The Florida Department of Health has allowed four new trauma centers to open, despite an ongoing legal fight with hospitals in the Jacksonville and Tampa Bay metropolitan areas.
The department Friday gave the go-ahead to trauma centers at Orange Park Medical Center in Clay County, Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County and Kendall Regional Medical Center in Miami-Dade County -- all part of the HCA hospital chain.
The decision, however, quickly fueled further legal challenges from hospitals opposed to the Clay, Pasco and Manatee trauma centers.
An administrative law judge in September sided with those hospitals -- Shands Jacksonville, Tampa General Hospital, St. Joseph's Hospital in Tampa and Bayfront Medical Center in St. Petersburg -- and ruled that the department was using an invalid rule in reviewing proposed trauma centers.
The department appealed the judge's decision to the 1st District Court of Appeal and argued it could approve trauma centers while the case remains pending.
But the opponents filed additional challenges this week after the trauma centers were allowed to open in what is known as "provisional" status. Those challenges likely will lead to another case before an administrative law judge.
"DOH acted improperly in issuing an immediate final order granting Blake provisional trauma status,'' Tampa General and Bayfront said in petitions challenging the Manatee trauma center. "Because there was no valid rule establishing a need for the proposed trauma center, the Blake application should have been rejected without further review.''
HCA last year announced a push to add trauma centers at hospitals in Florida. In a news release this week, Regional Medical Center Bayonet Point touted the approval of its trauma center as the "next natural step in the evolution" of the hospital.
"Having a trauma center here will mean faster treatment for trauma patients, which could be the difference between life and death and will satisfy a huge need in our community,'' Pam Schlicher, the hospital's vice president of emergency and trauma services, said in the release.
But the new centers would compete with already-existing facilities. Shands Jacksonville, Tampa General, St. Joseph's and Bayfront hospitals say, in part, that trauma centers are costly to run and that the new facilities could strip away patients, staff and revenues.
"It is a well-established fact that when it comes to health-care quality, providers need to experience high volumes to maintain proficiency and ensure optimal outcomes,'' Bayfront said in a prepared statement. "In the case of trauma centers, 'more' does not equal better.''
The September decision by Administrative Law Judge W. David Watkins centered on a 1992 rule that outlined a process for approving trauma centers, including carving the state into 19 trauma regions. Opponents argued the rule was outdated, a position supported by Watkins.
The Department of Health and HCA filed appeals last month. It is unclear when the 1st District Court of Appeal could take up those cases.
In approval letters dated Friday, the Department of Health said the new trauma centers could open the next day. But the "provisional" status requires the trauma centers to continue going through an approval process that will include resolving problems that might be found.