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Jackson Health System asks for Kendall trauma center shut-down

Ratcheting up the stakes in Miami-Dade’s hospital wars, Jackson Health System has filed two petitions with the state seeking to revoke Kendall Regional Medical Center’s trauma operations license, contending it was granted illegally.

Steve Ecenia, an attorney for the HCA hospital chain that owns Kendall Regional, called the Jackson move “bizarre” because it also targeted other facilities, including an HCA trauma center in Ocala that is “hundreds of miles away that can have no effect on Jackson.”

Jackson, which for years has had the county’s only trauma center, has been complaining loudly since Gov. Rick Scott’s administration decided the state needed more centers. Kendall Regional’s opened in November 2011.

Jackson estimates its Ryder Trauma Center has been losing about $28 million a year in revenue since then because, as one of its doctors maintained, Ryder tends to get inner-city gunshot victims who have no insurance while Kendall gets suburban car accident victims with insurance.

Mark McKenney, medical director of the Kendall center, said Wednesday the center has treated 2,500 patients in its first year “with mortality rates significantly below the state and national averages.” He said Kendall treats anyone who comes through the door, including plenty of gunshot and stabbing victims who may or may not have insurance.

McKenney said the state decided more trauma centers were needed after a 2006 study, which reported only 38 percent of Florida trauma victims were treated in specialized centers. Those treated in trauma units had a lower mortality rate of 18 percent, the report said.

In Miami-Dade, HCA’s Mercy and Tenet’s Palmetto General hospitals have also applied for trauma licenses. Jackson countered by seeking trauma units at its two community hospitals, Jackson North and Jackson South.

In its filings to the Department of Health on Jan. 2, Jackson’s lawyers asked for formal administrative hearings, citing recent court ruling that undercut the state’s trauma center policies. Jackson argues its North and South applications were unfairly denied approval in a Dec. 13 Department of Health letter that stated the regulators were rethinking rules on trauma centers after court decisions.

The Jackson petitions, first reported on Tuesday by Jim Saunders of News Service of Florida, noted that an administrative law judge in November 2011 found invalid the Department of Health’s trauma certification rule. After that, the department granted provisional licenses to Kendall Regional and three other hospitals.

On Nov. 30, 2012, the First District Court of Appeal upheld that administrative judge’s decision. Seven days later, the department approved the application of Ocala Regional, another HCA facility, and allowed it to open the following day. Gov. Rick Scott is the former chief executive of HCA.

Jackson’s attorneys accused the department of giving these other hospitals a “selective benefit.” They said that a hearing would show that “all provisional licenses issued under the invalid trauma rule need rule should be revoked,” as well as all pending applications, until the department established a legally acceptable rule on trauma centers.

Ecenia, the HCA attorney, said Jackson could petition only about its own facilities, not demand that others close. He said the appeals court decision wasn’t final and the Department of Health’s licensing has been fair.

A Department of Health spokeswoman said Wednesday that the department “had no additional information to provide.” A Jackson spokesman said executives couldn’t comment “because of pending litigation.”

Wayne Brackin, chief operating officer of Baptist Health South Florida, said Baptist is “very worried about this trauma issue.” In the 1980s, he said, the trauma system fell apart in Miami-Dade with many hospitals losing money on the service, and Baptist doesn’t want Jackson’s Ryder Center weakened by competition that could again endanger trauma care in the county.