Two weeks ago, American Advanced Management (AAM) was approved in the Federal Bankruptcy Court to move forward with its plan to purchase the hospital.
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Many state and county leaders opposed the approval, hoping the judge would grant more time to consider a new joint bid by Adventist Health and UCSF. They argued that UCSF and Adventist's reputations would make it easier to recruit staff and could turn Madera Community into a teaching hospital.
AAM already owns and operates Coalinga Regional Medical Center.
First, let's take a look at what happened with Coalinga Regional Medical Center. In 2018, the hospital shut its doors leaving patients with two options for emergency care travel more than 60 miles to Fresno or more than 40 to Hanford.
AAM made an initial offer to prevent the hospital from shutting down, but that plan was rejected by the California Department of Public Health.
In 2019, the Coalinga community overwhelmingly voted yes in a special election to allow the hospital district to lease and potentially sell the hospital opening the door for AAM to begin doing maintenance and repairs in anticipation of leasing and operating the hospital.
In May 2020, AAM's plan to take over the hospital was approved in bankruptcy court a step that we saw with Madera Community Hospital two weeks ago.
By December 2020, Coalinga Regional Medical Center was back open, but there were many many steps in between. Which we could see next in the North Valley.
It's been more than a year since Madera Community Hospital shut its doors, leaving residents to drive long distances for both medical emergencies and routine healthcare.
Now efforts to reopen the hospital could be similar to those taken in Coalinga several years ago.
"There are multiple steps that we go through," said Amy Micheli, COO of American Advanced Management. "I mean, initially, before we even get to the process of choosing to open a hospital, we do an evaluation of the community to see what the needs of the community are. We also really have to do an evaluation of why that hospital failed initially."
American Advanced Management Chief Operating Officer Amy Micheli said the first 45 days after approval are spent applying for licenses and permits, then policies must be updated, staff members need to be hired and trained, and equipment, supplies, and contract services must be purchased.
Micheli is optimistic all of that could happen in just six months because of steps the company has already taken.
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"We've started in the policies and procedures ahead of time, we have been contracting with vendors ahead of time," said Micheli.
Micheli said there are 5 people on staff in Madera keeping the hospital in working order and secure until it can reopen.
As for the future plans, California law requires hospitals to provide 8 services: medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services.
In Madera, there will be a focus on cardiac services.
"When we've met with the cardiologists in town, they have said, we would really like to be able to do advanced cardiac procedures, such as cardiac catheterization, where we can evaluate whether somebody has a blood clot in their cardiac arteries, whether they need a stent to be able to open that up," said Micheli.
Labor and delivery will likely not re-open right away. However, Micheli said they do hope to bring back the services someday.
AAM is still awaiting approval from the California Department of Public Health for their management services agreement and the Department of Health Care Access and Information for distressed hospital loan funds. The company also has other funding sources.
"Rather than have a big group of investors that expect a return on their investment, we are funded by a small group who really believes in rural health care," said Micheli. "So we're allowed to take the money that we make in other hospitals and reinvest them into hospitals that are not anticipated to make a profit."
AAM representatives said that a small group of investors is their Board of Directors.
We also reached out to the team at Coalinga's hospital to get a better sense of how the company operates its facilities.
The medical center depends on travel nurses and a staffing agency for about 50% of its staff.
The Director of Nursing said they are considered fully staffed right now with 220 employees.
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"We're licensed for 24 beds," said Allen Ackley, Director of Nursing. "Currently, I have enough staff that I feel comfortable going up to 20."
Patients we spoke with in Coalinga said they've been happy with the hospital.
"I haven't seen any signs of being understaffed," said John Albrecht, Coalinga Resident. "Yeah, we didn't wait very long."
"Oh, well for me I don't have any problems there -- when I have asthma and I can't breathe," said Victoria, Coalinga patient.
Action News also spoke with the former president of the Coalinga Regional Medical Board of Directors, William Lewis. He said the reopening process seemed to start slowly, but then quickly gained steam, and finished strong.
"After they opened it in 2020 they were running all the departments, and people were very happy in the community that we had a hospital again, and we had emergency and and and so forth," said Lewis.
Madera County's CAO released a statement in response that read: "With the court granting AAM the ability to move forward with their plan, we believe that everyone's focus should be on a successful return of hospital-based health care to Madera.
AAM has stated that it is well prepared financially to accomplish this with assistance from the distressed hospital loan program, and without need for local funding. AAM has made arrangements to keep County staff aware of their progress in the complex permitting and plan approval process, which has been appreciated by the County.
Should this effort not result in successful resolution to the bankruptcy, the County would certainly be interested in bringing its proposal back to the court for full consideration."
UCSF directed Action News back to their statement released after the decision was made in bankruptcy court. It read: "We are deeply disappointed to hear that the bankruptcy court has chosen a different path to reopening Madera Community Hospital. UCSF Health and Adventist Health remain committed to our proposal and are working together to understand what options may be available to jointly pursue our plan to restore lifesaving services to Madera County and bring high-quality, accessible care to the community for decades to come."
Adventist Health declined to comment.
As for teaching hospital opportunities, AAM said they have partnerships in place with other medical schools and would be open to a partnership with UCSF to make Madera Community a teaching hospital.
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