Daughters of Charity Sale to Prime Healthcare

allnurses Guide · Mar 11, 2015

It seems Prime will not buy the hospitals because they don't like what they would have to agree to. I my area that means no more trauma Center in the area when St. Francis closes.

St. Vincent Hospital, the first hospital in Los Angeles, the first west of the Mississippi to do transplants, 1st in California to do open heart surgery, will probably close. That is too bad.

... Prime, the Southern California hospital company, called the conditions placed on the sale by state Attorney General Kamala Harris "so burdensome and restrictive that it would be impossible for Prime Healthcare -- or any buyer -- to make the changes needed to operate and save these hospitals."...
Prime Healthcare passes on Daughters of Charity deal - San Jose Mercury News

DoGoodThenGo · Mar 12, 2015

It was news around here that the sale went through and I did see this press release: Attorney General Kamala D. Harris Issues Decision Approving Sale of Six Daughters of Charity Health Facilities | State of California - Department of Justice - Kamala D. Harris Attorney General.
However, Prime must not have liked the conditions and they have now backed out of the purchase:
Prime Healthcare rejects Daughters of Charity deal - San Jose Mercury News
Prime Healthcare pulls plug on Daughters of Charity deal - San Francisco Business Times
Back to zero, I guess.

Under California law the state DA must approve the sale of any non-profit hospital/healthcare system. That is what Ms. Harris did; ok the sale but with conditions, it remained for Prime Healthcare and the Daughters of Charity to hammer out a final deal under those said conditions. The latter was willing but the ball was in the former's court.

caliotter3 · Mar 12, 2015

As I recall, the news announcement I heard on the radio stated that bankruptcy proceedings would commence or continue. Very sad for those whose care is going to be affected.

DoGoodThenGo · Mar 12, 2015

Am sad but not surprised Prime Healthcare decided not to go ahead with the deal. The restrictions placed by Ms. Harris came on top of recent rule changes regarding non-profit hospitals by the Obama administration. See: Sen. Charles Grassley to Nonprofit Hospitals: Stop Suing Poor Patients - ProPublica

As one has repeatedly stated providing charity care and or being a hospital of last resort is not an easy road these days. These places face the same operating costs as any other hospital and yet do not have the same payer base as for profit or even non-profits that serve a more wealthy demographic.

Contrary to popular belief "Obamacare" isn't the savior many assume for charity hospitals.

These places serve populations that are often poor to indigent thus do not qualify for even subsidized insurance. Yes, many do qualify for Medicaid especially the expanded version, but that is just what many hospitals especially those struggling financially want or need; more Medicare/Medicaid patients. Neither program pays anything close to 100% on the dollar a hospital spends yet come with a vast and bewildering array of rules and regulations that increase costs.

This is one of the reasons Saint Vincent's in The Village went under. Despite all the new wealth in that area patients with good insurance avoided the place, preferring to go to the East Side hospitals instead. What the place ended up with was providing a large mix of Medicare/Medicaid and indigent care. This was fine for the Sisters since it meshed with their mission of providing healthcare regardless of ability to pay, however as noted you can no longer run a healthcare system on bake sales and well intentioned dedicated servants alone.

The dirty little secret in Washington D.C. and local governments is that Obamacare alone will not expand healthcare deeply as many wish. To reach a greater percent of the population they are going to force the feet of non-profit systems to the fire in order to get them to provide a greater share of "charity/indigent" care and eat a percentage of the losses. How this will play out is anyone's guess. IMHO you are going to see more closures and mergers as financially weaker or non-viable places are absorbed or simply close.

A decade or so ago everyone was rushing to build/open new hospitals; that is largely over. What we are going to see is more and more full service places closing replaced by urgent/ambulatory care facilities.

DoGoodThenGo · Mar 12, 2015

Am sad but not surprised Prime Healthcare decided not to go ahead with the deal. The restrictions placed by Ms. Harris came on top of recent rule changes regarding non-profit hospitals by the Obama administration. See: Sen. Charles Grassley to Nonprofit Hospitals: Stop Suing Poor Patients - ProPublica
As one has repeatedly stated providing charity care and or being a hospital of last resort is not an easy road these days. These places face the same operating costs as any other hospital and yet do not have the same payer base as for profit or even non-profits that serve a more wealthy demographic.
Contrary to popular belief "Obamacare" isn't the savior many assume for charity hospitals.
These places serve populations that are often poor to indigent thus do not qualify for even subsidized insurance. Yes, many do qualify for Medicaid especially the expanded version, but that is just what many hospitals especially those struggling financially want or need; more Medicare/Medicaid patients. Neither program pays anything close to 100% on the dollar a hospital spends yet come with a vast and bewildering array of rules and regulations that increase costs.
This is one of the reasons Saint Vincent's in The Village went under. Despite all the new wealth in that area patients with good insurance avoided the place, preferring to go to the East Side hospitals instead. What the place ended up with was providing a large mix of Medicare/Medicaid and indigent care. This was fine for the Sisters since it meshed with their mission of providing healthcare regardless of ability to pay, however as noted you can no longer run a healthcare system on bake sales and well intentioned dedicated servants alone.
The dirty little secret in Washington D.C. and local governments is that Obamacare alone will not expand healthcare deeply as many wish. To reach a greater percent of the population they are going to force the feet of non-profit systems to the fire in order to get them to provide a greater share of "charity/indigent" care and eat a percentage of the losses. How this will play out is anyone's guess. IMHO you are going to see more closures and mergers as financially weaker or non-viable places are absorbed or simply close.
A decade or so ago everyone was rushing to build/open new hospitals; that is largely over. What we are going to see is more and more full service places closing replaced by urgent/ambulatory care facilities.

