State reopens shuttered Miami hospital for COVID-only patients, boosts lease $300,000
Florida’s 11th COVID-only nursing facility was opened near Miami International Airport on Wednesday, providing a safety valve for local hospitals that are seeing a surge in patients with the infection.
The former Miami Medical Center, which is owned by Nicklaus Children’s Hospital and had been shuttered since October 2017, will serve up to 150 patients and accept transfers of COVID-positive patients from any long-term care facility and hospitals, the Agency for Health Care Administration said.
State officials originally planned to open the Miami-Dade facility, also known as the former Pan American Hospital, as a dedicated isolation facility for COVID-positive patients in April. But, when hospitals were able to cope with the infection numbers, the state canceled the original $42 million-a-month arrangement.
The Department of Emergency Management has now revived the deal under a plan that will pay Nicklaus Hospital nearly $1 million, significantly higher than the $150,000 a month the state originally agreed to pay. The state also hired a private company, the Avante Group, to staff the hospital for a price state officials have not disclosed.
According to the terms of the state’s Medicaid provider agreement, the state will reimburse the company at Medicaid rates ranging from $325 per patient per day to $582 per patient per day.
Because patients must test negative twice before being sent back to nursing homes, the new COVID-only facility will serve people who no longer require hospital-level care but are still COVID-positive. In addition, long-term care facilities can transfer COVID-positive residents who need more clinical monitoring and appropriate isolation to safely recover.
Together with the 10 facilities in other counties — Escambia, Leon, Polk, Charlotte, Lee, Pinellas, Palm Beach, Brevard and Broward — the skilled nursing facilities dedicated exclusively to COVID-19 cases will accommodate up to 750 patients.
The agreement between Nicklaus Hospital CEO Matt Love and Jared Moskowitz, director of the Division of Emergency Management, took effect on June 1, Nicklaus officials said, but the first day patients were admitted was July 1.
Instead of paying Nicklaus Children’s $150,000 a month for the lease as was originally intended in the first agreement, the state has now agreed to pay the hospital $485,397 a month for basic rent and an estimated $430,000 for operating expenses that include things like utilities, maintenance and security, according to documents obtained by the Herald/Times.
In addition, DEM has hired two other companies to provide security as well as food services, laundry and cleaning at the hospital but the agency would not provide requests for copies of those documents and has failed to post them on the state website as required by law.
No-bid agreements
Earlier this year, as DeSantis was publicly denying the epidemic was widespread in Florida, his staff was privately preparing for an influx of COVID-19 patients by signing $283 million in no-bid deals to build alternative hospitals to hold the overflow, a Herald/Times analysis has found.
One of those hospitals was the Miami Medical Center and, under that agreement, the state would have paid $42 million a month to SLSCO, a Galveston, Texas-based general contractor to operate and staff the hospital.
The property is for sale and the state arranged to use it under the name Children and Family Hospital after the state spent $3.5 million in emergency funds to make repairs to the building and pay its taxes. Coordinating the deal was Alex Heckler, a Miami lawyer and lobbyist for SLSCO. Heckler is a Democratic Party operative and friend of Moskowitz.
As need for the hospital declined in April and May, the state canceled the initial purchase order in mid-April. When hospitals renewed their elective surgeries and needed to free up staff and beds devoted to COVID-19 patients, the state revived the deal and signed the lease.
Using a middleman to lease the facility has become a frequent practice for the DeSantis administration as his agencies have handed out millions in emergency funds using as go-betweens people who have relationships with the officials deciding on the no-bid deals.
Heckler is now representing Avante Group. He registered as its lobbyist on May 21, the same day the Herald wrote about the canceled arrangement with SLSCO. He did not respond to requests for comment.
How much is the state paying Avante for staffing and operating the facility? What was the reason the terms of the lease agreement grew so dramatically?
The Division of Emergency Management, which signed the lease, would not respond to such questions.
“NCHS owns the property but is not involved in the operation of the facility,’’ said Rachel Perry, Nicklaus Hospital spokesperson.
AHCA produced the Medicaid provider agreement but would not say how much the state has budgeted for the hospital.
Where are the records?
For two weeks, the Herald has asked the agencies to disclose the details of the agreement, which is a public record, including any law firms and contractors that have served as the go-between the state and the subcontractors. Both agencies have refused to turn over the agreements.
Because the state is under an emergency order, DEM and AHCA are allowed to waive competitive bidding rules but they still must abide by state open records laws.
“These dedicated recovery buildings and units are a proven model that Florida has pioneered across our state,’’ said Katie Strickland, spokesperson for the Agency for Health Care Administration. “They are critical regional resources that serve to ensure we can transfer a COVID-positive individual who needs more clinical monitoring and isolation to safely recover and return to their home in a skilled nursing facility or assisted living facility.”
COVID-dedicated facilities are not unique to Florida but have been used as a successful option for hospitals experiencing a surge in COVID-19 patients in New York City, Chicago and elsewhere, said Tamara Konetzka, a public health researcher with the University of Chicago.
“Increasing hospital capacity, especially aimed at lower acuity COVID patients who may not need all the tech that’s available at a regular hospital, is something that’s been happening all along and seems like a good idea in the states that have done it,” she said.
Jackson Health CEO Carlos Migoya told Miami-Dade County commissioners Wednesday that the COVID-only facility will accept about 90 patients this week, including 30 patients who are now at Jackson Health facilities.
“As our places are getting fuller it’s not about the beds that we need but about the nurses that are there working with those patients and we’d like to transfer those patients if they have availability at that facility,” Migoya said. “That will augment the capacity of all hospitals in Miami-Dade by an additional 120 patients, and that’s going to help us a lot.”
Dr. Lilian Abbo, an infectious disease specialist with Jackson Health, said when doctors have a place to safely discharge COVID-positive patients who do not need an intense level of care, it helps the entire healthcare system.
“That alleviates the hospital and alleviates the use of resources and relieves nursing homes because we don’t want it spreading in nursing homes,” Abbo said.
The facilities are supported with Medicaid dollars within the state’s existing budget authority in the 2019-20 fiscal year, but the agency said it must obtain CARES Act dollars in fiscal year 2020-21 to fund these facilities going forward.
This is the list of the COVID-only nursing facilities under contract with the Agency for Health Care Administration:
▪ OakBridge Healthcare Center in Polk County
▪ Port Charlotte Rehab Center in Charlotte County
▪ Gulf Coast Medical Center/Skilled Nursing Unit in Lee County
▪ De Luna Health and Rehab Center in Escambia County
▪ PruittHealth Southwood in Leon County
▪ NSPIRE Healthcare Lauderhill in Broward County
▪ Carrington Place in Pinellas County
▪ Miami Care Center in Miami-Dade County
▪ Avante at Boca Raton in Palm Beach County
▪ Viera del Mar Health and Rehabilitation Center in Brevard County
▪ Oasis Health and Rehabilitation Center in Palm Beach County
Mary Ellen Klas can be reached at meklas@miamiherald.com and @MaryEllenKlas
This story was originally published July 2, 2020 at 6:47 PM with the headline "State reopens shuttered Miami hospital for COVID-only patients, boosts lease $300,000."
