It pains me to see that Christus Saint Joseph's Hospital is facing an uncertain future. It's been put up for sale by its owner, it's transferred its residency program to Methodist, and nobody really knows if it will remain operationally viable in the future, even though its emergency services are badly needed in Harris County.
The impact of a decision to shut down St. Joseph could be considerable, and not just for sentimental reasons to do with its designation as "Houston's Birthplace," the hospital where, at one time, nine of 10 native Houstonians were born. It is one of the city's key providers of charity health care and home to one of its few trauma centers.
Christus Health Gulf Coast, St. Joseph's parent company, has pledged to find a buyer that will continue to operate the hospital as a full-service facility. But health-care analysts are skeptical, questioning the viability of a downtown hospital.
In the meantime, hospital staff have adopted a wait-and-see attitude.
"I think the next 60 days will be crucial," said Dr. Cristo Papasakelariou , St. Joseph's chief of staff. "The staff's a little more hopeful now than immediately after the announcement, but if there's not positive news about a potential buyer by then, the mood will probably turn negative."
Papasakelariou has launched a campaign of sorts to save St. Joseph, including proposing that local government subsidize the 118-year-old hospital, the oldest in the city. The idea met with little enthusiasm.
Most recently, Rob Mosbacher Jr. , head of Harris County's public health care council, has held meetings to put together a consortium that would make an offer to St. Joseph to share its assets. He said he hopes the consortium, to be made up of the Harris County Hospital District and some institutions in the Texas Medical Center, can put an offer before Christus Health by mid-August.
Analysts say negotiating a deal that would keep St. Joseph a full-service hospital will be a formidable task because any new owner would face the same sort of difficulties driving the sale: steep competition from the Texas Medical Center, financial drain from the jump in uninsured patients, old buildings that need rehabilitating and expensive real estate.
"It's a stranded asset," said Michael Barbour , a principal at the Houston office of Towers Perrin, a consulting firm. "That's why Christus Health doesn't want it. That's why prospective buyers are likely to be bargain shoppers, people looking to get downtown real estate for cheap."
Papasakelariou criticizes that attitude, stressing the hospital's role in providing care to Houston's indigent population. He notes that almost 30 percent of the nearly 5,000 babies born at St. Joseph last year were charity cases.
Much of St. Joseph's charity care, of course, comes at its emergency room, where the traffic of trauma cases has increased in the past year because Harris County's trauma-care system is so overburdened. Dr. Guy Clifton , head of a coalition of doctors and others calling for more emergency rooms, called the future loss of St. Joseph's ER "inevitable" and said it would be a further blow to the region's trauma-care problem.
In the mind of Clifton and many others, the ideal candidate to buy the hospital is the county's hospital district, which has a critical shortage of beds and a strategic plan to add a third hospital by 2015. It held discussions with St. Joseph late last year, though they broke down.
St. Joseph is attractive to the hospital district for a number of reasons: it's licensed for around 750 beds; it's on mass-transit lines, making it accessible for some patients; it could provide a ready-made staff (St. Joseph has 2,000 employees) instead of forcing the district to hire a new staff; and it would give the district a third emergency room to alleviate overcrowding at Ben Taub's and Lyndon B. Johnson's emergency rooms.
David Lopez, president of the hospital district, said the staff is "very seriously" looking into a possible purchase and will put "something" before the board and the Commissioners Court.
"I think if you look at St. Joseph's facility and its mission, we're a pretty good fit," said Lopez. "We just need to make sure whatever we propose is a benefit to the community and makes good business sense."
The issue will be money. In the talks that broke down last year, the financially strapped district offered $80 million to $90 million, less than half of what St. Joseph wanted. The county would also need sufficient funding to operate the hospital, knowing, as Papasakelariou notes, that converting the hospital to a county facility would drive off private patients who help subsidize the charity care.