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Hospital staff unfazed by planned sale

The quality of care at Seven Rivers won't change with new ownership, employees say; but others worry what will happen to the psychiatric beds.

By COLLEEN JENKINS, Times Staff Writer
© St. Petersburg Times
published March 23, 2003

CRYSTAL RIVER -- When Tenet Healthcare Corp. put Seven Rivers Community Hospital on the selling block last week, the facility's bustling world barely blinked. Patients still needed care. Nurses and doctors still treated them with the skill that garnered them a top national ranking by a health care consulting firm.

The California-based company's decision just didn't seem all that monumental, at least not to several staff members asked to comment on the news.

After all, people such as Jane Byron have weathered similar sales before. Byron arrived as a nurse at Seven Rivers, located off U.S. 19 just north of Crystal River, six months after it opened in 1978. The hospital's management has changed hands twice since.

Now the director of the ambulatory surgery center, she's of the opinion that the quality of care depends more on the local health professionals than a board room hundreds of miles away.

"Who owns it is really not important," Byron said. "We continue to give (patients) the same quality of care that we've always given them. The way the country is right now, it's kind of on the back burner. There's a bigger issue now."

Tenet announced Tuesday its plan to sell or consolidate 14 of its 114 hospitals nationwide. The 128-bed Seven Rivers was the company's only hospital affected in Florida. The sale will leave Tenet with 14 properties concentrated in Broward, Dade and Palm Beach counties.

Byron's reaction echoed those initially offered last week by management. Morale at the hospital remained positive, officials said, making it business as usual.

But Tenet's move to sell Seven Rivers has raised some questions within the hospital and the community about which corporation might fill its shoes. The hospital is one of only two in Citrus County, and some important business decisions are at hand.

Take, for instance, the 16 beds in Seven Rivers' adult psychiatric unit. These are the only such beds in Citrus County, as Citrus Memorial Hospital officials have refused to establish a similar unit, mental health advocates said last week.

Seven Rivers recently received state permission to convert eight acute-care beds and eight beds from its adult psychiatric unit to 16 comprehensive medical rehabilitation beds. Such beds are reserved for patients recovering from stroke, spinal cord injuries, multiple traumas and brain injuries.

This permission will transfer to the hospital's new owner, according to Edith Orsini, executive director of the North Central Florida Health Planning Council, a regional group dedicated to improving health care through advocacy and community initiatives.

For its part, the council hopes the conversion plans don't go any further.

"This is damaging to the community," Orsini said, noting the dearth of adult psychiatric beds in Citrus.

She said psychiatric care is best delivered locally, so that the patients' families and local doctors can more easily be involved. Plus, a new hospital in Hernando County is available to serve the patients who need those long-term rehabilitation services.

But the council won't have any say about the sale of Seven Rivers in that regard, or any other, Orsini said.

Mental health advocates expect the new owner will take advantage of the state approval. They will be closely watching how the sale proceeds and fear the worst for the county's adult mental health patients, said Joan Murphy, co-founder of the local branch of the National Alliance for the Mentally Ill.

"Whoever buys Seven Rivers, they want to make a profit," Murphy said. "Let me assure you ... psych beds lose money. On the list of popularity, it's way down there."

Greg Bare, a charge nurse on Seven Rivers' medical surgical floor, holds a more upbeat outlook for the forthcoming corporate changeover. Sure, changes are likely, but he thinks the fresh blood will only strengthen his employer of nine years.

"It's going to create a positive potential for us to exceed our expectations, to continue to improve," he said.

But like many of his colleagues, he thinks the public should remember who really determines their quality of care.

"The local people are the backbones of the hospital," he said. "That is not going to go by the wayside just because the hospital is being sold."

In its press release, Tenet said its new management team wanted to "concentrate its attention on core networks principally in major markets."

Citrus County didn't meet the major market test.

But health management analysts said a handful of companies specialize in operating facilities that match Seven Rivers' description: a non-urban market, 128 beds and 505 employees.

Possible buyers include Community Health Systems, LifePoint Hospitals, Province Healthcare and Health Management Associates, they predicted.

Naples-based HMA is the most likely fit, said Frank G. Morgan, an analyst with Jefferies & Company in Nashville.

"They already serve the Florida market," he said Friday. "They also focus on rural and small city markets. It's exactly what they do."

HMA is among the most profitable public hospital companies in the country and is the largest operator of nonurban general acute care hospitals. The company operates 46 hospitals in 15 states, mostly located in the Southeast or Southwest. At least 15 of its hospitals are located in Florida.

These properties include the Brooksville Regional Hospital, Spring Hill Regional Hospital and Pasco Regional Medical Center in Dade City.

The company is a fairly aggressive buyer, one New York analyst said. Thursday, it acquired two additional hospitals in Washington state.

According to its Web site, the company buys hospitals that offer a strong primary care physician base, location in a high-growth, non-urban region, proven demographic need and the potential to become the sole or dominant healthcare provider in the market.

HMA officials could not be reached for comment.

"They have a really good record of going in and investing in hospitals, making them more efficient," Morgan said. "I would think they would be a good local partner for that location."

Some Seven Rivers doctors quietly have speculated about the possibility of Citrus Memorial making a bid on its chief competitor. However, Citrus Memorial officials would not comment on the possibility last week.

Thursday, a Tenet spokeswoman would not provide any details about possible buyers or the company's asking price.

"It's too early to speculate," she said in a phone interview. "We will let people know as we know."

Whoever the buyer, the spokeswoman said that the current owner would play a prominent role in the acquisition. The company is employing a national investment banking company to orchestrate the sale, she said.

"We're very committed to finding the right buyer for each of the hospitals," she said.

-- Times Staff writer Jim Ross contributed to this report. Colleen Jenkins can be reached at 860-7303 or

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