Trauma Drama: Tenet, HCA fighting over providing critical care

The hospital wars — readily apparent on practically every other billboard down the interstate — has now bled over into trauma with accusations that expansion by a competitor into the area threatens “the entire care system in our country.”

The fight pits two giants against each other: Tenet Healthcare and HCA Healthcare and puts taxpayers in the middle as the whole system is administered by the Health Care District of Palm Beach County.

Currently, the county’s state-designated Level 1 trauma centers are St. Mary’s Medical Center and Delray Medical Center.

Trauma centers handle the most extreme cases of emergencies, such as car accidents,  gunshot wounds. Life and death hang in the balance with each case that comes through the doors.

Tenet and HCA healthcare companies are squaring off over which hospitals will provide trauma in the county.

The current trauma drama stems from Tenet competitor JFK Medical Center in Atlanta filing a letter of intent with the Department of Health on Sept. 30 to upgrade its trauma care services to Level 2 that would cater only to adults.

It is a first step in formerly submitting an application next year.

In a letter sent out today by Mark Bryan and Gabrielle Finley-Hazle – the CEOs of St. Mary’s Medical Center and Delray Medical Center respectively – the Tenet hospitals excoriate the competitor’s plan, saying it would undercut a system in place for 25 years.

“There will be a lack of qualified trauma surgeons to cover an excess center and decrease trauma center staff proficiency,” the letter states.

In the letter addressed to its board members, the community, employees and doctors, the CEOs say that the proposal goes against the five-year plan approved and submitted to the Department of Health and the Health Care District.

The district is an independent taxing district that operates Trauma Hawk and provides a health care safety net for the county.

122611 (Alyssa Orr/The Palm Beach Post) Atlantis--JFK Medical Center off of South Congress Avenue in Atlantis.

The letter states since JFK is only offering adult trauma services it means if a tragic event occurs involving an entire family, then parents and children will be split up.

The Post plans on interviewing all players in this trauma drama and will update this story as warranted.

Whether its heart surgery or maternity, hospitals are very aggressive in vying for patients in the county.

St. Mary’s closed down its pediatric heart surgery unit last year following criticism that is now being leveled at JFK’s trauma plan: that the program diluted the number of patients and undercut the proficiency of existing programs in South Florida.

In the letter, the Tenet hospitals point to an investigation by the Tampa Bay Times into how HCA is targeting trauma for profit, charging exorbitant fees that pale in comparison to competitors.

“HCA is capitalizing on a marketplace that is unchecked by politicians or regulators. That has allowed one of the nation’s largest for-profit hospital chains to bill injured patients record fees,” according to the March 2014 story.


Health Care District looks to take on heroin epidemic

As opioid drug overdose deaths increase exponentially, the Health Care District of Palm Beach County — the taxpayer-supported safety net for medical services here — plans to partner up with first responders to help drug abusers in crisis.

Hypodermic needles mixed with cigarette butts and empty prescription bottles found in the trash at a cottage apartment rented by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

It’s a big first step for the district that already runs the Trauma Hawk air ambulance, Lakeside Medical Center in Belle Glade and primary care clinics and school nurses, among other services.

The opioid epidemic has been fueled by prescription pill abuse and the mixing of powerful synthetic opioids like fentanyl with heroin by traffickers and dealers to increase potency and profit.

The district this week applied for a $10 million state grant over five years from the Department of Children & Families that would allow it initially to provide services to addicts at their most vulnerable: right when they overdose and are taken to hospital emergency rooms.

The district will partner up with Southeast Florida Behavioral Health Network, the Palm Beach Sheriff’s Office, Palm Beach Fire-Rescue, as well as hospital emergency rooms.

The first stage of the plan is to get addicts in crisis who have been stabilized to an open bed at a local detox or drug recovery center.

Darcy Davis, CEO of the Health Care District of Palm Beach County, says it is time to tackle the heroin epidemic.

The Health Care District is also not just focusing on poor and homeless drug abusers, aiming to help any community drug users who needs to navigate the drug rehabilitation and insurance industries to get treatment, as well as providing those without means an avenue for recovery.

But the district’s CEO Darcy Davis says the second phase of the plan will establish a “centralized receiving facility” that would not only provide treatment for addicts but also mental health services.

“We recognize the opioid crisis is significant and we need to act as quickly as possible to respond,” she said. “And you have to start somewhere. It’s a huge problem. We feel like we need to get involved.”

Read more about the Health Care District’s plans to expand into addiction services this weekend in the Palm Beach Post.

And read our coverage of the heroin epidemic by clicking here.


Gov. Scott re-appoints two members of Health Care District Board

After a drama-filled year for the Health Care District, Chair Philip Ward and board member Nancy Banner weathered the storm to get new terms courtesy of Gov. Rick Scott.

Scott announced the  re-appointments on Monday. Both were originally appointed by the governor in October 2011 and continued in their capacity on the board after their terms expired last year.

Ward is president and managing partner of Ward Damon, a multi-disciplined law firm which he co-founded in 1987. He succeeded Carol A. Roberts as board chair last year.

The governor’s office said Ward is appointed to a term ended in September 2018, while Banner’s new term ends in September 2019.

The Health Care District has 1,200 employees and runs Trauma Hawk, Lakeside Medical Center in Belle Glade, primary care clinics and school nurses, among other services.

Last year, the board refused to give then CEO Dr. Ron Wiewora a vote of confidence and he abruptly resigned. The district also weathered several audits – including one by the State Auditor General. It also found itself challenged by the sheriff’s office for control of Trauma Hawk.

It seemed to be courting further drama when it considered for the open CEO position at least two officials from scandal-ridden Broward Health – the public health system in that county – but ended up choosing in March internal candidate Darcy Davis.

Florida Auditor General releases report on Health Care District

The state Auditor General released the much-anticipated report on the Health Care District of Palm Beach County — and despite resurrecting some ghosts of scandals past — this latest in a long line of audits found little new.

New CEO of the Health Care District Darcy Davis says taxpayers should be thrilled with the recent report from the State Auditor General that resurrected some old scandals but found little new.

The audit recommended the district get reimbursed for using the air ambulance Trauma Hawk out of county and put in conflict of interest safeguards when purchasing land or giving money away to outreach organizations. It also recommended increased independence when it comes to its internal audits.

Rep. Dave Kerner of Lake Worth – and county commission candidate – wanted Trauma Hawk placed under the power of the Sheriff’s Office.

The district has undergone a series of audits in about a year and this latest one was a political animal stemming from a takeover attempt last year by the Sheriff’s Office of Trauma Hawk. That coup failed, but one of its most ardent supporters, Lake Worth state Rep. Dave Kerner, called for an audit.

For Darcy Davis, the newly enthroned CEO of the district, the Auditor General’s report was a good start to her tenure. It is especially good news when compared to what has happen to the south with scandal-plagued Broward Health where the chair was removed by Gov. Rick Scott last month and then ordered reinstated by a judge on Monday.

“The taxpayers should be pleased that this is all the Auditor General would find,” she said. “Not to minimize their efforts, but seriously this gives me reassurance that the tax dollars are being used wisely.”

The report alludes to a scandal five years ago when the district spurned free county land to rebuild the Edward J. Healey Rehabilitation and Nursing Center at its existing – but problematic – site. Instead, the district purchased land for $4 million in which the family of the real estate broker for the district had an interest.

On Trauma Hawk, the report did say that not all out-of-county services were trauma-related, and thus were not reimbursed. The county footed about $452,500 for counties that called in for help.

Davis said that the District will renew negotiations with other counties, but it is a tough task since withholding such services could cost lives.