Doctors sue Fresno hospital over staffing shakeup they say could ‘disrupt’ patient care
A group of Fresno doctors wants to stop St. Agnes Medical Center from entering into an exclusive contract with a national staffing firm, saying the move would cause them to go out of business and disrupt care for hundreds of patients.
Central California Hospital Medicine Group Inc. filed a lawsuit on Dec. 23 against the hospital alleging it violated the state’s unfair competition laws, Medi-Cal laws and its own bylaws when it entered an exclusive contract with national physician’s group Vituity to take over the hospitalist services.
The contract went into effect Dec. 29, according to the lawsuit.
“This is a community hospital and they’re trying to ban community doctors from the hospital,” Dr. Alireza Zadsalamat, head of CCHMG, told The Bee in November.
The lawsuit is the result of months of tension following the hospital’s internal announcement of the proposed change. Lawyers for the doctor group had threatened to sue in letters to hospital leadership, arguing the hospital’s decision is an example of a corporate takeover of medicine that harms community doctors and their patients. The hospital’s lawyers responded that the change is the result of “patient safety” concerns.
The doctor group is asking for a preliminary injunction to temporarily block the hospital from entering the exclusive contract until the a final judgment is made. A hearing to review the group’s request for preliminary injunction is scheduled for Jan. 29.
In a statement, Casey Fares, a spokesperson for St. Agnes said the hospital does not comment on pending litigation.
“Saint Agnes has experienced a seamless transition of hospitalist physician services to Vituity, a well-known and highly-regarded physician group, without any disruption or elimination of services. Vituity has had a long-standing relationship with Saint Agnes in the Emergency Department,” Fares said.
According to its website, Vituity is a physician-owned and led partnership with a network of over 6,000 doctors that serves 10 million patients at over 690 locations nationwide.
Doctor group could go out of business, lawsuit says
Central California Hospital Medicine Group is a Fresno-based medical group whose 12 hospitalists provide general medical care for their patients at St. Agnes. Two other independent hospitalists that are not affiliated with CCHMG also joined the lawsuit.
A hospitalist is a physician who focuses on the general medical care of hospitalized patients. According to the lawsuit, this is “a practice that was formerly the norm but is increasingly rare.”
Prior to the lawsuit, Fares said in a November statement that existing hospitalists would be “welcome to work with Vituity.”
As of Dec. 29, CCHMG has been able to see and discharge existing patients at St. Agnes but is no longer seeing new patients there, Dr. Armen Bedrosian, the group’s CFO said Friday.
According to the lawsuit, CCHMG’s hospitalists are responsible for the care of approximately 100 inpatients at St. Agnes at any given time. CCHMG’s physicians are also primary care physicians, or PCPs, to approximately 1,500 patients, and when these patients are admitted to St. Agnes, they are treated by their CCHMG primary care physician.
“These patients will be forced to find new providers which may take a significant amount of time, a luxury that many of these patients do not have,” Zadsalamat said in court records.
The change would also likely cause CCHMG to go out of business.
“Caring for hospitalized patients at SAMC is CCHMG’s only source of revenue,” the group said in court filings. “If the closure (of the general medicine practice) is allowed to proceed, CCHMG will have no income, and anticipates it will simply stop doing business.”
Lawyers for the hospital leadership have said increased regulator scrutiny and quality of care issues also prompted the change, according to court filings.
In an Oct. 24 letter to CCHMG’s lawyers, Debra J. Albin-Riley, an attorney with ArentFox Shiff representing St. Agnes, said the hospital “has repeatedly encountered significant deficiencies in the current hospitalist care environment, which have undermined patient safety, created increased regulatory scrutiny, and resulted in inappropriate utilization of hospital resources.”
“It is clear to any reasonable observer that change must take place,” Albin-Riley said.
St. Agnes has undergone leadership changes in recent years. In May 2023, longtime CEO Nancy Hollingsworth announced her retirement amid a regionalization by parent company, Trinity Health. Dr. Gurvinder Kaur was named president and market leader of St. Agnes in January 2024.
The lawsuit raised questions about Kaur’s “deep, longstanding ties to Vituity,” where she was previously a senior regional director and member of the board of directors.
