L.A. County Board Approves Teaching-Hospital Proposal

After several weeks of sometimes bitter negotiations, a controversial plan to build a $100-million specialty-care teaching hospital operated jointly by USC and the nation’s second-largest medical corporation was approved Tuesday by Los Angeles County supervisors.

Under the agreement, Los Angeles-based National Medical Enterprises Inc.--which operates more than 571 facilities in 45 states--would build and manage the new 283-bed facility with adjacent 75-room hotel a short distance from County-USC Medical Center.

The board’s 3-1 approval, made over the objections of administrators from another hospital in the area, is contingent on the sale to USC of 10 acres of county land and four acres of school district land near Soto and Alcazar streets. The sale, at an estimated $14 million, is expected to go through.

The new teaching facility would operate as a sort of high-tech referral center for USC medical staff wishing to engage in some private practice. It would apply sophisticated--and expensive--medical techniques in the areas of coronary, neonatal, psychiatric, obstetric and gynecological care. Less complicated cases would continue to be handled by USC’s teaching staff at the existing medical center.

Although the new teaching hospital would handle primarily paying patients, USC and National Medical have agreed with the county to treat the complex medical problems of some indigent patients.

County officials have expressed concern that USC’s teaching faculty might abandon its long-observed commitment to treating the poor once the new facility opens in 1989.

But the USC vice president of health affairs, Joseph Van der Meulen, said that the agreement under which National Medical will build and manage the new facility will “sustain and even strengthen our relationship with County-USC,” and that indigent care will continue.

Services that these doctors provided to the county would be billed to the county, a feature favored by some county officials because taxpayers would pay only for services rendered. But Supervisor Ed Edelman, in whose district the new teaching hospital would be located, asked for a thorough study of such a payroll transfer.

Supervisor Mike Antonovich opposed the hospital plan after USC and National Medical refused to promise that its patient care would be confined to specialty treatment.

Antonovich’s opposition was fueled by a massive lobbying effort by White Memorial Medical Center, which is less than a mile from the proposed facility. For months, White Memorial officials and members of the Seventh-day Adventist Church, which sponsors the hospital, have argued both publicly and privately that the USC-National Medical venture is unnecessary and would drive White Memorial out of business.

White Memorial President Michael Jackson, in a last-gasp effort Tuesday, warned the supervisors that there is a glut of empty hospital beds in the project area that is not going to decrease significantly by the time the new teaching facility opens. Jackson said that by 1990, the area surrounding County-USC Medical Center will be “over-bedded by 2,000 beds.”

“We feel very strongly that if that occurs, it will not be in the public interest (to approve the new teaching hospital),” Jackson said.

USC’s Van der Meulen countered that White Memorial’s concerns are unfounded. He pointed out that when the UCLA Medical Center opened, it did not drive out nearby hospitals.

“This is sort of a smoke screen that’s been put up,” Van der Meulen said of Jackson’s assertions.

Van der Meulen also expressed willingness to work with White Memorial to establish interim specialty-care operations at White until the new facility opens. But White’s Jackson has insisted that without a written guarantee that the new hospital will not compete with White on lower-level patient care, no such interim plan could be reached.

Antonovich also proposed that USC and National Medical obtain, in effect, county permission to provide expanded patient care. The supervisor’s plan provoked an angry response from National Medical’s John Bedrosian, who strongly hinted that Antonovich was single-handedly jeopardizing the project with an “irresponsible” proposal.

Bedrosian said that National Medical views the new teaching hospital as important to Los Angeles County, but indicated at the same time that it is a costly venture.

“This is not an activity that NME is anxious to duplicate in other parts of the country,” Bedrosian said. He also accused Antonovich of caring “more about White Memorial than the interests of the county.”

Attorney Douglas Ring, representing White Memorial, said after the board vote that legal action may be taken to halt the project. He refused to be more specific, but pointed out that he soon would be reviewing the project’s environmental assessment and added that the land has not yet been sold.

“Until (the sale) is completed, it is a little premature to assume the issue is over,” Ring said.