MADERA, Calif. (KSEE/KGPE) – Residents in Madera worried about the sudden closure of the city’s hospital took part in a meeting Thursday evening in Madera to find out what’s next for the troubled hospital – and when it could reopen again.

Also at the gathering were former Madera Community Hospital (MCH) staff, various city officials, members of the Madera County Board of Supervisors, and doctors supporting the community.

The event was put together by the Madera Coalition for Community Justice in partnership with California Rural Legal Assistance and held at the Madera South High School cafeteria.

It featured a panel presentation that included Assemblymember Esmeralda Soria, Madera County Board of Supervisors member and Secretary of the Madera Community Hospital (MCH) Board of Directors Robert Poythress, the hospital’s Vice Chair of the Board of Trustees Stell Manfredi, Madera County Administrative Officer Jay Varney, and others.

What led to the hospital’s closure?

Madera County Supervisor Poythress gave a timeline of events that led to the closure of the hospital. According to Poythress during the ten years prior to 2020, MCH was “marginally profitable” despite not receiving adequate reimbursements from Medi-Cal for services provided (arguing that they were not keeping up with the rate of inflation).

This is an issue as 58% of patients that visited MCH used Medi-Cal which did not cover the cost of services. 45% used Medicare which allowed them to break even.

The “spiral” as Poythress called it came with the COVID-19 pandemic. Their ICUs were filled with sick patients and staffing suffered as nurses chose to retire rather than deal with the work demands of that time.

The nurse shortage forced MCH to staff traveling nurses, who according to Poythress, were costing the hospital about three times as much as a regularly staffed nurse, to the point where the companies providing the nurses were charging in excess of $200 an hour.

MCH did not have a choice in the matter as the State of California requires certain nursing ratios that if not provided, could lead to being shut down.

Another issue was the COVID-19 reimbursements.

“The COVID reimbursements were not equitably distributed, they were given out based on the hospital’s revenue,” said Poythress. “Unfortunately that meant that smaller less profitable hospitals were not going to get the reimbursements that they really needed.”

In late 2021 and early 2022, MCH began negotiations with St. Agnes that lead to an agreement to move forward pending approval from the California Attorney General. In the meantime, Trinity Health, loaned MCH $15 million to pay off their major debts and remain operating. Both Trinity Health and the Attorney General insisted that MCH remain fully operational without reducing any services.

At a point late in December – and at a time when MCH was running out of money (according to Poythress), the Attorney General unveiled their approval conditions which Trinity Health quickly turned down. That left no option other than Madera Community Hospital shutting down.

The plan or plans to re-open

Madera Community Hospital Vice Chair of the Board of Trustees Stell Manfredi detailed where the MCH Board has been focusing their time, energy, and money.

“Our board and our CO are committed to one thing and one thing and one thing only, to get the hospital re-opened,” said Manfredi.

According to Manfredi, MCH is preparing a startup plan that includes reopening with reduced initial services. This will include a preliminary plan from the hospital staff with the bulk of the turnaround developed by a consultant funded and coordinated by the Madera County Board of Supervisors. It is estimated that this will take about two months.

Madera County Administrative Officer Jay Varney says that the turnaround plan will go in front of the Madera County Board of Supervisors on March 7 for approval. Following that, there is an approximate 60-day timeframe for it to be completed. At the end of this process, according to Manfredi, it would make it feasible to re-open the hospital, but it will require funding from several sources.

At the same time as developing this plan, MCH is also soliciting hospital organizations to enter into an agreement to obtain and operate Madera Community Hospital. To date, they have entertained between 10 and 12 conversations, interviews, and letters of intent for the takeover and operation of the hospital. If any of these talks are successful, it would result in an affiliation agreement with MCH and that health organization.

Regardless of the agreement, the final approval would still have to come from the state Attorney General – the same step where they previously hit a roadblock.

Manfredi also commented on the pros and cons of entering into bankruptcy, which would protect their assets including the equipment, and buildings, and provide an alternative method for a hospital organization to acquire Madera Community Hospital. The problem is that every decision would then need to go through a judge, which was described as being tedious, time-consuming, and expensive.

Possible funds to re-open the hospital

Assemblymember Esmeralda Soria revealed that she has been working on re-opening the hospital.

“When I first got elected my issue was going to be housing that I was going to focus on. But this crisis made sure that I refocused my efforts on insuring that healthcare for Madera was a true reality. especially access to emergency care,” said Soria.

Soria says she has been working with local and state officials to find a solution to not only the hospital crisis in Madera but also other hospitals that are on the verge of bankruptcy as well.

With the help of State Senator Anna Caballero and former State Assemblyman Frank Bigelow, Soria says they were able to put together $5 million for the hospital – but it closed before they could use it. The money currently sits in the state budget and could be used pending the MCH’s re-opening plan.

As far as funds are concerned, Varney says that Madera County also has set aside $7 million in ARPA funds that the hospital may or may not need. They are holding those funds for the moment as they do not want their fate of them to be decided by a bankruptcy trustee, but rather ensure it goes to healthcare.

Future ideas to be better

While a plan to re-open is in place, officials note that things need to change going forward in order to survive. This is why Manfredi says they continue to support and encourage an increase in medical rates, especially for small rural hospitals. Soria also added that hospitals like MCH need to work with the colleges and possibly even become teaching hospitals to secure future healthcare workers.

“Madera Hospital has to be re-opened”, said Soria amid the crowd’s applause.