Cochise Regional Hospital in Douglas is expected to permanently close Friday, officials said.
On Thursday, U.S. District Judge Cindy K. Jorgenson denied the hospital’s request for a temporary restraining order on the federal government’s decision to terminate its Medicare contract. The U.S. Centers for Medicare & Medicaid Services stopped Medicare payments to the 25-bed acute care hospital near the U.S./Mexico border on July 10 because of patient safety concerns.
If the hospital closes, 70 employees will immediately lose their jobs, according to court documents.
The closure is “of great concern and utmost importance,” city of Douglas officials said in a news release issued Thursday afternoon. City officials say they are working with Cochise County to come up with both short- and long-term solutions for providing quality patient care to local residents.
During a court hearing July 22, hospital officials appealed to the government for a temporary restraining order on the contract termination, saying that ending the Medicare contract was going to in effect shut down the hospital. Officials said a closure would adversely affect the community of Douglas, which includes a population of about 20,000 people 118 miles southeast of Tucson.
Rural hospital closures are a “disturbing” national trend, said Dr.Daniel Derksen, director of the University of Arizona’s Center for Rural Health. He told a house subcommittee earlier this week that if Cochise Regional Hospital closes, it will be the 55th rural hospital in the U.S. to close since 2010.
In a July 27 letter to Sen.John McCain, Derksen said that when Medicare stopped paying Cochise Regional Hospital, so did other insurers.
“Cochise Regional Hospital serves 20,000 people living in Douglas, including Border Patrol personnel and the EMS/Ambulance system,” Derksen wrote. “The medical and economic impact to the community, and loss of access to health services are devastating.”
The nearest hospital to Cochise Regional is the Copper Queen Community Hospital in Bisbee, which is about 25 miles away. That hospital also operates a clinic in Douglas.
In her decision, Jorgenson noted that Cochise Regional Hospital never disputed the federal government’s findings that it was not in compliance with federal regulations during four surveys conducted between Feb. 19, 2014 and March 26 of this year.
Those surveys found, among many other issues, that there were continuing, serious problems with basic nursing care. During the fourth survey, completed on March 26, hospital nurses left a patient with congestive heart failure and renal disease unaccompanied and unmonitored, except for an admissions clerk, for 90 minutes while he waited for transportation to a dialysis center, according to a federal report.
The report says when the patient was transferred to the van, he was unresponsive and brought back to the emergency department without a pulse. He was placed on a ventilator, airlifted to Tucson and died, court documents show.
The federal surveys found numerous other problems, including that nurses failed to initiate oxygen for a patient with low oxygen saturation, failed to follow a physician order for another patient’s oxygen administration, and failed to ensure that nurses administering potentially dangerous drugs like Vecuronium and Etomidate and obtaining arterial blood gases were competent to do so.
The hospital has had prior problems with patient safety.
Last year, the hospital agreed to pay a civil fine of $4,250 to the Arizona Department of Health Services following an investigation that turned up numerous problems, including having no doctors credentialed to perform surgery and failing to keep the facility clean enough “to prevent the spread of infection.”
Jorgenson wrote that Cochise Regional Hospital did not meet “its heightened burden to establish that it is entitled to a TRO” (temporary restraining order).
Absent the reinstatement of Medicare coverage to the hospital by Friday, it is definitely closing permanently, Chicago-based attorney Harley Goldsteinwrote in an email Thursday.
Goldstein is a partner at the law firm of Goldstein & McClintock, which is lead counsel to both Cochise Regional Hospital and People’s Choice Hospital. People’s Choice Hospital is a national company that specializes in saving financially distressed hospitals. People’s Choice Hospital commenced managing Cochise Regional Hospital after the hospital (previously known as Southeast Arizona Medical Center) filed for bankruptcy twice.
“We certainly hope that the U.S. Attorney or the politicians will intervene and convince the appropriate regulatory folks to change their minds so this community is not left deprived of critical-access medical services,” Goldstein wrote.
Officials with the office of U.S. Attorney for ArizonaJohn S. Leonardodeclined comment Thursday.
“My understanding is that the U.S. Attorney has not offered any solution which would permit continued Medicare coverage for Cochise Regional Hospital (even during the administrative appeal process), and thus the closing of Cochise Regional Hospital appears imminent,” Goldstein wrote.
The city and county are engaging all medical agencies from the area to arrive at the most effective solutions, the city of Douglas release says.
“Absolutely all options are being considered and both medical and allied health agencies are coming together positively and optimistically to offer solutions to include but not limited to: Copper Queen Community Hospital, Canyon Vista Medical Center, Tucson Medical Center, Chiricahua Community Health Centers, Arizona Ambulance and Lifeline.”