Report on Hospital Sale Gives Both Sides Fodder

The sale of Queen of Angels-Hollywood Presbyterian Medical Center to a for-profit chain could lead to “overall destabilization” of the greater Hollywood area’s emergency medical system, according to a state-mandated report.

The problems would occur if the hospital cut or curtailed services, says the report by the Lewin Group, a health care consulting firm.

The document says the hospital is likely to scuttle services that operate at a loss or are not linked to its viability, and that the most vulnerable targets are services to the sickest Medi-Cal patients.

Yet the controversial proposed $86-million sale to Tenet Healthcare Corp. also carries some hefty potential pluses, including the prospect of linking the hospital to a chain that is strong enough to land coveted health maintenance organization contracts, the study says.

The report was ordered by the state attorney general’s office, which must review and approve any sale of a nonprofit hospital to a for-profit company. In this case, the findings gave fodder to both sides in the heated debate over the fate of the 410-bed Catholic-run medical center.

On one side are consumer groups, the hospital union, hospital medical staff and Cardinal Roger M. Mahony, who views Tenet ownership as incompatible with Queen of Angels’ charitable mission. On the other are the hospital board and its supporters, who see Tenet as a ticket to preserving--and enhancing--the hospital’s financial health and contributions to the community.

Opponents of the sale predicted Tuesday that the report will force Tenet to change its offer or face rejection by the attorney general.

“Unless this deal can be amended . . . the deal doesn’t have much hope of going through,” said Leslie Daniels, staff attorney for the National Health Law Program, a consumer protection group. “The community wants some assurance this hospital will not just be a fair-weather friend.”

But Tenet and hospital officials said they saw nothing new or insurmountable in the report. “It doesn’t look like anything that presents a serious obstacle,” said hospital spokesman Douglas Jeffe.

Harry Anderson, a Tenet spokesman, said the report may result in “enhanced or clarified language” but not a return to the negotiating table.

Among the concerns noted in the report:

* The possible closure or consolidation of services by the hospital would reduce access to health care because other facilities are “not as linguistically or geographically accessible.” The community served by the hospital is one of the most diverse--in terms of ethnicity and language--in the nation.

* The deal, as proposed, provides that emergency room and perinatal services will be maintained for at least five years, so long as Medi-Cal payments are not reduced. Yet significant reductions in Medi-Cal payments are anticipated in the next five years.

Tenet has said it foresees no cutbacks in these services and is proposing a $4-million expansion of the emergency room.

* Charity care could be put at “enormous risk” or be significantly reduced because of the terms of the deal. Tenet has said it will guarantee at least $15 million annually in charitable care, the same level as the hospital now provides, in perpetuity.

The second of two community meetings on the sale is March 28 at Virgil Middle School.