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Bayfront's commitment to charity care concerns St. Petersburg officials

ST. PETERSBURG — The for-profit company acquiring Bayfront Medical Center promises to continue the hospital's legacy of serving the poor. But city officials, who must sign off on the deal, questioned Tuesday if that pledge can be trusted.

The St. Petersburg City Council must agree to a new lease for Bayfront, which sits on city-owned land. That prompted the public discussion with Bayfront and its new corporate partner, Health Management Associates.

"We all know in this room that charity care is not profitable. Period," said council member Wengay Newton.

"It's not profitable, but it is a social responsibility," responded Alan Levine, who heads HMA's group of 22 hospitals in Florida.

He highlighted the company's track record in other communities serving large numbers of the poor and uninsured, including two Hernando County hospitals.

HMA has pledged to continue Bayfront's existing policies on charity care after it purchases an 80 percent majority interest in the downtown St. Petersburg hospital. Bayfront would create a new nonprofit that would own the remaining 20 percent. Despite the lopsided ownership, both institutions would have equal representation on a board overseeing the joint venture.

Council member Karl Nurse proposed also giving the city a nonvoting board position.

"Trust but verify," he said.

The length of the lease is among the topics to be negotiated between Bayfront, HMA and the city, which expect to hold a second workshop before a final vote, potentially in early January. Bayfront and HMA propose to close the acquisition in March.

HMA typically seeks a 40-year lease term, Levine said, noting that the company has committed to investing $100 million at Bayfront during the first five years.

St. Petersburg Mayor Bill Foster, an ardent supporter of the deal, stressed that the philosophical divide between for-profit and not-for-profit hospitals has become blurry in recent years.

"The proof is in the pudding when it comes to charitable commitment, which I believe will be enhanced (at Bayfront)," said Foster, noting that the HMA deal is free of the issues that ended Bayfront's last partnership.

In the 1990s, Bayfront was a founding member of BayCare Health System, a regional not-for-profit. Prompted in part by civil rights groups, the city sued after learning Bayfront had altered some of its policies regarding issues such as abortion in deference to BayCare's Catholic ties.

HMA leaves such decisions to the medical staff at each hospital, Levine said.

This time, the only opposition seems to be coming from the University of South Florida, irate over Bayfront's other prospective partner, Shands HealthCare, affiliated with the medical school at the University of Florida. Shands has a relationship with HMA at other Florida hospitals, and is part of this one too.

Shands CEO Tim Goldfarb told council members the relationship was not exclusive and other academic partners were welcome. Yet Shands retains a future option to acquire as much as a 20 percent interest in Bayfront.

Council members acknowledged their oversight is limited to their lease with Bayfront. But several saw value in raising questions publicly about Bayfront's conversion to a for-profit hospital — and getting HMA's answers on the record.

"My gut tells me that a for-profit is going to want to have higher dividends for their shareholders and that somehow is going to affect charity care," said council member Jim Kennedy, still struggling with the concern after Tuesday's workshop.

"I know that's not what we're hearing," he added.

Letitia Stein can be reached at or (727) 893-8330.