Prime Healthcare Services Explained

Prime Healthcare Services
Type:Privately held company
Industry:Health care
Hq Location:Ontario, California, U.S.
Key People:
  • Prem Reddy, (Founder, Chairman & CEO)
  • Kavitha Bhatia, (President and Chair, Prime Healthcare Foundation & Chief Medical Officer of Strategy)
  • Sunny Bhatia, (President & Chief Medical Officer)
  • Sonia Mehta, (CEO Region II, Corporate Chief Medical Officer & Chief Academic Officer)
  • Harsha Upadhyay (CEO, Region III)
  • Sunitha Reddy, (Chief Revenue Officer & Vice President of Operations)
  • Steve Aleman, (Chief Financial Officer)
Products:Health care services
Num Locations:44[1]
Num Locations Year:2020
Num Employees:45,000[2]
Num Employees Year:2021

Prime Healthcare Services is a United States privately held healthcare company. It was established in 2001, by chairman and CEO Prem Reddy, MD, and operates 44 hospitals in 14 states. It is affiliated with the nonprofit Prime Healthcare Foundation.

History

20th century

Prime Healthcare Services began in 1985 when Dr. Prem Reddy founded Desert Valley Medical Group in Victorville, California.[3] In 1992, Reddy established Primecare Medical Group and two years after he started building Desert Valley Hospital in Victorville.[3]

In 1998, PrimeCare Medical Group and Desert Valley Medical Group were sold to PhyCor, a Tennessee‑based publicly traded company.[4] In 2001, Dr. Prem Reddy founded Prime Healthcare Services, Inc. and reacquired Desert Valley Hospital.[5]

21st century

Between 2005 and 2012, Prime Healthcare acquired a number of hospitals in California. Among them include:Chino Valley Medical Center, Sherman Oaks Hospital, Montclair Hospital Medical Center, Huntington Beach Hospital and others.[6] [7] [8]

The healthcare company also acquired a number of hospitals between 2013 and 2020 in other locations across the United States. Among them include: Lower Bucks Hospital in Pennsylvania, Saint Mary's Regional Medical Center (Reno, Nevada), St. Mary's General Hospital (Passaic, New Jersey), and many others.[9] [10]

In July 2024, Prime Healthcare acquired nine Illinois hospitals from Ascension.[11]

Operations

Prime operates 44 acute care hospitals in 14 states.[12] The hospital network has over 45,000 employees and physicians and more than 8,700 patient beds. Prime Healthcare’s national corporate headquarters is located in Ontario, California.[12]

Prime Healthcare Foundation

The Prime Healthcare Foundation is an affiliated 501(c)(3).[13] Reddy and his family established the Prem Reddy Family Foundation, which has supported several efforts, including one of country's newest schools of medicine at the California University of Science and Medicine, the Dr. Prem Reddy Nursing Laboratory at CSUSB, and the Dr. Prem Reddy Lecture Hall at Western University of Health Sciences.[14]

Awards and recognitions

2024

2023

2022

2021

2020

2019

2018

2016

2012

Controversies

2000s

In 2007, the Los Angeles Times ran a news story that alleged that the policies of Prime HealthCare Services, Inc., resulted in higher-than-average profits for the possible cost of patient care: "When Reddy's company, Prime Healthcare Services Inc., takes over a hospital, it typically cancels insurance contracts, allowing the hospital to collect steeply higher reimbursements. It has suspended services — such as chemotherapy treatments, mental health care and birthing centers — that patients need but aren't lucrative.... On four occasions since 2002, inspectors have found that Prime Healthcare facilities failed to meet minimum federal safety standards, placing their Medicare funding at risk."[29]

