Hospital Seeks to Heal Long and Costly Rivalry

Community Memorial Hospital extended an offer of peace to the rival county hospital two blocks away on Friday, proposing that they end their costly war and work together to create a single regional medical center.

“My approach is to start with a clean slate,” said Michael Bakst, executive director at Community Memorial. “And to end these hospital wars.”

A majority of the county Board of Supervisors, also weary of the five-year battle between the two hospitals, welcomed the initiative.

“I think it’s a great step in the right direction,” Supervisor John Flynn said.

The hospitals, which cooperated fully for decades but battled in recent years over patients as policy changes put the institutions in greater competition, first discussed a merger in 1996.

That effort failed, partly because Community Memorial wanted to convert Ventura County Medical Center into an outpatient center. It also stalled because of lingering bitterness from the private hospital’s successful ballot campaign to block construction of a $56-million wing at the county hospital.

But Bakst and county officials say times have changed and the two hospitals need to work together now.

Faced with having to spend tens of millions of dollars to make their hospital safe during earthquakes, Community Memorial directors voted this week to start discussions with the county supervisors, Bakst said.

A state law passed after the 1994 Northridge earthquake requires that by 2008 all California hospitals must meet strict standards to prevent their buildings from collapsing during quakes. Bakst said reconstruction costs at both the newer private hospital and at the aging public hospital could be astronomical.

“But what we have to spend, we can spend together,” he said. “Let’s say it costs $30 million to $50 million at each hospital--and I wouldn’t be surprised at that--or we can have one [joint] facility spending $50 million and giving the community what it really needs.”

Currently, about half the beds at both hospitals are filled on an average day. Bakst said joint operation would allow the hospitals to streamline services and save money.

Further, both maintain costly intensive care units for newborn babies, but the Ventura area needs only one, Bakst said.

Community Memorial runs a small profit on operations, and the county hospital loses millions of dollars a year.

“I see this as an opportunity to minimize expense, maximize service and create for the community a situation where its two premier medical facilities are working together,” Bakst said. “I can see it evolving into a regional medical center.”

Supervisor Frank Schillo and board Chairwoman Judy Mikels also support Community Memorial’s proposal in concept, they said. They talked about such a move earlier this week, Schillo said, after a Community Memorial lawyer suggested in a meeting that the two hospitals cooperate to meet earthquake standards.

“The climate is really right, and we should be sitting down and talking with them,” Schillo said. “It’s a totally unnecessary adversarial position between two hospitals on the same street and in some cases serving the same patients. We ought to work together.”

Reaching an agreement may not be easy, however. Schillo and Mikels have met with Community Memorial representatives before without making a deal.

“I am more than happy to talk with the board of directors at CMH about cooperation,” Mikels said in a prepared statement from Greece, where she is vacationing. “I have met with them twice. If they are now prepared to meet again in good faith, I will be available at any time and am pleased to move forward.”

County officials have accused Community Memorial of refusing to bargain in good faith, most notably during the 1996 talks. The other side leveled similar charges against the county.

One Community Memorial director, Dist. Atty. Michael D. Bradbury, said the current proposal is a serious overture.

“This has been under discussion for some time, and it came to a head at our meeting on Tuesday,” Bradbury said. “The retrofitting requirements are so stringent they really require almost scrapping what we have if it was built before 1973 and starting from the ground up.

“This is an opportunity that we simply cannot afford to ignore,” he said. “If we do, shame on us.”

Community Memorial was built in phases--in 1967, 1974 and in the mid-1980s, Bakst said. At least the first phase would require substantial work, he said.

Most of the county hospital, which opened in 1921, was built before 1973, although a wing where about half its patients are housed was constructed in the mid-1980s and probably would require little seismic reinforcement, Administrator Samuel Edwards said.

Edwards said he could not estimate the cost of upgrading the county hospital because structural engineers have only begun their analysis. Just two weeks ago, the county approved spending $7 million to upgrade hospital utilities. The hospital also needs a new laboratory and a new kitchen to stay open, because those facilities are obsolete.

Edwards would not comment on practical problems a merger would present. But he said that even during periods when the hospital war was most intense, doctors continued to cooperate on patient care.

The county hospital shared Community Memorial’s million-dollar machine for sophisticated full-body X-rays. Heart surgery is not done at the county hospital because Community Memorial is equipped for that specialty.

“My feeling on the hospital wars is that I’ve never had hard feelings against Community,” Edwards said.

Pierre Durand, director of the county Health Care Agency and a key player in past talks, could not be reached for comment Friday. Under Durand’s direction, the county health system--its hospital and community clinics--greatly expanded and even offered treatment to thousands of county employees.

Community Memorial complained that the county’s aggressive posture amounted to an unfair competition for privately insured patients by a public entity. That is why the hospital said it opposed a new wing at the county facility.

Flynn said he thinks negotiations this time should be between the Board of Supervisors and Community Memorial directors and avoid intermediaries and that a merger should be pursued vigorously.

“We would be in serious trouble with the taxpayers if we didn’t go forward on this,” he said.