What's at stake:
After more than two years, Madera County's 160,000 got their hospital back. American Advanced Management, Inc., which acquired the hospital following lengthy bankruptcy proceedings about a year ago, reopened it Tuesday.
Over the last two years, Mohammad Ashraf has lost contact with dozens of his patients.
It was inevitable for the cardiologist, following Madera Community Hospital’s closure in December 2022.
Ever since then, every Madera resident in need of emergency care has had to weigh whether their medical needs are worth driving at least 40 minutes to the nearest hospital in Fresno. The answer isn’t always yes.
“Patients have died during this time because going to Fresno is not easy,” Ashraf told Fresnoland. “You have to find transportation, a lot of people don’t have transportation to go there. I’ve lost touch with so many patients.”
But as of Tuesday, Madera residents no longer have to deal with that dilemma.
Madera Community Hospital reopened Tuesday morning after sitting shuttering in late 2022 and filing for bankruptcy in March 2023.
“This is a dream come true,” Ashraf told Fresnoland. “We’ve been waiting for this for two years, and it just has been so difficult for our patients.”
The hospital’s reopening restored the only emergency room and intensive care unit for all 160,000 Madera County residents. In addition, the hospital is also restoring surgical and diagnostic services — which includes CT scans and other kinds of medical screening.
“We got our license yesterday — we rejoiced,” hospital CEO Steve Stark told Fresnoland. “I knew that today would be a monumental achievement.”
Stark works for American Advanced Management, Inc., which gained control of the Madera hospital in April 2024 after lengthy proceedings in federal bankruptcy court.
The reopened Madera hospital has 497 employees, with 50 physicians on staff, Stark said. He credited state Sen. Anna Caballero and Assemblymember Esmeralda Soria for securing $57 million in state funding for the hospital’s reopening.
Stark added that he doesn’t see any barriers to providing medical care to everyone in Madera County. He acknowledged that the hospital will not have a labor and delivery department, “but we will have trained staff ready to deliver a baby in an emergency if we need to.”
In 2023, Caballero and Soria spearheaded a state bill to establish a statewide Distressed Hospital Loan Program for nonprofit or government hospitals struggling financially. The Madera hospital got the largest grant from the $150 million program.
Alongside AAMI’s executives, the two state legislators organized a news conference Tuesday announcing the hospital’s reopening.
In a brief interview before the news conference, Caballero told Fresnoland that one of the reasons Madera Community Hospital closed was because its old operators weren’t communicating with the community and elected leaders.
“So it became a shock to find out that the hospital was in such critical condition and it became difficult to do something immediately,” Caballero told Fresnoland.
Caballero added that she’s been trying to help the hospital since even before its closure and eventual bankruptcy filing. She said she’s thrilled Madera is getting its hospital back.
“The board of directors of the hospital — they need to communicate with us and tell us how they’re doing so that we can continue to be helpful in any way we can,” Caballero said.
For a hospital, all roads lead to back reimbursement rates
Stark told Fresoland the hospital cannot sign contracts with health plans without a hospital license. Now that it’s restored, his team can ink agreements with those health plans and negotiate reimbursement rates.
Hospitals depend on reimbursements from insurance health plans in order to stay in business. That includes public insurance health plans that provide coverage to patients on Medicare and Medi-Cal, as well as private health plans that some employers make available to their workers.
“I think we’ve made vast improvements in our reimbursement model from where it was when they were closed,” Stark told Fresnoland.
In March 2023, Fresnoland found that when Trinity Health pulled out of acquiring Madera Community Hospital in 2022 — which led to the hospital’s closure — part of their reasoning was due to the hospital’s low reimbursement rates not only with public insurance health plans, but private ones, too.
Stark said most of the Madera hospital’s patients are on Medi-Cal, but said one strategy to generate revenue would be to sign viable contracts with employer health plans and get the best reimbursement rates possible.
Without appropriate reimbursement rates, a hospital can’t stay afloat.
“It’s one of the reasons why the victim of our story, really, is (obstetrics) and maternity (care),” Stark said. “There’s just not a model that existed currently that would allow a hospital to subsidize it to the level that it needed to run the service.”
What a restored emergency room can do for Madera County
The Madera hospital’s Chief Medical Officer Ali Rashidian told Fresnoland that the hospital used to see 100 patients every day back in 2022. He doesn’t know where all those patients ended up after the closure, but many went to Fresno hospitals.
Rashidian said that emergency rooms at St. Agnes Medical Center, downtown Fresno’s Community Regional Medical Center and Clovis Community Hospital have been seeing “at least 20 to 30 patients extra per day.”
He said the Madera hospital’s reopening will likely reduce that increased patient volume at Fresno hospitals.
“We are blessed and we are very excited to finally bring healthcare to this community of the whole county,” Rashidian said.
Madera County Public Health Director Sara Bosse attended the Tuesday news conference and told Fresnoland she’s hopeful the Madera hospital expands its services after reopening.
“I know that they plan on expanding, and we’re really hopeful for labor and delivery at some point,” Bosse told Fresnoland. “It would be a really important step for Madera to restore that as well, but we’re going to celebrate what we have today and anticipate the next steps as they come.”