In 2008 the State of California and Kaiser Permanente each sued Prime Healthcare over its balance billing practices and Kaiser obtained an injunction preventing Prime from continuing the practice; Prime had cancelled agreements with insurance companies when it acquired hospitals, leaving patients in an out-of-network situation resulting in higher costs, and has been aggressively pursuing patients including sending unpaid costs to collection agencies.[30] This was the first of several suits between Prime and Kaiser. In June 2010 Kaiser sued Prime Healthcare for "trapping patients" and contended that Prime Healthcare needlessly admitted emergency department patients, rather than transfer them to Kaiser facilities and then sending their insurance companies highly inflated bills.[31] Prime counter-sued Kaiser and the Service Employees International Union, claiming that Kaiser owed it $100 million in unpaid medical claims and that Kaiser and the union conspired to keep Prime out of the market;[32] that suit was dismissed in 2012,[33] and Prime appealed all the way to the US Supreme Court, which declined to hear the case in 2016.[34] In 2015 both sides agreed on dropping their respective lawsuits and resolve them through confidential and binding arbitration.[32]

2010s

In 2010 Prime Healthcare came under investigation by the US Department of Health and Human Services and the California Department of Justice about concerns over a reported spike in sepsis. The investigation centers around whether the spike in sepsis represents a large public health issue or multimillion-dollar Medicare fraud. Six Prime hospitals ranked in the 99th percentile of U.S. hospitals for sepsis and five were in the 95th percentile.[35] In 2011 Prime Healthcare Service had high rates of kwashiorkor among its elderly patients. At Shasta Regional Medical Center, Prime reported 16.1% of its Medicare patients suffered from kwashiorkor, but California's average for Medicare patients is 0.2%.[36] In 2011 California Watch reported that Prime Healthcare had a practice of transferring high numbers of patients from its emergency department to its hospital beds, specifically with patients on Medicare. Some families describe being trapped by doctors at Prime facilities and were unable to see their own doctor at another facility. Former Prime employees have described an orchestrated campaign of admitting Medicare and Kaiser patients, moving them from the emergency department to a hospital bed, in the interest of changing the fortune of a money-losing hospital.[37] In September 2011, California Attorney General Kamala Harris rejected the approval for the sale of the Victor Valley Global Medical Center in Victorville, California, and stated that the sale would not be in the public interest.[38]

In 2012, two executives at Prime Healthcare Services disclosed a patient's chart to multiple media outlets without the patient's express written consent. The release was in response to a California Watch article on Prime Healthcare Services billing practices at Shasta Regional Medical Center, which included claims by a Darlene Courtois about her treatment by Shasta. In this incident, Randall Hempling, the hospital CEO, and Dr. Marcia McCampbell, its chief medical officer, showed up at the offices of the Redding Record Searchlight and successfully convinced the paper's editor not to publish an article, echoing the California Watch claims by reference to Courtois' actual medical records.[39]

In May 2016 US Department of Justice joined a qui tam case against Prime Health Care and its chief executive concerning Medicare fraud.[40] The case was settled in August 2018 for $65 million, resolving the "allegations that 14 Prime hospitals in California knowingly submitted false claims to Medicare by admitting patients who required only less costly, outpatient care and by billing for more expensive patient diagnoses than the patients had (a practice known as "up-coding")."[41] An additional case was settled in February 2019 for $1.25 million for similar allegations regarding two Prime hospitals in Pennsylvania.[42]

2020s

In July 2021 US Department of Justice announce another settlement with Prime Health Care and its CEO Prem Reddy concerning kickbacks, overcharging for medical implants, and billing for a non-eligible provider by using another provider's billing identity. Dr. Reddy paid $1,775,000; and Prime paid $33,725,000.[43]

Hospitals

This is a list of Prime Healthcare Services hospitals in the United States.

