Hospitals confront budget strains, debt, market pressure

News outlets offer a variety of reports on how hospitals are faring in the health care marketplace. The outlook is full of challenges.

The New York Times: New Chief Of Hospitals Has A History Of Cost Cuts
As the second in command of New York City's public health and hospital system, Ramanathan Raju helped initiate a plan to close a $1.2 billion budget deficit in four years. The experience in New York, whose health system is five times the size of Cook County's, should come in handy when Mr. Raju starts his job next week as chief executive of the Cook County Health and Hospitals System. He faces a deficit of more than $90 million, a figure that would have been larger had the county not contributed a $274 million subsidy (Lu, 9/29).

Los Angeles Times: A Night In The ER: Adrenaline, Chaos And Very Long Waits
This is the county's safety net hospital, the place where the ill come for medicine, the wounded come for help, and the dying come for miracles. As many as 550 patients a day pass through its emergency room, one of the busiest in the nation. They wait an average of four hours to see a doctor -; and then longer for further evaluation, treatment or an open bed. The total wait from the time a patient arrives until he is admitted or discharged has averaged nine hours recently. The economy has made the delays worse. More jobless and uninsured people rely on the ER for primary care and prescriptions, and by law the hospital cannot turn them away. But much of the crowding stems from the decision to replace the old County/USC, an aging, earthquake-damaged relic, with a smaller hospital (Gorman, 9/30).

The Wall Street Journal: Hospital Debt Is Hurdle
Hoboken officials are hoping to salvage the sale of one of New Jersey's oldest hospitals to avoid shuttering the 350-bed facility and being left holding $52 million in debt. The nonprofit that operates Hoboken University Medical Center filed for bankruptcy protection in August to facilitate a $65 million sale to HUMC Holdco LLC, changing the hospital to a for-profit model. Most of the money from the sale would go to repaying $52 million in city-guaranteed bonds that were raised when Hoboken purchased the ailing hospital in 2007.  But the hospital still needs to reach a settlement with creditors owed $34 million before the sale can go through (De Avila, 9/30).

Times-Picayune: Hospital Corporation of America Is In New Orleans To Stay, Executive Says
Amid continued speculation about the future of Tulane Medical Center, the top Hospital Corporation of America executive in New Orleans said Thursday that a corporate reorganization does not portend the nation's largest for-profit inpatient hospital chain leaving the topsy-turvy New Orleans market. Mel Lagarde, who has led HCA's New Orleans-based Delta Division since 1995, ... said HCA is most interested in hospitals, though the firm also would look at specialty surgical centers (Barrow, 9/29). 

Health Policy Solutions (Colorado news service): Hospital Sale Spurs Debate On Protecting Community Health
Colorado Attorney General John Suthers plans to rule within about two weeks on the Colorado Health Foundation's proposed $1.45 billion sale of its share of HealthOne hospitals to Tennessee-based HCA. ... HealthOne now runs seven large hospitals, 13 surgery centers and 50 medical imaging and specialty centers [in Colorado] (McCrimmon, 9/28).