Five members of the Illinois state Health Facilities and Services Review Board will make a definitive decision on whether or not to approve a request from Sarah Bush Lincoln to demolish and replace the SBL Bonutti Clinic in Effingham, according to the board's administrator, Courtney Avery.
The board usually carries nine voting members appointed by the governor, with no more than five members from the same political party. Currently there are only five voting members, with four vacancies the governor has the option to fill. A majority of the nine members would be five voting members. Therefore, all decisions made by the board no matter how many members on the board would require five votes to approve the SBL Bonutti Clinic request.
Also on the board are three non-voting board members, representing the office of Secretary of Human Services, Director of Healthcare and Family Services and Director of the Illinois Department of Public Health.
Several speakers appeared Wednesday at a public hearing in Effingham before the review board. Sarah Bush Lincoln has proposed building a new, $35 million Bonutti Clinic. HSHS St. Anthony's Memorial Hospital has challenged the scope of the project, saying it would dupliucate some services that the local hospital already provides.
Illinois State Senator Dale Righter, R-55th District, testified that his main goal is to insure the discussion and consideration of the project was based on facts and urged the review board to approve the Sarah Bush Lincoln application.
Righter said Sarah Bush Lincoln services are housed in several locations in the city of Effingham and a new facility would allow for consolidation of several services under one roof. He said claims made that St. Anthony's Memorial Hospital would loose over $30 million worth of revenue are baseless.
“After my review of the application and other materials available, there is no evidence to support such a claim,” Righter said.
He said any significant loss of revenue to St. Anthony's is already happening today and construction of a new facility will not change change that fact.
Dr. Ruben Boyajian specializes in general surgery and is the medical director of the Womens’ Wellness Center and Cancer Services at St. Anthony’s Memorial Hospital.
“I am an independent physician, meaning I’m not affiliated with either of the pursuing applicants or the affected hospital,” said Boyajian, who noted that he arrived in Effingham long before Sarah Bush Lincoln did.
“After more than 40 years of practicing my specialty in Effingham, I believe I understand the community and it’s healthcare needs,” Boyajiian said. “I make no apology for advocating for my home hospital in the community.”
He opposes the project proposed by Sarah Bush Lincoln. He said the application in its current form would result in service cuts and job losses at St. Anthony’s Memorial Hospital.
“The net effect would be negative for the Effingham area,” Boyajian said.
Boyajian said collaboration was the key to successful rural health care and is needed now more than ever in Effingham. He said when the applicants first came to Effingham they were given access to a whole floor at St. Anthony's Hospital and use of hospital owned equipment.
He said a hallmark of their past collaboration was St. Anthony's becoming one of two hospitals in the state to earn a joint commission's gold seal of approval for advanced total hip and knee replacement certification.
“The COVID-19 pandemic has financially challenged all Illinois hospitals,” Boyajian said. “And has produced necessary layoffs at St. Anthony's. Especially now, it makes little sense to allow this unnecessary duplication and expansion of existing hospital services.”
“I truly hope the staff and members of the review board would find a way to the win-win solution that this community wants, needs and deserves,” Boyajian said. “The first step in getting there would be more complete information on this application.”
Nick Williams, a physician assistant at SBL Bonutti Clinic, read a summary of written testimony from Dr. Peter Bonutti, who is an orthopedic surgeon and namesake of Sarah Bush Lincoln Bonutti Clinic.
“For the past 30 years, I’ve done everything in my power to provide excellent and cutting edge care for my patients,” Bonutti said. “Despite offers of practice at prestigious institutions such as Stanford, Emery, University of Florida and among others, I chose to bring my practice to Effingham, Illinois, bringing the latest in orthopedic care to my patients.”
Bonutti said patients have traveled to Bonutti Clinic from 41 states and six countries.
“We see patients on a daily basis who travel hundreds of miles to our clinic,” Bonutti said. “This has required us to build a multidisciplinary facility which will encompass all clinical and diagnostic services under one roof; therefore allowing patients to have access to all services in the same day. This consolidation of services enhances not only the quality, but the cost efficiency of the patient’s care.”
He said after 25 years of exclusive work with St. Anthony's, the hospital was not willing to invest in his practice and a much needed new facility. Bonutti said HSHS demanded he travel to offer services in Breeze, Greenville and O'Fallon taking surgeries and revenue away from Effingham.