HospitalSettlementU.S. stateYear founded
Riverview Regional Medical Center [44] GadsdenAlabama1917
Centinela Hospital Medical Center[45] InglewoodCalifornia1924
Chino Valley Medical Center[46] ChinoCalifornia1972
Desert Valley Hospital[47] VictorvilleCalifornia1994
Encino Hospital Medical CenterEncinoCalifornia1954
Garden Grove Hospital Medical Center[48] Garden GroveCalifornia1982
Huntington Beach HospitalHuntington BeachCalifornia1967
La Palma Intercommunity Hospital[49] La PalmaCalifornia1972
Montclair Hospital Medical CenterMontclairCalifornia1973
Paradise Valley HospitalNational CityCalifornia1904
San Dimas Community HospitalSan DimasCalifornia1971
Shasta Regional Medical Center[50] ReddingCalifornia1945
Sherman Oaks HospitalSherman OaksCalifornia1969
St. Francis Medical Center[51] LynwoodCalifornia1945
West Anaheim Medical Center[52] AnaheimCalifornia1964
Lehigh Regional Medical Center[53] Lehigh AcresFlorida1965
Southern Regional Medical Center[54] RiverdaleGeorgia1971
Monroe Hospital[55] BloomingtonIndiana2006
Providence Medical Center[56] Kansas CityKansas1920
Saint John HospitalLeavenworthKansas1864
Garden City Hospital[57] Garden CityMichigan1947
Lake Huron Medical Center[58] Port HuronMichigan1954
St. Joseph Medical CenterKansas CityMissouri1874
St. Mary's Medical CenterBlue SpringsMissouri1981
North Vista Hospital[59] North Las VegasNevada1959
Saint Mary's Regional Medical Center[60] RenoNevada1877
Saint Clare's Behavioral Health[61] Boonton TownshipNew Jersey1955
Saint Clare's Denville Hospital[62] DenvilleNew Jersey1953
Saint Clare's Dover HospitalDoverNew Jersey1916
Saint Michael's Medical Center[63] NewarkNew Jersey1867
St. Mary's General Hospital[64] PassaicNew Jersey1895
Coshocton Regional Medical Center[65] CoshoctonOhio1909
East Liverpool City Hospital[66] East LiverpoolOhio1905
Lower Bucks Hospital[67] BristolPennsylvania1954
Roxborough Memorial Hospital[68] PhiladelphiaPennsylvania1890
Suburban Community Hospital[69] East Norriton TownshipPennsylvania1944
Landmark Medical CenterWoonsocketRhode Island1873
Rehabilitation Hospital of Rhode IslandNorth SmithfieldRhode Island1965
Dallas Medical Center[70] DallasTexas1964
Dallas Regional Medical CenterMesquiteTexas1964
Harlingen Medical Center[71] HarlingenTexas2002
Knapp Medical CenterWeslacoTexas1962
Mission Regional Medical CenterMissionTexas1954
Pampa Regional Medical Center[72] PampaTexas1950