Just read over this post but too late to edit.

"Yes, many do qualify for Medicaid especially the expanded version, but that is just what many hospitals especially those struggling financially want or need; more Medicare/Medicaid patients."

Should be .......just that is what many hospitals especially those struggling financially do not want or need....".

Red Kryptonite · Mar 12, 2015

Apparently the Daughters of Charity play hard ball:
Daughters of Charity Health System sues union that opposed sale to Prime Healthcare - San Jose Mercury News

Do not mess with nuns.

doggal · Mar 12, 2015

I am an older nurse from the 1970's. I worked with many nurses trained at St Vincent's hospital. I understand the corporate matter, -I get it. Intellectually I totally get it, but in my heart of hearts I cannot deal with it. I recently had to leave a facility run by the Little Sisters of the Poor as they were closing the site... and yep possibly to real estate. I work as a consultant and I tell you, I am darn near getting a job as a dog walker. I find much, not all, of the corporate climate as vicious and I can barely take it anymore. It is a matter of my identity as a professional-can't seem to shake it.

There is much to the faith based communities- there is the premise that one is working for something higher than the self-sorry if that sounds trite..

DoGoodThenGo · Mar 12, 2015

I am an older nurse from the 1970's. I worked with many nurses trained at St Vincent's hospital. I understand the corporate matter, -I get it. Intellectually I totally get it, but in my heart of hearts I cannot deal with it. I recently had to leave a facility run by the Little Sisters of the Poor as they were closing the site... and yep possibly to real estate. I work as a consultant and I tell you, I am darn near getting a job as a dog walker. I find much, not all, of the corporate climate as vicious and I can barely take it anymore. It is a matter of my identity as a professional-can't seem to shake it.
There is much to the faith based communities- there is the premise that one is working for something higher than the self-sorry if that sounds trite..

In my mind it is a mix of forces coming at once not just to faith based facilities but all those run with a mission to care for the indigent and or provide charity care.

Things started going downhill IMHO ironically with two programs designed to help the poor; Medicare and Medicaid. Those two schemes removed the need for those that couldn't pay for healthcare to seek out "charity". In short they could go to any hospital or healthcare facility, and many did which deprived charity institutions of "butts in beds" so to speak.

The other shoe that is falling comes in the form of action being taken against the ever loud rant concerning healthcare spending in the United States.

Even just a decade ago money would have been found on the state and or local level (if not federal as well) to save places like Saint Vincent's in New York and so forth. But times have changed. Budgets are tight, rate payers are demanding ends to ever increasing tax and spend policies, all coming against the feeling that in many parts of the country there is a surplus of inpatient beds.

What seems to be doing Catholic healthcare institutions in is a combination of dwindling numbers of religious along with ever increasing numbers of "cafeteria Catholics".

The large waves of Catholic immigrants from Europe that many institutions, parishes, and other church related facilities/organizations were founded to serve are no more. Even more bad news comes from Catholics no longer feeling obligated to send their children to parochial schools, use Catholic hospitals, and so forth.

The West Village area around the former Saint Vincent's Hospital was once heavily working class Italian and Irish, that isn't the case any longer. There are more Italian tourists in Little Italy than Italian American residents I shouldn't wonder.

IIRC Obama read book/studied about the old Philadelphia General Hospital while researching material to put together his national health plan. This isn't exactly a bad idea. For though secular the decision to close that place and the aftermath not only reverberates still in Philly healthcare, but seems to be serving as a template of sort for what is going today with indigent/charity care facilities.

Care for all: A look back at Philadelphia General Hospital

Advanced Practice Columnist / Guide · Mar 13, 2015

Under California law the state DA must approve the sale of any non-profit hospital/healthcare system. That is what Ms. Harris did; ok the sale but with conditions, it remained for Prime Healthcare and the Daughters of Charity to hammer out a final deal under those said conditions. The latter was willing but the ball was in the former's court.

I actually should have rephrased my previous post as "I've heard that the sale went through" rather than "its news around here". Actually, I've heard that the sale went through from nurses I know that work at Seton Medical Center and maybe I misheard it or those nurses were just wishfully thinking that the state's Attorney General's signature would have sealed the deal.

