Miami-Dade County

Patients flocking to Jackson South trauma center, hospital CEO says

Trauma nurse, Luis DeRosa, left, with trauma surgeon Dr. Gabriel Ruiz and Dr. Nicholas Namias inside one of the new trauma units on Wednesday, May 4, 2016. The new trauma center at Jackson South Community Hospital is a Level II facility.
Trauma nurse, Luis DeRosa, left, with trauma surgeon Dr. Gabriel Ruiz and Dr. Nicholas Namias inside one of the new trauma units on Wednesday, May 4, 2016. The new trauma center at Jackson South Community Hospital is a Level II facility. adiaz@miamiherald.com

Since opening a trauma center at Jackson South Community Hospital in Palmetto Bay on May 4, doctors and nurses at the county taxpayer-owned medical facility have treated 60 patients in about three weeks — exceeding the expectations of administrators, who said that the volume of cases is cutting into the competition’s business.

About 10 miles northwest of Jackson South, the for-profit Kendall Regional Medical Center, part of the nation’s largest hospital chain, HCA, announced its newly upgraded trauma center is open and prepared to treat pediatric patients and adults.

These could be the opening shots of a budding trauma center war in South Miami-Dade that is sure to intensify as the hospitals compete for a limited pool of seriously-injured patients, said Sal Barbera, a former hospital CEO who teaches healthcare management at Florida International University.

“It’s a profitable service line or these other hospitals wouldn't be that much interested in it,” Barbera said of trauma centers, which are designated by the Florida Department of Health.

Florida trauma centers receive funding from vehicle registration taxes and red light camera fines. Funding from red light camera fines spiked from $5.1 million in 2011 to more than $12.6 million in 2012. But in 2013 and 2014, red light camera funding declined 12 percent or about $1.4 million, according to a health department assessment.

Trauma cases can be lucrative for hospitals because such patients often require more than just emergency stabilization and a hospital stay. They also may need care from a physician specialist, and rehabilitative therapy and other follow up services.

“You’ve got a halo effect there,” Barbera said.

In addition, he noted, because trauma patients are sometimes injured on the job or in car accidents, hospitals also can draw from a wider range of payers, including workers compensation coverage and auto insurance policies.

Trauma centers also have proven very lucrative. A 2014 series published by the Tampa Bay Times revealed that the fees Florida hospitals charge for trauma services can differ by thousands of dollars depending on the medical center where an ambulance takes a patient.

Jackson South, which still requires further approvals from the state to retain its Level II trauma center, is a satellite facility of Miami-Dade's public hospital network, Jackson Health System, whose main campus in Miami, Jackson Memorial Hospital, houses one of the nation's only stand-alone Level I facilities, the Ryder Trauma Center.

In April, Kendall Regional won provisional approval as Miami-Dade’s second Level I trauma center — a designation that indicates the highest level of care available, including a staff of specialists and surgeons available around the clock.

Mark McKenney, a physician and medical director of Kendall Regional’s trauma center, said in a written statement that “Having a Level I trauma center is a natural service for KRMC to provide since we treat nearly 22,000 children in our pediatric emergency rooms each year.”

It’s a profitable service line or these other hospitals wouldn't be that much interested in it.

Sal Barbera, former hospital CEO

Miami-Dade’s fourth trauma center is a Level II facility, designated by state officials in May 2015, at Aventura Hospital and Medical Center, also an HCA-owned facility.

Now that Miami-Dade has four trauma centers, Barbera wondered about the limits. Too many centers, he said, would not give surgeons and specialists the necessary experience to be highly skilled. Too few centers, though, could leave severely injured patients without the attention they need.

A recent trauma assessment prepared by the health department noted that in 2013 Miami-Dade’s two centers at the time reported an annual patient volume of about 6,900 people.

“You can’t just manufacture trauma cases,” Barbera said. “It’s such a specialty area you almost want to believe it should be able to regulate itself in an open market system with competition.”

In fact, state health officials in March said there are too many trauma centers in South Florida, and suggested that three facilities may be enough for Broward, Miami-Dade and Monroe counties.

Gina Diaz, CEO of Jackson South, told the board of trustees that governs the hospital that patient volumes at the trauma center have exceeded expectations and are on track to beat the yearly projection.

She reported to the board that paramedics have told Jackson South officials their new trauma center has cut “50 percent” into Kendall Regional’s business — a figure that Kendall Regional representatives declined to confirm or deny.

“When we first started looking at trauma at Jackson South, the estimate was we would see one to two patients a day. Our average thus far is 3 1/2  patients a day,” Diaz said, noting that the hospital’s doctors and nurses have been able to deliver trauma services without needing to rely on the resources of the Level I facility at Jackson Memorial.

“To date, we have not had to transfer out one single patient,” she said.

Jackson’s board of trustees responded with a big round of applause.

Daniel Chang: 305-376-2012, @dchangmiami

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