The incident that triggered the official closing of Destin (Fla.) Hospital took place on Aug. 3, 1994, when Robert Holloway was brought to the hospital in critical condition. He had been hit in the chest by a jet ski. He died shortly after being transferred to another hospital.
Destin community leaders knew Columbia/HCA Healthcare Corp. was downsizing the hospital during the summer of 1994, but until the accident, no one knew how far that effort had gone, said Philip Cook, Destin city manager.
In its probe of the incident, the Florida Agency for Health Care Administration found "probable cause" to believe that a nurse at Destin Hospital refused to allow paramedics to bring Holloway to the hospital's emergency department. Paramedics treated Holloway until an air ambulance helicopter arrived 12 minutes later to transport him to Baptist Hospital in Pensacola, Fla. He died three days later.
The agency's report cited Columbia for three violations of state hospital licensing law: failure to operate an emergency department; failure to offer such required medical services as surgery and obstetrics; and failure to offer 24-hour inpatient care.
Florida officials also have forwarded their report to HHS' inspector general's office for investigation of a possible violation of the federal "patient-dumping" law, which requires hospital emergency departments to provide basic medical screenings to all patients.
In an Aug. 30, 1994, settlement with the state, Columbia agreed to immediately close the hospital and sell or lease it to another operator by year-end.
One interested operator was Scott Hopes, a St. Petersburg, Fla.-based healthcare consultant. During the fall of 1994, Hopes was wooing Destin officials and physicians. In early December, the Destin City Council unanimously supported Hopes' plan to revitalize the hospital. A group of 45 physicians formed the Destin Medical Society and pledged their support to the hospital.
But this May, Columbia advised the state that it did not intend to complete its deal with Hopes (See related story, p. 82). On May 16, the state revoked Columbia's license to operate Destin.
Columbia since has offered two plans to reopen the hospital. State and local officials rejected both. In general, the plans offered to immediately open rehabilitation, long-term-care and urgent-care services. Columbia promised, but did not guarantee, that inpatient services would be opened at a later date, Cook said.
"It's a matter of trust and credibility," Cook said. "We got the feeling they weren't going to operate a full-service hospital and 24-hour emergency department."
On Sept. 8, a state court in Tallahassee turned down Columbia's appeal of the state's license revocation order. MODERN HEALTHCARE has since learned that Columbia plans to reopen Destin as an immediate-care center and clinic.