THE CAPITAL, TALLAHASSEE, January 15, 2013………After seeing their trauma-center proposals get shelved, two hospitals in Miami’s Jackson Health System have filed legal challenges contending that the Florida Department of Health has made “selective” decisions about allowing new trauma facilities.
Jackson North Medical Center and Jackson South Community Hospital filed petitions this month with the department seeking a hearing before an administrative law judge. The petitions are the latest chapter in a series of legal fights about the department’s handling of trauma-center applications.
The Jackson hospitals submitted trauma-center applications last March but received notice in mid-December that they would not be approved until the department drew up a new rule for deciding whether to allow new trauma centers. An administrative law judge found in 2011 that the agency had been using an invalid rule — a decision that the 1st District Court of Appeal upheld in November 2012.
In the petitions, the Jackson hospitals say the department approved a trauma-center application for Ocala Regional Medical Center on Dec. 7 and also allowed Kendall Regional Medical Center and three other hospitals to open trauma centers in 2011 after the rule was found invalid. The petitions are seeking an administrative law judge to determine that the “selective” approval of what are known as provisional trauma licenses was not legally justified.
“The ultimate facts that will be established at hearing in this matter, are that all provisional licenses issued under the invalid trauma need rule should be revoked and all pending applications or letters of intent to apply to operate trauma centers should similarly be denied, instead of the selective benefit arbitrarily and invalidly conferred on some trauma center applicants by the department,” both petitions say.
The department did not respond to a question about why the Ocala Regional trauma center was approved and the Jackson trauma centers were not.
But Stephen Ecenia, an attorney for the HCA health-care chain, which operates Ocala Regional, Kendall Regional and the other three hospitals that have opened trauma centers, said he thinks the Jackson hospitals only have legal “standing” to raise issues about their applications — not the approvals of the other facilities. Ecenia also questioned whether the Jackson hospitals want to maintain a “closed trauma system rather than an inclusive trauma system.”
“Why a public hospital in Dade County would be spending resources to attack a hospital in Ocala makes no sense to me,” he said.
HCA, which announced in 2010 that it planned to open new trauma centers in the state, has been embroiled in the long-running legal fights. Its applications to open trauma centers at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Orange Park Medical Center in Clay County spurred the initial challenges that led to the department rule being declared invalid.
Four hospitals that have long operated trauma centers — Tampa General Hospital, St. Joseph’s Hospital in Tampa, Bayfront Medical Center in St. Petersburg and Shands Jacksonville Medical Center — launched those challenges, arguing in part that the department rule was outdated. While an administrative law judge agreed, the department allowed Blake, Regional Medical Center Bayonet Point and Orange Park Medical Center to go ahead with opening trauma centers in late 2011 during an appeal.
HCA argues that opening new trauma centers will expand access for people in more communities. But critics say more trauma centers will siphon patients from existing facilities and create competition for medical specialists, which would drive up costs.
The Jackson petitions allude to such arguments, saying the department’s decisions about the approved trauma centers “illegitimately and without authorization introduce competition for trauma center staff and resources, while limiting arbitrarily and without merit other trauma center applicants’ abilities to compete for the same resources.”
The department’s decision to allow Ocala Regional to open a trauma center also is being targeted in a lawsuit filed in December by Munroe Regional Medical Center in Ocala, Shands Hospital at the University of Florida and Shands Jacksonville. A Leon County circuit judge has scheduled a hearing in that case next month.
Amid the litigation, the department has started the process of creating a revised rule to deal with trauma applications. The department, which will hold a series of public meetings about the issue, announced last week that a team from the American College of Surgeons will review the trauma system and make recommendations.