By Phil Galewitz, The Palm Beach Post, Fla. Knight Ridder/Tribune Business News
Jul. 15--The state has fined Columbia Hospital in West Palm Beach and West Boca Medical Center $10,000 each for failing to alert health regulators before eliminating emergency neurosurgery services last year, according to documents released Wednesday by the Florida Agency of Health Care Administration.
The fines, which the state agency rarely levies, stem from an investigation Gov. Jeb Bush ordered in March into the lack of emergency neurosurgery care in Palm Beach County.
The inquiry was sparked by stories in The Palm Beach Post that revealed how emergency neurosurgery patients are increasingly being transported from Palm Beach County hospitals to hospitals in Broward and Miami-Dade counties, and sometimes as far as Tampa and Gainesville.
One of those patients, Mildred McRoy, 61, of Lake Worth, died in March, six days after being transferred from JFK Medical Center in Atlantis to North Broward Medical Center in Pompano Beach because no neurosurgeon was available to treat her in locally. McRoy faced a more than seven-hour delay in getting care from a neurosurgeon following a stroke.
State regulations require hospitals to inform the Agency for Health Care Administration before reducing medical services. The fines were disclosed in documents dated May 7, though state officials refused to release them until Wednesday. State officials were unavailable for comment.
Columbia and West Boca are among at least five county hospitals that reduced or eliminated emergency neurosurgery services in the past year. And JFK, Jupiter Medical Center and Palm Beach Gardens Medical Center in West Palm Beach have reduced services. It is unclear whether the state plans to issue more fines.
Hospitals in Palm Beach County have struggled to find neurosurgeons to work in their emergency rooms because soaring malpractice insurance costs have made these brain and spine specialists skittish to handle emergency patients for fear of being sued.
Until April, none of the county's 13 hospitals had 24-hour emergency room coverage for neurosurgery. In April, the county's two trauma hospitals, St. Mary's Medical Center in West Palm Beach and Delray Medical Center, made arrangements to have neurosurgeons available around the clock to handle trauma and non-trauma neurosurgical patients.
Columbia spokeswoman Jean Wicken said the hospital is appealing the fine. 'We disagree with it,' she said, declining to elaborate.
West Boca Medical Center spokeswoman Millicent Hunter said did not immediately return a call for comment.
The Agency for Health Care Administration contacted Palm Beach County hospitals in March to check the availability of neurosurgeons. It was only then that regulators said they learned that West Boca and Columbia had eliminated emergency neurosurgery care.
In fact, West Boca had eliminated neurosurgery, while Columbia's lone neurosurgeon provides only spine treatment.
The $10,000 fine represents a small amount of money considering both hospitals have annual revenues exceeding $100 million. Columbia is owned by HCA Inc., the nation's largest for-profit hospital chain. West Boca is owned by Tenet Healthcare Corp., another for-profit hospital chain that is the largest hospital operator in the county.
The paucity of emergency specialists has led to a surge in complaints against county hospitals for failure to provide appropriate emergency care.
In the past two years, state and federal hospital regulators have confirmed 17 instances in which county hospitals illegally refused to treat patients seeking emergency medical care.
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