Implementing SB 1953: 1998 into 2005

Abstract

California’s hospitals are incredibly diverse. The list of owners includes not-for-profit organizations, investor-owned companies, general purpose local governments, special hospital districts, and agencies of the State, including universities. Some have a single, free-standing facility, but many consist of one or more campuses, each with multiple buildings. Some hospital owners own many facilities in different locations. Some have single buildings to which additions have been made over decades. Others consist of a single building without major renovations or additions.

Given the diversity of hospitals and their owners, the great variations in their financial circumstances, and the high costs of complying with SB 1953, one could hardly expect a uniform response by hospital owners whose facilities were classified as SPC-1. Indeed, the hospital owners’ responses were many and varied, depending on the circumstances within which each of them found themselves when the SB 1953 regulations were promulgated and during the early years of program implementation. (The financial condition of hospitals and the major upheaval in healthcare economics is discussed in depth in Part 2B where we consider how owners and administrators made choices about whether or how to comply with SB 1953. It is impossible, however, to discuss the early years of implementation without some references to the severe financial problems of hospitals at the time the law was enacted, but we have tried to minimize the redundancy.)