See also

External links

Notes and References

  1. Web site: Prime Healthcare Locations . Prime Healthcare Services . 28 May 2021 .
  2. Web site: Factsheet Prime Healthcare About Us . Prime Healthcare Services . 28 May 2021 .
  3. Web site: The Prime Story. primehealthcare.com . 20 June 2023.
  4. Web site: Ontario physicians group part of nationwide pilot program. dailynews.com . 20 June 2023.
  5. Jim Steinberg,Web site: You see a failing hospital. CEO Prem Reddy sees an opportunity.. advisory.com . 22 December 2011 . 20 June 2023.
  6. Dan Bowman,Web site: Prime Healthcare Services to Acquire Three Hospitals from Tenet Healthcare Corporation. fiercehealthcare.com. 2 June 2008 . 20 June 2023.
  7. Web site: Prime Healthcare acquires Trinity Health hospital. healthcaredive.com. 4 March 2015 . 20 June 2023.
  8. Web site: Prime Healthcare continues growth, acquires four new hospitals. stateofreform.com. 5 February 2016 . 20 June 2023.
  9. Web site: Prime Healthcare Is Saving Lives by Saving Hospitals. americanhealthcareleader.com. 13 June 2022 . 20 June 2023.
  10. Web site: Prime Healthcare Successfully Completes Historic Acquisition of St. Francis Medical Center. stfrancismedicalcenter.com. 14 August 2020 . 20 June 2023.
  11. Web site: Prime Healthcare to acquire 9 Ascension hospitals. Chicago Tribune.
  12. Web site: Prime healthcare about.
  13. Web site: Health System. January 29, 2018. Prime Healthcare Services. 2019-06-09. 2019-06-09. https://web.archive.org/web/20190609080944/https://www.primehealthcare.com/News/2018/January/Prime-Healthcare-Foundation-Announces-Closing-of.aspx. live.
  14. Web site: Dr. Prem Reddy | Prime Healthcare | Southern California . Dr. Prem Reddy Family Foundation . 3 September 2018 . 4 September 2018 . https://web.archive.org/web/20180904011323/https://www.premreddy.com/ . live .
  15. Web site: Prime Healthcare Named to Newsweek. Newsweek.
  16. Web site: Prime Healthcare. Lown Institute.
  17. Web site: Prime Healthcare Hospitals Earn 2023 Leapfrog Top Hospital Award for Outstanding Quality and Safety . 2024-10-25.
  18. Web site: Kumar . Abhishek . 2023-03-21 . Prime Healthcare Celebrates Patient Safety Excellence Recognition from Healthgrades . 2024-10-25 . Daily Host News . en-US.
  19. Web site: The 2022 Fortune/Merative 100 Top Hospitals . 2024-10-25 . Fortune . en.
  20. Web site: Prime Healthcare . Lown Institute.
  21. Web site: Prime Healthcare Named to Eisenberg Award. Eisenberg.
  22. Web site: Healthcare . Prime . 2021-04-27 . Prime Healthcare Hospitals Once Again Named Among the Nation’s 100 Top Hospitals by Fortune/IBM Watson Health . 2024-10-25 . GlobeNewswire News Room . en.
  23. Web site: Fortune and IBM Watson Health Recognize Top-Performing U.S. Hospitals and Health Systems . 2024-10-25 . IBM Newsroom . en-us.
  24. Web site: Prime Healthcare Hospitals Named Among the Nation's "100 Top Hospitals" by IBM Watson Health, Five Receive Everest Award . 2024-10-25 . markets.businessinsider.com . en.
  25. Web site: 2020-03-25 . 100 great hospitals in America 2019 . 2024-10-25 . www.beckershospitalreview.com . en-gb.
  26. Web site: Prime Healthcare Named to IBM Watson Health. IBM Watson Health.
  27. Web site: 2016-04-12 . 49 hospitals with the lowest serious complication rates . 2024-10-25 . www.beckershospitalreview.com . en-gb.
  28. Web site: 2013-04-15 . Truven Health Analytics Announces Top Health Systems - CBS Detroit . 2024-10-25 . www.cbsnews.com . en-US.
  29. Daniel Costello, Hospital group rejects system and cashes in, July 8, 2007
  30. News: Costello. Daniel. Hospital operator is sued by state. Los Angeles Times. 2 July 2008. 2 January 2018. 24 October 2015. https://web.archive.org/web/20151024174553/http://articles.latimes.com/2008/jul/02/business/fi-prime2. live.
