San Jose Medical Center To Close in December
Nashville-based hospital chain HCA Healthcare on Wednesday announced that it would close San Jose Medical Center on Dec. 9, rather than in 2007 as previously planned, the San Jose Mercury News reports. According to the Mercury News, HCA had first said in 2002 that it planned to close the 81-year-old hospital because of higher costs from declining Medicare and Medi-Cal reimbursements, new state seismic retrofit regulations and new state nurse-to-patient ratio rules implemented in January.
The 324-bed hospital last year lost $16.3 million from revenue of $136.7 million (Feder Ostrov, San Jose Mercury News, 9/9). SJMC, which serves about 100 inpatients per day, also said it had lost $45 million over the past three years because of "increasing numbers" of uninsured patients and higher wage costs, the San Francisco Chronicle reports (Rubenstein, San Francisco Chronicle, 9/9). The hospital would become the sixth in the state to close this year (Los Angeles Times, 9/9).
About half of the hospital's 900 staff positions will be eliminated, and other personnel will be transferred to Regional Medical Center of San Jose or Good Samaritan Hospital, "'bumping' staffers there who are lower in seniority," the Mercury News reports.
Before SJMC closes, patients will be transferred to RMC and possibly other local hospitals. HCA officials said they plan to add an additional trauma center to RMC. According to the Mercury News, the expansion of RMC "could take months."
After the closure, emergency patients will be diverted to Valley Medical Center and Stanford Medical Center, the two remaining trauma centers in Santa Clara County.
Bob Sillen, executive director of the Santa Clara Valley Health and Hospital System, said a public clinic could be moved to the site of the closing hospital or near it. Sillen added that he did not know how the closing would affect emergency department waits at VMC.
The county and city have sponsored a $100,000 study on the impact of the hospital's closing that will be completed in November.
SJMC spokesperson Leslie Kelsay said HCA moved up the closing date because of "intensifying financial problems," the Mercury News reports. "[The center] has been losing money for years. The hospital had been hanging on by its fingertips, and we just couldn't hold on any longer," Kelsay said (Feder Ostrov, San Jose Mercury News, 9/9).
Hospital CEO Steve Dixon said, "This is not a decision we wanted to make. It is a decision forced on us, and other hospitals, by a health care system in California that is underfunded" (San Francisco Chronicle, 9/9).
Some patient advocates blamed the closure on HCA, which "has a reputation for buying competing hospitals in a market, then consolidating them, resulting in layoffs and reduced access to medical care," the Mercury News reports.
"This is just HCA living up to its reputation of being interested in only one thing, and that's their bottom line," Rosylin Dean of the Save San Jose Medical Center Coalition said.
However, Jan Emerson, a spokesperson for the California Healthcare Association, said "all types of hospitals" are closing, adding, "We've got to address the nursing shortage, how we deal with uninsured, seismic retrofit issues, flat reimbursement rates from Medi-Cal. All those forces are just reaching the absolute crisis point."
Donna Gerber, director of government relations for the California Nurses Association, said HCA might have moved up the closing date to avoid complying with the provisions of a bill (AB 2874) under consideration by Gov. Arnold Schwarzenegger (R) that would require hospital operators to announce closings 180 business days in advance and give communities the chance to bring facilities under local control.
HCA spokesperson Jeff Prescott denied Gerber's charge and said that the "real issue is we simply cannot continue to operate both San Jose Medical Center and Regional Medical Center of San Jose. They're losing way too much money" (Feder Ostrov, San Jose Mercury News, 9/9).
San Jose Mayor Ron Gonzales said, "Although we can't force HCA, as a private business, to change its business decision about closing the medical center, we ask them to reconsider it" (San Francisco Chronicle, 9/9).
Although the closure of the hospital was "inevitable" given its financial situation, the city's "challenge now is to find the best way to meet the downtown community's medical needs on a short- and long-term basis," a Mercury News editorial states. According to the editorial, the city should meet with HCA staff to discuss future emergency care plans and work out "logistical challenges in emergency situations," as well as decide how to provide "downtown residents with an array of walk-in medical services."
However, the editorial states, the "most important step the city should take" is to continue zoning the area as public so that it may be used for future medical uses, "including the possibility of building another downtown hospital in better economic times." The editorial concludes that "the city can demonstrate some foresight by anticipating the medical needs of its growing urban population and keeping the land available for an inevitable need" (San Jose Mercury News, 9/9).