Resolve hospice dispute

As Petaluma Health Care District officials continue working to secure a long-term contract with a new operator of the publicly-owned Petaluma Valley Hospital, a number of questions remain unanswered in what has become a hugely complex deal with numerous long-term ramifications impacting the healthcare for many thousands of people in the Petaluma area. Unfortunately, such questions are not likely to be fully answered until the late summer or early fall when district voters are expected to be asked to formally ratify the agreement during an election.

For the past 20 years, the district has leased the hospital to St. Joseph Health, the Catholic healthcare provider that also operates Santa Rosa’s Memorial Hospital. With the hospital’s management contract set to expire in January of this year, the district had been engaged in talks with St. Joseph, but late last year those discussions abruptly ended when a deal could not be reached.

In response, the district hastily relaunched its search for a suitable hospital operator. Only three companies responded to a request for proposals and, in February, the district selected Paladin Healthcare as its preferred operator.

Paladin, which operates four southern California hospitals, has since been working out the details of a transition agreement with the district. Additional complexities relating to differences in the two companies’ information technology systems, especially regarding medical records, have significantly slowed that process. St. Joseph recently agreed to stay on until the hand-off is complete, which could last until the end of this year.

As this ongoing, multifaceted management transition process continues, it has generated significant uncertainty for local physicians and hospital employees, along with a certain amount of disruption at the facility’s ancillary organizations. The latest controversy involves Hospice of Petaluma, a nonprofit entity which offers compassionate palliative and end-of-life care for patients and their families.

District officials say hospice is a longstanding “core service” of Petaluma Valley Hospital and should remain with the hospital. According to Faith, Petaluma’s well-regarded hospice services program was created by the district long before St. Joseph assumed management of the facility 20 years ago, and so should continue with the hospital once St. Joseph is gone.

St. Joseph has taken a different position, contending that the nonprofit health services provider has done an exceptional job of managing the program over the last 20 years, and so should continue operating it.

While it is not entirely clear why St. Joseph desires to retain control of Petaluma’s hospice program, it’s logical to assume that there must be some economic benefit for the company to want to do so. For 20 years, Petaluma Valley Hospital has been a feeder hospital for Santa Rosa’s Memorial Hospital, meaning that patients needing more extensive or complex medical services, such as heart surgery, have usually been referred to the Santa Rosa facility.

With the pending disengagement from managing Petaluma’s hospital, such referrals will no longer be automatic. A program like hospice could enable St. Joseph to retain an important community connection with Petaluma families whose loved ones are served by it.

People whose family members access hospice services are more likely to use other services offered by the same healthcare provider. As St. Joseph looks to remain competitive in Sonoma County following its separation from Petaluma Valley Hospital, retaining control of the local hospice program could help achieve that goal.

But whichever entity operates the local hospice program long-term is far less important than ensuring that these hugely beneficial services are preserved and maintained for the families in Petaluma who need it. Continued conflict between the public agency that gave birth to the hospice program and the agency that has capably operated it over the last two decades benefits no one.

Partly because of the ongoing dispute, the hospice program was not included in the letter of intent the district signed with Paladin because, according to Faith, the district did not want it to unnecessarily delay the already exceedingly-complicated lease negotiations with Paladin. It was a smart move.

If St. Joseph wishes to continue operating the Petaluma hospice program, then they should make a clear offer to purchase the program’s assets, which includes a district-owned building on Payran Street where hospice services are offered. In the interest of providing certainty to residents of Petaluma that the community’s hospice program will continue its excellent quality of care, the sooner this matter is resolved the better it will be for all concerned.