MADISONVILLE, Ky.—Trover Health System has entered into exclusive negotiations to join five-hospital Baptist Healthcare System. Trover includes 197-bed Regional Medical Center, Madisonville, as well as a number of clinics in the western part of the state.

Trover's board considered letters of intent from three finalists before settling on Louisville, Ky.-based Baptist Healthcare, according to a joint news release. Also on the short list were 47-hospital LifePoint Hospitals, Brentwood, Tenn., and 378-bed Owensboro (Ky.) Medical Health System. “We are confident that Baptist's sterling reputation and commitment to quality care will assist us in serving our region of Western Kentucky,” E. Berton Whitaker, Trover's president and CEO, said in the release. “By joining the Baptist system, Trover joins the Baptist statewide network of hospitals and will gain access to a broad range of operational and financial resources, as well as Baptist's clinical quality initiatives and experienced leadership.” The two will now begin negotiations toward a final agreement.

AUSTIN, Texas—Dr. Rolando Arafiles Jr., who this month pleaded guilty to misuse of official information and retaliating against two nurses who sent an anonymous complaint about him to the Texas Medical Board, surrendered his Texas medical license Nov. 11. The board will not seek further disciplinary action against Arafiles, who will pay a $5,000 fine and spend 60 days in the Andrews County Jail and five years on probation as part of an agreement with prosecutors, according to news releases from the medical board and the Texas attorney general's office. The board disciplined Arafiles in February but allowed him to continue practicing. In their letter to the board, the nurses—Vickilyn Galle and Anne Marie Mitchell—alleged that Arafiles endangered patients at 19-bed Winkler County Memorial Hospital, Kermit, Texas, with unorthodox care, such as treating them with herbal remedies. The letter referenced specific patient files by number, and the nurses were subsequently fired and charged with a third-degree felony misuse of official information. The charge against Galle was dropped just before her case was set to go to trial and Mitchell was acquitted. Winkler County Memorial Hospital administrator Stan Wiley pleaded guilty to playing a role in the retaliation and was sentenced to 30 days in jail. The prosecutor and sheriff who brought about the indictment were found guilty on related charges.

SAN ANTONIO—The system owned by Vanguard Health Systems, Nashville, is eliminating and consolidating positions to reduce its workforce, affecting 118 employees. Baptist Health System said in a statement that the job cuts are the direct result of cuts in the Texas Medicaid program and the federal Medicare program, as well as uncertainty about the local economy. None of the job cuts involved employees who provide care at the bedside, Baptist spokeswoman Patti Tanner said. The cuts leave the system with about 6,300 full-time equivalent positions, Tanner said. The Baptist system includes five campuses and about 1,300 staffed beds. Earlier this month, Nashville-based HCA said the Medicaid cuts that Texas implemented on Sept. 1 would cost the company approximately $80 million on an annual basis. In March, Vanguard trimmed its corporate staff by 10%, affecting about 21 people. Earlier this month, Charlie Martin, Vanguard's chairman and CEO, said the company expects reimbursement and volume pressures to continue, and the company is going to manage its costs to volume and reimbursement weakness. Weak economic growth, lack of coverage and more financial responsibility on patients are all weighing on volumes, Martin said during a conference call to discuss the company's results for the quarter ended Sept. 30: “Surgeries that I would have told you a few years ago were not electives are showing signs that people are putting them off.”

JACKSON, Miss.—Blair E. Batson Hospital for Children recently cut the ribbon on a 16,000-square-foot emergency department and trauma unit. The hospital, part of the University of Mississippi Medical Center, began construction on the $5.8 million facility in 2009. The existing 5,100-square-foot emergency department, built nearly 30 years ago, was designed to handle 15,000 patients annually. The ED currently treats about 20,000 more than that annually, according to a hospital news release. “This new children's emergency department enables us to serve even more children in the Jackson area and throughout the state of Mississippi,” Guy Giesecke, the hospital's CEO, said in the release. “The additional space and better flow will significantly help provide better service and privacy to our patients and families, and optimally respond to major pediatric traumas as well.” Dr. Magnolia Castilla, the hospital's director of pediatric emergency medicine, said the new facility would make it easier for staff to treat ever-increasing numbers of high-acuity patients. “There is a larger critical mass of patients coming through our doors that coincides with the children's hospital's expansion of its specialty and subspecialty programs,” Castilla said in the release. The new emergency department is scheduled to open its doors to the public Dec. 1, a hospital spokeswoman said. It includes 23 treatment rooms, two waiting rooms and two trauma areas, the hospital said in the release.

CORAL SPRINGS, Fla.—Coral Springs Medical Center completed the second phase of its two-stage emergency room expansion, creating a total of 28,000 square feet of space for emergency care and increasing the hospital's estimated patient count by about 4,000 cases a year. The first phase of the $21 million expansion lasted about 2½ years, ending in October 2010, according to a news release. The second phase lasted about a year, intended to renovate the medical center's original emergency department to match the new expansion. The expanded emergency department now has 40 exam rooms, up from 23, and has a separate pediatric waiting room and eight pediatric private rooms. Among a list of new additions, the renovations added a new secure department access, a secure hold room for behavioral health patients and three additional nursing stations with designated physician documentation areas. Taken together, the new ED is projected to attract about 58,000 patients a year, the release said. “The hard work and dedication by our team allowed for a seamless transition from the opening of phase one to the completion of phase two,” Dr. Daniel Stone, medical director of the emergency department, said in the release.

FORT MILL, S.C.—Two hospital systems whose bids to build a new hospital in Fort Mill were rejected by state certificate-of-need regulators have appealed the CON granted to Carolinas HealthCare System, Charlotte, N.C. In a statement, Charlotte-based Presbyterian Healthcare acknowledged that York County residents have waited a long time for additional hospital capacity—first recommended in the 2004 state health plan—but added that the decision by the South Carolina Department of Health and Environmental Control improperly based its decision in favor of Carolinas on the impact on the existing hospital in York County, 281-bed Piedmont Medical Center, Rock Hill, owned by for-profit Tenet Healthcare Corp., Dallas. Presbyterian is part of not-for-profit Novant Health, Winston-Salem, N.C. The 2004 state health plan recommended adding beds to Piedmont, but Tenet proposed in 2005 to build a separate hospital in Fort Mill. A Tenet spokesman confirmed that Piedmont also filed an appeal against the CON awarded to Carolinas on Nov. 15. Not-for-profit Carolinas said in a statement that it expects to prevail in the appeals.