Shands: Future of hospital undecided


Published: Tuesday, March 1, 2005 at 6:01 a.m.
Last Modified: Monday, February 28, 2005 at 10:43 p.m.
Officials with Shands HealthCare reiterated Monday that they have made no decision regarding the possible redevelopment or relocation of Shands at AGH.
With a visit from an inspection committee from the Joint Commission on the Accreditation of Healthcare Organizations, or JCAHO, coming up soon, however, the pressure is on to spell out the plans for the future of Gainesville's oldest community hospital, opened in 1928 as Alachua General Hospital.
The joint commission is charged with evaluating the quality and safety of care for more than 15,000 health care organizations in the United States. To maintain its accreditation, Shands at AGH must undergo an extensive on-site review once every three years. That inspection is expected to come later this month, although Shands HealthCare spokesman Lance Skelly said only that "it would be soon," when asked the date of the visit.
"Our intent is to avoid adding to public speculation about the future of Shands at AGH since, as we have already communicated . . . we have not yet made a decision on this subject," he said Monday.
Speculation continues, however, about the future of the hospital, which serves as a primary medical center for many living on Gainesville's east side.
Jamie Thomas, chief executive officer of North Florida Regional Medical Center, said Monday that whatever plans are in the works for Shands at AGH, he hasn't been privy to them.
"My sense is that there are very few people who really know firsthand what Shands is planning," Thomas said.
Shands is looking at the JCAHO survey as a deciding point, in Thomas' opinion.
"Perhaps they will come out of the survey and make a determination as to what they are going to do with the building and whether they will keep Shands in that immediate area," he said.
Thomas added that North Florida would not oppose the rebuilding of Shands at AGH, but if the ultimate decision was to relocate close to Interstate 75, "for competitive purposes, we would oppose any such move."
Last week, Gainesville Mayor Pegeen Hanrahan wrote to U.S. Rep. Corrine Brown, D-Jacksonville, seeking her support if plans for Shands at AGH eventually call for relocation.
In a statement Monday, Brown responded that she was a wholehearted supporter of the community hospital, saying, "I strongly believe that Gainesville's underserved residents need a place to turn for their medical needs, and Shands at AGH is one of the few facilities in the area to provide services to the indigent population."
The congresswoman insisted that it is of the utmost importance to keep Shands at AGH open. She promised to call an urgent meeting with Shands HealthCare and local officials to discuss funding options and ways to make sure that the doors to Shands at AGH "will not close on my watch.
Brown said in a phone interview Monday that the first time she had heard the concerns about the hospital was when Hanrahan mentioned them during a discussion last week. Shands officials had not mentioned any plans for its Gainesville hospitals at recent meetings, the congresswoman added.
"It kind of caught me off guard," Brown said.
Brown, who said she was committed to ensuring east Gainesville had accessible health care, said she has sent a letter requesting a meeting with Shands officials to discuss the future of the hospital and the role different levels of government could play.
"I don't expect that Shands, as a teaching, caring community hospital, will make the same kinds of decisions that a profit-making hospital would make," Brown said. "But I understand that they have a bottom line and our goal is to make sure they make their bottom line."
Inspection 'routine' Shands at AGH passed its last inspection three years ago and Skelly characterizes the JCAHO committee's visit as "routine."
"Our physicians, nursing staff and other dedicated employees have done an excellent job in delivering medical care, and the accreditation will reflect that," he said.
Publicly, Shands HealthCare CEO Tim Goldfarb has declined comment. Privately, however, he has expressed some concern that AGH's aging physical plant might not pass muster.
Last year, Shands HealthCare brought in a consultant from Cambio Health Solutions Inc., replacing Shands at AGH administrator Cynthia Toth. The firm, based in Brentwood, Tenn., is noted for its turnaround management, often working with community hospitals. Cambio had previously helped to improve the bottom line at Shands Jacksonville and now has been charged with helping to re-establish financial stability at Shands at AGH.
Accreditation inspections typically span three days and include site visits and interviews with patients, employees and physicians, Skelly said. A team of inspectors that usually includes a nurse, physician and hospital administrator looks at what the hospital is doing right and where it can improve.
At the end of the visit, the team provides an initial decision concerning accreditation, then follows within 30 days with a written report that outlines any areas that require improvement. The hospital is given 90 days to provide a plan that shows evidence that compliance is being met.
One option, if changes are called for, is to update the infrastructure of the existing hospital. But that could be an expensive choice.
Another option would be to build next to the current site. Shands owns much of the property immediately surrounding the hospital's location at 801 SW 2nd Ave. and could construct an up-to-date facility nearby without going through Florida's costly and time-consuming certificate of need application process.
Expansion ahead? Many doctors and community leaders speculate that Shands HealthCare plans an expansion, of some sort, on land it owns in northwest Gainesville. The spot, some say, would be easily accessible to out-of-towners from Interstate 75.
As it is now, Shands HealthCare operates two facilities - Shands at Vista, a psychiatric center, and Shands Rehab Hospital - on 20 acres it owns on the north side of NW 39th Avenue in the Health Park.
Last summer, Shands paid $4.6 million for 20 acres abutting the hospital's current property and fronting NW 39th Avenue, according to records with the Alachua County Property Appraiser.
Records show the land, once owned by Clay Electric, has an assessed value of about $909,000 - less than one-quarter of what was paid.
A Shands official said no decisions have been made on what to do with the land and explained that the company has multiple options, including a future expansion.
"The opportunity to purchase this property will ensure the continued tranquility of the area and convenient access for patients visiting our facilities," Skelly said. "It also provides Shands HealthCare with options that could include expansion of the existing facilities in our continuing efforts to meet the health care needs of our community."
Not part of comp plan Shands HealthCare's new property acquisition, however, is not included in a comprehensive plan amendment being proposed for SantaFe HealthCare's medical park, said Gainesville lawyer David Coffey, who is representing SantaFe in the process.
Shands HealthCare's two hospitals - Vista and Rehab - fall within boundaries of SantaFe's development of regional impact, a long-range plan for very large development projects. AvMed HealthPlan and Hospice of North Central Florida are also located there.
SantaFe proposes some changes to its plan to make it more compatible with SpringHills, a major commercial and residential center planned just west of the medical park.
The Clay Electric property falls outside the boundaries, which means if Shands wanted to build something there, it likely would have to request land-use changes from the county to move forward. The land has an office-use designation and an 11,000-square-foot office exists on the property.
Five more years? Plastic surgeon John Poser said administrators told staffers at a meeting last fall that Shands at AGH would remain as is for at least five more years.
But he said a decision on whether to rebuild Shands at AGH at its existing location or somewhere else is anticipated in coming months.
"They really haven't committed one way or the other," Poser said.
Poser, who has run a medical practice near Shands at AGH for 22 years, speculates that the hospital as it exists today will be no longer.
In its place, he said Shands HealthCare likely will create some type of specialty facility that could complement - not compete with - the services provided at its big sister hospital, Shands at the University of Florida.
"There are certain needs that can be filled," said Poser, who also works out of North Florida Regional Medical Center and teaches at the Veterans Affairs Medical Center.
Diane Chun can be reached at 374-5041 or chund@gvillesun.com. Staff writers Janine Young Sikes and Jeff Adelson contributed to this report.

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