Jackson Memorial’s comeback story

Miami-Dade residents who haven’t kept up with the new, improved Jackson Health System may have blinked and rubbed their eyes in shock when they read the news last week that the county’s only public hospital is planning a billion-dollar-plus upgrade.

Say what?

Isn’t this the same chronically broke entity that socked taxpayers with a bill for $330 million in losses in fiscal years 2009 and 2010? The same hospital that had to go hat-in-hand to the County Commission in 2011 to ask for a $32-million loan as a sort of “payday advance” on its future revenues to keep its doors open? The same hospital that a grand jury in August 2010 called a “colossal mess”?

Yep, sure is. And yet it isn’t.

The Health System has undergone a turnaround in fortune that began in the spring of 2011, when Carlos Migoya, a former banker and onetime pro bono Miami city manager, was hired. His selection was an act of desperation by a commission that was staring at years of red ink unless Jackson could stop losing money. It was deep in the hole and yet badly in need of improvements — which it could not finance unless it first got out of the hole.

Mr. Migoya’s selection was a Hail Mary pass. He had zilch experience in healthcare, but he knew numbers and understood management. Upon taking over, he estimated it would take three to five years to turn Jackson around. Then he began to cut the payroll, trim expenses and ask for give-backs from union members that were grudgingly rendered but vitally necessary.

At the time, Marcos Lapciuc, chairman of the Public Health Trust Financial Recovery Board, whose supervision was indispensable throughout the process, wrote in the pages of this newspaper: “Jackson is in the midst of reinventing itself. It will take time, but the process has already begun.”

Last week marked another milestone in Jackson’s comeback. Jackson unveiled an ambitious $1.4 billion building plan that will be financed in part by the $830 million in bonds approved by the public last fall following a series of revenue surpluses in what had once been a failing enterprise. The vote represented an endorsement of the new management team and its performance.

The remainder, $550 million, will come from the hospital’s own money — capital contributions from operating revenues that average $45 million per year through 2024 — plus a few other sources, including old revenue bonds.

The planned upgrades include $115 million for the Miami Transplant Institute, a well-regarded medical center and one of Jackson’s most profitable programs, a new rehabilitation hospital ($117 million) and $81 million for the Jackson North Medical Center. A centralized new Intensive Care Unit will place pediatric, neurosurgical and trauma ICUs, among others, in one place, putting all intensive care specialists in one location instead of having them scattered over the Jackson campus.

Having come this far, it’s important that the County Commission live up to the promise to appoint an independent oversight board whose members are shielded from undue political influence in deciding how to spend the money. That’s a tall order in this community, but it’s a promise that helped persuade the public to support the bond issue, and it’s a promise that must be kept.

Jackson’s recovery has been a great comeback story. Any hint of cronyism, insider influence or political log-rolling at this stage would spoil the ending.