Seton has a lot of problems few of which is a dwindling patient base and a patient case mix that has become heavily Medi-Cal. The hospital is in close proximity to other hospitals that are part of Kaiser (a corporation well poised for the current realities of hospital financing) and Sutter Health which has a newer building that attracts a better patient case mix. On top of that, Seton's physical building no longer conforms to newer California regulations that require hospitals to be seismically compliant - they must meet a deadline, the year 2020, to build a new structure to house in-patients.

DoGoodThenGo · Mar 13, 2015

I actually should have rephrased my previous post as "I've heard that the sale went through" rather than "its news around here". Actually, I've heard that the sale went through from nurses I know that work at Seton Medical Center and maybe I misheard it or those nurses were just wishfully thinking that the state's Attorney General's signature would have sealed the deal.
Seton has a lot of problems few of which is a dwindling patient base and a patient case mix that has become heavily Medi-Cal. The hospital is in close proximity to other hospitals that are part of Kaiser (a corporation well poised for the current realities of hospital financing) and Sutter Health which has a newer building that attracts a better patient case mix. On top of that, Seton's physical building no longer conforms to newer California regulations that require hospitals to be seismically compliant - they must meet a deadline, the year 2020, to build a new structure to house in-patients.

Not to beat a dead horse......

But same thing pretty much happened with Saint Vincent's in the West Village. Their plant was old and outdated. Operating rooms IIRC in particular weren't up to modern designs, and as with many older hospitals the place was a hodgepodge of buildings that went up as the place expanded all built around the original Saint Vincent's chapel.

Saint Vincent's could have continued operating but would have stood a better chance in competing for the sort of well insured/paying patient base it needed if a new facility was built. To complicate matters three hospitals are across town on the East Side (Bellevue, Beth Israel, and NYU). Further uptown you have New York Hospital the big Grand Daddy.

The original plan was to sell the original site of ST. V's to developers and use the O'Toole building across the street to build a new hospital. The local landmark community was up in arms more for tearing down either building than saving the hospital. The rest as they say is history. The hospital closed and the property was torn down and developed into luxury housing.

Don't know about California but here in NYC the Archdiocese just announced another round of parish closures, mergers and so forth. This is on top of the various churches, convents, parish houses, and other properties that have closed over the past ten years. Real estate industry is beside themselves salivating at getting their hands on some, any or all of these properties. The Cardinal's office denies real estate plays any part in these decisions. However they still need millions to fund the ongoing renovation/restoration work at Saint Patrick's Cathedral .

That is the common thread through all charity/indigent care facilities; often the property they are on is worth more than keeping the place open. Long Island College Hospital in Brooklyn ended its days pretty much the same way as Saint Vincent's played out. Most of the site will be developed into luxury housing with an urgent care facility replacing the full service hospital.

Brining it all home it is becoming clear to me at least the days of every community having a local full service hospital are going fast. The large facilities/networks with wealth and power will remain. Everyone else will make due with urgent/ambulatory care centers.

imuscle, MSN, NP · Mar 15, 2015

Praise Jesus!!! Prime Healthcare will not buy the Daughters of Charity Healthcare System. He walked away due to the Attorney General's stiff conditions...he had no intention of honoring any of them anyway. I work at St. Francis Medical Center in Lynwood, CA. St. Francis is the only hospital of the 6 in the chain that makes the money. We have been paying the bills for over 10 years. Our nurses opposed the sale to Prime and we did it proudly! We are not part of CNA thank god! Who wants to be part of a union that "dances with the devil?" That is exactly what they did with Prime and Dr. Reddy. At St. Francis we are part of the United Nurses Association of California/Union of Healthcare Professionals (UNAC/UHCP) and we fought long and hard to keep Prime out and we did it! We secured our three year contract back in December 2014 with the Daughters of Charity and we secured our Pension language that has to be honored regardless who the buyer is. Prime Healthcare is the most questionable and substandard healthcare organization in the country...hard to beleive any nurse would support that kind of organization especially when all the questionable practices are documented in court readings. We knew there were many lies and rumors being spread around by management...we were constantly told, "Prime or bankruptcy." Well Prime walked away last week and today our CEO found an extra 100 million dollars...Praise Jesus! How about that? All of a sudden they have some money and many buyers for the system...Our doors are open and we are told our CEO says we have months to decide on another buyer...how about that? How quickly things change...no bankruptcy...money available...and we have plenty of time to select a buyer. I find it amazing that so many supported Prime knowing all the negativity associated with the organization...I am so glad we objected to this sale and opened the door to healthcare organziations that do not engage in questionable practices. It is also comforting to know the attorney general was smart when she announced the conditions of the sale..she knew exactly what she was doing...Dr. Reddy showed his true colors...he said he would keep all the hospitals open...when the attorney general put it in writing it did no longer look good to Dr. Reddy. UNAC/UHCP had said it all along...Prime lies and he lied about this transaction and he had no intention on doing the right thing. CNA thought they had a deal...yeah they sure did...WOOPS!

imuscle, MSN, NP · Mar 15, 2015

Nuns steal Too!!! The money was not lost in stocks it was removed!!!

SEIU sues Daughters of Charity Health System over pensions, as it tries to sell hospitals - San Francisco Business Times