  31. News: Pfeifer. Stuart. Hospital chain Prime Healthcare faces a fight to grow – LA Times. Los Angeles Times. February 1, 2015. November 14, 2017. November 15, 2017. https://web.archive.org/web/20171115083056/http://www.latimes.com/business/la-fi-prem-reddy-20150201-story.html. live.
  32. News: Schencker. Lisa. Kaiser, Prime drop long-running court battles; Kaiser isn't backing Prime hospital purchase. Modern Healthcare. February 10, 2015. en-us.
  33. News: Prime Healthcare's Antitrust Lawsuit Against Kaiser, SEIU Dismissed. Beckers Hospital Review. September 18, 2012. en-gb. January 2, 2018. January 2, 2018. https://web.archive.org/web/20180102073104/https://www.beckershospitalreview.com/legal-regulatory-issues/prime-healthcares-antitrust-lawsuit-against-kaiser-seiu-dismissed.html. live.
  34. Beard. Kathryn. After denying cert in health law cases, SCOTUS ends term. Wolters Kluwer Legal & Regulatory U.S.. June 30, 2016. January 2, 2018. January 2, 2018. https://web.archive.org/web/20180102073418/http://health.wolterskluwerlb.com/2016/06/after-denying-cert-in-health-law-cases-scotus-ends-term/. live.
  35. Williams. Lance. Christina Jewett. Hospital chain's high infection rate leads to fraudulent billing concerns. California Watch. October 11, 2010. March 18, 2011. August 31, 2011. https://web.archive.org/web/20110831225130/http://californiawatch.org/health-and-welfare/hospital-chain-s-high-infection-rate-leads-fraudulent-billing-concerns-5647. live.
  36. Williams. Lance. Christina Jewett. Stephen K. Doig. Hospital chain, already under scrutiny, reports high malnutrition rates. California Watch. February 19, 2011. March 18, 2011. August 11, 2011. https://web.archive.org/web/20110811224635/http://californiawatch.org/health-and-welfare/hospital-chain-already-under-scrutiny-reports-high-malnutrition-rates-8786. live.
  37. Web site: Chain profits by admitting ER patients. California Watch. July 23, 2011. Jewett. Christina . Doig . Stephen K.. https://web.archive.org/web/20111106070036/http://californiawatch.org/health-and-welfare/chain-profits-admitting-er-patients-11561. November 6, 2011 .
  38. Web site: Attorney general denies sale to controversial hospital chain | California Watch. californiawatch.org. 2014-07-30. 2014-08-08. https://web.archive.org/web/20140808043824/http://californiawatch.org/dailyreport/attorney-general-denies-sale-controversial-hospital-chain-12691. live.
  39. Web site: Her case shows why healthcare privacy laws exist - Los Angeles Times. 4 January 2012 . Los Angeles Times. 2014-07-30. 2014-04-03. https://web.archive.org/web/20140403215821/http://articles.latimes.com/2012/jan/04/business/la-fi-hiltzik-20120104. live.
  40. News: Sisson. Paul. Justice Department accuses Ontario-based hospital chain of cheating Medicare system. Los Angeles Times. May 25, 2016. May 26, 2016. May 26, 2016. https://web.archive.org/web/20160526022737/http://www.latimes.com/business/la-fi-prime-healthcare-20160525-snap-story.html. live.
  41. News: Prime Healthcare Services and CEO to Pay $65 Million to Settle False Claims Act Allegations. 2018-08-03. 2018-08-09. en. 2018-08-10. https://web.archive.org/web/20180810010836/https://www.justice.gov/opa/pr/prime-healthcare-services-and-ceo-pay-65-million-settle-false-claims-act-allegations. live.
  42. Web site: Prime Healthcare Services and CEO, Dr. Prem Reddy, to Pay $1.25 Million to Settle False Claims Act Allegations . U.S. Department of Justice . 4 May 2021 . en . 14 February 2019 . 4 July 2021 . https://web.archive.org/web/20210704233637/https://www.justice.gov/usao-edpa/pr/prime-healthcare-services-and-ceo-dr-prem-reddy-pay-125-million-settle-false-claims-act . live .
  43. Web site: Prime Healthcare Services and Two Doctors Agree to Pay $37.5 Million to Settle Allegations of Kickbacks, Billing for a Suspended Doctor, and False Claims for Implantable Medical Hardware . U.S. Department of Justice . 20 July 2021 . en . 19 July 2021 . 19 July 2021 . https://web.archive.org/web/20210719213425/https://www.justice.gov/opa/pr/prime-healthcare-services-and-two-doctors-agree-pay-375-million-settle-allegations-kickbacks . live .
