Ratcheting up the stakes in Miami-Dade’s hospital wars, Jackson Health System has filed two petitions with the state demanding a hearing to consider its belief that the license for trauma operations at Kendall Regional Medical Center was granted illegally and should be revoked.
Jackson, which for years has had the county’s only trauma center, has been complaining loudly since the Scott administration decided the state needed more centers. Kendall Regional’s opened in November 2011.
Jackson executives estimate it has been losing about $28 million a year since then because, as one of its trauma doctors quipped, Jackson Memorial’s Ryder Trauma Center tends to get the inner-city gunshot victims who have no insurance while Kendall gets the suburban car accident victims with insurance.
State officials and the HCA hospital chain, which owns Kendall Regional, maintain that Miami-Dade’s size requires more than one trauma center.
Mark McKenney, medical director of the Kendall center, said Wednesday the center has treated 2,500 patients in its first year -- “with mortality rates significantly below the state and national averages.” He said Kendall treats anyone who comes through the door, including plenty of gunshot and stabbing victims who may or may not have insurance.
McKenney said the state decided Miami-Dade needed more trauma centers after a 2005 study showed that only 39 percent of the county’s trauma victims were treated in trauma centers. Those treated in ordinary emergency rooms showed a considerably higher mortality rate, McKenney said.
In Miami-Dade, HCA’s Mercy and Tenet’s Palmetto General have also applied for trauma licenses. Jackson countered by seeking trauma units at its two community hospitals, Jackson North and Jackson South.
In its filings to the Department of Health on Jan. 2, Jackson’s lawyers asked for formal administrative hearings, maintaining North and South were unfairly denied approval in a Dec. 13 Department of Health letter that stated the regulators were rethinking trauma rules on trauma centers after court rulings.
The Jackson petitions, first reported on Tuesday by Jim Saunders of News Service of Florida, noted that an administrative law judge in November 2011 decided that the Department of Health’s trauma certification rule was invalid. After that, the department granted provisional licenses to Kendall Regional and three other hospitals.
On Nov. 30, 2012, the First District Court of Appeal upheld that decision. Seven days later, the department approved the application of Ocala Regional, another HCA facility, and allowed it to open the following day. Gov. Rick Scott is the former chief executive of HCA.
Jackson’s attorneys accused the department of giving these other hospitals a “selective benefit.” They said that a hearing would establish that “the ultimate facts” show that “all provisional licenses issued under the invalid trauma rule need rule should be revoked,” as well as all pending applications, until the department established a legally acceptable rule on trauma centers.
Steve Ecenia, an attorney for HCA, called Jackson’s petition “bizarre” because, instead of seeking approval for its own applications, it was trying to hit back at other hospitals, including Ocala, “hundreds of miles away.” He said the appeals court decision wasn’t final, because there are demands for a rehearing, and the Department of Health’s licensing has been fair.
A Department of Health spokeswoman said Wednesday that the department “had no additional information to provide.” A Jackson spokesman said executives couldn’t comment “because of pending litigation.”
Wayne Brackin, chief operating officer of Baptist Health South Florida, said Baptist is “very worried about this trauma issue,” because in the 1980s, the trauma system fell apart in Miami-Dade with many hospitals losing money on the service, and Baptist doesn’t want the Ryder Trauma Center weakened by competition that could again endanger trauma care in the county.
