The hospitals that treat the Tampa Bay area's most critically injured patients are struggling financially — and their plight could rapidly worsen if the HCA hospital chain opens competing trauma centers under a partnership with the University of South Florida.
That's the word from a Tallahassee judge, who last week sided with three bay area hospitals seeking to stop a plan to open a network of new trauma centers in the state, including one at Pasco County's Regional Medical Center Bayonet Point.
State health officials, who are reviewing HCA's applications, said Wednesday they plan to appeal the judge's decision.
Tampa General Hospital, Bayfront Medical Center and St. Joseph's Hospital led the legal challenge to the HCA-USF trauma centers. They say there simply isn't enough business for so many costly facilities that are staffed and equipped to deal with the most severe injuries. Beyond the revenue that is at stake, they argue that trauma surgeons and other staff must stay busy to maintain quality.
"A community filled with trauma centers caring for too few patients is not good for anyone, especially the patients," said Bayfront spokeswoman Kanika Tomalin. The hospital's priority "is all about patient care and preserving a level of volume that's a prerequisite to a trauma center's success."
Even without added competition, fewer people need trauma care these days, possibly because of a decline in auto accidents.
HCA's plan calls for new centers in Pasco and Manatee counties that would draw more business away from the existing Tampa Bay trauma centers. All three said in the court case that they already are losing millions of dollars in trauma care.
With added competition from HCA, the court ruling indicates, Bayfront could stand to lose 669 patients based on 2010 numbers — 42 percent of that year's volume. That would cost the hospital more than $2.3 million a year, and it already is struggling to stem operating losses.
In recent years, the court noted, Bayfront has deferred building projects due to finances, and last year posted an operating margin of less than 1 percent.
Tampa General at best is expecting to break even this year, and may even lose $4 million in operations, according to the ruling, which had less detail about St. Joseph's overall finances.
Nearly a year ago, USF made a public announcement that it was joining with for-profit HCA to run the proposed centers.
This summer, Bayfront, TGH and St. Joseph's joined with another trauma hospital, Shands Jacksonville Medical Center, to challenge a 1992 state administrative rule that could be used to approve the HCA plan.
After a hearing, Tallahassee administrative court Judge W. David Watkins declared that the rule is outdated. He said it fails to take into account factors including advancements such as more helicopters to fly trauma patients farther and advanced life support capabilities in ambulances.
In 2005, a statewide analysis led by USF investigators determined that "Tampa Bay has adequate trauma center access." But it and other recent research were never incorporated into the state's approval process.
State Surgeon General Dr. Frank Farmer said Wednesday his agency will appeal the judge's decision. And HCA, the hospital chain formerly headed by Gov. Rick Scott, vowed to fight for its new trauma centers.
"We remain committed to improving access to quality trauma care to the citizens of Florida who live in underserved areas of the state," spokeswoman Ginger Mace said in a statement.
USF spokesman Michael Hoad said the university "wasn't a party to the suit and won't be in the future, so it would be inappropriate to comment about a legal issue between other people."
TGH is the main teaching hospital of USF, which plans to run the HCA trauma centers independent of the Tampa hospital.
Times researcher Shirl Kennedy contributed to this report.