A Cautionary Tale of Rural Healthcare and a Peek Inside a Health System Board Meeting
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4 responses to “A Cautionary Tale of Rural Healthcare and a Peek Inside a Health System Board Meeting”
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Jim, that’s a lot of bureaucratic verbiage for readers to wade through, especially if readers don’t know what to look for. What are your key take-aways from these documents?
One thing that stands out to me is the justification provided to keep the ambulatory surgery center closed — it would force the hospital to compete for nurses and undercut its profit margins on certain procedures. In other words, the hospital was protecting its own institutional self interest.
On the other hand, it is legitimate to ask if Tazewell County had the population base to support a hospital and a surgery center. Could continued operation of both hospital and surgery center cause both to go bankrupt?
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Agree. Revised above.
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This comes across to as a relatively small rural hospital making a business decision to protect its fiscal position. It would be costly to re-establish that ambulatory surgical center and it did not think the patient load was there to justify it. That additional facility would end up diverting the most profitable patients from the main facility.
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I posted this essay without enough reflection. I gave readers the entire report without enough analysis on my part. I revised it above.
The part of the revision that addresses your observations is as follows.
The issue isn’t whether Bluefield Regional Medical Center and the Bluefield ASC should have closed for lack of volume or for lack of nurses. I have no idea.
But we do now know that when the acquisition was approved by the State of West Virginia and the FTC let it happen, the acquirer, WVU Medical System campus in Princeton WV, told all including Bluefield residents that they planned to expand the services at Bluefield.
PCH closed it 10 months later.
They blamed COVID in the hospital closing press release. But they also had refused multiple requests from doctors to let them lease or buy the ASC.
The transcripts of the meeting of the Board of Princeton Community Hospital above appear to provide rare compelled evidence of likely violations of federal antitrust law with regards to the ASC.
The way PCH went about the acquisition, misrepresenting a plan to expand services to gain approval of the purchase and then closing the Bluefield hospital 10 months later, is at least unethical but they would pass it off as incompetence at the front end and COVID at the back end.
Refusing to lease, sell or even notify the VDH or Medicare that the ASC was closed is another matter. It was likely illegal. WVU Princeton Community Hospital created a regional monopoly with the acquisition and then utilized the monopoly to block competition by failing to notify the government that the ASC was closed.
If the Board had done so, which was its obligation, the Richmond COPN bureaucracy would have crossed it off its list and opened up the area for another ASC. Which local doctors wished to establish.
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