American Indian Tribe Seeks To Establish Hospital in Place of San Jose Medical Center
Michigan-based investor group AR Associates is considering buying San Jose Medical Center from HCA Healthcare and converting it to a hospital for American Indians, the San Jose Mercury News reports.
The informal proposal comes three weeks after HCA announced that it would close the hospital by Dec. 9 (Feder Ostrov, San Jose Mercury News, 9/27). HCA officials made the decision in part because higher costs have resulted from lower Medicare and Medi-Cal reimbursements, new state seismic retrofit regulations and new state nurse-to-patient ratio rules implemented in January (California Healthline, 9/15).
If AR Associates' plan moves forward, the hospital would be the first of its kind in the United States, according to James Walker, a medical compliance consultant working with the company.
Most health care services for American Indians are provided by the federal Indian Health Service. IHS officials said they had not heard about the AR Associates proposal.
AR Associates CEO Anthony DeFeo in an interview with the Mercury News said that IHS would run the new hospital, but Walker said it would be run privately.
AR Associates is working with an undisclosed tribe that is based in California and previously helped to establish a large Indian health diagnostic center in Clinton Township, according to DeFeo.
Walker and DeFeo last week met with Assembly member Manny Diaz (D-San Jose) and representatives from the office of San Jose Mayor Ron Gonzales (D). The group has not met with HCA.
It is not clear whether SJMC would be open to community residents under the proposal.
Walker said AR Associates had told city and state officials that the hospital would serve the community. The hospital could not be sustained without other patients from the community, Walker said, adding, "My understanding is that it's going to be open and available for all individuals.''
However, DeFeo said, "We're only concerned about the Indian nation at this time."
There are 333,346 American Indians in California, 11,350 of whom live in Santa Clara County. About 6,800 American Indians in San Jose are served by an Indian health center there.
David Vossbrink, a spokesperson for Gonzales, said, "They were just kind of scoping out the community, political interest, the hospital itself. It sounded like it was all pretty loose. There would be a lot of questions to ask, a lot of due diligence to be done. Our goal is to see if there's some kind of result that could provide appropriate levels of service to downtown San Jose, including a trauma center.''
SJMC spokesperson Leslie Kelsay said the hospital has not been notified of a proposal. She said other rumors have circulated that the hospital could be bought by a Vietnamese doctor, an East Coast Indian tribe and a group of investors from China. Kelsay said, "We've certainly heard plenty of rumors, and rumors is what they are. There are people who can present themselves as prospective buyers, but the property is not yet for sale'' (San Jose Mercury News, 9/27).
In related news, Regional Medical Center of San Jose announced in a letter to Gonzales on Thursday that the hospital plans in November to offer restricted trauma services in an effort "to soften the impact" of SJMC's scheduled closure, the Mercury News reports
Regional has not been designated an official trauma center by Santa Clara County health officials, and, therefore, only walk-in patients will be treated. Some people have voiced concern that the hospital will not be able to serve the estimated 95% of trauma patients who come to hospitals by ambulance and helicopter.
In 2003, 135 of SJMC's 1,922 trauma patients were walk-ins, according to Joy Alexiou, a county health department spokesperson. HCA is urging Bob Sillen, executive director of the Santa Clara Valley Health and Hospital System, to approve an official trauma center at Regional that would serve only adult patients. Approval could take up to six months, according to Sillen.
Approval would require the hospital to make infrastructural changes, including increasing the number of beds and nurses in its intensive care unit. Moreover, emergency departments typically handle patients with medical conditions such as heart attacks and some injuries, while trauma centers serve patients with life-threatening injuries from car or industrial accidents and gunshot or knife wounds.
Sillen said, "I'm very concerned because apparently the folks at Regional believe you can provide bona fide trauma services without gearing up the entire institution." He added, "It's a rigorous process to be designated a trauma center, and there's a real good reason for that. They're just going around it all. It's their -- and the community's -- risk."
If the hospital is allowed to serve only walk-in patients, the proposal could prove to be too expensive to operate, as it costs $1.5 million to $3 million annually to run a trauma center, according to Mike Williams of the Abaris Group, an emergency and trauma care consulting firm.
Kelsay said the hospital is seeking to prevent Regional's specialized surgeons and nurses from leaving for other trauma centers across the country. "Once those folks are gone, trying to recreate the team will be a tremendous challenge," Kelsay said.
In the letter, Regional officials said that the hospital would need "timely movement'' from the county to continue to offer limited trauma services.
Vossbrink said that the mayor is "interested in the maneuver" and that he welcomes the hospital's commitment to provide trauma services (Feder Ostrov, San Jose Mercury News, 9/24).
The Monterey County Herald on Tuesday examined how Monterey County trauma patients would have fewer hospital options after SJMC closes in December (Aljentera, Monterey County Herald, 9/27).
Last week, Santa Clara County health officials considered recommending the termination of a policy that allows trauma patients from nearby counties to be transported directly to trauma centers in Santa Clara County for treatment (California Healthline, 9/22).
If trauma services are restricted at Santa Clara Valley Medical Center and Stanford University Hospital to residents of Santa Clara County, Monterey County residents would be left "without a clear destination for lifesaving treatment," according to the Herald. Both hospitals have had agreements with neighboring counties to accept trauma patients. Trauma centers outside of Santa Clara County include the University of California-Davis Medical Center, San Francisco General Hospital and University Medical Center in Fresno.
Chris LeVenton, Monterey County Emergency Medical Services director, said the county is working to assemble a plan to handle trauma situations. He said, "There are multiple trauma centers in the Bay Area. If they won't go to those they'll go to others" (Monterey County Herald, 9/27).
Santa Clara officials "should work together with HCA to make Regional Medical Center the county's third trauma center," a Mercury News editorial states. Both Regional officials -- "who believ[e] the trauma center will help improve the hospital's bottom line" -- and opponents of the move who believe HCA bought SJMC "with the intent of closing it," need to "make sure they're putting the needs of area residents first," the editorial states. "The alternative leaves Santa Clara County facing a future with possibly one of the worst patient-to-trauma-center ratios in the state," according to the editorial (San Jose Mercury News, 9/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.