by Melissa Bailey | Sep 11, 2012 4:56 pm

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Posted to: Health

A beloved Catholic hospital ended a 105-year run, and one of the nation’s largest hospitals was born, as officials signed papers Tuesday afternoon to have Yale-New Haven Hospital take over the Hospital of Saint Raphael.

Two St. Raphael’s nurses called the occasion “bittersweet” as they posed for one last time with the sign outside their hospital. At around 9 a.m. Wednesday, the sign will bear the Chapel Street facility’s new name, “Yale-New Haven Hospital, Saint Raphael Campus.”

Workers and patients interviewed Tuesday professed a range of feelings about the changes. Some mourned a loss of identity at St. Raphael’s, while others looked forward to a greater sense of stability at an institution in deep structural debt.

Yale-New Haven is set to formally acquire the hospital at 12:01 a.m. Wednesday, becoming one 12,000-employee, 1,519-bed entity.

Officials signed documents at a 2 p.m. press event Tuesday at Yale-New Haven Hospital (YNHH) making way for the acquisition. The signatures capped two years of negotiations and approvals. Click here, here and here for background stories.

Officials touted the takeover as the way to save financially drowning St. Raphael’s, cut costs overall, and strengthen a top employer in the New Haven economy’s growing health-care sector.

About 200 workers at St. Raphael’s are losing their jobs as the result of the takeover, officials said. YNHH Vice President Vin Petrini said the hospital is working hard to find new positions for those people. And YNHH is keeping on 3,400 workers from St. Ray’s.

“We fully expect to grow jobs in the long run as we invest in the Saint Raphael campus and open up inpatient beds,” Petrini added.

At the press event in a hospital auditorium, YNHH CEO Marna Borgstrom said the takeover has three goals: to improve the quality, accessibility and affordability of health care. The move will save YNHH from spending $650 million on a new patient tower to accommodate an influx of patients. Patient volume has been so high at times that the emergency department has hit capacity, causing the hospital to divert patients to St. Raphael’s.

Borgstrom said the acquisition will enable the hospitals to coordinate care through common electronic records. It will allow for cost-cutting amid declining government reimbursements, “ensuring our vibrancy into the future,” she said.

“We must change, we must evolve, and we must be nimble,” Borgstrom said.

Before the takeover, St. Ray’s had about 4,000 employees; Yale-New Haven, 8,000. St. Ray’s has 511 beds; Yale-New Haven, 966.

St. Raphael’s CEO Christopher O’Connor said the acquisition is “the best and most effective way” to rescue his hospital from “imminent financial difficulties.” Joining a hospital just six blocks away will “drive effective and efficient use of medical resources,” he pledged.

O’Connor starts Wednesday in a new job: Instead of heading up St. Raphael’s, he’ll be the chief operating officer for the Yale-New Haven Health System, the umbrella organization that owns Yale-New Haven Hospital as well as hospitals in Bridgeport, Greenwich, and the Northeast Medical Group.

In his last public act as St. Raphael’s CEO, O’Connor sat down next to Borgstrom and signed acquisition papers.

“I haven’t read this,” he joked before penning his name.

“You’re going to hate it,” Borgstrom quipped.

Sister Rosemary Moynihan, chair of the Saint Raphael Healthcare System Board of Trustees, welcomed the moment. She is general superior of the Sisters of Charity of Saint Elizabeth, the group of nuns who founded the Catholic hospital in 1907 and ran the operation.

The Sisters now “enter this new chapter with pride and gratitude,” she said. She said she’s proud “knowing our tradition of caring will continue”—in line with the Catholic values it was founded on. According to the deal, St. Raphael’s will retain its “ethical and religious” restrictions as a Catholic hospital.

Taking the podium Tuesday, Mayor John DeStefano said “I stand in awe” of the Sisters of Charity for all the work they’ve done. “These women are heroes,” he said. DeStefano said the hospital has been his family’s choice for three generations. His parents received their final care there, he said.

