Englewood Health, for 130 years an independent hospital serving eastern Bergen County, plans to merge into Hackensack Merdian Health, one of two large health systems that now dominate medical care in New Jersey.

The merger agreement includes a commitment by Hackensack Meridian to invest $400 million in new operating rooms, expanded cardiac facilities and outpatient sites for Englewood physicians, executives of the two institutions announced Tuesday. Hackensack Meridian has also agreed to take on Englewood's outstanding debt of $182 million.

“We realize that we can do many things together that we cannot do alone,” Warren Geller, Englewood Health’s president and CEO, wrote in a message Tuesday to staff, employees and volunteers of the hospital.

The hospital employs 3,400, including 750 nurses represented by the Health Professionals and Allied Employees union, and has 1,100 affiliated physicians. No layoffs are expected.

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Some experts have found that hospital consolidation nationwide leads to an increase in prices and decrease in patient satisfaction, as competition is reduced and health systems gain leverage with insurers.

One out of three dollars spent on health care in the United States goes to hospital care. But rising prices and profit margins for hospitals have attracted less attention from lawmakers than drug prices, because most people have insurance coverage that limits their out-of-pocket payment. The main effect of increased hospital prices is higher insurance premiums, which are paid by employers and consumers.

The merger comes during a growth spurt for Hackensack Meridian. Less than a month ago, it announced a partnership with St. Joseph’s Health, whose hospitals are in Paterson and Wayne, that allows the Catholic hospital to maintain its religious health principles while investing $60 million in ambulatory care services in Totowa and an expansion of women’s health services.

And a year ago, Hackensack Meridian merged with the Carrier Clinic, a statewide provider of mental-health and addiction treatment; it recently announced plans to open a drug rehabilitation program in Mahwah and an urgent care center for mental health issues in Neptune.

The merger announced Tuesday brings the 541-bed Englewood hospital, located just 8 miles from Hackensack, into the orbit of the flagship Hackensack University Medical Center. Englewood had the second-lowest occupancy rate in Bergen County last year, with 37 percent of its beds occupied, on average, and Hackensack had the highest, with 78 percent, according to figures from the state Department of Health.

Englewood's network of 100 ambulatory care sites in six counties will also become part of Hackensack Meridian's network, which is expected to expand even more as the system works to bring care closer to patients, Geller said. Many physicians already maintain affiliations at both hospitals, but those who don't will have to go through Hackensack Meridian's credentialing process.

"We see health care is changing," Geller said. "Collaborative care is an absolute must. We don't need to waste resources." The merger will give patients access to clinical trials, transplants and Hackensack's children's hospital, with its many pediatric specialties, and enables the staff to participate in research on everything from artificial intelligence in medicine to the latest immunotherapy treatment for cancer, he said.

Known for its programs to reduce the use of blood transfusions in surgery, Englewood will retain and expand its open-heart surgery program.

“We will continue to improve the well-being of communities with more cost-effective care that delivers quality, safe outcomes, clinical excellence and a superior experience,” said Robert C. Garrett, Hackensack Meridian’s CEO.

The Health Professionals and Allied Employees union, founded 45 years ago at Englewood, called for transparency and community involvement as the deal is reviewed. The union represents employees at three of Hackensack Meridian's 17 hospitals, including the former Palisades Medical Center in North Bergen.

The union "looks forward to working with Hackensack Meridian to ensure the nurses at Englewood Health maintain a collaborative relationship with administration and that administration continue to listen to the voices of nurses," said HPAE spokeswoman Bridget Devane.

With the announcement, only a dozen of the 71 hospitals in the state remain independent from larger health systems. They include Holy Name Medical Center in Teaneck and Valley Health, owner of The Valley Hospital, which is in the midst of constructing a $735 million, 362-bed hospital in Paramus.

The other large system in New Jersey, RWJBarnabas Health, earlier this month signed a letter of intent to acquire Trinitas Regional Medical Center in Elizabeth.

Many factors have spurred hospitals to form larger networks that include hospitals as well as other types of facilities, such as nursing homes, rehabilitation centers, ambulatory surgery centers and physician offices, said Kerry McKean Kelly of the New Jersey Hospital Association. She cited a study by the American Hospital Association that said the cost of care was reduced and quality improved after mergers.

The merger was unanimously approved by Englewood’s board of trustees. The philanthropic foundations of the two institutions will remain separate, and Geller said his hospital's donors were enthusiastic about the merger.

The agreement must be reviewed by the state attorney general and the Federal Trade Commission, a process expected to take about a year.

Englewood signed a clinical affiliation with Hackensack in 2015.

The announcement comes a decade after Englewood and Valley teamed up to oppose Hackensack University Medical Center’s first expansion — the takeover of the former Pascack Valley Hospital in Westwood, which declared bankruptcy in 2007. Together, they fought to prevent Hackensack from opening the county’s first for-profit hospital.

They lost. Pascack Valley reopened in 2013, and it now is known as Hackensack Meridian Health Pascack Valley Medical Center.

After the merger, Englewood will be known as Hackensack Meridian Health Englewood University Medical Center.

Lindy Washburn is an award-winning health care reporter for NorthJersey.com and The Record and two-time Journalist of the Year for New Jersey.. To keep up-to-date about how changes in the medical world affect the health of you and your family, please subscribe or activate your digital account today.

Email: washburn@northjersey.com Twitter: @lindywa

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