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Hospital group rejects system and cashes in

A Southland doctor's company prospers by canceling insurance contracts and, some say, shortchanging patients.

July 08, 2007|Daniel Costello | Times Staff Writer

* In 2004, a patient listed as uninsured who was reportedly suicidal arrived at the Desert Valley ER after taking cyanide and waited 20 minutes to be treated by a doctor, during which time a less ill, insured patient was placed in a bed. The suicidal patient lost consciousness soon after and later died. Suzanne Richards, vice president of nursing for the company, says cyanide patients rarely survive.

* Early this year, a pregnant patient with severe abdominal pain and whose 8-month-old fetus had an elevated heart rate was discharged from Huntington Beach Hospital without adequate medical screening. The patient later gave birth in a nearby hospital.

The inspections even included meal service. A review of the patient food trays one day at La Palma Hospital showed roast pork being served in 1-ounce portions when the menu called for 3-ounce portions.

Reddy characterized the state and federal findings regarding Prime Healthcare as "insignificant" for a hospital chain its size and that the company had taken corrective measures. He said his hospitals continued to score highly on national accreditation surveys, including Desert Valley Hospital, which scored 98% on its most recent survey.

Reddy said state data showed that Prime Healthcare had increased the amount of care provided to the uninsured.

"The quality [of our care] is better than any of our peers," Reddy said. "I am a doctor and nothing is more important to me than my patients."

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X-ray of a profitable operation

Prime Healthcare Services is rewriting how hospitals make money, bycanceling managed-care contracts, collecting more from insurers andshuttering unprofitable services. At Desert Valley Hospital inVictorville, the company raised the bottom line by:

Examples of price changes for selected services and products at Desert Valley Hospital

*--* 2005 2006 Percent Service charge charge change Use of mechanical ventilator, first day $256 $6,144 +2,298% CL drug-eluting stent, to prevent blood $16,000 $63,900 +334% clots Vaginal delivery in maternity ward $1,475 $4,061 +175% One-hour ambulatory surgery $2,500 $4,000 +60% Blood test (CBC) $54 $76 +40% Pacemaker, single chamber $32,500 $22,500 --31% Angiogram $5,211 $2,957 --57%

*--*

Note: Hospitals prices reported to the state may not reflect the final charge on a patients bill.

Source: Office of Statewide Health Planning and Development. Graphics reporting by Daniel Costello

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Prime Healthcare Services' network

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*--* Year Number acquired County of beds Desert Valley Hospital 1995 San Bernardino 83 Chino Valley Medical Center 2004 San Bernardino 126 Montclair Hospital Medical Center 2005 San Bernardino 102 Sherman Oaks Hospital and Grossman Burn Center 2006 Los Angeles 153 West Anaheim Medical Center 2006 Orange 219 Huntington Beach Hospital 2006 Orange 131 La Palma Intercommunity Hospital 2006 Orange 141 Paradise Valley Hospital 2007 San Diego 301 Anaheim Memorial Medical Center 2007* Orange 217

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*Pending state approval

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Sources: Office of Statewide Health Planning and Development, Times research

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