Madera hospital reopening is pushed back again. Why is it taking so long?
When its management plans for Madera Community Hospital were approved by a federal judge in February, American Advanced Management Inc. said it could reopen the shuttered facility a few months later in the summer.
The hospital has secured a $57 million no-interest state loan to aid the reopening effort and its building has been remodeled. But its doors have now been closed to patients since December 2022, leaving Madera’s largely minority and significantly low income community without an adult emergency room between Fresno and Merced for two years. Some have died during emergency medical trips out of Madera, while others continue to make routine trips to Fresno for care they can no longer access in their hometown.
“It’s very stressful having to drive out there, especially during certain peak hours of the day when southbound traffic is bumper to bumper,” Madera resident Kim Crawford told The Fresno Bee.
Crawford, 61, said he began suffering respiratory issues after contracting Valley fever and being exposed to asbestos. He saw doctors at Madera hospital before its closure. He said his brother, Kevin Crawford, suffered a heart attack and also had to be rushed to a Fresno hospital. To this day, they continue to travel to Fresno for care.
“We take back roads and sometimes drive past Madera Community Hospital,” Crawford said. “We see they’re doing an enormous amount of work on it, but it’s not open.
“I’m not sure that once Madera Community Hospital reopens, it’s going to stay open.”
The hospital’s fate became a local political issue during the 2024 elections. Madera City Council candidates lamented that the hospital would lose local control and blasted incumbents for not paying attention to the facility’s finances as it accrued a $30 million-plus debt. At the county level, the Board of Supervisors was criticized for allocating dollars to try to keep the hospital in a functioning state until AAM could take over.
The Modesto-based hospital management firm took over in March, after more than a year of the hospital’s federal bankruptcy proceedings, major healthcare nonprofits backing out of potential partnerships, and a judge’s rejection of a heavily-supported last-hour bid from Adventist Health and UC San Francisco. AAM, a for-profit company known for reopening closed hospitals, also faced community skepticism of its track record as it sought to add the facility to its portfolio.
“When AAM came in in March, they thought a June (reopening) date,” Steve Stark, who AAM appointed as Madera hospital’s new CEO, told The Bee last week. “I think that that was somewhat of a sight unseen.”
But Stark reported in a Madera hospital social media post Dec. 20 that construction on the facility was more than 90% complete. He said it will open immediately after it passes a building inspection by the California Department of Public Health, which could take a few days to complete.
On Monday, Stark told The Bee in a text that the state agreed to begin its survey Feb. 10.
Why the delays?
Stark told The Bee that when AAM actually accessed the hospital building, the list of needed repairs quickly grew. But he said the bulk of the delays were caused by the electronic medical records (EMR) system requiring close to two years worth of updates because it sat idle for so long.
“That was something that became a much bigger challenge than what was originally thought,” Stark said. “These EMR systems are not stand-alone. They talk to everything from machines to your supply chain, to your outside vendors ... and all of those things have to be reconnected and retested.”
He said the hospital had to push back its December reopening goal because Hurricane Helene, which hit the East Coast in late September, damaged one of the country’s largest IV solution plants in North Carolina and led to a nationwide supply shortage. Stark said the plant is allocating solutions to healthcare facilities based on their order history, but Madera hospital has not made an order in two years.
“We could not find IV solutions,” Stark said. “That’s actually something we’re still working on.... We need about 4,000 IV solutions for the first month that we open.”
In the hospital’s Dec. 20 social media post, Stark said the hospital now has close to 400 employees on its roster and continues to interview candidates.
“I really don’t foresee any delays or challenges to reopening at this point,” he said in the post. “But again, we are somewhat at the mercy of just the conditions of the supply chain.”
Hospital closure impacts to community
Data from the California Department of Public Health show Madera County averaged 1,111 resident deaths per year between 2015-2019. The number of resident deaths rose to a yearly average of 1,414 between 2020-2022 during the COVID-19 pandemic, peaking at 1,496 in 2021.
In 2023, though, that number fell to 1,225. And through October 2024, there were 945 resident deaths in Madera County.
“But I don’t think that’s where you’re going to see the impact of the hospital closing,” Madera County Public Health Officer Paul Simon told The Bee. “People want specific data on things that have changed, but that data is hard to get.”
Simon said the region’s emergency response system adjusted well to Madera hospital’s closure. Fresno-area facilities, including Valley Children’s Hospital, filled the void and cared for sick and injured people from Madera in their emergency rooms. Simon also said many people who were not seriously ill were able to find new clinics.
But the true impact of the hospital’s closure, he said, concerns the type of people with more serious diseases, such as a bad case of diabetes. These people don’t necessarily need immediate hospital visits, but might have gone to an emergency room for care if it were available.
“Maybe they delayed their care, and that’s probably still going on,” Simon said. “It’s going to affect their outcomes four or five years from now, not in the next six months.”
This story was originally published January 2, 2025 at 5:30 AM.