“Three years ago, Jerry Esker, the Sarah Bush Lincoln President and CEO, and I talked about advancing orthopedics and the quality of care,” Bonutti said. “After understanding Jerry and Sarah Bush Lincoln's commitment for improving and investing in the quality of care for our patients, not only I, but the entire group of providers and staff all chose to partner with SBL.”
“Our partnership allows me to focus on continuing my research and development,” Bonutti said.
Bonutti said he has published more than 100 papers, has more than 400 patients and more than 700 licenses for medical products. He said during his 30 years of contributing to the Effingham community he has never had to ask for or received any financial incentives from the city of Effingham.
“Sarah Bush Lincoln is providing all capital to build a first-rate medical building,” he said.
“The clinic we are asking to build is a high quality building that will combine several Effingham medical practices into one location, and streamline services, and create efficiencies and comfort for all our patients,” Bonutti said. “It is amazing that Sarah Bush Lincoln is willing to invest $35 million into a state-of-the-art building for our community. This new facility is its long-term commitment to providing jobs, and quality of care in the Effingham community.”
“Even HSHS agrees the Bonutti Clinic needs to be replaced,” Bonutti said. “This certificate of application spells out specifically why the space is needed and how it will be used.”
“Please accept this letter as an indication of my wholehearted support,” Bonutti said. “I look forward to an expedited approval of the Certificate of Need as our aging facility is in urgent need of a new quality building to continue to provide excellent care to our patients.”
Dr. Andrew Mahtani is a hospitalist at St. Anthony's. He spoke in opposition of the Sarah Bush Lincoln Bonutti Clinic.
“Given the enormous financial and operational challenges for small hospitals from the ongoing COVID-19 pandemic, no category of hospital has been more profoundly harmed than rural hospitals,” Mahtani said.
Mahtani said St. Anthony's has been responding to the pandemic since March. He said the hospital established a COVID unit, conserved personal protection equipment, followed Centers for Disease Control guidelines, executive orders of the governor and IDPH guidance to close non-emergency services.
He said St. Anthony's followed state orders and prepared for an influx of COVID patients that never came.
“The loss of revenue from curtailed elective procedures was never offset by COVID related patient volume,” Mahtani said. “All the while our sole community hospital continued to make its essential services and resources available even as usage declined.”
He said money from the Federal CARES Act helped, but didn't cover all of the hospital's COVID losses. He said 75.9 percent of the hospital's revenue comes from outpatient procedures that would be duplicated at the new Bonutti Clinic.
“I am deeply concerned the project will threaten our sole community hospital's ability to sustain these essential services,” Mahtani said.
Effingham resident and business owner Doug Wohltman of Wohtman Construction of Effingham supports the Sarah Bush Lincoln Bonutti Clinic project.
“I was very surprised to learn HSHS St. Anthony's Hospital filed an objection to this $35 million project,” Wohltman said. “Without a doubt we need Sarah Bush Lincoln, its facilities and investment into our community.”
He said the construction of the new facility means positive entrepreneurial growth for the Effingham community. Wohltman said the project will bring several construction jobs to the Effingham area over the 18 months it will take to erect the building.
“This will also create several trickle down jobs in the community,” Wohltman said.
“A building of this caliber along Interstate-70 will most definitely be a welcome addition to the landscape and create a 'wow' impression to those taking exit 160 into Effingham,” Wohltman said.
Wohltman said it was time for the Effingham business to focus on the community at large and to move forward with a growth mindset.
The founder of Kingery Printing, John Kingery, spoke in opposition to the SBL proposal.
“I am completely committed to and involved in my the local community,” Kingery said. “As a community leader I well understand the Effingham area, the health care needs of our people and what our sole community hospital means to this community.”
Kingery said at one time he was volunteer board member of St. Anthony's Memorial Hospital. He stressed that St. Anthony's supports several service organizations in the community along with providing a variety of medical services for the park district, schools police and fire departments.
“St. Anthony's is the largest employer in Effingham County,” Kingery said. “It provides all essential hospital services, including an emergency room that never closes even when it doesn't pay for itself.”
“Our 144 year-old hospital is fundamentally important to virtually every aspect of life in Effingham,” Kingery said. “It is a precious asset worthy of preservation.”
Kingery said the new services proposed at the clinic and construction of an oversized facility are not in the best interest of the community.
“A win-win solution is certainly possible,” Kingery said. “It would be good for everyone to have complete, clear and consistent information from the applicant.”
The board is expected to review submitted information at a meeting at Bolingbrook Golf Club, 2001 Rodéo Drive, Bolingbrook, on Sept. 22.