The Brief

Three California hospitals that declared bankruptcy earlier this year are hashing out deals that could bring back or save much-needed health care services for their communities.

Defunct Madera Community Hospital in the San Joaquin Valley, cash-strapped Beverly Community Hospital east of Los Angeles and Hazel Hawkins Memorial Hospital in rural San Benito County are trying to clinch lifelines in deals with health chains that have a reputation for revitalizing distressed hospitals.

The proposals are far from the finish line, but they present a glimpse of hope for residents who face longer journeys to emergency rooms and increased risk when local medical centers close. Two of the three — Madera Community and Hazel Hawkins — are the only hospitals in their counties.

“This is really great news. There will be a number of stages, and the first stage is for (partnering chains) to indicate their interest,” said state Sen. Anna Caballero, a Democrat whose district includes Madera and San Benito counties. “Now there’s a lot of work that has to happen in a very quick period of time.”

Madera Community, which shut down at the start of the year, is trying to secure a management agreement with Adventist Health, the seventh largest health system in the state. As proposed, Adventist would take over operations of the closed hospital and its affiliated rural clinics. If all goes according to plan, Madera Community could reopen in six to nine months.

Adventist Health is also a candidate to buy Beverly Community Hospital in the city of Montebello outside of L.A. That hospital has to secure a deal ahead of a key bankruptcy court deadline this week.

Meanwhile, Hazel Hawkins Memorial Hospital in Hollister recently announced a proposed “lease to own” partnership with American Advanced Management, a company that operates six other California hospitals.

The three are among a handful of hospitals that in the past year or so publicly announced their financial troubles. The state responded this spring with a $300 million interest-free loan program that can provide emergency funds to hospitals. The state is expected to distribute the money later this month. The three bankrupt hospitals have already asked for $125 million.

Saving Madera Community Hospital

The proposed partnership in Madera is largely dependent on Madera Community securing an $80 million loan from the state’s Distressed Hospital Loan Program.

Karen Paolinelli, chief executive of Madera Community Hospital, told CalMatters that while she recognizes the requested amount is substantial, her hospital is the only one that is currently closed. “It is very expensive to reopen a hospital,” she said. “We don’t want to just reopen, we want to be sustainable; we don’t want to be back here in a couple of years.”

Madera is also awaiting another $5 million in state funding that was granted in last year’s budget but placed on hold when the hospital closed.

In a letter outlining its terms, Adventist Health said it will require at least $55 million to fund staffing, supplies, maintenance, training and services in the first year, and another $30 million in the second year. Madera Community Hospital would have to pay Adventist a management fee.

In exchange, the health system would provide its management expertise and personnel to support Madera’s reopening. According to the proposal, Adventist would have the option to purchase the hospital after three years.

Outlines of the Madera Community Hospital sign are partly covered by a tarp at the emergency room entrance on Jan. 2, 2023. Madera County Sheriff Tyson Pogue announced a state of emergency for the county when the hospital closed due to bankruptcy.

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Larry Valenzuela

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Paolinelli said a management agreement is the hospital’s best bet at reopening. It has not found a buyer for a straightforward sale. Paolinelli said she has not discussed with Adventist whether she will stay on as head of the hospital.

Adventist Health has experience reopening closed hospitals. For example, five years ago Adventist reopened and rebranded what was once known as Tulare Regional Medical Center. That hospital is now Adventist Health Tulare.

Obstacles to Beverly hospital’s sale 

Beverly Community, a 202-bed hospital in Montebello east of Los Angeles, filed for bankruptcy in April. It suspended a number of services by June, including maternity, pediatric and outpatient radiology.

The Attorney General’s office last month announced the conditional approval of the hospital’s sale to a Glendale-based chain called American Healthcare Systems. That proposed deal is quickly dissolving.

According to bankruptcy court documents, bondholders raised concerns about American Healthcare Systems’ ability to support the hospital financially. Recent filings show that Beverly Hospital is now exploring an alternative transaction with Adventist Health.

“Given Beverly Hospital’s critically low cash position and as of now uncertainty about state funding (from loan program), the bid from Adventist Health represents Beverly’s greatest chance of continuing to serve the community it has served for the past 75 years,” said Justin Bernbrock, a lawyer for Beverly Hospital.

This month will be key for the hospital. Beverly is losing about $5 million a month and projects to run out of cash by September, court documents show. The hospital applied for $35 million from the Distressed Hospital Loan Program.

