DHR hopes to double size, but faces opposition from other local hospitals
KRISTEN MOSBRUCKER | STAFF WRITER | Updated 23 hours ago
EDINBURG — Doctor’s Hospital at Renaissance is seeking to double the number of beds at its main campus within the next two years, but only if federal regulators bless its plan.
There are 513 licensed beds at the main campus and the application seeks to expand to 1,102 beds — large enough to become the biggest hospital in the Rio Grande Valley. The planned expansion is expected to cost $200 million.
For DHR to expand, it must petition the Centers for Medicare and Medicaid Services to allow its growth — a restriction enacted under the Affordable Care Act that prevents doctor-owned hospitals from expanding without government approval.
Doctor’s Hospital wants to have a Level I Trauma center — the highest level — which would be able to handle large-scale motor vehicle accidents or gunshot wounds, providing treatment for patients from prevention to treatment, all the way to rehabilitation.
But before that can happen, DHR needs to catch up with its local peers by becoming a Level III trauma center — a hospital that shows it can perform emergency intensive care and stabilization of patients.
McAllen Medical Center, Rio Grande Regional and Knapp Medical Center are all Level III trauma centers. The closest Level II trauma unit is in Corpus Christi and the nearest Level I trauma center is in San Antonio.
DHR is still applying for its level III certification, but officials expect to receive the certification soon.
“We believe that the community in South Texas deserves that level of care and we are willing to invest in it,” said Israel Rocha, chief executive officer at Doctor’s Hospital at Renaissance.
Ahead of any decision by the federal government, DHR faces opposition from other local, privately-owned hospitals, which criticized the doctor-owned hospital model and how much it contributes to providing healthcare for the poor.
Several Rio Grande Valley hospitals have fought against the request, with nearly all local hospitals submitted scathing letters during the public comment period that closed last month.
If approved by the government, DHR would grow larger than South Texas Health System — currently Hidalgo County’s largest hospital owner — which has 848 beds at several local hospitals.
“DHR currently does not contribute its fair share of uncompensated and charity care to the people of Hidalgo County,” wrote Douglas Matney, regional vice president of South Texas Health System. “While it may not be DHR’s policy that the hospital does not discriminate…it is clear that DHR permits its medical staff physicians to discriminate against such beneficiaries.”
>> Read DHR’s request to the government.
>> Read the public comments on DHR’s request.
>> Read DHR’s rebuttal to its critics.
Representatives with Knapp Medical Center in Weslaco provided the government with photographs of new buildings at Doctor’s Hospital’s campus where a new outpatient surgery complex was being built and asserted that the hospital was already expanding outside of the law.
“Allowing DHR to expand, especially the magnitude of expansion its requesting will in no way expand access to care for uninsured patients in Hidalgo County,” wrote Bill Adams, regional chief executive of Knapp Medical Center in a June 5 letter.
Doctor’s Hospital officials deny that the buildings under construction skirt the requirements and provided amended hospital bed licenses they say allow for the new construction.
Most of the other hospitals also argued that data provided by DHR to the federal government was misleading, including its nondiscrimination policy, which they claim is spotty. Hospital administrators signed affidavits, saying they called the offices of three DHR-affiliated doctors asking if they accept Medicaid, the federal insurance program for the poor, and saying they do not.
Medicaid typically reimburses hospitals less for medical procedures than private insurance companies. More than a third of Hidalgo County residents live below the federal poverty line and qualify for Medicaid if they have legal immigration status.
Rocha defended DHR-affiliated doctors’ practices regarding Medicaid patients.
“Every physician who is on our medical staff is required to see those patients — if they choose not to participate in the Medicaid program, they have to treat them free of cost. I think they were splitting hairs on that fact,” Rocha said.
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Additional Reading: South Texas Health System Defends 920% Price Markup
Editor’s Note: Several months ago we asked a hospital expert to review the financials of DHR, including payer mix and charge-to-cost ratios. Our expert’s findings: Well managed – efficient – profitable. Requiring government approval to expand one’s business seems contrary to traditional American business practices.