Prime Healthcare’s decision to drop its bid to buy six Daughters of Charity hospitals, citing strict conditions set by Attorney General Kamala Harris, should prompt discussion about basic standards for all California hospitals.
Harris established a new bar for how all hospitals should operate, and it ought to become the industry yardstick.
In the debate over the proposed sale to Prime, the California Nurses Association emphasized that the primary factor should have been to keep the six Daughters of Charity hospitals open. They deliver life-saving services.
Harris, who by law must approve such sales, established a benchmark. Her decision should extend beyond hospital sales. Every California hospital should be held to the same criteria every day of the year.
The California Hospital Association, the lobbying arm for the hospital industry, has been silent on the controversy over Prime. The association ought to insist all its members, including the multibillion-dollar corporate hospital chains that dominate the association’s policies, comply with those same standards.
Virtually every one of those standards would dramatically improve access to care and the quality of patient services.
For openers, Harris insisted that Prime maintain the hospitals as acute care facilities with emergency services for 10 years. Hundreds of hospitals have closed across the country during the past decade, many of them in California. Others are in dire straits.
Public agencies and wealthy hospital chains should work together to find mechanisms to keep those hospitals open.
Harris called for Prime to certify the hospitals’ participation in Medi-Cal and Medicare programs. That’s important. Many California hospitals limit participation in those vital programs, putting our most vulnerable, medically underserved patients at risk.
The attorney general also said Prime should uphold all critical services, including reproductive services. Yet there continue to be other hospitals that fail to do so and, in the process, jeopardize the health of California women.
Prime was directed to continue charity care and community benefits at Daughters’ “historic levels.”
California hospitals have a checkered record of shortchanging their charity care obligations. A California Nurses Association study in 2012 found that California nonprofit hospitals reap $1.8 billion in public subsidies beyond what they provide in charity care.
CNA campaigns for legislation to more clearly define charity care and improve transparency against the vehement opposition of the hospital association. Senate Bill 346, authored by Sen. Bob Wieckowski, D-Fremont, is the latest bid to rectify a history of abuses.
Harris directed Prime to guarantee its debt-collection practices do not violate state and federal laws and regulations. What a great concept. As it is, thousands of patients are regularly hounded by hospitals demanding payment for medical bills that often are inflated. Medical debt remains the leading cause of personal bankruptcy.
Harris required Prime to meet proper seismic safety compliance requirements. Even though several California hospitals have collapsed on patients following earthquakes, the hospital association regularly pushes the Legislature to delay seismic safety compliance.
Finally, the attorney general insisted Prime guarantee all pension obligations covering Daughters’ current and retired employees.
Many nurses and other health workers have cared for their patients for years, even decades, with substandard retirement security. Ensuring workers can retire with dignity should be a hallmark of a civilized society.
Legislators, who were so quick to jump in with positions on the proposed sale, should fully examine the criteria set by the attorney general for Prime and require a uniform, level playing field for all California hospitals.
Ultimately, we will continue to have a fragmented health care industry with far too many patients facing inadequate access and care based on ability to pay until we have a more humane, equitable system. Harris suggested such a policy shift. She should stand by it.
RoseAnn DeMoro is executive director of the California Nurses Association/National Nurses United.