On Thursday, the hospital is due to present a deal proposal to a bankruptcy court judge.

Hazel Hawkins takes first step with potential partner

Twenty-five bed Hazel Hawkins Memorial Hospital is San Benito County’s sole hospital. After months of looking for potential partners, management at Hazel Hawkins recently announced that it received a “letter of intent” from Modesto-based American Advanced Management.

The small chain is a private, for-profit company that operates six other hospitals in the state. It’s proposing to lease Hazel Hawkins for five to 10 years before having the option to purchase the hospital.

American Advanced Management has taken over a handful of distressed or closed hospitals in rural parts of the state, according to its website. These include Coalinga Regional Medical Center, Glenn Medical Center and Colusa Medical Center.

Hazel Hawkins is part of a publicly governed health care district, and the deal would need to be approved by the district’s board and by county voters.

Hospital leaders sought a partner that, among other things, “possessed the resources to guarantee a continuum of care delivery for the future needs of our county,” Mary Casillas, interim CEO at Hazel Hawkins, said in a statement.

Hazel Hawkins declared a fiscal crisis late last year, and in May filed for Chapter 9 bankruptcy, but has continued to provide services. Last month, the hospital applied for $10 million from the state’s Distressed Hospital Loan program. If the hospital is approved for this loan, it would be in addition to a separate $3 million loan it received from the state in January.

In its May bankruptcy filings, the hospital said it expected to run out of cash in November 2024. At least one group, the California Nurses Association, has questioned whether the hospital filed for bankruptcy prematurely. The nurses union said it has asked the hospital to explain how it calculates its projections but has not received answers.

According to its financial statements, the hospital reported earnings of just over $2 million in calendar year 2022.

The union represents about 120 nurses at Hazel Hawkins. Filing for bankruptcy, according to the union, has prompted nurses to leave for jobs in other hospitals, leaving staff there shorthanded.

Andy Pages drove in two runs with a bases-loaded single in the seventh inning to give Los Angeles the lead, and the Dodgers beat the Atlanta Braves 4-1 on Wednesday night to clinch their NL Division Series.

The Dodgers won back-to-back games in Atlanta to take the best-of-five matchup 3-1 and advance to the National League Championship Series as they seek to become the first NL team to win three straight World Series.

Pages lined a 3-2 pitch from Robert Suarez up the middle to drive in Teoscar Hernández, who singled off starter Tyler Mahle, and pinch-runner Tommy Edman for a 3-1 lead. Didier Fuentes walked pinch-hitter Josue De Paula and Kyle Tucker to load the bases. Edman ran for De Paula.

Max Muncy’s solo shot off Raisel Iglesias in the ninth padded the lead and gave the slugger 19 postseason homers with the Dodgers, extending his franchise record.

Dodgers right-hander Tyler Glasnow, making his first start since Sept. 24, allowed only one hit but walked five batters in 4 2/3 innings. After he issued two walks in the fifth, left-hander Alex Vesia ended the inning on Matt Olson’s groundout to second base.

The missed opportunity left the Braves with 18 walks in the series, and none scored.

Glasnow and four relievers combined to give up just three hits. Tanner Scott pitched a perfect eighth before Edwin Díaz got three quick outs for the save.

Mahle, a native of Newport Beach, California, who grew up a Dodgers fan, allowed two runs — one earned — in 6 1/3 innings.

Michael Harris II hit Glasnow’s first pitch for a single before stealing second and eventually scoring from third on a wild pitch that bounced off catcher Will Smith’s chest protector.

The Dodgers pulled even in the second with the help of two Atlanta errors. Shohei Ohtani walked, stole second and advanced to third on catcher Sean Murphy’s errant throw into center field. Muncy’s pop fly into shallow left field was dropped by shortstop Mauricio Dubón for another error, allowing Ohtani to score.

Hernández crashed into the wall while attempting to catch Ozzie Albies’ double off Vesia leading off the sixth. Hernández pointed to his head and neck when talking to an athletic trainer but remained in the game.

Edgardo Henriquez stranded Albies at second. Henriquez allowed one hit in 1 2/3 scoreless innings for the win.

Injury report

Dodgers second baseman Miguel Rojas was held out after leaving Tuesday night’s 3-1 win during an at-bat in the eighth inning with lower back soreness. Los Angeles manager Dave Roberts said Rojas would not be available off the bench.

Ronald Acuña Jr. started in right field for Atlanta one day after being moved to designated hitter in a late lineup change due to right knee soreness.

