By AT News Team, Feb. 16, 2015:   Adventist hospitals in Illinois join with Catholic hospitals in a new organization, while Adventist Health joins new corporate arrangements in Oregon and California. At the same time, headlines announce millions of dollars in legal penalties and commitments to new facilities by Adventist health care operations across the United States. Recent events may cause some Adventists to question the denomination’s health ministry organizations, but it is business-as-usual with faith-based health institutions in contemporary America.

Four Adventist hospitals in Illinois are joining with five Catholic hospitals to create a more comprehensive and efficient way of delivering health care in the suburbs of Chicago, reported the Daily Herald last week. Adventist Midwest Health has formed a joint company with Alexian Brothers Health System, completing a process that began in June last year and submitted for legal and regulatory approval in October. The new structure “allows the two separate organizations to preserve their respective religious identities and mission priorities, and to integrate operations while maintaining separate ownership of their assets,” the newspaper stated.

The joint arrangement “will provide our communities with high-quality care, while reducing cost and overhead,” said David Crane, chief executive officer of Adventist Midwest Health which is part of Adventist Health System (AHS) headquartered in Florida. The nine hospitals serve communities around Chicago with a total population of 3.8 million and more than 3,000 physicians. This includes the historic Hinsdale Adventist Hospital.

Portland Adventist Hospital has joined with three other hospitals in Oregon’s largest city to create a psychiatric emergency room at one central location. The letter of intent signed recently by the four institutions seeks to open “the state’s first comprehensive behavioral health care center in late 2016,” the Portland Business Journal announced on February 5. It will be called Unity Center and have 101 beds with an construction cost of $50 million, of which one of the collaborating hospitals is committing $10 million while donor organizations and government agencies have committed another $25 million so far. It is unclear what the Adventist share of the cost will be.

A hospital in the small central California town of Lodi recently agreed to come under the control of Adventist Health, the same regional health care nonprofit that operates Portland Adventist Hospital as well as 18 other institutions with a total of 2,700 beds in the three states on the Pacific coast as well as Hawaii. Lodi Memorial Hospital will become the 20th hospital in the system.

Health policy experts say that these kinds of larger corporate arrangements are absolutely necessary in the current economic context in the United States. “Individual stand-alone hospitals simply cannot survive any longer,” a retired health administrator and former government official told Adventist Today.

“Our goal is to create a healthier community,” Rita Waterman, an assistant vice president for Adventist Health, told the Lodi News-Sentinel. “Our mission is to serve our patients … with compassion, dignity and respect. … We are committed to sharing God’s love by providing physical, mental and spiritual healing [but] our ministry is not about proselytizing.” She stated that “every three years our hospitals conduct community needs assessments” from which they plan prevention programs for diabetes, heart disease, obesity, etc.

Adventist Health has committed an investment of over $100 million in the Lodi hospital, the newspaper stated. It will acquire the hospital and all of the its related services and assets, as well as its debts and liabilities.

AHS announced last week that it will spend $25 to $30 million to build a new hospital in Sebring, Florida. It will update and increase the size of the 25-bed facility that serves a another small town so that there can be a larger emergency room and more facilities for doctors’ offices and outpatient clinics, according to a report in the Tampa Tribune. Hardee Memorial Hospital was originally opened in 1970 and then closed in the early 1990s before AHS reopened it in 1994.

Legal Penalties Assessed

The U.S. government will deduct 1 percent from the Medicare reimbursements to a total of 721 of the hospitals across the country during 2015 because those institutions scored poorly on the prevalence infections and complications that patients acquire while in the hospital. “Of the 49 Adventist hospitals nationwide that were part of the federal [health agency’s] scoring, 10 were penalized,” reported the Kansas Health Institute. One of these was the Shawnee Mission Medical Center which scored the lowest among all the hospitals in the Kansas City metropolitan area.

Also in January, the U.S. Attorney in San Francisco announced that St. Helena Hospital and Adventist Health had agreed to pay $2.25 million “to settle allegations that it submitted false claims to Medicare for certain cardiac procedures,” according to the Record-Bee newspaper in Lake County, California. The patients were administered angioplasty on an inpatient basis which was “medically unnecessary [and] should have been treated on a less costly outpatient basis,” according the allegations of a former employee of the hospital. The hospital did not admit guilt although it paid the restitution.

This was not a criminal action, but a civil lawsuit filed under the “whistleblower” provisions of the False Claims Act. The suit was filed by Kacie Carroll who was employed for two months in 2010 as director of the emergency department at the hospital will receive $450,000 out of the settlement, the newspaper stated.

This is “the second time in a year and a half that Adventist Health has agreed to pay the Federal government over litigation brought under the … False Claims Act,” reported The Sacramento Bee, the major newspaper in the state capital. “In May 2013, the Adventist chain agreed to pay Federal and state officials $14.1 million to settle claims that is Los Angeles hospital, White Memorial Medical Center, paid inflated fees to a group of doctors who referred patients to the facility. Two doctors who blew the whistle on the alleged arrangement received $2.8 million of that settlement.”

The dynamic, even disruptive change in health care in the U.S. continues to make it very complicated for Adventist health institutions to chart a course in 2015. Flexibility and creativity are essential for the leaders of these institutions which have for more than a century been seen as stable, foundational elements of the Adventist mission in America.