To begin with, from what I can discern, the nonprofit Bristol Hospital is apparently selling the hospital itself to the Nashville-based Vanguard Health Systems. As long as the sale is at market value, that seems to be fine legally.But where does all the money wind up?
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I don't know what kind of numbers are involved in Bristol Hospital deal, but they're probably big. In 2010, according to The Health Care Blog, a for-profit chain paid $28 million for a 124-bed facility in Marion, South Carolina (population 7,000) and $86 million for a 108-bed hospital in Ottumwa, Iowa (population 25,000).
Bristol's hospital must be worth tens of millions anyway.So what does a nonprofit hospital organization do with a giant pile of money when it no longer possesses a hospital?
Then there is the obvious question of what Vanguard will do differently in Bristol so that it can make a profit, when Bristol Hospital has struggled for years to make sure it doesn't lose money. And sometimes it has wound up in the red despite its best efforts.
Everything I read seems to indicate that nonprofit hospitals that are converted typically wind up dropping some services that don't make money and added frills that attract only patients with insurance or high incomes instead, ultimately creating a situation where they don't serve the community as a whole quite as well.
Maybe that's inevitable, but it is clearly the thing Bristol has to be on guard about.
I don't have much doubt that the people who run the hospital are trying to do the right thing. It's hard to have a real hospital in a smaller city these days. The costs are so high and the margins so thin that making a go of it isn't anything like it used to be.
But there are many, many issues involved in this deal, most of them not discussed at all yet. They need to be.
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