  44. William Thornton,Web site: Prime Healthcare Services acquires Gadsden's Riverview Regional Medical Center. al.com . 2014-11-07 . 2023-07-12.
  45. Web site: Centinela hospital is bought by chain. Los Angeles Daily News . 2007-11-01 . 2023-07-12.
  46. Josh Thompson,Web site: Chino Valley Medical Center owner to pay $65 million in false Medicare claims case. championnewspapers.com . 2018-08-18 . 2023-07-12.
  47. Web site: Prime Healthcare acquires San Diego hospital. vvdailypress.com . 2010-11-18 . 2023-07-12.
  48. Web site: Prime Healthcare Services Completes Acquisition of North Vista Hospital, located in Nevada. gardengrovehospital.com. 2015-01-30 . 2023-07-12.
  49. Web site: La Palma Intercommunity Hospital Converts to Not-for-Profit. loscerritosnews.net. 2023-07-12.
  50. Web site: Prime to take over Shasta Regional. modernhealthcare.com. 2008-10-30. 2023-07-12.
  51. Jeff Lagasse,Web site: Prime Healthcare completes $350M acquisition of St. Francis Medical Center from Verity. healthcarefinancenews.com. 2023-07-12.
  52. Web site: Doctor sews up hospital deal. tmcnet.com. 2006-08-28. 2023-07-12.
  53. Frank Gluck,Web site: Lehigh Regional Medical Center's sale finalized. news-press.com. 2016-01-02. 2023-07-12.
  54. Web site: Prime Healthcare Foundation acquires Southern Regional Medical Center. news-daily.com. 2015-02-01. 2023-07-12.
  55. Web site: Prime Healthcare completes takeover of Monroe Hospital. heraldtimesonline.com. 2014-11-18. 2023-07-12.
  56. Web site: Prime closes on sale of Providence Med Center, Saint John Hospital. bizjournals.com. 2023-07-12.
  57. Hour Detroit,Web site: Prime Healthcare Completes Purchase of Garden City Hospital. dbusiness.com. 2014-07-02. 2023-07-12.
  58. Beth LeBlanc,Web site: Prime, Trinity to close on hospital sale. thetimesherald.com. 2015-08-31. 2023-07-12.
  59. Marisa Torrieri,Web site: Prime acquires North Vista Hospital in march towards IPO. healthcaredive.com. 2015-01-26. 2023-07-12.
  60. Web site: Prime Healthcare Services enters agreement to acquire Saint Mary’s Regional Medical Center in Reno from Dignity Health. thisisreno.com. 2012-03-30. 2023-07-12.
  61. Web site: Saint Clare's Health System sells to Prime Healthcare Services. chausa.org. 2015-08-01. 2023-07-12.
  62. Web site: Prime Healthcare completes acquisition of Saint Clare's hospitals. nj.com. 2015-10-01. 2023-07-12.
  63. Katy Stech,Web site: Prime Healthcare Wins Saint Michael’s Medical Center Auction. wsj.com. 2015-11-10. 2023-07-12.
  64. Web site: Prime Healthcare Services Acquires St. Mary’s Hospital in Passaic. njbmagazine.com. 2014-08-15. 2023-07-12.
  65. Web site: Prime Healthcare Foundation acquires Coshocton County Memorial Hospital. timesreporter.com. 2016-11-01. 2023-07-12.
  66. Web site: Acquisition of East Liverpool City Hospital completed. weirtondailytimes.com. 2023-07-12.
  67. Web site: For-profit Prime Healthcare buys Lower Bucks Hospital. inquirer.com. 2023-07-12.
  68. Web site: Prime Healthcare buys back Roxborough Memorial Hospital as part of $360M real estate deal. bizjournals.com. 2023-07-12.
  69. Michael Henrici,Web site: Prime Healthcare Foundation Completes Acquisition of Mercy Suburban Hospital. patch.com. 2023-07-12.
  70. Jessica Melton,Web site: Dallas Medical Center Sold to Prime Healthcare Services. dmagazine.com. 2012-09-26. 2023-07-12.
  71. Web site: Prime Healthcare takes over MedCath interests in Harlingen Medical Center. nsmedicaldevices.com. 2011-12-02. 2023-07-12.
  72. Web site: NewsChannel10 Investigates: Area hospital under new ownership. newschannel10.com. 2023-07-12.

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