When Columbia/HCA Healthcare Corp. targets a hospital for acquisition or joint venture, it doesn't take rejection kindly, and hospital executives should expect behind-the-scenes contact with board and community leaders to grease the deal.
That's the assertion of a new report from the Washington State Hospital Association. The 82-page document is a primer for the WSHA's largely not-for-profit membership on dealing with Columbia, the nation's largest for-profit hospital chain, when it comes calling.
According to the latest available figures from the American Hospital Association, 90 acute-care hospitals were operating in Washington state at the end of 1993. Of those, 86 were not-for-profit facilities and four were investor-owned.
Columbia owns one hospital in Washington but is rumored to be discussing deals with several others.
The report is believed to be the first of its kind by a national, state or regional hospital association, which historically have stayed away from preparing and disseminating specific analytical reports on member hospitals.
The WSHA commissioned the report at the request of its 30 urban hospital members, said Randy Revelle, director of the WSHA's urban project, a new member services initiative.
"They were interested in what's going on in the for-profit world, especially with Columbia/HCA," he said. "We're not picking on Columbia/HCA, and it's not intended to be either a propaganda piece for them or a hit piece."
For the experienced Columbia watcher, not much of the material is new. But for others who haven't dealt with the company, the report walks readers through a description of the company, its history, its executives and its approach to acquiring and managing hospitals. It includes case studies of the various ownership and joint-venture arrangements that the company has struck with not-for-profit hospitals.
Revelle said Columbia's national office is aware of the report and will receive copies this month. The association released copies to its membership in December. At deadline, Columbia executives were unavailable for comment.
The most noteworthy sections of the report deal with the behavior of the company when it pursues a hospital and "myths" about the company.
When Columbia approaches a hospital with a possible deal, the report said, the hospital's chief executive should anticipate: a well-prepared and very experienced acquisition team; an aggressive and persistent pursuit; unusual speed and flexibility in dealmaking; and the likelihood that Columbia won't overprice the hospital.
The attempt to close the deal may include pressuring board members and community leaders, the report said. It told of an unidentified hospital executive who rejected Columbia suitors only to have his board announce a deal months later and fire the executive.
But the report said there's little evidence to support several myths about the chain, saying that "writing about and complaining about Columbia/HCA has become its own growth industry."
One myth, the report said, is that the chain doesn't know how to run a hospital. The report said that whatever expertise the chain lacks, it hires. And, not only does the company know how to run a hospital, it's redefining how facilities will be run in the future.
Meanwhile, one local industry official said Columbia is likely to make a move on Washington State hospitals early this year.
But reports that a deal is imminent are simply "rumors more grandiose than reality," said Wylie Brooks, a spokesman for Health Washington, a seven-hospital association.
After a chance meeting between a Health Washington consultant and an old colleague who works for Columbia, Columbia officials visited the state last summer. Since then, "there have been some very informal telephone discussions" with Health Washington, Brooks said.
The association is made up of Swedish Health Services, with a hospital in Seattle and one in Ballard; and Multicare Health System, with three hospitals in Tacoma, one in Edmonds and one in Kirkland.