had any plans of going with them.

Some people did hand over copies of letters of intent. Some people had these with programs that were on the list that ACGME has been publishing and keeping up to date.

Most of the ACGME reps had a slack jawed look of utter disbelief on their faces. They just had no idea how bad things really are and I don't think they really believed us.

It did become clear that CMS funding is a totally separate thing which they assert 0 control over. What's being fought over in court is the medicare number which has the number of residency caps with it. It's unclear what would happen if the programs are de-accredited. They can yank accreditation of the program but that is a nuclear option; a lot of people don't haeve deals yet ( many do in various stages of completion, all of which are held up by us not being released) and this could mean interruption of pay/benefits and extension of training

It does appear that they will advocate for us to choose where we go and that we should not feel pressured or bound to go to Reading which is good because literally nobody wants to go. They also have legal representatives in the bankruptcy court.

The number of approved spots fro people to transfer to is no well over 1,000. NONE of them are at Reading though, and they made a point of saying that any accreditation would still take ages and a day to go through.

So until then, we need to all be ready and available in case hospital closure happens. Will it be tomorrow? Will it be August 25th when we were told we would be terminated? WIll it be the announced closure date of Sept 6? Nobody knows!

Pretty much they are as blindsided and confused and stunned as all of us. They're in the same reaction/anticipation/damage control mode as the rest of us. Everyone points to St. Vincents but that was a planned closure with MONTHS of notice.
 
Last edited:
iskander07 said:
It was very much not a bang but a whimper.

They were pretty well in the dark; they didn't know that ER was effectively closed. They didn't know that Labor and Delivery was closing that day; all of these were in the news. They had no idea how small the census was (47 for the whole hospital - that's like more than 10 trainees per patient!).

One entertaining bit was seeing a standing room only auditorium shout, "NO!" in unison when asked if anyone wanted to go to Reading with Tower Health.

Mostly it was disappointing, very much a fact finding mission for people that had no idea.

Psychiatry was complaining that they had been totally forgotten by all their leadership who were spending their time gearing up for Reading when none of the current residents had any plans of going with them.

Some people did hand over copies of letters of intent. Some people had these with programs that were on the list that ACGME has been publishing and keeping up to date.

Most of the ACGME reps had a slack jawed look of utter disbelief on their faces. They just had no idea how bad things really are and I don't think they really believed us.

It did become clear that CMS funding is a totally separate thing which they assert 0 control over. What's being fought over in court is the medicare number which has the number of residency caps with it. It's unclear what would happen if the programs are de-accredited. They can yank accreditation of the program but that is a nuclear option; a lot of people don't haeve deals yet ( many do in various stages of completion, all of which are held up by us not being released) and this could mean interruption of pay/benefits and extension of training

It does appear that they will advocate for us to choose where we go and that we should not feel pressured or bound to go to Reading which is good because literally nobody wants to go. They also have legal representatives in the bankruptcy court.

The number of approved spots fro people to transfer to is no well over 1,000. NONE of them are at Reading though, and they made a point of saying that any accreditation would still take ages and a day to go through.

So until then, we need to all be ready and available in case hospital closure happens. Will it be tomorrow? Will it be August 25th when we were told we would be terminated? WIll it be the announced closure date of Sept 6? Nobody knows!

Pretty much they are as blindsided and confused and stunned as all of us. They're in the same reaction/anticipation/damage control mode as the rest of us. Everyone points to St. Vincents but that was a planned closure with MONTHS of notice.
Click to expand...
Thank you for that awesome summary. I hope you and your fellow residents hear something more concrete very soon
 
Wow, the resident positions are literally being auctioned off.

whyy.org

Judge rules Hahnemann can sell its residency programs to highest bidder

The hospital's lawyers could not agree on a closure plan with city and state health officials in time for Friday’s scheduled hearing, and the matter was pushed to next week.
whyy.org whyy.org

The only matter considered by Judge Gross on Friday was the bidding procedure for the sale of the residency and fellowship slots. Tower is offering $7.5 million to Hahnemann for its national provider ID number, its Medicare provider number (which allows an institution to receive funding for doctors in training), and the Pennsylvania Department of Health license to operate an acute care center and resident-training program. The bidding procedure will allow other health systems to bid at that price or higher by Aug. 5.
Click to expand...

Raluca McCallum, a third-year radiology resident, addressed the judge, reading from a letter on behalf of medical graduates. She said she took umbrage at the way the residents’ expensive, difficult medical education and personal lives were being treated as commodities to be bought and sold.

“It’s the perception that residents are viewed as nothing more than assets, the sale of which might offset debt,” McCallum told Gross.

She said the residents feel that being stuck at Hahnemann, whose patient census is down to 30, is compromising their education.
Click to expand...

I am shocked and appalled that residency positions are being bought and sold this way. It is even more appalling that this is all happening while residents remain in limbo with interrupted training.
 
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