Hospital I

History of Hospital I

Hospital I is an exceptionally large, for-profit institution (400+ beds) providing acute-care, general services to the Southeastern region. This community hospital was founded in the late 1800s by a group of women to care for those in need, and ultimately revolutionized health care in the region. It is the oldest hospital in its area of the city, and one of the oldest and largest in its State.

Ownership of the hospital (by then part of one of the state's largest hospital systems) passed from nonprofit to for-profit control in 2019. Stipulations in the sale required the new for-profit owner to continue the hospitals' community service programs and actively address community health via the hospital system’s foundation, maintain an independent monitor and advisory board, continue financially supporting emergency centers in underserved areas, and invest in new hospital sites and renovations to existing hospitals.

Hospital I is in an urban community with between 80,000 and 100,000 residents and is surrounded by rural areas. The community is less racially diverse than the US population, with approximately 78% identifying as White non-Hispanic, 7 % as Hispanic or Latino, 11% as Black, 2% as Asian, and the remainder a combination of additional races and ethnicities. Educational attainment is higher than the average US population with approximately 92% of residents completing high school, and 49% obtaining a bachelor’s degree or higher. The most common employment for the city by industry is manufacturing and health care services. An average resident is 39 years of age, middle-class with a household income between $40,000 - $50,000. The community has a poverty rate between 11% and 14%, and median property values are between $250,000 and $300,000.

The state where Hospital I is located is one of 35 sates that have maintained their CON law after the federal government repealed CON mandates in the late 1980s; however, it is also one of 20 states that temporarily suspended the CON law during the COVID-19 pandemic.

Hospital I as an Anchor Institution

Hospital I has been ranked as in the top 1% among the nation’s hospitals and is committed to community investments via community partnerships, sponsorships, and grants in efforts to increase access to health care. Hospital I is committed to improving community health by promoting a more sustainable environment by minimizing their energy consumption. Additionally, Hospital I promotes diversity, equity, and inclusion via diverse recruitment and education and training programs, community collaborations that address the social determinants of health, and a commitment to diverse and localized purchasing and contracting. As Hospital I maintains a foundation, they are able to access grants and prioritize charity care. Hospital I is currently working to strategically address moms and babies having a healthy start, behavioral health and mental wellness, access to care for the uninsured in a post-COVID world, and advancing diversity, equity and inclusion and health equity.

Staff explain that motivations for carrying out anchoring efforts are rooted in the mission-oriented beliefs of the hospital that as a health care institution, they exist to improve lives and create healthier futures. An employee explained that in order to effectively do that, the hospital must provide more than services by partnering and working with the community; thus, the hospital is committed to community investments and engagement. The employee further explained that by engaging in anchoring efforts to improve the standard of living for current residents serviced by the hospital, the area becomes more attractive to potential residents, who may become future patients.

Challenges staff encounter while undertaking anchoring efforts are unique to for-profit versus nonprofit hospitals. Staff point to negative public perceptions regarding for-profit hospital motivations for serving the community, as the “perception about the intent and pursuits of a for-profit healthcare entity versus a nonprofit that by the business structure alone, you're all of a sudden going to have negative impact.” Staff also cite lack of access to federal and state grants as a barrier at for-profit hospitals, as only their foundation is capable of accessing grant funds, which can limit philanthropic endeavors at the hospital level.

Anchor Activities

Funding

Provide financial support for:

• Access to care for the uninsured
• Behavioral health and mental wellness
• Health equity
• Scholarships and job training for living wage health care careers
• Healthy start for minoritized and underserved moms and babies
• Local sponsorships and investments

Community Stability

• Hospital I is the primary employer in the area and dedicated to increasing access to living wage health care careers.
• Actively committed to community partnering, community development, and economic development of the community.

Health Promotion

• Community education seminars and initiatives.
• Fund a COVID-19 task force to assist community members.
• Charity medical care for underserved communities.
• Outreach and engagement efforts that focus on the social determinants of health.

Community Building

• Partners with community to address diversity and health equity.
• Hospital holds community and neighborhood meetings where residents can voice concerns.
• Hospital has an advisory board.