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By Melody Jameson
melody@observernews.net
If a large, lighted, local area scoreboard were recording calls in South Hillsborough’s which-hospital-where competition, the tally this week could read: South Bay, 1; St. Joseph’s, 1.
Florida’s Agency on Health Care Administration (AHCA) on Friday issued a “Final Order” approving a 2005 application by the St. Joseph’s-Baptist Healthcare network to build an acute care, 90-bed hospital on the south side of Big Bend Road.
This approval follows by about eight months approval from the same agency last December of a 2007 application by South Bay Hospital, a unit of Hospital Corporation of America (HCA), to relocate and expand most of its services from its current site on S.R. 674 to property on the north side of Big Bend Road.
The time-consuming, multi-million-dollar siting, construction, equipping, staffing and opening of a full service hospital to provide advanced medical treatments in a number of specialties, however, is not a game. Nor is the current status any sort of tie.
The two approvals reflect official actions in two separate application cycles and it may be that not until conclusion of an administrative court hearing now slated to begin in February, 2009, can a last chapter be outlined in the somewhat confusing tale-of-two-hospitals.
When both St. Joseph’s and South Bay proposed in 2005 to build new hospital facilities on their respective acreages abutting Big Bend Road, AHCA denied both requests for approval.
The St. Joseph management challenged that denial, seeking a judicial review. And, after a series of continuances, the administrative law court hearing of the 2005 denial proceeded in Tallahassee late in October and through early November, 2007. In May, 2008, Judge J. D. Parrish issued her recommendation that AHCA approve St Joseph’s 2005 application, based on a number of considerations such as desirability of varied medical services options, advantages of healthy competition and geographic accessibility of medical services.
And in its order released Friday, AHCA incorporated many of the judge’s findings as it gave the St. Joseph’s 2005 plan a green light.
Meanwhile, South Bay opted for a different tack, proposing in the 2007 application cycle that it be allowed to transfer most of its services being offered in the 25-year-old, 112-bed facility on S.R. 674 to a new, updated acute-care 112-bed hospital on Big Bend, while still maintaining limited services at the present location. The HCA-controlled management would continue emergency room care and some diagnostic services near Sun City Center, it said. What’s more, South Bay executives promised to develop a transportation system that would make reaching the new South Bay about eight miles distant easier for senior patients and visitors.
It was this 2007 proposal that AHCA approved during the same timeframe that the St. Joseph’s challenge of its 2005 denial was being weighed by the administrative law court. AHCA’s approval of the 2007 South Bay relocation plan came despite clear opposition loudly voiced by hundreds of seniors during a public airing last October in Sun City Center.
In last week’s order supporting St. Joseph’s, AHCA specifically echoed points made in Judge Parrish’s May recommendations. The agency noted projected population growth across the South County, the present lack of a not-for-profit hospital to serve this section of the county and non-existent obstetrical services in the region, among other points.
Considering the changing complexion of South Hillsborough from farming and mining ”expanses with scattered housing” to a high growth area with “modern shopping centers, apartment complexes, housing subdivisions, churches, libraries and new schools,” AHCA underscored the developing need for more medical care options. The agency pointed to the proposed St. Joseph’s satellite distribution of beds: 66 for medical/surgical patient use, 14 in an intensive care unit and 10 dedicated to maternity care. Patients rooms would be private and the facility would include a full-service emergency treatment department, AHCA noted.
AHCA also examined the matter of occupancy. South Bay’s occupancy rate in 2006 exceeded 80 percent and in the first seven months of 2007 topped 88 percent, it said. Such occupancy figures indicate the hospital is operating at or near capacity, a circumstance which is not recommended and in the long term “proves to be detrimental to hospital efficiencies.”
In addition, the agency asserted South Bay has experienced difficulty in staffing its emergency department and when confronted with capacity problems diverts admissions to other hospitals. Moreover, South Bay also has not moved to expand its emergency services to meet area needs. Other area hospitals, among those who opposed the St. Joseph Big Bend proposal, also are faced with seasonal over-capacity and have added beds to meet such demands, the order stated.
The St. Joseph’s satellite would alleviate the crowding, the agency posited, and would not pose an unfair competitive challenge to other medical services providers.
On the downside, the agency noted that since St. Joseph’s proposal for its Big Bend site was offered in 2005, costs of site preparation and construction in particular have increased radically. However, the agency expressed confidence in the medical provider’s financial strength “to construct and operate the project.”
Reaction of St. Joseph’s management to the AHCA decision has been appreciation of “the thoughtful consideration given our proposal,” a spokesperson said this week. “We’re very, very pleased,”said Lisa Patterson, public relations director, suggesting the most recent AHCA position is another step in a long process begun three years ago. She also commended the South County communities, including Sun City Center, that contributed heavily to the process with expressions of their views on hospital services for the area.
Speaking for Sun City Center’s taskforce, organized last fall to campaign for keeping South Bay in its present location, Jim Duffy characterized AHCA’s approval of the 2005 application as “verification of the right thing to do; an additional positive decision moving toward what we think is the right situation for the area,”St. Joseph’s on Big Bend Road and South Bay on S.R. 674.
Duffy estimated that 3,500 to 4,000 letters supporting that proposition have been sent from the retirement community in recent months to state officials, including the governor, AHCA leaders and legislators. “And we’ll continue to play a role,” he added.
At South Bay and in HCA offices this week, indicators pointed to careful combing of the AHCA order. Melissa Morgan, marketing and public relations director at South Bay, acknowledged “We disagree with the decision; we disagreed with the administrative law judge’s recommendation.” This is a time, she added, for evaluation of options. And, in Pinellas County corporate offices, Debra McKell, a HCA marketing manager, said she anticipated review of the AHCA order by company executives “on the detail level.”
Morgan also emphasized the difference between the AHCA decision supporting St. Joseph’s 2005 proposal and its okay of South Bay’s 2007 plan. “One does not necessarily impact the other,” she said.
Parties to the matter as defined in the AHCA order released last week have 30 days to appeal the decision. And, come February, 2009, an administrative law court is to hear appeals of the AHCA 2007 decision favoring South Bay’s relocation.
©2008 Melody Jameson
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