“Your race is not over,” he assured them. “Your healing work continues.”

The new institution will be the fourth largest in the nation, based on the number of beds, according to figures provided by Becker’s Hospital Review. Petrini said the number of beds tends to fluctuate, however, so the hospital is sticking with “one of the largest in the nation.” St. Raphael’s and Yale-New Haven will operate as one hospital under one provider number, he said. The two campuses are counted as one hospital—just like New York Presbyterian, which is considered the largest hospital in the U.S. with 2,200 beds at two campuses, Petrini said.

Laid-off St. Raphael’s employees were asked to sign an agreement in order to obtain the full amount of severance benefits. The agreement—a standard document in the industry, according to one experienced employment lawyer who reviewed it—limits their rights to speak publicly about the deal or to sue the hospital. Click here to read the document.

Employees who kept their jobs will become YNHH workers as of Wednesday morning.

“Bittersweet” Transition

That means Mary Iovino and Melissa Azukas (pictured), two nurses at St. Raphael’s, will have to start wearing YNHH’s uniform, royal blue scrubs.

Azukas, who’s worked at St. Raphael’s for six years, called the change “bittersweet.”

“It’s going to be sad,” she said, to lose the hospital’s identity.

Nearby at a Thai food cart, surgeon Gary Kaml said he has a new lab coat with the hospital’s new brand ready to don at midnight in case he gets called in to work. Other than that, he he said, “my practice for the most part will go unchanged.”

“I’ll keep cutting,” he said.

“Just because you change the name out front, doesn’t mean you change the quality of care,” he assured.

“I know people who were laid off, and they were good people,” he said. “I’m sorry to see them go.” But he said those cuts came for a good reason—to reduce costs in effort to adjust to declining reimbursements from the federal and state government.

Eventually, the hospital plans to move St. Raphael’s major trauma treatment to YNHH; that means major trauma victims in ambulances will be sent to YNHH instead of St. Ray’s. YNHH spokesman Rob Hutchison said that shift won’t take place until next year.

In the short term, Hutchison said, the hospital is focusing on making sure employees get paid and that the “supply chain isn’t disrupted.”

Sign Of The Times

Ahead of the takeover, doctors in residency at St. Raphael’s gathered Tuesday at 1 p.m. for a group photo under the front entrance sign. That sign, which now reads “Hospital of Saint Raphael,” will change to read “Yale-New Haven Hospital,” according to St. Raphael vice-president of corporate affairs, Cindy Von Beren. Beren said the rest of the title—“Saint Raphael Campus”—won’t fit on that particular sign.

Internal medicine residents Lena Wu and Chizoba Ugwummadu (pictured) reviewed the photos after their group shot.

“We don’t have a clear picture” of how the takeover will affect the residency, Wu said Tuesday.

All the residents will become part of YNHH’s residency program, Peter Herbert, chief medical officer at YNHH, clarified after the press event.

He said residents have met the news “with mixed emotions,” because “they love St. Ray’s so much.”

A 26-year-old radiology technician said he welcomes the takeover. “It’ll bring more financial stability to the institution,” he said.

He cited one drawback: A loss of extra work. He currently works 40 hours, for $24 to $26 per hour, at St. Raphael’s. In effort to grab extra money to save up to buy a condo, he had been looking for per diem work at YNHH. However, after the takeover, he’ll already be a YNHH employee. The hospital would have to pay him overtime pay to do the work, so he predicted he wouldn’t land the work after all.

One man outside welcomed the change: Kenn Joseph, who sells hot dogs for a cart owned by Sweeney’s. Joseph sat outside St. Raphael’s with few customers Tuesday, as nurses and doctors lined up at the Thai cart nearby.

Joseph said not many St. Raphael’s workers buy his hot dogs, georgia hots, kielbasa, burgers, or Italian sausages.

Joseph said he hopes the merger might bring some new faces past the entrance, lining up before his cart.

“All the doctors are health conscious,” he said. “They won’t eat my food.”