Hospital G

History of Hospital G

Hospital G is a for-profit, mid-sized institution (200-399 beds) providing acute-care, general services to the Western region. This community hospital was founded 50 years ago to provide services to a growing metro center. It is the oldest hospital in its area of the city.

Ownership of the hospital (by then part of the state's largest hospital system) passed from nonprofit to for-profit control in the early 2000s. Stipulations in the sale required the new for-profit owner to continue the hospitals' community oversight board, charity care, and community benefit programs, in addition to acceptance of Medicaid and Medicare patients, for a minimum of 10 years. Sale conditions also required the hospital to continue physician residency programs for a minimum of 5 years.

Hospital G is located in an urban community with between 350,000 and 400,000 residents. The community is more racially diverse than the US population. Approximately 45% of residents identify as White non-Hispanic, 16% as Black, 6% as Asian, and 20% as Hispanic; the remainder of residents identify as more than one race. Educational attainment is slightly lower than average for the US population when measured by percentage of high school and college graduates. The most common employment for the city by industry is health care and social assistance. The most common bachelor's concentration is nursing. An average resident is middle-class and in their mid-thirties. He or she is less likely than the average American to be a homeowner and has a household income between $50,000 and $70,000. Median property values are +300K.

The state where Hospital G is located does not currently have a CON law program. This state's CON law history illustrates national CON law trends. The CON law program was instituted by New York in the 1960s. Half of the states, including Hospital G's state, followed New York's lead with regulations in the next decade. The federal government tied federal funding to state passage of CON laws in the 1970s, which prompted 49 states to implement programs. When the federal government removed CON law requirements in the 1980s, many states, including Hospital G's state, followed suit by repealing their CON laws. Today 35 states and DC have regulation via CON laws.

Hospital G as an Anchor Institution

In a nonpartisan ranking of hospital civic leadership, which includes provision of community benefit as a criterion, Hospital G ranked within the top 5% of all US nonprofit and for-profit hospitals. Staff from Hospital G outlined "three pillars" of their strategy toward community outreach. Hospital leadership engages with the community through quadmester meetings. Leadership prioritizes where to invest time and resources by focusing on a "career pipeline for healthcare," "women and children's health," "preventing & managing disease," and "equity & healthcare disparities" with an "overarching concern for access to healthcare." Post-COVID, the hospital includes an additional emphasis on mental health.

Staff cite a variety of motivations for carrying out anchoring efforts which include establishing a "reciprocal relationship" of trust between the hospital and its community where each side is committed to long-term interactions beyond a one-off healthcare encounter. An employee further explained that by engaging in anchoring efforts to improve the standard of living for current residents served by the hospital, the area becomes more attractive to potential residents, who may become future patients.

Challenges staff face during anchoring efforts are unique to for-profit versus nonprofit hospitals. Staff point to public concerns regarding for-profit hospital motivations for serving the community as "they're in this for the money" rather than truly charitable. As a mid-sized community hospital, staff also point to their limited budget for marketing and manpower versus nonprofit hospitals who are better equipped for promotion and fundraising.

Anchor Activities

Funding

Provide financial support for:

• Chamber of Commerce
• Economic development committee
• Student leadership programs
• Public school gala

Community Stability

• Hospital H is a primary employer in the area and dedicated to increasing access to culturally competent care to better serve the community.

Health Promotion

• Community education seminars and initiatives.
• Charity medical care for underserved communities.
• Outreach and engagement efforts that focus on the social determinants of health.

Community Building

• Hospital holds meetings of a community advisory board composed of "thought leaders" like military, police, educators, healthcare entities, and general community members every quadmester to explore collaborations.
• Hospital organizes neighborhood meetings where community residents can voice concerns. Senior leadership e.g. CEO, COO, from the hospital attend.