Read the part that states 45% of their ER patients are uninsured. In South Miami Dade there are around 100,000 if not more illegals. Many are South and Central Americans who overstayed visas. If you went there you would think that you are in another country.

http://www.miamiherald.com/2010/03/08/v ... ld-be.html


Jackson South hospital could be multimillion-dollar white elephant

BY JOHN DORSCHNER
jdorschner@MiamiHerald.com
Of all the proposed cuts announced last week for the Jackson Health System, the one with the biggest implications is closing down Jackson South, where a $102-million, four-story addition is 40 percent complete.

Since voters approved a bond issue in 2004, the members of the governing Public Health Trust have planned the expansion of the hospital on Southwest 152nd Street as the move toward a state-of-the-art facility, luring customers in the affluent southern suburbs who have commercial insurance.

But future potential has been trumped by the present grim reality: Forty-five percent of the patients entering South's emergency room are uninsured. The hospital is expected to lose $20 million to $25 million in fiscal 2010.

``Life does change in six years,'' Jackson Chief Executive Eneida Roldan said Sunday. ``The demographics in the community have changed,'' with an older, poorer population around the hospital. ``Our market analysis showed a deterioration of the payer mix'' -- meaning more uninsured and more with Medicaid, the state-federal insurance for the poor that generally pays less than private insurance and Medicare.

What that means is that the Public Health Trust board is now debating whether it would be better to stop the South construction -- meaning $40 million or more of taxpayer dollars is down the drain -- or spend another $60 million of bond money to complete the expansion in hopes that it will make the hospital more attractive to a buyer.

``Why stop construction?'' County Manager George Burgess asked the board on Friday. He pointed out that the addition is being paid for with bond money, which is separate from the operating cash that is expected to run out in May unless drastic measures are taken.

``We have to look at all the realities,'' Roldan said Sunday about continuing construction. ``At this point, it's going to come down to a profit-and-loss analysis.''

Whether South would be sold or shuttered for possible reopening by Jackson later will be up to the County Commission.

Two weeks ago, Stuart Podolnick, then South's chief administrator, showed a Herald reporter and photographer through the new addition as dozens of construction men worked.

The 160,000-square-foot addition includes seven new operating rooms, with a new cardiac cath lab, a surgical suite for gastrointestinal work, a new 12-bed critical care unit and an expansion of the emergency room from 15 to 22 beds.

A fourth-story is designed as a shell, to be filled in as South's patient load expanded.

The hospital, built in the 1970s, was purchased by Jackson in 2001, originally with the idea of serving the poor and uninsured in the southern reaches of the county. All its rooms are ``semi-private'' -- meaning two beds.

Because the present facility has no cardiac cath lab, ambulances take patients with chest pains to other facilities, where there is the ability to quickly open arteries blocked by heart attacks. That has meant many elderly patients with Medicare go elsewhere.

``We're a very well-run hospital,'' Podolnick said at the time. He pointed out the average length of stay was about four days -- ``one of the shortest in Dade County,'' at least partly because South employs hospitalists who get patients treated as efficiently and quickly as possible.

Two weeks ago, the main rumor about South was that its emergency room might be closed. Podolnick said that would be ``very detrimental'' to the hospital, because 70 percent of all in-patients came through the ER. A couple of days after he said that, Podolnick was dismissed.

The hospital is in the center of an area of middle- and upper-class suburbs. Richmond Heights, a predominantly black middle-class area lies to its west. Farther west is the middle class non-Hispanic and Hispanic development of Country Walk. To the east are the upper-middle and upper-class neighborhoods around Old Cutler Road.

Its main competition is Baptist Hospital -- 6.2 miles away, Kendall Regional at 10 miles away and Homestead at 15 miles.

Jackson executives acknowledge that South's main problem is that it appears to be a magnet for the uninsured, even though by law any hospital ER must treat a patient, regardless of ability to pay. Baptist reports that 12 percent of its ER visits are from the uninsured, Homestead 25 percent -- far below South's 45.

``The brand of Jackson is all about being a safety net,'' said Roldan, meaning that the poor and uninsured believe Jackson is the place they ought to go.

A devastating analysis of South's potential was delivered by Qorval, a Naples consulting firm that was hired by Roldan last year.

After a Herald story revealed that a $425-an-hour Qorval consultant was linked to accusations of fraud with a Chicago window company, the relationship ended -- before the consultant could deliver an analysis of Jackson's problems, dated Oct. 23. A copy was delivered to Roldan a few days ago.

The Qorval report said South was ``dirty, disorganized and unkempt with dated equipment.''

Qorval recommended ``if possible, construction at JSMC should be halted immediately as the larger facility will likely increase JSMC losses. The project will likely go over budget with no viable incremental funding.''

Podolnick has reported to the board that construction has stayed on budget. It's scheduled to be done in 2011, if allowed to continue.

If Jackson South remained open, Qorval recommended that it try to get away from the Jackson brand by creating ``a quasi-independent image (Cutler Bay Regional Medical Center -- Affiliated with JHS).''

Local residents meanwhile are upset. ``People here count on that hospital,'' said James Marshall, a longtime Richmond Heights activist who served on the advisory board of the Deering Hospital, as Jackson South was previously known.

``People voted for that sales tax,'' he said of the 1991 vote to add a half-penny to support Jackson. ``Where did it go? We voted heavily for that'' in the Richmond Heights area. ``If you have that ER closing, you're going to have a lot of people dying, and that's not right.''