Operations of the publicly owned, 421-bed Munroe are scheduled to shift to Community Health Systems on April 1. UF Health Shands, which purchased a $10 million stake in the lease, has always been a secondary but important partner with CHS. (Originally, the dealings were with Health Management Associates, which CHS acquired this year.)
As Marion County Hospital District trustees finalized the lease with CHS, there was little public discussion of what Shands would bring to the table.
Shands has held off creating definitive, shared programs with Munroe medical staff until the lease is signed, according to Shands President and CEO Tim Goldfarb. The Marion trustees have signed their portion, and CHS is scheduled to do so later this month.
Still, in the interim, there have been enough talks among both hospitals' leading medical staffers to begin identifying what Shands will be doing.
For example, Munroe is prepared to create a neonatal intensive care unit. Goldfarb said that since Shands already offers Level 3 neonatal care — that is the highest level, providing treatment for the most ill infants — Shands can offer Munroe guidance and collaboration opportunities.
Shands pediatricians with advanced specialties could consult with Munroe doctors on a regular basis by way of video conferencing, for example.
Another option discussed is sending Shands pediatricians to Munroe, thus freeing up Ocala pediatricians to see more patients in their offices.
Sending pediatric staff to Munroe also could help Shands. Since UF Health Shands Children's Hospital is often at full capacity, keeping sick children at Munroe ensures Shands doesn't become overly burdened.
In addition, Goldfarb said, he will talk with Munroe medical staff about offering psychiatric services at Munroe's emergency room to evaluate patients with potential behavioral problems.
Dr. Lon McPherson, Munroe's senior vice president of medical affairs and chief quality officer, predicts that Shands' new relationship with Munroe will develop “very quickly” once the CHS lease is implemented. McPherson said the Munroe, Shands and CHS medical staffs have met regularly and made good progress.
One of the developments McPherson expects to see is UF medical students completing some of their residency requirements at Munroe.
McPherson said the Munroe/Shands/CHS partnership is a good fit because Shands brings its research and deep knowledge of specialty medicine to the table, CHS brings its vast health care resources, and Munroe contributes its tradition of providing quality community care.
CHS will pay the Marion County Hospital District $212 million for the 40-year lease and make more than $225 million in improvements to the hospital, including building off-site facilities and services.
CHS owns or operates more than 200 hospitals in 29 states.
Some health care experts say partnerships between community hospitals and teaching and research hospitals are becoming increasingly common. They allow the teaching hospitals to expand their health care footprint and reputations, and allow community hospitals to benefit from their counterparts' expertise.
Aaron Liberman, a recently retired professor from the University of Central Florida's Department of Health Management & Informatics, said people should expect to see more of these partnerships in the future as the competition for health care dollars heats up.
In this case, Liberman said, CHS benefits in an additional way: developing a relationship with Shands.
As for Shands, Liberman said the teaching hospital is extending its brand in a market that is seeing more competition. He specifically cited the growing influence of the UCF College of Medicine and Florida International University College of Medicine in Miami.
Liberman said many of these partnerships may include hospital expansions, such as Munroe's plans for a new patient wing and CHS' other construction plans on behalf of Munroe.
There may not be enough patients with the money to justify such growth, he said, and there could come a time when health care facilities pull back a bit.
“It's a very interesting time to sit back … and see what happens,” he said.
Contact Fred Hiers at 867-4157 or firstname.lastname@example.org.