Up next

The Dodgers will face Milwaukee or San Diego in Game 1 of the NLCS on Sunday.

The Democratic National Committee on Wednesday sued President Donald Trump’s administration for recent television advertisements that promoted his political message while costing taxpayers millions of dollars.

The complaint, filed in the U.S. District Court for the District of Columbia, alleges that the ads are illegal government-sponsored propaganda and accuses Trump of personally directing them. It asks the court to declare the ads illegal and stop the use of federal funds to pay for them.

Trump has faced bipartisan backlash for the ads, which glorify him and echo his campaign pitch as voters cast early ballots with the midterm elections less than a month away.

The spots, which began airing in September, already have cost more than $12 million to run, according to the media tracking firm AdImpact, and a total of $20 million in Homeland Security Department funding has been tapped to pay for them.

Responding Monday to the criticism, Trump defended the ads as “positive promotion for our Great U.S.A.” but said he’d pay for them using his MAGA Inc. super PAC going forward.

But on Tuesday, the fifth ad in the campaign began airing with the notice “paid for by the U.S. Government,” promoting Trump’s military actions in Venezuela earlier this year. The same day, Trump made it clear he hasn’t committed to reimbursing any money that has already been spent, telling reporters “we’ll decide.”

DNC Chair Ken Martin said in a statement that Trump is misusing taxpayer dollars in “a last-ditch attempt to save Republicans in November.”

“Americans deserve better than to have their hard-earned tax dollars used for Trump’s illegal schemes,” he added.

Legal experts have suggested the ads run afoul of a federal statute against congressionally appropriated money being used for “publicity or propaganda,” and potentially other federal laws. The Homeland Security money tapped for the ads comes from a $175 million package Congress gave to the department as part of Trump’s immigration enforcement agenda.

The White House has defended the ads as public service announcements akin to what past administrations have done to promote various policies. Legal experts have said the recent ads differ from many past public service announcements because they aren’t aimed at helping members of the public benefit from specific government programs.

The defendants in the lawsuit — Trump, the White House, DHS and the Office of Management and Budget — didn’t immediately respond to requests for comment.

Fall has only just begun, but it's already time to start thinking about the quintessential winter bug: the flu.

The annual flu season usually starts in October or November. But this year, it looks like the flu started to pick up in early September.

"There are enough signs pointing in the same direction to make me think, 'OK, yes. This is the start of flu season,'" says Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

The percentage of people testing positive for the flu in the West has been rising steadily since around the beginning of September, she says. And the number of people showing up in emergency departments because of the flu has also been rising for weeks, she adds.

"It's very uncommon to see flu activity rising this early. It's activity that we might normally see more like November or December," she says.

The timing of the flu season isn't the only thing that's odd. It's also unusual that flu activity seems to have started in Western states, such as California, Washington, Hawaii and Alaska.

"It typically starts in the South and then expands from there," Rivers says. "So two uncommon developments there."

Rivers stresses that the amount of flu activity is still very low in most parts of the country. But that's starting to change as the flu picks up nationwide.

It's unclear why flu activity would have started so early, and in such an unusual part of the country. But one clue might be a new variant that evolved a mutation, which appears to make it better at evading existing immunity, especially among teenagers.

"That's our best argument for what's going on right now in terms of this early flu season," says Dr. Alex Greninger, a virologist who heads infectious disease diagnostics at the University of Washington. Doctors there are seeing as much flu right now as they usually would around Christmas, and the mutated variant appears to be common, he says.

So Greninger, Rivers and others are urging people to think about getting their flu shot earlier than usual.

"It's crucial that people get an influenza vaccine," says Scott Hensley, a virologist at the University of Pennsylvania. "And this might be a year that people might want to get a vaccine early."

But the Centers for Disease Control and Prevention hasn't been promoting flu shots as it usually does. Health Secretary Robert F. Kennedy Jr., who oversees the CDC, is a long-time vaccine skeptic.

"It is disappointing that CDC is quiet given that flu kills of hundreds of kids a year and can result in tens of thousands of hospitalizations and tens of thousands of deaths," says Dr. Demetre Daskalakis, who resigned last year as the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention to protest what he called political interference at the agency.

The CDC declined to make an official available to NPR for this story. In a statement, a CDC spokesperson said, "CDC is developing a communications strategy to provide clear, accessible information about influenza vaccination and other critical steps people can take to protect themselves during respiratory virus season. This includes information about the benefits and risks of vaccination to support informed decision-making."
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