Battle over allowing new trauma centers goes on

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TALLAHASSEE, Fla. - Ratcheting up a fight about trauma care, Jacksonville and Tampa Bay hospitals have asked a state appeals court to halt the Florida Department of Health's decisions to approve the opening of three new trauma centers.

The dispute stems from the department's decisions last month to allow the immediate opening of trauma centers at Orange Park Medical Center in Clay County, Blake Medical Center in Manatee County and Regional Medical Center Bayonet Point in Pasco County.

Shands Jacksonville Medical Center, Tampa General Hospital and Bayfront Medical Center in St. Petersburg asked the 1st District Court of Appeal on Friday to issue a stay of a department decisions. Also, St. Joseph's Hospital in Tampa said it was filing a similar motion Monday.

The motions filed Friday argue that the Department of Health improperly allowed the immediate opening of the trauma centers without giving the Jacksonville and Tampa Bay hospitals an opportunity to challenge the decisions administratively.

The three new trauma centers are expected to compete for patients and staff with existing trauma facilities at the other four hospitals.

Shands, for example, said in its motion that Orange Park Medical Center's new trauma center started serving patients the day after the Department of Health gave what is known as "provisional" approval.

"The department's unlawful granting of an immediately effective provisional trauma center license to Orange Park will cause, and in fact is already causing, immediate harm to Shands Jacksonville,'' the document says.

But the new trauma centers contend that they will provide needed services to residents.

"This designation means we can now provide residents of Pasco and surrounding counties with trauma care in their own community and ensure that critically injured patients have access to treatment within the 'golden hour' --- the first hour after a serious injury during which there is the highest likelihood that prompt medical attention will prevent death,'' Shayne George, chief executive officer of Regional Medical Center Bayonet Point, said in a prepared statement after the department approval.

The appeals-court motions are the latest twist in months of legal battling about the new trauma centers. The dispute began when Tampa General, Bayfront, St. Joseph's and Shands Jacksonville challenged a 1992 rule that outlined the Department of Health's process for approving trauma centers.

An administrative law judge in September found that the rule was invalid. The Department of Health and the hospital company HCA --- which operates Orange Park Medical Center, Regional Medical Center Bayonet Point and Blake Medical Center --- appealed the judge's decision to the 1st District Court of Appeal in a case that remains pending.

The department said it could approve new trauma centers while the appeal remained unresolved. That position led to the Nov. 18 decisions approving the centers in Clay, Pasco and Manatee counties and another trauma center at Kendall Regional Medical Center in Miami-Dade County.

Days after those decisions, the Tampa Bay and Jacksonville hospitals also filed administrative challenges with the department. It was not clear Monday how those challenges will be resolved, though they could lead to another fight before an administrative law judge.

The department did not respond to questions Monday, and an HCA attorney could not be reached.

But in filings last month with the Department of Health, HCA said the approvals of the new trauma centers were not final.

It pointed to the "provisional" status of the department's decisions, which will require the new trauma centers to continue going through a final approval process that will include addressing problems that might be detected.

"In summary, Blake remains in the midst of the trauma center application process and has only received authorization to operate as a provisional Level II trauma center so that its ability to comply with operational trauma center standards can be reviewed and measured by the department,'' one of the filings said.

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